Orthodontics

An orthodontist is a dentist who has completed multiple years of specialized training to diagnose and treat dental and facial irregularities in patients. An orthodontist must apply, be accepted and graduate from an institution accredited by the American Dental Association. Throughout their training, the orthodontist learns skills required to manage tooth movement (orthodontic) and guide facial development (orthopedics).

It is recommended by the American Association of Orthodontists that a child first see an orthodontist by the age of 7 years old. You do not need to wait until all the permanent teeth are in before seeing an orthodontist. Some children may have tooth alignment or jaw growth problems than can be detected at an early age. Some of these problems are best treated early, thereby avoiding a more serious problem later on, minimizing or even eliminating braces as a teenager. 

• James "Jamie" F. Kane, III, D.M.D.
• Peiman Mahdavi, D.M.D.
• Katharine "Kate" Marcks, D.M.D.

The orthodontic department is open Monday, Tuesday, Wednesday and Friday from 7:30 a.m. to 4:30 p.m. We are also open one Saturday per month. Each orthodontist has a specific schedule and is only here on certain days. Our orthodontists work together as a team, and you are welcome to see any of them throughout your treatment. If you choose to see a specific orthodontist, your appointment times will be limited to the days that particular doctor is available.

Today, more than 30% of orthodontic patients are over 18 years old. The major difference between child and adult orthodontic treatment is that the adult bones are no longer growing. This means that it may take longer for adult teeth to move into their correct position, and certain bite discrepancies may not be fully corrected with orthodontics alone. Most of our adult patients can be treated with clear aligners (Invisalign) rather than traditional braces.

The orthodontist will evaluate your specific need by completing a full dental and skeletal examination, including the alignment of your teeth, the pattern of your bite, and the relationship of your jaws. The orthodontist will then sit down with you to discuss any problems they identify, and what treatment

options are available to you. There is no fee for an initial orthodontic evaluation.

This is a great opportunity to ask any questions, but remember this will not be your only opportunity! We love educating our patients and encourage you to ask questions anytime throughout treatment.

An orthodontist will recommend a set of comprehensive records to complete a formal treatment plan prior to starting orthodontics. Orthodontic records consist of a panoramic radiograph (to evaluate the development of all teeth) cephalometric radiograph (to evaluate the skeletal jaw relationship), digital intraoral scans (to fabricate virtual 3D models of the teeth) and digital photographs of your teeth and smile.

In most cases, the records simply allow the orthodontists to finalize the treatment plan that they discussed with you in your initial exam. In more complex cases, the orthodontist will need to review the full records before recommending treatment. We will have you return for a final consultation, where the orthodontic treatment coordinator and/or doctor will review your case and discuss any treatment options. Final consultations can sometimes be done virtually via Zoom, and for children can often be done with just the parent present.

Orthodontic treatment can be started on certain types of tooth problems before all permanent teeth have erupted. Early treatment usually begins after the four permanent upper and lower front teeth have erupted (between ages 7-9) and is recommended for several bite issues. These issues may include crossbites, excess spacing or crowding, open bites, deep bites, excessive overjet and underbites.

The advantages of early treatment include:

• Moving the front teeth back so they will be less susceptible to injury
• Improving the relationship of upper and lower jaws
• Taking maximum advantage of growth potential for successful treatment
• Improving facial appearance and self esteem
• Taking advantage of the good cooperation of patients this age
• Possibly avoiding the need for (or reducing the complexity of) further treatment when patient is older

Early treatment does not always require early braces. Our orthodontists also use space maintainers, removable retainers, fixed appliances, and/or Invisalign First (early clear aligner therapy) to achieve healthy smiles in younger kids.

In the comprehensive phase, the patient has all of their permanent teeth. The goals of treatment include straightening the teeth and achieving a healthy and functional bite. In some patients, comprehensive treatment can begin as early as 11-12 years of age in order to take advantage of growth. However, orthodontic treatment can be started at any age! We welcome older teenage and adult patients in our orthodontic department.

There are a few different types and styles of orthodontic appliances. The most common style of braces is the traditional metal (stainless steel) style. These are small braces that allow you to choose colored elastics to hold the wire in place. Many teenagers like the versatility of "changing their colors" for seasons, favorite colors, or sport teams.

We also offer clear (ceramic) braces. This style of bracket is less noticeable, but is bigger and bulkier than metal braces. The ceramic braces can slightly increase your time in treatment, and can only be placed on the upper teeth.

Invisalign is a different tool that our orthodontists can use instead of traditional braces in many cases. It works through a series of clear, removable, and comfortable aligners that no one can tell you're wearing- so you can smile more during treatment as well as after! For some tooth and bite problems, Invisalign may not be a suitable treatment option. Your orthodontist will discuss whether it is recommended in your particular case.

How does Invisalign work?

• You wear each set of aligners for 1 week, removing them only to eat, drink, brush, and floss.
• As you replace each aligner with the next in the series, your teeth will move - little by little, week by week - until they have straightened to the final position your orthodontist has prescribed.
• You'll visit us about once every 8-12 weeks to ensure that your treatment is progressing as planned

Successful orthodontic treatment requires excellent cooperation between the patient and the orthodontist. This "team" will work together to complete the goals established at the beginning of treatment. The patient's responsibilities include taking care of his or her teeth and wearing rubber bands, retainers, headgear or other appliances as recommended by the orthodontist.

Broken appliances can increase the length of treatment time and may affect the outcome of the orthodontic case.

For traditional braces, we recommend professional cleanings and cavity checkups at 3-month intervals. Your regular dentist (not your orthodontist) will provide these services.

Financial information and fee estimates will be thoroughly discussed with you at your initial consultation by our treatment coordinator. The following options are generally available:

OFFICE PAYMENT PLAN
An initial estimated payment of 33% is due the day that treatment begins. The balance will roll into a financial plan consisting of monthly installments. This is an interest-free payment plan.

PAYMENT IN FULL
A 2.5% bookkeeping courtesy is given for a credit card payment paid in full the day that treatment begins. All major credit cards are accepted.

FLEX PLANS
Companies may offer a medical spending account, which allows their employees to set aside pre-tax dollars to pay for future dental expenses. Please contact your employer for more details.

INSURANCE
Our office will be happy to assist you in determining if you have orthodontic coverage. In addition, as a courtesy to you, we will file your orthodontic claims. Please feel free to contact our office with questions on any of the options at (508) 653-2417.