When should my child have an initial orthodontic examination?
The American Association of Orthodontists recommends an initial orthodontic screening by seven years of age. This is the time when the permanent incisors and molars are growing in and enough jaw growth has occurred to enable detection of common orthodontic problems. Treatment at this age often involves guidance of facial development and tooth eruption (dentofacial orthopedics). Once a problem is detected, the orthodontist can advise the optimum time to begin early intervention.

Why is "early treatment" recommended for some children and not for others?
Certain types of orthodontic problems are more effectively eliminated at an early age, while other types of problems are best treated after all of the baby teeth are lost. All patients present with different problems, so it's always best to have an early evaluation to assess the proper time to start treatment of the patient's unique condition. The goal of early intervention is to guide the growing jaws and erupting teeth into more favorable positions; therefore reducing the magnitude of the problem, or in some cases, completely eliminating the need for complex treatment in the teen years. Thus, if the orthodontic problem, stems from underlying skeletal imbalances, or if the permanent teeth that have erupted so far are in poor relationships, early treatment may be suggested. In actuality, the majority of orthodontic problems are best treated in the pre-teen to early teen years.

Common interceptive orthodontic procedures include:

• Expansion of the upper jaw to eliminate a crossbite
• Expansion of one or both jaws to create space for overly crowded teeth
• Early removal of specific baby teeth to facilitate the proper eruption of permanent teeth
• Maintaining space for permanent teeth after the premature loss of a baby tooth
• Reducing the protrusion of upper incisors to decrease the likelihood of fracture from trauma
• Treatment to eliminate thumb or finger sucking habits

When is an adult too old for braces?
Adults who have healthy teeth and supporting gum tissues are never too old for orthodontic treatment. Increasing numbers of adults are taking advantage of the lifelong benefits or orthodontics. These are people who've made the choice to spend the rest of their lives with an attractive, healthy smile and the confidence that it brings.

Why are retainers so important?
Retainers are used to maintain the teeth in their new positions while the fibers that hold the teeth to the bone adapt to the new positions of the teeth. It takes months and sometimes years for these gum fibers to re-adapt. That is why we recommend that all orthodontic patients continue retainer wear for an extended period of time. Your orthodontist will set up a schedule of retainer wear for you after your braces are removed. To maintain your teeth as they are the day that the braces are removed, you must faithfully wear your retainers as instructed.

What is the average cost of orthodontic treatment?
There really is no average cost, as treatment needs differ from patient to patient. In our office, we schedule a one hour appointment to obtain pertinent dental history, to complete a thorough orthodontic examination, and to discuss the options of treatment and the length of treatment. The cost of treatment depends on the complexity and length of the treatment indicated.

How does my orthodontic insurance work?
Once we receive information regarding your insurance company and your specific policy, we will submit the necessary insurance forms for your treatment. All insurance benefits will be sent directly to the subscriber. If after contacting your insurance company, you still have questions or problems regarding payments, we will help you obtain the needed information. Keep in mind that having dental insurance coverage does not automatically mean there is orthodontic coverage.

How often would I need to come for appointments?
Treatment intervals for patients undergoing conventional orthodontic treatment are usually 6-8 weeks apart, while retainer patients are often seen once per year.

Are appointments available after school or work?
We schedule as many appointments during the after school/work time as we can; however, longer appliance adjustment appointments must be scheduled during the day. It helps to familiarize yourself with upcoming "days off" from school or to know which classes are easier to miss so that appointments can be made during the day hours.

What happens if I must reschedule or miss an appointment?
Appointments are set up on a 6-8 week interval and a make-up appointment may not be available for some time. Thus, having to reschedule at the last minute can result in prolonging treatment. We are often asked if we can squeeze a patient in, but in many cases this is not possible, as unscheduled patients who are squeezed into the schedule will cause a backup resulting in regularly scheduled patients waiting 15-30 minutes for their appointment. It is our goal to respect each and every patient's time. Please help us keep this goal by keeping your scheduled appointments.

What can I expect if I arrive to my appointment late?
If you arrive over half way through your appointment, you will most likely be asked to reschedule. We understand that traffic and other issues may cause late arrivals, so we encourage you to come 5-10 minutes early for your appointment. By the time the patient checks in and brushes their teeth, they have used approximately 8-10 minutes of their appointment time. We want you to complete orthodontic treatment in a timely manner, and having to reschedule appointments delays treatment. Please give us a call if you think you might be late and we will try to maintain your appointment while still staying on schedule.

Do I need to see my general dentist while in orthodontic treatment?
Our practice is limited to orthodontics, so we must work hand in hand with your general dentist to maintain the optimum health of your teeth and gums. We encourage you to maintain regular 6 month check-ups and cleanings with your dentist. Adults who have a history of periodontal (gum) disease may also need to see a periodontist (gum specialist) on a regular basis throughout orthodontic treatment.

How important is patient cooperation during orthodontic treatment?
Successful orthodontic treatment is a "two-way street" requiring consistent, cooperative effort by both the orthodontist and patient. To successfully complete orthodontic treatment, the patient must carefully clean his or her teeth, keep appointments as scheduled and occasionally wear rubber bands, headgear, or other appliances as prescribed by the orthodontist. Damaged appliances and unhealthy gum tissue can lengthen the treatment time and may undesirably affect the outcome of treatment. The teeth and jaws can only move toward the desired position if the patient follows home care instructions as prescribed.

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