Orthodontists are specialists who receive 3 years of specialty training in orthodontics after 4 years of dental school. This additional 3 years of education gives an orthodontist the experience necessary to effectively diagnose and treat issues with the alignment of teeth, bite, and jaws in children, adolescents, and adults with braces, Invisalign, and auxiliary appliances such as expanders. Although dentists can treat patients with braces or Invisalign if they so choose, an orthodontist is a specialist with the largest amount of expertise in the field.
The American Association of Orthodontics recommends that all children see an orthodontist at age 7. Although this may seem early, at this age a child’s mouth is changing immensely and many issues can arise during the eruption of adult teeth. For example, adult teeth can get stuck (impactions) or bump into other adult teeth, in the worst cases causing irreparable damage to adult teeth. In addition, issues with the child’s bite can leave teeth susceptible to fracturing or can negatively affect the growth of the jaws.
Phase I, otherwise known as early treatment or interceptive treatment, is orthodontic treatment recommended for children of approximately 7-10 years of age. Although the majority of children do not require treatment at this age, select issues with the teeth, bite, or jaws may require treatment in order to fix serious issues before they worsen or to improve the teeth, bite, or jaws to encourage normal growth and make later orthodontic treatment easier. Although differences in opinion exist, the conditions that are recommended for Phase I treatment include: issues with the eruption of permanent teeth (impactions, especially the upper canines), crossbites of the front or back teeth, severe crowding, severely protrusive front teeth leading to risk of fracture during falling, or space maintenance when baby teeth were lost too early.
Not all children require expanders but they may be necessary in certain cases when the upper jaw is too narrow, when the child has a crossbite (upper back teeth tipped inside the bottom back teeth), or when excessive crowding exists and there is no space for the erupting permanent teeth. Although many times it is favorable to use an expander at a younger age during Phase I treatment because the upper jaw is easily expanded at this age (ages 7-10), expanders are also routinely used prior to Phase II treatment (full braces) when the child is approximately 12 years of age.
When a child receives Phase I treatment at approximately age 7-10, select severe issues are addressed to avoid damage to the erupting permanent teeth and to limit the exacerbation of existing issues. During the following years, the remaining permanent teeth erupt and new issues with the teeth, bite, or jaws usually arise due to the large amount of change occurring in the child’s mouth. At approximately the age of 12, all of the child’s permanent teeth are usually erupted and a full assessment of the teeth, bite, and jaws can be made by the orthodontist.
To become an Invisalign Certified Provider, all that is required is a 1 day crash course that instructs an orthodontist or dentist how to use Clincheck, Invisalign’s software that is used to plan orthodontic treatment. Unfortunately, this means that many providers offering Invisalign treatment are not especially experienced in treating patients orthodontically with Invisalign. To ensure that you or your child receive the highest level of treatment possible, selecting an orthodontist with a large amount of Invisalign experience is your best choice. Each Invisalign treatment plan is meticulously planned out by a treating orthodontist, which usually amounts to at least 1-2 hours of time per patient. Although low-cost do-it-yourself services such as Smile Direct Club state that a dentist or orthodontist is planning your treatment, the patient knows nothing about the provider’s experience with the system or what amount of time is spent treatment planning their case.
Although certain severe issues with the teeth or bite may make Invisalign treatment extremely difficult, the vast majority of patients are capable of being treated with Invisalign. Similar to braces, Invisalign is a tool that places small amounts of pressure selectively on teeth to move them into a better position. However, the major difference between Invisalign and braces is that exceptional compliance with wearing the Invisalign trays is necessary and, if the patient does not wear the trays for a minimum of 18-20 hours per day, the teeth will not move effectively.
The unfortunate truth is that, despite the orthodontist’s best efforts, teeth always want to move back to their original position in the mouth. For children, adolescents, and adults, retainers are absolutely necessary after treatment is complete and failure to wear them as prescribed will result in relapse of their orthodontic issues. For young children undergoing Phase I treatment at ages 7-10 years old, a metal retainer is usually used and is recommended to be worn until the child’s remaining permanent teeth erupt (usually around ages 11-12) and the retainer no longer fits. For adolescents and adults, retainers should be used indefinitely, as there is no time when the teeth will be stable enough to avoid relapse without the use of a retainer.
Although a thorough exam can help diagnose orthodontic issues, a panoramic x-ray is necessary to visualize the health of the entire mouth, check if there are any pathologies, and, for children, to assess if all permanent teeth are erupting normally. If not taken, various issues can be missed, possibly leading to more serious conditions later in time. The radiation exposure is minor and is well worth the increased diagnostic information.
Frequently Asked Questions
According to the American Academy of Pediatric Dentistry (AAPD), your child should visit the dentist by his/her 1st birthday. The first visit allows the dentist to educate parents about their child’s oral health and also to evaluate the child for early dental issues.
You can make the first visit to the dentist enjoyable and positive. Your child should be informed of the visit and told that the dentist and their staff will explain all procedures and answer any questions. It is best if you refrain from using words around your child that might cause unnecessary fear, such as “don’t be scared”, needle, pull, drill or hurt. We let them see the office, ride up and down in the dental chair, and give them a prize so they go home with a happy memory. Once they become used to coming in and feel comfortable with us, they can be treated without fear.
We provide a 24 hour emergency service that connects directly to the dentist, so help is always available. Call us at 732-269-8555.
If you would like to whiten your teeth quickly, we offer an in-office professional teeth whitening system that provides amazing results during your office visit. For those patients who would like to whiten their teeth at home, we offer a professional-quality home bleaching system with custom bleaching trays that is superior and less irritating than bleaching systems you might find at the grocery store.
This is of primary importance to us. We adhere to the strictest standards of sterilization and infection control procedures. You’ll find our operating environment to be spotless and uncluttered. We are eager to answer any questions or concerns and we would love to show you our facilities with a tour of the office on your initial visit.
Yes, bleeding is usually an early sign of gum disease. Make an appointment as soon as possible to have your gums and teeth examined.
Buy toothbrushes with soft bristles. Medium and firm ones can damage teeth and gums. Use soft pressure, for 2 minutes, two times a day.
Both powered and manual toothbrushes clean teeth well. Manual brushes with mixed bristle heights or angled bristles clean better than those with all flat, even bristles. Powered toothbrushes may be easier if you have trouble using your hands.
Set a reminder to replace your toothbrush every 3-4 months. Toss it sooner if the bristles look bent or splayed out. Bent bristles don’t clean as well. (They’re also a sign you may be brushing too hard.)
Most toothpastes will clear away bacteria growth and acids from food and drinks. Toothpastes with the American Dental Association (ADA) Seal of Acceptance always have fluoride, which strengthens and protects teeth. If you want a non-fluoride option, stores carry toothpastes and powders made with natural ingredients that don’t have ADA testing and approval.
If cold or hot food or drinks make you cringe, pick a toothpaste for sensitive teeth and let your dentist know.
Morning time – Saliva flow almost stops during sleep and its reduced cleansing action allows bacteria to grow, causing bad breath.
Certain foods – Garlic, onions, etc. Foods containing odor-causing compounds enter the blood stream; they are transferred to the lungs, where they are exhaled.
Poor oral hygiene habits – Food particles remaining in the mouth promote bacterial growth.
Periodontal (gum) disease – Colonies of bacteria and food debris residing under inflamed gums.
Dental cavities and improperly fitted dental appliances – May also contribute to bad breath.
Dry mouth (Xerostomia) – May be caused by certain medications, salivary gland problems, or continuous mouth breathing.
Tobacco products – Dry the mouth, causing bad breath.
Dieting – Certain chemicals called ketones are released in the breath as the body burns fat.
Dehydration, hunger, and missed meals – Drinking water and chewing food increases saliva flow and washes bacteria away.
Certain medical conditions and illnesses – Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath.
Practice good oral hygiene – Brush at least twice a day with an ADA approved fluoride toothpaste and toothbrush. Floss daily to remove food debris and plaque from in between the teeth and under the gumline. Brush or use a tongue scraper to clean the tongue and reach the back areas. Replace your toothbrush every 2 to 3 months. If you wear dentures or removable bridges, clean them thoroughly and place them back in your mouth in the morning.
See your dentist regularly – Get a check-up and cleaning at least twice a year. If you have or have had periodontal disease, your dentist will recommend more frequent visits.
Stop smoking/chewing tobacco – Ask your dentist what they recommend to help break the habit.
Drink water frequently – Water will help keep your mouth moist and wash away bacteria.
Use mouthwash/rinses – Some over-the-counter products only provide a temporary solution to mask unpleasant mouth odor. Ask your dentist about antiseptic rinses that not only alleviate bad breath, but also kill the germs that cause the problem.
In most cases, your dentist can treat the cause of bad breath. If it is determined that your mouth is healthy, but bad breath is persistent, your dentist may refer you to your physician to determine the cause of the odor and an appropriate treatment plan.
We accept all insurance plans in which patients can choose their dentist (not HMOs). If you are not sure what kind of dental plan you have, please feel free to call our office, and we will be happy to verify your insurance for you.