FREQUENTLY
ASKED QUESTIONS

Orthodontics (also referred to as dentofacial orthopedics) is a specialized form of dentistry focusing on the diagnosis, prevention, and treatment of dental and facial abnormalities.

An orthodontist is a dental specialist who has received two to three years of additional training and experience. Your orthodontist can straighten teeth, correct misaligned jaw structure, and improve the function of your smile.

If you want to improve the look and feel of your smile, then any age can be a great age to see the orthodontist. The American Association of Orthodontists recommends that children first visit an orthodontist around the age of seven; however, orthodontic treatment is not exclusive to children and teens, with about one in every five orthodontic patients being over the age of 21. Whether you're considering treatment for yourself or a child, any time is a good time to visit the orthodontist.

Simply call our practice! Our front desk staff will be happy to help schedule your next appointment at your convenience. If you are a new patient or have been referred to our practice, please let us know and we will provide you with all of the information you need.

These are just a few of the questions surrounding the topic of early orthodontic treatment for children. The American Association of Orthodontists recommends that children see an orthodontist as early as age seven. At this point, the orthodontist will evaluate whether your child will need orthodontic treatment.

Early treatment (also known as Phase One) typically begins around age eight or nine (Phase Two will begin around age 11 or older). The goal of early treatment is to correct the growth of the jaw and certain bite problems, such as underbite. Early treatment also helps to make room for permanent teeth to come in properly, lessening the chance of extractions in the future.

• Early or late loss of baby teeth (your child should typically start losing teeth around age five, and will have all permanent teeth around age 13)
• Difficulty chewing and/or biting
• Mouth breathing
• Your child continues sucking his or her thumb after age five
• Speech impediments
• Protruding teeth (the top teeth and the bottom teeth extend away from each other)
• Teeth that don't come together in a normal manner or even at all
• Shifting of the jaw when your child opens or closes his or her mouth (crossbites)
• Crowded front teeth around age seven or eight

Orthodontic problems such as crowding of the teeth, too much space between the teeth, jaw growth problems, protruding teeth, and bad bites can be inherited or caused by injury to the mouth, early or late loss of baby teeth, or thumb-sucking habits.

Most children lose all their baby teeth by age 13, and by the end of their teen years, the jaw bones will harden and stop growing. Orthodontic procedures for adults often take more time and can involve tooth extraction or oral surgery. Receiving early orthodontic treatment as a child can help prevent the need for orthodontics as an adult, leaving little to no chance of extraction or surgery in the future.

If your child is between the ages of seven and eight and shows signs of needing orthodontic care, or if you have been directed by your family dentist to visit the orthodontist, please contact our practice and schedule an appointment. Our team will provide your child with an initial exam, and discuss with you the best steps to take toward caring for your child's smile.

Two-phase orthodontic treatment is a specialized process that combines tooth straightening and physical, facial changes. The purpose of two-phase treatment is to maximize the opportunity to accomplish the ideal healthy, functional, and aesthetic result that will remain stable throughout your child's life.

Putting off treatment can result in a need for more invasive treatment later in life that may not completely fix your child's smile. Early treatment is most effective for achieving lasting results.

The goal of Phase One treatment is to help the jaw develop in a way that will accommodate all of the permanent teeth and improve the way the upper and lower jaws fit together. Children often exhibit early signs of jaw problems as they grow and develop. An upper jaw that is growing too much or is too narrow can be recognized at an early age. If children over the age of six are found to have this jaw discrepancy, they are candidates for early orthodontic treatment. Also, if children around the age of eight have crowded front teeth, early treatment can prevent the need to extract permanent teeth later.

• Planning now can save your child's smile later. Children benefit tremendously from early-phase treatment. Receiving early treatment may prevent the removal of permanent teeth later in life, or the need for surgical procedures to realign the jaws.
• Making records to determine your child's unique treatment. Orthodontic records will be necessary to determine the type of appliances to be used, the duration of treatment time, and the frequency of visits. Records consist of models of the teeth, X-rays, and photographs. During your child's initial consultation, the doctor will take records to determine if early treatment is necessary.

In this phase, the remaining permanent teeth are left alone as they erupt. Retaining devices may not be recommended if they would interfere with eruption. It is best to allow the existing permanent teeth some freedom of movement. A successful first phase will have created room for permanent teeth to find an eruption path. Otherwise, they may become impacted or severely displaced.

• Monitoring the teeth's progress. At the end of the first phase of treatment, teeth are not in their final positions. This will be determined and accomplished in the second phase of treatment. Selective removal of certain primary (baby) teeth may be in the best interest of enhancing eruption during this resting phase. Therefore, periodic recall appointments for observation are necessary, usually on a six-month basis.

The goal of the second phase is to make sure each tooth has an exact location in the mouth where it is in harmony with the lips, cheeks, tongue, and other teeth. When this equilibrium is established, the teeth will function together properly. Phase Two usually involves full upper and lower braces.

At the beginning of the first phase, orthodontic records were made and a diagnosis and treatment plan was established. Certain types of appliances were used in the first phase to correct and realign the teeth and jaw. The second phase begins when all permanent teeth have erupted, and usually requires braces on all the teeth for an average of 24 months. Retainers are worn after this phase to ensure your child retains his or her beautiful smile.

The Carriere Distalizer (or Motion Appliance) is an orthodontic device developed to correct a bite without removing permanent teeth when teeth have erupted incorrectly. With an effect similar to headgear, but without the use of a bulky appliance, the Carriere Distalizer pushes upper teeth back to create a corrected bite prior to the addition of braces or aligners. How does the Carriere Distalizer work?

• First, your orthodontist will create an anchor point, most commonly with a lower Essix Appliance (similar to a clear, plastic retainer), a passive lingual arch, full mandibular fixed appliance, or mini-screws. A Carriere Distalizer arm is then attached to the upper teeth on both sides of your mouth.
• An elastic band is attached from the upper bar to the lower back molars and should be worn at all times except when eating, brushing or flossing.
• With good elastic wear, your bite can be corrected in a matter of months, depending on the severity of your case.
• When the Carriere Distalizer arms are removed, we will place upper braces to finish correcting your bite and aligning your teeth to the perfectly straight, ideal smile you've always wanted.

WE ARE A DIGITAL IMAGING PRACTICE: PROUD OWNERS OF AN ITERO® ELEMENT™ INTRAORAL SCANNER

WE'LL MAKE A GREAT FIRST IMPRESSION

The iTero Element Scanner is a state-of-the-art digital scanning system that eliminates the need for unpleasant traditional alginate impressions—no more messy putty in your mouth! With our iTero Element Scanner, we can digitally capture a detailed, 3D model of your teeth and gums. Not only is an iTero Element digital scan far more comfortable than the old putty-based impressions, but it’s faster and provides images that are more precise.

SAY “GOODBYE” TO THE GOOP-FILLED IMPRESSION TRAYS!

• No goop or gag to worry about
• Fast, accurate scan for superior diagnostics
• Ideal for all types of braces, including Invisalign® clear aligners and retainers
• See a simulation of your potential post-treatment smile with the Invisalign Outcome Simulator (IOSim)

During the scanning process, our team will use the iTero Element Scanner’s wand to capture images of your teeth and gum tissue. You can breathe or swallow as you normally would. You can even pause during the process if needed or just want to ask a question.

The iTero Element Scanner will give us a 3D model of your mouth that we can use with all orthodontic services, including the Invisalign Outcome Simulator, to show you what your new smile might look like.

Braces are used by your orthodontist to help you improve the look and feel of your smile. There are several different types of braces to choose from, including:

• Clear braces
• Ceramic braces
• Lingual braces
• Self-ligating braces
• Invisible braces
• Traditional metal braces

The amount of time spent in braces will vary depending on the individual patient because every smile responds differently to treatment. Treatment times can take anywhere between 6 and 30 months, but most standard treatments take about 22 months.

Braces do not often hurt though you may feel a small amount of discomfort for a couple of days as your teeth, gums, cheeks, and mouth get used to your new braces.

With braces, you should brush your teeth at least three times a day to keep your teeth, gums, and mouth healthy and clean. Brushing regularly will help remove any food that may be caught between the braces. You should also floss daily to get in between your braces where your brush isn't able to reach. Your orthodontist can show you how to properly brush and floss once your braces are placed.

Yes! In fact, it's even more important that patients receiving orthodontic treatment visit their dentist regularly. With braces, food may be caught in places that your toothbrush can't reach. This causes bacteria to build-up which can lead to cavities, gingivitis, and gum disease. Your dentist will work closely with your orthodontist to make sure that your teeth stay clean and healthy while wearing braces.

Playing an instrument or a contact sport may require some adjustment when you first get your braces, but wearing braces will not stop you from participating in any of your school activities. If you play a contact sport, it is recommended that you wear a mouthguard to protect your braces or appliance.

• ALWAYS remember to brush your teeth after every meal and floss at least once a day.
• Make sure to use toothpaste that contains fluoride, and ask your orthodontist or family dentist if you need a fluoride rinse. This will help prevent cavities!
• If you take out your retainer to eat, make sure you brush your teeth, floss, and remember to keep it safe in its container so that it does not get lost or broken.
• Keep your retainer clean, too, by brushing it gently with a toothbrush and toothpaste. You may also soak it in denture cleaner as instructed by your orthodontist. Do not put your retainer in boiling water or the dishwasher.
• During your treatment, try to avoid foods with a lot of sugar, which increases the number of bacteria that grows in your mouth, causing more plaque and possibly cavities.
• Avoid sticky and chewy foods (caramel, chewing gum, gummy bears), hard foods (hard candy, nuts, ice cubes), or any foods that could get stuck in your braces (corn on the cob, soft bagels, ribs, taffy, etc.).
• Be sure to schedule your routine checkups with your family dentist. It is recommended that you continue to visit the dentist every six months.