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What is orthodontics? Orthodontics is the branch
of dentistry that specializes in the diagnosis, prevention and treatment
of dental and facial irregularities. The technical term for these
problems is "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 teeth,
lips and jaws into proper alignment and to achieve facial balance.
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Why is orthodontic treatment important?Crooked and crowded teeth
are hard to clean and maintain. This may contribute to conditions
that cause not only tooth decay but also eventual gum disease and
tooth loss. Other orthodontic problems can contribute to abnormal
wear of tooth surfaces, inefficient chewing function, excessive stress
on gum tissue and the bone that supports the teeth, or misalignment
of the jaw joints, which can result in chronic headaches or pain in
the face or neck.
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What is an orthodontist?When left untreated, many orthodontic problems become worse. Treatment to correct the original problem is often less costly than the additional dental care required to treat more serious problems that can develop in later years. The value of an attractive smile should not be underestimated. Treatment may reduce appearance-consciousness, during the critical developmental years. Appearance can have an effect on popularity, social behavior, self-expectations, personality style, self-confidence and self-image. For children, orthodontic therapy may lessen the likelihood that he/she will be teased or picked on by other children. All orthodontists are
dentists, but only about 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
dental school or other institution accredited by the Commission on
Dental Accreditation of the American Dental Association (ADA). They
must then successfully complete an additional two- to three-year residency
program of advanced education in orthodontics. This residency program
must also be accredited by the ADA. Through this training, the orthodontist
learns the skills required to manage tooth movement (orthodontics)
and guide facial development (dentofacial orthopedics).
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What is the AAO?Only dentists who have successfully completed this advanced specialty education may call themselves orthodontists. The American Association
of Orthodontists (AAO) is the national organization of dental specialists
who limit their practice to orthodontics and dentofacial orthopedics.
Founded in 1900, the AAO is the oldest and largest dental specialty
organization in the United States and Canada. All members must meet
the specialty educational requirements as defined by the Commission
on Dental Education of the American Dental Association.
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At what age can people have orthodontic treatment?Both children and adults
can benefit from orthodontics, because healthy teeth can be moved
at almost any age. Because monitoring growth and development is crucial
to managing some orthodontic problems well, the AAO recommends that
all children have an orthodontic screening no later than age 7. Most
of the time, no treatment is necessary at this age. For others, their
orthodontic problems should be treated early. Waiting until all the
permanent teeth have come in, or until facial growth is nearly complete,
may make correction of some problems more difficult.
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What are the most commonly treated orthodontic problems?Most malocclusions are
inherited, but some are acquired. Inherited problems include crowding
of teeth, too much space between teeth, extra or missing teeth, and
a wide variety of other irregularities of the jaws, teeth and face.
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What causes orthodontic problems?Acquired malocclusions can be caused by trauma (accidents), thumb, finger or pacifier sucking, airway obstruction by tonsils and adenoids, dental disease or premature loss of primary (baby) or permanent teeth. Whether inherited or acquired, many of these problems affect not only alignment of the teeth but also facial development and appearance as well. Crowding: Teeth
may be aligned poorly because the dental arch is small and/or the
teeth are large. The bone and gums over the roots of extremely crowded
teeth may become thin and recede as a result of severe crowding. Impacted
teeth (teeth that should have come in, but have not), poor biting
relationships and undesirable appearance may all result from crowding.
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How long will orthodontic treatment take?Overjet or protruding upper teeth: Upper front teeth that protrude beyond normal contact with the lower front teeth are prone to injury, often indicate a poor bite of the back teeth (molars), and may indicate an unevenness in jaw growth. Commonly, protruded upper teeth are associated with a lower jaw that is short in proportion to the upper jaw. Thumb and finger sucking habits can also cause a protrusion of the upper incisor teeth. Deep overbite: A deep overbite or deep bite occurs when the lower incisor (front) teeth bite too close or into the gum tissue behind the upper teeth. When the lower front teeth bite into the palate or gum tissue behind the upper front teeth, significant bone damage and discomfort can occur. A deep bite can also contribute to excessive wear of the incisor teeth. Open bite: An open bite results when the upper and lower incisor teeth do not touch when biting down. This open space between the upper and lower front teeth causes all the chewing pressure to be placed on the back teeth. This excessive biting pressure and rubbing together of the back teeth makes chewing less efficient and may contribute to significant tooth wear. Spacing: If teeth are missing or small, or the dental arch is very wide, space between the teeth can occur. The most common complaint from those with excessive space is poor appearance. Crossbite: The most common type of a crossbite is when the upper teeth bite inside the lower teeth (toward the tongue). Crossbites of both back teeth and front teeth are commonly corrected early due to biting and chewing difficulties. Underbite or lower jaw protrusion: About 3 to 5 percent of the population has a lower jaw that is to some degree longer than the upper jaw. This can cause the lower front teeth to protrude ahead of the upper front teeth creating a crossbite. Careful monitoring of jaw growth and tooth development is indicated for these patients. In general, active treatment
time ranges from one to three years. interceptive, or early treatment
procedures, may take only a few months. The actual time depends on
the growth of the patient's mouth and face, the cooperation of the
patient and the severity of the problem. Mild problems usually, require
less time, and some individuals respond faster to treatment than others.
Use of rubber bands and/or headgear, if prescribed by Dr. Chen, contributes
to completing treatment as scheduled.
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How is treatment accomplished?While orthodontic treatment requires a time commitment, patients are rewarded with healthy teeth, proper jaw alignment and a beautiful smile that lasts a lifetime. Teeth and jaws in proper alignment look better, work better, contribute to general physical health and can improve self-confidence. Orthodontic appliances
are prescribed and designed by Dr. Chen according to the problem being
treated. They may be removable or fixed (bonded to the teeth). They
may be made of metal, ceramic or plastic. By placing a constant, gentle
force in a carefully controlled direction, braces can slowly move
teeth through their supporting bone to a new desirable position.
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Why are retainers needed after orthodontic treatment?Orthopedic appliances, such as headgear, Herbst and maxillary expansion appliances, use carefully directed forces to guide the growth and development of jaws in children and teenagers. For example, an upper jaw expansion appliance can dramatically widen a narrow upper jaw in a matter of months. Over the course of orthodontic treatment, a headgear or Herbst appliance can dramatically reduce the protrusion of upper incisor teeth (the top four front teeth) or retrusion of the lower jaw (a lower jaw that is too far behind the upper jaw), while making upper and lower jaw lengths more compatible. After braces are removed,
the teeth can shift out of position if they are not stabilized. Retainers
provide that stabilization. They are designed to hold teeth in their
corrected, ideal positions. Wearing retainers exactly as instructed
is the best insurance that the treatment improvements last for a lifetime.
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Will my tooth alignment change later?Studies have shown that as people
age, their teeth may shift. This variable pattern of gradual
shifting continues to a degree throughout life for most people.
Even children whose teeth developed into ideal alignment and
bite without treatment may develop orthodontic problems as adults.
The most common change is crowding of the lower incisor (front)
teeth. Wearing retainers as instructed after orthodontic treatment
will stabilize the correction. Beyond the period of full-time
retainer wear, nighttime retainer wear can prevent future shifting
of the teeth.
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What about the wisdom teeth (third molars) - should they be removed?Careful studies have shown
that wisdom teeth do not cause or contribute to the progressive crowding
of lower incisor teeth. However, their location, eruption pattern
and function should be evaluated on an individual basis. Dr. Chen,
in consultation with your family dentist, can help determine what
is right for you.
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Can orthodontic treatment do for me what it does for children?Healthy teeth can be moved
at almost any age. Many orthodontic problems can be corrected as easily
and as well for adults as children. Orthodontic forces move the teeth
in the same way for both a 75-year-old adult and a 12-year-old child.
Complicating factors, such as lack of jaw growth, may create special
treatment planning needs for the adult. Dr. Chen has treated many
patients who are adults, the oldest being in her 60's. The AAO estimates
that nearly 1,000,000 in the United States and Canada are receiving
treatment from an orthodontist.
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How does adult treatment differ from that of children and adolescents?Adults are not growing
and may have experienced some breakdown or loss of their teeth and
bone that supports the teeth. Orthodontic treatment may then be only
a part of the patient's overall treatment plan. Close coordination
may be required between the orthodontist, oral surgeon, periodontist,
endodontist and family dentist to assure that a complicated adult
orthodontic problem is managed well and complements all other areas
of the patient's treatment needs. Below are the most common characteristics
that can cause adult treatment to differ from treatment for children.
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My family dentist says I need to have some missing teeth replaced, butNo jaw growth: Jaw problems can usually be managed well in a growing child with an orthopedic, growth-modifying appliance. However, the same problem for an adult may require jaw surgery. For example, if an adult's lower jaw is too short to match properly with the upper jaw, a severe bite problem may result. The limited amount that the teeth can be moved with braces alone may not correct this bite problem. Bringing the lower teeth forward into a proper bite relationship could require jaw surgery, which would lengthen the lower jaw and bring the lower teeth forward into the proper bite. Other jaw-width or jaw-length discrepancies between the upper and lower jaws might also require surgery for bite correction if tooth movement alone cannot correct the bite. Gum or bone loss (periodontal breakdown): Adults are more likely to have experienced damage or loss of the gum and bone supporting their teeth (periodontal disease). Special treatment by the patient's dentist or a periodontist may be necessary before, during and/or after orthodontic treatment. Bone loss can also limit the amount and direction of tooth movement that is advisable. Worn, damaged or missing teeth: Worn, damaged or missing teeth can make orthodontic treatment more difficult, but more important for the patient to have. Teeth may gradually wear and move into positions where they can be! restored only after precise orthodontic movement. Damaged or broken teeth may not look good or function well even after orthodontic treatment unless they are carefully restored by the patient's dentist. Missing teeth that are not replaced often cause progressive tipping and drifting of other teeth, which worsens the bite, increases the potential for periodontal problems and makes any treatment more difficult. I need orthodontic treatment first. Why? Your dentist is probably
recommending orthodontics so that he or she might treat you in the
best manner possible to bring you to optimal dental health. Many complicated
tooth restorations, such as crowns, bridges and implants, can be best
accomplished when the remaining teeth are properly aligned and the
bite is correct.
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My teeth have been crooked for as long as I can remember. Why shouldWhen permanent teeth are lost, it is common for the remaining teeth to drift, tip or shift. This movement. can create a poor bite and uneven spacing that cannot be restored properly unless the missing teeth are replaced. Tipped teeth usually need to be straightened so they can stand up to normal biting pressures in the future. I have orthodontic treatment now? Orthodontic treatment,
when indicated, is a positive step especially for adults who have
endured a long-standing problem. Orthodontic treatment can restore
good function and help your teeth last longer. Teeth that work better
usually look better too! And a healthy, beautiful smile can improve
self-esteem, no matter what age!
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What do your fees include?Initial Examination
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What's the next step?
Initial Diagnostic Records
Orthodontic Treatment
Retention Treatment Braces Removed
Retention Follow-up (approximately 2 years)
In order to begin orthodontic
treatment, the following appointments will be scheduled:
STEP 1: INITIAL FREE CONSULTATION Dr. Chen will perform a brief exam and determine if the patient is a qualified candidate for orthodontic treatment, and in the case of younger patients, whether the patient is ready to begin orthodontic treatment. If the patient is ready, we may proceed directly to step 2. STEP 2. RECORDS APPOINTMENT AND SPACERS At this appointment, Dr. Chen and his staff will take all necessary x-rays, photographs, and models of the teeth. A detailed exam noting all orthodontic problems will be completed. The records fee is due at this time. Spacers are then placed. After having the spacer for one to two weeks, the braces will be placed. A "Clearance Letter" will be given to you or sent directly to your dentist to: 1) inform your dentist of your orthodontic treatment and 2) have your dentist certify that your teeth and gums are healthy and ready for orthodontic treatment. STEP 3: TREATMENT CONSULTATION AND PLACEMENT OF BRACES Dr. Chen analyzes all the information gained at the records appointment presents the best course of treatment (and if applicable, other treatment options). The Treatment Plan and Informed Consent forms are signed and the Orthodontic Financial Agreement is finalized. The Start Fee or payment in full is due at this time (unless the Orthodontists Fee Plan option is selected). Braces (brackets, bands, and wires) will then be placed.. Detailed oral hygiene instructions and brushing aids will be given to the patient. You are then on your way to a better, healthier, and more confident smile!
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