Crowding of the teeth
Patient started treatment at age eleven and wore braces for 26 months. He loves his new smile.
Openbite: Front teeth don’t touch
Patient sucked her thumb as a young child. She started treatment at age 13. She had braces and a special appliance — called a crib — to retrain the tongue, for 28 months. Now she can bite the lettuce out of a sandwich.
Deep overbite: Lower front teeth bite into palate
This adult patient, age 25, required braces and jaw surgery to correct his severe overbite, with treatment taking two years. His problem could have been corrected without surgery if he had been treated before he was a teenager.
Missing lateral incisors
This patient’s lateral incisors were congenitally missing. She had braces for 20 months to move the teeth into the correct position, then the missing teeth were replaced with bonded “Maryland” bridges.
Underbite: Lower front teeth in front of upper teeth
Patient’s underbite was causing her jaw joint discomfort and excessive wear patterns on her teeth. After 30 months of treatment starting at age 32, she now finds smiling and chewing much easier.
Spacing of teeth
Patient was bothered by the spaces between his teeth. Braces closed the spaces and gave him an ideal bite in 24 months. Special glued-in retainers help keep the spaces closed.
Overbite: Protruding front teeth
At age 10, patient had a big overbite with the top teeth protruding beyond the bottom. She had two phases of treatment. The first helped her jaws to grow more harmoniously and the second aligned her teeth and bite. At age 13, she was proudly displaying her new smile.
Sometimes braces are not needed to get noticeable improvements in tooth alignment. This patient was first seen at age seven for crowding of the lower permanent teeth. A procedure was performed to reduce the width of the adjacent baby teeth and the permanent incisors aligned on their own in nine months.
Patient’s parents were concerned about both aesthetics and the health of the erupting permanent teeth when they brought him to the orthodontist at age eight. The lower front teeth were crowded and they touched the palate, and the upper front teeth were extremely displaced from their normal positions. After 20 months of Phase I treatment with an expander and partial braces, patient’s appearance and dental function were vastly improved.
You may have noticed that our doctor specializes in “Orthodontics and Dentofacial Orthopedics.” While most people have heard of orthodontics, many are confused by the “dentofacial orthopedics” part of the title. We can explain!
Every orthodontist starts out in dental school. Upon completion of dental school, some graduates immediately go into practice as dentists. Others choose to pursue a dental specialty, which requires additional schooling during a two- to three-year residency program. There are nine specialties sanctioned by the American Dental Association. Some you are likely familiar with are Pediatric Dentistry (dentistry for children), Periodontics (dentistry focusing on the gums), and Oral Surgery.
One of the nine specialties is “Orthodontics and Dentofacial Orthopedics.” You probably know that an orthodontist straightens teeth, and indeed: “ortho” comes from the Greek for “straight” or “correct,” and “dontic” from the Greek for “teeth.” But what about dentofacial orthopedics? “Dentofacial” is “teeth” plus “face” while “ortho” again means “straight” and “pedic” is from the Greek for “child.”
Essentially, while orthodontics entails the management of tooth movement, dentofacial orthopedics involves the guidance of facial growth and development, which occurs largely during childhood. In both cases, appliances are frequently used – the more familiar braces for orthodontics, and other specialized appliances like headgear and expanders depending on what facial abnormalities are present. Sometimes orthopedic treatment may precede conventional braces, but often the two are accomplished at the same time. So if your child gets braces and headgear, he is undergoing orthodontics and dentofacial orthopedics!
With skills in both areas, the doctor can diagnose any misalignments in the teeth and jaw as well as the facial structure, and can devise a treatment plan that integrates both orthodontic and dentofacial orthopedic treatments.
What is surgical orthodontics?
Just as orthodontics repositions teeth, surgical orthodontics (also known as orthognathic surgery) corrects jaw irregularities to improve the patient’s ability to chew, speak, and breathe and for improved facial appearances. In other words, surgical orthodontics straightens your jaw. Moving the jaws also moves the teeth, so braces are always performed in conjunction with jaw correction. This helps make sure teeth are in their proper positions after surgery.
Who needs surgical orthodontics?
Your orthodontist will consider surgical orthodontic treatment for non-growing adult patients with improper bites and those with facial esthetic concerns. Jaw growth is usually completed by age 16 for girls and 18 for boys. All growth must be completed before jaw surgery can be performed. However the pre-surgical tooth movements can begin one to two years prior to these ages.
How does it work?
During your orthodontic treatment, which usually lasts 6-18 months, you wear braces and will visit your orthodontist for scheduled adjustments to your braces. As your teeth move with the braces, you may think that your bite is getting worse rather than better. However, when your jaws are placed into proper alignment during orthognathic surgery, the teeth will then fit into their proper positions.
Surgery is performed in the hospital with an oral surgeon, and can take several hours, depending on the amount and type of surgery needed. In lower jaw surgery, the jawbone behind the teeth is separated and the tooth-bearing portion is moved forward or backward, as needed. In upper jaw surgery, the jaw can be repositioned forward or backward, or the jaw can be raised or lowered. Certain movements may require the jaws to be separated, with bone added/removed to achieve the proper alignment and stability. Other facial bones that contribute to alignment may also be repositioned or augmented.
When you have completed surgery, you should be able to return to school or work within two weeks. After the necessary healing time (about 4-8 weeks), your orthodontist “fine-tunes” your bite. In most cases, braces are removed within 6 to 12 months following surgery. After your braces are removed, you will wear a retainer to maintain your beautiful new smile.
Millions of Americans suffer from chronic facial and neck pain as well as severe, recurring headaches. In some cases this pain is due to Temporomandibular Disorder, also known as TMD.
Your temporomandibular joints, or TMJs, connect your lower jawbone to your skull. These joints get a lot of use throughout the day as you speak, chew, swallow, and yawn. Pain in and around these joints can be unpleasant and may even restrict movement.
Symptoms of TMD include:
- Pain in the jaw area
- Pain, ringing, or stuffiness in the ears
- Frequent headaches or neck aches
- Clicking or popping sound when the jaw moves
- Muscle spasms in the jaw area
- A change in the alignment of top and bottom teeth
- Locked jaw or limited opening of the mouth
If you notice that you are experiencing any of these symptoms, let your doctor know at your next appointment. Your doctor canhelp determine if you have TMD, and will create a customized treatment plan to help relieve your symptoms.
Not all jaw pain is associated with TMD
If you feel that you might have TMD, it is always important to see your dentist and receive an exam. However, not all jaw pain is associated with TMD, and if you do not have TMD, there are many different preventive steps you can take to maintain a healthy, strong smile.
- Relax your face – “Lips together, teeth apart”
- Avoid grinding your teeth
- Avoid all gum chewing
- Don’t cradle the phone receiver between your head and shoulder – either use a headset or hold the receiver to your ear
- Chew food evenly on both sides of your mouth
- Do not sit with your chin rested on your hand
- Practice good posture – keep your head up, back straight, and shoulders squared
Many people get TMD without ever having braces. Symptoms usually wax and wane regardless of if braces are worn. If you are experiencing any of the symptoms listed above, and may be concerned that you’re a candidate for TMD treatment, please contact our office for a consultation.
Clear aligners are an effective alternative to traditional braces that use a system of clear, removable trays to straighten teeth. Each aligner is custom-made to fit over your teeth and designed to gradually move teeth into their proper position. Using clear aligners for orthodontic treatment is not for everyone. The best way to find out if clear aligners are the right option for you is to schedule a consultation with your orthodontist.
How do clear aligners work?
Clear aligners are created as an alternative to traditional braces, and are designed to help guide teeth into their proper position. Just like braces, clear aligners use gradual force to control tooth movement, but without any metal wires or brackets. The aligners are made with a strong plastic material, and are fabricated to fit your mouth. Each aligner is created a little different, so that each time you switch aligners, your teeth move a little more.
Aligners are worn for at least 20 hours each day, and for two weeks, before putting in a new aligner. The length of your treatment depends on the severity of your case, and can take anywhere between six months to two years.
Advantages of orthodontic treatment with clear aligners:
Clear aligners are a great alternative for patients who want a straighter smile but do not want to wear metal braces, or for patients who have had treatment in the past and want to make minor corrections to their smile. There are several advantages to orthodontic treatment with clear aligners.
- Clear aligners are easier to keep clean, making it easier to maintain the health of your teeth and gums.
- Clear aligners are comfortable and less likely to irritate your gums and cheeks.
- Clear aligners prevent wear on the teeth from tooth grinding.
- Clear aligners are removable so it’s easier for you to brush and floss after meals.
If you’re interested in orthodontic treatment with clear aligners, schedule an appointment and talk to your orthodontist about whether or not this is the right treatment option for you. Scheduling a consultation is your first step toward achieving the beautiful you’ve always wanted.