Braces 101: Cooperation: Is it a big deal?

A big question on the minds of many orthodontic patients is: How much do I actually need to be involved in the treatment to get it done right? Cooperation from patients has always been an important ingredient in successful orthodontic treatment. The orthodontist asks for cooperation in three basic categories: (1) The application of additional forces with rubber bands, headgear, retainers, etc. to assist with tooth movement and jaw growth, (2) Maintenance of good oral hygiene in order to prevent cavities, gum problems, etc, and (3) Attending all scheduled appointments so that treatment progress can be monitored and progressed properly. This article will focus on the first category.

Most orthodontist want to rely on patient cooperation as little as possible and have designed methods of treatment to increase predictability of results with or without patient involvement. Non-compliance appliances are designed to limit the need for headgear and elastic wear by placing fixed or cemented appliances in the mouth to accomplish this task in a different way. Yes...these appliances came about because of patients who would not comply with instructions, but orthodontists use these on most patients now because of their effectiveness and relative comfort. Head gears and elastics are still necessary in certain circumstances, but are much less common now then in decades past.

The success of non-compliance appliances lies in the design. These appliances can apply forces on teeth full time to make changes occur. Headgear is typically worn (even with best cooperation) 12-14 hours per day, while rubber bands are (at least) taken off during eating. The application of proper calibrated continuous forces enables safe, efficient, and predictable tooth movement.

An important home message is that your orthodontist will do his/her best to make your experience with braces as good as possible. You may be asked to help your progress along with rubber bands, head gear, or something else along the way. Remember, all of these requests are made to benefit the patient and improve the quality of the outcome. Ask lots of questions so that you fully understand why you need to be involved.