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Orthodontics

Why orthodontics?

Your dentist may have discussed with you the benefits of having healthy teeth and proper jaw function. It is more difficult to keep crooked, crowded or overlapping teeth clean and their supporting bone and gums healthy. Other orthodontic problems may contribute to abnormal wear of tooth surfaces, inefficient chewing function, and excessive stress on gum tissue and the supporting bone. For most people, a beautiful smile is the most obvious benefit of orthodontics.

What is orthodontics?

Orthodontics is a dental specialty that focuses on the diagnosis, prevention, and treatment of dental and facial irregularities. The practice of orthodontics involves the design, application and control of corrective appliances (braces or removable appliances) to treat and correct these irregularities.

What is an orthodontist?

An orthodontist is a specialist who has completed a two to three year advanced education program after dental school, to learn the special skills to diagnose facial irregularities, manage tooth movement and guide facial development.

At what age should orthodontic treatment occur? Can adults benefit from braces?

Orthodontic treatment can be started and can be successful at any age. Adults especially appreciate an attractive smile. For children, the timing of orthodontic treatment varies from child to child based on their specific needs and the severity of the problem. Treatment for young, growing children may be timed to correspond with skeletal growth spurts to improve treatment outcomes.  Many adults have never had braces or had them and their teeth have since shifted. We can achieve significant improvements in tooth alignment and bite correction at any age.

Why is age seven an ideal time for a first visit to the orthodontist? Why does the American Association of Orthodontics recommend an initial screening visit at age seven?

In most seven-year-old children, the permanent upper and lower incisors (front teeth) as well as the six-year molars (first molars) have erupted. This is the first opportunity for an orthodontist to evaluate the bite relationship of the front and back teeth. Based on Dr. Cohen clinical exam of the jaws and teeth, treatment may or may not be recommended at this age. If no treatment is necessary, periodic “check-ups” to ensure proper growth and development of the permanent dentition are scheduled; these visits are complimentary. Some terms for treatment in the mixed dentition (before all of the permanent teeth erupt) are early treatment, phase I, or interceptive treatment.

Why are so many young kids wearing braces these days? What orthodontic problems are best treated early or in younger children?

Dr. Cohen approaches treatment of young children on an individual basis and only recommend treatment that is interceptive in nature. With new advances in technology, there are some orthodontic problems that are easier to correct at younger ages. This may avert more serious problems (such as the need for jaw surgery) and complicated treatment protocols once all of the permanent teeth have erupted. Some examples of such problems include mismatched jaw position, severe tooth protrusion (buck teeth), cross-bites of the teeth or jaws, need for elimination of thumb or finger habits, and dental crowding. Depending on the child and family, esthetics may or may not be an indication for early treatment.

What is Phase I and Phase II treatment?

Phase I, or early interceptive treatment, is limited orthodontic treatment before all of the permanent teeth have erupted. Some examples are an expander or partial braces. Such treatment can occur between the ages of six and ten. This treatment is sometimes recommended to make more space for developing teeth, correct improper bite relationships (crossbites, overbites, underbites), or harmful oral habits such as thumb sucking. Phase II treatment is also called comprehensive treatment or full treatment, because it involves full braces when all of the permanent teeth have erupted, usually between the ages of eleven and thirteen. Phase II treatment may be necessary for some children who completed Phase I treatment.

What are some possible benefits of orthodontics?

  • A more attractive smile
  • Reduced self-consciousness
  • Increased self-confidence
  • Better function of the teeth & jaws
  • Better long term health of teeth and gums
  • Increased ability to clean the teeth
  • Reduced wear of the teeth
  • Guide permanent teeth into more favorable positions
  • Reduce the risk of injury to protruded front teeth
  • Aid in optimizing other dental treatment

What are some signs that braces may be needed?

  • Crowded or overlapped teeth
  • Spaces between the teeth
  • Upper front teeth protrude excessively over the lower teeth, or are bucked
  • Deep bite-upper front teeth cover the majority of the lower teeth
  • Underbite/Crossbite-upper front teeth are behind or inside the lower teeth
  • Openbite-the upper and lower front teeth do not touch when biting together
  • Habits-finger or thumb sucking after the age of five to six years old
  • The lower jaw shifts to one side or the other when biting
  • Difficulty chewing
  • Uneven or excessive tooth wear

How does orthodontic treatment work?

Braces use steady gentle pressure to gradually move teeth into their proper positions. The brackets that are placed on your teeth and the archwire that connects them are the main components. When the archwire is placed into the brackets, it tries to return to its original shape. As it does so, it applies pressure to move your teeth to their new, more ideal positions.  New technology also allows us to move teeth with Invisalign or clear plastic aligners. This treatment is not for everyone but is an amazing option for some.

How long does orthodontic treatment take?

Treatment times vary on a case-by-case basis, but the average time is from one to two years. Actual treatment time can be affected by rate of growth and severity of the correction necessary.  I would say that average treatment time is 2 years. This way if and when it’s less they’re pleasantly surprised.

Should I see my dentist while I have braces?

Yes, you should continue to see your dentist every six months for your regular cleaning and dental checkups.

Do braces hurt?

The placement of bands and brackets on your teeth does not hurt. Once your braces are placed and connected with the archwires you may feel some soreness of your teeth for one to four days.  Advil, Tylenol, or Motrin are extremely effective at reducing tooth soreness associated with orthodontic movement.

Will braces interfere with playing musical instruments?

No. However, there may be an initial period of adjustment. In addition, brace covers can be provided to prevent discomfort.

Will braces interfere with playing sports?

No. It is recommended, however, that patients protect their smiles by wearing a mouthguard when participating in any sporting activity.

For All Orthodontics

Why orthodontics?

Your dentist may have discussed with you the benefits of having healthy teeth and proper jaw function. It is more difficult to keep crooked, crowded or overlapping teeth clean and their supporting bone and gums healthy. Other orthodontic problems may contribute to abnormal wear of tooth surfaces, inefficient chewing function, and excessive stress on gum tissue and the supporting bone. For most people, a beautiful smile is the most obvious benefit of orthodontics.

What is orthodontics?

Orthodontics is a dental specialty that focuses on the diagnosis, prevention, and treatment of dental and facial irregularities. The practice of orthodontics involves the design, application and control of corrective appliances (braces or removable appliances) to treat and correct these irregularities.

What is an orthodontist?

An orthodontist is a specialist who has completed a two to three year advanced education program after dental school, to learn the special skills to diagnose facial irregularities, manage tooth movement and guide facial development.

At what age should orthodontic treatment occur? Can adults benefit from braces?

Orthodontic treatment can be started and can be successful at any age. Adults especially appreciate an attractive smile. For children, the timing of orthodontic treatment varies from child to child based on their specific needs and the severity of the problem. Treatment for young, growing children may be timed to correspond with skeletal growth spurts to improve treatment outcomes.  Many adults have never had braces or had them and their teeth have since shifted. We can achieve significant improvements in tooth alignment and bite correction at any age.

Why is age seven an ideal time for a first visit to the orthodontist? Why does the American Association of Orthodontics recommend an initial screening visit at age seven?

In most seven-year-old children, the permanent upper and lower incisors (front teeth) as well as the six-year molars (first molars) have erupted. This is the first opportunity for an orthodontist to evaluate the bite relationship of the front and back teeth. Based on Dr. Cohen clinical exam of the jaws and teeth, treatment may or may not be recommended at this age. If no treatment is necessary, periodic “check-ups” to ensure proper growth and development of the permanent dentition are scheduled; these visits are complimentary. Some terms for treatment in the mixed dentition (before all of the permanent teeth erupt) are early treatment, phase I, or interceptive treatment.

Why are so many young kids wearing braces these days? What orthodontic problems are best treated early or in younger children?

Dr. Cohen approaches treatment of young children on an individual basis and only recommend treatment that is interceptive in nature. With new advances in technology, there are some orthodontic problems that are easier to correct at younger ages. This may avert more serious problems (such as the need for jaw surgery) and complicated treatment protocols once all of the permanent teeth have erupted. Some examples of such problems include mismatched jaw position, severe tooth protrusion (buck teeth), cross-bites of the teeth or jaws, need for elimination of thumb or finger habits, and dental crowding. Depending on the child and family, esthetics may or may not be an indication for early treatment.

What is Phase I and Phase II treatment?

Phase I, or early interceptive treatment, is limited orthodontic treatment before all of the permanent teeth have erupted. Some examples are an expander or partial braces. Such treatment can occur between the ages of six and ten. This treatment is sometimes recommended to make more space for developing teeth, correct improper bite relationships (crossbites, overbites, underbites), or harmful oral habits such as thumb sucking. Phase II treatment is also called comprehensive treatment or full treatment, because it involves full braces when all of the permanent teeth have erupted, usually between the ages of eleven and thirteen. Phase II treatment may be necessary for some children who completed Phase I treatment.

What are some possible benefits of orthodontics?

  • A more attractive smile
  • Reduced self-consciousness
  • Increased self-confidence
  • Better function of the teeth & jaws
  • Better long term health of teeth and gums
  • Increased ability to clean the teeth
  • Reduced wear of the teeth
  • Guide permanent teeth into more favorable positions
  • Reduce the risk of injury to protruded front teeth
  • Aid in optimizing other dental treatment

What are some signs that braces may be needed?

  • Crowded or overlapped teeth
  • Spaces between the teeth
  • Upper front teeth protrude excessively over the lower teeth, or are bucked
  • Deep bite-upper front teeth cover the majority of the lower teeth
  • Underbite/Crossbite-upper front teeth are behind or inside the lower teeth
  • Openbite-the upper and lower front teeth do not touch when biting together
  • Habits-finger or thumb sucking after the age of five to six years old
  • The lower jaw shifts to one side or the other when biting
  • Difficulty chewing
  • Uneven or excessive tooth wear

How does orthodontic treatment work?

Braces use steady gentle pressure to gradually move teeth into their proper positions. The brackets that are placed on your teeth and the archwire that connects them are the main components. When the archwire is placed into the brackets, it tries to return to its original shape. As it does so, it applies pressure to move your teeth to their new, more ideal positions.  New technology also allows us to move teeth with Invisalign or clear plastic aligners. This treatment is not for everyone but is an amazing option for some.

How long does orthodontic treatment take?

Treatment times vary on a case-by-case basis, but the average time is from one to two years. Actual treatment time can be affected by rate of growth and severity of the correction necessary.  I would say that average treatment time is 2 years. This way if and when it’s less they’re pleasantly surprised.

Should I see my dentist while I have braces?

Yes, you should continue to see your dentist every six months for your regular cleaning and dental checkups.

Do braces hurt?

The placement of bands and brackets on your teeth does not hurt. Once your braces are placed and connected with the archwires you may feel some soreness of your teeth for one to four days.  Advil, Tylenol, or Motrin are extremely effective at reducing tooth soreness associated with orthodontic movement.

Will braces interfere with playing musical instruments?

No. However, there may be an initial period of adjustment. In addition, brace covers can be provided to prevent discomfort.

Will braces interfere with playing sports?

No. It is recommended, however, that patients protect their smiles by wearing a mouthguard when participating in any sporting activity.

About Orthodontics

General Soreness

When you get your braces on, you may feel general soreness in your mouth and your teeth may be tender to biting pressures for several days. During this time you may want to use ibuprofen (brand name Advil or Motrin),  an over-the-counter pain medication.  Eating softer foods such as soup or pasta may help with the discomfort. Warm salt-water rinses may be soothing.  The lips, cheeks and tongue may become irritated for the first couple of weeks as they become accustomed to the surface of the braces. Placing wax over the braces in these areas will reduce the irritation.

Loosening of Teeth

At times you may notice that your teeth feel loose. This is to be expected throughout treatment and is normal. Teeth must loosen first so they can be moved. The teeth will eventually become rigidly fixed in their new positions.

Food

To prevent breaking or damaging your braces or arch wires, please avoid sticky, crunchy or hard foods such as:  Ice, pizza crust, hard pretzels, hard chips, caramel, hard or sticky candy, gum, hard rolls, bagels, nuts, and popcorn.  Also avoid biting on things such as pens, pencils and fingernails, which can also cause damage the braces.

These foods may be eaten with caution: Raw carrots and apples (cut them up into small pieces first), corn on the cob (cut it off the cob) and soft drinks (high sugar content feeds oral bacteria, causing cavities).

smoothieAlternative snacks that will not harm your braces:

Fresh fruit, yogurt, pudding, smoothies, chocolate (no nuts), ice cream, frozen yogurt and cheese.

Compliance

Teamwork is the key to successful orthodontic care.  The teeth and jaws can only move into their corrected positions with your compliance and consistently following the instructions given. This includes keeping all scheduled appointments, maintaining excellent oral hygiene, and wearing the prescribed appliances (such as headgear or elastics) as requested. Non-compliance will delay completion of your treatment or result in a less optimal outcome.

Oral Hygiene

Excellent oral hygiene is essential while wearing braces.  Leaving plaque and tartar on your teeth will lead to scarring and cavities and may extend your treatment time.  It is important to brush after every meal and floss at least once per day. We will show you specific techniques and tools for cleaning around braces. Continue your routine of regular dental cleanings and exams.  If needed, more frequent cleanings (every 3 to 4 months) may be recommended while wearing braces.

Athletics / Injury

A protective mouth-guard is advised for anyone playing contact sports. Should you have any trauma to your face or teeth resulting in broken appliances, loose teeth, or bone fractures, please call our office immediately for an appointment.

Emergency Care

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 to resolve the problem, or in the case of after-hours calls you will be directed to call one of us directly.

You might be surprised to learn that you may be able to temporarily solve many problems yourself until you schedule an appointment with our office. After alleviating your discomfort, it is very important that you still call our office as soon as possible to schedule a time to repair the problem. Allowing your appliance to remain damaged for an extended period of time may result in disruptions in your treatment.

  • Poking Wire – Occasionally, an arch wire may shift, or extend past the last band, resulting in a poking wire.  Using a pencil eraser, push the poking wire down or place wax on it to alleviate the discomfort, and call our office to make an appointment to adjust or clip the protruding wire.
  • 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 and bring it to your next visit.  Each breakage will extend your treatment by approximately one month.
  • 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.  Surprisingly, the headgear may hurt less if it’s worn more, so be sure you’re getting in the prescribed hours.  The headgear needs to be adjusted periodically during treatment as the teeth move which may explain why it is no longer fitting.  Please refer to the instructions provided when we first gave you the headgear. If the metal bow is bent, please call our office for assistance.
  • General Soreness – When separators are placed or 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 will usually be relieved by using over-the-counter ibuprofen, commonly called Advil or Motrin.  Either the generic ibuprofen or the brand named drugs are fine and can be dosed as directed on the bottle, usually every 6-8 hours, until the discomfort dissipates.If you are unable to take ibuprofen, acetaminophen (Tylenol) may be used as directed on the bottle.  In our experience we have found this is helpful but just not as effective as the ibuprofen.  Warm salt water rinses may also be soothing after appliance placement.  Dissolve one teaspoonful of salt in 8 ounces of warm water, and rinse your mouth.The lips, cheeks and tongue may also become irritated for one to two weeks as they toughen and become accustomed to the surface of the braces. You can put wax on the braces to lessen this. We’ll show you how!

Invisalign ®

What are the 4 primary benefits of Invisalign®?

inline-invisalignFirst, they are nearly invisible: you can straighten your teeth without anyone knowing. Second, they are removable: you can still eat and drink what you want, when you want. They promote better oral hygiene because you can brush and floss normally to maintain healthy teeth and gums. Third, they are comfortable because there are no wires, metal or brackets to cause mouth abrasions. Finally, you can view your own virtual treatment plan in our office, so you can see how your corrected smile will look when your treatment is complete… even before you start!

What is Invisalign® and how does it work?

invisalign-picWhat is Invisalign® and how does it work? Invisalign® is the invisible way to straighten teeth without braces. Using advanced 3-D computer imaging technology to project tooth movement, Invisalign® creates a series of clear, custom-made aligners (repositioners) that gradually move your teeth. You wear each aligner for about 2 weeks, moving to the next set, until the goals you agreed upon with your dentist are reached.

What are the aligners made of and how are they made?

img-invisalignAligners, also called “repositioners” or “contact lenses for teeth,” look similar to some whitening trays, but are made of a clear, strong, medical-grade plastic polymer that is virtually invisible when worn. They are made utilizing a 3-D computer imaging technology which was first envisioned in 1945 by Dr. H.D. Kesling.

Does Invisalign® work for teenagers or kids?

Actually, most people are candidates for Invisalign®. In fact, it works for 80% of people over the age of 12 who could be treated with braces. If your teeth -including second molars- have grown in fully and you have no pending dental treatment or tooth decay, chances are good you will qualify.

What is the process for getting Invisalign®?

invisalignFirst, schedule an appointment for an initial screening. If you qualify, our orthodontist will review your medical & dental history and radiographs and, with your permission, our staff will take initial diagnostic impressions and photographs. If you accept the initial treatment objectives, we will schedule you for another appointment to take final impressions to submit to Invisalign®, who will use state-of-the-art technology to project your tooth movement. Invisalign® will then translate the treatment plan into a series of precisely customized aligners, each of which you will wear for about two weeks until your teeth are straight or the initial objectives have been met. Typically, you will return for appointments about once every 6-8 weeks. This is the only way for our office to determine that the treatment is progressing as planned.

What does Invisalign® cost?

Invisalign® costs about the same as conventional braces and is priced by the treating doctor. It varies from patient to patient and is based largely on the complexity of your case and the anticipated length of treatment.

Does insurance cover Invisalign®?

Typically, an insurance policy that covers traditional braces also covers Invisalign® to the same extent.

Are financing options available?

Yes, our office provides a wide variety of financing options available to you. Depending on your credit history or length of time with our office, you may even qualify for deferred payments or 3- or 6-month “Same as Cash” options available through www.carecredit.com . Ask our Office Administrator for details.

How long does Invisalign® take?

As with traditional braces, treatment times vary depending on how much straightening your teeth will need. However, treatment time is about the same as traditional braces, between 9 and 18 months, and the average number of aligners worn during treatment is between 18 and 30.

Time in treatment is dictated by treatment, not appliance. Invisalign® should take about as long as braces. Often, a second set of aligners is required after the initial set, but is included in the overall treatment plan.

How often must I wear the aligners?

The aligners should be worn day and night, except when eating, brushing or flossing and at least 22 hours per day.

Are there any food restrictions?

No. The aligners are removable, so you can still enjoy your favorite food and drinks; but don’t expect to chew any gum with them in your mouth… it sticks!

Will Invisalign® affect my speech?

invisalign123The aligners may temporarily affect your speech for a day or two, until your mouth adjusts to them. Some people may even experience a slight lisp; however, as their tongue gets used to having them in the mouth, all speech impediments should disappear.

How long will the results of my Invisalign® treatment last?

As with conventional braces, the answer will largely depend on you. Your final aligners will be made with a stronger, thicker gauge polymer to serve as your retainers, which you will wear about once every 2-4 weeks to maintain your new smile.

What if I lose one of my aligners?

The loss of one aligner will not usually affect the treatment. You will be instructed in most cases to advance to the next aligner in the series. In those instances when a replacement is required, a nominal fee will be charged for Align to make you another.

With so many, how will I know which aligners to wear and when?
Invisalign® has made it easy for you to know which aligners to wear (which are current and which aren’t) by supplying you with clearly-marked, color-coded cases to keep them in.

Does Invisalign® hurt?

There may be some temporary, minor soreness each time you start a new aligner series. This is a perfectly normal sign that the aligners are working – sequentially & incrementally moving your teeth to their final destination. The soreness -typically described as a feeling of pressure- subsides within a few days after you insert the new aligners in the series.

How do I get started?

Simply click on the “Online Appointments” button or telephone our office to schedule your first appointment. Your first Invisalign® screening appointment is always FREE, so you can find out if Invisalign® is right for you with no obligation.

After you have decided to proceed with Invisalign® treatment, our orthodontist will take impressions of all of your teeth to insure a high degree of accuracy throughout the process.

Then we will send Invisalign® your impressions which are used to make plaster models of your teeth.

Using advanced imaging technology, Invisalign® transforms your plaster models into a highly accurate 3-D image.

A computerized movie, called ClinCheck®, depicting the movement of your teeth from the beginning to their final positions is created.

Using the internet, our orthodontist reviews your ClinCheck® file, making any necessary adjustments to the proposed plan.

From your approved Clincheck® file, Invisalign® uses laser scanning to build a set of actual models that reflect each stage of your treatment plan.

Your customized set of aligners are made from these models, sent to our office and delivered to you.

You wear each aligner set for about 2 weeks. After wearing all of your aligners in the series, you get the beautiful smile you’ve always wanted.