Orthodontics

This is a question we hear all the time. Malocclusion, or what we call having a “bad bite,” is the improper alignment of teeth and/or jaws. When your teeth and jaws are not properly aligned, it may impact your bite, the ability to properly care for your teeth, your gum tissue health and even your appearance. Most people will experience some degree of malocclusion, but it generally is not severe enough to require orthodontic treatment. If your malocclusion is serious enough, however, treatment may be necessary to correct the issue.
Untreated malocclusion can lead undesirable mouth problems, including tooth decay, gum disease, or chipped and cracked teeth. The most common solution for malocclusion, of course, is orthodontic treatment. The actual course of treatment, including the length of time you will require braces, will be determined by severity of your malocclusion. The goal of your treatment is to move your teeth into the proper position and correct any misalignment in the jaw.
We use the most advanced technology in the field in order to ensure that you receive the best possible results. If you have any questions about malocclusion or about starting your orthodontic treatment, please give us a call!

Millions of patients undergoing orthodontic treatment will not be smiling this holiday season, and not because they didn't get the gift they wanted. These are people whose teeth and/or braces fall victim to the hard, chewy, gummy or sticky holiday treats.
We know orthodontic emergencies are never convenient nor timely. If you are a patient of record, we are committed to your oral health and are available to you. As a general rule, you should call our office when you experience severe pain or when you have a painful appliance problem that you can't take care of yourself. You might be surprised to learn that you may be able to temporarily solve many problems yourself until you schedule an appointment. When working with your appliances, you need to know the names of the parts of your appliances so you are able to identify what part is broken or out of place. After alleviating your discomfort, it is very important that you still call our office as soon as possible to schedule a time to repair the problem. Allowing your appliance to remain damaged for an extended period of time may result in disruptions in your treatment plan.
If you have a orthodontic emergency after regular office hours, please give us a call and follow the emergency prompts to contact our team! We hope you're having a great holiday season!

Did you know there is a direct correlation between your bite and your overall health? When your teeth and jaws are not properly-aligned, it may affect your breathing, speech, and, in extreme cases, even affect the appearance of your face. As a result of malocclusion, also commonly referred to as “bad bite,” your teeth may become crooked, worn or protruded over time. Most people experience some degree of malocclusion, but it is generally not severe enough to require corrective measures. If your malocclusion is serious enough, however, orthodontic treatment may be necessary to correct the issue.

Malocclusion may also be referred to as an underbite, crossbite or overbite. So, what, exactly, is the difference between the three?

• Crossbites, which can involve a single tooth or a group of teeth, occur when your upper and lower jaws are both misaligned, and usually causes one or more upper teeth to bite on the inside of the lower teeth. Crossbites can happen on both the front and/or the sides of the mouth, and are known to cause wear of the teeth, gum disease and bone loss.
• Overbites, also known as “overjet,” occurs when your upper teeth overlap considerably with the lower teeth. Overbites can lead to gum issues or irritation and even wear on the lower teeth, and are known to cause painful jaw and joint problems. Overbites can usually be traced to genetics, bad oral habits, or overdevelopment of the bone that supports the teeth.
• Underbites, which occur when the lower teeth protrude past the front teeth, are caused by undergrowth of the upper jaw, overgrowth of the lower jaw, or both. Underbites can also be caused by missing upper teeth, which can prevent the normal function of front teeth ( molars). This in turn leads to tooth wear and pain in your joints and jaw.

Fortunately, we are able to treat bite problems. If you suspect you or your child has a bite misalignment, we encourage you to be examined at our office as early as possible. By starting early, you can make sure you or your child avoid years of pain and self-consciousness.

Many of our patients consider the beginning of a new year a time to not only reflect on the year that was, but also to set personal goals for the upcoming year. How are you planning to improve your health and happiness in 2013? Because it's never too early to start thinking about New Year's resolutions, we recommend that you make a New Year’s resolution to benefit your oral health!
It’s important that New Year’s resolutions are reasonable and attainable, and that they improve your overall quality of life—for example, did you know that flossing every day is the very best way to prevent periodontal, or gum disease during your orthodontic treatment? Using a straw when drinking sugary beverages can also help prevent cavities while you’re wearing braces. There are many small steps that you can take to prevent cavities, oral infections and bad breath.
Be sure to give us a call if you need a few suggestions on ways to improve your oral health. After all, oral health is about more than just a beautiful smile.
If your resolution is to attain a great-looking smile, we’d love to help! Please give us a call and schedule your initial consultation. We look forward to working with you and your family!
Happy holidays!

Braces are an investment in your smile. When your teeth reach a desired straightness, you’ll have a beautiful smile, but it’s important to keep it that way! You can accomplish this with a retainer.
A retainer is a small, custom-fit device that reinforces the new position of your teeth after your braces are removed. But for many patients, especially the youngest ones, wearing a retainer may seem like an annoyance. So exactly how long after your braces come off should you wear your retainer?
Graduation of Wear Time
When we remove your braces, we will evaluate the condition of the bone structure surrounding your teeth and determine how well it is adjusting to the new position of your teeth. For the first few months, we may require you to wear your retainer both day and night, except during meal times and for brushing and flossing.
As the bone and gum tissues adjust to your new smile, we may determine that you need to wear your retainer only at night. After about one year of wearing the retainer every night, you may be able to take a couple of nights off each week.
However, we do not recommend ever stopping permanently. To best secure the position of the teeth, especially through future extractions and oral health changes, wearing your retainer a few nights a week will be necessary for many years.
Considerations
If you are concerned about your appearance when you wear a retainer, there are many that can be worn discreetly. You could choose a clear plastic one that is less obvious during the months immediately following removal of your braces. When you change to night wear only, clear wire retainers are available for minimal visibility as well.
Another option is a lingual retainer. It is placed on the back sides of your teeth so no one will ever know it is there! Lingual retainers are also permanent, so there’s no risk of losing them.
Remember, wearing your retainer is an investment in your smile. If you fail to wear it consistently, the tissues that support your teeth will be unsupported, and you may begin to experience noticeable shifting. You’ve worked hard to get that beautiful smile — your retainer will let you keep it!

Did you know that even in ancient times, people wanted to improve the look and function of their smiles? We think of modern orthodontic appliances as sleek, efficient technology, but this was not always so! Take a look at the highlights in the evolution of braces.
Ancient Times: From Greece to Rome

• According to The Angle Orthodontist, Aristotle and Hippocrates first thought about methods for straightening teeth between 400 and 300 BC.
• The Etruscans, in what we now know as Italy, buried their dead with appliances that maintained spaces and prevented collapse of their teeth and jaws during life. Archaeologists have discovered mummified remains in various locations that have metal bands wrapped around the teeth.
• A Roman tomb has also been discovered in which the teeth were bound with gold wire, including documentation on the wire’s use as a dental device.

18th Century: A French Development

• The French dentist Pierre Fauchard is acknowledged as the father of modern dentistry. In 1728 he published a book that described various methods for straightening teeth. Fauchard also used a device known as a “blandeau” to widen the upper palate.
• Louis Bourdet was another French dentist who published a book in 1754 that discussed tooth alignment. Bourdet further refined the blandeau and was the first dentist to extract bicuspids, or the premolar teeth between canines and molars, for the purpose of reducing tooth crowding.

19th Century: Orthodontics Defined

• Orthodontics started to become a separate dental specialty during the early 19th century. The first wire crib was used in 1819, marking the beginning of modern orthodontics.
• During this period, gold, platinum, silver, steel, gum rubber, vulcanite, and occasionally wood, ivory, zinc, and copper were used — as was brass in the form of loops, hooks, spurs, and ligatures.
• Edward Maynard first used gum elastics in 1843 and E. J. Tucker began making rubber bands for braces in 1850.
• Norman W. Kingsley published the first paper on modern orthodontics in 1858 and J. N. Farrar was the first dentist to recommend the use of force over timed intervals to straighten teeth.

20th Century: New Materials Abound

• Edward Angle developed the first classification systems for malocclusions (misaligned teeth) during the early 20th century in the United States, and it is still in use today. Angle founded the American Society of Orthodontia in 1901, which was renamed the American Association of Orthodontists in the 1930s.
• By the 1960s, gold was universally abandoned in favor of stainless steel.
• Lingual braces were the “invisible” braces of choice until the early 1980s, when tooth-colored aesthetic brackets made from single-crystal sapphire and ceramics became popular.

Today
As we arrive in the present, you need only look at your own braces to see how far we’ve come. Your treatment plan was probably created with a 3D digital model, and we’ve likely used a computerized process to customize your archwires. Perhaps you have clear aligners, self-ligating brackets, or highly resilient ceramic brackets with heat-activated wires.
Orthodontics has come a long way from the days of Aristotle, and even the bulky wrap-around braces of just 60 years ago. Regardless of your specific treatment plan, the development of high-tech materials and methods has made it possible for your orthodontic experience to be as effective, efficient, and comfortable as possible.
http://www.angle.org/doi/full/10.1043/0003-3219%282002%29072%3C0501%3AOBFTPT%3E2.0.CO%3B2
http://www.archwired.com/HistoryofOrtho.htm

One exciting part about wearing braces is getting to choose the colors of your rubber bands. Orthodontists place elastic bands, or ligatures, over each bracket to secure the archwire in place. These rubber bands may be individual or connected, depending on your mouth’s needs. You have the option of choosing the color of your elastics, which are changed about once every month at every visit. Our offices keep a color wheel handy to help you choose which ones suit you best!
Children and teens often enjoy picking different colors each month to express their creativity and coordinate their braces with outfits. Decorating your mouth with your favorite colors is fun for kids and takes some of the stress out of wearing braces. Adults who wish for subtlety have color options that blend in with the metal brackets and archwire. Common choices for adults include silver, clear, and gray tones.
Common Color Combinations for Rubber Bands
With individual ligatures for each bracket, you may choose different color combinations for special events. You can have alternating colors or place an entire rainbow over your teeth. Here are a few options to consider:

• School spirit colors
• Favorite sports team colors
• Patriotic colors
• Holiday themes

Some patients choose only one color to match their mood, personality, or favorite outfits. The palette of choices allows you to make bold statements with your braces or go for subtler tones that blend in with the metal structures. Keep in mind that bright colors make your teeth look whiter, while lighter shades, such as yellow and white, may cause your teeth to appear less bright.
What Your Rubber Band Color Says About You

• Red tones indicate that you are ready for action and take charge of your life with aggressive, forward-thinking steps.
• Blue tones are calm and relaxing. You are conservative and exhibit integrity when dealing with situations.
• Green tones represent growth and balance. You are level-headed and look for opportunities to grow emotionally and spiritually.
• Purple tones attract creative energies. You like to have fun and use your imagination in every aspect of your life.
• Orange tones indicate that you are optimistic and thrive in social situations where communication is open.

Pink is a romantic color that represents a caring personality. You also enjoy having fun with silly games and endless laughter.

When the time to remove your braces finally arrives, it is very exciting. Unfortunately, it can be somewhat confusing, too, because you are faced with choosing between two kinds of retainers. Should you go with permanent, removable, or a combination of the two? It is always wise to follow your dentist’s recommendations, but knowing more about the two types of retainer beforehand can be helpful.
Removable Retainers
Removable retainers offer the advantage of easy use: you will generally put a removable retainer in at night and take it out in the morning. Regardless of your retainer schedule, you'll be able to enjoy some time with no retainer. However, a removable retainer can easily be forgotten at times, and this means you won't be taking full advantage of teeth retention.
Another potential advantage of a removable retainer is that you can take it out and brush and floss your teeth with ease, which is more of a challenge with a permanent retainer. Although removable retainers can be very effective, they don't tend to be as effective as permanent retainers, especially if they are not used as directed.
Permanent Retainers
Permanent retainers are the clear choice for patients who want to “get it and forget it.” Once your permanent retainer is placed in your mouth, you won’t need to worry about daily retainer schedules, since it is permanently affixed to your teeth.
Because teeth begin to shift naturally as we age, a permanent retainer typically offers better long-term results for teeth straightening than a removable one. You can't forget to put it in — it's already there! Temporary retainers get lost or are forgotten on trips, and often fail to get used as often as they should be.
One drawback to permanent retainers is flossing. Some patients find it more difficult to floss with a permanent retainer, but we can show you effective ways to floss fairly quickly with your permanent retainer.
Some orthodontists may recommend a combination of the two; for example, a removable retainer for the top teeth and a permanent one for the lower ones because the lower teeth are smaller and tend to shift more.
Ultimately, the most important thing to remember is that wearing your retainer as directed is extremely important. As long as you follow our orthodontist’s advice, you will get the best results from your retainer, regardless of its type.

Orthodontic braces are used to straighten the teeth, which not only creates a more pleasing appearance, but also helps prevent tooth decay and other oral health problems. Braces are only effective when they are properly cared for, however. Certain foods, for example, are better suited for individuals who have braces, as opposed to hard and sticky foods that can cause damage. So what types of foods should you or your kids eat to protect dental appliances?
The best foods to eat with braces are those that are not high in sugar and do not require excessive chewing. For breakfast, try eggs, yogurt, bacon, wheat toast, or oatmeal. Lunch may steer toward a banana rather than an apple, a salad without nuts, and a glass of water. If you are looking for some after-school snacks for your kids, consider baked tortilla chips with salsa and guacamole, or try string cheese with fruit.
A healthy dinner can include most types of vegetables, so long as they are cooked to an appropriate softness. Pair that with a lean protein, such as fish or chicken, and follow up with dessert. Just be sure to brush afterward!
Post-Tightening Foods
As braces begin to adjust the alignment of the teeth, our office will periodically tighten them to continue the alignment process. After tightening occurs, the teeth may be sore and sensitive to certain foods. During this time, it is best to eat soft foods. Examples include:
• pudding
• mashed potatoes
• soup
• ice cream
• cottage cheese
• peas
• pancakes
• pasta
Foods to Avoid
According to the American Dental Association, anyone who wears braces – whether fixed or removable – should avoid excessive snacking and should aim to eat a healthy and balanced diet. It is also important to avoid foods that could cause damage to the braces, such as:
• hard candies
• gum
• nuts
• popcorn
• certain raw vegetables (for example, carrots)
Considerations
Regardless of what types of foods you eat with braces, it is important to keep the crevices between the teeth and around the braces very clean. That means brushing and flossing after meals to prevent the build-up of plaque and decay. Not only can failing to do so damage the teeth, but it can also cause discoloration.

Malocclusion, or "bad bite," is when the upper and lower teeth are not meeting correctly. When young, the jaw growth is a slow and gradual process. Once in a while something may go wrong with this process causing the upper and lower jaws to grow at different rates, resulting in an improper bite.
Leaving an improper bite untreated may threaten the long-term health of your teeth and gums. The jaw joint (TMJ) can also be negatively affected by a jaw misalignment. In addition, jaws of different sizes can affect appearance.
Appliances for Correcting Jaw Growth
Let me explain to you about corrective jaw treatments. We use a process called dentofacial orthopedics to correct jaw problems. The issue you have with your jaw is relatively minor, but some type of corrective measure is going to have to be taken. There are three types of appliances that we use to correct jaw growth problems: Headgear, the Herbst® appliance and the Bionator. I know, the names sound like something out of a science fiction movie, right? However, you have nothing to worry about. All of these appliances are straightforward and easy to use, and all of them will help make your upper and lower jaws more compatible. Let me explain further.
Headgear
Headgear is one of the most common orthodontic appliances. It works by applying pressure to the upper teeth and jaw. This pressure then helps guide, form, and correct upper jaw growth. It also helps align your upper teeth. Headgear is typically worn between eight and 12 hours. You might find it difficult to sleep with headgear on at first, but in no time at all, you won’t even know it’s there.
The Herbst® Appliance
The Herbst appliance is different. Unlike headgear, it can’t be removed from your mouth. The appliance is fixed to the molars. It works by holding the lower jaw forward, and this helps to create successful jaw growth and teeth positioning.
The Bionator
This is another example of a removable appliance. It enables the upper and lower jaws to grow proportionally. The Bionator holds the bottom jaw forward as well as guides the teeth. It will result in a perfectly aligned and corrected bite.

Most parents know that routine dental care should begin during the toddler years. But many are unaware of when orthodontic treatment should begin. According to the American Association of Orthodontists, the ideal age for an orthodontic evaluation is age seven or before, when children usually have a mixture of adult and baby teeth. Although treatment usually will not begin until one to five years after the initial evaluation, the evaluation is helpful in determining whether your child has any problems with emerging teeth — regardless of how subtle.
Children have more formidable bone structures than teenagers and adults, and as they grow, orthodontic appliances can help guide jaw growth, which may prevent the development of an overbite or under-bite, as well as tooth crowding due to space limitations. Orthodontic treatment is also helpful for guiding newly emerging adult teeth into a proper alignment, which is not only aesthetically advantageous, but also helpful in preventing tooth decay.
Why Early Evaluation?
Taking your child to the orthodontist for an evaluation means that you may be able to identify problems with the jaw and teeth early when they are still easy to treat. Early treatment often equals a more simplified treatment plan, which is beneficial to both children and their parents. Often, earlier treatment can cost less to correct a problem than delayed treatment.
If a problem is detected, our team will discuss corrective options and provide a recommended treatment schedule. Depending on your child's orthodontic needs, he or she may benefit from:

• Palatial Spacers - Helpful for correcting a crossbite by expanding the width of the upper jaw.
• Fixed Functional Appliance - Helpful for correcting severe upper tooth protrusion.
• Headgear - Helpful for guiding healthy growth of new teeth and the jaw. Headgear is removable, but usually must be worn at least ten hours per day.

If your child is approaching the age of seven, or has already surpassed his or her seventh birthday, it is time to schedule an appointment for an initial examination.

How long does orthodontic treatment take?

Orthodontic treatments are used to correct malocclusion, a condition more commonly known as a bad bite. The length of treatment time varies depending on the severity of the bite problem.
What is a "bad bite"?
A bad bite occurs when spacing or alignment problems are present. This often includes teeth that are protruding, crowded, or crooked. Sometimes teeth appear straight, but have an uneven bite because the upper and lower jaws do not align properly. Teeth that are irregularly spaced — either too far apart or too close together — can also cause bite problems.
Frequent causes of bite problems:

• Heredity
• Thumb-sucking
• Premature tooth loss
• Accidents

Benefits of orthodontic treatment:
Appearance -
Correcting a bad bite often creates a more attractive smile, which frequently raises the patient's self esteem.
Preventing Decay -
It also results in a healthier mouth. It is much more difficult to thoroughly clean teeth that are crooked, protruding, overlapped, or crowed. This may allow plaque to build up, which can lead to gum disease, tooth decay, and even tooth loss. Orthodontic treatment corrects these conditions, so cleaning can be more efficient.
Avoiding Alignment Issues -
An uneven bite can interfere with the motions of chewing and speaking. This can cause abnormal wear to tooth enamel, which may require pricey cosmetic restorative treatments, such as crowns or veneers, to correct. It can also lead to problems with the jaws. Orthodontic treatment lessens the likelihood of those issues, as well.
Types of orthodontic treatment:
Braces: Metal or ceramic brackets are bonded to the front of teeth. Wires and elastics are attached to the brackets to straighten teeth.
Invisalign®: Advanced 3D computer images of the patients' mouth are used to create clear, custom aligners that slowly move teeth. They are nearly invisible and are more comfortable than traditional braces. They are also removable, which makes it possible to continue with normal brushing and flossing.
Retainers: A retainer is a removable piece worn inside the mouth that uses pressure to force teeth to move into proper alignment. They are used after braces are removed.
Length of orthodontic treatment:
Treatment typically ranges from 12 to 36 months. Factors include the age, cooperation level, and growth occurrence of the patient. The complexity of the case also impacts the treatment time.

Are you thinking about orthodontic treatment to straighten teeth or correct jaw alignment? Consider making your first step an orthodontic consultation. During the consultation we will address your questions, concerns, and talk about a treatment plan that would best suit your situation.
We want you to feel prepared and in charge of your orthodontic treatment decisions, so keep these questions in mind when you come in for your appointment.
• If I do need some adjustments to my teeth, what options will I have besides braces?
(This will help you determine what approaches we use to straighten your teeth.)
• What kind of preparation is needed to get braces? How many visits will it take?
(It’s important to know how many appointments may be needed and what you will need to do between appointments to be ready for braces.)
• Can I expect any pain when getting braces?
(Ask about the ways we address pain management.)
• What determines how long I have to wear braces?
(The length of treatment will vary from patient to patient. During your consultation we can evaluate your teeth and jaw alignment to determine the correct course and length of treatment.)
• How will braces affect my lifestyle? Foods I can eat? Activities I can do?
(You may find that little needs to change in your daily routine to have a successful orthodontic outcome. We can discuss and address any changes so you can be prepared before you get your braces.)
• Who will be involved in the orthodontic work? Whom can I expect to see during my adjustment visits?
• What will my orthodontic work cost? What is the ”average” cost and what could be the maximum?
(Make sure you are clear about what your insurance covers, who contacts the insurance company for pre-authorization, who files the insurance forms, and what flexibility there is to pay the remaining amount not covered.)
Your initial orthodontic consultation may just be the first step in relieving a lot of pain and discomfort in your life. Going in with the right questions will help you to understand the entire process and prepare you to do your part for your own dental health. Be sure to bring a list of your questions!

As long as you practice good oral hygiene and follow these basic tips, you should have no problem keeping your teeth from decaying while you wear braces.