ortho 9/18/17

What is an orthodontist?
Orthodontists are qualified dentists, who after graduating from dental school, go on to additional full-time university-based education in an accredited orthodontic residency program supervised by orthodontists. That training lasts at least two to three academic years. By learning about tooth movement (orthodontics) and guidance of facial development (dentofacial orthopedics), orthodontists are the uniquely educated experts in dentistry to straighten teeth and align jaws.

What happens at my first visit?
Dr. Westfallen will listen to your concerns and provide an orthodontic examination of your jaws and teeth. Dr. Westfallen will indicate whether or not treatment is needed and what the treatment will involve. Dr. Westfallen and her staff will also be able to discuss fees for orthodontic care and payment options.

Typical steps prior to beginning treatment include gathering orthodontic records to provide specific information to tailor a treatment plan for that patient. Orthodontic records include x-rays, photographs, and impressions or “molds” made of the teeth. These “molds” are used to develop models for closer examination of the teeth and how the upper and lower teeth relate to each other. X-rays are used to measure your teeth and jaws. Photographs help diagnose your problem.

When should I begin treatment?
The American Association of Orthodontists recommends that children get a check-up with an orthodontist no later than age seven. Although only a few orthodontic problems need to be corrected at that age, an early exam allows Dr. Westfallen to offer advice and guidance as to when the appropriate age to start treatment would be.

How long will my treatment take?
Generally, the length of orthodontic treatment can range from 18 months to 30 months. The length of treatment varies depending on the complexity of the orthodontic problem that requires correction, growth and tissue response to treatment as well as the level of patient cooperation during treatment. New techniques such as the self-ligating In-Ovation system and digital imaging make treatment faster and more comfortable than ever.

What will orthodontic treatment cost?
Fees for orthodontic care vary with the complexity of the treatment based upon each individual’s needs. At your first visit, Dr. Westfallen will discuss the anticipated treatment fees and payment options.

What is expected of me during treatment?
Like other types of health care, patient cooperation with the directions of Dr. Westfallen is key in determining the length of treatment and the quality of the outcome. In many instances, patient cooperation is needed to help make sure the bite is right. Your first few appointments will most likely be about a week or two apart. Once your appliances are placed, you’ll see Dr. Westfallen every 4-8 weeks. See “What To Expect” for more details regarding the sequence of treatment and appointment descriptions. In addition, you must continue to see your dentist at least every six months, or more often if recommended, for check-ups and professional cleanings.

Questions From Patients

How do I know if my child is in need of orthodontic treatment?
It is usually difficult for you to determine if treatment is necessary because there are many problems that can occur even though the front teeth look straight. Also, there are some problems that look intimidating and complex which will resolve on their own. Asking your general dentist is good reference, but we are your best resource since orthodontics is all we do. Our initial exam is complimentary and we would be more than happy to see your child and make any recommendations necessary.

What are the early symptoms of orthodontic problems?
Although determining if treatment is necessary is difficult for you to assess, the following symptoms may help in prompting you to seek our orthodontic advice.

Ask your child to open their mouth, and let you look at their teeth. If you see any signs of crooked teeth, gaps between your child’s teeth or overlapping teeth, your child may need orthodontic treatment.

Ask your child to bite all the way down, but keeping their lips open so you can see their teeth. 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? All these are indicators for potential orthodontic treatment.

Look at the alignment of your child’s jaw. Does the jaw shift off center when your child bites down? If you see any misalignment or shifting of the jaw, your child may have a skeletal problem, which requires early orthodontic intervention.

These are only some of the obvious symptoms of orthodontic problems.

What age should my child be seen by an orthodontist?
The American Association of Orthodontists recommends that your child be evaluated by age seven. Early detection of some orthodontic problems is important in order to take early corrective action and avoid more difficult treatment later.

Can you be too old for braces?
No, age is not a factor, only the health of your gums and bone which support your teeth. About 25% of our orthodontic patients are adults and that number is still growing!

Will it hurt?
Orthodontic treatment has improved dramatically. As a rule, braces make your teeth sore for a few days, but it is not painful. This annoyance can be relieved with an over-the-counter pain reliever. Today’s braces are smaller, more comfortable and use technology that reduces the discomfort. We use the latest in miniature braces and the highest quality of orthodontic materials in order to reduce discomfort and treatment time.

Can I still have braces if I have missing teeth ?
Yes. When teeth are missing, adjacent teeth will drift into the empty space. This will cause a functional, esthetic or periodontal problem. Orthodontic treatment will correct and prevent these problems from happening and will also provide proper alignment for your dentist to replace the missing teeth.

Questions About Treatment

What is Phase I (Interceptive Treatment) and Phase II treatment?
Phase I or Interceptive Treatment usually starts while the child has most of their baby teeth and a few of their permanent front incisors. This stage in development is usually about the age of seven. The goal of Phase I treatment is to intercept a moderate or severe orthodontic problem early in order to reduce or eliminate it. These problems include skeletal dysplasias, crossbites and crowding. Phase I treatment takes advantage of the early growth spurt and turns a difficult orthodontic problem into a more manageable one. This helps reduce the need for extractions or surgery and delivers better long term results and treatment options. Most Phase I patients require a Phase II treatment in order to achieve an ideal bite.

Phase II treatment usually occurs a number of years later. Usually we are waiting for 12-16 more permanent teeth to erupt before Phase II begins. This most commonly occurs at the age of 12 or 13. The goal of Phase II treatment is to achieve an ideal occlusion with all of the permanent teeth.

What is Full or Comprehensive Orthodontic Treatment?
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.

Does everyone need a Phase I treatment?
Absolutely not! Only certain bites require early intervention. All others can wait until most if not all their permanent teeth erupt.

Can I wait on Phase I/Interceptive Orthodontic Treatment until my child is older?
This is not recommended. If your child needs Phase I treatment this usually means that he has a difficult problem that requires attention now. If no orthodontic action is taken, treatment options become limited, more difficult, and the long term stability may be compromised. In addition, it may lead to extractions, oral surgery and increase costs.

What is the length or duration of orthodontic treatment?
Braces may be on between 6 months to 30 months, or longer depending on the age of the patient, the severity of the problem, the patient’s cooperation, and the degree of movement possible.

What are extraction and non-extraction therapy, and what are the advantages and disadvantages of each?
Extraction therapy is a technique where some teeth are removed to make room for the other teeth in your child’s mouth. This is in contrast to non-extraction therapy where one expands a patients’ jaw and shave down some teeth to make everything fit.

What are lingual braces?
Lingual braces are mounted behind a patient’s teeth. They were used many years ago, before the advent of orthocosmetic ™ braces. Lingual braces are rarely used anymore. Generally, lingual braces are more uncomfortable than standard braces. Orthodontic treatment takes twice as long and is more costly. In addition, some people have trouble talking with lingual braces. Presently, Lingual braces are only used in special clinical cases.

Will I pay extra for designer braces, colored ligatures and brackets or flavored rubber bands?
Yes, but your stress levels will drop when your child looks forward to their visit at our office! In addition, the cost for these braces is a minor fraction of the cost of orthodontic treatment. Considering the time spent, orthodontics is regarded as dentistry’s best value.

Is orthodontic care expensive?
When orthodontic treatment is implemented at the proper time, treatment is often less costly than the dental care required to treat the more serious problems that can develop years later.

Orthodontic fees have not increased as fast as many other consumer products. Financing is usually available and our office offers many payment programs that will meet your needs. In addition, many insurance plans now include orthodontics.

Questions About TMJ Disorder and Wisdom Teeth

Can orthodontic treatment help me with Temporomandibular Joint (TMJ) problems?
There are some associations with a bite that is not correct (malocclusion) and TMJ disorders. TMJ disorders are a family of problems related to your complex jaw joint. If you have had symptoms like pain or a “clicking” sound, you’ll be glad to know that these problems are more easily diagnosed and treated than they were in the past. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.

No one treatment can resolve TMJ disorders completely and treatment takes time to be effective. Drs. Graver, Marshall and Underwood can help you have a healthier and more comfortable jaw.

TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. Or, you may have a damaged jaw joint due to injury or disease. Whatever the cause, the results may include a misaligned bite, pain, clicking or grating noises when you open your mouth, or trouble opening your mouth wide.

Do You Have a TMJ Disorder?

Are you aware of grinding or clenching your teeth?
Do you wake up with sore, stiff muscles around your jaws?
Do you have frequent headaches or neck aches?
Does the pain get worse when you clench your teeth?
Does stress make your clenching and pain worse?
Does your jaw click, pop, grate, catch, or lock when you open your mouth?
Is it difficult or painful to open your mouth, eat or yawn?
Have you ever injured your neck, head or jaws?
Have you had problems (such as arthritis) with other joints?
Do you have teeth that no longer touch when you bite?
Do your teeth meet differently from time to time?
Is it hard to use your front teeth to bite or tear food?
Are your teeth sensitive, loose, broken or worn?
The more times you answered “yes,” the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they’re treated.

There are various treatment options that we can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, we will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care as well as professional care.

Do wisdom teeth affect crowding of teeth after braces have been removed?
Unfortunately, the answer is not entirely clear. There are data to support and refute the claims that wisdom teeth cause crowding after braces have been removed. For this reason, we recommend wearing retainers full time after removal of braces. The orthodontist will tell you when you can switch to nighttime only wearing. Each patient is different so the time interval to go to nighttime only depends on the individual case. Always follow exactly what the orthodontists have told you to do.

The average adult has thirty-two teeth by age eighteen: sixteen teeth on the top and sixteen teeth on the bottom. Each tooth in the mouth has a specific name and function. The teeth in the front of the mouth (incisors, canine and bicuspid teeth) are ideal for grasping and biting food into smaller pieces while the back teeth, or molar teeth, are used to grind food up into a consistency suitable for swallowing.

However, the average mouth is made to hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. These four other teeth are your Third Molars, also known as “wisdom teeth.”

Why Should I Remove My Wisdom Teeth?
Wisdom teeth are the last teeth to erupt within the mouth. When they align properly, and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen. The extraction of wisdom teeth is necessary when they are prevented from properly erupting within the mouth. They may grow sideways, partially emerge from the gum, and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to erupt successfully.

These poorly positioned impacted teeth can cause many problems. When they are partially erupted, the opening around the tooth allows bacteria to grow and will eventually cause an infection. The result: swelling, stiffness, pain and illness. The pressure from the erupting wisdom tooth may move other teeth and disrupt the orthodontic or natural alignment of teeth. The most serious problem occurs when tumors or cysts form around the impacted wisdom tooth, resulting in the destruction of the jawbone and healthy teeth. Removal of the offending impacted tooth or teeth usually resolves these problems. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.
Meet the Doctor

If you are experiencing serious dental problems and pain or you are just not happy with the way you look and you want your smile to be perfect – you are facing the fact that you are in the need of braces. It is easy to think about it and make a research on this topic, but making a decision to actually go for it – that is something different.
First step in making of the decision is to be honest to your self and to be clear with the reason why are you doing it? Do you have crocked and crowded teeth and/or misalignment jaw? Is it severe medical problem or appearance issue? This is important first of all because of the time limit. If it is medical problem you should deal with it as soon as possible and then money is your first priority. Traditional, metal braces are cheap one. Ceramic braces are slightly expensive but they have some advantage over metal braces. And if there is no pain and medical rush – you can wait and collect enough money to buy ceramic braces.

Second step is to think how long your treatment will last. How long you are going to have strange object in your mouth? You must take in account how braces will feel. It is much different if you are going to have mouth full of metal and wire for a year or you are going to use ceramic braces. Not just for look – it will feel different when you touch it with your tongue. Just remember last time you were at dentist office and you had some works on one of your teeth – did you touch it with your tongue constantly on your way back home? It is normal, we are all doing it. We have something different in our mouth and because we can not have mirror with us all the time and check what is going on, we are using our tongue to examine the changes. Ceramic braces will be friendlier to your tongue than the traditional one. Even with the ceramic braces it will happen in the beginning – you will cut your tongue and inside of your chic few times – but you will get used to it and the cuts will heal. With ceramic braces this happens lot less than with metal ones.
OK, third step – what will people say? How will you look with your braces? Well, ceramic one is barely visible. They are following the colour of your teeth as much as possible. There are no braces that will blend in with your teeth and mouth that much as ceramic braces will. So, if you care how will you look not just after braces but also during the time you are going to use them – think about ceramic one as potentially very good solution.

Ceramic Braces Making a Decision
There is just one more thing you should think about and that is maintenance of your braces. All types of braces require adequate cleaning and your orthodontist will probably provide you with set of toothbrush, floss, wax and all the stuff you need to use regularly. But also, if you have ceramic braces you will have to pay attention to the food and drinks you are taking. You should try to avoid hard food and hard spices, also coffee and red wine. Hard to chew food can harm your braces and spices such as carry can cause discoloration, and your braces can go yellow. Discoloration goes for coffee and red wine, too. It will all be explained to you by your orthodontist. It is not a big deal – you should just pay little bit more attention than usual.
Now, think about this entire one more time, count your money and good luck with your decision. Just remember one thing: no meter the teeth and the jaw – every smile is beautiful, because of what it represents – happiness!


Rubber Bands for Braces | Ceramic Braces
In correction of crocked and crowded teeth rubber bands for braces are playing important role. Those are small elastic pieces that are used to speed up process of correction of your teeth or jaw. Proper use of rubber bands can shorten period of using braces for one third of the time. It is different from case to case but one third of treatment can be up to a year. So, rubber bands for braces are very useful and important part of your treatment. At some moment of treatment your orthodontist will suggest you to start with the use of rubber band for braces. He/she will explain how it is put on and you will do it your self every day, probably few times in a day. You should wear those 24 hours a day if possible. Do, some people are using them only during night. The role of rubber bands is to use their force and move your teeth in right direction. Depends of what are you trying to achieve: retracts upper teeth, retracts lower teeth, close the space between your teeth, close open bite or line up the centre of the upper and lower front teeth – the position of elastic will be different. It is up to your orthodontist to decide how you are going to use them and for how long. You should try as much as possible to follow his/her instruction.

Problem that you may face when you start the use of rubber bands for braces is that some times it want be easy to place them right. There are some small devices that can help you with it, just ask your orthodontist. Also, it is not easy to eat while wearing elastics. They are very strong – which is good for correction of your teeth – but it makes chewing of food hard. And if you do not take them of while eating, they will lose their elasticity and they can easily snap. If it snaps while in your mouth it will be painful, so be careful with that. Some food can harm rubber bands and make them weaker, so they will lose their efficiency. That is why you should change them every day. That is how you will have constant pressure on your teeth to be corrected at the maximum speed. If it happens that on one side of your jaw elastics snaps and you don`t have with you reserve one, you should take off the one that is still standing on the other side of your jaw. That is recommended because pressure should be constant all the time at all your teeth – not to have the situation that your teeth are not corrected all at the same time.

Rubber Bands for Braces
Also, be careful with opening your mouth really wide – that can cause elastics to snap, too. All of these potential difficulties make some people using rubber bands for braces only during the night. It is much easier but the period of wearing it will be longer. How and when are you going to use rubber bands for braces is up to you, but for every decision that you make about it you should consult your orthodontist. If you follow his/hers instruction about the use of rubber bands for braces, your treatment will be shortened and your teeth and smile will be perfect in no time!
Ceramic or Metal Braces | Ceramic Braces
Faced with the fact that one must start with the dental treatment that includes braces, first question that comes to persons mind is: witch one to use, Ceramic or Metal Braces? There are many orthodontic braces on the market. Most common one is metal braces. People usually refer to them as traditional one. They are mostly used by kids. Also, very popular are ceramic braces. They are especially well accepted with the adults and young people because of the material they are made of. Ceramic braces are following the colour of patient`s teeth almost perfectly and that is making them pretty much unnoticeable. So, the period while you are actually using braces is not that stressful. It is also fact that patients are reporting ceramic braces as less painful and are easier to use.

Decision which one to choose should be based on the opinion of your dentist but it would be good if you should also consider next few very important details. For a start: how big is your problem? Is it serious medical problem or it is more question of your perfect smile? Then – how long your treatment will last? And finally – how much money you are willing to spend?
If we are speaking about medical impact, metal and ceramic braces are equally efficient. Both types of braces will correct your problem as much as it is possible, no meter your age. If your teeth are healthy they can be corrected. Then again, if you need some dentist surgery, you should consult your dentist is he/she is willing to make a procedure while you are using ceramic braces. Just try to collect enough information before making final decision.
Duration of treatment is going along with the question of your perfect smile. If you care about the appearance then it will be important for you how are you going to look during the treatment. In this case, again it is better to go for ceramic braces. With the white colour of ceramic and rubber bands, only one wire will be visible and there is even possibility to avoid this one wire too.

Ceramic or Metal Braces
Question of money is the one only you can give an answer to. In some cases metal one can be covered with the insurance but for the ceramic don`t count on it. Also ceramic cost more then a metal brace does. Check on few places, ask around. Find the best offer.
At the end it is difficult to say that ceramic are better than metal braces or vice versa. We can easily say that ceramic one look much, much better. So, if the look is important for you – it will be easy to make a decision. But then again, we can not forget the money issue and it is evident that ceramic braces are expensive than the metal one, take this into account, as well. But all in all, final decision should be made together with the professional: your dentist and orthodontist. So the question you need to decide is Ceramic or Metal Braces.

Ceramic Braces
In strictly medical point of view ceramic braces have the soul purpose to correct bite and appearance of person with crowded and crooked teeth and misaligned jaw. This kind of deformity can cause all sort of dental health problems – based on the fact that teeth in this state are very difficult to be cleaned properly. Also, misaligned jaw can cause a lot of pain. So, it is important to correct this condition even if person does not feel any acute problems. The only solutions to this problem are orthodontic braces.

There are several types of orthodontic braces but one thing they all have in common is that it is not easy to get used to feeling of a strange object in the mouth. It is not easy to look at yourself in the mirror and see reflection that you are not used to see – with all the metal and wires and it is not easy not to think about what other people will say when they see you with the braces.

Ceramic braces beside the medical impact on person`s health also have very subtle appearance. Segment of appearance is very important part of person`s dental treatment. This kind of braces are made of white ceramic with white rubber bands and they blend in with the colour of the person`s teeth perfectly. The feeling of ceramic braces in the mouth is much different than one metal braces are giving because of the material they are made of. Due to use of different material ceramic braces are much easier to use and they are much less noticeable then traditional one, yet they are effective in correction of teeth as much as metal ones.

Cleaning of ceramic braces is easy but requires some attention. Teeth should be cleaned after every meal and person should avoid food that can harm the braces, such as hard candies, nuts and similar hard to chew food. Also ceramic braces are suitable to change of colour especially with the persons who are drinking a lot of sodas, coffee, red wine and similar drinks. It would be helpful at least to use straw while taking this kind of drinks.

Ceramic Braces
Having in mind that ceramic braces are providing adequate treatment while not interfering with person`s look, and also acknowledging the fact that they are much easier to use – the price of it is higher than the price of usual metal braces. Making the decision which one to use person should have in mind that braces will be a part of their body and everyday life for some time.


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