Why To Avoid Direct-to-Consumer Aligners: Understanding the Gap Between Orthodontists and Direct-to-Consumer Aligners"

April 22nd, 2024

In the pursuit of a straighter, more confident smile, individuals today are presented with many different treatment options. From traditional metal braces to innovative aligner treatments, the landscape of orthodontic care has evolved significantly. Among these choices, two prominent paths emerge: seeking treatment from an orthodontic specialist, seeking treatment from a general dentist performing orthodontic specialty work, or opting for direct-to-consumer aligner products when patients are. While both avenues promise results, the distinction between them is substantial and warrants careful consideration. In this blog post I will go into some of the critical differences between these two approaches.

or the purposes of this blog, a Direct-to Consumer aligner company is one where you taking impressions of your own teeth and send it in to get aligners for your teeth without the intervention of a dental professional or you visit a "Scan Shop" where a representative will take some type of model of your teeth and you will be sent aligners to straighten your teeth.

At Strouse Orthodontics, I design every aligner treatment plan that we provide our patients. First comes a complete diagnosis of your face, your jaws, and your teeth, the presentation of treatment options, and a final custom treatment plan to address your specific situation.

Aligner design requires an understanding of 1) the patient’s final goals, 2) the sequence and speed of tooth movements, 3) the biomechanics(how the teeth move) that must be built in the prescription to achieve the desired results, and 4) the additional features that are required for difficult tooth movements. Most direct-to-consumer aligners as designed by computer algorithms and then approved by “dental professionals.” Although there may be a dentist’s name on the aligner packaging, he or she had nothing to do with designing your aligners. General dentists(non orthodontic specialists) often do the same, doing little to no analysis or modifications to a patients treatment plan. There are several issues that can occur with a Direct-to Consumer Orthodontic plan.

No Visits

A huge selling point for DTC aligners is that no orthodontic visits are necessary. However, this is also the biggest red flag. You won’t see a orthodontist or even a dental professional at any point in the process. It may not seem like it, but moving your teeth into more optimal positions will impact your entire mouth. Even in simple cases, straightening the teeth will affect the health of your teeth as well as the gums, bones and roots. An orthodontist is trained to ensure all of these are healthy before and during the treatment process to produce safe movement of the teeth.

No Attachments

With Direct To Consumer "Orthodontics" no attachments are placed on the teeth. This is because there is no involvement of a dental professional. Due to the shapes of teeth, as well as the tooth movement being completed, there may be a need for tooth-colored attachments made of dental composite be attached to your teeth. Patients are not able to bond attachments to their own teeth. While there are some tooth movements can be occur without them, there are many tooth movements that may not be able to be predictably achieved without attachments.

Your Teeth Might Not Move the Way They Should
It is important that the teeth move the way the the orthodontist is intending over the course of treatment. If there are problems with how the teeth are movement for any reason(lack of attachments, wrong staging of tooth movements, wrong speed of tooth movement, poor compliance with aligner wear), with a Direct To Consumer Company, there is no way to have your progress evaluated. With an orthodontic specialist, you will be able to have your progress evaluated and be given instructions for how to handle a problem that arises during treatment.

No Rubber Bands

Both braces and aligners can both be straighten the top and bottom teeth individually. When modifications with the bite are needed in the bite however, orthodontists typically prescribe rubber bands connected between the top and bottom teeth to make these changes. Direct-to-consumer companies do not utilize rubber bands with their treatment. Furthermore, they typically have consumers sign a waiver that they understand that the aligners from their company will not improve their bite. This is similar with orthodontic treatment with a general dentist. While they are able to prescribe rubber band wear, they often lack the orthodontic knowledge to correct more advanced malocclusions, sometimes without informing the patient there are any bite issues present at all.

By seeing a specialist in orthodontics for orthodontic care(braces, Invisalign), you can feel confident that an expert is prescribing, planning and monitoring your care. An orthodontist will be able to monitor your teeth, discuss treatment goals, review various options for treatment and be able to provide the necessary in office adjustments that are not possible with a Direct-to-Consumer aligner company. You only get one set of teeth. Trust your smile to an orthodontic specialist.

Cost of Orthodontic Treatment

April 3rd, 2024


As you delve into the world of orthodontic treatment, understanding the financial aspects is just as crucial as understanding the clinical ones. While the cost of treatment can vary significantly based on the complexity of your case and other factors, it’s essential to consider additional factors that may affect your out-of-pocket expenses.

Insurance Coverage and Financing: Navigating Your Benefits and Making Treatment Affordable

For many patients, insurance coverage and financing options play a significant role in making orthodontic treatment more accessible.

Insurance Coverage: Some dental insurance plans offer orthodontic coverage, which can help offset a portion of the expenses. However, it’s important to note that coverage levels and limitations vary widely among insurance providers and individual plans.

Before beginning treatment, it’s advisable to review your insurance policy to understand the extent of your orthodontic coverage. Your orthodontist’s office can also assist you in navigating your benefits and determining how they apply to your treatment plan. While insurance coverage can help reduce costs, it’s essential to be aware of any deductibles, copayments, or exclusions that may apply.

Financing Options: For patients concerned about the financial aspect of orthodontic treatment, many orthodontic practices offer flexible financing options to make treatment more accessible. Interest-free financing plans allow you to spread the cost of treatment over manageable monthly payments, making it easier to fit orthodontic care into your budget.

Orthodontic financing plans typically offer competitive terms and can be customized to suit your individual needs. By taking advantage of these financing options, you can focus on achieving your dream smile without worrying about the upfront financial burden.

Consultation: Your First Step

Before diving into the specifics of cost, the first step in your orthodontic journey is a consultation with a qualified orthodontist. During this initial appointment, the orthodontist will conduct a thorough examination of your teeth, jaws, and overall oral health to assess your individual needs.

The consultation allows the orthodontist to develop a personalized treatment plan tailored to address your specific concerns. It also provides an opportunity to discuss your treatment goals, ask any questions you may have, and address any financial considerations.

Understanding Phase One Orthodontics

Phase one orthodontics, also known as early or interceptive orthodontic treatment, is aimed at addressing orthodontic issues in children at a younger age, typically between the ages of 7 and 10. This early intervention helps guide the growth and development of the jaws, creating a more favorable environment for the eruption of permanent teeth and correcting certain bite problems.

The cost of phase one orthodontics can vary depending on the complexity of the treatment and the specific needs of the child. While it typically ranges between $2000 and $4500, it’s essential to consult with your orthodontist to get an accurate estimate based on your child’s individual case.

Comprehensive Orthodontic Treatment

Comprehensive orthodontic treatment, often referred to as full treatment, is typically initiated when all permanent teeth have erupted, usually around the ages of 11 to 13. This phase of treatment focuses on achieving optimal alignment of the teeth and bite, resulting in a straighter, healthier smile.

The cost of comprehensive orthodontic treatment also varies depending on factors such as the complexity of the case, the type of braces or aligners used, and the duration of treatment. On average, comprehensive treatment ranges between $5000 and $7000. However, it’s important to remember that this is just a general estimate, and the actual cost may differ based on individual circumstances.

Conclusion

Orthodontic treatment is a valuable investment in your oral health and overall well-being. While cost is undoubtedly a consideration, it’s essential to prioritize quality care and the expertise of a qualified orthodontist. Your orthodontist will work with you to develop a personalized treatment plan that meets your needs and fits your budget, ensuring you achieve the smile you’ve always wanted. Don’t hesitate to discuss any questions or concerns you may have about the financial aspects of treatment. With the right guidance and support, you can achieve the smile you’ve always wanted while staying within your budget. Remember, the first step is scheduling a consultation to discuss your options and get started on your journey to a confident, beautiful smile.

All About Interproximal Reduction

March 7th, 2024

In orthodontics, the quest for a beautiful harmonic smile often involves various intricate techniques and methods. While braces or Invisalign can make the teeth straighter, in most cases, an orthodontic specialist has many variables to consider and a complex diagnosis and treatment planning is done behind the scenes. Some of these considerations involve a patients skeletal pattern, analysis of several radiographs, the patients facial profile and balance, symmetry, as well as the macro and micro esthetics of the teeth.

This post will focus on the last point. The macro esthetics encompass the relationships of the teeth to the face, lips and gums and the micro esthetics involve the individual tooth size, shapes and shades. There are many misconceptions about interproximal reduction, many of which come from General Dentists who have the best intentions, but are ill-informed, as well as social media. It is important to remember that Orthodontists are specialists in tooth movement and what is needed to obtain the best smile and proper bite relationship.

The size and shape of the teeth play as large role in the appearance of the smile as anything that an orthodontist does with braces or Invisalign. If the teeth have irregular size or shape sometimes the teeth themselves need to be altered in order to obtain an ideal bite as well as an optimal esthetic result. Interproximal reduction, or IPR, is a technique that can be utilized in order to obtain the best orthodontic outcome.

Interproximal reduction is a simple procedure in which the size and shape of the teeth are adjusted using precise diamond embedded instruments in which minute amounts of enamel are removed. This is typically done in between the teeth where they touch one another, known as the contact point. There are several reasons why this is done:

  • Tooth Size Discrepancy: The set of upper and lower teeth are like a puzzle and the individual teeth have ideal sizes in order to fit together properly. If the upper teeth are too big or the bottom teeth are too narrow in comparison, a patient will present with upper crowding, an excess overbite or spacing of the lower teeth. On the other hand, if the top teeth are too small or the lower teeth are too wide, there will be spaces on the top or crowding on the bottom. Through extensive orthodontic research, it was discovered that there are ideal proportions of the upper and lower teeth. If the upper and lower teeth do not match due to the tooth size, it is known as a "Tooth Size Discrepancy". On occasion, reduction of the upper or lower teeth is a solution.
  • This is a quick, safe and pain free procedure. Tooth enamel can be as much as 2.5 millimeters thick and Interproximal reduction typically involves no more than 0.2-0.4 millimeters. After IPR, there is plenty of excess enamel to keep the teeth healthy and strong, which has be shown in countless orthodontic research. IPR does not increase the risk of cavities. Research has shown that dentists are less comfortable performing IPR routinely and orthodontists who are more likely to have researched the long term effects of IPR on the teeth are more comfortable performing the procedure. Because of this, dentists will often inform patients and their families that IPR is unsafe, will damage the teeth or other statements that are incorrect, and not backed by scientific research.

  • Anatomy: Sometimes the shape of the teeth is such that an esthetic improve can be made by removing some excess enamel in order to improve the shape of the teeth or how to teeth connect to each other in order to obtain a more esthetic final result.

  • Black Triangles: Sometimes due to the shape of the teeth, how they connect to each other or due to gum recession, the appearance of what are known as black triangles occur. It is noticed as triangluar "spaces" close to the gum-line. While there are not actually spaces between the teeth, if the teeth are only touching at the tips and not up to the gums, a dark triangle will apear. On occasion, IPR can reshape these teeth and reduce the size and appearance of the black triangle once the space is closed.

  • Crowding: Another reason for using IPR is due to crowding of the teeth. Significant amounts of space can be created by removing very small amounts of enamel in between some of the teeth. If there is crowding between the teeth, but not enough crowding for the removal of permanent teeth, IPR can be used to create enough space for all of the teeth. In addition to create space, IPR also creates flat surfaces between the teeth which helps improve the stability of teeth to keep them straight after orthodontic treatment is completed.
  • Conclusion and Considerations: IPR is a safe procedure and extensive research shows that there is no increased decay after IPR, there is improved stability of the orthodontic results after IPR due to the improved contacts, and there is no increase in sensitivity when the amount of enamel removed is within proper limits.

The author, Dr. Eric Strouse DMD MDS is a specialist in orthodontics in the practice of orthodontics in Spring Hill and Lecanto, Florida. He was trained at Muhlenberg College for his Bachelors Degree where he competed on the track and field team. He completed his dental training at the University of Connecticut School of Dental Medicine, earning a Doctorate of Medicine in Dentistry(DMD). He completed a one year General Practice Residency at St. Luke's Hospital in Allentown, PA and his specialty training in Orthodontics and Dentofacial Orthopedics at Rutgers University where he also completed a Masters in Dental Science. Dr. Strouse has been published in several Dental and Orthodontic Journals. Dr. Strouse is an expert in two-phase orthodontic treatment, phase 1 interceptive treatment, extraction and non-extraction treatment, Invisalign clear aligners, and multiple bracket systems(custom braces, self ligating braces, conventional braces). This blog is for informational purposes only.

My Wisdom Teeth Made My Teeth Shift...Or Did They?

February 15th, 2024

Some very common statements I hear as an orthodontist from patients are "my wisdom teeth got removed and cause my teeth to shift" or "When my wisdom teeth came in my teeth started to shift". While it is a commonly held belief that the wisdom teeth are related to crowding, they are not related. The thought that wisdom teeth cause crowding or make your teeth crooked is somewhat of an old wives tale and is not true. So why do teeth because crowded after braces or Invisalign?

Essix Retainer

Panoramic X-Ray showing Wisdom Teeth in Pink

Teeth become crooked after orthodontic treatment for a few reasons. The main reason is lack of retainer wear. Research has shown that orthodontic retainers are the only way to keep the teeth in their new position after treatment and keep tooth movement to a minimum. Without retainers, the teeth will begin to shift and become crooked. Just like anything else in the body, teeth change over time, and maintenance is necessary. Keeping the teeth straight after braces requires wearing retainers for as long as you want them to stay straight.

Another factor that over time can lead to shifting of teeth is what is known as late mandibular growth. Put simply, there is a very small amount of lower jaw growth that happens in the late teens and twenties that puts a slight force on the lower teeth pushing them forward and upward very slightly into the back of the top teeth. Over time, this extra force or pressure can cause crowding of previously straight teeth.

Research at the University of Iowa showed that wisdom teeth can not exert pressure on the front teeth to cause them to become crooked. The way this was discovered was by using sensors that compared the pressure with wisdom teeth and without wisdom teeth. What they found was that there was no difference. Research also compared the amounts of crowding in children after braces with and without their wisdom teeth. There was no difference in the amounts of crowding, suggesting that wisdom teeth do not play any factor in crowding, or shifting of the teeth after orthodontics.

While everything in the body changes over the course of time, when it comes to maintaining the position of the teeth, the most important thing is to continue wearing your retainers for as long as you want the teeth to remain straight. The wisdom teeth do not play a role in cause the teeth to shift.

Do I Still Need To See My Dentist During Orthodontic Treatment?

February 10th, 2024

Embarking on the journey towards a straighter, more aligned smile through orthodontics with braces or Invisalign is an exciting and transformative experience. As you enter the world of braces or Invisalign, it is crucial to remember that your orthodontist is just one part of your oral health care team. In this post I will explore why regular dental checkups are essential even when you're undergoing orthodontic treatment.

Oral Health Assessment

While the orthodontist is focusing on straightening teeth and correcting bite issues, your dentist plays a crucial role in ensuring your overall oral health. Regular dental checkups provide a comprehensive assessment of your gums, tongue, cheeks, and the overall health of your mouth. This helps in identifying and addressing any potential issues before they escalate.

Monitoring Oral Hygiene

Maintaining good oral hygiene can be challenging with braces or aligners. The presence of orthodontic appliances creates additional nooks and crannies where food particles and plaque can accumulate. Your dentist will monitor your oral hygiene practices and provide guidance on effective cleaning techniques to prevent cavities and gum problems. It is especially crucial to maintain professional cleanings during orthodontic treatment.

Early Detection of Dental Issues

Dental problems don't take a break during orthodontic treatment. In fact, the presence of braces or aligners can sometimes make it more challenging to detect certain issues. Regular dental checkups enable early detection of problems such as cavities, gum disease, or signs of teeth grinding. Timely intervention can prevent these issues from interfering with your orthodontic progress.

Coordination between Orthodontist and Dentist

Collaboration between your orthodontist and dentist is key to achieving optimal oral health. Your dentist and orthodontist work together to address specific issues, such as restorations after orthodontics, tooth extraction, impacted teeth, or any concerns related to your overall oral health. This coordinated effort ensures that your orthodontic treatment aligns seamlessly with your broader dental care plan.

Conclusion: In conclusion, seeing your dentist regularly during orthodontic treatment is not only advisable but crucial for maintaining overall oral health. The collaboration between your orthodontist and dentist ensures that you receive comprehensive care, addressing both the specific goals of your orthodontic treatment and the broader aspects of oral health. Remember, a beautiful smile is not just about straight teeth – it's also about a healthy and well-maintained mouth.

Community Spotlight: Crystal River, Florida

February 5th, 2024

Nestled along the serene Nature Coast of Florida, Crystal River isn't just a scenic gem—it's home to a vibrant community we are privileged to serve at Strouse Orthodontics. At our orthodontic practice, we're more than just dental professionals; we're your neighbors, friends, and partners in achieving the smiles you've always dreamed of. Join us as we explore the unique charm of Crystal River and how our local orthodontic practice is making a positive impact on the community.

Crystal River takes pride in being the home of the stunning Three Sisters Springs and Crystal River Preserve State Park, where manatees seek refuge in the warm waters. Known as the "Manatee Capital of the World," Crystal River offers a unique opportunity for residents and visitors to witness these gentle giants in their natural habitat. Crystal River is celebrated for its scalloping season, where locals and tourists alike embark on exciting underwater adventures to harvest the delectable bay scallops. This annual tradition adds a culinary delight to the city's vibrant tapestry, bringing people together to savor the treasures of the Gulf. Beyond its aquatic treasures, Crystal River captivates with its historic charm, vibrant community spirit, and a plethora of recreational activities, making it a sought-after destination for those seeking a perfect blend of nature, history, and local warmth. As your trusted orthodontic provider, we are committed to helping you achieve a smile that matches the radiance of Crystal River's landscapes.

Our commitment to Crystal River goes beyond just the confines of our practice. We actively participate in local events, sponsor community initiatives, and collaborate with schools to promote oral health awareness. By being an active part of the community, we strengthen our bonds and create a positive impact on the lives of Crystal River residents.

While we celebrate the uniqueness of Crystal River, our orthodontic practice brings world-class expertise to your doorstep. Dr. Strouse and our team of skilled professionals combines local warmth with global knowledge, ensuring that you receive the best possible orthodontic care without having to travel far. Our office utilizes both braces and Invisalign, for you to achieve a smile to be proud of, in a way that best fits your lifestyle! Your smile journey is our priority, and we are dedicated to providing top-notch treatment right here in Crystal River.

We understand the diverse needs of Crystal River families, and we are committed to making orthodontic care accessible to all. Our practice offers flexible payment options, family-friendly scheduling, and affordable treatment plans, ensuring that every member of the Crystal River community can achieve a healthy and beautiful smile.

Case of the Month: February 2024

February 2nd, 2024

Age: 15.5

Treatment Duration: 20 months 

Before Treatment:

This patient came to our office looking to improve the crowding of her teeth. Before treatment she had a narrow smile, severe overbite, severe crowding, class 2 bite (when the upper jaw and/or teeth are ahead of the bottom jaw and/or teeth), narrow arches, retroclined (leaning back) incisors and a posterior crossbite on the right side.

Treatment Journey:

Our patients treatment plan involved upper and lower braces,the use of rubber bands, and anterior bite turbos. Anterior bite turbos are small ramps bonded to the inside of the upper front teeth(seen in blue here). They prevent the top teeth from excessively overlapping the bottom teeth. They are used to prevent breakage of the lower braces as well to allow the teeth to move more freely and for bit correction. Treatment for this case took just over a year and a half.

 

After Treatment:

In this amazing transformation we were able to correct all of the pre-existing orthodontic concerns, improving the overbite, correcting the class 2 to a class 1 proper bite, eliminating the crowding, aligning the midlines, and widening and broadening the smile. Our awesome patient was extremely diligent using the prescribed rubber bands. Treatment was completed in just 20 months.

Orthodontics can not only play a pivotal role in optimizing both oral health and functional well-being, but more importantly can elevate one's self-confidence. Our practice is committed to serving patients of all ages and embraces the belief that it's never too late to embark on the journey to your dream smile.

We invite you and your family to reach out to our office to schedule a complimentary consultation. Allow me the privilege of discussing the orthodontic solutions tailored to your unique needs. Your journey to your dream smile begins with an orthodontic specialist! We see patients from Hernando and Citrus County in areas such as Spring Hill, Brooksville, Crystal River, Lecanto, Beverly Hills, Inverness, and all surrounding areas.

Dr. Strouse

How Long Does Orthodontic Treatment Take?

February 1st, 2024

Orthodontic treatment is a transformative journey that can lead to a stunning and confident smile. For those seeking to correct misaligned teeth or bite issues, orthodontics offers a promising solution. However, many people wonder about the duration of the process before they embark on this life-changing path. In this blog post, I will delve into the factors that influence the length of orthodontic treatment and provide a comprehensive overview of what to expect on this exciting journey to a perfect smile.

Factors Influencing Treatment Duration

1. Complexity of the Issue: The severity of the orthodontic problem plays a significant role in determining how long the treatment will take. Minor alignment issues might only require a few months of treatment, while more complex cases may extend the duration to several years.

2. Patient's Age: Age can also impact the length of treatment. Younger patients with developing jaws and teeth might see faster results as their bones are more responsive to movement. However, advancements in orthodontic technology have also made it possible for adults to achieve excellent results with proper treatment.

3. Type of Orthodontic Appliance: There are various orthodontic appliances available today, including traditional metal braces, clear braces, and clear aligners like Invisalign. The type of appliance chosen can influence the treatment timeline for the given case.

4. Patient's Cooperation: The success of orthodontic treatment is greatly dependent on the patient's cooperation. Adhering to the orthodontist's instructions, attending regular check-ups, and maintaining good oral hygiene all contribute to achieving optimal results in a timely manner.

Estimated Treatment Durations for Different Appliances

On average orthodontic treatment can be anywhere from only a few months to as long as 1-3 years, it depends on your specific case. An average orthodontic case lasts somewhere between one(1) and two(2) years. 

Embarking on orthodontic treatment is an investment in both time and effort, but the results are undoubtedly worth it. The duration of orthodontic treatment depends on various factors, including the complexity of the issue, the chosen appliance, the patient's age, and their cooperation during the process. Remember, each individual's case is unique, and I will provide a personalized treatment plan based on your needs.

Before beginning any orthodontic journey, schedule a consultation with our office. It is important to see an orthodontic specialist for orthodontic needs.  I will thoroughly assess your case and provide an estimated treatment duration. Keep in mind that the length of treatment is only a small part of the bigger picture - the lifelong benefits of a beautiful and healthy smile are what truly matter. So, embrace the process, follow your orthodontist's guidance, and soon enough, you'll be flashing that stunning smile you've always dreamed of!

In short, treatment time depends on the severity of the issue. Most comprehensive orthodontic cases take 1-2 years, while minor or limited cases can be as short as a few months. We see patients from Hernando and Citrus County in areas such as Spring Hill, Brooksville, Crystal River, Lecanto, Beverly Hills, Inverness, and all surrounding areas. Schedule your consultation today!

Do I Still Have an Overbite?

January 29th, 2024

One common question I receive as an orthodontist is about overbites. I will answer some of the most common questions and review some terminology.

What is an Overbite?

An overbite is the vertical overlap of the top front teeth over the bottom front teeth. The truth is that it is completely normal to have somewhat of an overbite. We need to have an overbite in order to properly chew our food. If there was no overlap of the teeth, they would hit each other when you bite down which can lead to chipping of the teeth and premature wear of the enamel. Typically somewhere between 20-40% overlap is a relatively "normal" overbite. This can vary based on the patient. The overbite is generally considered excessive when it is more than 50% which is when it may cause issues.

What Can an Overbite Lead to?

  • Excessive tooth wear
  • Headaches
  • Speech issues
  • Tooth chipping
  • Gum disease due to difficulty cleaning between the teeth
  • Temporomandibular Joint Disorder (TMD)

Overbite vs. Overjet

These two terms are often used interchangeably, however they are two separate conditions. An overbite refers to the vertical overlap of the front teeth, while overjet refers to the horizontal distance between the top and bottom front teeth. Patients that have excessive overjet, have top front teeth that protrude or flare out. These is often referred to as "buck teeth". You can have both excessive overjet and excessive overbite, however they are two separate conditions. Many patients that are concerned that their front teeth stick out refer to their concern as an "overbite".

Excessive Overbite(vertical overlap)

Excessive Overjet(horizontal overlap)

Ideal Bite

What Causes an Overbite

An excessive overbite can be caused by many different factors such as

  • Genetics
  • Smaller lower jaw
  • Habits such as Thumb sucking, lip sucking, tongue thrusting
  • Abnormal tooth eruption

How Can an Overbite be Treated?

The treatment for an overbite depends on many factors depending on the original presentation. Please call our office for a free consultation to make the first steps to determining what is the best option for you!

  • Braces
  • Invisalign
  • Appliances: Some appliances can be used either alone or in combination with braces or Invisalign to correct an overbite
  • Surgery: if the jaw misalignment is very severe, surgery may be necessary and an oral surgeon will reposition the jaws in order to achieve a proper bite position. This is done in combination with orthodontic treatment.

FAQ's

Is having somewhat of an overbite normal?
Yes, there should be some overlap of the upper front teeth compared to the lower front teeth

What amount of an overbite is normal?
Generally 20-40% of overbite as a general rule can be considered normal

NOTE: The author, Dr. Eric Strouse DMD MDS is a specialist in orthodontics in the practice of orthodontics in Spring Hill and Lecanto, Florida. He was trained at Muhlenberg College for his Bachelors Degree where he competed on the track and field team. He completed his dental training at the University of Connecticut School of Dental Medicine, earning a Doctorate of Medicine in Dentistry(DMD). He completed a one year General Practice Residency at St. Luke's Hospital in Allentown, PA and his specialty training in Orthodontics and Dentofacial Orthopedics at Rutgers University where he also completed a Masters in Dental Science. Dr. Strouse has been published in the Sri Lankan Journal of Orthodontics and has written several articles for Dental Economics. Dr. Strouse is an expert in two-phase orthodontic treatment, phase 1 interceptive treatment, extraction and non-extraction treatment, Invisalign clear aligners, and multiple bracket systems(custom braces, self ligating braces, conventional braces). This blog is for informational purposes only.

Will I Need Impressions?

January 25th, 2024

Gone are the days of messy and uncomfortable orthodontic impressions, thanks to the advent of digital orthodontics. Our office does not use any traditional dental impressions and all models of the teeth are taken digitally in a quick and comfortable fashion.

The Downside of Traditional Impressions

Traditional orthodontic impressions involve using a putty-like material placed in a tray that is then pressed into your mouth to capture the shape and size of your teeth and gums. While this technique has been effective for many years, it comes with several downsides:

1. Discomfort: Orthodontic impressions can be uncomfortable, causing gagging sensations and discomfort in some patients.

2. Messy: The putty used in impressions can be messy, leading to some patients feeling anxious or uneasy during the procedure.

3. Time-Consuming: Traditional impressions may require multiple attempts to achieve accurate results, which can be time-consuming for both the patient and the dentist.

4. Material Storage: Orthodontic offices need to store physical impression molds, which can take up valuable space and require maintenance over time.

Our Digital Approach: Say Goodbye to Impressions

At our cutting-edge orthodontic office, we have fully embraced the power of digital orthodontics. Instead of relying on traditional impressions, we use state-of-the-art intraoral scanners to capture highly detailed 3D images of your teeth and gums. These scans provide us with precise digital replicas of your mouth, enabling custom treatment plans with unmatched accuracy. We also use these digital impression to 3-D print models to fabricate retainers. 

Advantages of Digital Orthodontics

1. Comfortable Experience: With our intraoral scanners, you can bid farewell to the discomfort and gagging associated with traditional impressions. The scanning process is non-invasive and allows for a more comfortable experience during your orthodontic visits.

2. Time-Efficient: Digital scans significantly reduce chair time, as there is no need for multiple attempts to get an accurate impression. This means fewer visits to the orthodontic office and quicker treatment planning.

3. Enhanced Precision: The digital scans provide detailed and precise images, allowing our dentists to create custom restorations that fit perfectly and deliver optimal results.

4. Environmentally Friendly: By eliminating the need for physical impression materials, our fully digital approach contributes to a more eco-friendly orthodontic practice.

5. Improved Communication: Digital scans can be instantly shared and stored in our computer systems, facilitating seamless communication with our orthodontic laboratory partners if needed.

At our digital orthodontic office, patient comfort and satisfaction are our top priorities. By embracing cutting-edge technology, we have eliminated the need for traditional impressions and the associated discomfort, mess, and inconvenience. Our intraoral scanners allow for a faster, more precise, and environmentally friendly orthodontic experience, leading to superior outcomes for our patients.

So, if you've been dreading the thought of orthodontic impressions, fear not! We see patients from Hernando and Citrus Counties in areas such as Spring Hill, Brooksville, Lecanto, Crystal River, Inverness, Beverly Hills and all surrounding areas. Schedule your appointment with us and experience the benefits of digital dentistry firsthand. Embrace the future of orthodontic care and let us take care of your oral health with our state-of-the-art, impression-free approach. Your smile deserves the best, and at our digital office, we're committed to providing you with exceptional orthodontic care, minus the impressions!

Can I Choose the Color Of My Braces

January 22nd, 2024

Braces have come a long way in the world of orthodontics. Gone are the days when braces were considered purely functional; today, they are a fashion statement! If you or your loved ones are about to embark on an orthodontic journey, you may be wondering if you can add a personal touch to your braces. The answer is a resounding YES! In this blog post, we'll explore the exciting world of colorful braces and how you can express your unique style while on the path to a beautiful smile. Check out some Examples Below!

Traditional metal braces have been the staple of orthodontic treatment for decades, and they continue to be an excellent option for achieving optimal teeth alignment.

Choosing Your Brace Colors

At our orthodontic office, we believe that each patient's smile is as unique as their personality. We offer a wide array of color choices for braces, allowing you to have some fun with your treatment while expressing your individual style. Here's how you can choose the color for your braces:

Explore a Rainbow of Colors: Today's braces come in various shades, ranging from classic colors like blue, red, and green to vibrant hues like neon pink, electric blue, and lime green. You can even choose seasonal colors to match your favorite holidays or events.

Mix and Match: Some patients get creative and mix different colors for a unique look. For example, alternating colors on each bracket can create a playful effect.

Powerchain on the top arch

Consider Your Personal Style: Your braces can be an extension of your personality and interests. If you have a favorite sports team, you can opt for their team colors. Or, choose a color that complements your eye or hair color for a coordinated and flattering look.

Benefits of Colorful Braces

1. Personal Expression: Colorful braces offer a chance to showcase your personality and add a touch of fun to your orthodontic treatment.

2. Boost in Confidence: Embracing colorful braces can make the journey to a beautiful smile feel more exciting and enjoyable, increasing your confidence throughout the process.

3. Motivation for Oral Hygiene: Some patients find that having braces in their favorite colors motivates them to be extra diligent with their oral hygiene routine, as they want their vibrant braces to shine beautifully.

At Strouse Orthodontics, we believe that orthodontic treatment doesn't have to be boring. With a wide range of colorful braces to choose from, you can make your smile journey uniquely yours. Express your individuality, showcase your style, and let your personality shine through your braces!

Ready to add some flair to your smile? Schedule a consultation with us, and together, we'll create a personalized treatment plan, complete with the colorful braces that best reflect your style. Get ready to embark on an orthodontic journey that not only transforms your teeth but also showcases the real you!

The Evolution of Braces

November 28th, 2012


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.

Sources: Angle.org, ArchWired

How to Protect Your Braces During Sports Activities

November 16th, 2012


Proper mouth protection is recommended when you participate in any sports activities. If you wear braces, this protection becomes essential. Injuries to your mouth can not only damage your teeth, but your braces could break and cut open your lip.

Full Facial Guards

Full facial guards are often used in football and offer protection to your mouth from most injuries. Even with full facial protection, you may benefit from additional mouth protection. While your face is protected from outside impact, you could still suffer from cuts or damage to your braces from internal impact.

Mouth Guards
Mouthguards referred to as boil-and-bites can be purchased at many retail stores. As the name implies, these guards are boiled in water to heat and soften the material. While the guard is still warm, you place it in your mouth and bite down gently. This causes the guard to form to the shape of your mouth. Unfortunately, these guards do not necessarily offer the best protection or fit.

The custom fitting of a mouthguard ensures you of better protection and a comfortable fit. Custom guards are also built in layers for durability. The American Dental Association recommends custom guards for orthodontic patients. Your mouthguard will be designed to provide proper protection for both your teeth and your braces.

No matter what type of sport you participate in, a mouthguard can protect your braces. Even an activity as seemingly harmless as table tennis can result in a contact injury. The Academy for Sports Dentistry states that a properly fitted mouthguard should not interfere with any athletic activity.

Our office will be glad to answer any questions you have so you can continue the activities you enjoy with little concern. If you do suffer any injuries to your mouth or braces during sporting activities, please contact us immediately. The sooner we can care for your mouth, the better the results will be.

Avoiding Common Problems Associated With Braces

November 9th, 2012


While braces play an important part in helping to create a healthy mouth and teeth, you might experience a few side effects while wearing them that are common and can be easily treated.

Even with the best of care, braces can cause soreness to your mouth. As your teeth begin to move, it is natural for your teeth to feel aches and your jaw to develop soreness.

If there are broken wires or loose bands on your braces, a sore tongue, mouth, or canker sore will occur. Canker sores are a common occurrence when braces rub inside the mouth. There are ointments available to reduce the pain and irritation associated with mouth sores. If you experience a sore mouth or any of the following problems, call our office to schedule an appointment.

· Loose brackets: Apply a small amount of orthodontic wax to the bracket temporarily. You might also apply a little between the braces and the soft tissue of your mouth.

· Loose bands: These must be secured in place by our dentist. Try to save the band for repair.

· Protruding or broken wires: The eraser end of a pencil can be used to move the wire carefully to a less painful spot. If you are unable to move it, apply orthodontic wax to the tip. If a mouth sore develops, rinse with warm salt water or antiseptic rinse.

· Loose spacers: These will need to be repositioned and sometimes replaced.

Besides Straight Teeth, What are the Benefits of Braces?

October 25th, 2012

Everyone wants a naturally aligned and beautiful smile, and it is no secret that orthodontic braces can help deliver one. However, there are greater benefits to wearing braces than just having straight teeth. You’ll gain many oral health benefits in addition to the cosmetic ones.

Tooth Decay and Gum Disease

Crooked or crowded teeth may overlap each other and create tight spaces in between. These can make it very difficult to brush and floss effectively, allowing bacteria and plaque to build up, and eventually leading to tooth decay and gum disease. With orthodontic treatment, your teeth will become properly aligned and spaced, which allows for more effective brushing.

Difficulties with Speech

Your teeth play an essential role in speech. When they are out of line or lean too far forward or backward, this can affect your speaking patterns, and possibly cause embarrassment and frustration. Braces can readjust the positioning of the teeth to allow for clearer, more professional speech.

Bone Erosion

Bone and gum tissues begin to erode when there are no teeth to support. This is also true for poorly aligned teeth that leave gaps and spaces or place too much pressure on the jawbone due to a bad bite. With braces, the bones and tissues are less likely to erode and can continue to support the teeth in their new alignment.

Digestion

Your teeth play an important role in digestion. Before food ever enters your stomach, it has been partially digested by the teeth. If teeth are severely out of line, however, they may not play their role in breaking down food as effectively as they should. With braces, your teeth will be straightened into optimal alignment for eating and chewing.

Foods That are Safe for Braces

September 14th, 2012


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.

Preventing Decay While Wearing Braces

August 9th, 2012


Having braces can present some new challenges when it comes to oral hygiene. Preventing tooth decay can be a big challenge simply because of the tendency for braces to trap food under the wires and between the teeth and the brackets. Here are a few tips to keep your teeth healthy while wearing your braces:

1.Eat Braces-Safe Foods
Keeping your teeth from decay starts with a proper diet. Foods that are high in sugar or starch can cause more plaque, which is difficult to remove during your brushing. There are certain foods that should be avoided while wearing your braces. First, sticky foods like caramel or gum can get stuck in your braces and be difficult to remove during brushing. Next, hard foods such as nuts and candy could bend wires or even break a bracket. Foods that are firm or hard to bite into like apples, carrots, or corn on the cob should be avoided. As much as we like to snack on them, those crunchy treats can harm your braces. Things like chips, ice, and popcorn can also bend or break your braces. On the other hand, bananas, mangoes, milk, water, poultry, and pasta all tend to be low in enamel-busting acids.

2. Proper Brushing
You want to place your toothbrush at a 45-degree angle against the gums in order to clean the whole tooth, and brush gently in the area between the wiring and the teeth. Use a softer toothbrush with fluoride paste for best results. Rinsing every day will help, too. Rinsing is important regardless, but especially important when you have braces as you need to disinfect the entire mouth, including those spots under the braces where your brush can't always reach.

3. Ask About Special Cleaning Tools
There are also special brushes, or other tools, to get under and clean your braces. You can find many of these items at your local pharmacy.

4. Regular Teeth Cleaning
It's important to keep your routine appointments with your dentist and dental hygienist for a thorough cleaning twice a year or as directed. The exact frequency of these visits will be up to your dentist as some types of braces are more demanding of a regular cleaning than others.
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.

Elements of Braces

July 27th, 2012

When coming to our office to have braces put on, you may find yourself feeling a bit intimated and nervous about the experience. We hope to help you feel more at ease by explaining exactly what the different parts of braces are, and what they do.

Parts of Braces

• Elastic Tie — This is a very small rubber band, and it holds the archwire in place.
• Archwire — This is the main part of the braces. It is a wire guide that tracks the teeth. The wire may be moved from time to time during treatment to continue straightening a patient's teeth.
• Loop in Archwire — This is not in all braces. If it is used, it is to close a gap left from a tooth extraction.
• Bracket — This piece of equipment holds the archwire in place. Formerly, many patients used colored rubber bands to keep the brackets in place, but now since most brackets are cemented on, this is no longer necessary.
• Headgear Tube — This is a hollow area near the back bands, which allows the headgear to fit into the braces. This is only used on patients who require headgear.
• Coil Spring — If needed, this would fit between a bracket and the main archwire. Its purpose is to open up the space between the teeth. This is not necessarily used on all patients.
• Tie Wire — This is another piece of equipment that is used to keep the archwire in place. It is a thin wire that wraps around the bracket.
• Band — This is a metal band that fits completely around a tooth. It is used to help adhere brackets to the tooth.
• Hook — This is the piece of equipment that is used to attach the elastics, also known as rubber bands, around the bracket.
• Elastic — These elastics are used to connect one point of the appliance to another. The purpose is to apply pressure, and encourage the teeth to move into the proper positioning.

By defining each appliance we hope you or your child will be less apprehensive about getting braces put on. At the end of your treatment, you will have a bright, straight smile to show off to all of your friends.

Top ten tips to keep your braces sparklin' clean!

July 9th, 2012



Keeping your teeth clean is more important than ever when you have braces! Food bits have more spots than usual to hide in your mouth, so you must be diligent in order to avoid bad breath, swollen gums, discolored teeth and cavities. If you remove plaque regularly during treatment, you'll experience better results and shorter treatment time. Keep plaque at bay with these top ten tips:

1. One tooth at a time. When you brush, take time with each individual tooth – at least 10 seconds each – and pay careful attention to the spots where your teeth touch your braces.
2. It’s all about the angles. Brush the tops of your teeth and braces with your brush angled down toward where they meet. Brush the bottoms of your teeth and braces with your brush angled up.
3. The tooth, the whole tooth, nothing but the tooth. While the front surface of your teeth may seem like the most logical to clean, it’s equally important to clean the inner surface of your teeth (tongue side) as well as the chewing surface. And be sure to clean along your gum line – a key spot for plaque buildup.
4. Step 1: eat, step 2: clean. While you’re in treatment, it’s important to brush after every meal. Bits of food can easily get caught between braces and teeth, and these food bits interact with bacteria in your mouth to cause decay. The longer food is in contact with your teeth, the greater opportunity for plaque to form. If you are eating somewhere that you can’t brush, thoroughly rinse your mouth with water.
5. Like a Boy Scout, always be prepared. The easiest way to be sure you can brush after every meal is to get in the habit of taking a toothbrush, toothpaste and floss with you wherever you go. Designate a special container just for your teeth-cleaning tools and keep it in your purse, backpack, or laptop case.
6. Remove the moving parts. If you have elastic bands or headgear, remove these parts before you brush or floss.
7. Fluoride is your friend. Fluoride helps prevent cavities. Be sure to brush with fluoride toothpaste, and rinse with fluoride mouthwash.
8. Pointy brushes reach tiny places. Interproximal brushes (sometimes called proxa brushes or interdental brushes) are cone-shaped and come in very handy for reaching spots around your braces that standard brushes can’t.
9. Find the floss for you. Regular floss works for some patients, but others find it easier to work with a floss threader, which helps you get the floss into tight places. Other patients like an all-in-one product called Superfloss, which comes with a stiff end for easy threading, a spongy section for cleaning wide spaces, and regular floss for narrow spaces.
10. Make time for the pros. It’s your job to take care of the everyday cleaning. But make sure to visit your dentist regularly while in treatment, to get the deep, thorough cleaning that only a professional can provide. If you need help finding the right Dentist for you, feel free to contact our office - we’d love to help!

We hope this helps, and remember to give our team a call if you ever have any questions!

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