All necessary dentistry must be completed prior to starting orthodontic therapy. It is essential that the patient maintain regular six-month appointments with their general dentist for exam and cleanings during the orthodontic treatment period.

Some possible but unusual occurrences can include: swallowing an appliance, chipping tooth, dislodging a restoration, a tooth becoming fused to the jawbone (ankylosed), an abscess or cyst may occur but are rare occurrences.

Sometimes a patient may experience the movement of teeth to positions as prior to treatment. Settling or shifting teeth following treatment as well as after retention will most likely occur in varying degrees and spaces can occur between front teeth where none existed before treatment. Sometimes we might advise the wearing of a retaining appliance every night or a few evenings each week for an indefinite period. Failure to follow this advice may cause serious and permanent injury and destroy all of our efforts. The lower incisors frequently overlap and have to remain as such, usually due to a strong bite.

Uncorrected fingers, thumb, tongue or similar pressure habits; unusual hereditary skeletal patterns; and insufficient or undesirable growth can all influence our results, affect facial changes and cause shifting of teeth during or following retention. Surgical procedures are sometimes necessary to correct these problems. On rare occasions it may be necessary to recommend a change in our original treatment plan.

In some instances, problems may exist before, during or following orthodontic treatment with the “sliding hinge” connecting the upper and lower jaws. Tooth positions and bite can be a factor in this condition. Tooth equilibration (selective tooth grinding) by your dentist may be recommended after appliances are removed to improve the occlusal relationship. TMJ problems are not all bite related. Most individuals that have a TMJ problem have never had orthodontic treatment. However, despite our best efforts, some patients have developed permanent jaw problems that require surgical or other additional treatment.

When a tooth or teeth are unable to erupt “normally” they are called impacted. In attempting to move the impacted tooth / teeth, especially canines, various problems are sometimes encountered that may lead to loss of the tooth or periodontal (gum) problems. The length of time required to move such a tooth can vary considerably. Occasionally the permanent second molars (aka 12-year molars) may be trapped under the crowns of the permanent first molars (aka 6-year molars.) Consequently, the removal of the third molars (aka wisdom teeth) may prove necessary. Sometimes impacted molars may cause relapse to otherwise successful orthodontic treatment.

“Shortening of root ends” can occur with or without orthodontic treatment. Under normal health conditions the shortened roots usually are not a problem. Injury, impaction, endocrine or idiopathic disorders can also cause this problem. However, untreated gum disease can aggravate the condition can cause early tooth loss.

Usually the result of an injured tooth, the nerve of an injured tooth can die over a period of time, with or without orthodontic treatment. This tooth may become infected (abscessed) during movement and may require root canal treatment. Discoloration of a tooth may be noticed after treatment has started or following the removal of appliances. De-vitalization is seldom due to orthodontics.