Common Orthodontic Questions

What is Orthodontics?

Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention and treatment of dental and facial irregularities. The technical term for these problems is “malocclusion,” which means “bad bite.” The practice of orthodontics requires professional skill in the design, application and control of corrective appliances, such as braces, to bring teeth, lips and jaws into proper alignment, thus achieving facial balance.

What is an Orthodontist?

An orthodontist is a dental specialist in the diagnosis, prevention and treatment of dental and facial irregularities. Orthodontists must first attend college, then complete a four-year graduate dental program at a university-level dental school accredited by the American Dental Association (ADA). They must then complete an additional two- to three-year residency program of advanced dental education in orthodontics accredited by the ADA. Only dentists who have completed this advanced specialty education may become orthodontists.

What is a Board Certified Orthodontist?

After graduating from an orthodontic specialty program, an orthodontist is eligible to become board certified through the voluntary examination process of The American Board of Orthodontics (ABO). Achieving certification is a demonstration of the orthodontist’s continued proficiency and excellence.

The certification process involves a written test as well as an oral case presentation and evaluation. The written examination covers all areas of information on which an orthodontist should be knowledgeable. Successful passage of the written exam allows the orthodontist to present treated cases, which will be evaluated by expert examiners of the board during a clinical examination. Certification is then awarded for a limited period and the orthodontist must re-examine on a periodic basis to retain this certified status.

What Causes Orthodontic Problems?

Most malocclusions are inherited, and some are acquired. Inherited problems include crowding of teeth, too much space between teeth, extra teeth, congenitally missing teeth and a wide range of discrepancies involving the jaws, teeth and face. Acquired problems can be caused by trauma, thumb or finger sucking, airway obstruction by tonsils and adenoids, dental diseases and premature loss of baby or adult teeth. Many of these problems affect not only alignment of the teeth but facial development and appearance as well.

How Do I Know If My Child Needs Orthodontic Treatment?

It is usually difficult for you to determine whether treatment is necessary because many problems can occur even though the front teeth look straight. Also, some problems that look intimidating and complex will resolve themselves on their own. Your general dentist is a good reference, but we are your best resource because orthodontics is all we do. Our initial exam is comprehensive and informative, and we would be more than happy to see your child and make any recommendations necessary.

What are the Early Signs of Orthodontic Problems?

Although you may find it difficult to determine whether treatment is necessary, the following signs can help in prompting you to seek orthodontic advice: crowded or overlapping teeth; gaps between the teeth; poor alignment of front top teeth with bottom teeth; top front teeth that do not meet with the bottom teeth; and top front teeth that cover more than 50% of the bottom teeth. If you see any misalignment or shifting of the jaw, your child may have a skeletal problem that could require early orthodontic treatment.

At What Age Should My Child See an Orthodontist?

The American Association of Orthodontics recommends that your child be evaluated by age 7. An orthodontic screening no later than this enables the orthodontist to detect and evaluate problems that exist, advise the parent on whether treatment will be necessary, and determine the best time for any treatment. Early detection of orthodontic problems is important so that early corrective action can be taken and more difficult treatment later can be avoided.

Can Adults Have Braces?

Age is not a factor in considering orthodontic treatment. Any adult in good general health with healthy gums and good bone support for the teeth is a good candidate for orthodontic treatment. About 25% of our orthodontic patients are adults, and that number is still growing!

Is Orthodontic Treatment Painful?

Orthodontic treatment has improved dramatically. As a rule, braces make your teeth tender and sore for a few days, but are not painful. This annoyance can be relieved with an over-the-counter analgesic. Today’s braces are more comfortable and use technology that reduces the any irritation. We use the latest in biocompatible braces, the advanced technique with light force and the highest quality orthodontic materials in order to reduce discomfort and treatment time.

What are Phase I (Interceptive) and Phase II (Comprehensive) Treatments?

Phase I or Interceptive Treatment usually starts about age 7 to 9, when the child has most of his or her baby teeth and a few permanent front incisors. The goal of Phase I treatment is to intercept moderate or severe orthodontic problems early in order to reduce or eliminate them. These problems include skeletal discrepancies, crossbites, and severe crowding. Phase I treatment takes advantage of the early growth spurt and turns a difficult orthodontic problem into a more manageable one. This often helps reduce the need for extraction or surgery and delivers better long-term stability. Most Phase I patients require a second phase of treatment in order to achieve an ideal final bite.

Phase II treatment usually occurs a number of years later. Usually, we wait for the remaining permanent teeth to erupt, including second molars, before beginning Phase II. This most commonly occurs at the age of 12 or 13. The goal of Phase II treatment is to achieve an ideal bite with all of the permanent teeth.

Does Everyone Need Phase I Treatment?

Not every child needs Phase I treatment. Only some children with certain bites require early intervention. All others can wait until most if not all their permanent teeth erupt. However, it is important that every child be evaluated by age 7.

What is the Duration of Orthodontic Treatment?

Braces may be on between 6 months to 30 months, or in rare instances longer. This depends on the development of the dentition, the severity of the problem, the patient’s cooperation and the degree of tooth movement required.

What is the Difference Between Extraction and Non-Extraction Therapies?

Each treatment is a way to address crowding of the teeth. Extraction therapy is a technique in which one or more teeth are removed to make room for the other teeth in the mouth. This is in contrast to non-extraction therapy, in which the patient’s jaw is expanded and/or the shape and size of some teeth are adjusted to make them fit within the jaw. Our office’s treatment philosophy is very conservative, and we do make every effort to avoid extraction. However, for severe crowding and severe jaw discrepancy, extraction may be required.

Is Orthodontic Care Expensive?

When orthodontic treatment is implemented at the proper time, treatment is often less costly than the dental care required to treat the more serious problems that can develop years later. Orthodontic fees have not increased as fast as the costs for many other consumer products. Financing is usually available, and our office offers many payment programs.