What is an Orthodontist?
In the United States the ADA, or the American Dental Association, recognizes nine specialties in the Dental Sciences. They are orthodontics and dentofacial orthopedics; pediatric dentistry; periodontics; prosthodontics; oral and maxillofacial surgery; oral and maxillofacial pathology; endodontics; public health dentistry; and oral and maxillofacial radiology. The base, or dental sciences, is the practice of studying, researching, diagnosis’s and treating any issues associated with the oral cavity. This includes your teeth, gums, all soft tissue, your jawbones, and even facial circumstances as a result of your mouth. Through extended education the specialty branches bring into focus a very specific area of treatment.
The Additional Education
After four years of undergraduate study a candidate enters the graduate school of the dental sciences and studies four more years to receive their DDS, the Doctor of Dental Sciences. At this point they are qualified to become and practice general, family dentistry. If a specified discipline is chosen another two years of education is necessary to achieve the focus necessary to then practice as a specialist. This amounts to an additional 4,800 hours of orthodontic training. This includes an orthodontist which represents about 6% of practicing dentists. The specialty branch of orthodontics focuses on misaligned teeth, crowded teeth, an overbite or an underbite. The orthodontist will help you by aligning your teeth, improving your bite, or fitting you with corrective braces or a similar device. The orthodontist will also help you with any TMJ or TMD disorders, jaw issues or even suggested extractions. Another way to summarize is an orthodontist specializes in correcting your bite, an occlusion, and the natural straightness of your teeth.
The Common Orthodontic Problems
The following is a list of common issues addressed by an orthodontist are:
- Overbite- The front teeth lie too far forward, sticking out over the lower teeth.
- Underbite- The lower teeth are too far forward giving the patient a bulldog look.
- Crossbite- The upper teeth do not come down slightly in front of the lower teeth.
- Open bite- There is a space between the biting surfaces of the front teeth when the back molars come together.
- Spacing- Gaps between the teeth as a result a missing tooth or teeth that just do not fill up the mouth.
- Crowding- When there is just not enough room or too many teeth for the arch to support.
- Misplaced midline- When the center of the upper teeth does not line up with the center of the lower teeth.
- Misaligned teeth- The most common issue addressed by the orthodontist, that of crooked or not straight teeth.
Common Orthodontic Treatments
To address any of these issues the most common treatments include different appliances, both fixed and removable. These appliances help move teeth, will retrain your muscles, and will affect the growth of your jaw. They work by simply applying gentle pressure on the teeth or jaws. The severity of your situation will dictate which treatment is best for you.
Braces, which is by far the most common appliance used in orthodontics, are now available in multiple formats. You can have the traditional, metal braces on the outside of your teeth or you can now have those wires mounted on the inside of the teeth, so they are not so visible. Both methods are now available in a ceramic format which again are less visible. Finally, the newest method that is growing in popularity is Invisalign. Clear, plastic trays designed by a CAD/CAM system are created to be worn 22 hours a day for two weeks and then replaced with the next tray. These trays, like the traditional braces, simply apply gentle pressure to move the teeth. Of course, these trays are removable.
Your general family dentist will have a good relationship with a trusted orthodontist in your market. If you are diagnosed with one of the listed issues, they will refer you to the orthodontist. You will have a relationship with your dentist for your lifetime. Your relationship with your orthodontist will be focused on the orthodontic treatment and regular follow-ups to monitor the results of the treatment.
The health industry strongly suggests that you brush your teeth twice a day for two quality minutes each time. You should compliment those good habits with flossing at least once. These at home oral health care efforts then should be supported by dental office visits twice a year. Your dentist or orthodontist will monitor your efforts and build a history of your oral care. Professional teeth cleaning assists you with your efforts of removing damaging plaque and to continue with a deliberate preventative approach.
Your orthodontist understands these issues and embraces your oral health and the contributions a healthy smile has on your self-esteem and your self-confidence. Your orthodontist will be a valuable member of your oral health team.
How Does Orthodontic Treatment Work?
Orthodontics is a specialty branch of the dental sciences. To know how orthodontic treatments work we will start with general dentistry first and then flow into specific problems and treatments that would need orthodontic treatment. Dentistry, or the dental sciences, is a branch of medicine that studies and focuses on any and all conditions related to the oral cavity. Dentistry diagnosis’s provides prevention and treatments of diseases, disorders and conditions associated with your teeth, gums, and all soft tissues of the mouth.
Like a medical doctor, the education necessary is extensive. The candidate begins with four year of undergraduate studies. Upon entering the dental college, they will dedicate another four years to studying and training regarding all issues and conditions with your oral health. Upon completion they will earn a Doctor of Dental Sciences degree and can practice general dentistry. These dentists are your family dental practices that have a good, overall, general understanding of dentistry. If the candidate desires to extend their studies into a specialty another two years will be necessary to accomplish that goal. There are nine recognized branches or specialties with orthodontics representing about 6% of practicing specialists. Orthodontists are trained to diagnose and treat issues with your teeth, gums and mouth that relate to proper alignment. They focus primarily on tooth and jaw alignment making sure they are set correctly. A quick list of common issues that orthodontic treatment will correct are:
- Misaligned Teeth
- Crowded Teeth
- An Overbite, an Underbite, an Open Bite, or a Cross bite
- Spacing, or gaps called Diastema
- Issues with your jaw such as TMJ
How does Orthodontic Treatment work?
Most of the issues listed above can be addressed with a form of an appliance, such a braces or clear aligners. The teeth are gently moved by a controlled force or a period of time. This takes time because below the surface of the gums your teeth are held in place by many ligaments and sometimes the movement includes the rebuilding of bone tissue.
The types of appliances most commonly used
The orthodontist will review your situation and determine the type of appliance that will work best for you. The first option is the traditional metal braces. A bracket is affixed to each tooth and then a flexible arch wire is attached to each bracket or band. The arch wire will deliver the tension to push or pull the teeth into the desired position. You can take the brackets and wire and move it to the inside of the teeth, or the backside facing your tongue, so they are harder to see. This method is called lingual braces. Another option is to have the brackets made from a tooth-colored ceramic, so they are also more difficult to see. Finally, a recent option driven by modern day technology is that of Invisalign. This method is clear plastic trays. These trays are designed by a CAD/CAM system, digitally starting where your teeth are and then projecting movements for the desired results. Every two weeks the trays are changed out with the trays designed to continue to push the teeth. These trays must be worn 22 hours a day to achieve their results, but they are difficult to see and are removable.
How do these appliances actually move the teeth?
All the appliances mentioned and used work by constantly putting a pushing or pulling pressure on your teeth, slowly encouraging them to move into the desired position. It is important to understand that as you look at yourself in the mirror you are only seeing the crown of each tooth. Under the gumline the roots of the tooth are protected by something called a periodontal membrane. So, the braces not only encourage the crown of the tooth and the roots called alveolar bones to move they are also putting pressure on the soft tissues as well. This membrane, including supporting ligaments, will literally stretch out allowing the tooth to move. This process is actually much like bone remodeling. This movement ends up being a good thing as it strengthens the tooth. The pressure applied results in new types of cells which then enhances bone density.
The benefits of Orthodontic Treatment
There are the obvious benefits of having your teeth aligned properly. This might also lengthen the life expectancy of the teeth involved as well as reducing any discomfort or pain. The perception of a healthy smile looking back at you in the mirror is foundational for your personality, your self-esteem, and your self-confidence. Talk to your family dentist and see if any orthodontic treatment can improve your oral health.
Choosing an Orthodontist
An orthodontist is a dentist who has extended his/her studies and training in the Dental Sciences to specialize in orthodontic treatment. A high-level view is simply the proper alignment of your teeth and jaws. They also are trained to assist in dentofacial orthopedics, which is the development of the face and jaws. An orthodontist specializes in correcting your bite, an occlusion, and the natural straightness of your teeth. Orthodontists are also credited with the creation of beautiful smiles across all patients, children, young adults, and mature adults.
The orthodontist will help you by aligning your teeth, improving your bite, or fitting you with corrective braces or a similar device. The orthodontist will also help you with any TMJ or TMD disorders, and jaw issues.
Consider an image of a tree. The Dental Sciences is the trunk, the specialties are the branches. In the United States the American Dental Association recognizes nine specialties in the Dental Sciences. They are orthodontics and dentofacial orthopedics; periodontics; pediatric dentistry; prosthodontics; oral and maxillofacial surgery; oral and maxillofacial pathology; endodontics; public health dentistry; and oral and maxillofacial radiology. The base, or dental sciences, is the practice of studying, training, diagnosis’s and treating any issues associated with the oral cavity. This includes your teeth, your gums, all soft tissue, your jawbones, and even facial circumstances because of your mouth. Through extended education the specialty branches bring into focus a very specific area of treatment.
A Doctor in Dental Sciences will undergo four years of undergraduate studies then another four years in the dental college. After that, a specialist such as an orthodontist will study yet another two years focusing on orthodontic treatment.
Choosing Your Orthodontist
Often times what happens is your orthodontist is a referral based on your evaluation or consultation with your family dentist. Even if that is the case you can still consider several of the following suggestions:
- Consider their education- Once you have a list, either referrals or self-guided, do your research. Where did they go to school for their education and what kind of continuing education do they participate in. Make sure they are a licensed member of the American Association of Orthodontists and that they are up to date on the latest and most effective clinical treatments.
- Think about a consultation from more than one orthodontist- No different than buying a car or hiring a painter, develop your options. Orthodontists may very well have different treatment styles. You can compare their suggestions, the length of time involved and the cost. Compare their chairside manner and is the staff friendly and helpful.
- Ask questions at your consultation- Research your orthodontic problem before your consultation so you are prepared to ask questions. The orthodontist will appreciate your embracing the issue and solution.
- Some additional considerations- Does the orthodontist oversee your treatment or an assistant? Think about office location and your travel. What are the office hours in comparison to your daily schedule? Will they accept your insurance plan, and will they assist with submissions?
If you have crooked teeth you certainly can skip an evaluation by your family dentist and seek out an orthodontist on your own. Pay close attention to the treatment suggestions and have the potential office review your insurance coverage. Not all orthodontic treatments are covered because some insurance plans may consider an orthodontist a specialist.
Common Orthodontic Treatments
The American Association of Orthodontists recommends that you take your child in for an orthodontic evaluation no later than the age of 7. The orthodontist can spot subtle problems with the growth of the jaw and emerging teeth that your family dentist may miss.
The most common orthodontic treatment that we are all familiar with is that of wearing corrective braces. These appliances correct crooked teeth, spacing gaps, overbites, underbites, cross bites and all alignment issues. The traditional braces are metal brackets affixed to the teeth with arch wires fastened to the brackets. The adjustments in the arch wire creates a gently pushing or pulling of the teeth for the desired correction. Braces can now be mounted on the lingual side, or the inside of the teeth, to reduce visibility. The metal can be replaced with natural colored ceramic to do the same. The latest in orthodontic treatment is the introduction of Invisalign. This CAD/CAM generated solution creates clear plastic trays. To be worn 22 hours a day and then replaced ever two weeks with the next tray, the digitally designed trays introduce gently pushing and pulling as well.
Your orthodontist is an important member of your oral health team. They are conscious of your alignment issues for medical reasons but also very tuned into the health of your smile and the benefits it brings to your quality of life.
Benefits of Orthodontics
Although the primary benefit is very much visual, the cascading list of benefits of having orthodontic treatment goes much deeper than just what you see. Let us first identify what the practice of orthodontics is, the number of treatments they specialize in, and then address the benefits of those treatments from the visual to your oral health to your mental health.
In the US nine specialties are recognized by the American Dental Association: orthodontics and dentofacial orthopedics; pediatric dentistry; periodontics; prosthodontics; oral and maxillofacial surgery; oral and maxillofacial pathology; endodontics; public health dentistry; and oral and maxillofacial radiology. To achieve a specialty a candidate must first complete four years of undergraduate studies, then four year of the dental sciences earning their Doctor in Dental Sciences, then finally another two years of their chosen specialty.
An orthodontist specializes in dealing with the initial diagnosis, the prevention, and the correction of any mispositioned teeth and jaws and misaligned bite patterns that may be the result of those problems.
Common Orthodontic Problems
A quick list of the most common orthodontic problems is:
Crooked Teeth- Teeth come in crooked because there may not have been enough room.
Extra Space between Teeth- Called Diastema this is a gap between teeth. Sometimes hereditary, sometimes from a missing tooth.
An Overbite- When the upper jaw protrudes more than 10% over the lower teeth. These can cause speech impediments such as a lisp, difficulty eating and some jaw pain.
An Underbite- The opposite of an overbite, much like a bulldog. This problem can cause speech impediments, difficulty eating, some jaw pain and the teeth will not wear evenly.
Crossbites- When the upper teeth on one side end up on the inside of the lower teeth causing the teeth to wear down unevenly and also the possibility of gum disease and bone loss.
Open Bites- A problem when the jaw is closed, the back teeth are touching, and the front teeth are not. This problem can lead to speech issues, the teeth not wearing evenly and jaw pain.
The Most Common Orthodontic Treatments
Research claims that close to 70% of people have some mild orthodontic problem. The lion’s share of orthodontic problems are addressed with some form of an appliance to gently move the teeth. So, we will focus on those common treatments. Traditional braces consist of a series of metal brackets attached directly to the teeth. These brackets are linked by an arch wire that is used to move the teeth. You can choose to move the wire to the inside of the teeth and that is call a lingual set of braces. There are now ceramic brackets and wires available to minimize the visibility of the braces. Finally, a newly introduced method is called Invisalign. Designed by a CAD/CAM system, this features a series of removal plastic trays that through their digital design move the teeth. They are to be worn 22 hours a day and are to be replaced by the next tray every two weeks.
The Benefits of Orthodontic Treatments
The most obvious benefit is immediately the visual difference. Whether it be straight teeth or correcting an overbite, the orthodontic treatment has given you back a healthy natural smile. Research has shown that a healthy smile can easily be the foundation for your personality. It can drive your improved self-esteem and self-confidence in your personal circles, your social encounters, and your professional engagements. So, the mental benefits are difficult to quantify but are evident non the less. The physical benefits can result in correcting a speech impediment, the logistics of simply biting and chewing, and extending the life expectancy of your natural teeth. Of course, the elimination of any and all jaw pain goes without saying that that is a huge benefit. If some of these problems are left unattended, they can result in unnecessary stress on your gums and supporting bones, facial and neck pains and even pounding headaches. These orthodontic treatments in the long run are less costly than dealing with some of these unnecessary problems from the lack of the proper orthodontic care.
An Orthodontic Referral
If you do indeed see a general dentist twice a year for the suggested checkups and evaluations, they can and will refer you to a trusted orthodontist in your market. You should always, day in and day out, continue to exercise good oral hygiene at home and see your dentist consistently to remain in a preventative mode for your oral care. An orthodontist may see you after your treatment to do the same thing, to monitor the improvements and to maintain their condition.
Difference Between Orthodontist and Dentist?
Dentistry, or the dental sciences, is a branch of medicine that studies and focuses on any and all conditions related to the oral cavity. Dentistry diagnosis’s provides prevention and treatments of diseases, disorders and conditions associated with your teeth, gums, and all soft tissues of the mouth. The field of dentistry or dental medicine also includes aspects of craniofacial issues such as the temporomandibular joint and other supporting elements such muscular, lymphatic, nervous, vascular, and anatomical structures.
The history of dentistry dates back thousands and thousands of years. In fact, dentistry is thought to have been the very first specialization in all of medicine. The word dentist derives from the French and Latin words for tooth. All branches of dentistry are practiced around the globe according to the World Health Organization because oral diseases are a major public health problem, even more specifically with the disadvantaged social-economic groups.
Education necessary to qualify for a Doctor of Dental Sciences begins with at least four years of undergraduate studies resulting in a bachelor’s degree followed by four years of dental school. After receiving the DDS degree, they next can add additional education to focus on one of the nine branches or disciplines focusing on various specific areas on oral medicine.
The Different Branches of the Dental Sciences
The branches are as follows and the area of focus:
- Endodontics- the dental specialty concerned with the study and treatment of the dental pulp.
- Orthodontics-is a specialty of dentistry that deals with the diagnosis, prevention, and correction of mispositioned teeth and jaws, misaligned bite patterns.
- Minimal intervention dentistry-is a modern dental practice designed around the principal aim of preservation of as much of the natural tooth structure as possible.
- Prosthodontics-also known as dental prosthetics or prosthetic dentistry, is the area of dentistry that focuses on dental prostheses.
- Pediatric dentistry-the branch of dentistry dealing with children from birth through adolescence.
- Periodontics-the specialty of dentistry that studies supporting structures of teeth, as well as diseases and conditions that affect them.
- Oral and maxillofacial surgery-a surgical specialty focusing on reconstructive surgery of the face, facial trauma surgery, the oral cavity, head and neck, mouth, and jaws, as well as facial cosmetic surgery.
- Oral pathology-concerned with diagnosis and study of the causes and effects of diseases affecting the oral and maxillofacial region.
- Oral medicine-the discipline of dentistry concerned with the oral health care of medically complex patients.
The primary difference between a general, family dentist and an orthodontic then begins with the additional education for the orthodontist allowing a focus on more specific needs versus just an overall oral health care approach.
The Treatments and Procedures
Let us now look at the procedures that you can expect from the office of either your family dentist or an orthodontist. The American Dental Association, or ADA, defines a practicing dentist encouraging good oral hygiene and then provide services related to tooth decay, root canals, gum disease, crowns, bridges, veneers and even teeth whitening. Your orthodontist will specialize in misaligned teeth, crowded teeth, an overbite or an underbite. They will help you by aligning your teeth, improving your bite, or fitting you with corrective braces or a similar device. The orthodontist will also help you with any TMJ or TMD disorders, jaw issues or even suggested extractions.
Your Family Dentist
The relationship between your family dentist and a recommended orthodontist will often look like this. The health industry strongly suggests that you schedule regular preventative appointments with your family dentist twice a year. At these visits you can expect to have a thorough diagnosis of your teeth and your gums and all soft tissue. They will look for any tooth decay and any indication of periodontal disease, or gum disease. If all looks well, they will provide you with a professional cleaning of your teeth and send you off.
If the patient is your child and the family dentist suggest you might want to have the teeth straightened, an orthodontist will be suggested. Or if you are tired of your overbite and underbite again an orthodontist will be up next on your oral health team. In either case the orthodontist will evaluate the situation and make some suggestions based on the patient. Orthodontic correction can be provided by traditional braces, or braces mounted on the inside of the teeth, clear braces that are more difficult to see or even the new Invisalign system that uses CAD-CAM developed trays to move the teeth. If you have developed uncomfortable TMJ pain an orthodontist is trained to assist with this problem.
An orthodontist can play an important role in your oral health or your child’s. They certainly appreciate the value of a healthy smile.
Patients who have crooked or misaligned teeth, but would prefer to avoid having traditional dental braces may be good candidates for Invisalign. Invisalign treatment involves wearing customized trays for approximately 22 hours a day. Treatment time will vary from patient to patient but averages under 15 months in our practice.
Patients who have crooked or misaligned teeth may benefit from having dental braces. By wearing braces over an extended period of times, patients can enjoy improved oral health, develop a better bite, and improve their overall dental health. In addition to straightening teeth, braces can also help improve other issues, such as malocclusions, underbite, overbite, or other flaws in your jaws and teeth.
Teeth Whitening & Ortho
Patients who have braces often find it difficult to perform teeth whitening procedures. Our office has several in-office teeth whitening procedures that we can provide and is also happy to discuss different take-home kits and teeth whitening products and help you learn best practices for practicing good oral hygiene that is compatible with your orthodontics.
Habit therapy refers to an approach to help patients (typically children, but adults as well) learn how to break habits that are having a negative impact on their oral health. For children, this typically presents in the form of thumb sucking, but there are a variety of habits that can be addressed and improved. Our clinic has resources and many different painless exercises for you and your children that, over time, can help them break bad habits and develop good ones.
Patients who have severe oral issues, such as incorrect position of teeth (malocclusion), jaw bone abnormalities, or severely bad bites may benefit from orthognathic surgery, a method for treating such severe cases. Although not commonly performed, undergoing orthognathic surgery can have a significant impact on improving periodontal problems, joint paint, facial dysfunction, speech difficulties and other related issues.
Palatal expansion refers to a treatment that is typically performed on children, although adults can also benefit from the treatment, especially for obstructive sleep apnea. Palatal expansions use a palatal expander to widen the maxillary (upper jaw) to improve the fitting of the top and lower teeth and allow better healthier positioning of our tongue.
Obstructive Sleep Apnea
Patients who snore heavily or wake up gasping for air while sleeping may be suffering from obstructive sleep apnea. Obstructive sleep apnea occurs when the patient’s throat muscles relax to the point that they begin to block the airway. There are a range of treatment options available, the most popular of which is a CPAP machine. Share your experience with Dr. Pan to see what we can do for you.
A common misconception for people who wear braces is that once they have finished their treatment, their teeth will be permanently corrected. While it would be nice if this were the case, the truth is that your teeth can shift back towards their original locations. To prevent this from happening, it is now considered best practice to begin wearing a retainer following the removal of your braces for a life time retention. There are several different retainer options that are available. Dr. Pan will discuss what options are available and are best suited to meet your unique needs.
Sleep apnea affects over 18 million Americans, and most commonly presents itself as heavy snoring or waking up gasping for air while sleeping. If you are experiencing any of these symptoms, you may be suffering from sleep apnea. Sleep apnea occurs when the patient’s throat muscles relax to the point that the muscles block the airway. There are many health risks associated with sleep apnea, including behavioral problems in children and an increased risk of stroke or heart attack in adults. Fortunately, there are a range of treatment options available, including lifestyle changes, CPAP machines, or surgery.
Special Needs Dentistry
Patients who require assistance for a disability (mental, medical, or psychological) and/or who have been diagnosed with issues such as ADHD, Down Syndrome, behavioral issues, and cleft lip often require unique approaches to their dental care. Our staff is trained to provide special needs dentistry care, with an emphasis on creating a safe and loving environment that puts our patients at ease and providing them support through the means of enhanced communication and positive reinforcement.
Tooth exposure is performed when a permanent tooth fails to erupt. This can occur for a variety of reasons, such as large curves of the root, the tooth bud being abnormally positioned, or the tooth becoming fused to the bone. Regardless of the reason, it is important to have this procedure performed, because if left untreated, your teeth can become misaligned which can alter your bite and negatively impact the appearance of your smile.
TMJ & TMD
Patients suffering from TMD (temporomandibular disorder) have a dysfunction of their TMJ (temporomandibular joints), which is the joint that is responsible for connecting your lower jawbone and skull together. There are a range of factors that can cause TMD, such as arthritis, stress, or bruxism. If you have been experiencing locking in your jaw, difficulty chewing, or tenderness or pain in the area surrounding your jaw, you may be suffering from TMD. Fortunately, there are steps you can take to correct this issue, which we will be happy to discuss with you.