Common Orthodontic Questions

Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention, and treatment of dental and facial irregularities. The technical term for these problems is “malocclusion,” which means bad bite. The practice of orthodontics requires professional skill in the design, application, and control of corrective appliances, such as braces, to bring teeth, lips and jaws into proper alignment to achieve facial balance.

An orthodontist is a dental specialist in the diagnosis, prevention and treatment of dental and facial irregularities. Orthodontists must first attend college, followed by a four-year graduate dental program at a university level dental school accredited by the American Dental Association (ADA). They must then successfully complete an additional two to three-year residency program of advanced dental education in orthodontics accredited by the ADA. Only dentists who have successfully completed this advanced specialty education may become an orthodontist.

Most malocclusions are inherited, and some are acquired. Inherited problems include crowding of teeth, too much space between teeth, extra teeth, congenitally missing teeth, and a wide range of discrepancies of the jaws, teeth, and face. Acquired problems can be caused by trauma, thumb or finger sucking, airway obstruction by tonsils and adenoids, dental diseases, and premature loss of baby or adult teeth. Many of these problems affect not only the alignment of teeth but also facial development and appearance as well.

It is usually difficult for you to determine if treatment is necessary because there are many problems that can occur even though the front teeth look straight. Also, there are some problems that look intimidating and complex which will resolve on their own. Asking your general dentist is a good reference, but we are your best resource since orthodontics is all we do. Our initial exam is comprehensive and informative, and we would be more than happy to see your child and make any recommendations necessary.

Although determining if treatment is necessary is difficult for you to assess, the following signs may help in prompting you to seek orthodontic advice: crowded or overlapping teeth, gaps between the teeth, front top teeth not lining up with the bottom teeth, top front teeth not meeting with bottom teeth, and top front teeth covering more than 50% of the bottom teeth. If you see any misalignment or shifting of the jaw, your child may have a skeletal problem, which may require early orthodontic treatment. These are only some of the obvious symptoms of orthodontic problems.

The American Association of Orthodontics recommends that your child be evaluated by age seven. An orthodontic screening no later than age seven enables the orthodontist to detect and evaluate problems that exist, advise if treatment will be necessary, and determine the best time for the treatment. Early detection of any orthodontic problems is important in order to take early corrective action and avoid more difficult treatment later.

Age is not a factor in considering orthodontic treatment for adults. Any adult in good general health with healthy gums and good bone support for the teeth is a candidate for orthodontic treatment. About 25% of our orthodontic patients are adults, and that number is still growing!

Orthodontic treatment has improved dramatically. As a rule, braces make your teeth tender and sore for a few days, but it is not painful. This annoyance can be relieved with an over-the-counter analgesic. Today's braces are more comfortable and use technology that reduces the discomfort. We use the latest in biocompatible braces, the advanced technique with light force and the highest quality of orthodontic materials, in order to reduce discomfort and treatment time.

Phase I, or Interceptive Treatment, usually starts while the child has most of his or her baby teeth and a few of his or her permanent front incisors. This stage in development is usually between the ages of seven and nine. The goal of Phase I treatment is to intercept a moderate or severe orthodontic problem early in order to reduce or eliminate it. These problems include skeletal discrepancies, cross bites, and severe crowding.

Phase I treatment takes advantage of the early growth spurt and turns a difficult orthodontic problem into a more manageable one. This often helps reduce the need for extraction or surgery and delivers better long-term stability. Most Phase I patients require a second phase of treatment in order to achieve an ideal final bite.

Phase II treatment usually occurs a number of years later. Usually, we are waiting for the remaining permanent teeth to erupt, including second molars, before Phase II begins. This most commonly occurs at the age of 12 or 13. The goal of Phase II treatment is to achieve an ideal bite with all of the permanent teeth.

Not every child needs a Phase I treatment. Only some children with certain bites require early intervention. All others can wait until most, if not all, of their permanent teeth erupt. However, it is still important that every child be evaluated by age seven.

Braces may be on between 6 to 30 months or, in rare instances, longer. This depends on the development of the dentition, the severity of the problem, patient cooperation, and the degree of tooth movement required.

Each treatment is a way to address crowding of the teeth. Extraction therapy is a technique where one or more permanent teeth are removed to make room for the other teeth in the mouth. This is in contrast to non-extraction therapy where one expands a patient's jaw and/or adjusts the size and shape of some teeth to make them fit within the jaw. Our office's treatment philosophy is very conservative, and we do make every effort to avoid extraction by treating patient at an early age to accommodate all teeth in a growing patient. However, for severe crowding and severe jaw discrepancy, the extraction approach may be required.

When orthodontic treatment is implemented at the proper time, treatment is often less costly than the dental care required to treat the more serious problems that can develop years later. Orthodontic fees have not increased as fast as many other consumer products. Financing is usually available, and our office offers many payment programs that will meet your needs. In addition, many insurance plans now include orthodontics.