Frequently Asked Questions

What is orthodontics?
Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention and treatment of dental and facial irregularities. Braces are appliances or devices used to make these corrections.

What is an orthodontist?
An Orthodontist is a highly trained specialist who has completed two to three years of training after graduating from dental school. An orthodontist not only straightens teeth but also is interested in the bite, facial profile, and oral growth.

What is a Board Certified Orthodontist?
A Board Certified Orthodontist is a person who has completed a comprehensive written examination covering all phases of orthodontic and dentofacial orthopedic care. They also demonstrate actual accomplishment in patient care, with detailed reports on the treatment provided for a broad range of patient problems. A Board Certified Orthodontist achieves the title of Diplomate of the American Board of Orthodontics.

Why should I have my teeth straightened?
Orthodontic treatment improves your smile and your health. Your smile is the most striking part of your face. Look in the mirror. Do you like your smile now? Can your smile be improved? Think about how you react to someone with a pretty smile. Do you find them more attractive? Will you be more attractive with an appealing smile? Orthodontic treatment will make your smile look fabulous. The fabulous smile can last for the rest of your life. Think about how a fabulous smile will improve your life. Orthodontic treatment will also make your face look delightful. Wouldn't a delightful face be wonderful?

Your health is also affected by poorly arranged teeth that can break easily and trap food particles that cause tooth decay and gum disease. They can also lead to poor chewing and digestion which can be bad for your overall health such as:

Dental problems. Crooked teeth are hard to clean so that people with crooked teeth tend to have more cavities and gum problems than people who have orthodontic treatment. Crooked teeth wear in ways that they should not. This puts extra stress on your teeth, gums and jaw which can lead to problems later on.

Breathing problems. As you get older the roof your mouth can sometimes partially block the air passages in your nose. If you have orthodontic treatment you may avoid this possibility.

Statistically, people who have had braces as children have lower incidence of cardiovascular disease as adults. Children who get braces learn to take care of themselves, and that translates into a reduced risk for cardiovascular disease. There is also some recent data which indicates that oral bacteria might play a direct role in cardiovascular disease, by dissolving calcium in your mouth and depositing it into your arteries. Orthodontics helps prevent oral infections which may have a direct effect on heart disease.

The American Association Of Orthodontics (AAO) has a new program called a smile bank, which uses computer imaging to show you how much better your face will look after orthodontic treatment. Contact the AAO at 1-800-787-2444

How do braces straighten crooked teeth?
Braces use steady, gentle pressure over time to move teeth into their proper positions. They don't look like they're doing much just sitting there. But in fact, every moment of your orthodontic treatment, there's something happening in your mouth. Something good for you. The brackets we place on your teeth and the main wire that connects them, are the two main components. The bracket is a piece of specially shaped metal or ceramic that we affix to each tooth. Then we bend the arch wire to reflect your "ideal" bite - what we want you to look like after treatment. The wire threads through the brackets and, as the wire tries to return to its original shape, it applies pressure to actually move your teeth. Picture your tooth resting in your jaw bone. With pressure on one side from the arch wire, the bone on the other side gives way. The tooth moves. New bone grows in behind. It may look like nothing is happening--but we're making a new smile here. Thanks to new materials and procedures, all this happens much quicker than ever before. It's kind of an engineering feat.

How can I tell if my child needs orthodontic treatment?
It is usually difficult to know if your child will need orthodontic treatment until your child is 7-8 and their permanent teeth start to come in. We recommend that you bring your child into the orthodontist when your child is 7 years old to evaluate whether treatment will be needed. Generally, the orthodontist will evaluate your child, and if your child needs treatment, the orthodontist will take corrective action to avoid costly and uncomfortable treatment later on.

What are the early symptoms of orthodontic problems and how can I look for them?
It is most important to examine your child's teeth as the permanent teeth grow in. Although children mature at different rates, there are some averages for permanent tooth arrival. It is always better to consult a professional. Still, there are some warning signs that you can look for to help evaluate whether your child needs orthodontic treatment. The figure above shows what proper occlusion is like. Notice how the top teeth exactly line up with the bottom teeth, and there are no spaces or gaps. If your child teeth look perfect, your child probably will not need orthodontic treatment. On the other hand if your child's teeth look as shown in one of the figures below, your child will need orthodontic treatment.

First ask your child to open their mouth, and let you look at their teeth. Are all of their teeth straight? Do any of the teeth slant to the side? Are there any gaps between your child's teeth? Do any of your child's teeth overlap? If you see any signs of crooked teeth, gaps between your child's teeth or overlapping teeth, your child may need orthodontic treatment.

Next ask your child to bite down. Does the center of the front top teeth line up with the center of the front bottom teeth? Do your child's top teeth protrude out the front of their mouth? Does your child have bucked teeth? Do the top front teeth cover more than 25% of the bottom teeth? Are any of the top teeth behind the bottom teeth? Do the teeth come together smoothly, or are there any gaps? If your child's teeth do not come together smoothly, or if any of your child's teeth do not lining up properly your child may need orthodontic treatment.

Now look at the alignment of your child's jaw. Do all of the teeth come together smoothly, or does your child's jaw shift off center when your child clenches their teeth together? If you see any misalignment or shifting of your child's jaw, your child may need orthodontic treatment.

If you see any of the above symptoms, or if you are not sure, bring your child in for orthodontic treatment. It's best not to wait hoping that the problems will go away.

At what age should I take my child to an orthodontist for an orthodontic screening?
The American Association of Orthodontists recommends a screening at age 7. The most appropriate age varies for each particular problem. We recommend that you have an initial appointment as soon as any problem is evident; we can then monitor the problem if it is too soon to treat. Many orthodontic problems are treated using growth and it is important that we see children before their growing phase. How many permanent teeth they have is not initially important.

Can you be too old for braces?
No. If the bone and gum tissue around the teeth are healthy, age is not a factor. About 20% of orthodontic patients are adults.

Will additional jaw growth allow self correction of crowded teeth visible in a 8 year old?
No. The space available for the front teeth does not increase after the permanent 6 year molars erupt. In most people, the space available for the front teeth decreases with increasing age.

If I wait, isn't there a chance that my child's bite will get better on its' own?
Usually it is just the opposite, if you wait orthodontic problems will almost always get worse. If a few teeth are crooked or crowded, the orthodontist can realign the crowded teeth easily. However, if you do not treat the crowding right away, the crooked teeth will encroach onto your child's other teeth and push the other teeth out of alignment too. As a result if you wait, your child's orthodontic problems will usually get worse.

Further, as your child gets older, orthodontic treatment becomes more uncomfortable. As your child ages, fibers grow in to anchor your child's teeth to your child's jaw. It takes more force to move the fibers as your child ages so treatment is more uncomfortable. Also the bones in the roof of their mouth harden as your child ages, which makes treatment even more difficult.

If you avoid needed treatment when your children are teens, the children will usually need more uncomfortable treatment later in life. Isn't it better to take care of the problem when it is first discovered rather than waiting until the problem gets worse?

It is hard to see into the future, to tell how the lack of orthodontic treatment will affect your child. Certainly, a child who needs orthodontic treatment but does not get it will have problems with the teeth for years to come; so much so that many adult patients are now going back for orthodontic treatment. The difficulties with not getting needed orthodontic treatment include:

Teeth that wear unevenly leading to weak enamel and tooth loss
Teeth that are difficult to clean, leading to gum problems and eventual tooth loss
Difficulty chewing
Periodontal (Gum) problems as your child gets older
The health issues, that go well beyond good oral hygiene

Also, chewing is the first step in digestion. If your children cannot chew their food properly, their digestive system will not work as well. Stomach problems are very common in people who skip needed orthodontic treatment since if your child cannot chew their food right, it irritates their stomach, and produces a lifetime problem.

Is treatment more difficult for adults?
Adults can be treated successfully at any time. However, treatment options using growth are no longer available.

What causes crooked teeth?
Just as we inherit eye color from our parents, mouth and jaw features are also inherited. Local factors such as finger sucking, high cavity rate, gum disease, trauma and premature loss of baby teeth can also contribute to a bad bite.

Can I have my teeth straightened without having braces glued to my teeth?
Yes, if you are an adult with only 1 - 6 millimeters of crowding or spacing of your front teeth and no missing or severely tipped teeth. A series of 3-D computer generated invisible aligners made by Invisalign may allow creation of a beautiful smile for you without glued on braces. This advanced technology is not for growing children.

What do rubber bands do?
Rubber bands or elastics contribute a lot to straighter teeth. They are marvels of physics. Attached to your braces, elastics exert the force that creates the right amount of pressure to move teeth in directions that the braces alone can't. It's important to wear your elastics as prescribed and change them every day so the force is constant which the teeth like. A lack of consistency in wearing rubber bands can bring treatment to a standstill. Teeth never fail to move when elastics are worn consistently as directed. As for bouncing an elastic off someone across the room, it will happen (don't worry, your aim will improve).

Can I get colors on my braces?
Colors have gone over very big with countless braces wearers. With colors, patients decide to become involved in their treatment and usually take better care of their braces. Patients won't take time to choose special colors unless they intend to use them and speed their treatment. There are soft pastels that coordinate with wardrobe to bright hues for celebrating holidays or expressing team spirit. These colors can be changed when the wires are changed to add constant variety. Once the braces are off, retainer color choices are only limited by your imagination.

If I don't want to show colors on my braces, what can I do to play down braces?
Give clear tooth colored braces a try or if you use makeup, use it to draw attention away from your mouth. Go wild using eye shadow and keep the lips simple with beige or nothing at all. Stay away from lip gloss that makes the metal parts of braces more reflective.

Will braces correct TMD or jaw joint problems?
Braces may or may not improve jaw joint problems. More conservative approaches should be tried first.

How many people receive orthodontic care?
Approximately 4 million people are in braces in the US at any one time. About 70% of people in the US need orthodontic treatment. The benefits of orthodontic treatment go beyond making your face look wonderful. You will be able to chew your food easier. Chewing is the first step in digestion. If your teeth are crooked, you will not be able to chew your food properly which can lead to recurrent indigestion.

Will orthodontics change my lifestyle?
You'll have to give up extremely hard and sticky foods. These foods can get caught on the braces and pull the braces off. Soft foods are much better. You'll have to spend a few extra minutes cleaning your braces after meals. But, for the most part, you'll find braces don't cramp your style. You'll still have fun. You'll still be able to sing, play your musical instrument, smile, play sports and of course, kiss. You can even make a fashion statement by having your orthodontist add color to your braces.

How long do you have to wear braces?
That depends a lot on you and how bad your bite is to begin with. The better you are about wearing and taking care of your braces, the sooner your teeth will improve.

Will any teeth be pulled?
Only if there's not enough room for all your teeth. Don't worry, if you have teeth pulled, the spaces will be closed and no one will even notice.

When is the best time to schedule an initial consultation?
Every child should see an orthodontist at an early age. This could be as young as 2 or 3, but should be no later than age 7. Early consultation allows the orthodontist to determine the optimum time for treatment to begin. Many parents and some family dentists assume that they must wait until a child has all of his or her permanent teeth, only to find out that treatment would have been much easier if started earlier. Early treatment can eliminate the need for more drastic measures. In some cases, satisfactory results are unattainable once the face and jaws have finished growing. With proper timing, children may not have to endure years of embarrassment. Adults can be treated at any age as long as the gums and bone holding the teeth are healthy.

Why should you choose an orthodontic specialist?
Teeth and sometimes faces are permanently changed by orthodontic treatment; therefore, it is very important that the treatment be done properly. A licensed orthodontic specialist is a expert at moving teeth, helping jaws develop properly and working with you to help make sure the teeth stay in their new positions. Some advanced techniques such as Invisalign are only available through a specialist.

Do you need a referral from your family dentist to see an orthodontist?
You don't need a referral from your family dentist unless you are in a managed care plan with a "gatekeeper" primary care dentist. Word of mouth recommendations from friends and families of existing patients is often the primary way orthodontists meet new patients. Spread the word if you like your orthodontist!

What will happen at the first appointment?
You will be seen for an initial orthodontic exam where they will answer your questions about such issues as; do you/your child need braces, what type of treatment do you/they need and about how long will it take. Information about approximate fees with a sample contract will be drawn up for you to review payment options. They will also answer any other question you have about orthodontic treatment. Normally, this appointment takes about 15-20 minutes.

Are braces uncomfortable?
Each person finds braces quite different. Placing braces takes a long time (about an hour). However, it is a relatively painless procedure. The following couple of days the teeth may be uncomfortable however they soon settle down and you get used to the new feeling. Patients generally adjust very quickly to the braces and before you know it is it just another part of everyday life.

Is orthodontic care expensive?
Orthodontic fees have not increased as fast as many other consumer products. In 1952, it cost the ordinary US worker about 432 hours of labor to purchase orthodontic treatment for a child. In 1997, that parent will only work 279 hours to purchase orthodontic treatment. Compare that to a single family home which cost 6,528 hours of work in 1952 and today costs 10,480 hours. Fees for an initial consultation are minimal. Financing is usually available. Many insurance plans now include orthodontics. Well timed orthodontic treatment to correct a problem is often less costly than the additional dental care required to treat the more serious problems that can develop years later.

How much does orthodontic treatment cost?
It matters where you live and how much needs to be done. If you live in a rural area, where rents are low and malpractice attorneys rare, orthodontic treatment can be found for under $3,000. Typically orthodontic treatment costs between $3,000 and $7,000 in the USA. The cost goes up to $18,000 in Tokyo! This may seem like a lot, but think about how much you spend to maintain your car.

Can I negotiate lower fees with my orthodontist?
Generally, orthodontists will not cut their fees to individuals. Orthodontists need to pay for a lot of specialized, expensive equipment and to pay their staff and their rent. The Orthodontists need to pay for all of their materials and the operation of their sterilizers. Then there is the cost of malpractice insurance. Most of an orthodontist's fee goes to paying their fixed cost.

Orthodontic treatment is still costly, is it worth the cost?
Yes! Think about the cost of not getting braces. It is hard to see into the future, to tell how the lack of orthodontic treatment will affect your child. Certainly, a child who needs orthodontic treatment and does not get the treatment will have problems with their teeth for years to come; so much so that many adult patients are now going back for orthodontic treatment. The health issues, go well beyond good oral hygiene. A breathing problem cannot be corrected without major surgery.

Also stomach problems are very common in people who skip needed orthodontic treatment. If you/your child cannot chew their food right, it irritates the stomach, and produces a lifetime problem.

There also is some initial data (unverified) that orthodontic treatment can lower your children's chance of cardiovascular disease.

We cannot predict whether your child will develop a breathing problem or a stomach problem if they do not undergo orthodontic treatment. However, lifetime orthodontic treatment costs no more than the lifetime maintenance on a car. Isn't it worth investing as much time in maintaining your children's teeth as you invest in maintaining your car?