What is Orthodontics?
Orthodontics is a special field of dentistry that concentrates on the diagnosis, prevention, and treatment of dental and facial irregularities. The technical terms for these problems are “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 the lips and jaws into proper alignment, to achieve facial balance and create a beautiful smile.

What is an Orthodontist?
All orthodontists are dentists, but only 6% of dentists are orthodontists. An orthodontist is a specialist in the diagnosis, prevention, and treatment of dental and facial irregularities. Orthodontists must first attend college, and then complete a four-year dental graduate program at a University or Dental School or other institution accredited by the American Dental Association. They must then successfully complete an additional 2-3 year residency program of advanced education in orthodontics. This residency program must also be accredited by the American Dental Association and the American Association of Orthodontics. Through this extensive training, the orthodontist learns the skills required to manage the overall care of the orthodontic patient. Only dentists, who have successfully completed this advanced specialty education, may call themselves orthodontists.

What is a Board Certified Orthodontist?
Dr. Patel is Board Certified, and he holds Diplomate status with The American Board of Orthodontics. This is a distinction that less than 50 percent of American orthodontists achieve. As a Diplomate of the American Board of Orthodontics, he strives to uphold the standards of the Board with each and every one of his cases. Click here to find out what it means to be a Board Certified Orthodontist.

What causes Orthodontic problems?
Most orthodontic problems (malocclusions) are inherited and some are acquired. Inherited problems include a wide variety of irregularities involving the jaws, teeth, and face such as crowding of teeth, spacing, extra or missing teeth, and/or upper and lower jaw deficiencies. Acquired problems occur due to finger habits, airway obstruction by enlarged tonsils and adenoids, allergies, asthma, premature loss of baby and/or permanent teeth, and dental disease. Whether inherited or acquired, many of these factors affect the alignment of teeth as they erupt and the facial development throughout the growing years.

What is the best age for treatment?
Each orthodontic problem determines its best starting time. We provide the right treatment at the right time. However, the American Association of Orthodontics recommends that all children be evaluated by an Orthodontist by age 7, even earlier, if the problem is noted by either parent or the family dentist. Most orthodontic problems are inherited and therefore cannot be prevented. However, at this age, developmental problems relating to facial growth or eruption of teeth can be improved or corrected, if diagnosed early.

Orthodontics, for any age, is appropriate as long as there is healthy bone, teeth and gum tissue. The following signs may indicate that you or your child needs to be evaluated by an Orthodontic Specialist:

• thumb or finger sucking
• overlapping or crowding of erupting/erupted permanent teeth, broken or missing teeth
• difficulty chewing food
• mouth breathing due to allergies, enlarged tonsils and/or adenoids
• jaw joints that click, pop or experience discomfort
• developing underbite, overbite, crossbite or abnormal bite development
• teeth wearing unevenly or excessively
• spaces between the teeth
• lower jaw shifts from one side to the other when biting together

Why is Orthodontic treatment important?

• Crowded and malaligned teeth are difficult to clean and maintain. This condition may cause tooth decay, eventual gum disease and/or tooth loss.
• Gum problems have been associated with serious medical problems such as heart attacks and stroke.
• Orthodontics can improve airway and breathing in some patients with Apnea.
• Healthy bites reduce or eliminate factors contributing to abnormal tooth wear.
• Improves inefficient chewing function that causes excessive stress on gum tissue and the bone that supports the teeth. This inefficiency may contribute to TMJ dysfunction of the jaw joints that may also cause headaches and joint discomfort.
• Left untreated, many orthodontic problems become worse. Orthodontics is often less costly than the additional dental care required to treat more serious problems that may develop in later years.
• A beautiful, healthy smile is a personal asset that will follow the young and remain with the old, throughout life. A great smile is vital to one’s self-confidence and improves one’s general attitude towards life.

How long is the initial exam?
This initial appointment takes approximately one hour. Our objective is to communicate proposed orthodontic treatment, if required, in a friendly, caring, and enjoyable atmosphere. The treatment coordinator will review the orthodontic treatment plan, as determined by the orthodontist, during the clinical exam. She will also discuss financial arrangements and answer questions regarding insurance, appointments, and treatment concerns if indicated at that time.

What is the cost of treatment?
The treatment coordinator will discuss fees and payment options, during the initial exam, if treatment is required. We have different payment plans to suit your budget, and we participate in most insurance plans. We also offer discounts for paying in full at the start of treatment and discounts for additional family members undergoing orthodontic treatment in our practice. We work hard to make orthodontics affordable!

What does my investment include?
Your investment includes:

•    Orthodontic records, which consists of a digital x-rays if indicated, photos, impressions, and solutions to your concerns and orthodontic problems.

•    Active treatment fee includes Phase I (early treatment) appliances or Phase II (comprehensive appliances or braces); each Phase, if required, is a separate investment.

•    This fee includes all appliances, office visits, and procedures performed in the office. Appliances are durable and should last through the entire treatment period if instructions are followed by the patient.

•    One set of final retainers will be provided upon completion of treatment. There is a replacement fee for each additional retainer that is lost or broken.

How long is orthodontic treatment?
Comprehensive treatment typically lasts two years, depending on age, the growth of the patient’s mouth and face and the severity of the problem. Patients will respond differently to orthodontic treatment, so the time to case completion may change from the original estimate. The patient’s diligent use of any prescribed rubber bands, proper oral hygiene, following the recommended diet to avoid emergencies and keeping scheduled appointments are important factors in achieving your beautiful smile in a timely manner. Interceptive, or early treatment procedures, may take as few as 6 months, depending upon the problem.

What is Phase I and Phase II treatment?
Phase I (early interceptive) treatment, is limited orthodontic treatment (example: expander or partial braces) before all the permanent teeth erupt. Such treatment can occur before the permanent teeth erupt. This treatment may be recommended to make more space for developing teeth, to correct crossbites, overbites, underbites, or harmful oral habits.

Phase II treatment is also called comprehensive treatment, because it involves full braces when all the permanent teeth erupt, usually between the ages of eleven and thirteen. The female patient’s permanent teeth normally erupt one year earlier than the male patient’s permanent teeth. Consequently, the gender timeline varies. Hereditary factors also play a part in early or later eruption of permanent teeth and may affect when Phase II treatment begins.

How does orthodontic treatment work?
Orthodontic appliances can be made of metal, ceramic or plastic. They may be removable or they may be brackets bonded to the teeth. By placing a constant, gentle force in a carefully controlled direction, braces or Invisalign® aligners slowly move teeth to a corrected position. You can choose brackets that are clear or metallic. You can choose the color of the ties that hold the wire into the brackets. Wires are also less noticeable than they used to be and the latest titanium wires move teeth faster, with less discomfort to patients and with fewer appointments.

• Standard metal brackets. Colored elastics are available
• Ceramic brackets
• Invisalign® -”invisible” Aligners for both children and adults

Do braces hurt?
The placement of bands and brackets or Invisalign® on your teeth does not hurt. Once your braces are placed and connected with the archwires or your Invisalign aligners are inserted, your teeth begin to move. You may feel some soreness of your teeth for one to four days. Tylenol or Advil works well to alleviate discomfort during this time. Your lips and cheeks may need one to two weeks to get used to the braces on your teeth. We will provide you with all the information necessary to make this transition as easy as possible after the appliances are placed.

How do we take braces off?
We use a special plier to squeeze the curve on the back of the bracket to break the bond to the plastic adhesive. The plastic bonding material is simply fractured gently off the back of each bracket. The brackets remain attached to the wire and everything is removed, at once, in less than a few minutes with little discomfort. If any bonding material remains on the tooth, it is smoothed off with a polishing disk. When the braces are removed, your teeth feel very smooth and strange, since it will have been a long time since you felt the real thing!

Will braces interfere with playing sports?
No. However, we recommended that patients protect their smiles by wearing a mouth guard when participating in any sporting activity. We supply our patients with special orthodontic mouth guards that come in a variety of styles and colors. Please let us know if you require a mouth guard when treatment begins.

Will braces interfere with playing a musical instrument?
No. However, there may be an initial period of adjustment. Wax is provided to prevent discomfort while the lips and cheeks callous. Please let us know if you play a musical instrument.

How long do I wear my retainers?
Upon completion of orthodontic treatment, we recommend that all patients wear retainers for at least 12 hours per day, as instructed by Dr. Patel. Once the bite has stabilized, the retainers are worn part-time, indefinitely. This is your insurance policy that the teeth will remain in position for a prolonged period of time. Teeth move throughout life, and it t is a normal consequence of the aging process. If retainers are worn indefinitely, the change will be minimal over a lifetime.

Should I see my general dentist while I wear braces?
Yes. You should continue to see your general dentist at least every six months, for cleanings and dental checkups. If your child is a patient of Dr. Trotter’s, he/she can be conveniently scheduled with both doctors on the same day.

What are Damon brackets?
While Dr. Patel does not use Damon brackets, we understand that you may have questions about them. Like Invisalign®, Damon has had a very successful marketing campaign. However, research studies show that most of their claims are not true. In efforts to shed truthful light on the Damon appliances, we found some literature that helps explain the myths behind Damon brackets. The first article is written by an orthodontist who actually uses Damon brackets in his practice, while the second article addresses a variety of orthodontic myths. Furthermore, the third article is a systematic review of scientific studies that investigated the truth behind self-ligating brackets, demonstrating no clinically significant advantage of such brackets in comparison to conventional brackets. If you have any further questions about Damon appliances, please let Dr. Patel know, as he will be happy to discuss them further with you.