1. When should my child see an orthodontist?
2. How can I tell if my child needs to see an orthodontist?
3. Why is orthodontics important?
4. Can I be assured that all instruments are sterilized and that there is adequate infection control?
5. What are orthodontic records?
6. How much do braces cost?
7. Will insurance pay for orthodontic care?
8. Do braces hurt?
9. How long will I have to wear braces?
10. Should I continue to see my general dentist while in braces?
11. Will I be able to play sports?
12. Will braces interfere with playing musical instruments?
13. Are retainers necessary and how long will I have to wear one?

Q. When should my child see an orthodontist?

A. The American Association of Orthodontists (AAO) recommends that children be seen no later than age 7. Many orthodontic problems are easier to correct if detected at an early age before jaw growth has slowed. Early treatment can help tooth eruption and guide facial growth, which may mean that a patient can avoid surgery and more serious complications. Another plus is that early intervention frequently makes treatment easier, less time consuming, and in some cases, more economical. At this early age orthodontic treatment may not be necessary, but with periodic appointments you can anticipate the most advantageous time to begin treatment.

Q. How can I tell if my child needs to see an orthodontist?

• Thumb and/or finger sucking
• Mouth breathing – the face and jaws can grow unfavorably in a child who routinely breathes through his mouth. If such a condition is recognized and treated early, growth can proceed favorably.
• Early or late loss of baby teeth
• Extra or missing teeth
• Overlapping, rotated and crowded teeth – teeth may be aligned poorly because the dental arch is small and/or the teeth are large. Impacted teeth (teeth that should have come in, but have not) and poor biting relationships may result from crowding. Crowding can often be corrected by expansion, space management, arch development, etc, and many times permanent tooth removal can be avoided.
• Cross bite – a bite problem where the upper teeth lie behind the lower teeth. This may cause misaligned jaw growth and uneven tooth wear.
• Over jet or protruding upper teeth – these teeth will be subject to injury if left untreated very long. This can indicate a poor bite of the back teeth (molars) and an underlying jaw growth problem.
• Deep Overbite – the upper front teeth extend out over the lower front teeth, sometimes causing the lower front teeth to bite into the roof of the mouth.
• Open bite – the upper and lower front teeth do not overlap, which can impact proper chewing. Open bite may also cause a number of unwanted habits such as tongue thrusting and speech impediments.
• Spaces between the teeth
• Dental midlines not matched – this type of problem is caused when the back bite does not fit and match appropriately, which may negatively impact jaw and proper dental function.

If you notice any of these indicators, consult with an orthodontic specialist.

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Q. Why is orthodontics important?

A. An attractive smile and improved self-image is just one of the benefits of orthodontic treatment. Alleviating and preventing physical health problems is just as important. Without treatment, orthodontic problems can lead to tooth decay, gum disease, bone destruction, chewing and digestive difficulties, speech impairments, tooth loss and other dental injuries. Orthodontics can bring teeth, lips, and jaws into proper alignment and achieve facial balance. It also plays an important role in reducing wear on your teeth and stress on the supporting soft tissue, bone and jaw joints (TMJ) – which can result in damage and loss of soft tissue, chronic headaches or pain in the face or neck.

Q. Can I be assured that all instruments are sterilized and that there is adequate infection control?

A. Yes! Our advanced sterilization procedures comply with the highest standards developed by the Centers for Disease Control, the American Dental Association, and the Occupational Safety and Health Administration (OSHA) to ensure your health and safety. The effectiveness of our sterilization protocol is independently monitored on a regular basis.

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Q. What are orthodontic records?

A. Orthodontic records are a set of diagnostic tools that enable me to evaluate existing and potential orthodontic problems and determine the best options for treatment. These records include:

Impressions for plaster models of the teeth (made by placing a tray of soft Jell-O® - like material in your mouth)
Photographs of the teeth, face and smile
Cephalometric x-ray (a profile x-ray to show the facial form and growth pattern)
Panoramic x-ray (used to locate impacted teeth, missing teeth, and shortened or damaged tooth roots, and the development of permanent teeth that have not yet come in) The appointment takes about 45 minutes.

Q. How much do braces cost?

A. Costs vary depending on the type of treatment. As a service to our patients, we offer several financial options to suit your individual needs. We offer up to 100% financing through a third party and we also offer “in-house” interest free financing (includes an initial down payment with monthly installments) as an option. We strive to ensure that orthodontic treatment be affordable for you. We believe that cost should not be a barrier when you seek the highest quality, professional orthodontic care. After all, the benefits of treatment will last a lifetime.

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Q. Will insurance pay for orthodontic care?

A. Today many dental policies include orthodontic benefits making orthodontic fees more affordable than ever before. We will gladly assist you in submitting claims to your insurance carrier. However, our primary financial relationship is with our patients and their families and not with their respective insurance companies. Final responsibility for collection of benefits from your insurance company rests with the insured party.

Q. Do braces hurt?

A. Most orthodontic patients experience some discomfort the first week after their braces are put on, and a day or two after each adjustment. Using warm salt-water rinses and taking aspirin, Tylenol or Ibuprofen, can relieve generalized mouth soreness.

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Q. How long will I have to wear braces?

A. The time needed to undergo orthodontic treatment will vary for each patient. Length of treatment depends on factors such as the complexity of your bite problem, response to treatment, and cooperation from patient.

Q. Should I continue to see my general dentist while in braces?

A. Yes! It’s very important that you continue to have regular dental checkups to prevent or determine dental decay and to monitor the health of the supporting structures. Periodic professional dental cleanings by your dentist will maintain overall dental health and prevent dental disease.

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Q. Will I be able to play sports?

A. Yes. It is recommended, however, that patients protect their smiles by wearing a mouth guard when participating in contact sports or any sports where there is a chance that you could be hit in the mouth. Mouth guards are inexpensive, comfortable, and come in a variety of patterns. We have mouth guards available in our office that work well with braces for no charge.

Q. Will braces interfere with playing musical instruments?

A. No. With practice and a period of adjustment, braces typically do not interfere with the playing of musical instruments. In addition, brace covers can be provided to prevent discomfort.

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Q. Are retainers necessary and how long will I have to wear one?

A. The retainer is designed to “retain” teeth in the position they have been moved to and prevent your teeth from drifting or moving while the bone and tissue around your teeth adapt to the treatment changes and stabilizes. The longer you wear your retainer, the better your chances that your teeth will not relapse. Wearing retainers exactly as instructed is the best way to assure that your teeth will stay in perfect alignment while your jaw continues to grow or develop.

Throughout life your teeth are always moving, even if you have never worn braces. It happens more in some people than others. For this reason, we recommend wearing retainers as long as you can. Usually, we recommend patients wear retainer’s full time for at least 3 months and then on an as needed basis, but not less than one night per week.

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Definitions

Tooth filing

Most orthodontic cases involve crowded teeth, which means that the width of all the teeth within the dental arch exceeds the arch circumference. It was common 40 years ago to have permanent teeth removed to gain the necessary space, even when the degree of crowding was minimal. This often resulted in problems – either spacing after treatment, flattening of the profile, and according to some experts TMJ problems.

Many cases are still treated today with the removal of permanent teeth, including some cases in our practice. However, we resort to this only when the crowding or bite problem (malocclusion) is severe. In lieu of tooth extraction, a technique called interproximal tooth reduction (air rotor stripping) is performed. A file is used to slightly and gently recontour the teeth in the crowded area. It is completely painless, since there are no nerve endings in the outer layer of teeth, and the teeth are not left more susceptible to decay. Years of clinical research have demonstrated this, and nearly every orthodontist uses this technique.

TMJ

TMJ Dysfunction is a condition of the jaw that occurs when the Temporo Mandibular Joint is misaligned or malfunctioning in a way that subjects the joint to excess pressure. TMJ can seriously affect how your mouth works and often includes side-effects such as blocked nasal passages, neck pain, headaches and difficulty chewing.

Malocclusion

The technical term for teeth that do not fit together correctly is “malocclusion.” Most malocclusions are inherited, however, it is possible to acquire a bad bite from habits such as tongue thrusting and thumb sucking. The premature loss of baby teeth or the extraction of adult teeth can cause the development of malocclusion. Inherited malocclusions are usually caused by difference between the size of the teeth and the size of the jaw structure. Whether inherited or acquired, malocclusions affect not only the alignment of the teeth, but also the appearance of the face.

Spacers

Spacers are inserted before placement of your braces to provide some space between teeth for attaching the bands. In just a few days they gently move desired teeth slightly apart. Spacers often cause some soreness, but this goes away in a few days. Rinse your mouth with warm salt water to relieve the irritation. Your normal chewing also helps to get your mouth feeling better.

Bracket

The “braces” or small attachments applied to your teeth. The brackets are the parts of your braces to which the doctor or assistant attaches the archwire.

Arch wire

This is the part of your braces that actually moves your teeth. The arch wire is attached to the brackets by small elastic ties, or ligature tie wires.

Passive Alignment and Proper Eruption

There is a difference in size between baby teeth and adult teeth (some baby teeth are actually larger than the permanent teeth that replaces them). By managing this space difference with selected removal of baby teeth, arch length or room is provided for the erupting permanent teeth.

When given enough room, teeth will move into a better alignment without orthodontic appliances. This movement occurs because the soft tissues (muscles, gums, etc…) and the associated functions of chewing, breathing, talking, etc… create a force on the teeth. This dental movement will continue until all the forces are in balance. (This balance point is impossible for an orthodontist to know precisely.) This space management and resultant dental tooth movement is beneficial orthodontically for the following reasons:

Helps the orthodontist know where that balanced position is on each patient.
Teeth in balance do not move, create stability and decrease relapse potential.
Teeth that are moved orthodontically have a built in relapse potential. The more Mother Nature moves a tooth (decreasing the amount the orthodontist has to move the tooth) the less relapse will occur and the result will be more stable.
During the 4-5 years when a child is exchanging baby teeth for permanent teeth, their teeth will have a less crowded appearance.
This space management may prevent the need for permanent tooth extraction.
This space management will lessen the severity of the orthodontic problems and/or will allow for more viable options for orthodontic treatments in the future.

Mouth Breathing (Obstructed Nasal Passage)

God designs us to breath through our noses comfortably. Patients that predominantly breath through their mouths (either through habit or obstruction) are effected in many ways:

• Medically: Mouth breathers tend to have more respiratory problems, more colds, more sinus problems, etc.
• Dentally: Mouth breathers tend to have more dental decay, gum problems and halitosis (bad breath). They tend to grow long in the face - very vertical facial growth with dental open bites.
• Physically: Mouth breathers do not process enough oxygen while they sleep. They tend to manifest the problems associated with lack of sleep - less alert, groggy, dark rings under their eyes, etc. Some patients may exhibit opposite effects due to sleep apnea and can be misdiagnosed with ADD or ADHD
• Socially: Mouth breathers tend to be sloppy eaters, appear to have a lower I.Q. as they walk around with their mouth open, and are at a higher risk of choking while eating.
• Chronic mouth breathing is pathological and should be evaluated by an ear, nose and throat specialist (Otaolaryngologist) for proper treatment.