FAQs

Orthodontic FAQs

GENERAL QUESTIONS

How do you know if a person needs orthodontic treatment?

It is usually difficult to know if treatment is necessary because there are many problems that can occur even though the front teeth look straight. Asking your general dentist is good reference, but we are the best resource since orthodontics or braces are all we do. It’s our specialty, and Dr. Vonny has received specialized training in orthodontic care. Our initial exam is complimentary, so it only makes sense to get a consultation with us. We will be happy to give necessary recommendations.

What are the signs or symptoms of orthodontic problems?

Although determining if treatment is necessary is difficult for you to assess, the following may help in prompting you to seek our orthodontic advice.

Look at the teeth at any age. If you see any signs of crooked teeth, gaps between your child’s teeth or overlapping teeth, orthodontic treatment is indicated.

Bite all the way down, but keeping their lips open so you can see the teeth. Do the front top teeth line up with the bottom? Do the top teeth protrude out away from the bottom teeth? Do the top front teeth cover more than 50% of the bottom teeth? Are the top teeth behind the bottom teeth? All these are indicators for potential orthodontic treatment.

Look at the alignment of the jaws. Does the jaw shift off center during biting down? If you see any misalignment or shifting of the jaw, it suggests a skeletal or jaw bone problem, which requires early orthodontic intervention.

These are only some of the obvious symptoms of orthodontic problems.

At what age should an orthodontist see my child? Do all baby teeth have to fall before initiating orthodontic treatment?

The American Association of Orthodontists recommends that your child be evaluated by age seven. All baby teeth need not be gone before initiating orthodontic treatment. In fact, early detection of some orthodontic problems is important in order to take early preventive/interceptive action and avoid more difficult treatment later. Early treatment also potentially prevents extraction of teeth which is needed in some cases if the teeth get very crowded. Again, since our initial consultation is complimentary, it helps to get a consult as soon as possible.

Can you be too old for orthodontic treatment?

No, age is not a factor. So long as the gums and bone which support your teeth are healthy one can get orthodontic or braces treatment at any age. About 30% of our orthodontic patients are adults and that number is still growing! Our oldest patient treated was 72 years old.

Will orthodontic treatment hurt?

Orthodontic treatment mechanics have advanced technologically over the last few years. Introduction of new high tech wires, smaller braces, innovative accessories and stress of preventive/interceptive treatments make today’s orthodontic treatment fairly comfortable. We do not use any anesthetic injections for any of the procedures. As a rule, braces can cause a little discomfort initially until one gets used to them. Teeth can get a little sore a day after every adjustment appointment but they are not painful. This annoyance can be relieved easily with over-the-counter pain relievers, if needed.

Can I still have orthodontic treatment if I have missing teeth?

Yes. When teeth are missing, adjacent teeth will drift into the empty space. This will cause a functional, esthetic or periodontal problem. Orthodontic treatment will correct and prevent these problems from happening and will also provide proper alignment for your dentist to replace the missing teeth.

QUESTIONS ABOUT TREATMENT

What is Phase I (Early Interceptive Treatment) and Phase II treatment?

Phase I or Early Interceptive Treatment usually starts while the child has most of their baby teeth with few of their permanent teeth. The goal of Phase I treatment is to intercept a moderate or severe orthodontic problem early in order to reduce or eliminate them. These problems include jaw bone problems, cross bites and developing crowding. This phase does not use full braces as braces are never put on baby teeth. Generally we use expanders, removable appliances, herbst appliance (instead of headgear) and retainers during this phase. These treatment approaches takes advantage of the active growth to change the jaw bone structure to either make extra room or address jaw bone discrepancies. This helps reduce the need for extractions or jaw surgery and delivers better long term results and treatment options. Most Phase I patients require a Phase II treatment in order to achieve an ideal bite.

Phase II treatment involves use of full braces with a goal to finish the occlusion or bite ideally. It usually occurs when all permanent teeth are present. Many times there is a gap of some time between Phase I and start of Phase II treatment. This phase most commonly occurs around the age of 12 or 13 years.

What is Full or Comprehensive Orthodontic Treatment?

This is another name for orthodontic treatment in the permanent dentition at any age. It is more commonly used when a Phase I treatment was not performed.

Does everyone need a Phase I treatment?

Absolutely not! But in many cases early intervention helps a lot. We will offer Phase I treatment only if it makes a difference in the future otherwise we keep the patients for a complimentary consultation every 12 months.

What is the length or duration of orthodontic treatment?

In our office, Phase I treatment usually lasts 9-12 months. Phase II or full orthodontic treatment may last from 15-24 months. In both situations, we generally see the patients every 6 to 12 weeks for their appointments.

Treatment time and its success depends on multiple factors such as, age of the patient, the severity of the problem, the patient’s cooperation and the speed of natural response of teeth movement.

What are extraction and non-extraction therapy, and what are the advantages and disadvantages of each?

Extraction therapy is a technique where some teeth are removed to make room for the other teeth in your child’s mouth. This is in contrast to non-extraction therapy where one expands patients’ jaw and/or shave some teeth to reduce their width to make everything fit. We will make a thorough evaluation at the consultation and discuss the options to determine which procedure best suits the patient.