An Impacted Tooth may be trapped within the surrounding bone. In most cases, impacted teeth can be successfully aligned. We might recommend additional diagnostic studies (special radiographic CBCT scans, etc.) to help determine the exact position of the impacted tooth and the surrounding teeth. In order to align an impacted tooth, a referral might be made to an oral surgeon or a periodontist (dental specialist who treats gum problems) to have the impacted tooth or teeth uncovered and/or a temporary attachment placed on the tooth or teeth. The fees for services performed by other specialists are separate and additional to the orthodontic treatment fees. There is a possibility that if a temporary attachment is placed on the impacted tooth or teeth, it might detach during orthodontic treatment. It might have to be replaced. This might require a second surgical procedure. In rare cases, an impacted tooth might be fused to the surrounding bone (ankylosis) and might not move with orthodontics. If so, tooth removal might be necessary. In some cases, the space might be closed with additional orthodontic treatment after the ankylosed tooth is surgically removed. In other cases, the ankylosed tooth may need to be surgically removed and replaced by your family dentist. The additional costs for tooth replacement are separate from the fee for your orthodontic treatment. An impacted tooth might have caused damage to adjacent teeth that is not evident until the tooth or teeth are moved. Additionally, if an impacted tooth is moved, it might push against the roots of the adjacent teeth and damage them. This complication might be unavoidable because of the position of the impacted tooth. The root of the impacted tooth might also shorten during movement. In severe cases, one or more teeth might be lost due to root shortening. During movement of an impacted tooth, the nerve of the impacted tooth or of the adjacent teeth might be damaged. This occurrence might be unavoidable because of the position of the impacted tooth. Root canal treatment might be necessary. The cost of root canal treatment is separate and in addition to the orthodontic fee. If the impacted tooth is brought into alignment, it might become evident that the tooth is a different shape or color than the adjacent teeth. You might choose to ask your general dentist to provide cosmetic correction. The cost of cosmetic correction of a tooth or teeth is separate and additional to the orthodontic fee. When the alignment of the impacted tooth is complete, the gum line along the formerly impacted tooth and the adjacent teeth might be uneven. Impacted teeth often experience some gum recession during alignment. If the appearance of the gum line can be improved, the service of another dental specialist may be required, the cost of which is separate and additional to the orthodontic fee.
Temporary Anchorage Devices (TADs) used to obtain orthodontic anchorage are widely accepted. They have changed the way orthodontists treat some patients’ malocclusions (bite problems). Orthodontics utilizing TADs might have advantages to treat some problems that historically could only be achieved by using other devices, (e.g. headgear, facemasks) or jaw surgery. TADs provide a fixed point from which to apply a force to move teeth. They can be placed in many different sites within the mouth. We may recommend the use of one or more Temporary Anchorage Device(s) (TAD) as a part of your or your child’s orthodontic treatment. The use of TADs as part of orthodontic treatment has generally proven to be safe and predictable. As with any procedure or medical device, the outcome cannot be guaranteed. Irritation to the oral tissues might result from TAD placement. This is generally a short-term irritation that resolves without additional treatment once the TAD is removed. Rarely, additional treatment might be necessary. Proper home care, as instructed by your orthodontists, can reduce the irritation and inflammation of the oral soft tissues. A topical and/or local anesthetic may be applied to the gums and/or nearby oral tissues before the placement of the TAD. TAD placement is typically in close proximity to the teeth. The TAD might come in direct contact with the root of a tooth. Rarely will the root be harmed. If damage to the root were to occur, this damage will often self-repair once the TAD is removed. In rare occasions with root damage, close monitoring of the root might be necessary and additional dental procedures could then become necessary. Forces placed on teeth and TADs could possibly cause the device to loosen. If you find that the TAD has become loose it might need to be removed and placed in a different location in the mouth. TADs are constructed of medical grade titanium, a hypoallergenic material. In rare circumstances a TAD might break during its insertion or removal. If the residual portion were to be a source of irritation it would be necessary to have this portion removed. The chemicals in tobacco can interfere with bone health after TAD placement.
We may recommend Laser Treatment to cosmetically or functionally enhance or expedite your (or your child’s) orthodontic treatment result. Generally, the use of a laser to treat the oral tissues is a safe and predictable procedure. As with any procedure, the outcome cannot be guaranteed. Occasionally laser treatment might be used to improve the appearance of individual teeth by altering the gum line or gum margin. If a soft tissue laser is used for this purpose, upon healing, the level of the gum line might not be perfectly symmetrical. Damage to the other oral tissues might result from laser treatment. This is generally a self-limiting short-term injury that usually resolves without additional treatment. In rare circumstances, additional dental and/or medical treatment might be necessary. A topical anesthetic and/or local anesthetic may be applied to the gums before the procedure. Protective glasses must be worn by all persons near the laser. Failure to do so might result in permanent eye damage. Laser treatment in areas near large blood vessels, (under the tongue, for example) could possibly damage the blood vessels. If damage occurs, additional medical or dental treatment might be necessary. The chemicals in tobacco can interfere with healing after laser treatment.
Periodontal Diseases are serious bacterial infections that destroy the attachment fibers and supporting bone that hold your teeth in your mouth. These diseases can lead to tooth loss. During your orthodontic treatment, you MUST continue your regular visits to your periodontist or general dentist. Your periodontist or general dentist will supervise the health of your teeth and gums. It’s essential that you follow your periodontist’s or general dentist’s instructions on oral hygiene, medications and return appointments. If you fail to follow your periodontist’s or general dentist’s instructions, you risk losing one or more teeth. Although the chief cause of periodontal disease is bacteria that attack the gums and bone, there are other factors that can cause periodontal disease to worsen. Tobacco in any form makes your gums much more prone to periodontal disease. You should not smoke or chew tobacco while undergoing orthodontic treatment. Stress, poor diet and genetics have also been linked to periodontal disease. If your periodontal disease is not controlled, your gums are prone to localized infections (periodontal abscesses) that are very destructive to the underlying bone. You might be prescribed antibiotics to take by mouth and/or apply to the infected area. Fixed appliances (braces) make thorough brushing and flossing more challenging. We might recommend additional oral hygiene aids (electric toothbrush, flossing aids, mouthrinses) OR using INVISALIGN appliances to improve the health of your gums. We might recommend periodic x-rays or other diagnostic studies to monitor the health of your gums. Periodontal disease can be very difficult to control. It is possible that even if you follow all the recommendations of your dentists, your periodontal disease might worsen during or after orthodontic treatment. In the worst case, you might lose one or more teeth to periodontal disease.
Bisphosphonates are medications prescribed by your physician for the treatment of a variety of difficult medical disorders. Bisphosphonate medication types that you may be taking, or have taken, can be: Fosamax (alendronate), Actonel (risedronate), Boniva (ibandronate), Skelid (tiludronate), Didronel (etidronate), Aredia (pamidronate), or Zometa (zoledronic acid). There may be some additional brand names in addition to the above, but they are all known as “bisphosphonates.” Every medication has risks and benefits. All bisphosphonates inhibit osteoclastic (related to bone) activity. They have the ability to, and probably will, inhibit tooth movement during orthodontics. This issue may slow your response to orthodontic movement and lengthen orthodontic treatment time. The effects of these medications may be severe enough to stop tooth movement, which may cause braces to be removed regardless of favorable or unfavorable tooth position. No orthodontist can predict the effect bisphosphonates will have upon an individual’s tooth movement. Long-term bisphosphonate use has been observed to decrease bone healing. It is possible that tooth movement and any surgery procedures performed within the jaws or bone surrounding the teeth may be difficult, and, in some cases, no bone healing may occur. The risk for developing osteonecrosis is higher for cancer patients on i.v. bisphosphonate therapy
Welcome to our Orthodontic "family" of patients! Over the years, our practice has become one of the
most trusted resources for outstanding Orthodontic care.
Our reputation is founded on
attention to detail, professional integrity and total commitment to our patients.
To provide you with the best quality Orthodontic care, we must ask that you strictly adhere to the following state and office regulations and policies:
1) Maintain a healthy and POSITIVE attitude
Orthodontic treatment is a privilege—not a right. Patient motivation is necessary for successful treatment results.
Our office will not initiate treatment on uncaring individuals.
2) Do NOT MISS any scheduled appointments.
Canceled and missed appointments may result in significant delays in treatment.
Failure to appear for appointments will not be allowed by the State Program.
The State requires six visits during the first six months, if you do not make these appointments, appliances will be removed unless responsible party wants to pay for treatment.
3) Be ON TIME for all appointments.
Punctuality demonstrates a respect for other patients within the practice.
We value your time and know you would do the same for others.
4) Demonstrate flexibility with scheduling.
We have reserved special appointment times specifically for your treatment. Procedures must be completed during the
morning and early afternoon
(8:30-2:30)
hours. We will provide school excuses.
5) Practice good oral hygiene.
Proper brushing and flossing techniques must be maintained throughout the entire course of treatment. Inadequate home care will lead to cavities and gum disease, which will result in
immediate removal of the braces.
6) Take care of your braces.
. Frequent breakage and neglect of your braces may lead to significant delays in treatment and unpleasant side effects. Frequent breakage of orthodontic appliances will result in
immediate removal of the braces.
7) Wear your rubber bands as instructed.
Excellent compliance is necessary to achieve excellent results. In order to keep your treatment on schedule,
you must follow our specific directions
for elastic wear.
8) Keep the lines of communication open.
If at any time you have additional concerns or questions,
please ask.
Patients deserve the right to be well-informed regarding the treatment progress.
9) Keep your MEDICAL HISTORY, ADDRESS AND PHONE NUMBER current and accurate
We must
always
be able to reach you for schedule changes when necessary.