Treatments

COMMON TREATMENTS

Crowding of the teeth

Patient started treatment at age eleven and wore braces for 26 months. He loves his new smile.

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.

SURGICAL ORTHODONTICS

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 improve 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 appliance. 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.

CRANIOFACIAL ORTHODONTICS

Craniofacial Orthodontics – Cleft Lip and Palate Treatment

Craniofacial orthodontics is the sub-specialty of orthodontics that focuses on the multidisciplinary and interdisciplinary treatment of patients with birth defects, such as cleft lip and palate. These conditions often require coordinated surgical and medical interventions or extraordinary behavioral management to make orthodontic treatment practical and effective. Braces treatments for cleft lip and palate patients tends to be more complex, take more time and clinical resources, and require working with multiple dental, surgical, and medical providers to get the best results. Current practice standards call for a coordinated plan of care between the fellowship-trained craniofacial orthodontists and plastic-craniofacial surgeons – among other specialists – in order to achieve excellent and aesthetic facial results.

Treating patients with cleft lip and palate is commonly done in a team setting and usually spans the first two decades of life. Our doctor has the experience and education necessary to deliver cleft lip and palate treatments by virtue of specific post-residency craniofacial and surgical orthodontic fellowship training. We have clinical expertise in all aspects of orthodontic braces treatment for infants, children, adolescents, and adults with facial clefts, craniofacial diagnoses, and complex medical and special needs. Our doctor brings extensive training in, and knowledge of, craniofacial and dental growth and development to deliver successful treatment results.

We are experienced and confident when working with patients who require craniofacial and special care treatments. Our doctor brings formal craniofacial orthodontic fellowship training, combined with prior special care dentistry training and clinical research, and a long-standing interest for caring for the more complex types of jaw and face abnormalities.

Patients and parents may access additional resources related to these conditions by visiting the website for the American Cleft Palate-Craniofacial Association (ACPA) www.acpa-cpf.org. The ACPA recommends that patients born with birth defects benefit the most when all their providers work together in interdisciplinary or multidisciplinary teams, ensuring not only the best outcome, but also the most effective utilization of health resources.

For questions regarding the orthodontic braces treatment options for cleft lip and palate, contact our office today.

Additional resources are also available from the website of the Cleft Palate Foundation at http://www.cleftline.org

TADS

Temporary Anchorage Devices

Temporary Anchorage Devices, or TADs, are small titanium anchors used in certain orthodontic cases to help achieve quicker tooth movement with more efficiency and comfort. TADs may be used in addition to braces or as an alternative to headgear.

How are TADs placed?

A strong anesthetic is used to numb the gum tissue and the jaw surrounding the area the TAD will be placed. Once the area is numb, your doctor will gently place the TAD through the gum tissue and firmly into the jawbone. The placing of a TAD is quick and may be over before you know it. While your doctor is placing the TAD, you may feel slight pressure; however, within a day, you will no longer be able to feel the TAD. Your TAD is removed once your treatment is complete or when it is no longer needed to help straighten your teeth. Removal of a TAD is a comfortable procedure that takes just a few minutes.

What can I do to relieve discomfort caused by my TAD?

If you do feel any discomfort from having your TAD placed, Tylenol® is recommended to help relieve your pain. If you continue to experience discomfort days after your treatment, please contact us as soon as possible.

How can I keep my TAD clean?

A TAD can be cleaned the same way you clean your braces: by brushing your teeth at least three times a day. When your TAD is placed, we will also provide you with an antimicrobial mouthwash that you will need to use twice a day.

If you have questions about TADs, please contact our practice. We will be able to answer any of your questions and provide you with detailed information about your orthodontic treatment.