Treatments

Dentofacial Orthopedics

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's 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.

Common Treatments

Crowding of the Teeth

Before

After

Patient started treatment at age 11 and wore braces for 26 months. He loves his new smile.

Openbite

Before

After

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

Before

After

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

Before

After

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

Before

After

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

Before

After

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

Before

After

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.

Non-braces Treatment

Before

After

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.

Phase 1

Before

After

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.

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 for improved facial appearances. In other words, surgical orthodontics straightens your jaw. Moving the jaws also moves the teeth, so braces are always used 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 aesthetic 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 six to 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 four to eight weeks), your orthodontist "fine-tunes" your bite. In most cases, braces are removed within six 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, takes more time and clinical resources, and requires 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 so 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 that 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 inter-disciplinary or multi-disciplinary teams, ensuring not only the best outcome, but also the most effective utilization of health resources. www.acpa-cpf.org/teamcare/Parameters07rev.pdf

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

TMJ/TMD

Temporomandibular Disorder

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 can help 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.

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 where 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 TADs 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.

Sleep Apnea

Are you drowsy during the day with no explanation? Do you snore loudly or wake up breathless in the middle of the night? If you're experiencing any of these symptoms, you may be one of more than 12 million Americans who are affected by sleep apnea.

What is sleep apnea?

Sleep apnea is a condition in which your breathing stops periodically during sleep, as many as 20-30 times per hour. Each time you stop breathing in your sleep, the resulting lack of oxygen alerts your brain, which temporarily wakes you up to restart proper breathing. Since the time spent awake is so brief, most people with sleep apnea don't remember it, and many feel like they are getting a good night's sleep, when in fact, they are not. The constant wake-sleep, wake-sleep cycle prevents those with sleep apnea from achieving deep sleep, resulting in a constant drowsy feeling during the day.

What are the signs of sleep apnea?

The following symptoms can indicate the presence of sleep apnea. If you notice one or more of these, contact our practice.

Insomnia or difficulty sleeping
Loud snoring at night
Waking up at night short of breath
Snorting or choking sounds during the night (indicating a restart of breathing)
Headaches upon waking in the morning
Falling asleep unintentionally during the day
Extreme drowsiness throughout the day

Are there different types of sleep apnea?

There are three categories of sleep apnea. The most common is called obstructive sleep apnea (OSA), and occurs due to a physical blockage, usually the collapsing of the soft tissue in the back of the throat. Less common is central sleep apnea (CSA), in which breathing stops because the muscles involved don't receive the proper signal from the brain. And some people suffer from "mixed" or "complex" sleep apnea, which is a combination of obstructive and central.

What are risk factors for sleep apnea?

Obstructive sleep apnea is more common in males than females, and more common in older adults (40+) than younger adults and children. However, anyone — regardless of gender or age — can suffer from sleep apnea. Other risk factors include obesity, smoking, drinking, use of sedatives or tranquilizers, and family history. Central sleep apnea strikes most often in people with heart disorders, neuromuscular disorders, strokes, or brain tumors. It is also more common in males.

Is sleep apnea dangerous?

Sleep apnea is considered a serious medical problem and if left untreated can lead to high blood pressure, increasing the risk of heart failure and stroke. The ongoing state of fatigue caused by sleep apnea can lead to problems at work or school, as well as danger when driving or operating heavy machinery. Sleep apnea can also cause complications with medication or surgery; sedation by anesthesia can be risky, as can lying flat in bed after an operation. If you know or suspect you suffer from sleep apnea, let your family doctor know before taking prescribed medication or having surgery.

How is sleep apnea treated?

Treatments for sleep apnea depend on the severity of each individual case, and the type of apnea. Basic treatment can be behavioral — for instance, patients are instructed to lose weight, stop smoking, or sleep on their sides instead of on their backs. Beyond that, oral devices can be used to position the mouth in such a way that prevents throat blockage. In more severe cases, surgery may be the best option.

What should I do if I suspect that someone in my family suffers from sleep apnea?

Contact our practice, and we can refer you to a sleep apnea specialist. The specialist may recommend a "sleep study" to diagnose the precise extent of the problem, and can prescribe appropriate treatment. Depending on the patient's situation, treatment may involve an oral device that we can custom-create for you.

Clear Aligners

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 smile you've always wanted.

Clear Braces

Having braces doesn't necessarily require highly noticeable metal brackets and wires. In fact, many of today's braces are made from either clear or natural tooth colored materials to provide patients with an attractive, less noticeable alternative to traditional braces.

What is the difference between clear braces and clear aligners?

Clear braces are the same as traditional metal braces except that they are clear! Clear braces are a less noticeable alternative to traditional metal braces and provide patients with an equally effective treatment.

Clear aligners are different from clear braces. Clear aligners are pieces of hard plastic that are designed to fit into your mouth like a mouthguard. Clear aligners are great for patients requiring minor orthodontic treatment.

What are the advantages and disadvantages to clear braces?

As with any orthodontic treatment, it is important to choose the right option for your needs and lifestyle. Clear braces are a great alternative to traditional metal braces; however, you and your orthodontist will know if they are the right treatment for you.

Advantages to clear braces:

Appearance: Ceramic braces and clear braces are much less noticeable than traditional metal braces. Clear and ceramic braces offer an aesthetic alternative for patients seeking options other than traditional metal braces.
Confidence: Many patients who choose ceramic or clear braces feel more confident about their orthodontic treatment, especially knowing that people are focusing on their smiles rather than their braces.

Disadvantages to clear braces:

Cost: Ceramic and clear braces may cost more than traditional metal braces. Your orthodontist may offer convenient payment plans to help control the costs of your treatment. Be sure to talk to your orthodontist about all of your financial options.
Discoloration: The clear elastic ties that are used with clear and ceramic braces may become slightly discolored from drinking tea, coffee, wine, eating certain foods, or smoking. Ask your orthodontist about how you can keep your braces looking their best.
Treatment Time: Orthodontic treatment with clear or ceramic braces may take longer than with traditional metal braces. If you don't mind investing a little more time in your smile, then talk to your orthodontist to find out how long your treatment time will be with clear or ceramic braces.

Are clear or ceramic braces the right choice for my smile and me?

By talking to your orthodontist, you can decide if clear or ceramic braces are the right treatment for you. Your orthodontist can provide answers to your questions and extra information explaining the benefits of each treatment. If you would like to learn more about clear braces, ceramic braces, and all of the options available to you, please contact our practice and schedule an appointment today.

Invisalign®

We are a Certified Invisalign Provider

Consider Invisalign to get the beautiful straight teeth you’ve always wanted — without braces. A complimentary consultation with our office can determine if Invisalign is right for you.

What is it?

Invisalign uses a series of invisible, removable, and comfortable aligners that no one can tell you’re wearing. So, you can smile more during treatment as well as after. Invisalign is made with 3-D computer imaging technology and has been proven effective. More than 70% of orthodontists in the US and Canada are certified to treat with Invisalign.

Why would I want it?

Not only are the aligners invisible, they are removable, so you can eat and drink what you want while in treatment. Plus, brushing and flossing are no problem. They are also comfortable, with no metal to cause mouth abrasions during treatment. And no metal and wires usually means you spend less time in your doctor’s office getting adjustments. Invisalign also allows you to view your own virtual treatment plan when you start so you can see how your straight teeth will look when your treatment is complete.

How does it work?

You wear each set of aligners for about 2 weeks, removing them only to eat, drink, brush, and floss. As you replace each aligner with the next in the series, your teeth will move — little by little, week by week — until they have straightened to the final position your doctor has prescribed. You’ll visit our office about once every 6 weeks to ensure that your treatment is progressing as planned. Total treatment time averages 9-15 months and the average number of aligners worn during treatment is between 18 and 30, but both will vary from case to case.

Invisalign Teen™

We are a Certified Invisalign Teen Provider

Bummed out about having braces? Invisalign Teen gives you a whole new way to wear braces for a "clearly" amazing smile!

I have enough to worry about…
…now I need braces too?

The team has a game this Friday night, homecoming is in a month, and what about my yearbook pictures?! Don’t stress; with Invisalign Teen you won’t need to turn down any dates, wear a paper bag over your head, or hide out in your room for two years! Invisalign Teen aligners are a perfect fit for your lifestyle, because aligners are:

Clear
Removable
Super comfortable
Customized just for you

Pizza, Popcorn… no Problem!

You’ve probably heard from friends that with braces you won’t be able to eat anything. With Invisalign Teen you can eat whatever you want!

Unlike traditional metal braces, your Invisalign Teen aligners are removable, which means you can go ahead and eat all the things you love without worrying about breaking a bracket or losing a rubber band. Cheers!

It’s your life, keep it that way!

Invisalign aligners are really comfortable and very durable. They fit in with any of your extracurricular activities. So whether you’re swimming the 50 meter race, out on the field throwing the football, or playing the clarinet with the school’s band, you don’t have to worry about your braces getting in the way!

See What Other Teens Are Saying:

Invisalign is on Facebook and Twitter! Connect with other teens to share your Invisalign experience and find out what other people have to say about their treatment.

Clarity™

Clarity® SL — The Most Advanced Braces Technology Available

Self-Ligating Braces from our Orthodontic Practice

At our orthodontic practice, we’re always looking for ways to give our patients more comfort, more confidence, and more reasons to smile! We’re very pleased to offer the Clarity SL Self-Ligating Appliance System to all of our patients needing braces. Clarity SL braces provide an advanced and aesthetic alternative to traditional metal braces, allowing you to smile, even during orthodontic treatment!

Performance You’ll Notice. Start to Finish.

Clarity SL braces provide a safe, effective, and virtually pain-free way to correct your smile and achieve the results that you want. With Clarity SL braces you can experience the benefits of a straighter smile in less time than with traditional metal braces, and with more comfort during your treatment.

An Attractive Option that will make you Smile.

Clarity SL braces treatment starts with you! A complimentary consultation with our doctor can help you determine if Clarity SL braces are the best treatment choice for your smile.

Style. Comfort. Dazzling Results.

Clarity SL self-ligating braces are a choice you can feel good about. They use the latest technology, so that they work fast and look good.

What do Clarity SL Self-Ligating Braces provide?

Durable, translucent ceramic brackets
Self-ligation means fewer appointments and office visits
Beautiful results in potentially less time than with traditional metal braces
Smooth, molded, comfortable edges for less pain and irritation
Self-Ligating — no ligatures to attract plaque, trap food, or cause staining to the teeth
Helps you maintain good oral hygiene with its open design
Each bracket is designed to fit your tooth and help move your teeth into place quickly.

If you are interested in learning more about Clarity SL Self-Ligating Braces, please contact our office and request a FREE orthodontic Clarity SL braces consultation.

Incognito™

The Secret Behind a Beautiful Smile

Discover a completely different way to wear braces

Incognito™ Orthodontic Braces are placed behind your teeth, so no one will even know you are wearing braces unless you want them to! These unique braces are created using state-of-the-art technology and are the only 100 percent customized, invisible, fixed braces system on the market today. Incognito Braces can give you a beautiful smile, even while you’re wearing them.

Braces made just for you

Because no two people are alike, no two sets of Incognito Braces are alike. Unlike other braces, Incognito Braces are 100 percent customized to the shape of your teeth and to your individual dental situation. These advances are designed to minimize the amount of time your doctor spends making adjustments and results may be seen more quickly than with traditional braces. You get efficient, effective tooth movement and great aesthetics.

Who can wear Incognito Braces?

Just about anyone. Men and women, teenagers or adults, from 13 years to over 60 years of age, from students to professionals, all can choose invisible braces. Odds are, if you can be treated with traditional braces, you are a good candidate for Incognito Braces.

Incognito Orthodontic Braces might be right for you if:

You are concerned about wearing braces that are visible
You want to maintain a professional image while getting a great smile
You want to avoid damage to the front surfaces of your teeth and inner lips
You play a wind instrument
You play contact sports

Call us to set up a consultation or visit www.hiddenbraces.com for more information.

Look great while you straighten your teeth … invisibly!

Incognito Braces were formerly marketed as iBraces™ Orthodontic Braces.

Simpli5

Today’s orthodontic appliances are designed to be comfortable, discreet, and fit the needs of your unique lifestyle. Invisible aligners have become a popular alternative to traditional orthodontic appliances like metal braces and headgear giving patients the beautiful smiles they’ve always wanted without ever having to wear braces.

Our office is pleased to offer our patients a "clear" alternative to metal braces with Simpli5 invisible aligners.

What are Simpli5 aligners?

Simpli5 is a revolutionary new system of aligners designed to correct minor imperfections in about five to six months. Each set of aligners are customized to fit your mouth and to give you the smile you’ve always wanted. Simpli5 aligners are designed to correct minor crowding or spacing, and to realign teeth that have already received orthodontic treatment.

What are the benefits of using Simpli5?

Simpli5 offers many great benefits, including:

Quicker treatment times — With Simpli5, you can begin your treatment just three to four weeks after your doctor has taken impressions, and most cases are completed within just five months.
Comfort — The Simpli5 plastic aligners are custom made to fit your mouth. The aligners are made of a unique plastic material that is smooth and invisible! The aligners fit so well that your family and friends may never even know you're wearing braces.
Convenience — Each aligner is worn for only three to four weeks, for five to six months. After your treatment is complete, you're left with a beautiful, straight smile in less time than with traditional orthodontic appliances.

Is Simpli5 the right treatment for me?

If you’re interested in orthodontic treatment with Simpli5 aligners, please contact our practice. We can answer any questions you might have and provide a comprehensive consultation to determine if Simpli5 is the best treatment for your smile.