1. The American Association of Orthodontists (AAO) recommends that every child has an orthodontic evaluation by the age of 7. Not all young patients need treatment, but having an early Orthodontic exam is the best way to ensure that certain malocclusions are diagnosed and addressed in a timely manner, preventing catastrophic outcomes. Orthodontic treatment is not exclusive to children and teens, with about one in every five orthodontic patients being over the age of 21. More and more orthodontic patients are adults these days. Adults who have tolerated dental misalignment throughout their lives are thrilled with their new smile. They realize the value of improved dental health as well as the increased self-esteem derived from improving their appearance.

Whether you're considering treatment for yourself, or for a child, any time is a good time to visit the orthodontist.

2. If any of the following problems are present, you can benefit from orthodontics –

• Crowded or overlapped teeth
• Spaces between the teeth
• Upper front teeth are too far forward over the lower teeth (rabbit/buck teeth)
• Upper front teeth are behind or inside the lower front teeth (under-bite)
• Upper front teeth cover the majority of the lower teeth when biting together (deep bite)
• The upper and lower front teeth do not touch when biting together (open bite)
• The center of the upper and lower teeth do not line up
• Harmful habits - Finger or thumb or lip sucking, tongue thrusting habit (after 7 years old)
• Teeth wearing unevenly or excessively
• The lower jaw shifts to one side or the other when biting together
• Eruption disturbances
• Some missing / lost teeth

We realize the reasons for pursuing orthodontic treatment vary greatly with individual patients. Our goal, however, remains constant - to help you achieve an attractive and the healthiest smile possible. Such a smile can be effective in boosting confidence and self-esteem throughout your lifetime.

3. No, it is not. Many patients are referred by their family dentist, yet many other patients take the initiative to schedule an examination directly themselves.

7. The amount of time spent in braces can vary depending on the individual patient, as every smile responds differently to treatment. Treatment times can take anywhere between 6 and 36 months; however, most standard treatments take about 24 months.

8. Braces use steady gentle pressure to gradually move teeth into their proper positions. The brackets that are placed on your 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 your teeth to their adjusted, more ideal positions.

9. Removing teeth is not always necessary for orthodontic treatment. Straight teeth and a balanced facial profile are the goal of orthodontics; to meet that goal and to achieve the best orthodontic result, sometimes removal of teeth is needed.

10. At the completion of the initial examination, we will determine whether a patient will need an expander.

11. Braces do not often hurt; however, you may feel a small amount of discomfort for a couple days as your teeth, gums, cheeks, and mouth get used to your new braces. In these situations, pain medications such as Advil or Tylenol will ease the discomfort. However, after most visits, patients do not feel any soreness at all! We often remind our patients, “It does not have to hurt to work!”

12. Yes.

13. No.

14. Yes. Some orthodontic problems are significant enough to require early intervention. However, if a patient is not yet ready for treatment, we will follow that patient's growth and development until the time is right for treatment to begin.

15. Appointments are scheduled according to each patient's needs. Most patients in braces will be seen every 4 to 8 weeks. If there are specific situations that require more frequent monitoring, we will schedule appointments accordingly.

16. Unfortunately, we cannot schedule all appointments for students during after-school hours. However, because most appointments are scheduled 4 to 8 weeks apart, most patients will miss minimal school due to their orthodontic treatments. We will, however, make a sincere effort to meet your scheduling needs.

17. Yes. We understand your busy schedule, and we are happy to help you make the most of your time. On some occasions, we may request to speak with a parent when they return, so we ask that parents check in with their patient care coordinator manager before dropping off their child.

18. Yes! Regular checkups with your family dentist are important while in braces. Your family dentist will determine the intervals between cleaning appointments while you are in braces.

19. Yes. Once treatment begins, we will explain the special instructions. Patients should avoid hard and crunchy, soft and sticky foods. Some of those foods include: ice, hard candy, raw vegetables and all sticky foods (i.e. caramel and taffy). Orthodontic patients should also avoid chewing on hard objects like pens, pencils and fingernails. And never chew ice. It’s much too hard on your teeth – even without braces. You can avoid most emergency appointments to repair broken or damaged braces by carefully following our instructions.

20. Bad breath (halitosis) can be an unpleasant and embarrassing condition.  Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning.

There are various causes that attribute to bad breath, but in healthy people, the major source is microbial deposits on the tongue.  Some studies have shown that simply brushing the tongue reduced bad breath by as much as 70 percent.

What causes bad breath?

• Morning time – Saliva flow almost stops during sleep, reducing its cleaning power and allowing bacteria to grow, which results in bad breath.
• Certain foods – Garlic, onions, etc.  Foods containing odor-causing compounds enter the blood stream; they are transferred to the lungs, where they are exhaled.
• Poor oral hygiene habits – Food particles remaining in the mouth promote bacterial growth.
• Periodontal (gum) disease – Colonies of bacteria and food debris residing under inflamed gums.
• Dental cavities and improperly fitted dental appliances – May also contribute to bad breath.
• Dry mouth (Xerostomia) – May be caused by certain medications, salivary gland problems, or continuous mouth breathing.
• Tobacco products – Dry the mouth, causing bad breath.
• Dieting – Certain chemicals called ketones are released in the breath as the body burns fat.
• Dehydration, hunger, and missed meals – Drinking water and chewing food increases saliva flow and washes bacteria away.
• Certain medical conditions and illnesses – Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath.

Keeping a record of what you eat may help identify the cause of bad breath.  Also, review your current medications, recent surgeries, or illnesses with your dentist.

What can I do to prevent bad breath?

• Practice good oral hygiene – Brush at least twice a day with an ADA approved fluoride toothpaste and toothbrush.  Floss daily to remove food debris and plaque from in between the teeth and under the gumline.  Brush or use a tongue scraper to clean the tongue and reach the back areas.  Replace your toothbrush every 2 to 3 months.  If you wear dentures or removable bridges, clean them thoroughly and place them back in your mouth in the morning.
• See your dentist regularly – Get a check-up and cleaning at least twice a year.  If you have or have had periodontal disease, your dentist will recommend more frequent visits.
• Stop smoking/chewing tobacco – Ask your dentist what they recommend to help break the habit.
• Drink water frequently – Water will help keep your mouth moist and wash away bacteria.
• Use mouthwash/rinses – Some over-the-counter products only provide a temporary solution to mask unpleasant mouth odor.  Ask your dentist about antiseptic rinses that not only alleviate bad breath but also kill the germs that cause the problem.

In most cases, your dentist can treat the cause of bad breath.  If it is determined that your mouth is healthy and bad breath remains persistent, your dentist may refer you to your physician to determine the cause of the odor and an appropriate treatment plan.

21. Brushing and flossing help control the plaque and bacteria that cause dental disease.

Plaque is a film of food debris, bacteria, and saliva that sticks to the teeth and gums.  The bacteria in plaque convert certain food particles into acids that cause tooth decay.  Also, if plaque is not removed, it turns into calculus (tartar).  If plaque and calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease.

Plaque formation and growth is continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids.

Toothbrushing – Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.

• Brush at a 45 degree angle to the gums, gently using a small, circular motion, ensuring that you always feel the bristles on the gums.
• Brush the outer, inner, and biting surfaces of each tooth.
• Use the tip of the brush head to clean the inside front teeth.
• Brush your tongue to remove bacteria and to freshen your breath.

Electric toothbrushes are also recommended.  They are easy to use and can remove plaque efficiently.  Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.

Flossing – Daily flossing is the best way to clean between the teeth and under the gumline.  Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

• Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
• Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
• Curve the floss into a “C” shape around each tooth and under the gumline.  Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Rinsing – It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush.  If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.

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

23. Brushing our teeth removes food particles, plaque, and bacteria from all tooth surfaces, except in between the teeth.  Unfortunately, our toothbrush can’t reach these areas that are highly susceptible to decay and periodontal (gum) disease.

Daily flossing is the best way to clean between the teeth and under the gumline.  Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of living bacteria, food debris, and saliva.  The bacteria produce toxins (acids) that cause cavities and irritate and inflame the gums.  Also, when plaque is not removed above and below the gumline, it hardens and turns into calculus (tartar).  This will further irritate and inflame the gums and will also slowly destroy the bone. This is the beginning of periodontal disease.

How to floss properly:

• Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
• Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
• Curve the floss into a “C” shape around each tooth and under the gumline.  Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Daily flossing will help you keep a healthy, beautiful smile for life!

24. Yes, keeping your teeth and braces (or other appliances) clean requires a little more effort on your part. Your orthodontist will explain how to brush and floss, how often to brush and floss, and give you any special instructions based on the kind of orthodontic treatment you are having. Be sure to follow your orthodontist’s dental hygiene prescription to get the best results possible. Check with your orthodontist about dental products and tools that might be helpful.

Also be sure to see your family dentist for a professional cleaning and check-up at least every six months during your orthodontic treatment or more often, if recommended.

25. You should have your teeth checked and cleaned at least twice a year, though your dentist or dental hygienist may recommend more frequent visits.

Regular dental exams and cleaning visits are essential in preventing dental problems and maintaining the health of your teeth and gums.  At these visits, your teeth are cleaned and checked for cavities.  Additionally, there are many other things that are checked and monitored to help detect, prevent, and maintain your dental health.  These include:

• Medical history review: Knowing the status of any current medical conditions, new medications, and illnesses, gives us insight to your overall health and also your dental health.
• Examination of diagnostic X-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss.  X-rays also help determine tooth and root positions.
• Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
• Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
• Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
• Examination of existing restorations: Check current fillings, crowns, etc.
• Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for sometime and is now firmly attached to the tooth surface.  Calculus forms above and below the gum line, and can only be removed with special dental instruments.
• Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of living bacteria, food debris, and saliva.  The bacteria produce toxins (poisons) that inflame the gums.  This inflammation is the start of periodontal disease!
• Teeth polishing: Removes stain and plaque that is not otherwise removed during toothbrushing and scaling.
• Oral hygiene recommendations: Review and recommend oral hygiene aids as needed (electric dental toothbrushes, special cleaning aids, fluorides, rinses, etc.).
• Review dietary habits: Your eating habits play a very important role in your dental health.

As you can see, a good dental exam and cleaning involves much more than simply checking for cavities and polishing your teeth.  We are committed to providing you with the best possible care, and to do so, will require regular check-ups and cleanings.

26. Four out of five people have periodontal disease and don’t know it!  Most people are not aware of it because the disease is usually painless in the early stages.  Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms.  Having regular dental check-ups and periodontal examinations are very important and will help detect if periodontal problems exist.

Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums.  The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone.  Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.

Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:

• Smoking or chewing tobacco – Tobacco users are more likely than non-users to form plaque and tartar on their teeth.

• Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.

• Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives.  Some medications have side affects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums.

• Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.

• Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.

• Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis.  Patients with a family history of tooth loss should pay particular attention to their gums.

Signs and Symptoms of Periodontal Disease

• Red and puffy gums – Gums should never be red or swollen.

• Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.

• Persistent bad breath – Caused by bacteria in the mouth.

• New spacing between teeth – Caused by bone loss.

• Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).

• Pus around the teeth and gums – Sign that there is an infection present.

• Receding gums – Loss of gum around a tooth.

• Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.

Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

27. 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.

28. Treatment fee varies from patient to patient. The fee of your braces can only be determined after the initial examination.

29. We offer many financial options. Since financial needs vary, custom payment options will be designed for the individual patient.

30. We will review your insurance policy and help to maximize your benefit and file your claims.

31. No, they will not. In most people, the space available for the front teeth decreases as we grow and the crowding increases.

32. Teeth, and sometimes entire facial structures, are permanently changed by orthodontic treatment. It is important that the treatment be appropriate and properly completed. Orthodontic specialists have extensive and specialized training after doing general dentistry that enables them to provide their patients with professional, personalized treatments.

33. Phase One treatment, if necessary, is usually initiated on children between the ages of 7 and 10. Phase One treatment lasts about 6 - 18 months. The primary objective for Phase One treatment is to address significant problems to prevent them from becoming more severe and to improve self-esteem and self-image.

34. 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.

35. A surprising percentage of our patients are adults. In fact, 30 percent of all orthodontic patients are adults. Health, happiness and self-esteem are vitally important to adults. No patient is "too old" to wear braces!

36. There’s no time like the present, and healthy teeth can be moved at any age. Orthodontic treatment can create or restore good function, and teeth that work better usually look better, too. A healthy, beautiful smile can improve self-esteem, no matter your age.

37. 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 and sometimes even close the gaps created by missing teeth.

38. The ads you are seeing may be for veneers. They cover crooked teeth and mask the problem, but do not address the structure in the mouth or how the upper and lower teeth meet. Veneers are not permanent. Many require removal of significant amounts of tooth enamel. If plaque collects where the veneer and the remaining natural tooth meet, the area will be susceptible to what is known as “recurrent decay.”

Call us for free consult or ask your family dentist if Orthodontic treatment Orthodontic treatment is an option for your esthetic concerns.

Orthodontic treatment is far more than simply treating how teeth look. It’s about aligning teeth and jaws so that they meet and function effectively. It just so happens that when teeth and jaws are functioning well, they look good, too.

39. Should your case warrant it, you might want to ask your orthodontist about lingual braces, which are attached behind the teeth. Ceramic braces may be another option to lessen the visibility of braces; they blend in with the teeth for a more natural effect. Additionally, the use of a series of clear aligner trays (invisible braces) instead of traditional braces may be used to correct some problems. Talk with your orthodontist about less visible treatment options that will help you reach your treatment goals.

40. Discuss this question with your OBGYN/physician/healthcare professional and orthodontist before you start any orthodontic treatment, as pregnancy brings on bodily changes that may affect the mouth. Soft tissues such as gums become much more susceptible to infection.

41. Yes, but make sure you wear a protective mouth guard. Ask your orthodontist to recommend the right kind of mouth guard while you are having orthodontic treatment. Keep your smile beautiful after treatment and wear a mouth guard at every practice and every game.

42. With practice and a period of adjustment, braces typically do not interfere with the playing of wind or brass instruments.