What is orthodontics and dentofacial orthopedics?

Orthodontics and Dentofacial Orthopedics is one of the nine dental specialties that deals with the diagnosis, prevention, and treatment of dental and facial irregularities. You probably know that an orthodontist straightens teeth. Indeed, “ortho” comes from the Greek for “straight” or “correct,” and “dontic” from the Greek for “teeth.” But what about dentofacial orthopedics? “Dentofacial” is “teeth” plus “face,” while “ortho” again means “straight,” and “pedic” is from the Greek for “child.”

Therefore, orthodontics involves the management of tooth movement, and dentofacial orthopedics involves the guidance of facial growth and development, which occurs primarily during childhood. In both cases, appliances are commonly used — the more familiar braces for orthodontics, and other specialized appliances, like headgear and expanders, depending on what facial abnormalities are present. Sometimes, orthopedic treatment may be used before conventional braces, but often the two are applied at the same time. So if your child gets braces and headgear, he’s undergoing orthodontics and dentofacial orthopedics!

What is an orthodontist?

An orthodontist is a specialist who has completed an advanced education program following dental school to learn the special skills required to control tooth movement and guide facial development. Every orthodontist starts out by completing dental school. Upon finishing dental school, some graduates immediately go into practice as dentists. Others choose to pursue a dental specialty, which involves additional schooling during a two- to three-year residency program. There are nine specialties sanctioned by the American Dental Association. Some that you may be familiar with are Pediatric Dentistry (dentistry for children), Periodontics (dentistry focusing on the gums), and Oral Surgery.

What are some possible benefits of orthodontics?

  • A more attractive smile
  • Better function of the teeth
  • Possible increase in self-confidence
  • Increased ability to clean the teeth
  • Improved force distribution and wear patterns of the teeth
  • Better long-term health of teeth and gums
  • Permanent teeth guided into more favorable positions
  • Reduced risk of injury to protruding front teeth
  • Aid in optimizing other dental treatments

What are some signs that braces may be needed?

  • Upper front teeth protrude excessively over the lower teeth giving the appearance of “Buck teeth”
  • Upper front teeth cover the majority of the lower teeth when biting together. This is called a deep bite.
  • Upper front teeth are behind or inside the lower front teeth. This is called an underbite.
  • The upper and lower front teeth do not touch when biting together. This is called an open bite.
  • Crowded teeth that are overlapping
  • The center of the upper and lower teeth do not match up
  • Finger or thumb-sucking habits that continue beyond five years of age
  • Difficulty chewing food
  • Teeth wearing unevenly or excessively
  • The lower jaw shifts to one side or the other when biting together. This could be the result of a crossbite.
  • Spaces or gaps between the teeth

At what age should orthodontic treatment occur?

Orthodontic treatment can start at any age. Many orthodontic problems are easier to correct if detected at an early age, before jaw growth has slowed. Some of the benefits of early treatment may mean that a patient can avoid surgery and more serious complications later in life. The American Association of Orthodontists recommends that every child first visit an orthodontist by age seven, or earlier if a problem is detected by parents, the family dentist, or the child’s physician.

What is Phase-One and Phase-Two treatment?

Phase-One, or early interceptive treatment, is limited orthodontic treatment using appliances like expanders or partial braces, before all the permanent teeth have erupted because there are orthodontic problem that are significant enough to require treatment while a child still has baby teeth present. Such treatment can occur between the ages of six and ten. This treatment is sometimes recommended to make more space for developing teeth, correction of crossbites, overbites and underbites, or harmful oral habits. Phase-Two treatment is also called comprehensive treatment because it involves full braces when all the permanent teeth have erupted, which is usually between the ages of 11 and 13.

What if my child doesn’t need Phase I treatment?

If a patient is not yet ready for treatment, as is the case with most children, Dr. Newman will follow the patient’s growth and development until the time is right for treatment to begin.

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. However, the need for a second phase of orthodontic treatment doesn’t mean that Phase I shouldn’t be performed. There are some orthodontic problems that can only be corrected in a young, growing child.

Will my child need an expander?

At the completion of the initial examination, Dr. Newman will determine whether your child will benefit from an expander. Palatal expansion improves the way the upper and lower jaws and the upper and lower teeth work. It widens the jaw so there is sufficient room for permanent upper and lower teeth to come in. Expansion can make the final smile broader and more attractive. Without expansion, and depending on the problem, permanent teeth may not have enough space to come in; or the lower jaw could grow out of proportion, which could require corrective surgery as an adult. Left untreated, a narrow palate can lead to excessive wearing of the teeth or the need for extensive dental work as an adult. A narrow upper jaw may affect your child’s appearance and may contribute to difficulties with biting, chewing and speech. Palatal expansion needs to be completed while the child is still growing because the suture on the palate has not yet fused. Patients who have completed growth may require surgically-assisted rapid palatal expansion.

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. In fact, as orthodontists, we can many times notice developing malocclusions and problems in dental eruption before your dentist does. As mentioned above, The American Association of Orthodontists recommends that every child see an orthodontist by age 7. Think of it as a “well visit” for your growing jaws and teeth.

How does orthodontic treatment work?

Braces place gentle, steady pressure to move teeth gradually into their proper positions. The brackets placed on the teeth and the archwire that connects them are the main components. When the archwire is placed into the brackets, it tries to return to its original shape. As it does so, it applies pressure to move the teeth to their more ideal positions.

How long does orthodontic treatment take?

Treatment times vary on a case-by-case basis, but the average time is 12-24 months. Actual treatment time can be affected by rate of growth and severity of the necessary correction. Treatment length is also dependent upon patient compliance. Maintaining good oral hygiene and keeping regular appointments are important in keeping treatment time on schedule.

Do braces hurt?

The placement of bands and brackets on your teeth does not hurt. Once your braces are placed and connected with the archwires, you may feel some tenderness or soreness of your teeth for a few days. Your lips and cheeks may also need one to two weeks to adjust to the braces on your teeth. After most adjustment visits, patients do not feel any soreness at all! We often remind our patients, “It does not have to hurt to work!”

Will braces interfere with playing sports?

No. It is recommended, however, that patients protect their smiles by wearing a mouthguard when they participate in any sporting activity. Mouthguards are inexpensive and comfortable, and come in a variety of colors and patterns.

Will braces interfere with playing musical instruments?

No. However, there may be a short period of adjustment. In addition, brace covers and wax can be used to prevent discomfort.

Should I see my general dentist while I have braces?

Yes, you should continue to see your general dentist every six months for cleanings and dental checkups unless they recommend more frequent intervals.

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. And, it is much easier to correct problems with crowding when there are baby teeth still present.

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 or send us an e-mail. You can fill out an appointment request at the bottom of this page and we will be happy to contact you to schedule your appointment. When you call to schedule your appointment, our front office staff will request some basic information from you.

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. At times, the jaws do not have enough room to accommodate all the teeth and trying to fit them all can be more detrimental than beneficial and the result of orthodontic treatment will not be as good. However, because new technology has provided advanced orthodontic procedures, removing teeth is not always necessary for orthodontic treatment.

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. The cost of treatment varies from patient to patient depending on the severity of the case. We will cover the exact cost and financial options during the initial examination. We have several financing options available to accommodate our patients needs, and we will review these with you. We never want finances to stand in the way of orthodontic treatment. We will also review your insurance policy and help to maximize your benefit and file your claims.

How often will I have appointments?

Appointments are scheduled according to each patient’s needs. Most patients in treatment will be seen every 4 to 8 weeks. At times, there are situations that require more frequent monitoring and we will schedule appointments accordingly.

Can I return to school the same day as my braces are placed?

Yes. There is no reason you cannot return to school the same day.

Do you give shots?

No. Shots are not necessary in orthodontic treatment. The process of putting braces on is quite painless.

Do you use recycled braces?

Absolutely not! In fact, our braces come individually packaged and are brand new for each patient.

Are there certain foods I cannot eat while I have braces?

Yes. Once treatment begins, we will go over 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.

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 brush and floss their teeth with braces and may also provide a prescription for a special fluoride, if necessary.

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.

Is it too late to have braces if I am already an adult?

Many of our patients are adults. In fact, 25 percent of all orthodontic patients are adults. Orthodontic treatment can be successful at any age. Health, happiness and self-esteem are vitally important to adults. No patient is “too old” to wear braces!

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. Dr. Newman can talk to you about the specifics of treatment when teeth are missing.

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. As a Board Certified Orthodontic Specialist, Dr. Newman has extensive and specialized training that enables her to provide her patients with professional, personalized treatments.