common treatments

Partial Upper Braces
Braces are frequently placed only on certain teeth.  This is common in cases of severe overbites, crowding, or when a mixture of baby teeth and permanent teeth are present


Partial Upper Braces

Bite Plate Appliance
A bite plane is like a retainer with a thickened portion behind the upper front teeth.  The bite plane prevents all of the teeth from touching together when biting down.  It can help correct overbites, reduce tooth wear from grinding, and can be used to temporarily hold the teeth apart for correction of certain bite problems.  Bite planes are usually worn full time except for eating and brushing, although they are worn only at night in certain situations. The doctors will instruct you on correct wear of your bite plane


Bite Plate Appliance

Bite Turbo with braces
A bite turbo is a small, specialized brace that is placed on the back of one of the upper front teeth.  It is used to prevent the full closure of the teeth.  This protects the lower braces from the trauma of the bite, and it turbo charges the correction of a deep overbite.  The bite turbo makes it difficult to chew certain foods in the beginning, but the back teeth come together rather quickly (from a few weeks to a few months after starting), and chewing will be normal.  The turbo can be left in to reinforce the overbite correction during treatment.  Eating soft foods like pasta, eggs, soups, potatoes, etc. will be helpful for the first few weeks while adjusting to the presence of the bite turbo.


Bite Turbo with braces

Class II Elastic Wear
Elastic rubber bands are used to help coordinate the bite of the upper and lower teeth.  The rubber bands are placed and removed by the patient, and full time wear is essential for rapid, predictable tooth movement.  Rubber bands can be removed for eating and brushing.  We have rubber bands in tooth color or in bright neon colors.


Class II Elastic Wear

Class III Elastic Wear
Elastic rubber bands are used to help coordinate the bite of the upper and lower teeth.  The rubber bands are placed and removed by the patient, and full time wear is essential for rapid, predictable tooth movement.  Rubber bands can be removed for eating and brushing.  We have rubber bands in tooth color or in bright neon colors.


Class III Elastic Wear

First Upper Bicuspid Extraction Therapy
Optimal stability, esthetics, and dental health require that the positions of the teeth be balanced with the lips, supporting gums, and bone structure.  On occasion, this requires the removal of certain teeth in order to position the remaining teeth ideally.  When extractions are required, the remaining teeth are positioned for optimum esthetics, increased long-term stability, and optimal gum health.  The following animation illustrates an example of extraction orthodontic treatment of the upper first premolar teeth (teeth #’s 5 and 12.)


First Upper Bicuspid Extraction Therapy

First Bicuspid Extraction with Favorable Lip Posture
Optimal stability, esthetics, and dental health require that the positions of the teeth be balanced with the lips, supporting gums, and bone structure.  On occasion, this requires the removal of certain teeth in order to position the remaining teeth ideally.  When extractions are required, the remaining teeth are positioned for optimum esthetics, increased long-term stability, and optimal gum health.  The following animation illustrates an example of extraction orthodontic treatment of the upper first premolar teeth only (teeth #’s 5 and 12).


First Bicuspid Extraction with Favorable Lip Posture

Forsus Appliance (Direct Push Rod)
Springs which are connected to the sides of the braces are called Forsus Springs  The Forsus Springs exert a light, continuous force on the teeth, and gently move the upper teeth back, and the lower teeth forward, thus correcting the bite.  Like any permanently attached device, they take some time to get used to when they are placed (generally a few days), but patients quickly adjust to their presence in the mouth.  Care must be taken not to bend or break the springs by eating hard foods or chewing on things like pens, pencils, or ice.


Forsus Appliance (Direct Push Rod)

Four-bicuspid Extraction all 1st
Optimal stability, esthetics, and dental health require that the positions of the teeth be balanced with the lips, supporting gums, and bone structure.  On occasion, this requires the removal of certain teeth in order to position the remaining teeth ideally.  When extractions are required, the remaining teeth are positioned for optimum esthetics, increased long-term stability, and optimal gum health.  The following animation illustrates an example of extraction orthodontic treatment of the four first premolar teeth (teeth #’s 5, 12, 21 and 28.)


Four-bicuspid Extraction all 1st

Four-bicuspid Extraction all 2nd
Optimal stability, esthetics, and dental health require that the positions of the teeth be balanced with the lips, supporting gums, and bone structure.  On occasion, this requires the removal of certain teeth in order to position the remaining teeth ideally.  When extractions are required, the remaining teeth are positioned for optimum esthetics, increased long-term stability, and optimal gum health.  The following animation illustrates an example of extraction orthodontic treatment of the four second premolar teeth (teeth #’s 4, 13, 20 and 29).


Four-bicuspid Extraction all 2nd

Four-bicuspid Extraction Upper 1st Lower 2nd
Optimal stability, esthetics, and dental health require that the positions of the teeth be balanced with the lips, supporting gums, and bone structure.  On occasion, this requires the removal of certain teeth in order to position the remaining teeth ideally.  When extractions are required, the remaining teeth are positioned for optimum esthetics, increased long-term stability, and optimal gum health.  The following animation illustrates an example of extraction orthodontic treatment of the upper first and lower second premolar teeth (teeth #’s 5, 12, 20 and 29).


Four-bicuspid Extraction Upper 1st Lower 2nd

Hawley Retainer for retention
After active orthodontic treatment has been completed, retainers are necessary to hold the teeth in their corrected position while the gums, supporting bone, and muscles adjust to the new positions of the teeth.   Retainers are typically worn full time for a few months after active treatment has been completed, then are worn only while sleeping.  Research indicates that the teeth will continue shift throughout a lifetime, so the only way to assure straight teeth in the future is to continue sleeping in the retainer forever.  Some people consider this bad news, but we consider it good news that there is something that can be done to prevent the natural shifting of the teeth. Unlike changes in the hair and skin, the teeth can be kept beautifully straight throughout a lifetime by simply sleeping in a retainer.


Hawley Retainer for retention

Headgear
A headgear is used to correct overbites in growing children, as well as to hold the upper back teeth in their current positions while the other teeth are moved into their corrected positions.  A headgear is one of the most tried and true orthodontic appliances in use.  It has a track record of well over 50 years, and has been extensively researched.  We recommend that it be worn approximately 12 hours per day, so it rarely needs to be worn outside of the house.  Consistent wear is essential for the headgear to work.


Headgear

Hyrax Rapid Palatal Expansion Braces After
A palatal expander (sometimes called a butterfly appliance) is used to widen the upper jaw.  In most patients, it actually widens the entire upper jaw, creating room for displaced teeth.  The palatal expander is activated at home for several weeks, and then is held in place for a few months to stabilize the upper jaw.  The patient will usually develop a gap between the upper front teeth while the expander is being activated, but the gap will close quickly when the appliance is stabilized.


Hyrax Rapid Palatal Expansion Braces After

Impacted Cuspid Treated
Impacted canine.  An oral surgeon or periodontist will expose the impacted canine.  Generally, an orthodontic brace with a gold chain is placed on the tooth so that it can be guided into its correct position.  Occasionally, the tooth will be exposed and allowed to grow into the mouth on its own. The doctors will discuss this with you at the time that the surgical exposure is needed.


Impacted Cuspid Treated

Interproximal Reduction Crowding (Rotary Disk)
The selective polishing of a small amount of enamel between selected teeth is occasionally recommended.  This polishing (called interproximal enamel reduction or IER) slightly reduces the width of the teeth making them easier to align.  It also enhances the long-term stability of the correction.  The amount of enamel reduction is carefully calibrated so that the teeth are not made sensitive.  Published research also indicates that the teeth are also no more susceptible to cavities or other problems by this procedure.


Interproximal Reduction Crowding (Rotary Disk)

Invisalign (Invisible Aligners)


Invisalign (Invisible Aligners)

Lower Lingual Arch
A lower lingual arch is a passive appliance placed on the lower teeth to hold all available space open for the eruption of the remaining permanent teeth.  It helps the lower teeth to be more stable in the long run, and reduces the need for the removal of permanent teeth in the future.  It is a very easy appliance to wear, and does not make the teeth sore or uncomfortable.  While wearing the lingual arch, it is important to avoid hard foods such as ice, hard candy, and nuts, as well as very sticky foods like Starburst, Now-N-Laters, gummy bears, etc. as these can damage the lingual arch.


Lower Lingual Arch

Molar Distalization
There are several orthodontic appliances whose purpose is to push the upper molars back.  We refer to this group of appliances as Molar Moving Appliances (MMA).  The MMA is attached to the upper side teeth, and the first permanent molars.  It is used to push the permanent molar in a backward direction.  The MMA is glued to the teeth but is completely hidden from view.  It usually will create a speech impediment for the first several days after it is placed. The MMA will remain in the mouth for several months. The constant pressure on the molars results in the rapid backward movement of these teeth.  After the teeth are in the correct positions, the appliance will remain in place for a period of time in order to hold the molars in their corrected positions.


Molar Distalization

Nance Appliance
A Nance appliance holds open all available space for the eruption of the remaining upper permanent teeth.  It is not an uncomfortable appliance, as it fits passively on the teeth and the roof of the mouth.  A slight speech impediment may be noticeable for a few days after the appliance is placed, but it will diminish rapidly.   While wearing the Nance appliance, it is important to avoid hard foods such as ice, hard candy, and nuts, as well as very sticky foods like Starburst, Now-N-Laters, gummy bears, etc. as these can damage the appliance.


Nance Appliance

W-arch Appliance
W-arch is a wire appliance that is attached to the upper back teeth, and is adjusted by the doctor to expand (widen) the upper teeth.  No home adjustments are needed.  It is completely hidden in the palate, and rarely causes discomfort after the first few days of adaptation.  A speech impediment may be noticed for the first few days.


W-arch Appliance

Twin Block Appliance
The Twin Block appliance is worn to correct overbites, and to help the lips and chin muscles learn to function correctly.  The Twin Block is usually worn full time until the bite is corrected, and is then used as a retainer at night while the permanent teeth finish erupting.  Speech is slightly affected in the beginning, but most children can learn to speak and even drink while the appliance is being worn.  Excellent wear is essential for the appliance to work.


Twin Block Appliance


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