At what age should I begin orthodontic treatment?
The American Association of Orthodontists recommends an orthodontic screening at age 7. However, if a specific orthodontic problem exists prior to age 7, it is recommended to seek professional opinion. The orthodontist will decide the optimal time for treatment. Every case is unique and requires individual attention. Early treatment in specific cases is very advantageous and may save the child from extractions and the need for jaw surgery.

Will teeth straighten out on their own as the child continues growth?
No. Teeth will not straighten on their own. The space available for teeth does not increase as the child grows. Quite contrary, the amount of space (arch length) decreases after the eruption of permanent first molars (at about 6 years of age). Therefore, as more permanent teeth erupt, the amount of crowding may increase.

What happens at the initial appointment?
Initial appointment consists of a thorough examination to determine if orthodontic treatment is indicated. If orthodontic treatment is indicated, we will obtain records, which constitute of X-rays, photographs and molds of your teeth. During this initial appointment, we will answer any questions that you might have regarding your child’s condition and determine whether treatment is needed and if it is, we will determine the best time to begin treatment. The cost of treatment will also be discussed.

How much does orthodontic treatment cost?
We are unable to give you a specific quote without first conducting an initial examination. Our fees are based upon treatment time and the severity of the case. Because there is such a wide range, we cannot quote a fee without first examining the patient. We do try to provide payment options that are sufficiently flexible to accommodate most financial situations.

What financial options are available?
After the initial examination, we will discuss all financial options available.

How much will my insurance pay?
Please contact our office manager to find out what the insurance portion will be and what is your out-of-pocket amount. You may contact our office prior to your appointment and ask to have your insurance information ready for when you arrive for your initial consultation.

How often do I need to come in for appointments?
Appointments are scheduled according to a patient’s needs. Most patients in braces will be seen every five to ten weeks. If there are specific situations that require more frequent monitoring, we will schedule appointments accordingly.

How can I schedule an appointment for an initial exam?
To schedule an appointment, you may e-mail us or contact us by phone. Our staff will be happy to schedule an appointment for you.

What is the cost for the initial exam?
The initial exam is free.

What would I learn from the initial exam?
During the initial examination, we will evaluate if orthodontic treatment is indicted. Secondly, we will determine what must be done in order to correct the problem. We will also inform you if any teeth will have to be removed, how long treatment will take and how much it will cost.

Will I need teeth extracted with braces?
Your orthodontist will have to evaluate your specific case in order to fully answer this question. In very severe cases, extractions may be necessary to achieve an ideal result; however, recent advances in orthodontics greatly reduce the need for removal of teeth. Also, early (interceptive) treatment significantly decreases the chance that extractions of permanent teeth will be needed.

How long will the treatment take?
Treatment time obviously depends on each patient’s specific orthodontic problem. In general, treatment ranges from 12 to 24 months. The “average” amount of time for full orthodontic treatment is approximately 18-24 months. Interceptive (Phase One) treatment usually takes between 8-12 months.

Do braces hurt?
No. After certain visits, teeth may be sore for a period of 2-3 days. In these situations, pain medication, such as Advil or Tylenol, will ease the discomfort. However, most of the patients do not feel any soreness at all.

Do I need to bring the child to each appointment or can I drop them off?
We request your presence during your child’s appointments. After the initial placement of appliances, we try to keep our appointments short. If you are unable to bring your child to the appointments, please have a responsible adult with them to keep you informed of the treatment progress.

Can I return to school after the placement of braces?
Yes. It does not hurt to have the braces placed, and there is no reason to miss school after an orthodontic appointment.

Do I need to continue seeing my dentist during braces?
Most definitely! Regular dental checkups are very important while in braces. Your dentist will determine the intervals between cleaning appointments while you are in braces. Most patients continue to have their teeth cleaned every six months and some require three-month intervals. So please contact your dentist to evaluate how often you need to be seen for cleanings.

Do I need to get all of my fillings done prior to braces or wait until treatment is completed?
All dental work should be completed prior to initiation of orthodontic treatment. In some instances, the dentist might want to wait with more extensive work (crowns, bridge work, implants, bleaching) until after the orthodontic treatment. Therefore, please inform your dentist if you are thinking of beginning orthodontic treatment.

I have seen some people with white scars on their teeth from braces? How does that happen?
Poor oral hygiene during orthodontic treatment results in permanent decalcifications (scars) on teeth. Excessive consumption of soda and juice may also have a similar effect. Consequently, while in braces, keep excellent oral hygiene and limit the amount of sugar and acid (juice, soda) consumption to keep your teeth clear and strong.

Is any toothbrush better than the other during braces?
We recommend any soft bristle brush. Electric toothbrushes are also recommended and work very well.

Are there any foods I should avoid when in braces?
Yes. We recommend that you limit the amount of soda and juice that your drink. Minimize sugary foods; they cause tooth decay. Also any hard, sticky and high in sugar content foods should be avoided. Hard foods can break or damage wires and brackets and slow down treatment. Sticky foods can get caught between brackets and wires.

How often should I brush my teeth while in braces?
Oral hygiene is essential to maintain a healthy smile. Braces, wires and bands trap food particles and make it difficult to brush or floss away plaque. Careful brushing and flossing, preferably after each meal and snack, is the best way to prevent plaque buildup, tooth decay and gum disease.

What is early treatment?
Phase One (early/interceptive) treatment, if needed, is usually initiated on children between the ages 7-10. Phase One treatment on an average lasts 12-18 months. The primary objective of early treatment is to address significant problems to prevent them from becoming more severe and to improve self-esteem and self-image. Often during this phase of treatment, we are able to achieve favorable facial growth corrections that may save the child from the possible need for jaw surgery in the future.

Can orthodontic treatment be done if the child still has baby teeth?
Yes. Phase One treatment is considered partial treatment and even though the child does not have all of his or her permanent teeth, enough teeth may be present to achieve desired correction. To best assess the need and timing for treatment, you may visit your orthodontist no later than age 7 for an initial consultation.

What would be the benefit of early treatment?
Many advantages exist. Here are just a few:

• Create room for crowded, unerupted teeth
• Create facial symmetry by influencing favorable facial growth
• Reduce the risk to trauma to protruding front teeth
• Reduce the need for future tooth removal
• Reduce the severity of future treatment
• Reduce treatment time with braces
• Improve child’s self-esteem

Will my child still need full braces if he/she receives early 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 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.

What is an orthodontic emergency? What should I do?
Very few true orthodontic emergencies exist. Here are some emergency tips:

A true emergency situation will be if your child fell or got hit in the mouth and severely displaced his or her anterior teeth. Please contact your dentist or orthodontist immediately. In severe trauma instances, go to the emergency room immediately.

Some minor orthodontic problems are a follow:

• Sore teeth and gums : take Tylenol or Motrin and rinse you mouth with warm salt water. A heated pad or warm cloth may also help to reduce the soreness.
• If you loosen or break a removable appliance or retainer, please call our office during normal business hours to schedule an appointment to get a replacement retainer as soon as possible
• If you lose a spacer, please call our office to determine if the spacer needs to be replaced or if it can wait until your next visit.
• Wire poke: use a pencil eraser to push the wire away from the irritated area. If this does not work, use the wax or sugarless gum to cover the area. If the wire is so long that it cannot be covered, cut it with the nail clippers. Please call the office if irritation persists or if you had to cut the wires.
• Loose bracket or band : call our office so we may schedule you for a repair appointment.

Why should I choose an orthodontist if my dentist does braces?
Othodontists have two to three years of highly specialized training about and beyond that of a general dentist in tooth alignment and correcting jaw and bite irregularities. An orthodontic specialist does only orthodontics. Other types of dentists can legally offer braces to their patients but lack the intensive training and specialized experience of an orthodontist. A pediatric dentist has specialized knowledge of how to do fillings and crowns for children. A general dentist lacks specialized training in bite correction and jaw irregularities. Just as we seek the opinions of a medical specialist, such as cardiologist and dermatologists for specific medical problems, it is important to choose the proper dental specialist for bite corrections.

Can I wear braces if my teeth have crowns and fillings and I have several missing teeth?
Yes. A tooth with a crown will move just like a tooth with a simple filing. When teeth are missing, the orthodontic team will aid in the alignment of the remaining dentition and aid the general dentist in restoring the mouth.

What is an expander?
An expander is a palatal spreading device. If there is lack of bone growth in the upper (maxillary) arch, the expander is used to aid in development of proper arch form. Even though it sounds pretty drastic, surprisingly enough, it is a simple device. Since the upper jaw is joined in the middle by the palatal suture, this device helps to open this suture and create more room in the upper arch. This suture is wide open in children, thus not much discomfort results from using this appliance.

Do you still use headgear?
Due to the advancements in the field, we rarely use the headgear anymore.

 Is it too late for orthodontic treatment if I am an adult?
It is never too late for orthodontic treatment. Teeth can be moved at any age and dramatic improvements in appearance and dental health can be obtained even in adult patients. Due to incredible advancements in orthodontic treatment today, treatment options are a lot more esthetic, efficient and comfortable. No patient is too old for orthodontic treatment, since it is never too late to look better.

 What are the disadvantages of adult orthodontic treatment?
One disadvantage of receiving treatment in later stages of life is slower tooth movement. Adult teeth do respond to the orthodontic forces but do so in slower matter.

Are there any risks associated with braces?
Very few risks exist. One of the biggest complications of treatment results from a patient’s inadequate care for his or her teeth while in treatment. Poor oral hygiene can result in tooth scarring, tooth decay and periodontal problems. Root shortening is a second minor risk that occurs in a very small percentage of patients undergoing orthodontic treatment. This is usually very rare, very minor and of no consequence to the patient. It is very important to provide your orthodontist with complete medical history so he or she can assess any other treatment complications that you may have.

 What if my child is allergic to latex or nickel? Can he or she still have braces?
Yes. However, please make sure to inform your orthodontic team about your child’s allergy. We will take special precautions, such as using latex-free gloves and rubber bands, if you child is allergic to latex. In cases in which children have a confirmed allergy to nickel, we use surgical stainless steel appliances and wires, thus treatment can progress as normal.

 Why should I get braces? My dentist recommended that I see an orthodontist but I don’t see the need to get treatment? Are there any health concerns if I don’t get treated?
According to studies by the American Associations 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. Open bites can result in tongue thrusting habits and speech impediments. Orthodontics not only creates a pretty smile, it creates a healthier you. Better aligned teeth function better in chewing, so your digestion may improve. Orthodontics may also help you avoid premature tooth loss and will make you look and feel better.

 What is jaw surgery?
A small percentage of patients present a very severe form of jaw misalignment. Orthodontic treatment alone will not help them achieve a correct bite. These patients are referred for a surgical consultation in order to evaluate what type of surgery might be needed to correct their problem. Orthognathic Surgery (jaw surgery) in conjunction with orthodontic treatment might be needed in order to achieve the desired result.

 What can I do to speed up my treatment?
Healthy bodies function better….. healthy teeth move faster, thus one more reason to keep great oral hygiene! The other way you can ensure to finish on time is to avoid breakage of the appliances….. broken brackets waste time! If your orthodontist prescribes you to wear rubber bands, follow the instructions closely. Rubber bands, if worn as prescribed, will speed up the treatment.

 Do I really need to wear the rubber bands? Would the orthodontist know if am wearing them or not?
Yes and yes. Rubber bands are a very important part of your treatment. They help to correctly align the jaws and perfect the bite. Without proper rubber band wear, the final result of your orthodontic treatment will be inadequate and less than perfect. Your orthodontist will know if your rubber band wear is inadequate because there will be no progress in your treatment.

 My child still sucks her thumb - what can I do?
Thumb sucking should stop prior to permanent teeth eruption, or in other words, age 6. If your child still sucks her or his thumb past that age, he or she needs to seek a professional consultation. Prolonged thumb sucking distorts the dentition and adverselyinfluences facial growth.

 How do braces work?
In great simplicity, every tooth receives a handle (bracket) that is joined to a straight wire. The super flexible wire allows the teeth to straighten along the side of the wire. So in other words, in order for the braces to work, all of the brackets and bands need to be securely attached to the wire. If a bracket breaks, the tooth cannot move and the treatment slows down.

 What are spacers?
Spacers are little rubber donuts that are placed in between teeth to create room for the band (tooth ring). They spread, slightly separate, the teeth and allow the band to be securely placed.

 Why do I need to call the office when my child breaks a bracket?
Broken appliances do not move teeth, thus they slow down your progress. By calling the office prior to your appointment, we can ensure that extra amount of time is reserved for the repair to get your treatment back on track.

 What can I do to keep my teeth healthy and strong during braces?
Great oral hygiene is a must. Brushing and flossing, in addition to a healthy diet, is the formula for success! In addition to the regular hygiene routine, you may purchase fluoride mouth rinse to strengthen your teeth while in braces.

 Can I bleach my teeth while in braces?
No. We do not recommend that you bleach your teeth while in treatment.

 How should I select an orthodontist?
There are many factors you should consider when deciding on an orthodontic specialist. Since you will be visiting their office at regular intervals throughout treatment for an extended period of time, make sure that you choose an office where you feel comfortable. You should know what is involved in each aspect or your or your child’s treatment before you start and should feel comfortable asking questions.

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