Most problems involving the alignment of your child’s teeth and the growth of their jaws can be identified by the time they are in the first or second grade. That is why the American Association of Orthodontists recommends that all children have a check up with an orthodontic specialist no later than age 7. At this visit the orthodontist will carefully examine your child’s bite and assess the alignment and development of the teeth. The orthodontist will also look at the growth and relationships of the jaws, and in particular check for any shifts or dysfunction. It will also be determined if any premature tooth loss, habits, swallowing or breathing patterns are having an effect on your child’s occlusion.

Following this visit the orthodontist will indicate if any immediate preventative or interceptive orthodontic care is needed. In many circumstances no treatment is required right away and the child can be observed until it is the appropriate time for care. Your child’s dental development as well as their prospective facial growth will be carefully considered in outlining the best timetable for care.

Orthodontic treatment for children typically begins between the ages of 9 and 14. At this time they are generally in the mid to late mixed dentition stage. This means they have a mix of permanent front teeth, permanent molars, and some baby teeth. The benefit of placing braces at this stage is that the orthodontist can improve the alignment of permanent front teeth, guide the incoming new adult teeth into position, and utilize the child’s growth and development to best advantage.

EARLY TREATMENT

Often habits such as prolonged thumb sucking, tongue thrusting, and certain swallowing or breathing patterns that can open or distort the bite are better dealt with when care is initiated at a younger age. Early treatment is also helpful when the top jaw is too narrow, not developing in harmony with the lower jaw, or permanent top teeth are behind the lower ones when closing the jaws. Likewise, if a young child’s front teeth protrude excessively or very severe crowding is present a first phase of orthodontic care can be beneficial.

The objectives of early treatment and a first phase of orthodontic care are to influence jaw growth, create more space for crowded teeth, help to correct harmful habits, and improve facial aesthetics. With early treatment the likelihood of impacted permanent teeth as well as the need for extractions of permanent teeth can be lessened. Early treatment can also simplify the next phase of orthodontic care.

Greater than half of all orthodontic patients are teenagers between the ages of 12 to 17 years. At this stage of development most of their permanent teeth, with the exception of the wisdom, have already erupted into place. Any problems with the alignment of the teeth, issues with the bite, as well as discrepancies in jaw relationships are readily detectable at this time, making your teen an excellent candidate for orthodontic care.

The teenage years are typically a time of significant physical and emotional development. In addition to acquiring a more adult appearance, teens are developing a heightened sense of self-awareness, building self-confidence, and investing more in peer relationships. Having teeth that are crooked, gapped, crowded, or protruding can have a negative impact on their self-image as well as their self-esteem. In addition to that, malocclusions can predispose teens to TMJ issues, headaches, and dental disease.

Helping your teen to achieve a well aligned, more pleasing, and healthier smile means making a commitment to orthodontic care. Although orthodontic treatment involves wearing some type of appliances and takes time, the ultimate reward of a beautiful smile is well worth the effort.

The good news is that, thanks to advances in modern orthodontics today’s image conscious teens can choose from a wide selection of braces that are far less bulky, much less noticeable, and more comfortable than ever before.

A generation ago it was extremely unusual to see an adult with braces on their teeth. Today that is no longer the case. Thanks to advances in dental technology, greater access to care, and an increased awareness of the benefits of a beautiful and healthy smile; now over twenty percent of people wearing orthodontic appliances are adults.

With the wide variety of orthodontic treatment options available to adults, the process of wearing braces is more convenient, more comfortable, more efficient and much less conspicuous than ever before. Bulky metal braces are truly a thing of the past. The latest generations of metal appliances are substantially smaller and less unsightly than any of their predecessors. Moreover, an adult interested in orthodontic care can select braces that are hardly visible at all. Today’s tooth -colored ceramic braces, lingual braces or removable clear aligners can all effectively deliver treatment to achieve successful and pleasing outcomes of care.

Although, adult orthodontics requires an investment of time and resources the payoff is well worth it. The value of a healthy and attractive smile is priceless. Thanks to modern orthodontics, having teeth that look good and function well is something that can be enjoyed at any age.

If a child’s facial growth and development does not proceed in a normal and harmonious manner then the jaws may not achieve the proper relationship or alignment. This can present an individual with varying degrees of functional and cosmetic problems. When the jaws are not in the anatomically correct positions it can have a negative effect on the occlusion (the bite), facial symmetry and balance, as well as the temporomandibular joint. Problematic jaw relationships can even make eating, speaking, and normal breathing more difficult.

Orthodontic treatment alone is often insufficient to address all of the issues caused by these improper or disproportionate jaw relationships. Orthognathic surgery, more commonly known as corrective jaw surgery, is sometimes necessary to help address these skeletal and dental irregularities.

Orthognathic surgery involves a team approach with an orthodontist preparing and finalizing the alignment of the teeth along with an oral and maxillofacial surgeon to treatment plan and perform the corrective jaw procedures. If needed, other specialists may be involved in treating the patient to address any additional dental or medical issues necessary to achieve the best functional and cosmetic result.

The most common type of braces seen today, remain “metal braces”. Made of high-grade stainless steel these braces are significantly smaller and have a lower profile than their predecessors from years ago. Each brace, which is known as an orthodontic bracket, is individually bonded to the front of each tooth. Metal braces allow for efficient and highly controllable tooth movement.

In a case where a set of conventional braces is the best approach, but a more cosmetic appearance is desired, ceramic braces are an excellent alternative to traditional metal braces. Ceramic braces or clear braces blend in with the natural color of your teeth. While being far less visible, they still function in very much the same way as metal braces and deliver outstanding results of care. While an excellent aesthetic choice, ceramic braces can be a bit more fragile than their metal counterparts.

Other types of orthodontic appliances may also be used during the course of treatment. Some of these appliances are removable and can be taken in and out of the mouth, while others will be attached to the teeth until they are no longer needed. Depending upon the specific needs of the case, these appliances may be used to accomplish a number of things including:

Invisalign offers adults and teens a more cosmetic, comfortable and convenient alternative to other types of orthodontic appliances.

Designed to move teeth through a planned sequence of clear aligners, Invisalign is virtually invisible to the outside world. Transforming smiles with minimal interference to daily activities, Invisalign allows teens and adults to enjoy eating all of their favorite foods, and engage in sports without the fear of breaking their orthodontic appliances or sharp poking wires. Moreover, as the aligners are completely removable, toothbrushing and flossing is much easier. There is no need to struggle to clean in between and around any attached orthodontic brackets and wires.

While not a solution for every type of orthodontic case, orthodontic treatment with Invisalign is an excellent choice for many image-conscious teens and adults. The most discrete and easy to wear option in orthodontic care, Invisalign for teens also features a special blue dot indicator to monitor treatment compliance.

Digital radiography utilizes computer technology and digital sensors for the acquisition, viewing, storage, and sharing of radiographic images. It offers several advantages over the older traditional film based methods of taking x-rays. The most significant of theses advantages is that digital radiography reduces a patient’s exposure to radiation. Other benefits are that images can be viewed instantly after being taken, can be seen simultaneously as needed by multiple practitioners, and can be easily shared with other offices. Digital x-rays are also safer for the environment as they do not require any chemicals or paper to develop.

An electronic pad, known as a sensor is used instead of film to acquire a digital image. After the image is taken, it goes directly into the patient’s file on the computer. Once it is stored on the computer, it can be easily viewed on a screen, shared, or printed out.

Every orthodontic patient will experience a period of adjustment when his or her appliances are initially placed. The first few days of wearing braces are typically the most challenging. During this time you may feel a general soreness in your mouth and your teeth may be tender to biting pressure for a few days. Depending on the type 
of braces you have been given, it may also take a week or two for the lips, cheeks, and tongue to get accustomed to the presence of the appliances. It is important that you keep in mind that these sensations will pass.

To help you cope with this initial short-term discomfort our office will recommend a number of remedies and tips. These techniques can also be utilized during any brief “achy” episodes that may follow future adjustment visits. If you are wearing conventional braces, a supply of orthodontic wax and instructions as to how to apply it to a wire or a brace that has become irritating will be provided.

During the time that you are wearing braces it is very important to be careful about what you are eating as well as more diligent in keeping your teeth and orthodontic appliances very clean. Eating certain foods (especially hard, sticky, crunchy, or tough foods) and certain oral habits (like chewing ice, biting pens, or nail biting) can be very damaging to braces. Risky oral behaviors can lead to frequent breakage of orthodontic appliances, which can significantly prolong your treatment time and possibly compromise your treatment outcome.

Although, there may be some foods to avoid during treatment, there are still many delicious and satisfying things that you can eat. It is important to remember the key to good health is maintaining a nutritious and well-balanced diet.

Keeping your teeth, gums, and orthodontic appliances clean over the course of care is of the utmost importance. Food and plaque are easily trapped in the tiny spaces between your braces as well as underneath your removable appliances or aligners. In the absence of good oral hygiene you are at an increased risk of developing dental decay, areas of decalcification or stains on your teeth. Furthermore, your gums can become irritated and inflamed and you may even develop a dental infection.

Brushing after every meal, and flossing at least once a day, is the best way to insure that your teeth and gums remain healthy throughout your orthodontic treatment. It is also recommended that you brush your teeth after eating snacks. However, if you don’t have a toothbrush on hand at this time, you can occasionally clean your mouth by rinsing vigorously with water. You may also consider adding other useful items like a floss threader, a small interdental toothbrush (proxabrush), or an oral irrigator (water pick) to your dental care toolkit to assist you in keeping your appliances, as well as all of the small spaces around your braces, clean.

Make sure to see your general dentist regularly for routine care and to have a thorough dental cleaning.

Preserving and stabilizing the result of your orthodontic treatment is known as “retention” and the appliances used for this purpose are called “retainers”. Almost every individual who has undergone orthodontic care will need to wear some type of a retainer.

There are two major kinds of orthodontic retainers. A removable retainer is one that can be taken in and out of the mouth, while a permanent retainer is fixed or bonded to the back of the teeth. Before removing your braces our orthodontist will explain which of the available retainer options you will need to maintain your smile.

Removable retainers come in two forms. A Hawley retainer is the most traditional orthodontic retainer. It is typically an acrylic based appliance with a single wire that sits in front of the teeth to maintain the corrections along with some small clasps to stabilize it in the mouth. The other type of removable retainer is a vacuform “invisible” retainer that is called an Essix retainer. This retainer looks similar to a clear custom bleaching tray or dental aligner. It is made of a thin transparent plastic that is fabricated to precisely fit over the teeth and prevent any unwanted shifting. While a Hawley retainer has the advantages of being quite durable and easy to adjust, an Essix retainer is less visible and can be easier to adapt to wearing.

In some cases a fixed retainer may be recommended to maintain a corrected smile. A fixed retainer is a special thin wire that is bonded to the back of the front teeth. It remains in place all of the time and does not show at all when you smile. This type of retainer is a good option when there’s a high risk that teeth could revert to their former position, especially the lower front teeth. A fixed retainer provides excellent stability, but requires extra care to keep the teeth and gums around the appliance clean.

At the time your retainers are inserted, we will provide you with detailed guidelines for wearing these appliances as well as directions as to how to clean and care for them.

Taking care to protect your braces from damage and your mouth from injury is extremely important. Wearing a mouthguard while participating in sports is a good way to safeguard your appliances as well as your smile. It is important that you wear a mouthguard that has been specifically designed to fit over your braces. Our office can guide you in selecting the most suitable one.

At the start of your orthodontic care, our office will review with you how to handle most cases of broken or loose braces, as well as irritations due to your appliances. While some situations can be adequately managed until your next scheduled visit, others will require immediate professional attention. 
Keep in mind that loose and damaged orthodontic appliances are often the result of eating the wrong foods or harmful oral habits such as biting your nails or chewing on ice, pencils, and pens. However, there are occasions when even with normal usage and good care a brace will break, a protruding wire can become irritating, or elastic accessories dislodge.

Common orthodontic emergencies may include:

• Poking or protruding wires
• A loose molar band
• A loose or broken orthodontic bracket
• Dislodged elastic ligature band
• Broken or bent removable appliances

Although all of the above situations can be uncomfortable and upsetting, other problems can develop that fall into the category of serious health emergencies. If you start to experience severe pain, develop significant swelling, or have sustained an injury to the teeth, the mouth, or jaws, it is essential to get prompt medical and dental attention. Once the extent of your injury or infection has been determined, it can be treated accordingly. As your orthodontist, we will work with your medical and dental team to adjust, remove, or replace your appliances as needed.

Most parents wonder when is the best time to have their child evaluated for braces. One common misconception regarding orthodontic treatment for children is to wait until all of the permanent teeth (with the exception of the wisdom teeth) are present. This is not the case. An orthodontist is able to identify most problems involving the alignment of your child’s teeth and the growth of their jaws by the time they are in the first or second grade. That is why the American Association of Orthodontists recommends that all children have a check up with an orthodontic specialist no later than age 7.

It is important to keep in mind that aligning the teeth and the jaws does not happen overnight. Whether you are wearing conventional braces, clear aligners, or any other type of appliance, orthodontic movement is a gradual process. Orthodontic tooth movement is based on the use of light and continuous forces to correct your bite in an incremental, predictable, and healthy manner.

The total duration of orthodontic care, not including wearing retainers to maintain the result, depends on a number of factors. Treatment time can be influenced by such factors as growth as well as your compliance with care. On average comprehensive orthodontic care to correct a malocclusion can take anywhere between 18-36 months. Orthodontic treatment for more limited problems with tooth alignment typically ranges from 6 to 18 months.

Because orthodontic movement takes time, most appointments after the initial placement of appliances are scheduled approximately four to eight weeks apart. This interval gives your teeth time to move at both a steady and healthy pace. However, there may be situations where more frequent visits to evaluate the status of your case, tooth movement, or to have a special adjustment are required.

Empowered by the knowledge that one is never too old to have orthodontic care, greater numbers of adults are actively seeking treatment for either crooked teeth or jaw problems, as well as to address teeth that have shifted over time due to extractions, habits, or abnormal bite patterns.

Teeth can be moved at any age. Orthodontic treatment as an adult can completely transform an imperfect and poorly aligned smile into one that is attractive and functions well. However, initiating orthodontic care and achieving a successful outcome relies on the presence of healthy teeth and supporting bone. For these reasons it is important for adult patients to address any outstanding dental problems before their appliances are placed and to be diligent in maintaining their oral health throughout care.