Frequently asked questions about orthodontics

The first examination makes sense once the permanent incisors and the first permanent molars are in place – usually at eight to nine years of age. With unusual jaw growth or a crossbite it can be worthwhile much earlier, sometimes as early as the primary dentition.

Yes. Teeth can be moved at any age, as long as the gums are healthy and enough bone is present. The difference from a child: in adults jaw growth is complete, so growth can no longer be guided. Purely jaw-related misalignments may then require surgery.

For diagnosis and treatment planning, the specialist orthodontist. The ongoing monitoring of caries and gums remains with your family dentist – both are especially important during treatment with a brace.

The fitting itself does not. In the first days afterwards and after each adjustment the teeth are sensitive to pressure; many describe it as a pulling sensation when biting. This subsides after a few days. Persistent pain is not a normal part of treatment and should be looked into.

No. What matters is whether it has consequences: are individual teeth being overloaded, are edges wearing down, has a spot become impossible to clean, is speech affected? Slight crowding of the lower incisors without such consequences is not a compelling reason for treatment.

In the mixed dentition much is still changing. Crowding of the primary teeth can resolve as the jaw grows. A crossbite or a pronounced overbite, on the other hand, does not as a rule grow out – for these misalignments an early visit pays off.

Not automatically. It becomes harmful when the misalignment distributes chewing forces unevenly or when areas develop that brush and floss can no longer reach. Then the risk of caries and of periodontal disease increases.

The orthodontist, based on models, photos and X-rays. The classification into the KIG (German orthodontic indication groups) also determines whether statutory health insurance covers the treatment.

The one that fits the findings. There is no design that is superior to all others. With pronounced misalignments there is usually no way around a fixed brace; for minor corrections in the front area, aligners come into consideration; during growth, a removable appliance guides the jaw.

Within limits. If several approaches are professionally justifiable, you have a say. If only one is suitable, the practice should say so clearly – and give reasons. Ask them to explain what can be achieved with the method you prefer and what cannot.

Depending on the extent of the correction, one to three years. This is followed by stabilisation with a retainer, and that takes considerably longer – often permanently.

No. Lingually bonded brackets sit on the inside of the teeth and are invisible from the outside. Aligners are barely noticeable in conversation. Both options are more expensive than the classic fixed brace on the outside.

Between eight and nine years of age, once the permanent incisors and the first permanent molars have come through. If your dentist notices something before then – a crossbite, strongly protruding incisors, an open bite – then earlier.

A consultation, an examination of the teeth and jaw joints, usually impressions or a scan, photos and a panoramic X-ray. From this comes the assessment of whether and when treatment should take place. As a rule, no treatment is carried out at this appointment.

No. It has clear indications and usually does not replace the later treatment but comes in addition to it. Without such an indication, waiting is the better decision – it spares the child years with an appliance.

Raise it at the practice instead of fighting it out at home. With removable appliances, wearing time decides success; if it is not achieved, a fixed brace is often the more honest solution. Some practices read the wearing time from a sensor – that takes the argument out of the family.

Medically yes, if the malocclusion has consequences – for instance overloading individual teeth or making cleaning difficult. Treatment tends to take somewhat longer in adults because bone remodelling is slower. The result is not affected by this.

As a rule, no. Statutory health insurance only covers orthodontic treatment up to the 18th birthday. The exception is severe jaw misalignments in which orthodontics and surgery have to be combined.

Yes, in two ways: with aligners or with brackets bonded on the inside. Both are more expensive than the classic fixed brace. Which option comes into consideration depends on how far the teeth need to be moved.

Usually not. Brackets adhere less well to ceramic than to enamel, but there are solutions for that. A bridge, however, rigidly connects several teeth – it might have to be separated beforehand. That belongs in the planning, not among the surprises.

If the statutory health insurance covers the treatment, you initially pay the co-payment of 20 percent and get it back after successful completion. Without coverage, or for adults, the amount depends on the scope: the number of teeth to be moved, the duration, the type of appliance. The figure only becomes reliable with the written treatment and cost plan.

Kieferorthopädische Indikationsgruppen – the German orthodontic indication groups. The orthodontist measures the findings and assigns them to one of five grades. From grade 3 upwards, statutory health insurance covers the treatment. The classification is tied to measurable values, such as the overbite in millimetres.

Yes, in full once the treatment has been successfully completed. If the treatment is discontinued or ends without a final report, there is no refund. Submit the receipts to your health insurance after completion.

Only if it was taken out before the diagnosis. Almost all policies exclude treatments that have already been recommended or are under way. Anyone who takes out the insurance only after the orthodontist has recommended a brace pays premiums without receiving benefits.

One to three years of active treatment, depending on the extent of the correction. This is followed by stabilisation with a retainer – that takes considerably longer and is permanent for many.

With a fixed brace every four to eight weeks, with aligners at longer intervals but with aligner changes at home. In addition, the check-ups with your family dentist continue – monitoring for caries is especially important during treatment.

Don't bite into anything hard – better to cut apples, carrots and bread crusts into small pieces. Nothing sticky like caramel or chewing gum, which loosens the brackets. And as little sugar as possible between meals, because cleaning is already more difficult.

That is decalcified enamel around the brackets, caused by plaque that was left sitting there. The spots remain visible after the brace is removed and can only be treated to a limited extent. The only reliable protection is thorough cleaning throughout the entire wearing period.

That is decided by the findings, not by appearance. Treatment is given when the malocclusion has consequences or will foreseeably have them – overloaded teeth, worn-down edges, areas that cannot be cleaned, or a bite that forces the jaw joint. Ask to have the classification explained to you.

For children and adolescents with a pronounced malocclusion, statutory health insurance covers the treatment; you advance 20 percent and get it back after successful completion. For minor misalignments and for adults, the treatment has to be paid privately. The figure only becomes reliable with the written cost plan.

Yes – with aligners or with brackets bonded on the inside. Both are more expensive than the classic fixed brace and not suitable for every case. What is possible in your case is determined by the examination.

One to three years of active treatment, depending on the extent. This is followed by stabilisation with a retainer, which accompanies many people permanently.

Statutory health insurance covers the treatment if the front-tooth overjet is more than six millimetres; between three and six millimetres it only steps in if there are additional findings. Treatment can be medically worthwhile below that too – then paid privately.

No. The position of the jaws changes during growth, but not in the direction of compensation. A pronounced overbite persists without treatment and can even become worse through habits.

The overbite describes the distance to the front, the deep bite the overlap downwards: with a deep bite the upper incisors cover the lower ones too far. Both can occur together.

No. Tooth and jaw movements need sustained pressure; exercises alone do not move teeth. Myofunctional therapy can accompany a treatment by correcting tongue and lip function – it cannot replace the appliance.

As soon as it is detected. Unlike with most malocclusions, here you do not wait for the change of teeth. Treatment in the primary or early mixed dentition can avoid a later operation or at least reduce its extent.

Often yes – jaw size is strongly hereditary. But there are also acquired forms, for instance through a forced bite: if the teeth do not fit together, the child pushes the lower jaw forward, and that shapes development.

During growth, in many cases yes. After growth, the teeth can be positioned so that they interlock correctly, while the jaw position itself remains. How far that goes depends on the severity.

The lower jaw is forced out of its natural position when biting because the teeth would otherwise not fit together. This strains the jaw joint and can steer jaw development in the wrong direction. A forced bite should be examined promptly.

As a rule yes, and promptly. It does not grow out, and the longer the lower jaw deviates when biting, the more it shapes the development of the joint and the face.

A fixed appliance is anchored to the upper molars. A screw in the middle is turned a little each day and stretches the palatal suture. The resulting gap fills with bone. The active phase lasts a few weeks, after which the appliance stays in place for a few more months for stabilisation.

When the screw is turned you feel pressure behind the nose, and sometimes the teeth briefly feel wobbly. Pain in the true sense is rare. A gap between the upper incisors is intended and closes again by itself.

Yes, but differently. The palatal suture has fused; expansion then requires surgical support. If individual teeth are in crossbite, an ordinary orthodontic correction is often enough.

If the cause disappears early – for instance thumb sucking ends at age four – a mild open bite in the primary dentition can still close. If the habit continues or there is tongue thrusting, this does not happen.

An exercise programme for the tongue, lips and cheeks, usually guided by speech therapists. The aim is for the tongue to rest against the palate when swallowing and at rest, instead of between the teeth. It does not replace a brace, but without it the result often does not last.

Biting off is difficult – many cut or tear their food instead. Chewing works via the back teeth, which as a result carry more load than they should.

The part that removes the cause takes months and depends on cooperation. The subsequent tooth correction is within the usual range of one to three years. The open bite is considered one of the malocclusions with the highest risk of relapse.

Not dangerous, but wearing. The abrasion on the incisors is irreversible; lost enamel does not grow back. The earlier the bite is corrected, the less substance is lost.

Because the lower ones grind along the inner surface of the upper ones when biting. With a deep bite this happens with every swallow – around a thousand times a day. That adds up over the years.

To a limited extent. Lifting the front teeth and bringing the back teeth further out are vertical movements, and that is where aligners are at a disadvantage. Mild deep bites can be treated; pronounced ones as a rule require a fixed brace.

They are two different measurements: the overbite measures to the front, the deep bite downwards. They often occur together because both have the same underlying cause – a lower jaw positioned too far back.

No, and it is not the first choice either. With a few millimetres of space shortage, widening or slight polishing of the contact surfaces is enough. Only with a larger deficit does the removal of teeth come into consideration – usually the first premolars.

Late crowding of the lower front teeth is widespread and also occurs without previous treatment, often between the ages of 20 and 40. After orthodontic treatment, a retainer is the only reliable protection against it.

The targeted slimming of the contact surfaces between the teeth, technically known as interproximal enamel reduction. Only a few tenths of a millimetre per surface are permitted; the enamel remains intact. Carried out correctly, the procedure does not increase the risk of caries.

Not directly, but it favours it. Where teeth overlap, plaque remains that the brush cannot reach. Whether that turns into caries is decided by oral care – it is simply more difficult in such places.

As a rule one to three years, depending on the extent of the correction. This is followed by the retainer for stabilisation.

The bonding itself does not. In the first days and after each adjustment the teeth are sensitive to pressure, especially when biting. At first the brackets can chafe against the cheek and lip – there is protective wax for that. Both subside.

Do not reattach it yourself. If it is still sitting loosely on the archwire, leave it there and call the practice; if it has fallen off, keep it. A single missing bracket is not an emergency, but it should be rebonded promptly, otherwise the tooth no longer moves along.

Don't bite into anything hard – cut apples, carrots and bread crusts into small pieces first. Nothing sticky like caramel or chewing gum. And as few sweet things as possible between meals, because cleaning is already more difficult.

As a rule 14 to 16 hours. The practice will tell you exactly what applies – and success depends on it. A brace that is only worn at night, although 16 hours would be needed, prolongs the treatment without moving it forward.

Raise it at the practice instead of fighting it out at home. If the wearing time is persistently not achieved, a fixed brace is the more honest solution – it works without cooperation. That is not a failure, but an adjustment to reality.

Daily with a brush and cool water, without toothpaste – it roughens the plastic. Cleaning tablets occasionally, not daily. Never place it in hot water, the plastic warps.

Report it to the practice immediately. A new one has to be made, and in the meantime the teeth move back. The longer the gap, the more of what has been achieved is lost.

Barely visible is more accurate. Up close and in certain light you can see the aligner, especially the bonded attachments. In conversation, most people do not notice them.

For mild to moderate corrections, above all in the front area: crowding, gaps, tilted teeth. Pronounced bite misalignments, severe rotations and vertical movements are their weak point.

They are a private service, even for children and adolescents with insurance coverage – the insurance pays for the standard care, not for the aligner. The amount depends on the number of aligners and is set out in the cost plan before treatment begins.

They are taken out for eating; afterwards the teeth are brushed and the aligner is put back in. With the aligner in, only water may be drunk – sugary or hot drinks damage the tooth underneath or deform the plastic.

Continuously for the first one to two years. After that, experts today assume that permanent stabilisation is necessary if the result is to last. A fixed retainer therefore often simply stays in place.

Go to the practice promptly. A wire that is only attached to some of the teeth can move individual ones – in an uncontrolled way. That is worse than no retainer at all.

Not the wire itself, but the plaque that collects on it. Tartar forms more easily under the retainer. Anyone who keeps it clean there with floss and interdental brushes has no disadvantage; anyone who neglects it gets gum inflammation in exactly that spot.

Hardly in the area the retainer holds. The back teeth, however, are not secured, and late crowding of the lower front teeth also occurs without previous treatment. That is why the retainer belongs in the regular dental check-up.

No. Without a clear indication it only prolongs the overall duration. The benefit is limited to certain findings – for those, however, it is considerable.

For the recognised indications yes, independently of the later main treatment. The classification is made as usual via the KIG (German orthodontic indication groups).

Usually six to eighteen months. This is generally followed by an observation phase until the change of teeth is complete, and only then is it decided whether a main treatment becomes necessary.

Yes, if there is an indication – for instance a crossbite. Without one it is not sensible. Ask for the reasons and for what happens if you wait instead.

Somewhat, yes. A dummy shaped to be kind to the jaw distributes the pressure better than a thumb, and it can be given up without taking something away from the child that is always at hand. The time limit applies to both.

Address it, don't punish. Have the tooth position looked at – if an open bite is already showing, that is an indication for early treatment. Orthodontic aids can support the weaning process when persuasion is no longer enough.

In the primary dentition often yes, if the habit ends in time. Once the permanent incisors have erupted into the wrong position, it remains.

The mouth is open at rest, the child snores or sleeps restlessly, the lips are dry. Constant mouth breathing is not a matter of habit but usually has a cause in the nose or throat – that should be investigated before orthodontic treatment begins.

The orthodontist, based on the measurements of models and X-rays. The classification goes to the health insurance together with the treatment plan, which reviews it – in some cases through the Medical Service (Medizinischer Dienst).

Against the insurance's rejection, yes. This makes sense if findings were not taken into account or the condition has changed. The measured values themselves, however, are determined objectively and do not change through an appeal.

Then the treatment has to be paid privately. Ask what consequences are to be expected without treatment – with some findings they are minor, with others not. And have the classification redone after one to two years: during growth the findings can shift.

No. For adults, statutory health insurance does not pay as a matter of principle, regardless of severity. The exception is severe jaw misalignments that are treated jointly by orthodontics and surgery.

Three minutes is the minimum, five is more realistic. The time required increases because every bracket has to be cleaned around individually and the area under the archwire needs its own attention.

Both work. An electric brush with a small head takes some of the work off you, but it does not replace the interdental brushes. More important than the device is that every surface is really reached.

They develop where plaque remains permanently: the enamel loses mineral. Some of it can be restored through fluoridation if you react early enough. Spots still present when the brace is removed usually remain visible.

Yes, at longer intervals. It reaches what is left behind at home and provides an opportunity to correct your brushing technique. It is a private service.

Two to three days, most strongly on the first evening and the second day. Then it subsides. After each adjustment this repeats in a milder form.

As a rule yes, but discuss it with the practice. Some active ingredients are suspected of slowing down bone remodelling – with occasional use this plays no role, with continuous use it can.

Cover the spot with protective wax and ask for an appointment. Do not cut anything off yourself – cut-off pieces of wire can be swallowed, and the archwire is part of the plan.

Slight mobility during active treatment is normal; the tooth is moving, after all. If the loosening increases or persists after completion, it should be examined.

For a correction of the front teeth often six to twelve months, for more extensive findings up to two years. The number of aligners is fixed at the start – and with it the planned duration.

The teeth cannot keep up with the plan, and at some point the next aligner no longer fits. Then a new scan and a new plan are needed – that costs time and, depending on the agreement, money as well.

The professional societies advise against them. Without an X-ray it is impossible to judge how much bone supports the teeth and whether a root is damaged. Moving teeth without this knowledge is a risk borne by the patient alone.

Yes, just as after a fixed brace. Relapse does not depend on the type of treatment but on the tissue. Without a retainer the teeth drift back.

Not fundamentally. With small corrections they can be faster because there is less to move. With the same findings there is no reliable time advantage – the bone remodels at the same speed in both cases.

As a rule yes, and for children and adolescents with insurance coverage always: the insurance pays for the standard care, the aligner is a private additional service. For adults both options are paid privately; there the difference depends on the scope.

Yes, that happens – for instance when aligners reach a limit or the wearing time is not achieved. A switch costs time and usually money as well; it should therefore already be discussed as a possibility during planning.

They exist: first a fixed brace for the difficult movements, then aligners for the fine-tuning. Or brackets on one jaw only. Such approaches are not unusual and are often the most sensible solution.

Only for simple cases. Where individual teeth have to be positioned precisely, there is no way around brackets. A removable brace can, however, prepare the way for the fixed one and thereby shorten it.

Because the two do different things. During growth the jaw can be guided – that is the task of the removable appliance. The precise positioning of the teeth comes afterwards and requires brackets.

Then nothing happens, and the treatment drags on without progress. Raise the issue. A fixed brace is then often the more honest solution than another six months of persuasion.

After the screw is adjusted it presses for a day or two. If it constantly chafes in one spot, it needs to be adjusted – that is not something to endure, it is a reason for an appointment.

That depends on the policy. Many private insurers and supplementary policies reimburse orthodontic treatment in part, some with maximum amounts or age limits. Submit the cost plan before treatment begins and get the commitment in writing.

Because a separate aligner is made for each stage of treatment – often twenty, thirty or more. On top of that comes the digital planning. The fixed brace, by contrast, works with the same brackets from start to finish.

That depends on the agreement. Some offers include a certain number of additional aligners, others charge for each one individually. Ask about this before you sign – follow-up corrections are common, not the exception.

Many practices offer this, sometimes through an external provider. Pay attention to whether interest is charged and what happens to the remaining instalments if the treatment is discontinued.

If visibility matters to you, yes – it is an aesthetic decision, not a medical one. Expect them to break more easily and the treatment possibly to take a little longer.

The brackets themselves hardly, but the elastic rings do – through coffee, tea, curry, red wine. They are changed at every appointment. Anyone who chooses self-ligating ceramic brackets avoids the problem.

They are charged per tooth; the amount is stated in the additional-cost agreement, which must be signed before treatment begins. Ask to be shown whether only the front teeth or all teeth are meant – many practices offer both.

Bonding and removal cost a very thin layer of enamel – that is harmless. What really causes damage is plaque that sits around the bracket for months.

In the first weeks, yes, especially with s and sh sounds. The tongue needs time to get used to the changed shape. For most people it is no longer an issue after two to four weeks; anyone who speaks a lot professionally should schedule the start accordingly.

The pressure on the teeth is the same. In addition, the tongue can become sore at first where it rubs against the brackets. Protective wax helps during this period.

With very short tooth crowns, the bracket finds too little hold on the inside. A very deep bite can also be a reason to take a different approach first. The examination clarifies this.

Considerably more than a fixed brace bonded on the outside, and usually more than aligners as well. The exact amount depends on the system and the extent of treatment and is stated in the treatment and cost plan.

When the screw is turned, there is a feeling of pressure behind the nose that subsides after minutes. Pain in the true sense is rare. If a child complains more strongly, the screw can be turned more slowly – ask at the practice.

It is intended and is the visible sign that the suture is opening. It closes by itself within a few weeks after the end of the active phase, because the fibres between the teeth pull the crowns back together.

Usually the parents, following precise instructions and mostly with a key handed out by the practice. What matters is keeping to the schedule: every day at the same time, and no catching up if a day was missed – ask instead.

In many children, yes, because widening the upper jaw also broadens the floor of the nose. That does not make it a therapy for nasal breathing – if there is a cause in the throat, it needs to be investigated as well.

No. Household adhesives do not belong in the mouth, and the position of the bracket determines the movement of the tooth – it is planned to a tenth of a millimetre.

Usually not on the same day. Call and describe the situation; the practice will tell you how urgent it is. But do not wait until the next regular appointment in eight weeks.

Wax on anything that rubs, soft food, and call on Monday. A real emergency is only an injury that bleeds, or a tooth loosened by a blow – that is what the emergency dental service is for.

This happens often – the brace ends up in the napkin and then in the bin. Report it to the practice; a new one takes time. A container for the brace that does not look like a napkin prevents a repeat.

No. Enamel does not form anew. What is possible is the redeposition of mineral into the porous area – this reduces the contrast but rarely makes the spot disappear completely.

Bleaching lightens the healthy enamel as well – the difference remains or even becomes more pronounced. Caries infiltration is the approach that targets the spot directly.

They are the preliminary stage: mineral has left the enamel, but the surface is still intact. If it progresses, the surface breaks down – then it is tooth decay and must be filled. That is exactly why early detection counts.

Hardly. The aligner is taken out for brushing, so the tooth surface remains freely accessible. That is the greatest practical advantage of aligner treatment.

No. Nothing is operated on and no anaesthesia is given. A normal appointment, to which you come well fed and rested.

For treatment planning, yes. Without an image, nobody knows which teeth are present, where they lie and how much bone supports them. Existing images from your family dentist can be brought along and save taking a new one.

Usually 30 to 60 minutes, depending on whether impressions and images are taken at the same time. Discussing the finished plan is often a second, shorter appointment.

For those with statutory health insurance, the examination is covered. Additional services – such as a three-dimensional image or a digital scan instead of impressions – can be charged privately and should be discussed beforehand.

In the mixed dentition, often yes. After the change of teeth is complete, usually not any more – then it stays if nothing is done.

Medically, usually not. It is an aesthetic decision, and statutory health insurance generally does not cover it. It is different if the gap is part of a larger finding.

The neighbouring teeth tip into it over time, and the opposing tooth grows into the gap. Both make later restoration more difficult. Anyone who wants to keep the gap open needs a space maintainer.

With a lateral incisor, the gap can often be closed elegantly by moving the canine into its place and reshaping it. With molars, closing is more involved. The decision should be coordinated between orthodontist and dentist, not taken one after the other.

By the title itself: "Fachzahnärztin für Kieferorthopädie" or "Fachzahnarzt für Kieferorthopädie" (specialist dentist for orthodontics). Additions such as "Spezialist" (specialist) or "Tätigkeitsschwerpunkt" (practice focus) are something else. If in doubt, ask directly.

Yes. The orthodontist checks the position of the teeth, not the teeth themselves. During brace treatment, the regular check-ups with your family dentist are more important than usual, because cleaning is more difficult.

No. You can go to an orthodontic practice directly. In practice, the family dentist often refers because something has caught their eye – but it is not necessary.

There is no blanket answer. With simple findings, it can go well. With pronounced malocclusions, with children who are still growing and with combined treatments, the training speaks for the specialist.

Through cooperation, yes: keep to the wearing times, attend the appointments, report incidents quickly. Through technology, hardly – the speed of bone remodelling cannot be negotiated.

Bone remodelling runs somewhat more slowly, and the growth that helps in children is missing. The difference is measurable but not dramatic – and it changes nothing about the result.

With a fixed brace, often after just six to eight weeks, especially in the front area. That is encouraging, but it says little about the total duration – the last millimetres take the longest.

The teeth stay where they happen to be – frequently in an intermediate state that is worse than the starting point. With statutory insurance treatments, the reimbursement of your own contribution is also forfeited.

Better not. Chewing gum pulls on the brackets and gets caught on the archwire. Sugar-free chewing gum is kind to the teeth, but it causes the same mechanical problem.

Popcorn is tricky because of the hard kernels, crisps because of the sharp edges that lodge between bracket and gums. Neither is forbidden, but they end in an extra appointment more often than other foods.

Yes. The question is asked more often than it is spoken out loud. It feels unfamiliar, nothing more.

Not with the aligner in place: heat deforms the plastic, and coffee stains it. Aligner out, drink, brush your teeth, aligner back in.

Yes, as long as the teeth that are to be moved have their own roots. The implant stays where it is. Whether that fits the treatment goal is shown by the planning.

Not necessarily, but it happens. If the tooth stands differently afterwards, the shape may no longer fit; with front teeth this is more noticeable. Factor in the possibility before you begin.

Often yes. If it has to be cut, a gap arises that is restored in the meantime. That is effort, but not a reason for exclusion. Have the orthodontist and dentist plan together.

Then the first question is whether the gap is closed, or kept open and restored. Both are possible; the decision is made before treatment, because it determines the entire course.

As a rule, no. The treatment then counts as already advised and is excluded. Ask the insurer in writing before you sign – a verbal statement is no help in a dispute.

Some plans pay precisely when statutory health insurance does not – that is, for KIG 1 and 2. Others only pay in addition to the statutory benefit, that is, from KIG 3 upwards. This is the point where plans differ most.

If orthodontic services are included, usually yes – but often capped. Submit the treatment and cost plan before treatment begins and get the commitment in writing.

After the waiting period, which is eight months to two years depending on the plan. Some plans waive it – then the graduated limits in the first years are usually all the stricter.

The fixed one, because it cannot be forgotten. But it only holds the teeth it is bonded to – usually the six front teeth. For the whole arch, a removable retainer is needed.

The first one to two years continuously. After that, the profession assumes permanent stabilisation if the result is to last. A fixed wire therefore often simply stays in place.

It is usually a private service, even after treatment covered by statutory health insurance. The amount belongs in the treatment and cost plan before treatment begins – together with the question of who pays for a replacement if it is lost.

After a few days, no. The tongue rests against the inside and gets used to it quickly. It is noticeable at first; later, most people forget it – which is exactly the point.

Below about twelve hours a day, little happens; the usual target is 14 to 16. That is not a safety margin but the value the planning is based on.

Report it to the practice, without drama. A lost appliance often says more about willingness to be treated than about attentiveness – that is a reason for a conversation, not for reproaches.

In many cases yes, as long as no time window is missed. With growth-dependent treatments – underbite, palatal expansion – it is not possible; there, the opportunity closes as growth ends.

Sometimes in the short term. Over two years, it rarely carries. What carries longer is the child understanding what it is all about – and experiencing the treatment as its own, not as its parents' treatment.

Roughly at 16 to 18 in girls and 18 to 21 in boys – individually very different. The orthodontist estimates it from an X-ray, not from the date of birth.

Often because the tongue has not shaped it from the inside – typical with constant mouth breathing, for example due to enlarged adenoids. A high, pointed palate and a crossbite are the common consequences.

Guided, yes; created, no. An appliance can influence the direction of existing growth and steer the lower jaw into a more favourable position. It cannot make a jaw grow that is not growing.

Yes, lifelong. Late crowding of the lower incisors between 20 and 40 is widespread and also occurs without any previous treatment – one reason why retainers are thought of long-term today.

Because it does not act on individual teeth but sets both jaws in relation to each other. That takes bulk. It is almost always unfamiliar during the first nights; after one to two weeks it is usually no longer an issue.

Only to a limited extent with the removable appliances – which is why they are worn at night and in the evening hours. The fixed Herbst appliance leaves speech largely unaffected.

An appliance that is supported at the neck or head via an external part and slows the forward growth of the upper jaw. It is used less often today than in the past, because it is visible and demands a lot of cooperation – but for certain findings it remains the right solution.

Usually not. It aligns the jaws with each other; the exact tooth position comes afterwards. Both together make up the total duration – the treatment plan should state this from the outset.

It can, because the archwire experiences more friction in the ceramic slot. The difference is usually small and hardly matters with modern bracket designs – but it has been described.

More often than metal brackets, especially when biting into something hard. Every break means an additional appointment and, depending on the agreement, additional costs.

Removal is more involved than with metal, because the ceramic bonds more firmly and is brittle. Carried out professionally, the tooth remains unharmed; a very thin layer of enamel is lost with every bracket removal, regardless of the material.

It pays the share that falls to the standard care – that is, what metal brackets would have cost. The difference is private and belongs in an additional-cost agreement before treatment begins.

No. It is the expected reaction of the tissue. An error would be failing to point it out or not providing for a retainer.

The first changes can occur within weeks, especially in the first year. After that it slows down, but it does not stop.

As a rule, no. A completed orthodontic treatment is not covered twice. Follow-up corrections are a private service.

Have the situation looked at. Often the change is smaller than feared, and a new retainer holds what is still in place. Where things have already shifted noticeably, a short follow-up correction is the alternative.

For minor corrections, yes – this is often offered as a short aligner treatment. The limit lies where the change at the front affects the occlusion at the back. Then it is not enough.

Yes, considerably. But whether it is sufficient is a professional question. A result that does not last after two years is the more expensive option.

Because the lower teeth form the counterpart for the upper ones. If teeth are moved on top, the occlusion has to fit again at the end – and for that, the bottom often has to be at least stabilised.

It is possible, but it is usually more involved than complete treatment from the start. And statutory health insurance generally does not cover a second treatment.

They can remove a cause – for example tongue thrusting that sustains an open bite. They do not correct an existing malocclusion. Sensible as an accompaniment, not as a replacement.

The professional societies advise against offers where the impression is taken at home and no practice is ever entered. The X-ray is missing, and with it the basis for recognising risks.

For appearance, yes; for function, no. An uneven bite remains uneven, even if the front looks straight. And the removal of tooth substance is final.

No. They shift lifelong, but not towards order – late crowding of the lower front teeth is the best example of that.

That depends on which tooth it is and how long it will be until the successor arrives. With a primary molar that is lost years before the change of teeth, a space maintainer usually makes sense. Have it looked at instead of waiting.

With the lower incisors this is common and often sorts itself out when the milk tooth falls out. If the milk tooth stays firmly in place, it should be extracted. Have it looked at promptly.

At around eight to nine years, when the permanent incisors are in place. That is why the first orthodontic examination is set at this age.

About six years, from age six to twelve. The wisdom teeth come – if they come – considerably later, usually between 17 and 25.

No. Nothing is drilled and nothing is injured; the brackets are bonded to the tooth surface. Anaesthesia would serve no purpose.

It is a short, firm push per tooth – unpleasant, but over before you really notice it. The teeth are sensitive for a day or two afterwards.

Usually yes – unless white spots have formed. These only come to light now. The gum line also needs a few weeks to settle down.

With polishing and retainer, one to two hours. Do not schedule it into a lunch break.

A serious figure only exists after the examination. The range is wide, because a short front-tooth correction and the treatment of an entire bite are hardly comparable. Do not be taken in by figures from advertising.

Proportionately, depending on the plan. Submit the treatment and cost plan before treatment begins and get the commitment in writing – information given over the phone is no help later.

As an extraordinary burden (außergewöhnliche Belastung), insofar as it is medically justified and above the reasonable personal contribution. The justification should be evident from the documents. If in doubt, ask your tax adviser – only they can assess this reliably.

The price difference is real, and so is the aftercare. Orthodontic treatment needs check-up appointments every four to eight weeks over a period of years. Anyone who cannot manage the journey on a lasting basis should leave it.

No. A dental implant fuses with the bone and carries a tooth replacement. The orthodontic screw only grips mechanically, is much smaller and is removed again after treatment.

Not under local anaesthesia. Afterwards, the spot is sensitive to pressure for one to two days, comparable to the feeling after the brace has been adjusted.

It happens, especially if the gums around it become inflamed. It is then removed and placed again at another spot. Careful cleaning lowers the risk considerably.

As a rule, no – it counts as a private additional service, even if the rest of the treatment is covered by the insurance. The amount belongs in the additional-cost agreement in advance.

No. You can go to an orthodontic practice directly. The family dentist often refers because something has caught their eye – but it is not necessary.

For those with statutory health insurance, the examination is covered. Additional services such as a three-dimensional image can be charged privately – that should be said beforehand, not put on the bill.

By the title itself. It is protected and requires three years of further training with an examination. Additions such as "Tätigkeitsschwerpunkt" (practice focus) or "Spezialist" (specialist) are something else.

Because the directory is still being built up. It does not show which practices exist, but which have registered. Feel free to ask your practice whether it would like to register.