Orthodontics

First Appointments

At your first appointment, a complete examination will be performed by our Doctor, digital x-rays may be taken if indicated, and an overview of any necessary treatment will be given. A complete diagnosis and treatment plan will be provided once diagnostic records have been taken. The appointment may take up to one hour in length. The cost of treatment and financial arrangements will be presented at the first appointment.

Subsequent appointments vary in length depending upon the treatment procedures being provided for the patient. For example, a banding appointment might require one hour but a minor adjustment may take 10 to 15 minutes.

Two-Phase Treatment

The goal of First Phase Treatment is to develop the arch forms of the upper and lower jaws so that they match one another, as well as to guide the eruption of the permanent teeth and to maintain or create the space necessary for their eruption. Not all children require First Phase Treatment, however children over the age of seven are candidates for early orthodontic treatment since growth can be a valuable tool in assisting with jaw development. A variety of fixed or removable appliances are available to our Doctor in helping with early intervention.

After first phase treatment has been completed a retainer is usually placed to maintain the First Phase correction. Once all of the permanent teeth have erupted, Second Phase Treatment can be started. This requires the placement of braces where each tooth is aligned in harmony with the lips and tongue to create a beautiful smile and achieve facial balance.

Retaining Straight Teeth

• What is my responsibility in keeping my teeth straight?

  Once your braces have been removed and you have beautiful, well aligned teeth, you will need to wear retainers to keep them that way. At first, you will be asked to wear your retainers all the time, except when eating and brushing your teeth. After one year, when your teeth have had adequate time to stabilize, your will be instructed to wear your retainers at night only.

  If you do not wear your retainers as instructed your teeth will move. Rotations and tipping of the teeth may occur and spaces may open between the teeth.

• How long will I wear retainers?

  Retention is a lifetime commitment. As previous stated, after one year retainer wear will be decreased to night only but it will be your responsibility to continue to wear your retainers indefinitely to maintain the alignment of the teeth.

• What causes the teeth to shift after the braces have been removed?

  As a general rule, teeth naturally shift as we age. Very few people have naturally straight teeth. A variety of forces act throughout life to cause the teeth to change position. This includes natural wearing of the teeth from chewing, placement of fillings and crowns, gum disease, removal of teeth and changes in the bones and muscles of the face with age. Although the shifting is usually very slight and gradual, if the front teeth are involved you may not be happy with your appearance.

• What should you do if your retainers become lost, broken, or do not fit?

  Please call our office immediately to avoid any shifting of the teeth. If the retainer is bent or broken, a new retainer must be made to maintain the alignment of the teeth. There is a charge for this service. If you wait, your straight teeth may shift to the point where a retainer will not straighten them. If this occurs, retreatment involving the placement of braces will be necessary to realign the teeth.

• What about future appointments?

  You will be contacted periodically by our office to check and adjust your retainers. These appointments are necessary to ensure that your retainers are fitting properly and comfortably. We will check the alignment of your teeth and your bite and, with your permission, take any necessary x-rays to check the development of your wisdom teeth, if they are present. There will be charges for any necessary x-rays and your checkup appointments.

  If we cannot reach you or you do not hear from us periodically, please contact our office. If you have a change of address or telephone number, please let us know.

  Thank you for your cooperation and enjoy your beautiful smile!

Tongue Thrust

• What is tongue thrusting?

  Tongue thrusting is the habit of placing or “thrusting” the tongue against the teeth or between the upper and lower front teeth when swallowing. It is an infantile swallowing pattern that has been retained by an individual.

  We swallow between 1,200 to 2,000 times per day. The average force exerted by the tongue against the teeth when swallowing is four pounds. It is this constant pressure exerted by the tongue that forces the teeth out of alignment in a child with a tongue thrust problem.

• What causes tongue thrust?
  1. Thumbsucking
  2. Allergies, nasal congestion or obstructions leading to mouth breathing
  3. An abnormally large tongue
  4. Large tonsils, adenoids, or frequent sore throats which cause difficulty in swallowing
  5. Hereditary factors within the family, such as a steep jaw line
  6. Neurological, muscular, or other physiological abnormalities
  7. Short lingual frenum (tongue tied)
• What are the consequences?

  The force of the tongue against the teeth is an important factor in contributing to malocclusions (bad bites). This is manifested by anterior or lateral open bites where the teeth do not meet properly. Many well-treated orthodontic cases have suffered relapse because of the patient’s tongue thrust swallowing pattern. If the tongue is allowed to continue pushing against the teeth, it will tip the teeth forward and alter the orthodontic treatment result.

• Who diagnoses tongue thrust?

  The most difficult problem of all is correctly diagnosing tongue thrust. In many cases, the tongue thrust may not be detected until the child is under orthodontic care.

  Diagnosis is usually made when the child exhibits a dental or speech problem that needs correction.

• How is a tongue thrust corrected?

  Generally a tongue thrust swallowing pattern is handled in one of two ways:

  1. An appliance is placed by the orthodontist to control the tongue thrust
  2. Correction by oral habit training. This method involves working with a trained speech therapist to retrain the muscles associated with swallowing by changing the swallowing pattern.

  With sincere commitment and cooperation of the child, correction is possible in the majority of cases. At the present time, successful correction of tongue thrust is as follows:

  1. 70% of the treated cases are successful
  2. 25% of the treated cases are unsuccessful due to poor cooperation or lack of commitment on the part of the parent or child
  3. 5% of the treated cases are unsuccessful due to factors that make correction impossible

Technology

Our Doctor and our staff provide the latest in orthodontic and computer technology such as:

• Digital radiography: Digital x-rays are provided free-of-charge at the initial examination, if necessary, to assist in assessing the needs of the patient. In addition, digital x-rays are taken as part of the comprehensive records needed to accurately diagnose and plan necessary treatment.
• Digital photography with state-of-the-art imaging is used to assist our Doctor in the diagnosing and treatment planning of cases.
• The latest in orthodontic bracket design: The new self-ligating bracket with “super sliding” technology is offered in our practice. This bracket is designed with a gate that secures the wire into the bracket making traditional “tightening” of the braces obsolete. As a result, teeth can be moved with lighter forces. This means greater patient comfort and longer intervals in between appointments. These brackets are offered in both stainless steel and ceramic (clear) designs.
• Wilckodontics - ACCELLERATED OSTEOGENIC ORTHODONTICS: This is a technique for fast braces for active adults. It can shorten treatment times by 75%.

Sterilization

Our office uses state-of-the-art sterilization procedures that meet or exceed all OSHA and Texas state law requirements. Our sterilization equipment is monitored weekly by an independent laboratory to ensure that it is functioning properly. When treating patients, gloves and protective eyewear are always worn. Masks are worn when indicated.

Emergencies

If a bracket or band comes loose or you or your child is experiencing discomfort due to appliance breakage or a loose or long wire please call our office immediately. Our Doctor or a staff member will be able to determine if something needs to be replaced immediately. Often, instructions can be handled over the phone to alleviate the problem. If there is an “after-hours” emergency please telephone our office and listen to the prerecorded message for instructions.

Changing or canceling an appointment is not an emergency. A message can be left on the answering machine. You will be contacted the next office day to assist you in making a new appointment.