What is orthodontics?
Orthodontics is the specialty branch of dentistry that addresses the diagnosis, prevention and treatment of dental and facial irregularities (crooked, crowded and spaced teeth; overbites, under-bites, and jaw discrepancies). Braces are one of many methods used to make these corrections.
What is an orthodontist?
An orthodontist is a dental specialist whose work are the diagnosis, prevention and treatment of dental and facial irregularities. An orthodontist has at least 6 years of post-graduate training. Orthodontists must graduate from college and then complete a four-year dental graduate program accredited by the American Dental Association (ADA). Then, they must successfully complete a two to three-year residency program of advanced education in orthodontics.
Only dentists who have successfully completed this advanced specialty education may call themselves orthodontists. All orthodontists are dentists, but only about 6 percent of dentists are orthodontists.
When is the best age to schedule an initial consultation?
Both children and adults can benefit from orthodontics, because healthy teeth can be moved at almost any age. The American Association of Orthodontists (AAO) recommends that all children have an orthodontic screening by age seven. 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 their adult teeth, only to find out later that treatment would have been much easier if started earlier. Early treatment can accomplish beneficial tooth and/or jaw movement that may be much more difficult or nearly impossible at later times, especially if the patient has completed growing. We pride ourselves in starting treatment at the right time for our patients. We strongly believe in working smarter and not harder and putting on braces too soon may only create a longer treatment time.
What causes orthodontic problems?
Just as we inherit eye color from our parents, mouth and jaw features are also inherited. Often the size of the teeth does not match the size of the jaws and this can cause crooked teeth. Other causes include finger sucking, high cavity rate, gum disease, trauma, early loss of baby teeth and jaw growth discrepancies.
What are the most commonly treated orthodontic problems?
Crowding: Teeth may be crowded because the jaws and the teeth are not in proportion to each other. Crowding can cause the following problems:
- Impacted teeth (teeth that should have come in, but have not)
- Poor biting relationships
- The bone and gums over the roots of extremely crowded teeth may become thin and recede (in cases of severe crowding)
- Undesirable appearance
Protruding upper teeth ("Buck Teeth"): Upper front teeth that protrude beyond "normal contact" with the lower front teeth often indicate unevenness in jaw growth. Usually, protruded upper front teeth are associated with a lower jaw that is short in proportion to the upper jaw. Thumb and finger sucking habits can also cause Buck teeth. These teeth tend to be more prone to injury.
Deep overbite: A deep overbite occurs when the lower front teeth bite too close or into the gum tissue behind the upper front teeth. When the lower front teeth bite into the gum tissue behind the upper front teeth, significant bone damage and discomfort can occur. A deep overbite can also contribute to excessive wear of the lower front teeth.
Open bite: An open bite results when the upper and lower front teeth do not touch when biting down. This open space between the upper and lower front teeth causes all the chewing pressure to be placed on the back teeth. This excessive pressure makes chewing less efficient and may contribute to significant tooth wear.
Crossbite: The most common type of a crossbite is when the upper teeth bite inside the lower teeth. Crossbites can occur in either the front or back teeth. It is best to correct crossbites early since they are usually associated with biting and chewing difficulties.
Under-bite: About 3 to 5 percent of the population have a lower jaw that is long in proportion to the upper jaw. This can cause the lower teeth to stick out in front of the upper teeth creating an under-bite. An orthodontist should evaluate this condition as soon as it is detected because careful monitoring of jaw growth and tooth development is vital in the treatment of these problems.
Why is orthodontic treatment important?
Poorly arranged teeth can wear unevenly and can 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. Finally, poorly arranged teeth detract from your smile, which is one of the most important features of your face. Orthodontic treatment can help correct all of these problems and give you a healthy and attractive smile.
When left untreated, many orthodontic problems often become worse. Treatment by a specialist to correct the original problem is often less costly than the additional dental care required to treat more serious problems (crowns, bridges, restorations, gum disease) that can develop in later years.
Why should I 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 has advanced training at moving teeth and helping jaws develop properly, and will work with you to make sure the teeth stay in their new positions.
Is orthodontic care expensive?
Orthodontic fees have not increased as fast as many other consumer products and services. Since the 1970's, the national cost for a year of college has quadrupled, while the cost of a new car is 7.5 times what it was 20 years ago. Orthodontic costs are about two times higher than two decades ago.
The actual cost of treatment depends on several factors, including the severity of the original problem and the treatment approach selected.
Our office offers a number of convenient payment plans. The cost of treatment can be stretched out over the time of treatment. In our office, you will be able to thoroughly discuss fees and payment plans before any treatment begins. In addition, many insurance plans now include orthodontic benefits. 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 which may include crown and bridge, restorations, gum disease.
How long will I have to wear braces?
In general, active treatment time ranges from 12 months to 30 months. The actual time depends on your cooperation, the growth of the jaws and the type of orthodontic problem you or your child starts with. The more conscientious you are about taking care of your braces (which includes brushing well), the sooner your teeth will improve.
What are orthodontic records?
Orthodontic records are made to document the original problem and to help plan for the best course of treatment. Complete orthodontic records include a medical/dental history, clinical examination, plaster study models of the teeth, photographs of the face and teeth, a panoramic and cephalometric X-ray of the teeth and jaws. From the necessary records a custom treatment plan is created for each patient.
How is treatment accomplished?
Depending upon you or your child's orthodontic problems, braces, custom-made appliances (including retainers) or some combination of both may be used to treat the malocclusion. Braces may be made of metal, ceramic or a composite material. The appliances may be removable or fixed (cemented and/or bonded to the teeth). Dr. McDonough individually plans everyone's treatment and he designs each custom-made appliance.
Are there less noticeable braces?
Today's braces are generally less noticeable than those of the past, when a metal band with a bracket (the part of the braces that holds the wire) was placed around each tooth. Now the front teeth typically have only the brace bonded directly to the tooth, minimizing the "tin grin". Braces can be metal, clear or colored, depending on the patient's preference.
Modern wires are also less noticeable than earlier ones. Some of today's wires are made of "space age" materials like nickel titanium that exert a steady gentle pressure on the teeth, so that the tooth-moving process may be faster and more comfortable for patients.
How do braces feel?
Most people have some discomfort after their braces are first put on or when adjusted during treatment. After the braces are on, teeth may become sore and may be tender to biting pressures for three to five days. Patients can usually reduce their discomfort by taking whatever pain medication they might commonly take for a headache and by eating a softer diet. The lips, cheeks and tongue may also become irritated for one to two weeks as they become accustomed to the surface of the braces. Overall, orthodontic discomfort is short-lived and easily managed.
Do teeth with braces need special care?
Dr. McDonough and his staff teach patients how to best care for their teeth gums and braces during treatment. They instruct patients (and/or their parents) how often to brush, floss, and if necessary they will suggest other cleaning aids that will help the patient maintain good dental health.
People undergoing orthodontic treatment need to avoid hard and sticky food and must not chew on pens, pencils or fingernails because this can damage braces. Damaged braces usually cause treatment to take longer. It is especially important for teeth to be kept clean to prevent tooth decay and gum disease while undergoing orthodontic treatment.
Do I still see my dentist when I have braces?
Yes! You should be evaluated by your dentist prior to orthodontic treatment to have cavities filled and a cleaning. When you are wearing braces, you will need a check-up and a cleaning every 3 - 6 months.
How important is patient cooperation?
Successful orthodontic treatment is a "two-way street". It requires teamwork between Dr. McDonough and the patient. Cooperation is key. To successfully complete treatment, the patient must carefully clean his or her teeth, wear rubber bands, headgear or other appliances as prescribed by the Dr. McDonough and keep their scheduled appointments. Patients who do their part consistently make themselves look good and usually complete treatment in a more timely fashion.
Will orthodontics change my lifestyle?
Not to a great extent. You only need to make a few changes to your diet and brushing habits. You'll have to give up extremely hard and sticky foods. These include chewing gum, taffies, caramel, peanuts, pretzels, etc. These foods can get caught on the braces and pull them off or can pop braces off the teeth. We provide our patients with a comprehensive food list. Brushing is even more important when you are wearing your braces. You need to spend a few extra minutes cleaning your braces after meals and sugary snacks.
For the most part, you'll find braces don't alter your lifestyle. You'll still have fun. You'll 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 colored rubber bands to your braces. Before you know it treatment will be completed and your smile will be bright and beautiful.
Do I need a referral from my 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 our patients are one of the ways we meet new patients. 
