FAQs

Q: Do braces hurt?
A: As a rule, braces do not hurt. Usually after an adjustment, your teeth will be sore for a day or two. This annoyance is relieved with an over-the-counter pain reliever if necessary.

Q: How long will treatment take?
A: Treatment time obviously depends upon your original problems. However, today we have many techniques and materials which will safely move your teeth with less discomfort in a shorter time.

Q: Are braces expensive? Are financing options available? How does my insurance work?
A: Compared to today's dental expenses, braces are a bargain. Considering the time spent, orthodontics is regarded as dentistry's best value. We have many financing options available to meet your needs and will be happy to go over them with you. Many of our patients have insurance coverage. Our office will help you in filing procedures.

Q: Will I need to wear a retainer after treatment?
A: Yes. Even after our best orthodontic treatment, teeth will have a tendency to move slightly. A retainer is the best way to minimize this movement.

Q: Are braces noticeable?
A: Braces were very noticeable when they went completely around the teeth. Today, most of the braces are bonded to the front of the teeth thereby eliminating the amount of metal on each tooth. It is also possible to have ceramic braces which blend in with your natural tooth color.

Q: As an adult, am I too old for braces?
A: You are never too old for braces. We provide orthodontic care for many adults at all ages. Treatment time may be a little slower, but the benefits are definitely worth it.

Q: Will I talk funny with braces?
A: For the first day or two after you get your braces you may be more aware of your braces. Soon, however, they will become part of you and you will not have a problem with speech.

Q: Will I have to have teeth removed for braces?
A: Removal of teeth is sometimes necessary for an orthodontic correction. However, with today's technique, the need for removing teeth is greatly reduced.

Q: Can I still have braces even though I have crowns and missing teeth?
A: Yes, you can still have braces with crowns. When teeth are missing, orthodontic treatment will aid in the alignment of the remaining teeth so the missing teeth can be properly replaced.

Q: Will braces leave marks on my teeth?
A: No. The bonding agents used today contain fluoride so underneath the brace is protected. However, if your oral hygiene is poor, the accumulation of plaque can result in the formation of marks on the teeth.

Q: What is the best age to begin treatment?
A: The age of treatment varies with the patient's needs. We do not put braces on every patient who visits us. If a patient is not ready for treatment, we will follow that patient at no charge until the time for treatment is right.

Q. Why do I need braces if my teeth are straight?
A. The goal of orthodontic treatment is much more than straight teeth. The most important part of your smile is a good bite. Even though your teeth may be straight, your bite may be off and need correction.

Q: Can I still have braces if I have some teeth missing?
A: Absolutely! Often when teeth are missing, adjacent teeth will drift into the empty space causing a periodontal, esthetic or functional problem. Orthodontic treatment will correct and prevent this from happening and also provide the proper alignment for your dentist to replace the missing teeth if you so choose.

Q: Do you use recycled braces?
A: Absolutely not. Not only do we feel each patient should be provided with their own braces, we consider braces a tool to achieve optimum results. This is why we make the investment for quality braces and do not settle for worn, used, recycled braces.

Q: I don't like the idea of having braces on my teeth. Are there any alternatives?
A: A new technology called Invisalign allows you to move the teeth using a series of clear, removable aligners. Though not for everyone, it does offer another treatment option to our patients.

Q: How do I compare orthodontic offices?
A: When comparing orthodontic offices, check out the following:

Sterilization including testing and records
Your child’s safety
Warm, friendly staff
In-house lab so there is fast turn-around for all lab needs
Commitment to quality and excellence
Communication between doctor and patient
Financial options
Punctuality
Latest in diagnostic equipment
Community involvement

QUESTIONS PARENTS OF CLEFT LIP AND/OR PALATE CHILDREN SHOULD ASK THEIR ORTHODONTIST:

1. When should we see an orthodontist?
A. Age seven years is an ideal time for your child to see the orthodontist. It does not necessarily mean your child will begin treatment at this time. However, it does give your child an opportunity to meet the orthodontist and it provides an opportunity to assess your child’s needs.

2. Will my child be missing teeth?
A. Many things can happen to the teeth in and adjacent to the cleft site. Also, what happens in the primary dentition (baby teeth) does not necessarily happen in the permanent dentition (adult teeth). Your child may have a primary tooth in the cleft but does not have a permanent tooth. Usually, the tooth that is supposed to be in the cleft site (lateral incisor) is missing. One may also find more than one tooth (supernumerary) in the site. Sometimes, the adjacent teeth to site and the tooth in the site, if there is one, may have enamel malformation. Fortunately, with modern dentistry, all of these situations can be addressed favorably.

3. What are the usual orthodontic procedures for the average cleft lip and palate patient?
A. As an infant, your child’s lip was repaired and as a toddler, your child’s palate was closed. Your child has been growing continually. Unfortunately, these surgical procedures have left normal scar tissue that does not grow and often restricts growth of the upper jaw. You will probably notice that the upper jaw is narrower than the lower jaw and may be further back than the lower jaw. At the proper time, usually 7-9 years, the first stage of orthodontics will begin. The upper jaw needs to be expanded to the appropriate width. There are a variety of orthodontic devices to do this and may or may not use braces. Once proper expansion has been achieved, a surgical procedure is required to place bone in the cleft site. The bone graft, usually your child’s own, can be gotten from many places but usually from the hip. The bone enables the two cleft halves to become one and provides bone into which the permanent teeth can erupt. Also, your orthodontist at this time may address the front-to-back discrepancy of the jaws with another orthodontic device. When the initial goals are achieved, the orthodontic devices and braces may be removed to wait for more permanent teeth to erupt. The second phase of orthodontic treatment usually begins when most of the permanent teeth have erupted and addresses the alignment of both the teeth and the jaws. Each child’s treatment will vary. If the jaw discrepancy is so great so as not to achieve a satisfactory result with braces only, then an orthognathic surgery procedure is needed to coordinate the jaws. As you can imagine, treatment time can vary from patient to patient. Often, to totally complete the orthodontic treatment will take several years. Do not get discouraged, the result is definitely worth it.

4. At what age do you recommend an alveolar bone graft?
A. Bone grafting depends upon many factors. Obviously, one factor would be the stage of growth and development of your child. As you can imagine, people grow and mature at different rates. Therefore, bone-grafting age will vary among a group of children. Another factor is the development and eruption of teeth. Specifically, the root development of the canine near the cleft site is an indicator for timing of the graft. This being said, the average age is 7-9 years to begin expansion in preparation for the bone graft.

5. How would you replace the missing tooth in the cleft site?
A. Permanent replacement of the missing tooth depends on many factors. Sometimes, the canine adjacent to the cleft can be used as the missing lateral incisor. This often requires dental bonding for esthetics after treatment. In this treatment, there is no need to replace the missing tooth. Please note, not all patients can have this type of treatment. Often a dental implant is used to replace the missing tooth. An implant is a device placed in the bone and acts as the root of the tooth. A crown is placed upon the implant. However, in order to have a successful implant, the patient must have no more facial growth. On the average, a person completes facial growth at age 18-20 years, long after orthodontic treatment. A good intermediate and semi-permanent replacement is a resin-retained bridge. In this case, a prosthetic tooth matching contour and color is held in place by bonding to the adjacent teeth. Little or not tooth structure is removed for this procedure. Of course, there is always a conventional bridge that can be used when there is poor enamel on adjacent teeth. The teeth are reduced and completely covered with a restoration that holds the prosthetic tooth.

6. What other specialties do you feel are important in the total care of a cleft lip and palate person?
A. Depending upon your child’s needs, the following specialties should at least be consulted. This list is not all inclusive.
Plastic Surgeon
Orthodontist
Oral Surgeon
Otolaryngologist (ENT)
Geneticist
Speech Pathologist
Audiologist
Child Development Specialist

ABOUT DIGITAL RADIOGRAPHY

We are proud to say we are one of the very few orthodontic offices to have direct digital radiography for our patients. What does this mean? It means that we are able to achieve the greatest diagnostic images with the least amount of radiation, the best in the industry. While many offices may employ digital radiography, it usually is indirect versus direct digital imaging. What is the difference? Indirect digital radiography still employs the use of X-rays and a film plate albeit at a lower dosage. Direct digital radiography does not use a film plate and the images are produced immediately on a computer screen. Direct digital radiography produces the best images with the least exposure and in the least time. We have made this investment so we can provide you and your family with the best and safest care.