As you go through the process of choosing an orthodontist, you should be asking yourself, “Why should I choose one orthodontist over another? Or “what information can I gather than will help me evaluate my needs in terms of the skills and expertise of various orthodontists?”
Since you are entrusting someone to diagnose, prescribe and treat you or your child, it is crucial that you feel comfortable with the orthodontist, with his or her staff and office and with the way you are treated.
We respect your choice, and thought we’d offer you some information to help you decide.
QUESTIONS THAT SHOULD BE ADDRESSED PRIOR TO STARTING TREATMENT
Can the orthodontist reduce the term of treatment and at the same time improve the quality of care? ABSOLUTELY!
The length of treatment can vary from orthodontist to orthodontist. The length of treatment can substantially be reduced by the orthodontist's ability to accurately position the braces on the teeth.
The precise positioning of the braces on the teeth plays an important role in affecting treatment time and the quality of the result --- it also lowers the chance of future relapse.
Our extremely precise customized technique for orienting the braces on the teeth has reduced treatment time on most patients from 18-24 months to 9-18 months. All patients greatly appreciate this significantly abbreviated treatment.
Before choosing, should I know what schooling should my orthodontist has had?
Before initiating any treatment, you should verify that the practitioner is an orthodontist who received training at a recognized and accredited school.
What compromises a full set of braces?
Be sure to question the orthodontist at the initial consultation if braces or brackets will be placed on each of the adult teeth. On an adult normal dentition, there should be braces placed on each of the 28 teeth (excluding the four wisdom teeth). Teeth that are left out of the full braces cannot be aligned properly with the rest of the bite.
Neglectfully, braces are left off the upper and lower 12-year molars. If you notice these braces are missing, you should be aware that you are receiving incomplete treatment.
Incomplete treatment can introduce future dental health problems including:
- Discomfort during chewing
- Contributing to periodontal disease
- TMJ dysfunction
- Annoying and painful food impaction sites during chewing
- Braces on the second permanent molars are mechanically beneficial when wearing certain kinds of rubber bands to correct the malocclusion.
How can I determine that my teeth are as straight as they can be prior to the removal of my braces?
A key to excellent treatment is the accurate alignment of the marginal ridge heights and all contact points. Teeth meet each other at specific points called contact points. The back teeth have to join each other with the marginal ridge height of one tooth matching the marginal ridge height of the tooth next to it. This may not be apparent to you, but if you ask your orthodontist, dentist or hygienist to confirm that this has been accomplished before your braces are removed, then you can be assured that your treatment results are acceptable.
If my teeth are not properly aligned, what happens?
Poor alignment of marginal ridges and contact points contributes to:
- Annoying and painful food impaction between teeth requiring constant flossing
- Unnatural jaw shift or jaw slide causing muscle pains and/or TMD or TMJ dysfunction
- Periodontal problems
- Irregular wearing of teeth
- Discomfort during biting
- Crowding of lower teeth
What is Phase 1 of early treatment and how do you decide if it is indicated? How do you decide if Phase I of early treatment is indicated?
Phase I treatment can be divided into two categories:
- Necessary early treatment or interceptive treatment
- Optional or elective treatment
1. NECESSARY PHASE I ORTHODONTIC TREATMENT, also known as interceptive treatment,
is recommended to benefit growth and development, including:
- Correction of conditions that, if otherwise untreated, would cause irreversible damage to soft tissue and/or teeth and bones or jaw joints
- Correction of conditions creating discomfort or pain
- Correction of aesthetic conditions to offer the child a better self-image
- Expansion of the dental arches to allow space for eruption of permanent teeth
2. OPTIONAL OR ELECTIVE PHASE I ORTHODONTIC TREATMENT addresses aesthetic considerations that can be postponed until the dentition has fully developed. Parents must decide if optional or elective treatment is right for their child.
Optional treatment means :
- Additional cost
- Additional visits to the office
- Child will experience treatment burn-out or exhaustion, so that when treatment really becomes necessary at a later stage, the child will not want to participate
If you have been advised to have early or Phase I treatment, it would benefit you to seek another opinion to reassure yourself if this treatment is necessary or optional.
When is the appropriate time to begin full orthodontic treatment?
In most cases, full orthodontic treatment should not be initiated until the loss of all baby or primary teeth. When treatment is initiated during the stage when deciduous or baby teeth are still present, the treatment time period is usually unnecessarily elongated.
In most cases, the braces cannot perform their entire function without all the permanent teeth present, but there are exceptions. Seek a second opinion if full treatment is recommended with baby teeth still present. You and your child may be starting your orthodontic journey too early.
Who should position the braces on the teeth, and does the accuracy of the placement of the braces on the teeth affect the quality of your treatment?
Since the precise placement of the braces on the teeth is one of the single most important parts of the treatment process, it should be performed exclusively by your orthodontist.
The orthodontist is the one most familiar with the tooth anatomy and the relationship of the teeth to the braces. When braces are precisely positioned on the teeth, the teeth become better aligned in a shorter period of time. The braces serve as handles that direct the teeth in all dimensions. If the braces direct the teeth to the wrong position or in the wrong direction, the following can occur::
- Discomfort in chewing
- Food impaction between teeth
- Temporomandibular Joint Dysfunction, known as TMJ
- Headaches
- Uncomfortable shifting of the jaws
- Prelude to periodontal disease
- Unstable results and high probability of relapse
- Uncomfortable trauma to individual teeth
Are extractions necessary in orthodontics?
Extracting permanent teeth for orthodontic reasons is a thing of the past. Extractions for orthodontic reasons should, in most instances, be avoided. With the exception of the third molars, always, if extractions are recommended, seek a second opinion. Extractions reduce the size of the dental arches and can cause premature aging.
What retainer is best for long-term stability?
Fixed bonded retainers are routinely used to maintain the alignment of teeth following treatment. They are the ideal retainers and the retainer of choice for the lower teeth. These retainers can remain in place indefinitely, assuring little chance of relapse. Removable retainers on the lower jaw are often lost or not utilized properly, both of which can lead to relapse. It needs to be emphasized that fixed bonded retainers should only be inserted when results are ideal.
What are the FEES for orthodontics?
When comparing treatment plans and costs, be sure you are comparing apples to apples. For example, you may find one orthodontist who places braces on all teeth and another one who neglects to put braces on all the teeth. Certainly, your best choice would be the orthodontist who is more thorough.
At your initial consultation, ask whether the orthodontist places braces on all teeth, including the very important upper and lower second molars. If these teeth are excluded from treatment, continue your search for the right orthodontist. (We routinely place braces on all teeth including second molars.)
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