Early treatment may be necessary for younger patients in some cases to allow for proper dentofacial development as well as proper tooth positioning. We only recommend early treatment when it will make a difference to your child’s long term dental development. Frequently needed treatment procedures include expansion, treatment of skeletal discrepancies (jaw and teeth not growing in alignment), and habit appliances (appliance to deter thumb sucking).
Titanium braces are a perfect choice for the patient who doesn’t mind showing metal and loves our endless color selection. New and improved titanium braces combine a very precise bracket system with the proven benefits of titanium.
Clear ceramic braces are the bracket of choice for most of our adult patients and some of our teens that don’t want to show metal. Ceramic braces are less visible and allow us to do everything we can do with more visible metal braces. They blend with your tooth color and bond directly to your teeth like metal braces.
Lingual braces are attached to the back side of the teeth which makes them invisible. They were designed for adults who want to pursue orthodontic treatment without letting others know they are wearing braces.
There are times especially in adults and “non growing” patients where the bones are not in alignment. Orthognathic surgery in combination with orthodontics can be used when the skeletal correction is beyond what can be achieved with orthodontics alone or where greatly enhanced facial balance can be achieved by putting the bones into alignment.
A combined orthodontic/orthognathic approach is frequently used when the lower jaw is too small or too far behind the upper jaw. Bringing the lower jaw forward can greatly enhance the patients profile while simultaneously correcting the bite discrepancy.
Similarly the lower jaw can out grow the upper jaw causing an under bite and unfavorable facial balance. Surgery to advance the upper jaw or to set back the lower jaw or a combination of the above is frequently used to again put the bones of the face in balance.
Other times an open bite develops where there is a large gap between the front teeth when the patient is biting down. Again surgery can be done to impact the posterior of the upper jaw allowing the lower jaw to rotate forward and close down the bite.
Orthognathic surgery should be used in combination with orthodontics treatment to enable the bite to be ideal after the surgery done. The facial changes are often dramatic as can be seen by the following treated cases.
Computer imaging can be used to predict soft tissue changes that follow hard tissue change (movement of bones and teeth).
Patients who have had long standing malocclusions or who have suffered trauma to their lower jaw, can have pain in their “jaw-joints” or temporomandibular joints (TMJ). There are times when patients can not open their months completely, have a deviation to one side, and have serve pain that mimics an ear ache. These patients frequently need to be treated with “splint therapy”. An acrylic appliance is inserted between the upper and lower teeth to reposition the lower jaw or create space to allow the disc between the upper and lower jaw joint to move back to its intended position. Once normal function is achieved and the pain is alleviated, orthodontic stabilization is frequently prescribed to address the existing malocclusion.
Missing permanent teeth including congenitally missing teeth can be replaced with implants during or after orthodontic treatment. Often times, having the implant and a temporary crown in place (if the patient is age-appropriate) prior to removing braces will help with stability and may prevent adjacent teeth from shifting into the space.
It is important that the roots of adjacent teeth are properly diverged to facilitate placement of the dental implant. It is also important that that bite is correct in an anterior/posterior relationship because once the implant is placed, the teeth on either side cannot be moved a significant amount because the implant does not move! For example, a Class II malocclusion where the upper teeth are ahead of the lower needs to be corrected prior to implant placement.
In addition, if a front tooth needs to be replaced, having the front teeth in a correct bite (ideal overbite/overjet relationship) allows for superior placement and greatly enhances aesthetics.