Office Update - COVID-19

Leader in Technology

We are very proactive in evaluating new technology as it becomes available. As a clinical instructor at Albert Einstein Medical Center in Philadelphia since 1995, I am continually challenged by the residents to keep up with recent advances in orthodontics. Some of my favorite new technologies are listed below:

3-D Imaging

It is a very simple medical concept that better information leads to a more accurate diagnosis and better results. With this in mind, we have invested in the latest 3-D imaging that replaces the traditional 2-D X rays of the past. We now have a 3-D volume of our patient’s head that allows for an accurate evaluation of the teeth, jaws, airway and TMJ. Remarkably all of this additional information is created with no significant increase in radiation that was used to produce the old 2-D X rays. This technology is awesome!

Planmeca Imaging3-d image

iTero® Digital Impression System


Using the iTero® digital impression system, we can capture very precise 3-D digital images or impressions. No more gagging and discomfort. This innovative technology replaces the uncomfortable, unpleasant and messy traditional putty impressions that are similar to stuffing a big piece of gum in your mouth. Not only are traditional impressions unpleasant, they can sometimes be inaccurate and multiple impressions may be needed. With iTero, we get a more accurate impression from the start, which means you will receive optimum treatment results and have a more pleasant experience. Thanks to this technology, you can view your teeth in 3-D immediately. This helps to improve communication during your consultation and treatment.

How does it work?

We will use a radiation-free laser similar to a compact, hand-held wand to scan your teeth and gums. This equipment uses the latest in optical technology. Within 3-5 minutes the laser renders a precise 3-D impression. Once we begin scanning your teeth and gums, we can stop and start the process anytime. Using the digital software, we will be able to show you your treatment progress. iTero can be used for any type of orthodontic treatment, including the Invisalign® System.

Diode Laser Treatment

We utilize the Diode laser for many treatments, including:

Removing Extra Gum Tissue: Gum tissue acts as a “frame” for your teeth. Using orthodontic lasers like the Diode, we can safely and efficiently remove excess gum tissue to improve the function and appearance of your teeth, which enhances your overall smile. Best of all, in many cases, we don’t use needles. We simply place a topical anesthetic on the area of the gum tissue being treated so the procedure isn’t painful. All you will feel is the slight movement of the tip of the laser.

Assist in Bracket Placement: If your gums have not receded properly or a tooth is erupting slower than anticipated, we can use the Diode laser to remove excess tissue. This gives Dr. McDonough enough space to place a bracket precisely where it needs to be on the tooth. We can also do this procedure to place TADs, which are an alternative to the headgear appliance.

Help with Impacted Teeth: If a tooth hasn’t erupted properly, we can use the Diode Laser to help speed up the eruption process, which means we do not have to postpone treatment so the tooth can erupt on its own or refer you to an oral surgeon.

Aesthetic Gingival Recontouring: After your braces are removed, Dr. McDonough may recommend gingival recontouring. This treatment helps to maximize the aesthetics of your smile. During the procedure, Dr. McDonough will use the Diode laser to remove extra gum tissue around the upper teeth, which makes them appear longer. If the gum line is not even, gingival recontouring can reshape the gums so your smile will appear more symmetrical.

Frenectomy: The lingual frenulum connects the tongue to the base of the mouth. If it is too short, you may have ankyloglossia, also referred to as tongue-tied. Ankyloglossia can cause speech difficulty. Specifically, this condition can hinder your ability to make certain sounds, such as those made on the alveolar ridge (/t, d, n & l/) and those requiring careful placement of the tip of the tongue (/s, z, and r/). Dr. McDonough can treat this problem using the Diode laser.

The labial frenulum is between your upper front teeth. It is sometimes very large and responsible for a space between the teeth. A laser frenectomy in conjunction with orthodontic tooth movement can close the space.

Temporary Anchorage Device (TADs)

One of the many important advances in orthodontics has been the development of temporary anchorage devices or TADs. Made of bio-compatible titanium, TADs are miniscrew anchors utilized in some orthodontic cases. They are designed to help teeth move faster, more efficiently and with greater comfort. TADs can be used in conjunction with braces or as an alternative to the headgear appliance. TADs even make some tooth movement possible that was once considered impossible without them. Dr. McDonough was among the first orthodontists in the country to use TADs. It is now commonly taught in most orthodontic residency programs.

How are TADs placed?

Dr. McDonough will apply a topical anesthetic on your gum tissue and the jaw near the area where the TAD will be placed. After the area has numbed, Dr. McDonough will gently insert the TAD through the gum tissue and into the jawbone. The procedure is quick. You may feel a little pressure while Dr. McDonough is placing the TAD. Luckily, within a day you will not even be able to feel the TAD. The TAD will be removed once your treatment is complete or when Dr. McDonough decides that you no longer need it to help straighten your teeth. Removing the TAD is simple and comfortable and typically only takes a few minutes.

What can I do to relieve any discomfort?

You can take Tylenol if you feel any discomfort after your TAD is placed. Please contact our office immediately if the pain persists days after your procedure.

How do I keep my TAD clean?

Simply brush your teeth three times a day, just as you do to keep your braces clean. Dr. McDonough will also prescribe an antimicrobial rinse that you must use two times a day.