We Believe That Great Smiles Are Worth It

Why Braces?

For most people, a beautiful smile is the most obvious benefit of orthodontics. After your braces come off, you’ll feel more self-confident. During your treatment, we want you to feel as comfortable as possible.

How Orthodontic Treatment Works
Orthodontic appliances can be made of metal, ceramic, or plastic. They may be removable or they may be brackets bonded to the teeth. By placing a constant, gentle force in a carefully controlled direction, braces slowly move teeth to a corrected position. This is a great time to wear braces! Gone are the days when a metal band with a bracket was placed around each tooth. You can choose brackets that are clear or metallic color. You can choose the color of the ties that hold the wire in the brackets. Wires are also less noticeable than they used to be, and the latest materials move teeth faster with less discomfort to patients.

Duration of Treatment
Treatment time typically ranges from one to three years, depending on the growth of the patient’s mouth and face and the severity of the problem. Patients grow at different rates and will respond variously to orthodontic treatment, so the time to case completion may differ from the original estimate. The patient’s diligent use of any prescribed rubber bands is an important factor in achieving the most efficient treatment. Interceptive, or early treatment procedures, may take as few as six months.

Parts of Braces

Appliance – Anything your orthodontist attaches to your teeth that moves your teeth or changes the shape of your jaw.
Archwire – The metal wire that acts as a track to guide your teeth as they move. It is changed periodically throughout treatment as your teeth move to new positions.
Band – A metal ring that is cemented to your tooth that goes completely around it. Bands provide a way to attach brackets to your teeth.
Bond – The seal created by orthodontic cement that holds your appliances in place.
Bracket – A metal or ceramic part cemented (“bonded”) to your tooth that holds your archwire in place.
Coil Spring – A spring that fits between your brackets and over your archwire to open space between your teeth.
Elastic (Rubber Band) – A small rubber band that is hooked between different points on your appliance to provide pressure to move your teeth to a new position.
Elastic Tie – The tiny rubber band that fits around your bracket to hold the archwire in place. They come in a variety of colors.
Headgear – Headgear uses an external wire apparatus known as a facebow to guide the growth of your face and jaw gently by moving your teeth into proper position. The force is applied to the facebow by a spring-loaded neck strap or head strap. The straps have a safety release that disconnects if the facebow is pulled or snagged.
Headgear Tube – A round, hollow attachment on your back bands. The inner bow of your headgear fits into it.
Hook – A welded or removable arm to which elastics are attached.
Ligature – A thin wire that holds your archwire into your bracket.
Lip Bumper – A lip bumper is an archwire attached to a molded piece of plastic. The lip bumper holds back the molars on your lower jaw to provide more space for your other teeth.
Mouthguard – A device that protects your mouth from injury when you participate in sports or rigorous activities.
Palatal Expander – A device that makes your upper jaw wider.
Retainer – An appliance that is worn after your braces are removed, the retainer attaches to your upper and/or lower teeth to hold them in place. Some retainers are removable, while others are bonded to the tongue side of several teeth.
Separator or Spacer – A small rubber ring that creates space between your teeth before the bands are attached.
Tie Wire – A fine wire that is twisted around your bracket to hold the archwire in place.
Wax – Wax is used to stop your braces from irritating your lips.

Orthodontic Procedures

Banding – The process of fitting and cementing orthodontic bands to your teeth.
Bonding – The process of attaching brackets to your teeth using special orthodontic cement.
Cephalometric X-ray – An X-ray of your head that shows the relative positions and growth of the face, jaws, and teeth.
Consultation – A meeting with your orthodontist to discuss a treatment plan.
Debanding – The process of removing cemented orthodontic bands from your teeth.
Debonding – The process of removing cemented orthodontic brackets from your teeth.
Impressions – A model of your mouth made by biting into a soft material that hardens into a mold of your teeth. Your orthodontist will use these impressions to prepare your treatment plan.
Invisalign® – An alternative to traditional braces, Invisalign straightens your teeth with a series of clear, custom-molded aligners. Invisalign can correct some, but not all, orthodontic problems.
Ligation – The process of attaching an archwire to the brackets on your teeth.
Panoramic X-ray – An X-ray that rotates around your head to take pictures of your teeth, jaw, and other facial areas.

What is the advantage of two-phase orthodontic treatment?

Two-phase orthodontic treatment is a specialized process that combines tooth straightening and physical, facial changes. The purpose of two-phase treatment is to maximize the opportunity to accomplish the ideal healthy, functional, and aesthetic result that will remain stable throughout your child’s life.

What if treatment is put off?

Putting off treatment can result in a need for more invasive treatment later in life that may not completely fix your child’s smile. Early treatment is most effective for achieving lasting results.

Phase One

A Foundation for a Lifetime of Beautiful Smiles

The goal of Phase One treatment is to help the jaw develop in a way that will accommodate all of the permanent teeth and improve the way the upper and lower jaws fit together. Children often exhibit early signs of jaw problems as they grow and develop. An upper jaw that is growing too much or is too narrow can be recognized at an early age. If children over the age of six are found to have this jaw discrepancy, they are candidates for early orthodontic treatment. Also, if children around the age of eight have crowded front teeth, early treatment can prevent the need to extract permanent teeth later.

Planning now can save your child’s smile later

Children benefit tremendously from early-phase treatment. Receiving early treatment may prevent the removal of permanent teeth later in life, or the need for surgical procedures to realign the jaws.

Making records to determine your child’s unique treatment

Orthodontic records will be necessary to determine the type of appliances to be used, the duration of treatment time, and the frequency of visits. Records consist of models of the teeth, X-rays, and photographs. During your child’s initial consultation, the doctor will take records to determine if early treatment is necessary.

Resting Period

In this phase, the remaining permanent teeth are left alone as they erupt. Retaining devices may not be recommended if they would interfere with eruption. It is best to allow the existing permanent teeth some freedom of movement. A successful first phase will have created room for permanent teeth to find an eruption path. Otherwise, they may become impacted or severely displaced.

Monitoring the teeth’s progress

At the end of the first phase of treatment, teeth are not in their final positions. This will be determined and accomplished in the second phase of treatment. Selective removal of certain primary (baby) teeth may be in the best interest of enhancing eruption during this resting phase. Therefore, periodic recall appointments for observation are necessary, usually on a six-month basis.

Phase Two

Stay healthy and look attractive

The goal of the second phase is to make sure each tooth has an exact location in the mouth where it is in harmony with the lips, cheeks, tongue, and other teeth. When this equilibrium is established, the teeth will function together properly. Phase Two usually involves full upper and lower braces.

At the beginning of the first phase, orthodontic records were made and a diagnosis and treatment plan was established. Certain types of appliances were used in the first phase to correct and realign the teeth and jaw. The second phase begins when all permanent teeth have erupted, and usually requires braces on all the teeth for an average of 24 months. Retainers are worn after this phase to ensure your child retains his or her beautiful smile.

Orthodontics for Children

It is best for an orthodontist to see children by age 7 to advise if orthodontic treatment is required or whether it may be necessary in the future. The first permanent molars and incisors have usually come in by age 7, and crossbites, crowding, and other problems can be evaluated. When treatment is begun early, the orthodontist can guide the growth of the jaws and guide incoming permanent teeth. Early treatment can also regulate the width of the upper and lower dental arches, gain space for permanent teeth, avoid the need for permanent tooth extractions, reduce likelihood of impacted permanent teeth, correct thumb-sucking, and eliminate abnormal swallowing or speech problems. In other words, early treatment can simplify later treatment.

Orthodontics for Adults

Orthodontic treatment can be successful at any age, and adults especially appreciate the benefits of a beautiful smile. One of every five patients in orthodontic treatment is over 21. Adults also may have experienced some breakdown or loss of their teeth and bone that supports the teeth and may require periodontal treatment before, during, and/or after orthodontic treatment. Bone loss can also limit the amount and direction of tooth movement that is advisable. Orthodontics can be used to actually grow bone around the teeth, thus prolonging their longevity! Orthodontics can benefit adults, not just by improving the alignment of the teeth, but also by providing the proper amount of space for dental restorative work, such as veneers or implants, in order to achieve the best cosmetic results.

Crowding of the teeth

Patient started treatment at age 11 and wore braces for 26 months. He loves his new smile.

Before After
crowding of the teeth before crowding of the teeth after

Open bite – Front teeth don’t touch

Patient sucked her thumb as a young child. She started treatment at age 13. She had braces and a special appliance — called a crib — to retrain the tongue, for 28 months. Now she can bite the lettuce out of a sandwich.

Before After
open bite before open bite after

Deep overbite – Lower front teeth bite into palate

This adult patient, age 25, required braces and jaw surgery to correct his severe overbite, with treatment taking two years. His problem could have been corrected without surgery if he had been treated before he was a teenager.

Before After
deep overbite before deep overbite after

Missing lateral incisors

This patient’s lateral incisors were congenitally missing. She had braces for 20 months to move the teeth into their correct positions, then the missing teeth were replaced with bonded “Maryland” bridges.

Before After
missing lateral incisors before missing lateral incisors after

Underbite – Lower front teeth in front of upper teeth

Patient’s underbite was causing her jaw joint discomfort and excessive wear patterns on her teeth. After about 30 months of treatment starting at age 32, she now finds smiling and chewing much easier.

Before After
underbite before underbite after

Spacing of teeth

Patient was bothered by the spaces between his teeth. Braces closed the spaces and gave him an ideal bite in 24 months. Special glued-in retainers help keep the spaces closed.

Before After
spacing of teeth before spacing of teeth after

Overjet – Protruding front teeth

At age ten, patient had a big overjet with the top teeth protruding beyond the bottom. She had two phases of treatment. The first helped her jaws to grow more harmoniously and the second aligned her teeth and bite. At age 13, she was proudly displaying her new smile.

Before After
overjet before overjet after

Non-braces treatment

Sometimes braces are not needed to get noticeable improvements in tooth alignment. This patient was first seen at age seven for crowding of the lower permanent teeth. A procedure was performed to reduce the width of the adjacent baby teeth and the permanent incisors aligned on their own in nine months.

Before After
non braces treatment before non braces treatment after

Phase-One

Patient’s parents were concerned about both aesthetics and the health of the erupting permanent teeth when they brought him to the orthodontist at age eight. The lower front teeth were crowded and touching the palate, and the upper front teeth were extremely displaced from their normal positions. After 12 months of Phase-One treatment with an expander and partial braces, patient’s appearance and dental function were vastly improved.

Before After
phase 1 before phase 1 after

Surgical orthodontics, also known as orthognathic surgery, is a type of orthodontic treatment used to correct severe cases that include bad bites, jaw bone abnormalities, and malocclusion. Oral and maxillofacial surgery is one of the nine recognized dental specialties, and it focuses on treating complex craniofacial cases that involve the mouth, jaw, face, and skull. If you need surgical orthodontics, your orthodontist will work with an oral and maxillofacial surgeon to ensure that you receive the best care possible.

When might surgical orthodontics be needed?

Surgical orthodontics may be used to treat adults with improper bites or other aesthetic concerns. Typically, jaw growth stops by age 16 in females and 18 in males. In order to receive orthognathic surgery, the jaw must be done growing. The need for surgical orthodontics occurs when the jaws do not line up correctly, and a proper bite cannot be achieved with orthodontic treatment alone. Orthognathic surgery will help properly align the jaw, and orthodontic braces will then be used to move the teeth into their proper position.

How do I know if I need orthognathic surgery?

Your orthodontist can tell you if orthognathic surgery is needed as part of your treatment. Depending on the severity of your case and the alignment of your jaw, you may or may not need surgery.

How does orthognathic surgery work?

An oral and maxillofacial surgeon will perform your orthognathic surgery, and the surgery will take place in a hospital. Orthognathic surgery can take several hours depending on each individual case. Once the surgery is complete, you will have about a two-week rest period. Since orthognathic surgery is a major treatment, we recommend that you schedule some time away from work and school during the healing process. After your jaw has healed, your orthodontist will once again “fine-tune” your bite. After surgery, you will have to wear braces, and most braces are removed within six to 12 months following surgery. After your braces are removed, you will wear a retainer to help maintain your new smile.

What are the risks associated with orthognathic surgery?

As with any major medical surgery, there may be certain risks of having orthognathic surgery. However, the process of orthognathic surgery is not new, and it has been performed for many years in practices and hospitals. If you’re concerned about an upcoming treatment with orthognathic surgery, please contact our practice and let us know. We are happy to answer any questions that you may have, and provide you with any additional information. Your comfort is important to us.

What are the rewards of having orthognathic surgery?

For many patients, the most important reward of having orthognathic surgery is achieving a beautiful, healthy smile that lasts a lifetime. Whether you need orthodontic treatment to correct a bad bite, malocclusion, or jaw abnormality, orthognathic surgery can help restore your confidence and leave you smiling with confidence for many years to come.

You may have noticed that our doctor specializes in “orthodontics and dentofacial orthopedics.” While most people have heard of orthodontics, many are confused by the dentofacial orthopedics part of the title.

Every orthodontist starts out in dental school. Upon completion of dental school, some graduates immediately go into practice as dentists. Others choose to pursue a specialty, which requires additional schooling during a two- to three-year residency program. There are nine specialties sanctioned by the American Dental Association. Some you are likely familiar with: pediatric dentistry (dentistry for children), periodontics (dentistry focusing on the gums), and oral surgery.

“Orthodontics and dentofacial orthopedics” is one of the nine specialties. Essentially, while orthodontics entails the management of tooth movement, dentofacial orthopedics involves the guidance of facial growth and development, which occurs largely during childhood. Appliances are frequently 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 precede conventional braces, but often the two are used at the same time. So if your child gets braces and headgear, he’s actually undergoing orthodontics and dentofacial orthopedics.

Being skilled in both areas, our doctor is able to diagnose any misalignments in the teeth and jaw as well as the facial structure, and can devise a treatment plan that integrates both orthodontic and dentofacial orthopedic treatments.

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