Orthodontic Questions:

Do you provide orthodontic treatments?

While Dr. Hanus has years of study and experience in orthodontic treatment, at this time, we are recommending patients to orthodontists who recognize the body-wide impact of dental mal-occlusion and utilize techniques to optimize that relationship.  It involves more than just having straight teeth in the front when you smile.

What type of orthodontics do you recommend?
We recommend functional orthodontic treatment whose focus is providing the best possible structural foundation for the teeth and jaws while reducing / eliminating the need for extractions.

How does Functional Orthodontics differ from Traditional Orthodontics?

Functional orthodontics treats patients at an earlier age when problems are first recognized.   Its goal is to make enough room in the jaws for teeth to fit and harmonize the relationship of the jaws to each other.  This technique usually results in broader, healthier smiles.  Traditional orthodontics often treats later on in life, usually with more extractions of teeth, which can result in narrower smiles, retruded (flattened) profiles, and loss of vertical support.  Because the difference in smile results can be seen, functional orthodontic treatment is increasingly popular even as the removal of teeth has been decreasing.  The bottom line is this:  most people who need orthodontic treatment have crowded teeth.  Therefore, you can start early to make room for teeth, or you accept that later your options become increasingly limited.  Early intervention may ensure that more invasive and expensive options (extractions or jaw surgery) may be avoided. Functional  orthodontics is progressive and, most importantly, shows excellent clinical results – wider smiles.
Why is it better to avoid extractions whenever possible?
If we extract teeth (other than 3rd molars / wisdom teeth) for the purpose of “having room to straighten the teeth” (in other words for aesthetic purposes), it will almost certainly have the result of reducing the size of the jaws and the vertical dimension (distance between tip of the nose and bottom of the chin) of the face.   When the size of the jaws are reduced the tongue (strongest muscle in the body) does not shrink to match its new environment.  This means it will likely be forced backward into the throat, interfering with the function the of naso-pharyngeal airway.  This can have a variety of negative, body wide effects.  When we reduce the vertical dimensions of the jaws we increase the stresses and pressures experienced by the Temporomandibular Joint (TMJ), which can result in significant structural problems as these forces mount over time.  See below for symptoms and consequences of TMJ problems.

Reduction of the airway space may be related to sleep related problems such as snoring and apnea.

At what age can you begin to treat patients for orthodontic concerns?
An orthodontic examination can take place as early as two years old, when all the baby teeth have erupted and the upper and lower jaws function together.   Early treatment to prevent and correct jaw alignments could be prescribed as early as age 2, 3 or 4.  Just as with modern early orthopedic correction of crooked feet, early jaw orthopedics is better than delaying while crooked growth occurs.   It is best to assume that your child will need full braces even after Phase One treatment.  The period following Phase One treatment is called the “resting period,” during which growth and tooth eruption are closely monitored.  Throughout this period, parents and patients are kept informed of future treatment recommendations.

Am I too old to undergo orthodontic treatment?

No.   Patients may have a need to be treated when they only have baby teeth to when  they are  in their 80’s.  The body is almost never too old or young to respond to this positive treatment.  In fact, 25 percent of all orthodontic patients are adults. Health, happiness and self-esteem are vitally important to adults.

How long will it take to complete my treatment?

On a basic level, the type of treatment needed will largely determine the answer to this question.  Orthodontics usually takes 1 – 3 years while general restorative dentistry can be completed in a relatively short period of time (weeks to months).  This question can be more accurately answered after all needed records are completed and analyzed.  In younger patients, an even better estimate of needed time can be given after the first phase of treatment is completed, and patient progress and cooperation can be determined.  Patient cooperation is a critical component in determining total treatment time.   Treatment for children, before their permanent teeth have fully erupted, will often involve breaks in treatment while baby teeth fall out and are replaced by permanent ones.  

Will I have to wear an appliance for the rest of my life to keep my teeth from becoming crowded again?

Probably, yes.
Healthy tongue, cheek, and lip habits along with proper nutrition will help the retention of your completed orthodontic treatment.   Orthodontic treatments are usually ended with a removable retention appliance that is worn regularly for a set period of time, and then worn occasionally as the patient finds need for it.  Generally speaking, the older a patient is when they start orthodontics the longer they will need to wear some form of retention appliance while sleeping.  The need to wear a retainer may be indefinite in order to maintain the relationship of the teeth at completion or orthodontic treatment.