FIRST EVALUATION
When is the best time to begin orthodontics?
Though an orthodontist can enhance a smile at any age, there is an optimal time period to begin treatment. Beginning treatment at this time ensures the greatest result and the least amount of 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 this early age, orthodontic treatment may not be necessary, but vigilant examination can anticipate the most advantageous time to begin treatment.
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, an orthodontist can carefully monitor growth and development and begin treatment when it is ideal.
Why is age 7 considered the optimal time for screening?
By the age of 7, the first adult molars erupt, establishing the back bite. During this time, an orthodontist 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
Are you a candidate for orthodontic treatment?
Orthodontics are 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 you smile, chew, clean your teeth or feel about your 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 smileit creates a healthier you.
DEVELOPMENTAL CARE
The Two Phases of Treatment
Phase One: Interceptive care helps provide adequate space for permanent teeth, helps align permanent front teeth and improves the bite.
Phase Two: Braces finish the alignment of both jaws and remaining permanent teeth for a healthy attractive smile.
A specialized process that encompasses tooth straightening, jaw and facial improvements is accomplished in two phases. In many cases, Two Phase Treatment can have a dramatic effect on skeletal change and can save permanent teeth. Before Two Phase Treatment techniques were developed, children began orthodontic treatment with full braces after the complete eruption of permanent teeth. Skeletal problems were left untreated, which later compromised the final result. Without the first phase of treatment, it was extremely difficult to align the upper and lower jaws so that they fit together; the skeletal discrepancy was not functionally healthy or stable. Therefore, otherwise preventable adult tooth extraction or jaw surgery was required.
Phase One of Two Phase Treatment is interceptive care. Treatment occurs during a young childs active growth years, before skeletal problems are firmly set. Treatment plans are designed to guide and enhance a childs own natural growth to establish proper upper and lower jaw development. An upper or lower jaw that is growing too much or not enough or is too wide or too narrow can be discovered when a child is very young. Because they are growing rapidly, children can benefit enormously from orthopedic ( bone correction) orthodontic treatment. Early childhood is also an ideal time to treat aesthetic concerns that may have an impact on a young childs self-esteem. Phase One therapy rarely extends longer than 12 months.
Phase Two of treatment follows after most of the permanent teeth have erupted. The second phase of treatment finishes the alignment of both the jaws and permanent teeth for proper function and excellent aesthetics. This second phase may last 6 to 24 months depending on the childs growth and development and the complexity of the treatment.
ADULT ORTHODONTICS
Even if you missed the chance to have orthodontic treatment as a child, it is never too late to have a perfect, healthy smile. More adults are seeking orthodontic treatment than ever before. An attractive smile is an asset, which will help you in both your personal and professional life. It is one of the best investments you can make for your self-confidence and your health.
New orthodontic treatments are constantly being developed. Todays braces are smaller, more cosmetically pleasing, more resilient and more comfortable than the appliances used
in past years. New materials have been developed so that treatment time is minimized. You can choose between clear, silver and gold braces. In some instances, removable appliances may be used to move teeth. The opportunity to have the smile you want is here and now!
APPLIANCE CHOICES
Metal Braces
Metal braces are the most common type. They are made of high grade stainless steel. Today’s metal braces are smaller, comfortable and attractive. Reichheld Ting Orthodontics uses an incredibly specialized bracket that decreases friction, allowing a significantly increased comfort level and decreased treatment time.
Ceramic Braces
Ceramic braces are made of translucent (clear) material. They are most popular with adult patients, due to their cosmetic appeal.
Gold Braces
Gold braces are stainless steel braces coated with 24-karat gold and are popular with patients of all ages.
The Invisalign System is a series of clear overlay templatescalled alignersthat have been generated by computer simulation to gradually move the teeth. This system is available to adults and teenagers with certain orthodontic bite problems. Ask us if you are a candidate for the Invisalign system. For more information on Invisalign, click here.
O-RING COLORS
Your braces can be aesthetically enhanced with different color O-rings. These will be changed at each visit so you can always stay in style. Gray, gold or clear O-rings are also available to cosmetically blend with your braces.
INFORMATION ABOUT APPLIANCES
Separators/Spacers
Separators are little rubber elastics which fit in between your back teeth. They gently open small spaces between these teeth so that bands can be placed at your next visit. Your teeth may be sensitive. Any discomfort should disappear in a few days. To relieve any soreness, Tylenol or what you normally take for a headache would be fine. Foods that are sticky or chewy like gum should be avoided. Please continue to brush regularly and floss only between teeth that do not have separators in them. If a separator happens to fall out, don’t worry, enough space has been made. If you have any questions, please call during our regular office hours. A lost separator does not have to be replaced.
Food Guidelines
Avoid any hard, sticky or chewy foods
Hard: Popcorn, nuts, peanut brittle, ice, corn chips, Doritos, pretzels, bagels, subrolls, pizza crust, hard candy, lollipops, jawbreakers, etc. Corn may be eaten as long as it is cut off the cob first. Slice hard fruits and vegetables such as carrots, celery, and apples into bite size pieces and chew on your back teeth.
Sticky: Gum (sugarless, Freedent and Stick Free gum), caramel, taffy, gumdrops, Starbursts, Gummy Bears, Sugar Daddy, Charleston Chew, Snickers, Fruit Roll Ups, etc.
Chewy: Beef jerky, Slim Jims, granola bars. Meats such as chicken, steak, spare ribs, and pork chops may be eaten but please cut meat from the bone.
Hints: Instead of biting down into foods with your front teeth, you may find it easier to use a fork and knife to cut food into bite size pieces. One way to damage your appliances is picking at them or playing with them. Chewing on pens and pencils can cause brackets to break.
Remember: If anything becomes loose or broken, call the office as soon as possible for instructions.
Palatal Expander
The palatal expander is used to widen your narrow top jaw. It is usually painless, but some pressure may be felt as the expander is activated.
1. Your appliance needs to be activated each a day, for the number of turns you have been instructed to apply.
a. Insert the key into the hole in the middle of the appliance.
b. Gently and steadily push the key toward the back of your mouth. Push it as far back as possible.
c. Remove the key towards the back of your throat trying not to pull forward which would reverse the previous turn!
2. You will experience a tingling sensation around your nose for a minute.
3. After several turns (or after several days), you may notice a space between your front teeth. This is a good sign!! This is only temporary and will be closed.
4. Be sure to keep your appliance free of food particles.
a. You can do this by brushing your appliance while you brush your teeth, by directing your toothbrush towards the roof of your mouth.
b. Rinsing with a glass of water will also help loosen food particles which my become lodged on the top of your expander.
5. If at any time you experience discomfort that does not go away or if your appliance becomes loose, please call the office.
6. If for any reason you cannot keep your scheduled appointment, do not activate your appliance beyond the instructed number of turns.
Elastics
Elastics help us move your teeth by a gentle but continuous force. Teeth move best when elastics are worn consistently.
Rules to follow:
- Elastics need to be worn 24 hours a day, 7 days a week for your teeth to move.
- If possible, leave elastics on while eating to gain maximum benefit.
- Remove elastics to brush your teeth.
- Change them once a day because they lose their strength.
- It’s a good idea to leave elastics in the same area when you brush your teeth.
- This way you will see them and remember to put them back on.
- ALWAYS carry elastics with you so that if an elastic breaks you will be able to replace it right away.
- Your teeth may be a little tender for a couple of days.
- If you wear them as instructed, any discomfort will soon disappear.
- If you take them on and off, your teeth will never get a chance to become accustomed to them, and your teeth will always be sore.
Please call the office if you run low and we will gladly mail some to you.
Headgear
Headgear is an added force that will move your teeth to their proper position.
Now that you are wearing a headgear we need your full cooperation wearing it as instructed, otherwise the headgear will not work. It’s up to you now; you are playing a big part in creating the smile of your life. Your Headgear must be worn at least 12 hours a day. To build up to this, wear it: 4 hours the first day, 8 hours the second day, 12 hours the third day. The best time to wear your headgear is during quiet times . . . immediately after school while doing homework, watching television, and while sleeping.
To avoid serious injury:
- Never wear while playing active sports
- Never wear while riding in an automobile
- Don’t let anyone pull or play with it at all!
Some temporary discomfort may be experienced during the first night or two. Your upper molars may become tender and even seem a little loose. This is normal and will subside. Remember, DO NOT miss any days; you can put yourself behind schedule . . . for one day lost it takes THREE to catch up.
Please bring your headgear to every appointment so it may be adjusted to assure a proper fit.
Biteplane
The Biteplane is used to allow proper placement of your lower braces. For this appliance to work properly, it must be worn all the time, except when brushing your teeth. Food should be sliced into small pieces and chewed carefully for proper digestion. It will take some time to adjust to eating with this appliance. While you are wearing your biteplane, your back teeth will not be touching.
Speech may also be affected for a few days. Speaking slowly and distinctly will bring your speech back to normal. Please keep biteplane free of plaque by brushing it with your toothbrush and toothpaste with cold water every time you brush your teeth.
Lip Bumper
Your Lip Bumper is used to gain space for your crowded lower teeth.
- For this appliance to work properly, it must be worn 24 hours a day, 7 days a week.
- Wear your Lip Bumper while eating.
- Remember, plaque can also form on you Lip Bumper, so while brushing your teeth, be sure to brush it thoroughly with toothbrush and toothpaste.
- It is common to develop a groove on the inside of the lower lip where the Lip Bumper rests.
Retainers
Retainers are used to hold your teeth in their corrected position.
To keep your teeth in their new position, your retainers should be worn 24 hours a day for one week, then at night while you sleep. We will instruct you further when you may reduce wearing time. ALWAYS keep your retainers in your case when eating. NEVER leave them on a lunch tray, in a pocket, or wrapped in a napkin. Any of these situations may result in losing or breaking your retainers. When brushing your teeth, be sure to brush you retainers also. (Remember plaque can also form on your retainers, so keep them clean.) Use your toothbrush, toothpaste, and cold water. Never boil or use hot water as this could damage your retainers. Your speech may be affected the first few days of wearing your retainers. Reading aloud to yourself can help you become more accustomed to your retainers and will allow your speech to quickly return to normal. To assure a proper fit, it is very important to bring your retainers to your appointments so they may be adjusted. To avoid a charge for broken or lost retainers, please handle with care!
FREQUENTLY ASKED QUESTIONS
1. Is it required that my family dentist schedule my appointment with the orthodontist?
No, it is not. Many of our patients are referred by their family dentist, yet many other patients
take the initiative to schedule an examination themselves.
2. At what age should I schedule an appointment for an orthodontic screening?
The American Association of Orthodontists recommends an orthodontic screening at age 7. By this age, several permanent teeth in most children have erupted, allowing us to effectively evaluate your orthodontic condition.
3. Will my teeth straighten out as they grow?
No, they 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.
4. How do I schedule an appointment for an initial exam?
If you or your child can potentially benefit from orthodontic treatment, simply call our office. 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.
5. What will happen at the initial examination appointment?
Upon arriving, you will be welcomed by our scheduling staff at the front desk. Digital photographs and a digital X-ray maybe taken so the doctor can evaluate your orthodontic case. Treatment options will be explained, and all of your questions will be answered.
6. What will I learn from the initial examination?
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?
· How long will the treatment take to complete?
· How much will the treatment cost?
7. Will I 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.
8. How long will it take to complete treatment?
Treatment time obviously depends on each patient’s specific orthodontic problem. In general, treatment times range from 12 to 30 months. The “average” time frame a person is in braces is approximately 22 months.
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 you. We will cover the exact cost and financial options during the initial examination. We have many 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.
10. How often will I have appointments?
Appointments are scheduled according to each patient’s needs. Most patients in braces will be seen every 5 to 10 weeks. If there are specific situations that require more frequent monitoring, we will schedule appointments accordingly.
11. Can I schedule all of my appointments after school?
Unfortunately, we cannot schedule all appointments for students during after-school hours. However, because most appointments are scheduled 5 to 10 weeks apart, most patients will miss minimal school due to their orthodontic treatments. We will, however, make a sincere effort to meet your scheduling needs.
12. Can I drop my child off for an appointment?
Yes. We understand your busy schedule, and we are happy to help you make the most of your time. On some occasions, we may request to speak with a parent when they return, so we ask that parents check in with the orthodontic assistant before leaving the office.
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!
14. Can I return to school the day I receive my braces?
Yes. There is no reason to miss school because of an orthodontic appointment.
15. Do you give shots?
No. Shots are not necessary in orthodontic treatment.
16. Do you use recycled braces?
Absolutely not! All appliances are new and sterilized. Nothing in our office is recycled. Ever.
17. Can I still play sports?
Yes. We recommend a mouth guard for all sports.
18. Do I need to see my family dentist while in braces?
Yes! Regular checkups with your family dentist are important while in braces. Your family dentist will determine the intervals between cleaning appointments while you are in braces.
19. Are there foods I cannot eat while I have 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.
20. How often should I brush my teeth while in braces?
Patients should brush their teeth at least four times each day: after each meal and before going to bed. We will show each patient how to floss their teeth with braces and may also provide a prescription for a special fluoride, if necessary.
21. What is an emergency appointment? How are those handled?
If your 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.
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.
23. What is Phase One (early) Treatment?
Phase One treatment, if necessary, is usually initiated on children between the ages of 7 and 10. Phase One treatment lasts about 12-21 months. 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. Phase One Treatment is also known as Developmental or Interceptive Care.
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.
25. Is it too late to have braces if I am already an adult?
A surprising percentage of our patients are adults. In fact, 25% of all orthodontic patients are adults. Health, happiness and self-esteem are vitally important to adults. No patient is “too old” to wear braces!
26. 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.
27. Why should you choose an orthodontic 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 specialists have extensive and specialized training that enables them to provide their patients with professional, personalized treatments.
