Orthodontics

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.

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.

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?

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.

Our office and the American Association of Orthodontists (AAO) recommends children get their first check-up with an orthodontist either at the first recognition of an orthodontic problem or at age 7. It is important not to rely on your general dentist(the dentist that does your checkups and cleanings) to properly evaluate for orthodontic concerns.

Around that age, children have a mix of baby (primary) and permanent teeth. An examination at this age gives the child orthodontist a wealth of information. If a problem exists, or if one is developing, your orthodontist is able to advise you on which treatment is recommended, when it should begin, and estimate its length. "Waiting for the baby teeth to fall out" without being evaluated and monitored by an orthodontist is a mistake that can lead to serious issues down the road.

If your child is younger than 7, and you notice something that appears “off,” it’s not necessary to wait until your child turns 7 or until you get a recommendation from your dentist. You should take your child to an orthodontist the moment you notice an issue, regardless of age. No referral needed to set up an appointment for an orthodontic evaluation. At Strouse Orthodontics, as well as most orthodontic offices, initial consultations are complimentary. Orthodontists care about the well being and orthodontic health of your family and will be able to advise if any treatment is needed.

What Happens at the First Exam? Generally five questions will be answered

1. Is there an orthodontic problem, and if so, what is it?
2. What are the options to correct the problem?
3. Is there a possibility any teeth need to be removed?
4. How long is the recommended treatment expected to take?
5. How much will the recommended treatment cost?

Frequently Asked Questions

Won't my child's teeth become straighter as they grow?

Unfortunately, a common misconception is that a child's teeth will naturally align as they age. However, the reality is quite different. The space available for permanent front teeth does not expand with growth. In fact, after the eruption of the permanent molars around age 12, there's often less room for the front teeth, potentially resulting in orthodontic issues like protrusion or misalignment. Furthermore, untreated orthodontic problems tend to exacerbate over time and can pose greater challenges as a child matures.

Should I wait for our Dentist to refer my child to an orthodontist?

No. Parents are usually the first to realize something is off about their child's teeth or jaws. If you have any concerns please contact our office to schedule an initial consultation.

Where did my child's orthodontic problems come from?

Most orthodontic problems are genetic. Some are “acquired,” developing over time by sucking the thumb or fingers, mouth breathing, dental disease, abnormal swallowing, poor dental hygiene, or early or late loss of baby teeth, accidents and poor nutrition. Regardless of the cause, an orthodontist will likely be able to treat the condition.

Over the last decade clear aligners such as Invisalign have gained immense popularity as a discreet and effective orthodontic appliances. Many individuals contemplating improving their smile and bite with orthodontics wonder “Can my regular dentist do Invisalign?”(or any Orthodontic treatment for that matter) While it is true that legally dentists can offer clear aligners, the stark reality is that not all providers are created equal when it comes to understanding orthodontics. 

Clear aligners are an appliance that can be used for orthodontic treatment(to straighten teeth and correct a patient's bite). The success of Invisalign treatment hinges on the proficiency and experience of the practitioner. Here is the candid truth: your dentist may legally offer clear aligners, but without extensive expertise, they may be charting uncharted territory. 

Whether braces or clear aligners are used, orthodontic treatment requires a nuanced understanding of tooth movement, biomechanics, occlusion, growth and development, tooth eruption and comprehensive treatment planning. One red flag to here from a provider is that a dentist states they are “certified in Invisalign” or that they now have new technology to do Invisalign. Clear aligners are not new technology, and Invisalign has been available since the late 1990’s. This is a common phrase used by general dentists to lead unknowing patients to believe they are on the leading edge and experts on orthodontics. The truth is dental school has very limited to no orthodontic training with most programs have nothing more than a few lectures on Invisalign and no hands on training, let alone starting and finishing a case or any fundamental knowledge in orthodontics.

Orthodontic specialists go on to a 2-3 year ADA approved residency program. All Orthodontists are dentists first, and out of 100 dental school graduates only 6 go on to become orthodontics because of the competitive nature. In these residency programs, orthodontists become experts on the skills required to manage tooth movement and guide growth and development while treating hundreds of cases. In practice, orthodontists focus on straightening teeth and correcting bite issues all day, every day.

Opting for clear aligners or braces from an under qualified dentist could lead to suboptimal results, prolonged treatment times, and extensive complications down the road. Most times, dentists will focus on straightening the front teeth that a patient sees and will not address and bite issues. They may not tell you, or even be aware of bite or occlusion issues you may have. A bad bite can lead to many dental problems down the road such as tooth wear over the entire life, TMJ discomfort, and a smile that does not last a lifetime. 

Orthodontists are experts at using both clear aligners(Invisalign) as well as braces, expanders, jaw surgery, and various appliances and are specialists in straightening the teeth and correcting bite issues.

So what should you consider when contemplating orthodontics?

1. Inquire on their specific training and experience in orthodontics and if they are actually an orthodontist. Have they gone to an ADA and CODA approved residency program?
2. Ask if they are confident they can provide the same level of orthodontic care of a licensed orthodontist.
3. Ask to see some cases they have treated that are similar to yours to see before and after photos. Make sure that you are shown the issues, if any, with your bite and how they plan to be addressed. An orthodontic specialist will be better equipped to handle the complexities of treatment.

Having a general dentist perform orthodontics is similar to a general physical doing plastic surgery. While maybe it can legally be done, do you want to risk it? If you needed a knee or hip replacement and your general physician told you they recently got certified in the procedure, you would be skeptical and would would to see an orthopedic surgeon with the expertise and experience to complete the procedure. Just as a cardiologist will have a lot more specialization when it comes to heart conditions than a general physician, the same holds true with teeth and orthodontics.

Remember, while your dentist can legally offer and deliver clear aligners, seeing a provider that completed an orthodontic residency and is best way to ensure your orthodontic care is completed by a real orthodontist. Why risk the health and esthetics of your teeth as well as your money by seeking treatment from a provider with less education, knowledge and training?

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!

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!

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.

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!

When the time to remove your braces finally arrives, it is very exciting. Unfortunately, it can be somewhat confusing, too, because you are faced with choosing between two kinds of retainers. Should you go with permanent, removable, or a combination of the two? It is always wise to follow your dentist’s recommendations, but knowing more about the two types of retainer beforehand can be helpful.

Removable Retainers

Removable retainers offer the advantage of easy use: you will generally put a removable retainer in at night and take it out in the morning. Regardless of your retainer schedule, you'll be able to enjoy some time with no retainer. However, a removable retainer can easily be forgotten at times, and this means you won't be taking full advantage of teeth retention.

Another potential advantage of a removable retainer is that you can take it out and brush and floss your teeth with ease, which is more of a challenge with a permanent retainer. Although removable retainers can be very effective, they don't tend to be as effective as permanent retainers, especially if they are not used as directed.

Permanent Retainers

Permanent retainers are the clear choice for patients who want to “get it and forget it.” Once your permanent retainer is placed in your mouth, you won’t need to worry about daily retainer schedules, since it is permanently affixed to your teeth.

Because teeth begin to shift naturally as we age, a permanent retainer typically offers better long-term results for teeth straightening than a removable one. You can't forget to put it in — it's already there! Temporary retainers get lost or are forgotten on trips, and often fail to get used as often as they should be.

One drawback to permanent retainers is flossing. Some patients find it more difficult to floss with a permanent retainer, but we can show you effective ways to floss fairly quickly with your permanent retainer.

Some orthodontists may recommend a combination of the two; for example, a removable retainer for the top teeth and a permanent one for the lower ones because the lower teeth are smaller and tend to shift more.

Ultimately, the most important thing to remember is that wearing your retainer as directed is extremely important. As long as you follow our orthodontist’s advice, you will get the best results from your retainer, regardless of its type.

Can you believe it's already October? For those who don't know, it’s National Orthodontic Health Month. This month-long event is organized by our pals at the American Association of Orthodontists, or AAO.

Our team realizes that this is a great opportunity for us to raise awareness about the importance of oral hygiene. National Orthodontic Health Month also aims to recognize the dedicated work of orthodontists and other dental professionals.

The AAO recommends patients avoid the following Halloween treats, or recipes with these ingredients:
• Caramel
• Nuts
• Popcorn (including un-popped kernels)
• Taffy
• Jelly beans
• Hard pretzels
• Licorice
• Bubblegum
• Ice

Trick-or-treating safety guidelines:

• Young children should always be accompanied by an adult
• Carry a flashlight
• Wear a light-colored or reflective costume
• Choose face paint over masks for young ghosts and goblins
• Have an adult inspect all treats before the children dig in

If you have any questions, please feel free to give us a call or ask us on Facebook. Have a fun and safe Halloween!

Did you know one in every five orthodontic patients is an adult? We’re living longer and technology is improving, making orthodontic treatment an appealing and safe option for patients of all ages. As the trend toward treatment later in life grows, we’re seeing braces on parents as well as children – and even adult celebrities such as Tom Cruise, Gwen Stefani and Nicholas Cage have shown off their braces. It’s never too late to look and feel your best!

Can Braces Work for Adults?

People of all ages can benefit from orthodontic treatment. The physical process for moving teeth is the same, young or old, which means it’s never too late to address issues such as an overbite or underbite, crooked or crowded teeth, or jaw disorders.

How Do I Get Started?

If you’re considering orthodontic treatment, we’ll make a consultation appointment with you. During this meeting we will perform a general assessment of your oral health, discuss options for treatment, and answer any questions you may have. We will also discuss matters of cost and insurance. The next step is an orthodontic records appointment in which we take x-rays, photos, and an impression of your teeth. This information drives your unique treatment plan.

What Are the Benefits?

Straightening your teeth can improve your smile, your self-esteem, and your dental health. Technologically advanced new treatments make it easier to identify the option that best fits your lifestyle. Modern techniques and materials have made braces and aligners more effective, comfortable and unobtrusive than ever.

If you think you might benefit from orthodontic treatment, give our team a call, so we may set up a consultation to determine what type of treatment best meets your needs.

Usually patients in orthodontic treatment already have their permanent teeth – they are pre-teens, teens and adults. But in some cases we have to start treatment earlier, even before the patient’s permanent teeth come in. We call this “two-phase treatment.”

When we have patients with clear developmental problems at an early age, it’s best to start work when they are young, before the problems get bigger and more difficult to treat.

Examples include:
• An upper or lower jaw that is not growing correctly
• A mouth growing in a way that doesn’t leave enough room for all the permanent teeth to come in
• A severe malocclusion, or bad bite, which means the jaw doesn’t fit together correctly

In these cases we will start early and do one round of treatment – phase one – while the patient still has their baby teeth. Phase one usually does not involve braces, but can include a different type of appliance that helps the jaw grow into place properly. We’ll follow up with phase two usually a few years later, when permanent teeth are in place. Generally phase two involves braces.

In order to catch early problems, we recommend that children have an orthodontic check-up no later than age seven (and so does the American Association of Orthodontists). However, if your dentist or pediatrician sees any sign that early treatment might be necessary, he or she may recommend your child visit our office even sooner.

Are you thinking about orthodontic treatment to straighten teeth or correct jaw alignment? Consider making your first step an orthodontic consultation. During the consultation we will address your questions, concerns, and talk about a treatment plan that would best suit your situation.

We want you to feel prepared and in charge of your orthodontic treatment decisions, so keep these questions in mind when you come in for your appointment.

• If I do need some adjustments to my teeth, what options will I have besides braces?
(This will help you determine what approaches we use to straighten your teeth.)

• What kind of preparation is needed to get braces? How many visits will it take?
(It’s important to know how many appointments may be needed and what you will need to do between appointments to be ready for braces.)

• Can I expect any pain when getting braces?
(Ask about the ways we address pain management.)

• What determines how long I have to wear braces?
(The length of treatment will vary from patient to patient. During your consultation we can evaluate your teeth and jaw alignment to determine the correct course and length of treatment.)

• How will braces affect my lifestyle? Foods I can eat? Activities I can do?
(You may find that little needs to change in your daily routine to have a successful orthodontic outcome. We can discuss and address any changes so you can be prepared before you get your braces.)

• Who will be involved in the orthodontic work? Whom can I expect to see during my adjustment visits?

• What will my orthodontic work cost? What is the ”average” cost and what could be the maximum?
(Make sure you are clear about what your insurance covers, who contacts the insurance company for pre-authorization, who files the insurance forms, and what flexibility there is to pay the remaining amount not covered.)

Your initial orthodontic consultation may just be the first step in relieving a lot of pain and discomfort in your life. Going in with the right questions will help you to understand the entire process and prepare you to do your part for your own dental health. Be sure to bring a list of your questions!

Visibly crooked teeth are not the only reason to take your child into the orthodontist. There are some subtle things to look for as well, which may indicate the onset of more serious orthodontic issues. Many orthodontic issues are much easier to address if treated and corrected during a child's development.

Waiting until facial development is complete or until the permanent teeth have come in can make correction of many orthodontic issues more challenging. Both children and adults can benefit from orthodontic care at any age, but addressing issues early is almost always the ideal choice.

If you're wondering if you or your child might have need for orthodontic care, there are some things you can be on the lookout for. Here are some of the most common warning signs of orthodontic issues:

• Difficulty when chewing or biting
• Chronic mouth-breathing
• Sucking the thumb, the fingers, or any other oral sucking habits that continue after the age of six
• Overbite - when the upper teeth overlap the lower teeth by more than 5mm
• Top front teeth that cover more than 25% of the bottom teeth while biting
• Underbite - when the top front teeth go behind the bottom row of teeth when biting
• Crowded, crooked, overlapped, misshapen, misplaced teeth or extra teeth of any size
• Crossbite - when one or more teeth tilt toward the cheek or toward the tongue causing excessive stress on the jawbone
• The center of the top and bottom teeth don't line up
• Uneven teeth-wearing
• Baby teeth coming out too early for the child's age
• Pain in jaws
• Clicking in the jaw joints
• The jaw shifts off-center while chewing or biting
• A jaw that protrudes, or recedes, too much
• Difficulty speaking or enunciating clearly
• Chronic biting of the inner cheek or roof of the mouth
• Asymmetrical facial structure
• Grinding or clenching of the teeth

If you notice that either you or your child has one or more of these conditions, they could be signs that there is a risk of orthodontic or health problems. The sooner these problems are addressed, the wider and brighter you will be able to smile going forward!

Orthodontic treatments vary from dental treatment, in that they primarily address malocclusions, jaw spacing and tooth alignment, rather than the actual health of the teeth. That is why it is often more difficult for parents to determine when a child needs orthodontic treatment than dental treatment. So how can you know it is time to take your child to the orthodontist?

• Bad Bite - As the adult teeth begin to replace primary teeth, bite occlusions can develop. These often become visible to parents between middle childhood and the pre-teen years, although an orthodontist can identify a bad bite with early evaluation.
• Visible Tooth Crowding - If your child's newly emerging teeth are already crowded, you should make an appointment with our office to discuss braces.
• Tooth Grinding (Bruxism) - Children who grind their teeth at night may do so unconsciously, but the condition requires treatment to prevent the development of headaches, TMJ, and tooth damage. Oral appliances are available to correct nighttime tooth grinding.
• Difficulty Chewing, Biting, or Speaking - If your child is displaying difficulty speaking or eating, or if he or she often experiences cheek biting, schedule an orthodontic consultation.
• Asymmetry - If your child's face is asymmetrical, or if his or her teeth do not meet together in a natural way, orthodontic treatment may be necessary.

Evaluation and Preventive Care

Even if your child has no visible tooth or jaw alignment problems, the American Association of Orthodontics recommends that every child visit the orthodontist for an initial examination no later than age seven. The reason for early evaluation is because orthodontists are capable of finding subtle problems with the jaw and teeth growth and spacing before they become more pronounced and also more difficult to treat. By bringing your child in for an evaluation, you may be able to treat orthodontic conditions with shorter and more simplified treatments that are also more affordable than treatment during the teenage and adult years.

Orthodontic treatments are used to correct malocclusion, a condition more commonly known as a bad bite. The length of treatment time varies depending on the severity of the bite problem.

What is a "bad bite"?

A bad bite occurs when spacing or alignment problems are present. This often includes teeth that are protruding, crowded, or crooked. Sometimes teeth appear straight, but have an uneven bite because the upper and lower jaws do not align properly. Teeth that are irregularly spaced - either too far apart or too close together - can also cause bite problems.

Frequent causes of bite problems:

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

Benefits of orthodontic treatment:

Appearance -
Correcting a bad bite often creates a more attractive smile, which frequently raises the patient's self esteem.

Preventing Decay -
It also results in a healthier mouth. It is much more difficult to thoroughly clean teeth that are crooked, protruding, overlapped, or crowed. This may allow plaque to build up, which can lead to gum disease, tooth decay and even tooth loss. Orthodontic treatment corrects these conditions, so cleaning can be more efficient.

Avoiding Alignment Issues -
An uneven bite can interfere with the motions of chewing and speaking. This can cause abnormal wear to tooth enamel, which may require pricey cosmetic restorative treatments, such as crowns or veneers, to correct. It can also lead to problems with the jaws. Orthodontic treatment lessens the likelihood of those issues, as well.

Types of orthodontic treatment:

Braces: Metal or ceramic brackets are bonded to the front of teeth. Wires and elastics are attached to the brackets to straighten teeth.

Invisalign®: Advanced 3D computer images of the patients' mouth are used to create clear, custom aligners that slowly move teeth. They are nearly invisible and are more comfortable than traditional braces. They are also removable, which makes it possible to continue with normal brushing and flossing.

Retainers: A retainer is a removable piece worn inside the mouth that uses pressure to force teeth to move into proper alignment. They are used after braces are removed.

Length of orthodontic treatment:

Treatment typically ranges from 12 - 36 months. Factors include the age, cooperation level, and growth occurrence of the patient. The complexity of the case also impacts the treatment time.

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!

Summer is here! Kids and adults alike will now be spending more time outside being active and enjoying the hotter temperatures. What’s better on a hot summer day than a delicious treat that will cool you down after doing something active in the summer sun? Luckily, our friends at the American Association of Orthodontists (AAO) have just the thing, Watermelon Sorbet! You can find the complete recipe below:

Watermelon Sorbet

Ingredients
• ¾ cup water
• ¼ cup sugar
• 1 teaspoon lime juice
• 2 to 3 cups watermelon, diced, no seeds or rind
Directions
In a small saucepan, heat the water, sugar, and lime juice on medium high for 1 to 2 minutes, stirring until the sugar has dissolved. Chill this “syrup” at least 20 minutes. In the meantime, place the watermelon chunks in a food processor or blender and liquefy them. Add the chilled syrup to the watermelon puree and blend. Freeze sorbet in an ice-cream maker according to manufacturer’s directions. Serve immediately.

Happy Summer!

True orthodontic emergencies are very rare, but when they do occur we are available to you. As a general rule, you should call the office when you experience severe pain or when you have a painful appliance problem that you can't take care of yourself. We’ll be able to schedule an appointment with our office.
You might be surprised to learn that you may be able to temporarily solve many problems yourself until you get in to see us…

The following solutions may help you relieve your discomfort:

Poking Wire: Using a pencil eraser, push the poking wire down or place wax on it to alleviate the discomfort.
Loose Bracket or Band: If your bracket or band is still attached to the wire, you should leave it in place and put wax on it. If the wire comes out entirely, wrap the bracket with a tissue.
Loose Wire: Using a tweezers, try to place your wire back into place. If doing this and using wax does not help, as a last resort use a small fingernail clipper to clip the wire behind the last tooth to which it is securely fastened. If your discomfort continues, place wax on it.
Loose Appliance: If your appliance is poking you, place wax on the offending part of your appliance.
Headgear Does Not Fit: Sometimes headgear discomfort is caused by not wearing the headgear as instructed by your orthodontist. Please refer to the instructions provided by your orthodontist. If the facebow is bent, please call our office for assistance. Surprisingly, headgear becomes more comfortable the more it's worn, so be sure you’re getting in the prescribed hours.
General Soreness: When you get your braces on, you may feel general soreness in your mouth and teeth may be tender to biting pressures for three to five days. This can be relieved by rinsing your mouth with a warm salt water mouthwash. Dissolve one teaspoonful of salt in 8 ounces of warm water, and rinse your mouth vigorously. If the tenderness is severe, take aspirin or whatever you normally take for headache or similar pain.

Remember, after alleviating your discomfort, it is still very important that you call our office as soon as possible to schedule a time to repair the problem.

The number one goal of orthodontic treatment is to give you or your child a good bite, meaning straight teeth that work well with the teeth in the opposite jaw. A good bite makes it easier for you to eat, chew and speak. It can enhance your dental health and your overall health, and may well improve your self-esteem. As a part of your comprehensive dental health care plan, orthodontic treatment can help you retain your teeth—and your smile—for a lifetime.
Let your smile express yourself! Nothing can show the world how happy you are quite like a beautiful smile. In fact, it’s one of the first things others notice about you, too. With orthodontics, you can be proud to flash your smile, because you’ll know that your smile truly represents your positive attitude.
Make your mouth healthy! Straight teeth aren’t just pretty, they’re healthy as well. Teeth that are properly aligned are easier to clean, reducing the amount of plaque buildup and risk for gingivitis. The cleaner you keep your teeth, the longer they’ll last!
Feel free to live your life! Orthodontics is easier today than ever before, with treatment options that fit your lifestyle and schedule. We can personalize your treatment to suit all of your needs!

In honor of June Dairy Month, our team would like to thank all of our hard working families in the Dairy Industry.

In fact, dairy is important to your overall health! A 2008 study from the American Academy of Periodontology (AAP) found that regular consumption of dairy products, such as milk, cheese and yogurt, can lower your chances of contracting periodontal disease (also known as gum disease).

Results of the study show that adults who consume at least 55 grams of lactic acid a day are less at risk for gum disease. Eating dairy is not just healthy for building strong bones, but is essential for maintaining a strong, healthy mouth.

Questions about which foods you should steer clear of and which you should enjoy during orthodontic treatment? Give us a call or ask us on Facebook!

We know that having an attractive smile puts a spring in your step—or two—as well as increases your self-confidence, no matter if you’re 14 or in your late forties. Smiling not only makes people happy and puts them in a good mood, doing it often can even help you live longer, according to previous studies!

If you’ve been hiding your smile because you have crooked teeth or gaps between your teeth, it’s time to consider orthodontic treatment at our practice. You’ll be pleasantly surprised to learn how quickly and efficiently today’s most advanced correction techniques can straighten your smile!

Don’t hide your smile any longer — give us a call today to schedule yours or your child’s orthodontic consultation.