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Richard Gobbie DMD, MDS
George Deme DMD, MDS

Orthodontics Q&A


What is the science of orthodontics?

Orthodontics is the specialty branch of dentistry that involves the diagnosis, prevention, and treatment of dental and facial irregularities. Orthodontic treatment will straighten crooked teeth, align jaws, establish balanced facial profiles, and create healthy and beautiful smiles that with proper hygiene care will last a lifetime.

What is an orthodontic specialist?

An orthodontist is a dentist with an advanced degree that has continued their education and training so as to understand and to treat the patient with complexities and irregularities in the developing teeth and facial structures. In addition to receiving a dental degree, an individual must complete an advanced training program that can last two or three additional years after graduation from dental school. While any dentist can "move" teeth to make them look better, only an orthodontist has the skill and expertise needed to provide a comprehensive treatment of a malaligned bite. Only a dentist with the proper training and expertise may call themselves an orthodontic specialist.

How can I determine whether my dentist is an orthodontic specialist?

Of course the easiest way to determine if your dentist is an orthodontic specialist is to simply ask him or her about their advanced training. Any orthodontist would be proud to discuss their advanced educational training, and give you a sense of their experience. Another way to determine the credentials of your orthodontist is to look for their membership in the American Association of Orthodontists (AAO). Only those dentists who have completed an advanced educational program in an accredited facility are eligible for membership in the AAO.

What causes a bad bite?

There are several reasons why an individual will develop a bad bite. The primary cause is usually hereditary. We tend to grow in a similar fashion to our parents. So, if Mom or Dad had crooked teeth or a large overbite, then the chances are great that this will be passed down to the children. Other factors can also influence the development of the bite. Physical habits such as thumb sucking, or tongue thrusting may alter development of the face or the teeth. Trauma or disease may also play a role in the overall health of the teeth. Whatever the reason, the orthodontic specialist is trained to diagnosis these problems and recommend the proper treatment at the proper time.

What is the best age to be evaluated by an orthodontic specialist?

The American Association of Orthodontists recommends that an orthodontist evaluate a child at the age of seven (7). This does not necessarily mean that treatment will begin this early. By examining a child at this age, the orthodontist can begin to assess the manner in which the teeth are erupting into the jaws, and most importantly, determine if the upper and lower jawbones are growing properly. Often times, by identifying these problems early in a child's development, an orthodontist can suggest a first phase, or "phase one", of treatment that may prevent further and less complicated orthodontics in the future.

What is Phase 1 treatment?

There are basically two types of problems that concern an orthodontic specialist. The first deals with the position of the teeth. This can include crowded teeth, rotated teeth, or spaced teeth. The second type of problem involves the position of the jawbone. These are the types of problems that can lead to large overbites, cross bites, facial asymmetries, or long open faces. These are the most difficult problems to correct because they require movement not only of the teeth, but also of the underlying bone structure. Often times, by starting the treatment early enough in the child's development, the orthodontist can realign the jawbones and establish a new position of the teeth and facial features, such as the chin and lips. This preliminary phase is often referred to as Phase 1. It is often performed in the early years of a child's development and can last several years.

If a Phase 1 treatment is recommended, does that prevent having to wear braces in the future?

There are times when the Phase 1 treatment will be all that is necessary to correct the problem in the developing child. More often than not, the child will still need some type of conventional brace placement to fine tune and detail the bite. This part of orthodontic treatment is referred to as Phase 2.

What is Phase 2 treatment?

Phase 2 of the orthodontic treatment plan is the part that almost everyone is familiar with. It involves the placement of actual braces on the adult teeth so that they can be moved into the proper alignment. While the objectives of Phase 1 is to broadly align jaws and bring the abnormal bite back into proper development, "phase two" treatments are performed when growth and development has stopped. The objective in "phase two" is to completely align the bite and restore proper function and esthetics to the adult teeth.

What happens if orthodontic problems are not treated?

There comes a point in an individual's development where the teeth will no longer improve their position on their own. This will determine the long-term health and appearance of the teeth. Of course, teeth that are crowded, spaced, or in an improper opposition will not look right. This may cause an individual to feel uncomfortable about their appearance or to be self-conscious about their smile. Feeling good about your teeth is one of the primary reasons people seek out orthodontic treatment. A more important reason to treat a bad bite is the long-term dental issues that can arise due to poorly positioned teeth. Increased incidences of tooth decay, gum problems, bone loss, or weakening of the teeth are just some of the problems that can occur if the orthodontic problem is left untreated.

Does orthodontic treatment benefit the adult patient?

Of course! Orthodontic treatment is a benefit at any age. As long as the teeth and the supporting tissues are healthy, the successful treatment of malpositioned teeth can be accomplished in adult patients. However, there are some additional concerns in adult treatment that you should understand. First, because facial development is complete in an adult, the treatment may require a more complicated technique than that of the younger patient. Second, because the adult biology does not respond as rapidly as it does in a child, orthodontic treatment in an adult may take longer to complete. However, neither of these factors should discourage the well-supervised movement and the successful completion of the orthodontic treatment in the adult.

Do braces always have to be metal?

Over the past few years, orthodontic technology has progressed to the point where there are several new systems available, especially for our adult patients. Braces today are much more esthetic than the traditional silver, metal braces. The most popular method is the use of porcelain brackets, or tooth colored braces. These braces are composed of a very hard glass material that when placed in the mouth take on the coloration of your natural teeth. The result is a near invisible appliance that works just as effectively as the standard metal brackets and bands. The latest technique available to move teeth and still be esthetic is the "Invisalign" system. While this method is available for a very select group of patients, it is another method available to move teeth while being conscious of your appearance.

How much does orthodontic treatment cost?

The cost of orthodontic treatment varies accordingly based on the severity of each particular case and, on the amount of time required to complete the case. Options such as porcelain brackets or the "Invisalign" system will add to the overall cost of the treatment. The best way to determine the fee is to make an appointment for an orthodontic consultation in our office. At that time, your particular situation will be properly evaluated and the fee for your particular situation will be discussed. One note of importance in discussing the cost of treatment in our office; all of our fees reflect the total cost of treatment from the initial records to the placement of retainers to complete your case.

Will my insurance pay for orthodontic treatment?

Each person has an individual diagnosis, and each person has an individual insurance program. Insurance programs have different amounts of coverage available for orthodontic treatment, and in the majority of cases, those patients that have orthodontic benefits through their employer can expect to receive some type of reimbursement from the insurance company towards the total cost of treatment. During your initial consultation, we will discuss with you how your particular policy handles orthodontic claims. In the meantime, you may call your insurance company yourself to request information concerning your particular orthodontic coverage. We do participate in several insurance plans. You may call the office or call your insurance company to see if we participate in your particular insurance plan.

Are payment plans available to cover the treatment costs?

Yes. Most of our patients choose to have the balance of their orthodontic Treatment Fee spread out over the approximate duration of treatment. During your initial consultation, we will discuss a payment plan, which is comfortable and affordable to your particular situation.

How do I schedule an initial consultation appointment?

It is easy. Just call our appointment secretary to schedule an appointment. There is no fee for the initial visit. The appointment takes approximately 30 minutes. During that time the patient will be evaluated and any problems will be noted and discussed. An appropriate treatment sequence will be presented, and the cost of the treatment will be discussed, as well as payment options and your insurance information. It is most helpful for both of us, if you have your insurance benefits with you at the time of the appointment. The goal for this initial visit is to determine whether Orthodontic Therapy is needed and to answer any questions you may have regarding the treatment and the cost of treatment.

Why is your office unique?

Orthodontic offices in our area, and across the country, have developed a trend in treating orthodontic patients in volume. Most practices try to see as many patients as possible in a given time frame. Sometimes, four to six patients are seen at the same time. To accomplish this, the orthodontist delegates tasks to the orthodontic assistant that he or she should be performing. Because of this type of scheduling they are unable to see the patient on an individual basis. In our office, we have made a dedicated decision not to enter into this policy. We see each and every patient on an individual basis. We pride ourselves on the fact that the doctor treats each patient, himself, as we feel it should be. We arrange appointments so that there is enough time to complete each procedure, evaluate the progress of each case and address any concerns that the patient or parent might have. We feel by limiting the number of patients that pass through our office door in the course of a day, that we can continue to provide the best in orthodontic care possible. We are proud of our results, and are gratified by our satisfied patients.

More Questions?

Please contact us with any questions you may have. We look forward to hearing from you soon.