Orthodontics FAQ’s

Summary

• What is Orthodontics?
• What is malocclusion?
• Signs for Orthodontic treatment.
• What are functional habits?
• Early warning signs.
• Benefits of early treatment.
• Phase I Orthodontic treatment – functional appliances.
• What is a functional appliance?
• Phase II Orthodontic treatment – braces.
• Metal Braces Vs.Ceramic Braces & Lingual Braces Comparison Chart.
• What is Invisalign®?
• Retainers.
• Adult Orthodontics.
• Invisible Braces.

What is Orthodontics?

Orthodontics is a form of dentistry that specializes in the diagnosis, prevention, and treatment of dental and facial irregularities. Technically speaking, these problems are classified as “malocclusion,” meaning “bad bite.” Our orthodontic team is skilled 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.

Most people associate orthodontia with placement of braces to correct crooked teeth in children. Our orthodontic team, however, treats a wide variety of conditions in people of all ages – from overbites to underbites.

What is malocclusion?

Malocclusions are usually acquired or inherited.

Acquired Malocclusion
Can be caused by functional trauma such as:

• Thumb sucking
• Finger sucking
• Pacifiers
• Tonsils and adenoids enlargements that obstruct the airway
• Premature loss of primary or permanent teeth.

Inherited malocclusion
Determine how well your teeth fit together using attributes as tooth and jaw size. For example, people can inherit large teeth and small dental arches, or the reverse. A “poor bite” is often caused by teeth that have too much or too little room in the jaw. Other common causes of crooked teeth are factors that move the teeth out of place, including oral habits and early tooth loss, which leads to tooth shifting to the areas where other teeth used to be.

Regardless of whether malocclusions are inherited or acquired, many of these problems affect not only alignment of the teeth but also facial development and appearance as well.

Signs for Orthodontic treatment

If you or your child have any of the following symptoms, have your general or pediatric dentist evaluate whether a poor bite may be responsible:

• difficulty chewing due to improperly aligned teeth
• facial muscle or jaw pain
• headaches and ear aches
• teach grinding at night
• permanent teeth coming in (erupting) out of their normal position
• problems with biting the cheek or roof of the mouth
• speech difficulties
• functional habits such as thumb sucking, mouth breathing or tongue thrusting.

If the patient has a problem such as the upper jaw being too narrow or an underdeveloped lower jaw, this will require a special appliance called a functional jaw orthopedic appliance to correct the problem. Minor tooth crowding can also be corrected early if it appears as though it may compromise the eruption of other permanent teeth.

Narrow Smile

Broad Smile

What are functional habits?

Effects of Finger Habit

Habit Corrected

Early warning signs?

Deep Bite
Do the upper teeth completely hide the lower teeth when you bite down or does your child bite on the roof of their mouth?

Open Bite
Do the upper and lower teeth not meet in the front when your child bites together?

Overjet
Do the upper front teeth seem to be more noticeable and stick out quite a bit, compared to the lower front teeth?

Facial Asymmetry
When looking at your child from the front does it appear that their face or chin are shifted to one side? Are they growing crooked?

Crossbite
When you look into your child’s mouth are the upper teeth on the inside of the lower teeth? If you think of the upper jaw as the garage and the lower jaw as the car the garage should be bigger than the car!

Habits
Does your child suck their finger or their thumb? Do they breathe through their mouth instead of their nose? Do they stick their tongue between their teeth when they swallow?

Before

After

Crowding
Are the permanent teeth starting to come in crowded?

Headaches
Does your child complain frequently of headaches? If your child grinds their teeth or has a deep bite, the muscles may be over-worked and can contribute to headaches in children.

Earaches
Sometimes a bad bite or a deep bite can cause undue pressure on the small membranes of the ear, contributing to earaches.

These are all sign that your child may need the early intervention!
Functional Appliances work with your child’s growth and development to guide the jaws to their proper size.

Contact us for an assessment of your child, if you have noticed any of the above symptoms.

Benefits of early treatment

Early interceptive orthodontic treatment usually starts before the eruption of the permanent teeth or when the child has very few permanent teeth present. Our goal at Envy Smile Dental Spa is to guide the growth of the upper and/or lower jaw to make adequate space for the eruption of all the permanent teeth. We feel that children should be evaluated by the age of 5 to see if there is a malocclusion problem.

It is always very beneficial to correct a problem when the patient is younger rather than wait for the problem to become more serious in the future.

Other benefits of early treatment:

• Improves profiles, smiles, and self-esteem.
• Corrects harmful habits, such as thumb sucking and tongue thrusting.
• Functional appliances develop the arches and make more room for the tongue.
• Improves speech.
• Reduces the amount of time spent in fixed braces and frequently eliminates the need for the extraction of permanent teeth.
• Increases nasal breathing which improves health.
• Eliminates airway constriction.
• Creates beautiful broad smiles by developing the arches.
• Eliminates grinding of the teeth at night.
• Prevents headaches and earaches.

Phase I Orthodontic treatment – functional appliances

Functional Appliances are used mainly in growing children to help solve the problem of narrow upper and lower jaws, which could cause crowding of the permanent teeth. When the narrow upper and lower jaws are developed to normal shape and size with functional appliances, in the majority of cases it is not necessary to extract permanent teeth.

Most children with crowded teeth and bad bites have narrow jaws and underdeveloped lower jaws, which could be corrected with functional appliances. Functional appliances help correct the bone problems, while the tooth problems are corrected with the orthodontic braces.

The ideal age for the use of functional appliances is between ages seven and eleven when the cooperation level is the highest. However, functional appliances can be utilized as early as age 5, if the upper jaw is too narrow and is having a negative effect on the child’s breathing and speech. Arch Development (functional appliances) can also be used in adults to develop the arch to a more normal shape and size before applying the braces.

The use of functional appliances can reduce the time the child must wear fixed braces and also can reduce the need for the extraction of permanent teeth. Functional appliances develop the dental arches so that all the permanent teeth can erupt, which ensures an outstanding profile, broad smile, and healthy jaw joints.

What is a functional appliance?

Once a thorough and proper diagnosis have been made, the best appliance to be used to correct your child’s problems will be selected. A functional appliance is a tiny device designed like a mouth retainer, with micro-screws, to make the appliance able to activate and stimulate the change in bone, therefore making the jaw grow to it’s potential. The initial records and x-rays, taken at the beginning of treatment, determine growth potential.

How long does Phase I treatment last?
Phase I treatment usually lasts approximately 10-12 months depending on the severity of the case. The appliance is usually active (making changes to the jaw) for 4-6 months then the appliance should be used as a holding appliance for 6 months or as a retainer to prevent any relapse in the treatment. As the permanent teeth erupt, it will be determined when it is no longer necessary to wear the holding appliance.

At what point will my child need orthodontics?
Once the early phase of treatment is finished your child will be evaluated on an ongoing basis to monitor the eruption of the permanent teeth. Once the permanent teeth are all present. We will set up a consultation appointment to determine whether there is a need for braces. Usually, orthodontics, which means fixed braces, does not begin until the patient has all their permanent teeth (age 11 to 13). While braces are the most popular among younger patients, they can be worn as a teenager or an adult. More adults these days are asking for braces to help improve their smile and appearance. Set up an initial screening appointment for your child today!

Phase II Orthodontic treatment – braces

Orthodontics is usually our Second Phase of treatment, following the use of functional appliances. The braces would now be placed to move the teeth into alignment to support the development of the bone achieved in the first phase of treatment. The second phase of treatment is initiated when most of the permanent teeth have erupted.

Braces are the small, square metal attachments (called brackets) that are bonded with special orthodontic adhesive to the teeth. There is a small slot in the in the middle of the bracket into which the orthodontic wire fits. In order to hold the wire in place, small tiny elastics are wrapped around the outside of the braces. It is the combination of the braces, the wire and the elastic that help the tooth move into is a proper position.

Most patient’s today think braces are “cool” because of all the different colors. In fact, there are more that 40 different combinations of colored elastics, which fit over the braces to keep the wires in place. Every month the patient has their choice of colored elastics. Most children pick the metal braces, which are much smaller today. Adults and teenagers prefer the clear braces because they blend in with the color of the teeth and are harder to see. We have some females who prefer gold braces since they look like jewelry. The newest and latest trend is toward invisible braces, where trays that are changed periodically and move the teeth into a better position.

This phase of treatment usually lasts between 12-24 months depending on the amount of tooth movement necessary to align the teeth and to establish a proper bite. It is important to remember that treatment time is estimated. Dr. Rondeau has specific treatment goals in mind and will usually continue treatment until these goals have been achieved. Patient cooperation is the best way to keep on time with your treatment. Be sure to take care of your braces and to wear your rubber bands as instructed and we will both be able to achieve our desired result.

After phase II is completed it is necessary to wear retainers to hold the final result. The great part about our retainers is that they are virtually invisible which helps guarantee patient acceptance and ensures they will be worn at the appropriate times.

Metal Braces Vs. Ceramic Braces & Lingual Braces

Comparison Chart	Metal Braces	Ceramic Braces	Lingual Braces
	Braces
How they bonded to the tooth?	Placing bands, or rings, around each and every tooth	The same size and shape as traditional braces, but mimic the color of the teeth	Placed on the inside of the teeth
A length of time for treatment?	18-36 months	18-36 months	18-36 months
Are they invasive?	Far less invasive	No invasive	Greater initial discomfort. They may irritate the tongue
Affordable	Most cost effective	More expensive	Expensive
Noticeable	Most noticeable form of braces	Less noticeable than regular braces	Completely invisible from exterior observation
How to clean them?	Easy cleaning	Brackets may stain easily	Difficult to clean
Are they recommended for everybody?		NO	NO
Awkwardness with speech	NO	NO

What is Invisalign®?

Invisalign straightens your teeth without wires and brackets, using a series of clear, customized, removable appliances called aligners. It’s virtually undetectable, which means hardly anyone will know that you’re straightening your teeth.

Clearly Different
The Invisalign System combines advanced 3-D computer graphics technology with 100-year-old science of orthodontics. Invisalign aligners are designed to move your teeth in small steps to the desired final position prescribed by your orthodontist. Each aligner is precisely calibrated and manufactured to fit your mouth at each stage of the treatment plan. Your first step is to visit our office to determine if Invisalign is right for you. After sending precise treatment instructions, Invisalign uses advanced computer technology to translate these instructions in a sequence of finely calibrated aligners — as few as 12 or as many as 48. Each aligner is worn for about two weeks and only taken out to eat, brush and floss. As you replace each aligner with the next, your teeth will begin to move gradually—week-by-week until the final alignment prescribed is attained. Then you’ll be smiling like you never have before!

If you want to learn more about Invisalign and how it works, please visit the Invisalign Homepage.

To ensure the best possible results, only an orthodontist who has been trained and certified by Align Technology can diagnose and treat using Invisalign. Invisalign is not intended for children and is not appropriate for every adult. Only an orthodontist can determine if this treatment is an effective option for you. To see if Invisalign can help you achieve the smile you’ve always wanted, call us at (718) 891-0606 to make an appointment.

Retainers

The length of time in retainers varies depending on the amount of tooth movement that was necessary. However, as a general rule of thumb, we recommend full-time wear of the upper clear retainer for 1 full year and 1 year at night only. We generally like to make the lower retainer fixed, behind the lower front teeth, and it remains in place for 3-5 years.

Exciting news regarding new clear retainers! The newest retainer now has a clear labial bow which makes the retainer practically invisible. Patients love these new clear retainers.

Adult Orthodontics

Orthodontics involves the diagnosis, prevention, and treatment of structural problems involving the jaws and malocclusion commonly known as bad bites. Orthodontic problems can affect your dental and general health as well as your personal appearance.

Every patient wants to have an attractive smile. When you smile with confidence, you look your best and feel good about yourself. Straight teeth and a broad smile are very important to a person’s positive self-image. Everyone wants straight white teeth. We always recommend that patient’s get their teeth whitened after they are straightened with braces. As your teeth, jaws, and lips become properly aligned through orthodontic therapy, your self-image can improve. This is just one of the many benefits.

If the teeth are out of position, they are more difficult to clean, increasing the risk of tooth decay and periodontal (gum) disease. If chewing is difficult, people may not eat the foods needed for good nutrition. If your bite is poor, the extra strain may be placed on the chewing muscles, possibly causing pain and problems with your jaw joint. Some of the symptoms of jaw joint problems include headaches, neck aches, ringing in the ears, dizziness, fainting, pain behind the eyes and difficulty swallowing.

Orthodontic treatment can be beneficial at any age and approximately 25% of today’s orthodontic patients are adults. Teeth can be moved at any age and therefore more adults are proceeding with orthodontic treatment today in an effort to achieve straight teeth, a beautiful smile, and healthy jaw joints. Many adults today prefer the clear or gold braces, which are more aesthetically pleasing than the standard metal braces.

No two smiles are alike, and therefore no two orthodontic treatment programs are either. Typically, active treatment times range from one to two years and vary with the degree of tooth movement and the severity of the problem

You are never too old to improve your smile. We also have options for invisible braces with clear plastic trays that are worn in cases with minor crowding. If you have crooked teeth or you don’t like your smile, come in for a consultation appointment to see what treatment options are possible.

Invisible Braces

Dr. Weiner and her staff offer the latest advancements in invisible orthodontic braces. This newest development in orthodontic technology allows you to smile with confidence throughout treatment.

Correcting your smile is possible at any age. Some patients may choose the new clear braces or invisible tooth aligners.

Clear Braces vs. Metal Braces

Clear Braces—Mystique, which uses the latest aesthetic ceramic technology, provides outstanding results and high translucency. The clear braces are bonded to the tooth just like the ordinary metal braces. Treatment time with the Mystique is approximately 12-14 months depending on the difficulty of tooth movement. Adults are asking for invisible (clear) braces today.