Frequently Asked Questions
Early Orthodontics
Orthodontic Terms & Questions
 

What is an Orthodontist?

An Orthodontist is a dentist who has completed specialized training to diagnosis and treat dental and facial irregularities in patients. An Orthodontist must apply, be accepted and graduate from an institution accredited by the American Dental Association. Throughout their training, the Orthodontist learns skills required to manage tooth movement (orthodontic) and guide facial development (orthopedics)

When does my child see an Orthodontist?

It is recommended by the American Association of Orthodontists that a child first see an Orthodontist by the age of 7 years old. You do not need to wait until all the permanent teeth are in before seeing an Orthodontist. Some children may have tooth alignment or jaw growth problems than can be detected at an early age. Some of these problems are best treated early, thereby avoiding a more serious problem later on, minimizing or even eliminating braces as a teenager.

What happens during an initial orthodontic examination?

The Orthodontist will evaluate your specific need by completing a full head, neck and dental examination. He or she will also evaluate your child’s facial growth, spacing between teeth, crowding extra or missing teeth. They also look for habits like thumb sucking or tongue thrusting which may hinder normal growth and development. These problems can change tooth alignment as well as alter facial appearances. Some bite problems are inherited and others are acquired.

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Who are the Orthodontists at your office?

DR. JAMES KANE

DR. JAMIE KANE 

DR. BALES-KOGAN

The orthodontic department is open Monday through Friday 8-5pm and two Saturdays a month. Each Orthodontist has a specific schedule for specific days.  If you choose to see a specific Orthodontist, our front desk receptionists will assist you in making these appointments with the specific Orthodontist. Both Orthodontist work together as a team and you are welcome to see any of them throughout your treatment.

Do you see adults?

Today, more than 30% of orthodontic patients are over 18 years old. The major difference between child and adult orthodontic treatment is that the adult bones are no longer growing. This means that it may take longer for adult teeth to move into their correct position. In general, adult treatment takes between 18 and 30 months.

What are the benefits of having orthodontic treatment?

To create a healthy beautiful smile

Reduced appearance self-consciousness during the critical growth years

Better tooth and jaw functions to achieve a proper bite

Increased self-esteem and confidence

Reduce or eliminate the need to extract permanent teeth

Reduce or eliminate the need for future jaw surgery

Reduce the risk of injury to protruded front teeth

Improved speech and swallowing

Controlling dental habits (thumb sucking or tongue thrusting)

Prevent premature loss of teeth
 

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What is my next step after the Orthodontist says braces are needed?

An Orthodontist will recommend a set of orthodontic records to complete a formal treatment plan. Orthodontic records consist of a panoramic radiograph (jaw x-ray that shows all the teeth on one film), cephalometric radiograph (side x-ray of the jaws), diagnostic casts (plaster models of both the upper and lower teeth) and digital photographs (pictures inside the mouth and pictures of the face and jaws)

After records are completed you will return for a Final Consultation. The orthodontic treatment coordinator will review the treatment plan with you that were proposed by the Orthodontist.

This is a great opportunity to ask all of your questions, but remember this is not your only opportunity to ask questions. We encourage everyone to ask question throughout treatment.

What is Phase I Treatment?

As mentioned before, orthodontic treatment can be started on certain types of tooth problems before all permanent teeth have erupted. Early treatment usually begins after the four permanent upper and lower teeth have erupted (between ages 7-9) and is recommended for several bite issues. These issues may include crossbites, excess spacing, crowding, open bites, deep bites, excessive overjet and underbites.

The advantages of early treatment include: 

• moving the front teeth back so they will be less susceptible to injury

• improving the relationship of upper and lower jaws, allowing more future

• growth and development

• taking maximum advantage of growth for successful treatment
  improving facial appearance and self esteem

• taking advantage of the good cooperation of patients  this age

• possibly avoiding or reducing the need for further treatment when patient is older

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Do you have any payment plans for braces?

OFFICE PAYMENT PLAN
An initial estimated payment of 33 % is due the day treatment begins. The balance will roll into a financial plan consisting of monthly installments. This is an interest-free payment plan.

PAYMENT IN FULL
5% bookkeeping courtesy is given for cash or check payment paid in full the day treatment begins.
A 2.5% bookkeeping courtesy is given for a credit card payment paid in full the day treatment begins.

PAYMENT PLAN
Consumer Payment Solutions (CPS) offers flexible payment plans that can fit in any budget allowing patients the opportunity to receive treatment now while paying overtime for their care. CPS is designed specifically for dental patients and offers great benefits such as:

• No initial payment

• Low, fixed rates starting at 5.99% APR

• Low monthly payments with terms up to 60 months

• No prepayment penalty

• Potential tax savings

• Fast and easy application process with quick decisions

• Click on the CPS logo below to begin the easy and secure application process.

CREDIT CARDS - Credit cards accepted: 
MasterCard
Visa
Discover
American Express

FLEX PLANS
Companies may offer a medical spending account, which allows their employees to set aside pre-tax dollars to pay for future dental expenses. Please contact your employer for more details.

INSURANCE
Our office will be happy to assist you in determining if you have orthodontic coverage. In addition, as a courtesy to you, we will file your orthodontic claims. Please feel free to contact our office with questions on any of the options at (508) 653-2417.

Separators are doughnut shaped elastics or small springs that are placed in between the back (molar) teeth. They create space between the teeth for attaching the bands. The separators stay in for a couple of days. On the day that braces are placed, the separators are removed.

If a separator falls out, do not worry. We ask that you arrive 30 minutes before you appointment on the day we place your braces, and we will replace any missing separators.

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What style of braces can I choose from?

There are several types and styles of braces. The most common style of braces is the metal “stainless steel” style. They are small braces that allow you to choose colored elastics to hold the wire on to the braces. Most teenagers like the versatility of “changing their colors” for seasons, favorite colors, sport teams.

We also offer clear “Ceramic Braces”. This brace is less noticeable but bigger and bulkier than the stainless steel style. The ceramic braces can slightly increase the time you wear your braces

The invisible way to straighten your teeth, without braces.  Invisalign® can give you the beautiful straight teeth you've always wanted.  It works through a series of invisible, removable, and comfortable aligners that no one can tell you're wearing. So you can smile more during treatment as well as after. Invisalign® has been proven effective in clinical research and in dental and orthodontic practices nationwide. 

How Does Invisalign® Work?

• You wear each set of aligners for about 2 weeks, removing them only to eat, drink, brush, and floss.

• As you replace each aligner with the next in the series, your teeth will move - little by little, week by week - until they have straightened to the final position your Orthodontist or dentist has prescribed.

• You'll visit us about once every 6 weeks to ensure that your treatment is progressing as planned.

• Total treatment time averages 9-15 months and the average number of aligners worn during treatment is between 18 and 30, but both will vary from case to case.

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What should I expect when the braces are placed?

Placement of the braces takes approximately 1 ½ to 2 hours in the morning only.

Initially, the braces just feel different. After a couple of hours, the teeth may feel achy and sore.  Patients usually manage this discomfort well with whatever pain medication you might commonly take for a headache. The lips, cheek and tongue may also become slightly irritated during the first week as they become accustomed to the braces.

What foods should I avoid while wearing braces?

Eating proper foods, minimizing sugar intake and proper oral hygiene are essential during orthodontic treatment. Braces are precise appliances that can be damaged by eating hard or sticky foods. Some of the hard foods to be avoided are as follows:
 

What can I do to stay on track with my orthodontic treatment?

Successful orthodontic treatment requires cooperation between the patient and the orthodontic. This “Team” will work together to complete the goal established at the beginning of treatment. The patient’s responsibility includes taking care of his or her teeth, wear rubber bands, retainers, headgear or other appliances as recommended by the Orthodontist.

Broken appliances can increase the length of treatment time and may affect the outcome of the orthodontic case.

Early Orthodontic Treatment 
 'Two Phase Planning'
Phase 1   |   Phase 2   |   Early Treatment is Important to Consider
 

Phase Two - Braces - Ages 12 to 14

Early Treatment is Important to Consider!

Cooperation - Younger children between the ages of 8 and 11 are often much more cooperative than children of ages 12 to 14.

Shorter Treatment Time - Another advantage of early Phase One treatment is that children will need to wear fixed braces on their adult teeth for less time.

To Correct Underdeveloped or Overdeveloped Jaws - Almost 55% of children who need orthodontic treatment due to a bad bite have underdeveloped or overdeveloped upper or lower jaws. Functional appliances and/or limited braces can reposition the jaws, improving the child's profile and correcting the bite problem - within 7 to 9 months!

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Orthodontic Terms and Questions

What Causes Crooked Teeth  /  Lower Lingual Arch (LLA)  /  Malocclusion
Occlusion  /  Palatal Widening Appliance  /  Retainers

Crowded teeth, thumb sucking, tongue thrusting, premature loss of baby teeth, a poor breathing airway caused by enlarged adenoids or tonsils can all contribute to poor tooth positioning. And then there are the hereditary factors. Extra teeth, large teeth, missing teeth, wide spacing, small jaws - all can be causes of crowded teeth.
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A lower lingual arch is a space maintainer for the lower teeth. It maintains the molars where they are, it does not move them. This is fabricated by placing bands on the molars and connecting them to a wire that fits up against the inside of the lower teeth. It keeps the molars from migrating forward and prevents them from blocking off the space of teeth that develop later. This is used when you have the early loss of baby teeth or when you have lower teeth that are slightly crowded in a growing child and you do not want to remove any permanent teeth to correct the crowding.
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Poor positioning of the teeth.

Types of Malocclusion:

Class I A Malocclusion where the bite is OK (the top teeth line up with the bottom teeth) but the teeth are crooked, crowded or turned.	Class II A Malocclusion where the upper teeth stick out past the lower teeth.	Class III A Malocclusion where the lower teeth stick out past the upper teeth. This is also called an "underbite".

The alignment and spacing of your upper and lower teeth when you bite down.

Types of Occlusion:

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An appliance which is placed in the roof of the mouth to widen the upper dental arch. The maxilla, or upper dental arch, is joined in the center by a joint, which allows it to be painlessly separated and spread. Temporarily you may see a space develop between the upper two front teeth. This will slowly go away in a few days. Once this has occurred, the two halves knit back together and new bone fills in the space.

Care of appliance: Brush as usual. Brush the appliance and roof of the mouth thoroughly. Rinse often to clean any food lodged between the arch and appliance.
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At the completion of the active phase of orthodontic treatment, braces are removed and removable appliances called retainers are placed. To retain means to hold. Teeth must be retained or held in their new positions while the tissues, meaning the bone, elastic membranes around the roots, the gums, tongue and lips have adapted themselves to the new tooth positions. Teeth can move if they are not retained. It is extremely important to wear your retainers as directed!
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