Dr. Greg Jorgensen
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Rio Rancho, NM 87124

The Jorgensen Orthodontics Blog

Three Reasons Your Orthodontic Braces Are Still On

Posted by Dr. Jorgensen on March 25th, 2012

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Getting your braces on is exciting, but getting them off is the best day ever! Your orthodontist most likely gave you an estimated treatment time before your braces went on. If that day has come and gone, you are probably wondering why your braces are still on. There are three things that could cause your braces to stay on longer than expected: your orthodontist, you, or biology.

Your orthodontist has advanced training to help him diagnose your problems and come up with a treatment plan that will best correct them. His experience should not only allow him to produce the best result, it should also help him select an approach that gets you there in a reasonable amount of time. Not all orthodontists are the same however. Some place more emphasis on speed than quality. Some are “hands-on” while others are not as intimately involved. It is a personality difference. Your treatment time will be directly affected by the treatment plan your orthodontist choses and how efficiently he executes it. Some ways he can make your treatment take longer include 1) problems with the original diagnosis, 2) problems with the original treatment plan, 3) changes in the original treatment plan during the process, 4) too much time between appointments, or 5) insufficient attention to your progress. Some problems really do take 30 months to correct, but an experienced doctor should be able to warn you about those up front.

You (the patient) are the second variable that affects your treatment time. Your orthodontist may have the perfect diagnosis and treatment plan, but he cannot succeed without your cooperation. Some things you might be doing to sabotage your own treatment time include 1) missing, changing, or spreading out your appointments, 2) arriving late to appointments so the technicians don’t have sufficient time to perform all planned procedures, 3) not getting other necessary procedures done in a timely manner (surgeries, extractions, restorative, etc.), 4) breaking or bending your wires or brackets between visits, or 5) not following instructions regarding rubber bands, aligners, and oral hygiene. Doing your part will not only help keep your treatment on schedule, it will give you the best final results too.

Even if your orthodontist is brilliant and you are the most compliant patient in history, there is still one other factor that neither of you can control. That factor is your biological response. Estimates of treatment time are based upon the complexity of the problem and the normal response of teeth to typical orthodontic forces. In some patients the teeth move faster than normal. In others they move slower. Some patients may have a condition called ankylosis where some teeth won’t move at all. In these cases it won’t matter what you or your orthodontist do, treatment time will be extended. The take home message is that even if you and your orthodontist are both vigilant in your roles, you’ll still need for your teeth to cooperate to get done on time.

If you are in treatment now and are concerned by your prolonged treatment time, consider these three factors: Are you really doing your part? Have you discussed your treatment progress with your orthodontist to see if anything has changed from his perspective? If you’re confident that both of you are doing your best, it may be that your body’s response to treatment is just slow. If you haven’t started yet, ask around and see if the orthodontist you are considering has a reputation for efficient treatment plans and finishing on time. Not all orthodontists are the same.

NOTE: The author, Dr. Greg Jorgensen, is a board-certified orthodontist who is in the private practice of orthodontics in Rio Rancho, New Mexico (a suburb on the westside of Albuquerque). He was trained at BYU, Washington University in St. Louis, and the University of Iowa in the United States. Dr. Jorgensen’s 25 years of specialty practice and 10,000 finished cases qualify him an expert in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems (including conventional braces, Damon and other self-ligating brackets, Suresmile, and lingual braces). This blog for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. Jorgensen is licensed to diagnose and treat patients only in the state of New Mexico. He cannot diagnose cases described in comments nor can he select treatment plans for readers. Because he has over 25,000 readers each month, it is impossible for him respond to all questions. Please read all of the comments associated with each article as most of the questions he receives each week have been asked and answered previously. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.

22 comments so far in response to “Three Reasons Your Orthodontic Braces Are Still On”

  1. Alice Wright says:

    Is it possible that jaw problems would extend treatment time? I got my braces on a little over a year ago (August 20th, 2012) and was told I would get them off on August 20th of this 2013. Yet, now the orthodontist is saying that I’ll get them off in February 2014. At the start of treatment, I had a slight overbite and one crooked tooth. My teeth are perfectly fine now with the exception of the slightest cross bite (I’m talking about 2 mm off). Is there any way I can get them off by November?

    • It is possible that issue with your bite could affect the length of your treatment. Clenching, for example, puts a lot of pressure on the teeth and it may make it possible for the flimsy little wires to change the depth of your bite. TMJ problems like degenerative arthritis can cause the bite to change before, during, and after treatment and can easily lengthen treatment time. Normal TMJ issues like popping and clicking however are unrelated and should not affect your treatment at all.

  2. Holly says:

    I have had my braces on for just over a year including the removable retainer that I had before I had to have 4 teeth extracted. All of my teeth are straight, there are no gaps and when I put my back teeth together, the front ones over lap by just under a mm. I went to the orthodontist 4 weeks ago and he said I have 5-9 months left and I have been since. By judging what I have said above, how long approximately will I have left until I get my braces off?

  3. Melissa says:

    I’ve had my braces for a little over two years now. The expected time was originally 24 months. I got my braces in february of 2012. It has now passed the expected time! Ive been following everything the orthodontist has told me, including wearing my rubber bands 24/7. I’ve never missed one app, and avoid chewing gum. I am a very patient person. However, I would LOVE to know when my braces are coming off. My bite seems corrected, and my spaces are closed. I am 19 right now, and was wondering if my age has anything to do with the delayed process? My orthodontist has said NOTHING about whether I’m close or far from getting my braces off. I have not asked her either, because I understand how often she probably is asked that question. But now, I really just want to know. Any ideas of how much longer I have?

  4. Karla says:

    I got my braces 20 months ago. I have a tooth back on the palate and my orthodoncist still hasn’t done anything about it and when i ask her, she says it doesn’t fit on the space yet, but she’s not doing anything different. I was looking on the internet and i figured out that maybe power chains could help speeding the process. The thing is she told me it will take 24 months and i asked her last week if they will be done by July, but she said no. I wonder what is the standard procedure to treat a tooth on the palate and if power chains can help to speed the process, so i can suggest something to my orthodoncist and see what can she do about it.
    Besides, my brackets keep falling with normal food (one of them fell eating banana and another eating a hot dog) but when i go she doesn´t glue them again, cause she says the other glue is still there, can it be removed somehow?
    I would really appreciate your answers.
    Thank you

    • Power chain closes spaces and open coil springs make space. If you have a tooth on the palate, the first step is make the necessary space with the spring. After there is room, then the tooth can be moved forward. My concern is that this should have happened in the first 6 months of treatment, not the last 6.

      • Karla says:

        So what can i suggest to my orthodoncist? I have had the spring almost since the begining. At first, i still had the baby teeth, but i started to feel to much pain cause it was pushing towards the wire so she took it out at the second week or so, and then she put me the spring. I have it since then. I’m a bit dissapointed cause i don’t want to use them another year. Can it be done on the last 4 months or is it impossible? is anything she can do to speed the process?
        Thank you for your answers

        • These are all questions for your orthodontist. The timing and length of time your springs are in is determined by the severity of your problem and how your body responds to the force. You need to have your orthodontist explain this to you while you’re in the chair at your next appointment. Good luck!

  5. Lindsey says:

    I had 8 extractions and got my braces placed last week. They put these “tie wires” from my eye teeth to my back molar under the archwire…I’m assuming it is to move the eye teeth into position (all 4 are in front and above the other teeth)…My question is, about how long will it take for these wires to pull the teeth back? They are quite sharp, it’s like Freddy Crougar had his way in my mouth.
    They seem flimsy, I don’t want to cake them in wax and risk breaking them but they’re all kinds of awful.

    • The teeth typically move 0.5mm to 1.00mm per visit. I cannot comment on your case specifically, but if you feel that something is poking you, you should see your orthodontist to see if anything can be adjusted.

  6. Ian says:

    My daughter a 14 year old with attitude. Has had braces for two years. I took her to an appointment today only to have to book another appointment in 13 weeks. She wont brush or clean often enough and therefore the treatment isn’t working. I think it pretty unlikely she will wear a rubber band 24/7 as asked to do. so i have asked him to terminate the treatment.
    He then said i would have to pay for all the treatment, as the NHS wont if he terminates. Is this true please? as my daughter is obviously distressed, even though she is the one at fault. I couldn’t possibly afford to pay for the treatment, but feel she would be better off without the bleeding gums the braces have given her. I’m being bribed into keeping my daughter in discomfort and distress. Help!

    • Hi Lan. If your contract was based upon 24 months of treatment your orthodontist has done his part, it is only fair that his practice be paid what was agreed at the start. He cannot help that your daughter hasn’t done her part. As for not getting paid if he takes the braces off now, that doesn’t make sense. If she is not going to wear her elastics and the teeth are being damaged, the braces should come off and a set of retainers made now before more damage occurs. Ending the treatment now should not affect how much the office collects from NHS if he has done what he contracted to do.

  7. goldy says:

    I got my braces like 32 months ago. During my first year my orthodontist told like it is going to be not more than 18 months. she is dragging too much. And I almost lost trust in her. She has been doing this circus from past 12 months again and again to make tilted teeth straight. She has been tilting them from one side to the other and again from the other side and has been failing to make them straight.I dont understand and I dont like this trail and error with me. My tooth is reacting very quick to her treatment. Whenever she makes a change within few hours I can make out that my teeth is moving(not necessarily the correct way). When ever I ask her how long its going take more..she says your teeth are moving slow..I dont agree 100% with her because they are constantly moving and she is very bad at bending the wires..My god the tooth are moving completely in a different direction..I went asked once why the teeth are moving when we intent to move the other way..She said “I dont understand they are not suppose to move this way and let me try something different”.what does she mean by that? The reason she tilted the teeth is make a space to bring one of my other tooth front.She made such a big space like you can bring like couple of teeth there. And from past 18 months she is struggling to bring back the pushed tooth. And she is has no clue when she is going to be done. My question is when the tooth are not moving in the intended direction should I wait till my next visit(like 4 weeks) to hear that it didnt do the right thing? Iam not a kid…Iam 32 old coming from a techical background. I clearly understand what she is trying to do and its not rocket science. Iam very frustated with the treatment. Do I have any options to change to a new orthodontist?

    • It sounds like you and your orthodontist need a fresh start. I would find a new orthodontist that you trust more. Sometimes personalities just don’t match. Trusting your doctor is important for a successful treatment.

  8. katie says:

    Hello :)
    I’m getting my braces off in around 4 months (well that’s what my Ortho told me anyway) and I was wondering what should I do after I get them off, how long should I wait until using whitening strips and are there any strip brands that you would say are the best
    Thanks :)

    • You can proceed with whitening immediately after appliance removal. There is no reason to wait. I don’t have a preference for bleaching products. They all use the same active ingredient.

  9. Anna says:

    Hi. I have had braces on for about 8 months now and one tooth refuses to move. It is the second one to the right on the bottom, and it feels like it is twisted. Could there be a problem with this tooth? My orthadontist has suggested that as my teeth are 95% straight that they are ok, but I am not happy that this tooth isn’t straight as the gums around it get quite painful. Any advice would be much appreciated.

    • The only condition that I’m aware of where a tooth won’t move is called ankylosis. If this is the case with your tooth, then you’ll either need to leave it crooked or have it crowned so that it looks straight. I would seek a second opinion before I had my tooth crowned however.

  10. ashleigh says:

    ive had my braces on for about 8-9 months right now and my orthodontist said i need to keep them on for 18 months but my teeth are straight and I’ve had my elastics for 3 months and she even said that my jaw and everything is going really good and at my last appointment they said they don’t even need to change the wire until next time but i think that they might be ready to be taken off is there any way to make this possible

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