Frequently Asked Questions

General

What is the difference between a dentist and an orthodontist?


All orthodontists are dentists, but only 6% of dentists are orthodontists. That is not only because it requires 3 more years of training after 4 years of dental school to be legally called an orthodontist, but also because only 5% of total dental-student-applicants, therefore only the top students, get into those selective programs. During the 3-year orthodontics residency training, as compared to usually company-run half-day training for general dentists, orthodontists learn how to properly trace different radiographs, to accurately diagnose skeletal problems as well as dental problems, and to provide a wide range of treatment options that not only improve patients' smiles but also improve patients' function and health.




How do I know that a doctor is actually an orthodontist?


Only a nationally certified orthodontist can be a member of AAO (American Association of Orthodontists). Be aware that general dentists without nationally recognized certification can become a member of other orthodontic organizations and companies, including Invisalign, American Orthodontic Society, and International Association of Orthodontists. If you are ever in doubt, visit http://mylifemysmile.org to verify who is actually a certified orthodontist or for reliable information on orthodontics.




Do I need a referral from my dentist to schedule an appointment?


No. You can make the initial consulation appointment with an orthodontist without referral from general dentist.




What will happen at the initial exam and consultation appointment?


Patient will be examined not only for teeth alignment ('malocclusion') but also for facial and profile analysis, any skeletal discrepancy, TMJ (temporomandibular joint) problem, as well as any harmful habits related to malocclusion. Then we will discuss whether patient's chief concern can be treated with orthodontic treatment (either braces or Invisalign) and also whether patient needs any other treatments such as extractions of teeth, jaw surgery in case of severe skeletal problems, or any other consultation by other specialists, such as pediatric dentists / TMJ specialists / periodontists. For comprehensive diagnosis and treatment planning, patient needs to have full 'records' taken, which comprise of: (1) X-rays (panoramic radiograph and lateral cephalometric radiograph, which are rarely taken by general dentists), (2) photographs (of teeth and facial and profile), and (3) molds of teeth. Records can be taken at the same visit to save time or can be scheduled for later visit.




Why is orthodontic treatment so important?


Orthodontic treatment creates a better bite, making teeth fit better, and decreases the risk of future potentially costly dental problems. Crooked and crowded teeth are hard to clean and maintain. A malocclusion can cause tooth enamel to wear abnormally, difficulty in chewing and/or speaking, and excess stress on supporting bone and gum tissue. Without treatment, many problems simply become worse.




What causes orthodontic problems (malocclusion)?


Most orthodontic problems (malocclusions) are inherited. Examples of these genetic problems are crowding, spacing, protrusion, extra or missing teeth, and some jaw growth problems. Other malocclusions are acquired as a result of thumb- or fingersucking habits, dental disease, accidents, the early or late loss of baby (primary) teeth, or other causes.




What is my (patient's) role in orthodontic treatment?


Orthodontic treatment is a partnership between the patient and the orthodontist. The orthodontist provides custom-made fixed or removable appliances that use gentle pressure over time to move teeth into their proper positions. Your job is to follow the orthodontist’s instructions, keep scheduled orthodontic appointments and maintain excellent oral hygiene so you achieve your best results. You will also need to see your primary care dentist as recommended.




How long does orthodontic treatment take?


Orthodontic treatment averages less than two years, but can range from one to three years. When “active” treatment ends, retainers are prescribed for most patients to keep teeth in their new positions.




How much does orthodontic treatment cost?


The cost of orthodontic treatment depends on many factors, including the severity of the problem, its complexity and length of treatment. We will be glad to discuss fees with you before treatment begins. Many patients find that orthodontic treatment is more affordable today than ever. We offer a variety of payment plans, and your employers may offer dental insurance plans with orthodontic benefits, and/or the option to set aside pre-tax dollars in a flexible spending account or other health savings account.




Are all dentists who provide Invisalign or braces orthodontists?


No. Some general dentists or online companies offer braces or aligners. However, only an orthodontist who has taken the additional 3 years of advanced training at an accredited residency can call themselves an orthodontic specialist or be a member of the AAO. It’s not worth the risk of permanent damage to your face and smile to allow anyone who isn’t an orthodontist to attempt to move your teeth. By selecting an AAO orthodontist, you are choosing a specialist who possesses the skills and experience to give you your best smile. Look for the AAO logo at your orthodontist’s office, or locate an AAO orthodontist using ‘Find an Orthodontist’ at aaoinfo.org/truth.




What is an orthodontist?


* Orthodontists are dental school graduates. There are three steps in an orthodontist’s education: college, dental school, and orthodontic school. Similar to becoming a medical specialist, such as a surgeon or an internist, orthodontists complete orthodontic residency program for two to three years after dental school. There are more people who apply for orthodontic residencies than there are residencies available. In fact, there are about 15 applications for every opening. While there’s some instruction regarding orthodontics in dental school, it is minimal. It’s in the orthodontic residency program that orthodontists receives intensive instruction to learn proper, safe tooth movement (orthodontics) and the guidance of dental, jaw and facial development (dentofacial orthopedics). These extra years of schooling make the orthodontist the dental specialist in moving teeth and aligning jaws. This is the only focus of their practice. * Orthodontists diagnose, prevent, intercept and treat dental and facial irregularities. These problems may include teeth that are crowded or too far apart, teeth that meet abnormally or don’t meet at all, teeth that stick out, and mismatched jaws. Orthodontists treat existing problems, and can identify problems that are developing, and take timely action to resolve problems before they fully develops. Orthodontists treat patients of all ages, they regularly treat children, adolescents and adults. Orthodontists treat patients of all ages, they regularly treat children, adolescents and adults. Orthodontists create a custom treatment plan for each patient. Every patient is different. Orthodontists use in-person exams as well as 2D or 3D xrays, photos and molds of the teeth to create a personalized treatment plan for each and every patient. Orthodontists use the full range of “appliances” to correct orthodontic problems. The “appliance” is the term used for the device that moves teeth. It can be traditional braces, clear aligners or braces on the inside of the teeth. The orthodontist is uniquely qualified to recommend the most appropriate type of “appliance” to correct an individual’s problem. The American Association of Orthodontists (AAO) is open exclusively to orthodontists – only orthodontists are admitted for membership. The only doctors who can call themselves orthodontists have graduated from dental school and then successfully completed the additional two-tothree years of education in an accredited orthodontic residency program. * There are board-certified orthodontists. In the United States, some orthodontists opt to become board-certified. The American Board of Orthodontics (ABO) certifies orthodontists who have graduated from fully accredited residency programs. Those who are board-certified by the ABO are known as Diplomates of the American Board of Orthodontics. In the US, board certification is voluntary. Other jurisdictions, such as Canada, require board certification by the Royal College of Dentists of Canada (RCDC) in order to be considered licensed specialists. And now you know the facts about orthodontists! The American Association of Orthodontists (AAO) is open exclusively to orthodontists – only orthodontists are admitted for membership. The only doctors who can call themselves “orthodontists” have graduated from dental school and then successfully completed the additional two-to-three years of education in an accredited orthodontic residency program. When you choose an AAO orthodontist for orthodontic treatment, you can be assured that you have selected a specialist orthodontist, an expert in orthodontics and dentofacial orthopedics who possesses the skills and experience to give you your best smile. Locate AAO orthodontists through Find an Orthodontist at aaoinfo.org.





Invisalign

Is braces better or faster than Invisalign?


No. Most of the time, both traditional braces and Invisalign will work similarly in terms of treatment efficiency. However, there are some tooth movements that are challenging with Invisalign and thus require traditional braces. Correct diagnosis and treatment planning with orthodontic specialist will make sure you get the right appliance for your orthodontic treatment.




Are all Invisalign-provider an orthodontist?


No. Not all Invisalign providers are orthodontists. Some general dentists or online companies offer braces or aligners. However, only an orthodontist who has taken the additional 3 years of advanced training at an accredited residency can call themselves an orthodontic specialist or be a member of the AAO. Only the best ones get selected into highly competitive Orthodontic programs to become orthodontists, and so only 7% of dentists are orthodontists. It’s not worth the risk of permanent damage to your face and smile to allow anyone who isn’t an orthodontist to attempt to move your teeth. By selecting an AAO orthodontist, you are choosing a specialist who possesses the skills and experience to give you your best smile. Look for the AAO logo at your orthodontist’s office, or locate an AAO orthodontist using ‘Find an Orthodontist’ at aaoinfo.org/truth.




How do I know if my bite can be fixed with Invisalign?


3D simulation that Invisalign providers or company provide to patients may merely be computer graphics. Whether the tooth movements will occur as in the 3D simulation depends on a lot of factors which only well-trained orthodontists/dentists can evaluate. Therefore, it is critical to have an actual consult with an orthodontist to evaluate your bite clinically. It may require more than clinical examinations, such as X-rays and molds or scan of your teeth.





Children

When should I bring my child for consultation for braces?


No later than age 7. To have a healthy smile that’s good for life, your child needs teeth and jaws that are properly aligned. The American Association of Orthodontists (AAO) recommends that your child get a check-up with an orthodontist at the first recognition of the existence of an orthodontic problem, but no later than age 7. By then, your child has enough permanent teeth for an orthodontist to determine whether an orthodontic problem exists or is developing. Putting off a check-up with an orthodontist until a child has lost all baby teeth could be a disservice. Some orthodontic problems may be easier to correct if they’re found early. A check-up no later than age 7 gives your orthodontist the opportunity to recommend the appropriate treatment at the appropriate time. If early treatment is in order, the orthodontist may be able to achieve results that may not be possible once the face and jaws have finished growing.




Why should my child have a consultation for braces?


Because many skeletal and dental problems can be avoided or minimized when they are diagnosed and treated at the right time - before their adult teeth erupt or before their growth is remaining. With orthodontic as well as orthopedic appliances, orthodontist can not only positively alter children's skeletal and dental development but also improve their self-esteem. Since some skeletal or dental problems should be managed before age 8-9 - for example, deficient upper jaw or anticipated lack of space for adult teeth - the first orthodontic consultation for all the children should be no later than age 7. Some children will undergo 'phase 1' orthodontic treatment when they still have baby teeth, in order to treat such problems. Otherwise, most children will wait until age 10-11 for treatment with braces.




What are 'phase 1' and 'phase 2' orthodontic treatments for kids?


Phase I orthodontic treatment is for some chlidren of age 6-10 with severe dental and/or skeletal problems that need to be addressed early even if some of their adult teeth are not yet out. It is a limited treatment of 6-18 months to correct the problem that needs to be corrected at this age and usually not require full braces on all the teeth. Patient may need phase II treatment at later time when all the adult teeth come out. Phase II orthodontic treatment is for adolesent patients of age 11-16 with full braces or Invisalign. Some of such problems that definitely need treatment early with phase I treatment include: (1)'anterior crossbite' (commonly called underbite) where upper front teeth are behind lower front teeth, (2) severely crooked teeth because of lack of space, (3) smaller upper jaw, compared to lower jaw.





Adults

Is braces better or faster than Invisalign?


No. Most of the time, both traditional braces and Invisalign will work similarly in terms of treatment efficiency. However, there are some tooth movements that are challenging with Invisalign and thus require traditional braces. Correct diagnosis and treatment planning with orthodontic specialist will make sure you get the right appliance for your orthodontic treatment.




I have gum recession, can I still get orthodontic treatment?


Yes. However, if you have a periodontal disease, you have to get it under control before orthodontic treatment because orthodontic forces may accelerate the problem and can damage the bone, soft tissue, and sometimes teeth.




Can adults benefit from braces?


Yes. Age is not a consideration when it comes to orthodontic treatment. Healthy teeth can be moved at any age. Today, adults account for one in every five orthodontic patients. Thanks to the variety of “appliances” used by orthodontists, adults may be able to inconspicuously achieve the great smile they want. Advances in today’s orthodontic materials mean patients see the orthodontist only about once every six weeks during active treatment.





Braces

Will braces hurt?


Yes, but some people are more sensitive than others, and pain usually gets better over time as you get used to it. However, if your teeth are very sensitive, you may take over-the-counter painkiller.




Do I need tooth extraction?


Some patients with severe lack of space and protrusive profile may benefit from taking some teeth out to create space to align the crooked teeth and to retract anterior teeth back to improve their profiles. However, all three planes of space must be accurately analyzed for patients skeletal, dental, and soft-tissue aspects to determine the need for extractions.




How long will the braces take?


Usually, mild cases will take about 6 months, moderate cases will take 1-2 years, and severe cases can take more than 2 years. You will need to get an examination by orthodontist because even cases which look mild can be difficult cases, and cases that look challenging may not be so difficult to treat.




Are there any other options than taking out teeth?


In borderline crowding (lack of space), stripping of teeth called 'inter-proximal reduction' can be done instead of extracting teeth. However, in severe crowding situation, extractions will probably the only answer, yet there are other factors that need to be considered, such as your profile and inclination of teeth.





Other

How long do I have to wear retainers after treatment?


For your lifetime! As with the rest of our body which continues to remodel over our lifetime, jaw bones for your teeth continue to remodel over our lifetime. Without using your retainer, you may lose the treatment result from your orthodontic treatment over time. However, each patient may have a different need for retainer use, in terms of type of retainers or frequency of retainer use. So consult your orthodontist!




How do I take care of my retainers?


When your removable retainer is not in your mouth, put it in its case. Always carry a retainer case with you. Avoid dropping your retainer into a pocket or purse – the retainer can be damaged. Never wrap your retainer in a napkin – it’s too easy to throw away. Keep your retainer out of the reach of pets – dogs in particular seem to be attracted to retainers, and can quickly chew them into a state of uselessness. Avoid heat – your retainer can become deformed if it’s left on a heater, a hot stove, or in a hot car. Keep your retainer clean. Your orthodontist will give you instructions for cleaning removable retainers, which could include brushing with toothpaste before you put them in and after they are removed, and/or the use of an effervescent cleanser. Permanent retainers can be brushed and flossed; interproximal brushes may also be helpful. If you have removable retainers, ask your orthodontist if they should be removed before you eat. If you have an Essix retainer, you may be advised to avoid drinking liquids (except water) when the retainers are in place. Liquids can seep into the retainer, and the liquid is held against the teeth until the retainer is removed. Liquids with color (coffee, tea, red wine, etc.) can stain teeth. Liquids with sugar and/or acids, such as regular and diet soft drinks, can cause tooth decay. If you have a problem with your retainer – it’s lost, broken, warped, too loose, too tight, etc. – contact your orthodontist. Unless it’s lost, bring your retainer with you when you visit your orthodontist.





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