It is often difficult for a parent to determine if treatment is
indicated. There may be serious orthodontic problems even
though the front teeth look straight. Some problems that look
intimidating and complex are easily treated. Asking your general
dentist is a good place to start, but we are your best resource
since orthodontics is all we do. The initial examination only takes
a few minutes and is complimentary.


The following suggestions may be helpful. Look at your child’s teeth.
If you see crooked teeth, gaps between the teeth or overlapped
teeth, your child may need orthodontic treatment.
Ask your child to bite all the way down, keeping their lips open.
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? If you see any of these conditions an orthodontist should evaluate your child.
Look at the alignment of your child's jaw. Does the jaw shift off
center when your child bites down? If you see any mal-alignment
or shifting of the jaw, your child may have a skeletal problem.

Other common signs include:




All children should receive their first orthodontic evaluation by age
seven, or earlier if a problem is detected by parents, the family
dentist, or the child’s physician. An early evaluation allows us to
determine when a child’s particular problem should be treated. In
many patients, early treatment provides results that are unattainable
once the face and jaws have finished growing.



Generally not, the jaws grow in the back to allow for eruption of the
12-year molars and wisdom teeth, but not in the front. In most
children the amount of available space DECREASES as the permanent
teeth erupt.
Either in children or adults, untreated orthodontic problems usually
become worse. Orthodontic treatment is often less expensive than
the additional dental care needed to treat serious problems that
often develop later in life.



No. Age is not a factor, any adult in good general health with a
healthy gums and supporting bone is a good candidate for ortho-
dontic treatment. About 20% of our orthodontic patients are adults
and that number is still growing!



Orthodontic treatment has improved dramatically. As a rule, braces
make your teeth sore for a day or 2 after they are placed or adjusted,
but it is not "painful". Today's braces are smaller and more comfor-
table. High tech wires move the teeth more efficiently and with less
discomfort.



Yes. When teeth are missing adjacent teeth will drift into the empty
space. This often causes functional, esthetic or periodontal problems.
Orthodontic treatment can close the space or provide proper
alignment for your dentist to replace the missing teeth.




Malocclusion literally means "bad bite"



Phase I (Interceptive Treatment) is indicated for some orthodontic
problems. It usually begins when the permanent first molars and
permanent incisors are erupted (age 6 or 7). The goal of Phase I
treatment is to "intercept" an orthodontic problem before it bec-
omes more severe and/or more difficult to treat. Problems comm-
only treated in Phase 1 include severe skeletal imbalances, cross-
bites and severe crowding.
Interceptive treatment can make difficult orthodontic problems more
manageable. In addition, early correction of some problems produces
the most stable results. Most Phase I patients will require a second
phase of treatment (Phase II) for optimal results.
Phase II treatment usually occurs a number of years later when most
or all of the permanent teeth have erupted. (Generally age 10-12).
The goal of Phase II treatment is to achieve optimal alignment and
bite of all permanent teeth.


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.


| Absolutely not! Only certain bites require early intervention. All
others can wait until most or all or the permanent teeth are erupted.



Failure to provide appropriate Phase I treatment at the correct time
can limit later treatment options, compromise stability of the result,
and necessitate extractions or surgery.



Treatment typically lasts from 6 months to 30 months depending on
the age of the patient, severity of the problem, and the level of
patient cooperation.



Selected permanent teeth are removed in extraction therapy to
make room for crowded teeth, to correct bite relationships, or to
change the facial profile.
Non-extraction therapy does not require the removal of permanent
teeth.
The doctors will discuss the "pro’s and con’s" of different treatment
options at your New Patient Examination, and again at the Consul-
tation Appointment.




Orthognathic surgery combines orthodontic treatment with surgery
of the jaw to correct or establish a stable, functional balance
between the teeth, jaws, and facial structures. The goal of maxill-
ofacial surgery is to treat any jaw imbalance and the resulting inc-
orrect bite, which could adversely affect the cosmetic (esthetic)
appearance as well as the proper functioning of the teeth. This
procedure involves diagnosis, treatment planning, and execution of
treatment by combining orthodontics and oral/maxillofacial surgery
to correct musculoskeletal, dento-osseous, and soft tissue deform-
ities of the jaws and associated structures.



The word "orthognathic" was coined by an oral/maxillofacial surgeon
and means "straight jaws," just as orthodontics means "straight
teeth." Prior to that time, the term surgical orthodontics or "facial
orthopedics" was used to describe this medical specialty.



Orthognathic surgery is needed when jaws do not meet correctly
and/or when the teeth do not seem to fit with the jaws. The
teeth are straightened with orthodontics, and corrective jaw surgery
repositions the mal-aligned jaws. This not only improves the facial
appearance (esthetics), but also ensures that teeth meet correctly
and function properly.



There are many different types of abnormalities of the jaw structures
that can result in facial deformity and improper bite. These abnorm-
alities in the jaws and facial bones may be congenital (present at
birth) or developed during growth and development. They may also
be acquired after birth as a result of hereditary, environmental
influences, or trauma/illness to the face.

It has been estimated that dentofacial (involving the teeth and face)
deformities affect approximately 20 percent of the population.

Any individual with difficulty in the following areas should be
evaluated for possible orthognathic surgery:


The specific goal for orthognathic surgery will vary from patient to
patient, depending on the actual diagnosis. In general, the team will
address the following:



The most important aspect of overall patient management is a
thorough evaluation and diagnosis. Patient evaluation for orth-
ognathic surgery can be divided into four main areas:
After an examination by each of the orthognathic surgery team
members (dentist, orthodontist, and maxillofacial/oral surgeon), a
diagnosis is made and a coordinated treatment plan is prepared. The
complete process usually takes place in several stages over the
course of one to two years.

Treatment process of orthognathic surgery:
The treatment process occurs in stages. Any general dental mainte-
nance, prevention, or restoration should be performed prior to
orthodontic and surgical intervention. Then, the first stage of tre-
atment is the alignment of the teeth into a stable relationship with
the underlying jaw by orthodontics, which prepares the dental
arches for the surgical repositioning. This stage usually takes the
longest, from a few months to over a year. At this stage, the
abnormal bite (malocclusion) may become more noticeable.

Once ready for the surgical procedures, the orthodontist and maxill-
ofacial surgeon will review photographs, x-rays, and dental models to
finalize the surgical plan. The operation may involve a single jaw or
both jaws (maxilla and mandible). The surgery may also be combined
with other procedures, such as rhinoplasty (nose correction) or
genioplasty (chin correction) to improve the general appearance of
the face.


The procedure may take two to four hours, depending on the
complexity. Most patients are kept in the hospital for two to five
days, depending on the specifics of the procedure and the post-
operative condition.



Most patients return to their normal activities within a week or two
after their surgery. The surgeon will monitor the healing, and review
the changes in the facial structures and occlusion (bite). The
orthodontist will adjust the braces to fit the new repositioned jaw.
Orthodontic treatment may continue for several months to ensure
optimal positioning of the teeth.