Patient Information

EARLY TREATMENT

The American Association of Orthodontists recommends an initial orthodontic evaluation at the first sign of orthodontic problems or no later than age 7. By age 7, the first adult molars have erupted and the orthodontist can evaluate tooth relationships in all directions.

At this age, there are certain conditions which should be treated in order to avoid damage to the teeth and the bite. Some of these conditions are:

  1. Crossbite of the front teeth  (a top front tooth being behind a lower front tooth)
  2. Crossbite of the back teeth which causes a deviation in jaw growth
  3. Protrusion of the upper teeth which could result in them being damaged during a fall
  4. Harmful habits such as thumb sucking
  5. Significant crowding
  6. Space maintenance for unerupted teeth if baby teeth are lost

According to The American Association of Orthodontists, untreated malocclusions can result in a variety of problems.

  1. Crowded teeth are more difficult to properly brush and floss which
    may contribute to tooth decay and gum disease.
  2. Protruding teeth are more susceptible to accidental chipping.
  3. Crossbites can contribute to unfavorable growth and uneven tooth wear
  4. Open bites can result in speech impediments
  5. Studies have shown that people who are unhappy with the way their
    teeth look are less likely to take good care of them.

Parents often ask, “Why should I pay for treatment at an early age, if I will have to pay for treatment again in the future?”

In Dr. Bobkin’s practice, the fee that you have paid for early treatment becomes part of the total cost for complete treatment in almost all cases. In fact, early treatment for the above conditions often reduces the total cost and length of treatment.

However, many children have minor crowding or spacing of the upper and lower front teeth around age 7.  In some cases this will correct itself. In other cases treatment will be necessary when all the permanent teeth have erupted. Dr. Bobkin will advise you in these cases and we will monitor your child at 6 month intervals at no cost. 

ADULT TREATMENT

Many people think they are too old for braces. It is common to see people of all ages wearing braces. If esthetics is a concern, clear braces are available in some cases. If your bone structure and gums are healthy, it’s never too late for orthodontic treatment.

 Adult treatment may be simple or more complicated. In some cases, periodontal treatment (gum treatment), endodontic treatment (root canal treatment), prosthodontic treatment (crowns, bridges or implants) or corrective jaw surgery may be necessary for the best results. At your consultation, all of your options will be discussed.

If you already have periodontal problems and/or missing teeth, it is important to improve the condition of your teeth and jaws in order to make it possible to maintain the rest of your teeth for a lifetime. Crooked teeth and a bad bite may contribute to further deterioration of your oral health, such as tooth decay, abnormal wearing of tooth surfaces, and in extreme cases may contribute to headaches and jaw joint pain.

JAW SURGERY

Sometimes orthodontic treatment alone cannot correct all malocclusions. In particular, open bites (large spaces between your upper and lower teeth), underdeveloped or overdeveloped lower jaws, and narrow upper jaws may require corrective jaw surgery (orthognathic surgery).

In conjunction with an oral and maxillofacial surgeon, combined orthodontic and surgical treatment can achieve dramatic changes in appearance and function. In almost all cases, modern materials such as titanium plates and screws have eliminated the need to wire closed the jaws after surgery.

RETENTION

Retention is possibly the most important part of treatment. While you are wearing braces, pressure is being applied to your teeth. This pressure softens the bone around the teeth allowing them to move. Studies have shown that it takes at least one year and in some cases longer for the bone to harden after treatment, while there are no guarantees that teeth will not move after treatment, wearing a retainer is the best way to minimize this movement.

In most cases Dr. Bobkin will place a small wire behind your lower front teeth and give you a removable upper retainer. A bonded upper wire is usually not possible because the lower teeth will bite against this wire and break it.

For the first year, the upper retainer must be worn 24 hours a day, including while eating. After that, the wearing time decreases. Total retention time is usually two years. After this, you may choose to remove the lower wire. Some patients choose to leave the wire on, or replace it with a removable lower retainer to wear when they choose.

As long as you have a bonded lower wire, Dr. Bobkin must see you every six months to ensure that the bonding is secure. Loose bonding may trap food and cause serious decay.