All About Orthodontics

First Visit

When is the best time to begin orthodontics?
Though we can enhance a smile at any age, there are optimal time periods to begin treatment. Beginning treatment at these times ensures the best result and the least amount of treatment time and expense. The American Association of Orthodontists recommends that the initial orthodontic evaluation should occur at the first sign of orthodontic problems or no later than age 7. At Dentistry for Children, we do an orthodontic exam at every child's first visit and at each and every checkup visit thereafter.

What are the benefits of early orthodontic evaluation?
Early evaluation provides both timely detection of problems and greater opportunity for more effective treatment. Prudent intervention guides growth and development, preventing serious problems later. When orthodontic intervention is not necessary, our pediatric dentists and orthodontists carefully monitor growth and development and begin treatment if and when it is ideal.

Why is age 7 orthodontically important?
By the age of 7, the first adult molars erupt, establishing the back bite, and the front teeth begin to emerge as well. During this time, we can evaluate front-to-back and side-to-side tooth relationships. For example, the presence of erupting incisors can indicate possible overbite, open bite, crowding or gummy smiles. Timely screening increases the chances for an incredible smile.

What are the advantages of interceptive treatment?
Some of the most direct results of interceptive treatment are:

Creating room for crowded, erupting teeth
Creating facial symmetry through influencing jaw growth
Reducing the risk of trauma to protruding front teeth
Preserving space for unerupted teeth
Reducing the need for tooth removal
Reducing treatment time with braces

Is your child a candidate for orthodontic treatment?
Orthodontics is not merely for improving the aesthetics of the smile; orthodontic treatment improves bad bites (malocclusions). Malocclusions occur as a result of tooth or jaw misalignment. Malocclusions affect the way your child smiles, chews, brushes and flosses and feels about her/his smile.

Why should malocclusions be treated?
According to studies by the American Association of Orthodontists, untreated malocclusions can result in a variety of problems:

Crowded teeth are more difficult to properly brush and floss, which may contribute to tooth decay and/or gum disease.
Protruding teeth are more susceptible to accidental chipping.
Crossbites can result in unfavorable growth and uneven tooth wear.
Openbites can result in tongue-thrusting habits and speech impediments.

Ultimately, orthodontics does more than make a pretty smile – it creates a healthier child and adult.

Interceptive Orthodontics

Two-phase treatment

Two-phase treatment occurs when a patient is evaluated and needs intervention before starting regular orthodontic treatment, resulting in two separate treatment periods.

The first phase of treatment, Phase I, usually occurs when the patient is a child and still has his or her primary teeth. The Phase I treatment plan can include preventive, interceptive or modifying treatment. Orthodontic appliances may be placed to prevent a problem from occurring, to correct a current problem or damage caused by a habit such as a thumb, finger or pacifier, or to help direct jawbone growth. Various conditions related to tooth alignment, gums, jaws and facial asymmetries can be corrected with Phase I treatment. Another common added benefit of Phase I treatment is less Phase II treatment time.

Typically, Phase II treatment is 'normal' orthodontic treatment. This involves placing braces on the patient once his or her permanent teeth have erupted. The braces straighten the permanent teeth and finish correctly aligning the patient’s jaw.

Patients who have undergone both Phase I and Phase II treatment are more likely to have lasting results. Our goal for your child's two-phase orthodontic treatment is to give your child correctly aligned teeth that provide ideal jaw function and a great smile!

Adult Orthodontics

Braces aren’t just for kids anymore. Tooth alignment can be changed at any age if your gums and bone structure are healthy. We offer a variety of treatments that are designed for different age groups – including adults. A new smile can begin today.

Orthodontic treatment in adulthood can dramatically improve your personal appearance and self-esteem. Improving the health of your teeth and gums is equally important. Crooked teeth and a bad bite can contribute to gum and bone loss, tooth decay, abnormal wear of tooth enamel, headaches and jaw joint (TMJ/TMD) pain.

Good news! The new techniques and appliances we use greatly reduce discomfort levels, decrease the frequency of visits, shorten treatment time and may allow you to choose from several options. Your options may include metal braces, translucent braces, tooth colored braces, Invisalign™ or transparent aligners that can be worn at night to improve mild cases of misaligned teeth.

During your initial examination, we will be able to determine the best possible treatment for your individual needs and outline a recommended treatment plan, anticipated treatment time and the approximate cost.

A significant number of our patients are adults, and they all agree that it’s never too late to improve your smile.

Invisalign®

Invisalign is the clear way to straighten teeth without braces, using aligners. Aligners are removable and virtually invisible, which means you can straighten your teeth without anyone knowing; and you can still eat and drink what you want. Also, you can brush and floss normally to maintain healthy gums and teeth; and there are no wires, metal or brackets to cause mouth abrasions.

Some of our patients who had never considered traditional braces are now happily and comfortably improving their smiles with Invisalign.

What is Invisalign?

Invisible way to straighten your teeth without braces.
Series of clear, removable, custom-made Aligners.
Uses no metal wires or brackets.
Custom-made for comfort.

How does Invisalign work?

Wear each set of Aligners for about two weeks.
Remove only to eat, drink, brush and floss.
Your teeth will move gradually each week.
Visit us every 8-10 weeks.
Total treatment time averages 6-15 months.
Average number of Aligners is between 18 and 30.

Information About Appliances

Spacers | Foods to Avoid | Rapid Palatal Expander
Elastics | Headgear | Retainers

Spacers

Spacers - also known as separators - are small elastics that fit snugly between certain teeth to move them slightly so bands can be placed around them later. Separators can fall out on their own if enough space has already been created. If a separator falls out more than a day prior to the scheduled band fitting appointment, however, call our office top arrange to have it replaced. Gum and sticky candy must be avoided while wearing separators.

Foods to Avoid

For most situations, common sense will tell you and your child what to avoid. Hard foods, sticky foods and foods high in sugar must be avoided. Hard foods can break or damage wires and brackets. Sticky foods can get caught between brackets and wires. Minimize sugary foods - they cause tooth decay and related problems. Nail biting, pencil and pen chewing and chewing on foreign objects should be avoided.

Examples of Sticky Foods to Avoid:
Gum (sugar-free or regular)
Licorice
Sugar Daddies
Toffee
Tootsie Rolls
Caramels
Starburst

Examples of Hard Foods to Avoid:
Ice
Nuts
Hard taco shells
French bread crust/rolls
Corn on the cob
Apples and carrots (unless cut into small pieces)
Bagels
Chips
Jolly Ranchers
Pizza crust
Uncooked carrots (unless cut)

Minimize Sugary Foods like:
Cake
Ice Cream
Cookies
Pie
Candy

Only Once a Day:
Soda
Sweetened tea
Gatorade
Kool-Aid
Drinks with sugar

It’s important to regularly check braces at home for bent or loose wires and brackets. In the event of a loose/broken wire or bracket, call our office immediately to arrange an appointment for repair.

Rapid Palatal Expander

Attached to the upper molars through bonding or by cemented bands, the Rapid Palatal Expander is an orthodontic device used to create a wider space in the upper jaw. It is typically used when the upper jaw is too narrow for the lower jaw or when the upper teeth are crowded or blocked out of the dental arch.

When patients are still growing, their connective tissue between the left and right halves of their upper jaw is very responsive to expansion. By simply activating the expander through turning a screw in the center, with a special key we provide, gradual outward pressure is placed on the left and right halves of the upper jaw. This pressure causes an increased amount of bone to grow between the right and left halves of the jaw, ultimately resulting in an increased width.

Elastics

Elastics are a vital part of treatment and are also contingent upon patient compliance. They add extra pressure to the braces to help move the teeth. Generally worn at all times (excluding eating and tooth brushing ), elastics should be changed at least once a day. They come in various sizes as they are each used for a specific purpose. We will provide the appropriate size.

It is important to wear them consistently or treatment setbacks may occur. If only one day is missed, it could cause teeth to shift back to their original position!

Headgear

Headgear is often used to correct an excessive overbite. This is done by placing pressure against the upper teeth and jaw to hold the teeth in position or help move them into better positions. The severity of the problem determines the length of time headgear needs to be worn. The key to success with the headgear appliance is consistency. Headgear must be worn a certain number of hours per day, and if not, it must be made up the following day.

Headgear should never be worn while playing sports and should also be removed while eating or brushing.

Retainers

When we remove braces at the end of active treatment, we begin the retention stage of treatment. The retention phase lasts for a minimum of 24 months and often indefinitely. The final orthodontic result depends on retainers, so follow through with the hard work you or your child have put in so far. Remember to remove the retainers before brushing, and brush the retainers before placing them back in the mouth.

Orthodontic Videos

Introduction to Braces and Orthodontic Appliances

Frequently Asked Questions

Is it required that my family dentist schedule my appointment with the orthodontist?
At what age should I schedule an appointment for an orthodontic screening?
Will my teeth straighten out as they grow?
How do I schedule an appointment for an initial exam?
What will happen at the initial examination appointment?
What will I learn from the initial examination?
Will I need to have teeth extracted for braces?
How long will it take to complete treatment?
How much will braces cost? Are financing options available? How does my insurance work?
How often will I have appointments?
Can I schedule all of my appointments after school?
Can I drop my child off for an appointment?
Do braces hurt?
Can I return to school the day I receive my braces?
Do you give shots?
Do you use recycled braces?
Can I still play sports?
Do I need to see my family dentist while in braces?
Are there foods I cannot eat while I have braces?
How often should I brush my teeth while in braces?
What is an emergency appointment? How are those handled?
Can orthodontic correction occur while a child has baby teeth?
What is Phase One (early) Treatment?
Will my child need full braces if he/she has Phase One treatment?
Will my child need an expander?
Is it too late to have braces if I am already an adult?
Can I wear braces even though I have crowns and missing teeth?
Why should you choose an orthodontic specialist?

1. Is it required that my family dentist schedule my appointment with Dentistry for Children?

No, it is not. Some of our patients are referred by their family dentist, yet many other patients take the initiative to schedule an examination themselves.
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2. At what age should I schedule an appointment for an orthodontic screening?

The American Association of Orthodontists recommends an orthodontic screening no later than age 7. By this age, several permanent teeth in most children have erupted, allowing us to effectively evaluate your child's orthodontic condition. Some problems can be most effectively treated even earlier. No child is too young for an orthodontic exam.
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3. Will teeth straighten out as they grow?

No, they generally will not. The space available for the front teeth does not increase as you grow. In most people, after the permanent molars erupt, the space available for the front teeth decreases with age.
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4. How do I schedule an appointment with an orthodontist?

If you feel that you or your child can potentially benefit from orthodontic treatment, simply call our office, send us an e-mail or fill out our appointment request form online. We will be happy to schedule an appointment for you. When you call to schedule your appointment, our front office staff will request some basic information from you.
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5. What will happen at the initial orthodontic appointment?

Upon arriving, each patient and parent will be seen by the staff and doctor who will carry out a brief but thorough examination. The orthodontist will then discuss the exam findings with you. We may take the necessary photographs, X-rays and impressions that allow us to make a complete diagnosis at this same visit.

To read more about your first visit, see our First Visit Page.
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6. What will I learn from the initial examination with the orthodontist?

There are five essential questions that we will cover during the initial examination:

· Is there an orthodontic problem, and if so, what is it?
· What must be done to correct the problem?
· Will any teeth need to be removed?
· How long will the treatment take to complete?
· How much will the treatment cost?
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7. Will my child need to have teeth extracted for braces?

Removing teeth is sometimes required to achieve the best orthodontic result. Straight teeth and a balanced facial profile are the goal of orthodontics. However, because new technology has provided advanced orthodontic procedures, removing teeth is not always necessary for orthodontic treatment.
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8. How long will it take to complete treatment?

Treatment time obviously depends on each patient’s specific orthodontic problem. In general, treatment time lasts from 8 months to 30 months. The "average" time frame a person is in braces is approximately 18-24 months.
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9. How much will braces cost? Are financing options available? How does my insurance work?

It is impossible to give an exact cost for treatment until we have examined your child. We will cover the exact cost and financial options during the initial examination. We have several financing options available to accommodate your needs, and we will review these with you. We will also review your insurance policy and help to maximize your benefit and file your claims.
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10. How frequent are orthodontic appointments?

Appointments are scheduled according to each patient's needs. Most patients in braces will be seen every 4 to 8 weeks. If there are specific situations that require more frequent monitoring, we will schedule appointments accordingly.
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11. Can I schedule all of my appointments after school?

Unfortunately, we cannot schedule all appointments for students during after-school hours. The lengthier appointments such as initial placement of braces are usually scheduled earlier in the day so we that can reserve the after school hours for shorter appointments. This way we maximize the availability of after school appointments for the greatest number of patients. Because appointments are scheduled 4 to 8 weeks apart, most patients will miss minimal school due to their orthodontic treatment. Within these guidelines, we make every effort to meet your scheduling needs.
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12. Can I drop my child off for an appointment?

Most orthodontic appointments are not very long, and we prefer that children not be dropped off. There are times when the orthodontist needs to obtain additional information from the parent or to discuss a child's treatment. Our orthodontic assistants generally speak to every parent at the end of each orthodontic visit to give an update on treatment progress. To help you make the most productive use of your time during your child's orthodontic visits, we've equipped our reception rooms with free wi-fi access.
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13. Do braces hurt?

Generally, braces do not "hurt." After certain visits, teeth may be sore for a few days. In these situations, pain medications such as Advil or Tylenol will ease the discomfort. However, after most visits, patients do not feel any soreness at all! We often remind our patients, “It does not have to hurt to work!”
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14. Can my child return to school the day braces are placed?

Yes. There is no reason to miss school because of an orthodontic appointment.
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15. Does the orthodontist give 'shots'?

No. 'Shots' are not necessary in orthodontic treatment.
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16. Do you use recycled braces?

Absolutely not! It is our belief that each patient should be provided with their own braces to achieve the best orthodontic result possible.
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17. Can my child still play sports with braces?

Yes. We recommend a mouth guard for all sports and provide every orthodontic patient wih a free orthodontic mouthguard.
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18. Does my child need to have regular checkups while in braces?

Absolutely! Regular pediatric dental checkups are even more essential while in braces. Since braces make toothbrushing somewhat more difficult, excellent oral hygiene becomes critical in maintaining healthy gums and decay free teeth. We therefore urge all our orthodontic patients to have dental cleanings three times a year instead of the usual two while in braces.
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19. Are there foods my child cannot eat while in braces?

Yes. Once treatment begins, we will explain the complete instructions and provide a comprehensive list of foods to avoid. Some of those foods include: ice, hard candy, raw vegetables and all sticky foods (i.e. caramel and taffy). You can avoid most emergency appointments to repair broken or damaged braces by carefully following our instructions.
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20. How often should teeth be brushed while in braces?

Patients should brush their teeth at least three times each day - in the morning, after dinner and before going to bed. We will show each patient how to floss their teeth with braces and will also provide a special prescription fluoride to brush on every night.
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21. What is an emergency appointment? How are those handled?

If braces are causing extreme pain or if something breaks, you should call our office. In most cases, we can address these issues over the telephone. If you require an emergency appointment, we will set aside time for you.
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22. Can orthodontic correction occur while a child has baby teeth?

Yes. Some orthodontic problems are significant enough to require early intervention. However, if a patient is not yet ready for treatment, we will follow that patient's growth and development until the time is right for treatment to begin.
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23. What is Phase One (early) Treatment?

Phase One treatment, if necessary, is usually initiated on children at an early age using orthodontic appliances that do not necessarily include braces. The primary objective for Phase One treatment is to address significant problems to prevent them from becoming more severe and to improve self-esteem and self-image.
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24. Will my child need full braces if he/she has Phase One treatment?

It is best to assume that your child will need full braces even after Phase One treatment. The period following Phase One treatment is called the "resting period," during which growth and tooth eruption are closely monitored. Throughout this period, parents and patients will be kept informed of future treatment recommendations.
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25. Will my child need an expander?

At the completion of the initial examination, we will determine whether a patient will need an expander.
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26. Is it too late to have braces if I am already an adult?

A surprising percentage of our patients are adults. In fact, 25 percent of all orthodontic patients are adults. Health, happiness and self-esteem are vitally important to adults. No patient is "too old" to wear braces!
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27. Can I wear braces even though I have crowns and missing teeth?

Yes. A tooth with a crown will move just like a tooth with a simple filling. When teeth are missing, orthodontic treatment will aid in the alignment of the remaining teeth.
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28. Why should you choose an orthodontic and pediatric dental specialist?

Teeth, and sometimes entire facial structures, are permanently changed by orthodontic treatment. It is important that the treatment be appropriate and properly completed. Orthodontic and pediatric dental specialists have extensive and specialized additional training that enables them to provide their patients with state of the art, comprehensive and personalized care.
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