Orthodontic Questions:

Do you provide orthodontic treatments?                                                                                  We provide orthodontic treatment to children and adults.

ALF Treatment

                                Before                                                 One year treatment                           

No photo description available.

What type of orthodontics do you recommend?
In accord with the American Dental Association policy on airway and sleep disorder our  focus is screening and identifying airway and sleep disturbance patterns in children and adults and developing plans.

According to the policy, the dentist’s role in the treatment of sleep-related breathing disorders:


Includes, but is not limited to, the following:

“In children, screening through history and clinical examination may identify signs and symptoms of deficient growth and development or other risk factors that may lead to airway issues. If risk is determined, intervention through medical or dental referral or treatment may be appropriate to help treat the disorder and/or develop an optimal physiologic airway and breathing pattern.”

It is especially important to identify this in children where most of facial growth is completed in the first several years of life.

In this study, based on one hundred twenty-three children  aged 11.5 ± 2.7 nearly 50 % of children were found to have SDB (Sleep Disordered Breathing)


In addition, tooth decay and periodontal disease / bleeding gums were significantly higher.

“Results: One hundred twenty-three children were enrolled (11.5 ± 2.7 years, female = 48%). Forty-nine percent were classified as SDB+. COHIP scores were higher among the SDB+ group (24.5 versus 11.6, P < .001 as reported by caregivers, and 25.9 versus 10.3,
P < .001 as reported by children). The incidence of dental caries [tooth decay] present on examination was higher (60% versus 20%, P < .001) in the
SDB+ group. In addition, the indices of periodontal diseases were higher among the SDB+ group when compared to the SDB− group
(periodontal pocket depth was 2.0 ± 1.0 versus 0.0 ± 0.7, P < .0001, and bleeding on probing was 90% versus 20%, P < .001).
Conclusions: This study suggests that caregiver reports of SDB symptoms in those seeking pediatric dental care are common. In
addition, children in the SDB+ group.”

In adults as many as 30 % have sleep apnea.


This number does not include people  with less severe sleep disordered breathing and the common less severe symptoms, many of   tooth destruction caused by clenching / grinding / bruxing and / or TMJ (jaw joint) damage / degeneration.                                                              Both children and adults frequently have these symptoms.

These problems are treated using airway focused functional orthodontics.

How does Functional Orthodontics differ from Traditional Orthodontics?

Functional orthodontics strives to treat patients at an early age when problems are first recognized, often at 3-4 years of age.   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 and more airway space.

Traditional orthodontics often treats later on in life, sometimes with  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?

Remember – appliance therapy and braces are two different things.  Appliance therapy tends to have a much bigger impact on the airway than braces and tends to be more physiologically friendly.

Depending on the age treatment was provided, maybe, yes, particularly with braces and especially adults.
Healthy tongue, cheek, and lip habits along with proper nutrition will help the retention of your completed orthodontic treatment.

Adolescent and adult 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.

ALF orthodontics – Primary functional appliance used by Dr. Hanus

IT”S NOT JUST ORTHODONTICS ANYMORE (part 1) or “Braces gave me a pretty smile at the expense of my face and head.”

“For years, orthodontists thought their job was only
to straighten teeth,” says Derick Nordstrom, D.D.S. “But we know it’s not
just about making teeth straight and attractive. It’s about
helping the patient swallow and breathe properly and about
the long-term stability of the face and body. Just straightening the teeth doesn’t always make a healthy patient.”

Invented by Darick Nordstrom, DDS, the ALF
appliance encourages the jaw to develop properly so
that it can better accommodate all of its original teeth.
This device can be used on patients as young as 3
or 4 years old, gradually expanding the jaws as children
grow, preventing overcrowding of incoming teeth.
The ALF appliance snaps around the molars and fits
along the inside of the teeth, like the inner tube inside a
tire. The appliance moves when the patient swallows and
works in accord with the natural movement of the skull.
Many holistic dentists who use the appliance — about
400 worldwide have been trained — will later use light,
flexible braces to straighten the teeth after the jaw has
properly developed. But they consider this more-cosmetic
work to be the completion of a task that must begin with
foundational, functional work on the jaw.



Actual case in treatment by Dr. Hanus

Before                                                                           After 10 months treatment

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After one year treatment