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Frequently Asked QuestionsWhat are the treatment parameters that you follow? Like every area of dentistry, the practice of orthodontics is continuously developing. The parameters for treatment encompass a wide variety of considerations, including early treatment, first phase treatment, functional therapy, mixed dentition, permanent dentition, extraction or non-extraction therapy, surgical considerations, temporomandibular joint complications, and retention. Each orthodontic case has two components to examine: the dental component and the skeletal or facial component. I analyze and evaluate the patient's dentition using dental models and panographic radiographs. The skeletal component of the examination includes a series of intraoral and extraoral photographs and cephalometric radiographs. The skeletal component of an orthodontic case may be dynamic if the patient is a growing child. Facial harmony is established when both components fit closely together. The further apart the two components are, the greater the discord and the more complex the case. At what age should general dentists refer patients to an orthodontist? The age at which we begin treating patients represents a paradigm shift in orthodontics. At the present time, the American Association of Orthodontists (AAO) recommends seeing children by the age of seven versus waiting until the 12-year molars have erupted. This change has come about in part due to the use of functional appliances. These appliances are used to arrest, enhance, and/or redirect skeletal growth. The fact that our professional journal is now called "Orthodontics and Dental-Facial Orthopedics" reflects this new emphasis on facial harmony in our specialty. In addition to facial orthopedics, another significant advantage to early mixed dentition treatment the preservation of teeth that would have to be extracted under permanent dentition treatment. Also early alignment of crowded or rotated anterior teeth decreases the potential for relapse since the transseptal fibers are reoriented and held in the corrected position longer. How do you structure your orthodontic treatment plan? A first phase of orthodontic treatment involving mixed dentition may consist of myofunctional therapy, maxillary and/or mandibular expansion, headgear, space maintenance, anterior alignment, a biteplate, etc. The fee for this first phase of treatment can range from $400.00 to $2800.00 depending on the complexity and scope of the case. We work with a patient's family to arrive at a manageable payment plan. My favorite time to begin a second phase of treatment or full treatment is when the first premolars have erupted but the deciduous second molars remain in place, generally speaking between the ages of 10 1/2 and 11 1/2. Beginning treatment at this stage of development enables me to fully utilize the leeway space during treatment. The fee for comprehensive treatment can range from $2200.00 to $4500.00. Surgery cases are not necessarily the most expensive cases since a surgical procedure often substantially reduces treatment time. Fees are based on complexity, type of therapy and duration of treatment. What is your approach to working with a patient's dentist? I consider communication with our patients' general dentist to be absolutely vital. This is especially true if their dentist has planned restorative work. I like to meet with the general dentist in person to establish an open line of communication and answer any questions about the patient's orthodontic treatment. Progress reports on active patients are sent to the general dentist in January and July. Because I believe teamwork between the orthodontist and general dentist is a prime factor in a successful treatment result, suggestions on enhancing patient care are always welcome. How do you stay current on new developments in orthodontics? To keep up with the changing face of orthodontics, I subscribe to various professional journals and attend several day and evening courses throughout the year. In addition, I attend at least one three-day course per year. The courses that may be of some interest to the general dentist would include Pankey's and Dawson's courses for specialists. With the next millennium just around the corner, I expect the pace of change in the field of orthodontics to increase as new methods and technologies evolve. Our office is committed to staying on the cutting edge of our profession by utilizing treatment enhancements such as digital photography and video imaging to serve our patients better. However, there is one constant that will carry us into the next century and beyond: our commitment to providing our patients the highest quality orthodontic services. What is a "gummy smile" and what should be done about it? As an orthodontist, I am often the first health care professional to analyze how a child will look when he or she grows up. When I examine a patient's facial features, I consider both the vertical and horizontal proportions of the mouth. The most common areas of imbalance horizontally involve the maxillas, the bones that form the upper jaw, and the mandible, the lower jaw. The upper jaw can be either too large or too small. If the region from the eyes to the upper lip is too small, the face will appear sunken in and the lower jaw will seem too strong, creating a generally unhappy or sour facial expression. If the upper jaw is too big, the gums will show whenever the lips are parted - producing a gummy smile. The technical term for this condition is vertical maxillary excess. Anything more than a little gum showing above the teeth is considered a gummy smile. Because a gummy smile is caused by a skeletal malformation involving the growth of the facial bones, early intervention is critical. Sometimes I can either redirect, stunt or encourage bone growth, depending on which is needed to correct the problem. In many cases, however, a surgical correction is required. If so, I refer the patient to either a plastic surgeon, who alters the soft tissue areas above the mouth, or a maxillofacial oral surgeon, who adjust the skeletal structure. Even if surgery is necessary to create the proper balance between the upper and lower jaw, I very often stay involved in the case in order to straighten the teeth for cosmetic purposes. In fact, the wires and brackets used for cosmetic corrections also play a role in correcting the skeletal components of the case. The oral surgeon uses the brackets, bands and wires that I install to move the jaws into the correct position and hold the skeletal parts together during the healing process, which takes four to six weeks. What insurance do you accept? We accept: Trigon, Aetna, Cigna, Great
Western, Massachusetts Mutual, Metlife, Mailhandlers, Prudential, Delta Dental,
Travelers, Signature, military United Concordia, United Concordia and others.
"While we cannot be responsible for insurance we will help with filing". OTHER QUESTIONS WE'LL WRITE ANSWERS TO 1. What is orthodontics? 2. Who needs orthodontics? 3. At what age should a child been seen by an orthodontist? 4. Is orthodontics expensive? 5. How long are braces worn? 6. Do braces damage teeth? 7. Is it true that orthodontics can contribute to mental as well as physical health? 8. What can happen if orthodontic problems go untreated? 9. What are congenitally missing teeth? 10. Is thumb sucking or tongue thrusting harmful to teeth? 11. Are two phases of treatment really necessary, or is it just a way for the orthodontist to make more money? 12. What are functional appliances? 13. What is headgear? 14. How often should a child wear his/her elastics? 15. How often should a retainer be worn? 16. Does a child still need to see his/her general dentist once orthodontic treatment has begun? 17. How do you become an orthodontist? 18. Do you enjoy being an orthodontist? 19. What about the new form of cosmetic dentistry for improving the appearance of your teeth? *** Our office offers a service to potential patients that allows them to see what they might look like after orthodontic treatment. Simply give us a close-up photograph of a frontal view of your face with a natural, toothy smile. We will return a photo that has been digitally altered to show what you might look like with straight teeth. |
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1029 West Mercury Blvd, Hampton, VA 23666 * {757} 838-2006
Member American Association
of Orthodontists |
