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Ortho 101


Click each question to view the answer.

What is orthodontics?

Orthodontics is a specialty branch of dentistry that treats problems with the alignment of the teeth and jaws. Orthodontists are dental specialists who diagnose, prevent and treat dental and facial irregularities.

What is an orthodontist?

All orthodontists are dentists, however orthodontists receive an additional two to three years of specialized education beyond dental school. During specialty training, they learn the proper way to align and straighten teeth and correct jaw misalignment. Only orthodontists have the proper training and skills to diagnose and comprehensively correct tooth and jaw abnormalities.

What causes orthodontic problems?

Most orthodontic problems are inherited. Examples of these genetic problems include crowding, spacing, protrusion, extra or missing teeth and some jaw growth problems. Other problems are acquired by thumb or finger-sucking, dental disease, accidents and the early or late loss of baby teeth among other causes.

When should my child be seen for an orthodontic consultation?

The AAO (American Association of Orthodontics) recommends that your child get an orthodontic check-up by 7 years of age. By that time, orthodontists can spot subtle problems with jaw growth and emerging teeth while some baby teeth are still present. That’s important because some orthodontic problems may be easier to correct if they’re found early. Most orthodontic patients begin active treatment between ages 9 and 14.

Can adults benefit from orthodontic treatment?

Orthodontic treatment can be successful at almost any age. In fact, about one in every five orthodontic patients today is over age 18. Thanks to today’s smaller, less visible, more comfortable orthodontic appliances, adults are finding treatment more appealing. At Germantown Orthodontics, we have several cosmetic options for adults as well.

Why is orthodontic treatment important?

Crooked and crowded teeth are hard to clean and maintain. Also, teeth that are out of alignment with each other can cause abnormal wear of tooth surfaces, difficulty in chewing and/or speaking and excess stress on supporting bone and gum tissue. Without treatment, many problems become worse and can require additional dental care later in life.

How long will treatment last?

The length of treatment will depend on the difficulty of the tooth alignment and bite being corrected. Typically a patient who is in full braces can expect to stay in treatment from 18-24 months. Some cases are shorter or longer and again it all depends on the difficulty of the treatment. Dr. Kopicki will give you an estimated length of treatment at your consultation appointment so that you have a better idea of how long your specific treatment may take.

How Braces Work

Braces are composed of several elements.


These are metal rings that fit all the way around your back molar teeth and have a bracket welded to the side. They will remain on your teeth during your entire active orthodontic treatment and will be removed when your braces are completed.


These are the individual braces that are bonded to the outside of your teeth with special orthodontic tooth glue. They will remain on your teeth during your active orthodontic treatment and will be removed when your braces are completed. Sometimes, brackets are used on the back molar teeth instead of bands.


These fit inside slots on the brackets. The archwires are what gradually shift your teeth into place. As you progress through your treatment, you will receive different types and thicknesses of wires depending on the tooth movement needed. This is what often feels “tight” after an orthodontic adjustment. The “tightness” is likely from the fact that your wires have been changed.

Elastic O Ties

These are miniature rubber bands that fit around the outside of the bracket and secure the wire in place. These can either be colorful or clear and will be changed at every appointment.

Braces Parts

Timing Of Treatment

Click each phase to review process.

Early (Phase I) Treatment

What is Early Treatment?

Early treatment typically occurs when the patient has a mixture of primary (baby) and adult teeth present in their mouth. This phase of treatment is necessary when there are problems with the way that the adult teeth are erupting into the mouth, when there is not enough room for the adult teeth to come in or problems with the way that the jaws are growing and developing relative to one another. Usually, this phase is more limited in treatment time than a full set of braces and usually takes about a year or less.

how will I know if my child needs early treatment?

Not everyone will need phase I treatment and Dr. Kopicki will decide if early treatment is right for your child. The idea of early treatment is that it will decrease the difficulty of phase II treatment and help establish a stable bite and jaw relationship. Most children who receive phase I treatment still end up needing full braces when all of their permanent teeth erupt.

What Types of Problems Are Addressed During Early Treatment

Common problems that are addressed in Phase I are:

  • Crossbites
  • Excessive Crowding
  • Excessive Spacing/Protrusion of Teeth
  • Habits like thumb sucking or tongue thrusting
  • Open Bites or Severe Deep Bites
  • Underbites
Phase II Treatment

Often, children are treated in two phases of orthodontic treatment. Early/phase I treatment when some baby teeth are present and then full/phase II treatment once all of the permanent teeth have erupted. The reason for separating the treatments is that limited treatment early can help minimize the invasiveness, length or severity of the subsequent full treatment. See below for more information on sequencing of treatment.

Phase I/Early Treatment

Early treatment will occur when your child has a mixture of baby teeth and permanent teeth. At this stage of life, the growth of your child can be evaluated and redirected if a problem exists. For example, a narrow or high palate can be readily identified and corrected at this age. This phase of treatment is more limited in scope than full treatment and is aimed at reducing the complexity of your child’s overall orthodontic treatment. Without early treatment, the chance of extractions of permanent teeth, of developing impacted teeth and of more invasive full treatment later in life increases. This phase of treatment typically takes a year or less and usually will include an appliance to create space or correct jaw alignment and sometimes some limited braces.

Evaluation Period

Once phase I is completed, the appliance and/or braces will be removed and your child will be put on evaluation every 6 months to 1 year to assess the eruption of the remaining permanent teeth. The teeth at this stage are not in their final positions as permanent teeth are still erupting into the mouth and need some wiggle room as they come in.

Phase II/Full Treatment

Phase II treatment is typically full upper and lower braces and will be started once all of your child’s permanent teeth have come into the mouth. This is the phase of treatment where all of the teeth will be definitively aligned and the bite will be fully corrected. This treatment takes between 18 and 24 months on average. At the end of this phase of treatment, retainers will be made to keep the teeth in place.

Handling Orthodontic Emergencies

Emergency Treatments

The following orthodontic emergencies and their treatments are listed in the order of the least severe to the most severe. Only the most severe emergencies may require immediate attention by an orthodontist.

Food Caught Between Teeth

food caught between teeth

This is not an emergency, but can be a little uncomfortable or embarrassing for the braces wearing patient. It is easily fixed with a piece of dental floss. Try tying a small knot in the middle of the floss to help remove the food, or use an interproximal brush or toothpick to dislodge food caught between teeth and braces.

Ligatures come Off

Ligatures come Off

Tiny rubber bands or small, fine wires, known as ligatures, hold the wire to the bracket. If a rubber ligature should come off, you may be able to put it back in place using sterile tweezers. If a wire ligature comes loose, simply remove it with sterile tweezers. If the wire ligature is sticking out into the lip but is not loose, it may be bent back down with a Q-tip or pencil eraser to eliminate the irritation.

Of course, when one ligature pops off or breaks, others may follow. Be sure to examine all ligatures. Missing or broken ligatures should be brought to the attention of the patient’s parent/guardian,who should then inform the orthodontist.

If a rubber or wire ligature is lost, notify the parent/guardian so that the orthodontist may advise whether the patient should be seen.


It’s normal for a patient to have discomfort for a day or two after braces or retainers are adjusted. But it can make eating uncomfortable. Reassure the patient that the discomfort is both normal and temporary. Encourage soft foods. Have the patient rinse the mouth with warm salt water.

Mouth Sores

mouth sores

Some patients are susceptible to episodes of mouth sores. While braces do not cause them, they may be precipitated or exacerbated by an irritation from braces. One or several areas of ulceration of the cheeks, lips or tongue may appear. This is not an emergency, but may be very uncomfortable for the patient. Prompt relief may be achieved by applying a small amount of topical anesthetic (such as Orabase or Ora-Gel) directly to the ulcerated surface using a cotton swab. Instruct the patient to reapply as needed.

Irritation of Lips or cheeks

Irritation of lips or cheeks

Sometimes new braces can be irritating to the mouth, especially when the patient is eating. A small amount of non-medicinal relief wax makes an excellent buffer between metal and mouth. Simply pinch off a small piece and roll it into a ball the size of a small pea. Flatten the ball and place it completely over the area of the braces causing irritation. The patient may then eat more comfortably. Let the patient know that if the wax is accidentally ingested, it’s not a problem. The wax is harmless.

Protruding Wire

protruding wire

Occasionally, the end of a wire will work itself out of place and irritate the patient’s mouth. Use a Q-tip or pencil eraser to push the wire so that it is flat against the tooth. If the wire cannot be moved into a comfortable position, cover it with relief wax. (See Irritation of Lips or Cheeks above for instructions on applying relief wax.) The patient’s parent/guardian will need to make the orthodontist aware of the problem.

In a situation where the wire is extremely bothersome and the patient will not be able to see the orthodontist anytime soon, you may, as a last resort, clip the wire.

Reduce the possibility of the patient swallowing the snipped piece of wire by using folded tissue or gauze around the area. Use a pair of sharp clippers and snip off the protruding wire. Relief wax may still be necessary to provide comfort to the irritated area.

Loose Brackets, Wires or Bands

Loose Brackets, Wires or Bands

If the braces have come loose in any way, the parent/guardian needs to be notified, and they should call the orthodontist to determine appropriate next steps.

Brackets are the parts of braces attached to teeth with a special adhesive. They are generally positioned in the center of each tooth. Then bracket can be knocked off if the patient has eaten one of those hard or crunchy foods orthodontic patients are instructed to avoid, or if the mouth is struck while at play. (Encourage all patients, especially those with braces, to wear a protective mouth guard while playing sports.)

If the bracket is off center, the adhesive may have failed. Call the parent/guardian, and recommend
that they immediately notify the orthodontist, who will determine the course of action.

If the loose bracket has rotated on the wire and is sticking out and the patient cannot immediately be taken to the orthodontist, you can do a temporary fix to alleviate discomfort and prevent further damage. But take care to prevent swallowing or other injury.

To put the bracket back in place, use sterile tweezers to slide the bracket along the wire until it is between two teeth. Rotate the bracket back to the proper position, then slide it back to the center of the tooth.

Piece of appliance is swallowed

This is rare, but when it does happen, it can be fairly alarming to the patient. Encourage your patient to remain calm. If the patient is coughing excessively or having difficulty breathing, the piece could have been aspirated.

If you are able to see the piece, you may carefully attempt to remove it. But do not make the attempt if you could cause harm.

If appropriate under the circumstances, examine the patient’s braces for problems that may result from the missing piece, such as looseness or irritation, and treat as specified above.

If you are unable to see the piece and believe it may be have been aspirated, notify the parent/ guardian and the orthodontist immediately.

Poking Wire

Foods To Avoid

What Sets Us Apart?

Board Certified Orthodontist

Dr. Kopicki became a Diplomate of the American Board of Orthodontics in 2012. Achieving diplomate status involves a rigorous series of exams and presentations of treated orthodontic cases. Not every orthodontist is Board Certified and it is a true testament to her commitment to the field of orthodontics to have undergone this additional testing. You can feel comfortable and confident in her ability to treat you or your children knowing that she has taken the extra step in ensuring her professional expertise.

Individualized Care

We realize that one size does not fit all. Dr. Kopicki will tailor each treatment plan specifically for you and your individualized needs. She will thoroughly discuss all treatment options with you to make sure you feel comfortable and knowledgeable in proceeding with treatment.

New State Of The Art Facility

Germantown Orthodontics is a brand new facility. We trust that when you walk through the door you will feel comfortable and at home in our contemporary, modern and clean office.

All Digital Technology

Germantown Orthodontics utilizes the latest and greatest in orthodontic and dental technology. We are an all digital office including x-rays which reduces radiation dosage to our patients.

One Doctor

Dr. Kopicki strongly believes in continuity of care. She is the only doctor in the office and she will be with you at every step, from the initial consultation visit to the wonderful day when your braces are removed ensuring you receive the best possible care and have the highest level of results possible.


We love to have fun at our office and want to make straightening your teeth as enjoyable as possible. We have regular drawings and contests with great giveaways, and also hand out Germantown Orthodontics swag. During your treatment, we have tons of flavors to choose from for your impressions and over 30 cool colors to customize your braces!