General Dentistry
Comprehensive Dental Exams
A regular dental cleaning and check-up every 6 months is recommended and needed to help keep your teeth working well and functioning healthily for life. They are important because they can help spot dental health problems early on when treatment is likely to be simpler and more affordable. Combining both preventative and general dentistry together to create a tailored dental plan to your needs in consideration of function, aesthetics and comfort
Dental exams will include:
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Thorough medical history review
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Thorough jaw joint examination, including joint vibration analysis
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Intra- and extra-oral soft tissue exam, including oral cancer screening
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Inspecting your teeth with looking for decay, cracks or faulty restorations
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Examination of your bite to assess whether the way you bite is damaging your teeth or causing pain in your head and neck
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Intra- and extra-oral x-rays of teeth, as well as extra- and intra-oral photos to assist diagnosis
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Gum health analysis
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Dental Cleaning and Polishing
Brushing twice a day for 2 minutes and flossing daily are essential to remove plaque on and in between the teeth and is the best way to prevent tooth decay and gum disease. However the plaque in our mouth can turn into hard deposits we call “tartar” or “calculus” through our saliva composition that cannot be brushed away. This is very common. The surface of these hard deposits are highly favourable for bacteria to stay on, and can occur above and below the gums, thus our dental hygienists may use special instruments to remove them for you in what we call scaling. Polishing is a procedure where superficial stains are removed to whiten and brighten the teeth resulting in a clean and smooth feeling teeth. Those who have not had active maintenance for several years may find temporary discomfort due to heavier deposits of calculus on the teeth.
Crowns
A crown is a cover or a “cap” placed over the tooth to restore its normal shape, size and function. They strengthen and protect the remaining tooth structure and can improve the appearance of your teeth, making them a great solution to restore form and function. Crowns come in a variety of materials.
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Porcelain or ceramic – the most natural-looking type of dental crown which is often preferred by patients for repairing the front teeth
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Porcelain fused to metal (PFM) – natural looking porcelain that overlays metal for extra reinforcement
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Full gold crowns – gold crowns are sometimes recommended for back teeth that sustain extra force when chewing
Bridges
When missing teeth are replaced with a bridge, the adjacent teeth require crowns in order to support the replacement teeth. A bridge prevents the drifting of neighbouring teeth into the tooth space "created" after tooth extraction to restore functions of teeth, including chewing, speech and aesthetics.
Resin bonded (stuck on) bridges or implants are generally preferred over conventional bridges as they don’t require reducing the adjacent teeth.
Bruxism and TMJ
Disorders of the jaw joints and muscles (‘temporomandibular dysfunction’, or ‘TMD’) can cause a variety of symptoms in the head and neck and affect a large percentage of the population.
Bruxism is known as chronic teeth grinding can be attributed not only to stress but sleep disorders, tobacco use, abnormal bite and teeth that are missing or crooked. Arthritis and displacement of the jaw joint disks can also cause TMD pain.
TMJ symptoms include:
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Headaches, neck, shoulder or back pain
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Dizziness, migraines
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Numbness in the fingers and arms
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Difficulty swallowing
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Limited movement of the jaw
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Clicking or grating sounds in the jaw joints
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Pain behind the eyes
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Facial pain
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Unexplained loosening of the teeth
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Ear aches, stuffiness or ringing in the ears (tinnitus)
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Sore jaw and jaw pain, especially upon waking
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Noisy sleep due to grinding of teeth
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Worn, broken or chipped teeth
Treatment may involve:
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Occlusal splints (night guard) - to prevent the upper and lower teeth from contacting each other and worn while you sleep
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Occlusal (bite) adjustment
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Orthodontic treatment
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Muscle Relaxants, Anti-inflammatory Medications
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Modifications to diet ie. softer foods
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Massage therapy
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Stress management
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Ice and hot packs
Orthodontics
Conventional Fixed Braces
Remain the gold standard of treatment in orthodontics due to its efficiency, precision and 3D control.
There is no difference in clinical performance between metal and ceramic braces, however ceramic braces are slightly more costly.
Invisalign
Uses a series of clear plastic aligners to be worn 20-22 hours a day as an alternative to fixed braces. Aligners are almost invisible, generally more comfortable and have less impact on eating and brushing. But committing to wearing it is key to success. In some instances like protruding teeth or mild crowding cases aligners can perform more efficiently and effectively than fixed braces.
SureSmile Aligners
This is a more cost effective aligner treatment method. Suresmile is a US company that allows us to plan the tooth movements on the computer and exporting the digital files to our 3D printer to manufacture aligners in-house. This option is great for simple cases, combined treatment cases where we pair aligner treatment with fixed or lingual (behind the teeth) braces or in situations where the patient is tired or can’t wear fixed braces any more and prefers to finish in aligners.
Lingual Braces
We enjoy helping people with lingual braces.
Lingual braces are completely discreet and are better than aligners in certain situations like deep overbite cases or in extractions cases.
We use Suresmile lingual technology to plan the position of braces and order customised wires from the US to ensure an unparalleled level of accuracy.
However, lingual braces can be more uncomfortable to the tongue and generally more costly than the other options.
Customized Robotic Wires
Suresmile wires allow for a more efficient and precise treatment result. Because this technology provides custom archwires, we can use it for braces on the outside of the teeth or hidden braces bonded to the inside of the teeth. Our doctors are all certified, trained and maintain continuing education to be able to use this technology at the highest level.
Pediatric Dentistry
Following guidelines set by International Paediatric Dental Associations, we recommend children to come in as early as 12 - 18 months of age. It is important to bring them in at an early age to allow them to familiarise themselves with a dental environment, even if it is to just have fun at their first appointment. This is to prepare a foundation for a positive attitude towards dentistry and develop healthy oral hygiene habits early on that will create a lifelong impact on their teeth.
We offer a wide range of services including:
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Toothbrushing instruction
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Dietary advice
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Prevention of dental decay
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Prevention of dental trauma
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Monitoring of skeletal growth and dental development
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Teeth cleaning and prophylaxis
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Fissure sealants
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Fluoride treatment
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Stabilisation of caries
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Fillings
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Pulp and root canal treatment
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Dental extraction
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Sports guards
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Labial and tongue frenectomy
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Sedation
For dentally anxious or complex treatments for children and adults, we offer nitrous oxide (laughing gas) for light sedation to make the experience easier.
Sedation
Cosmetic and Restorative Dentistry
We love making smiles!
Carefully crafted composite fillings or veneers can greatly enhance the appearance of the front teeth. In general, composite fillings require no or minimal tooth preparation (grinding) and can be used to reshape, lengthen or fill in spaces between teeth.
Porcelain veneers or fillings usually have superior long term results but may require more tooth preparation.
We offer three bleaching options.
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In-office bleaching done in the practice for 45 mins
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Home bleaching using customised trays with varying levels of bleach concentration to be used either during the day for a couple of hours or overnight
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Take home bleaching products like the Snow home whitening system.
To help you make decisions on how to improve your smile, we use the latest digital planning software such a Digital Smile Design or Smilemate to let you see the projected results before it happens.
Teeth Whitening
We offer three bleaching options:
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(a) In-office blue light bleaching done in the practice for 45 mins over 1-2 visits
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(b) Home bleaching using customised trays with varying concentrations of bleaching gel to be used for a couple of hours during the day or overnight for around 2 weeks
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(c) Take home bleaching products like the Snow whitening system for around 4 weeks
In-Office Zoom!®️
Teeth Whitening
Perfect for busy people due to its efficiency and convenience, in-office Zoom!®️ teeth whitening can deliver dramatically whiter teeth in only one office visit. The whitening formula contains hydrogen peroxide and is activated by a special light. This potent combination oxidizes years of stains away—often revealing results up to ten shades whiter!
The entire Zoom!®️ process is simple. First, our teeth whitening Specialist will place protective retractors and a napkin to protect your lips, followed by a special rubber coating to form a barrier over your gums. The Zoom!®️ whitening gel is then applied directly onto the surface of your teeth, and the powerful light is used to activate the gel for deep penetration of the bleaching agents. Throughout treatment, you’ll be able to sit back, relax, watch TV and listen to music—and multiple rounds will be done until your desired whiteness is achieved.
After using Zoom!®️, your teeth will always be whiter than they were before you started because the enamel and dentin of your teeth is lightened. Over time, you will likely pick up new stains, but you can always touch up your smile with our take-home whitening trays!
Teeth Whitening Q & A
What is Zoom! teeth whitening?
Zoom! is a bleaching process that lightens the discoloration of enamel and dentin.
How Long Do Teeth Whitening Results Last?
The longevity of teeth whitening results is highly variable based on numerous factors, but most of our patients are able to enjoy their brightened smile for anywhere from 12–24 months before they might desire a touch up treatment.
Recommendations for helping to extend your teeth whitening outcome include remaining cognizant of the foods and beverages (with dark stains such as coffee, tea and wine) you regularly consume, as well as refraining from smoking cigarettes or using other tobacco products. Of course, maintaining a proper oral hygiene routine and receiving routine dental cleanings at least twice annually also help to prolong results.
Should the time eventually come that you feel you need to consider whitening again, our teeth whitening Specialist will be happy to help you decide between an in-office treatment or take-home trays based on your unique needs and smile goals.
What can cause tooth discoloration?
There are many causes. The most common include aging and consumption of staining substances such as coffee, tea, or tobacco. During tooth formation consumption of tetracycline, certain antibiotics, or excessive fluoride may also cause tooth discoloration.
Who may benefit from teeth whitening?
Just about anyone can benefit from tooth whitening. However, treatment may not be as effective for some as it is for others. With an oral exam, BRACES AND FACES Doctors or Teeth Whitening Specialist can determine if you are a candidate for this procedure, including a shade assessment.
Absolutely! A bright, beautiful smile can make a big difference. The Zoom! Whitening System makes it easier and faster than ever before.
Is teeth whitening becoming more popular?
Yes, research and clinical studies indicate that whitening teeth under the supervision of a dentist are safe. In fact, many dentists consider whitening the safest cosmetic dental procedure available. As with any tooth whitening product, Zoom! is not recommended for children under 13 years of age and pregnant or lactating women.
Is teeth whitening safe?
Do the results last a long time?
By following some simple post whitening care instructions, your teeth will always be lighter than they were before. We recommend flossing, brushing twice daily with Zoom! Whitening Toothpaste, and touch-ups with Zoom! take-home gel. These are professional formula products designed specifically to keep your teeth their brightest. They are available through our office.
Is there any difference between over-the-counter tooth whiteners and Zoom!
Yes! Consulting BRACES AND FACES Doctors or Teeth Whitening Specialist is always the first step to whitening your teeth safely. Over-the-counter tooth whitening strips, brush-on gels, and toothpaste take weeks or months to whiten your teeth in just a few shades. Zoom! is clinically proven to whiten your teeth eight shades* in one hour or six shades* in just one weekend.
How does the Zoom! In-Office System work?
The Zoom! light-activated whitening gel’s active ingredient is Hydrogen Peroxide. As Hydrogen Peroxide is broken down, oxygen enters the enamel and dentin, bleaching any colored substance while keeping the structure of the tooth unchanged. The Zoom! light aids in activating the Hydrogen Peroxide and helps it penetrate the surface of the tooth.
Is the Zoom! In-office procedure painful?
No. During the procedure, patients can actually watch television or listen to music. Many fall asleep.
Are there any side effects?
Some people experience temporary increased tooth sensitivity to cold during treatment. These symptoms disappear within 1-3 days after interruption or completion of the treatment.
How long does Zoom! Take-Home Whitening take?
The Zoom! take-home gel is designed to be worn between four and eight hours per application. BRACES AND FACES Doctors or Teeth Whitening Specialist will advise you on how long you should wear each application. A recent study showed that you can achieve an average improvement of six shades* after just three nights of use. BRACES AND FACES Doctors or Teeth Whitening Specialist will help you determine how many applications are right for you.
How is the Zoom! Take-Home System different from the Zoom! In-Office System?
The main difference between the two systems is that you use Zoom! Take-Home System in the convenience of your own home over a few nights. The Zoom! In-Office System is performed entirely in the office.
Facial Aesthetics
Facial Aesthetics
We are highly sensitive towards smile and facial aesthetics. We don’t believe dentistry is just about teeth. Our work can either change or are influenced by the jaw and soft facial structures (e.g, lips and cheeks). Through our orthodontic, surgical, Botox/fillers and cosmetic dental procedures (e.g. veneers) we can alter lip positions, facial lines and jaw profiles.
Oral Surgery
At Braces and Faces we have specialists that perform:
Extraction of Erupted or Impacted Wisdom Teeth
Wisdom teeth commonly develop around 18-20 years of age. They may erupt in alignment but more often they come through at an unfavourable angle or not erupt at all.
Often wisdom teeth can be very difficult to keep clean resulting in cavities and gum disease affecting the wisdom teeth itself or the teeth in front. Sometimes they can also affect the position of the adjacent teeth. Removal of wisdom teeth may be difficult at times and may require a minor surgical procedure to remove them. Although not pleasant, it’s important not to compromise the long term health and position of the molars.
Oral Biopsies
The inside of the mouth is lined with a special type of skin called mucosa which is smooth and coral pink in colour. Any alteration in this appearance (outside of genetic pigmentations) could be a warning sign of a pathological process (e.g., cancerous growth), and this could happen anywhere in the oral cavity, including the lips, gum tissue, cheek lining, tongue and the hard or soft palate.
Exposure of Impacted Teeth
Patients may have adult teeth that never erupt into the mouth due to crowding, genetic factors or unfavourable tooth positions. After the wisdom teeth, the upper canines are the most common teeth to be impacted.
Early detection around the age of 10 is important for the long term prongnosis of these teeth. If the teeth remain impacted then it requires “exposure”, which involves a small procedure to lift the gums away to reveal the impacted tooth for a gold chain to be bonded on and gently drawn into place by orthodontic treatment.
Dental Implants
At Braces and Faces all implants are placed by experienced postgraduate trained dentists. Digital 3D scanners, X-rays and software are used to meticulously plan the final position before the start of treatment.
We use the two most reputable brands; Nobel Biocare and Straumann implants. This ensures the highest success rates and both are internationally recognised for when the crown needs to be replaced.
Dental Implants
Implants are often a permanent solution to missing, dead or damaged teeth. The titanium dental implant ‘root’ is anchored in the jawbone. However early tooth loss or extractions can lead to the loss of the bone that once supported the missing tooth. If insufficient bone is present to support the dental implant, additional procedures such as bone grafting and sinus lifts are required to make implants possible. There are generally 3 phases to an implant:
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Surgical placement of implant into the jaw
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Osseointegration - when the bone heals around the implant which takes up to three to six months
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Dental Implant Crown - looks like a tooth that is attached to the implant
Advantages of dental implants:
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Durable and hard-wearing
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Natural looking for a beautiful smile
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Strong and stable, allowing you to eat what you want
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Effective for oral and jaw health, holding your other teeth in position and stopping jawbone erosion
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Solidly implanted so there’s no slipping, giving you precise speech with no slurring or mumbling
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Attractive, helping your confidence and self-esteem
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Highly convenient
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A lifetime solution instead of a series of temporary ones
If you are in good general health this treatment may be an option for you. In fact, your health is more of a factor than your age. You may be medically evaluated by a physician before any implant surgery is scheduled.
Chronic illnesses, such as diabetes or leukemia, may interfere with healing after surgery. Patients with these issues may not be good candidates for implants. Using tobacco can also slow healing.
Periodontal (Gum) Treatment
Periodontal Treatment
Periodontal or gum disease is an infection of the gum, bone and surrounding structures of the teeth caused by the bacteria found in plaque. It is the leading cause of tooth loss in adults, and can cause halitosis (bad breath), bleeding gums, mobile teeth, and a displeasing smile for some.
Gum disease is progressive and cyclical, and often painless-so you may not even be aware you have it or that it is active again. Early gum disease also known as gingivitis is characterised by swollen gums and often bleeding is reversible with improved home care and regular dental cleanings.
However, advanced gum disease known as periodontitis is not reversible but progression can be halted with proper maintenance. Symptoms of periodontitis may include:
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Gum recession
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Tooth mobility
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Bone loss
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Bad breath
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Pocketing at the gumline
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Attachment loss
Treatment Methods
Non-surgical therapy
The mouth is mapped out and split into quadrants where the dentist or periodontist will focus on one side of the mouth at a time. Soft and hard deposits will be removed above and below the gum line.
If the periodontal disease has progressed to an advanced stage, our specialist may require you to come in for a series of dental cleanings. In some cases, local anaesthetic may be administered for your comfort.
Gum Grafts
Some patients experience sensitivity because the roots of the teeth are exposed from loss of soft tissue either from brushing too hard, or from heavy biting surfaces causing trauma on the teeth. Some patients experience sensitivity because the roots of teeth are exposed from gum recession either from brushing too hard, or heavy bite forces. In some cases, tissue from another part of the mouth can be grafted onto the exposed area to resolve symptoms and restore aesthetics. In some cases, taking tissue from another part of the mouth can be grafted onto the exposed area can resolve symptoms.
Dental Cleaning
(Scaling and Polishing)
Cleanings are usually recommended every 6 months and are performed by our dentists or hygienists.
Prior to a first cleaning appointment, a thorough check up by the dentist is required to ensure the teeth and gums are healthy.
Cleanings help to remove plaque, tartar and stains that build up over time. Appointments typically take 30 minutes for children and 45 mins for adolescents and adults. Fluoride varnish may also be recommended as an anti-cavity and anti-sensitivity treatment.
For orthodontic patients with fixed braces, we recommend the cleanings can be done during a routine adjustment appointment when the wires are removed prior to the cleaning for a more thorough and comfortable clean.
For stubborn stains that often occur between the teeth or on surface grooves, we recommend using a salt or xylitol power spray that is effective yet gentle.
For patients who have aggressive or severe periodontal (gum) disease, we would recommend the cleanings to be done by the periodontist (gum specialist) and certain follow ups can be done by the general dentist or hygienist.
Root Canal Treatment
All root canal treatments at Braces and Faces are done by post-graduate trained dentists using a dental microscope for absolute detail. Root canals are done under local anesthesia and should be painless. They can however be technically challenging and require thorough cleaning and patience for success.
Joint Clicking, Pain
and Grinding
Joint Clicking, Pain (TMD) and Grinding
Our team of dentists and specialists can diagnose the cause of the joint disorder. If suitable, our restorative dentists can provide stabilising hard or cushioning soft night guards to alleviate joint pain or reduce the harmful effects grinding has on teeth.
Sleep and Grinding
The dentist can support better sleep by collaborating with the sleep specialist or medical doctor by providing oral appliances for sleep apnea and snoring patients in both children and adults.
For children, upper jaw expansion and facial or tongue exercises may be helpful in promoting good nasal breathing, which is helpful in promoting balanced facial growth and dental development. Working with your speech therapist is often crucial for success.
For adults, oral appliances (e.g. SomnoMed) worn during sleep can be helpful to improve airway patency to reduce snoring or the harmful effects of sleep apnea.
Sedation
We offer nitrous oxide (laughing gas) sedation as a safe and effective means of light sedation to help reduce anxiety in children and adults.
For deeper sedation we offer Monitored Anaesthesia Care (MAC) or Intravenous (IV) Sedation carried out by an anaesthetist in our sister practice, Central Smile. Deeper sedation may be recommended for more complex procedures or for anxious children with multiple cavities.
Oral Hygiene Program
We cannot underestimate the importance of this service. At routine dental appointments, often the focus is on treating dental issues, leaving little time to review brushing and flossing or discussing oral hygiene aids.
We therefore offer a complementary service for children and adults to participate in this program with our hygienist at non-peak hours to go through oral hygiene practices and products in detail. Clinical photos and disclosing agents that temporarily stain unclean areas will be applied on teeth to help patients visualise where they can improve. Please let us know if we can help.
Retail
We stock dental products that we strongly believe are helpful in promoting good oral health. Some of our items are not available or hard to find in Hong Kong.
We have developed our own “razor floss” to make it easier for people of all ages to floss. We are also the first to provide products such as the popular US Snow home bleaching. The Plaque HD toothpaste that indicates unclean areas is also popular amongst patients. Other unique items we stock include the Curaprox tongue scraper, specialised children toothpaste or other interdental cleaning agents.
Outreach Services
Our dentists and specialists are happy to give oral health advice to schools or community groups. We offer fun and interactive educational presentations and experiments for children. Email us if we can help at info@bracesandfaces.co.
Types of Braces
Comparing different types of braces for adults, teens, and children. There are a lot of options, depending on your orthodontic needs and your budget. Here are the most popular kinds of braces that are currently on the market we offer at Braces and Faces
Metal Braces
When people think of orthodontic treatment, they think of metal braces. They remain one of the most efficient and cost-effective treatment methods, and today’s metal braces are smaller and more comfortable. Teens also enjoy customising the colours of their braces.
Self-Ligating Damon Braces
For complicated cases requiring more tooth movements, we suggest the Damon self-ligating braces. These braces have a “gate” to hold the wires to the brackets and don’t require coloured elastics. We believe this improves efficiency and effectives of tooth movement as it lowers the friction and forces of the braces. They are also smoother and easier to clean.
Ceramic Braces
For a more discreet treatment option, we offer clear braces with brackets made out of a ceramic materials. For the front teeth, we choose self-ligating ceramic brackets that don’t discolour so you have the peace of mind they won’t turn yellow with certain foods and drink (e.g. coffee)
Invisalign
Invisalign is the most popular and recognised aligner company. It involves a series of clear, plastic removable trays that move teeth into optimal position sequentially over time. They are a lot more discrete, comfortable, and convenient when eating and brushing. However, one must be committed to wearing them 20-22 hours/day. Attachments are small “nubs” we bond onto teeth that are also necessary to provide grip for Invisalign to move the teeth predictably.
SureSmile Aligners
For simple cases (less than 6-9 months) that don’t require paying extra for Invisalign, we recommend Suresmile clear aligners. They work just like Invisalign. Suresmile is a US company, which allow us to move the teeth using their computer software and we export the 3D data file to our 3D printer to manufacture in-house aligners. For simple cases, it's less costly, turnaround time is faster (as it's made locally) and perhaps the biggest advantage is it requires less attachments due to the rigidity of the aligner material.
Lingual Braces
Lingual braces are bonded behind the teeth and are completely discrete. They are the treatment of choice for teens or adults who prefer a completely invisible option, have complex cases not suitable with clear aligners, patients who cannot commit to 20-22 hours of wear a day or for those who want to avoid the inconvenience of taking their aligners in and out all the time. In general, the efficiency and comfort level is similar to outside traditional braces but lingual braces are more expensive and can affect speech in the short term.
Functional Appliances
When there is a jaw discrepancy in growing children. For example, a small lower jaw in overbite cases or small upper jaw in underbite cases, we would recommend a functional appliance that encourages the growth of the jaws. Most of these appliances resemble a traditional retainer and should be worn every night. Examples of overbite correctors include the Twin-Block, Van Beek Activator, Herbst or Reverse headgear in underbites.
Orthodontic Expander
In narrow palates, bite problems, mouth breathing or cases with potential for severe crowding, we may recommend a rapid palatal expander to expand the jaw to improve the bite and and make room for growing teeth. It is better to expand at an early age (8-10 years old) to gain more skeletal (bone) expansion but expanders can still be used in younger adolescents. Adult expansion is more complicated and less predictable.
Types of Retainers
After orthodontic treatment is complete and the patient has a beautiful, straight smile, it’s important to know the work isn’t over yet. Orthodontic retention begins right after treatment ends, and we will suggest a retainer option that fits your treatment needs and lifestyle.
We offer two retainer options. Option 1, upper and lower fixed retainers and removable retainers at night or Option 2, Vivera retainers to be worn as much as possible for the first three to six months, then every night for at least two years or more.
The only way to guarantee a patient maintains that beautiful smile is if they continue to wear either a fixed or removable retainer most nights in the long term.
Fixed Retainers
Fixed retainers are very thin and precisely bent customised wires that are bonded to the back of the upper and lower incisors. They ensure the front teeth remain stable after orthodontic treatment. Although it may feel different for the first few days, most patients don’t notice them there after a week.
Fixed retainers typically last around 5-10 years and we recommend using either thin interdental brushes or waterpiks to clean between the teeth.
Essix Retainers
The Essix retainer prevents your teeth from moving out of position. Teeth naturally tend to move a little within your mouth, and a retainer works to minimize the movement. The Essix is custom made thermoplastic material made to fit over the entire arch of your teeth.
Vivera Retainers
Are digitally fabricated clear retainers made by Invisalign. Vivera retainers come in three identical pairs made from durable and resilient plastic. If worn every night, each pair should last about a year. We suggest using Vivera retainers if the patient prefers not to have fixed retainers.
Hawley Retainers
Are digitally fabricated clear retainers made by Invisalign. Vivera retainers come in three identical pairs made from durable and resilient plastic. If worn every night, each pair should last about a year. We suggest using Vivera retainers if the patient prefers not to have fixed retainers.
Braces Tips and Care
Top things to do before you get braces
These tips will help you feel prepared and ensure you get the best result for yourself and your smile. Don’t forget to ask us any questions you may have during your consultation, we recommend writing down a list of questions or concerns before the appointment and feel free to ask us any questions you like. Remember we are here to service you.
Preparing for braces
It is imperative that the teeth are healthy before starting orthodontic treatment. We may suggest seeing your own dentist or one of our own dentists for a check up and/or hygienist for a cleaning to ensure there are no cavities or gum disease prior to starting. It’s important we move healthy teeth otherwise moving teeth with active infection may lead to worsening of dental health, more discomfort or ceasing orthodontic treatment until the health issues are addressed.
Also, be sure to thoroughly brush your teeth and floss in the lead up to your appointment so that your teeth and gums are in the best possible condition on the day your braces are applied.
What foods should you avoid with braces?
Some foods are not good for braces. They can pop brackets and bend wires, which will lead to unexpected trips to the office. Please: Avoid very hard foods like nuts
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• For other hard healthy foods like apples, carrots, hard crust pizza, please cut up into small bite size pieces. Biting a whole apple and tearing it away from your teeth puts a lot of strain on the braces.
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Avoid bubble or chewing gum that contains sugar. The occasional sugar-free chewing gum is acceptable as this promotes saliva flow to flush food/bacteria between the braces.
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Careful when biting into popcorn. As unsuspecting kernel seed can easily break the braces.
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Please avoid or reserve for special occasions high sugar or acidic beverages such as fizzy drinks or energy drinks. They cause decalcification of the enamel and can leave very unsightly permanent scars on the teeth when braces are removed.
What to do the day you get your braces fixed
Bonding braces are straightforward and there really shouldn’t be anything to worry about. It’s a painless procedure that takes 30 to 45 minutes. However we kindly request you:
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Clean your teeth thoroughly
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In order to have the cement adhere to your teeth correctly, we need a plaque-free surface, so it’s best to gently clean your teeth before your appointment.
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Take a before selfie
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When we’re feeling self-conscious about our teeth, we tend to smile with our mouth closed, but before we head intakes a photo with our teeth on display. You’ll enjoy looking back on your teeth before treatment and seeing how much your smile is changing along the way.
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Run your tongue over your teeth
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While the temptation is strong, you’re going to want to avoid poking around your braces with your tongue. After cleaning your teeth take a moment to run your tongue over your teeth to feel the smoothness – it will also be the first thing you do once your braces come off.
How do you put braces on?
The bonding of braces typically takes 30 to 45 minutes. The steps to bonding the braces are:
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We will clean the bonding surface using a sandy paste called pumice
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A sour gel is applied to prepare the tooth surface for the braces.
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The bonding cement is applied to the braces and a tasteless bonding liquid is applied to the teeth.
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A powerful blue light will shine on each tooth for roughly 10 seconds to harden the glue.
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After the braces are bonded, the patient takes a rinse and chooses their braces colour (O-rings) until their next adjustment appointment in about 6 weeks time.
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A thin flexible Nickel Titanium alloy wire is inserted to give a “tight” feeling. This is not painful but will feel “weird”.
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You are ready to eat and drink straight away. But please be mindful about avoiding hard, sticky or sugary foods.
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A mild dull ache usually starts 24 hours after the braces are bonded and typically lasts for 3 to 5 days.
Do you need to get cavities filled before braces?
All cavities should be filled before braces. However, sometimes your dentist may suggest monitoring a potential cavity. In these circumstances, please let us know and continue to see your dentist as scheduled.
Please inform us who your dentist is and we will send them treatment reports before, during and after to keep them up-to-date with your treatment progress. If you are unsure about the health of your teeth and gums please feel free to let us know your concerns.
Is it okay to whiten your teeth before getting braces?
We usually recommend whitening your teeth after braces, rather than before. This is because some patients notice uneven tooth colour when their braces are removed. The lighter colour is a result of the brackets protecting the enamel from exposure to all of the food and drink you have consumed during the course of your treatment.
Aftercare
Once your braces are fitted, you’ll need to make small changes to your day-to-day behaviour. Here are some of the habits you can start the day after your appointment.
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Keep pain relief handy. You may experience some discomfort for up to a week as you adjust to your new braces. If necessary, take some over-the-counter pain relief like Paracetamol (e.g. Panadol/Tylenol) or Ibuprofen (e.g. Nurofen/Advil).
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Eat soft foods. You will most likely prefer to eat soft foods during the weeklong adjustment period. Bananas, soups, rice and pastas are all great options.
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Brush your teeth after eating. Keeping food out of your braces can be tricky, but try to start brushing your teeth after every meal. Get a soft travel toothbrush and pop it in your bag so you’ll always have it on you.
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Clean between your teeth with floss, inter-dental brushes or waterpik’s
Yes you still need to floss with braces! Use either superfloss to thread the stiff end under the wire and floss as normal. This can be cumbersome and time consuming but is the most effective.
Platypus floss picks are handy for patients who struggle to use super floss. However, they are one-time-use and use the same piece of floss every time.
A waterpik is the most convenient option. This uses high-powered water jet to dislodge the food and plaque between the teeth. However this requires additional cost and can get quite messy.
An inter-dental (Tepe) brush is needed for cleaning between the braces. Make sure you press the brush against each side of the braces. We suggest you use the inter-dental brush right after brushing your teeth with toothpaste still in the mouth. Please note, the inter-dental brush is for cleaning in-between your braces and not a replacement for flossing in most cases.
When do you start seeing changes with braces?
You may notice a difference in your smile after four weeks, but generally, it takes two to three months for braces to begin noticeably straightening your teeth. As with all orthodontic treatment, every person’s bite and circumstances are different – meaning the time it takes for braces to start visibly aligning your teeth will differ as well. People with slightly crooked teeth or had tooth extractions will probably notice a difference sooner than those with severe malocclusion.
What is Invisalign?
They are clear, thin and removable aligners that worn over the teeth and changed by the patient every week. Each aligner is programmed to move the teeth as programmed by your doctor and you will see your teeth gradually straighten giving you a beautiful smile.
The aligners are worn 20-22 hours per day except when eating, drinking and when you need to brush and floss.
The advantages include:
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Comfort
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Invisibility
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Removable
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Ease of brushing and flossing
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Highly accurate
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Simulation of final results
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No metal brackets and wires
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Used in children and adults
How do I get started?
Please feel free to book a dental check up with our dentists or a consultation with our specialists. Our staff will take 3D digital impressions (scan) of your teeth - this replaces the traditional putty moulds that are messy and can trigger a gag reflex in patients. This is a highly accurate scan that pieces images of your teeth together and gets sent to Invisalign where your teeth are modelled and your doctor works on your individualised treatment plan based on your goals and main concerns. X-rays will be prescribed if needed.
How do I clean my aligners?
We recommend brushing them twice a day with a soft bristled toothbrush, separate from the one you brush with.
You can use the following solutions to soak them in, please rinse thoroughly afterwards:
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Mouthwash
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Lukewarm water
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Lemon water
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Diluted liquid soap and water
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Denture tablets (once a week for 20-30 minutes)
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Use an ultrasonic bath to wash it
Please note you will be switching them every 7 days so they may not have the time to discolour before moving into a new tray.
Can I see my final result?
One benefit of digital treatment plans is that we can project the final result based on the treatment goals. This simulation can be shared and discussed with you at any time in the office or remotely.
What are chewies?
Invisalign chewies are a soft chewing device the size of a cotton roll that can be re-used by patients treated with Invisalign. It is a small cylinder made of a soft spongy plastic that are used to help eliminate spaces between the aligner and the tooth to improve the overall fit.
They can be used after every time you place you aligners in or approximately for a total of 5-10 minutes / day. Position the chewie between your teeth (either ‘longways’ or ‘shortways’ and bite down. Move it from one end of your mouth to the other continuing to bite up and down until you have bitten on it with all of your teeth.
How to use chewies?
What are attachments?
Attachments are tooth-coloured structures that are placed on your teeth to help Invisalign move your teeth in the desired position. They are temporary and is based on a composite resin material - the same material used for dental fillings. They help the Invisalign grip the shape of your teeth for more effective and predictable movements. We generally avoid placing attachments on any implants or crowns patients may have. Attachments are usually placed two weeks after the start of your treatment and is a painless process.
What is IPR (Interproximal reduction)?
When there is crowding and we need more space to align the teeth, we will discuss something called IPR as a possible alternative to extracting teeth. Interproximal reduction (IPR) involves a metal strip that goes in between the teeth to slenderise the shape of teeth. It is a very common procedure done simply in the clinic and only takes 5 minutes. You will feel like it is a metal piece of floss pulling the teeth.
This involves removing minimal amount of enamel to create space and does not cause sensitivity to the teeth.
Prior to interproximal reduction, teeth slightly overlap.
After wires are removed, the orthodontist gains some space by gently contouring the sides of the overlapping teeth.
Following interproximal reduction, teeth have sufficient room to align, the patient has a more aesthetically-pleasing smile and an improved bite.
Photo courtesy of American Association of Orthodontists.
When can I expect my aligners to be ready?
Aligners take approximately three to four weeks to be fabricated and shipped to Hong Kong from the United States.
Overall, patients will find clear aligners more comfortable over metal braces as there are no wires and brackets rubbing against the cheeks and lips. The movement in aligners is programmed to be gradual and targeted but are much more effective if worn 20-22 hours/day. However, clear aligners require commitment and can be quite troublesome to some.
Is there less pain if I wear clear aligners over traditional braces?
Can I wear elastics with aligners?
Yes - aligners can have pre-cut hooks where you can attach rubber bands to. Additionally, we will place a metal hook on your tooth where the elastic band stretches to for ease of placement rather than the plastic being distorted.
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What happens if my aligner breaks before I’ve worn it for 7 days or I’ve lost a set?
Please jump to the next aligner and wear it for a few more days. Feel free to Whatsapp us a photo of your teeth with and without aligners on if you have concerns regarding the aligner fit. Frequent breakage or loss of aligners will lead to "off tracking" and will require ordering new sets, which will slow treatment down and may incur additional costs.
I see a large gap (>3mm) between my tooth and aligner? Is that normal?
When you first fit your aligners at your initial appointment, the aligners should fit as snug as possible meaning they wrap around your entire tooth. Over the course of treatment, because of either the aligner has not been worn enough or not properly put on - the aligner can start to “lose track” of certain teeth meaning it is no longer wrapped around the tooth and cannot move the tooth as effectively.
At the initial stages this can be corrected by use of chewies in the particular area and staying in your last most fitted aligner for a few more days before switching into the next aligner to give the aligner time to get that tooth “back on track”.
Additionally sometimes it is simply a difficult movement for the aligner along with the shape of the tooth being hard to grip, you may find the gap frequently in the same spot. If you are unsure, we welcome you to send us a picture of you wearing the aligners as the first point of contact so that we can instruct you on what to do. If necessary, we may schedule an appointment to come into the clinic for a new scan.
What is a refinement scan?
Your Invisalign treatment may span over the period of months to years. The total number of aligners in your initial set is not necessarily directly related to your treatment time. We often describe it as “tailoring a dress”. We do it in stages, and may scan your teeth when we feel it is necessary or when you have finished wearing all your aligners in the batch. When we perform a refinement scan, this just means we want to update Invisalign and tell them specifically what areas to focus on to provide you with more effective treatment. The refinement scan is then sent to Invisalign and there is a 4 week processing time required until the new batch of aligners come back. In the mean time, we will ask patients to continue with their aligners but switch to 14 days per aligner or wear the last one they have nightly until the new ones arrive then go back to a 7 day cycle.
Why do I notice more visible staining on the attachments while I’m wearing my Invisalign?
The attachments are made of composite resin and is stable and does not discolour easily.
However there are a lot of reasons that can cause staining:
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It is an irregular surface on the tooth and can accumulate more plaque and stain easily
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Frequent acidic beverages such as soda, coffee, wine, black tea stain them over time (we recommend use of a straw)
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Intake of citrus fruits frequently with the Invisalign
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Use of tobacco
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Intake of turmeric, curry
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Inadequate cleaning of aligners after eating
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Poor oral hygiene
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Bonding agent used in the dental procedure
Dental care professionals can clean the accumulated debris around the attachment in case of surface staining. They may also remove and polish these attachments if required. However, we avoid extensive polishing attachments as doing the same can result in slight changes (alteration) in their shape, making them useless to work with existing aligners.
Can I whiten my teeth during my Invisalign treatment?
We generally advise patients to hold off on whitening their teeth during orthodontic treatment as the whitening gel cannot reach the tooth surface below the attachments. Patients may end up with spots on parts of teeth below these attachments when removed.
Adolescent Treatment / Phase II
Why Is Adolescence The Best Time For Treatment?
Each child’s situation is unique, and sometimes additional intervention is needed to begin correcting orthodontic issues and prevent oral health issues down the line. However, the most popular time to begin treatment is anywhere between ages 11-15. During this time, most teens have lost all their baby teeth and have a full set of permanent teeth with subsequent orthodontic issues. Braces and other orthodontic appliances work in tandem with the teenage growth spurt and higher metabolism levels, so that treatment is completed in an efficient and effective manner.
The Benefits Of Treatment
Adolescence is the perfect time to begin receiving treatment for the following reasons:
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Improved Facial Appearance & Oral Health – As your teen progresses through orthodontic treatment, you’ll notice positive changes to their appearance and smile. Also, straighter teeth and a healthier smile are much easier to maintain.
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Positive Social Experience – Many teens will also have or planning to have braces, which makes visible braces more socially acceptable.
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Better treatment outcomes - Dental crowding often misaligns the gums and bite, which can contribute to gum recession and tooth wear in the long term. Aligning the teeth early allows the teeth and gums to develop a better foundation earlier before long term long-term impacts are evident.
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Saves Time & Money – The longer you wait to solve orthodontic issues, the worse they can become. Choosing to align treatment with your child’s natural growth and development will probably save you time and cost.
Orthodontic Treatments At Braces and Faces
Adolescence is the perfect time to begin receiving treatment for the following reasons:
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Improved Facial Appearance & Oral Health – As your teen progresses through orthodontic treatment, you’ll notice positive changes to their appearance and smile. Also, straighter teeth and a healthier smile are much easier to maintain.
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Positive Social Experience – Many teens will also have or planning to have braces, which makes visible braces more socially acceptable.
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Better treatment outcomes - Dental crowding often misaligns the gums and bite, which can contribute to gum recession and tooth wear in the long term. Aligning the teeth early allows the teeth and gums to develop a better foundation earlier before long term long-term impacts are evident.
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Saves Time & Money – The longer you wait to solve orthodontic issues, the worse they can become. Choosing to align treatment with your child’s natural growth and development will probably save you time and cost.
Teeth Shifting: Signs, Causes, Prevention and Treatment
Teeth shifting isn’t usually something you notice overnight – it can take months or years to recognise a change in your smile.
It is normal for your teeth to shift over time. Your teeth will continue to move ever so slightly over the course of your life toward the front and centre of your mouth – a process known as mesial drift. But this shift is incremental, so you won’t be able to see it happening day-by-day. However, several factors – including periodontal (gum) conditions and other health issues – may exacerbate the degree of movement your teeth undergo. This can lead to complications including crooked teeth and a misaligned jaw. If you’re concerned about your teeth shifting and want to minimise their movement, it’s best to see us for a professional assessment to either start monitoring the movement of correcting it early before it worsens.
What causes teeth to shift in adults?
We often see patients who have seen changes in the position of their upper and particularly their lower front teeth as late teens or as young adults. Some of these patients had very well aligned teeth before. It is easy to blame the wisdom teeth for these changes, as this is the time that they tend to erupt, but there are actually many other possible factors which can affect teeth positions.
Your teeth are housed in remodelling bone, rather than set in “concrete”. Therefore, teeth positions can be affected by any or a combination of the following factors.
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Late lower jaw growth which can lead to inward tipping of the lower front teeth
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Changes in the elasticity of the cheeks and lips and/or pressure from the tongue
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Loss of gum tissue or bony support for the teeth through gum disease
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Loss of teeth or changes to the bite
Do teeth shift back after braces?
Yes – without the correct use of your retainer. Braces exert a subtle yet steady pressure on your teeth, slowly shifting them into alignment. Once your braces are removed, your teeth will always have some potential to move out of position, however, the amount is unpredictable and can differ greatly between individuals. This is where your retainer comes in. A retainer is an orthodontic device designed to hold your beautifully aligned teeth in position. It’s incredibly important that you wear your retainer every night for the long-term. If you have fixed retainer, ensure you have it checked with us or your dentist regularly every 6-12 months.
If you’re athletic, we also recommend that you wear a sporting mouthguard to safeguard your newly straightened teeth during contact sports.
How do you know if your teeth are shifting?
Signs of teeth shifting include:
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An uncomfortable or ill-fitting retainer. Your retainer is custom made to fit your well-aligned teeth. So if your retainer no longer fits, this is a sure sign your teeth have shifted. Unfortunately, this is usually due to incorrect wear of your retainer.
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Mid-line shift of teeth. With correct tooth alignment, your two upper and lower front teeth should fall in the center of your nose and eyebrows. An increase in asymmetry in one or both dental arches – known as midline drift – is a common sign of shifting teeth.
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Gum bleeding. May be a sign of periodontal (gum) problems, which may increase the likelihood of teeth shifting.
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Gaps in your teeth. This is a common and easy-to-spot sign that your teeth are shifting. Gaps may also be a sign of developing periodontal (gum) problems.
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Tooth pain or sensitivity. If your teeth are more tender or more sensitive than usual, this could indicate shifting teeth.
The best way to ensure stability of your treatment result is to see us for retainer reviews every 6-12 months. We will take a digital scan for your teeth and superimpose it with the original scan taken when the braces came off to check very accurately if your teeth are shifting. The good news is, if they have shifted, often making a new retainer based on the first scan will shift them back to their original positions.
Teeth shifting is an incremental and gradual process, so it generally does not cause pain.
How to prevent your teeth from shifting
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Close monitoring using digital iTero scans at your regular dentist/hygiene or retainer review appointments to accurately assess potential changes to teeth position, wear and gum recession.
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Correct use of your retainer.
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Regular dental check-ups. Your general dentist will assess the health of your teeth and gums to help prevent teeth shifting due to gum disease.
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Good dental hygiene. Brushing and flossing regularly will prevent food and bacteria from building up, preventing issues such as gum disease that can cause teeth shifting.
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Fabricating a night guard with the general dentist if there is a grinding or clenching habit.
Naturally, the body inevitably changes as we age. Tooth movement, like wrinkles, occurs with time as a part of the normal ageing process. Thankfully we can hold off unwanted teeth changes, through maintaining good oral health and the simple wearing of retainers.
