Q: What happens at the initial visit?

A: At this appointment, one of the doctors will perform a thorough clinical examination and discuss with you the current state of the patient’s dental condition. Sometimes, it may be necessary to obtain diagnostic records (see below) to aid in the diagnosis of a particular problem. If it is felt that the patient is not ready for treatment, the doctor may recommend that the patient return at a future time for a follow up examination.

Q: What are orthodontic records and why are they necessary?

A: Diagnostic records usually include an x-ray of the teeth (panoramic x-ray), an x-ray of the jaws (cephalometric x-ray), models of the teeth, and photographs of the teeth and jaws. These records provide a wealth of information that is not always apparent by a visual examination. We will check for missing teeth, extra teeth, the condition and development of tooth roots, the condition of the bone supporting the teeth, growth pattern of the face and jaws, jaw symmetry, facial esthetics, smile esthetics and a host of other factors.

Complete records form the basis for a thorough and accurate diagnosis and a sound treatment plan. If the doctor needs additional time to further study these records, you may be rescheduled to come back in several weeks for a consultation. At the consultation appointment, all aspects of treatment will be explained to you by one of the doctors. If treatment is indicated, you will also be quoted a fee for treatment at that time.

Q: What is the process of getting the braces on?

A: Generally, getting fitted with braces involves two appointments. The first appointment is short (15 minutes) and involves the placement of separators or spacers between the back molars. These spacers create a small amount of room between teeth so that bands that encircle the teeth can be placed. The following week a longer appointment is needed, from 45 minutes to 90 minutes, to place the braces. The actual process of placing the braces involves little discomfort. The teeth are polished, and their surfaces conditioned prior to placement of the braces.

Q: Do the braces hurt?

A: When patients leave the office after getting their braces, they usually will not feel any major discomfort. Over the next couple of days, patients can expect to feel some generalized soreness as the teeth begin to move. Additionally, their lips and cheeks may become sore as they rub against the surfaces of the braces. Again, this will last for a few days as the lips and cheeks become “toughened up.” Taking Tylenol as needed, or other over the counter medication, will help alleviate the soreness. Patients should maintain a soft diet for the first few days.

Q: How often do I visit the office once the braces are placed?

A: Typically, patients are seen every 4-6 weeks for normal adjustments of the braces. These appointments may typically last 30-45 minutes and are scheduled so as to minimize time away from school or work. Occasionally, longer appointments are needed during treatment if additional procedures are planned. You will be notified of these appointments ahead of time so you can plan accordingly.

Q: How long does orthodontic treatment take?

A: Since there is a large variation in possible treatment times depending on the complexity of treatment, the doctors will discuss with you the approximate length of time your treatment will last.

Q: Do I need to brush more often with braces?

A: Absolutely, the brackets on your teeth will collect more food and plaque than your smooth teeth did prior to braces, thus you will need to brush more often. We go over very thorough oral hygiene instructions including flossing and rinsing with fluoridated mouth rinses when any braces or appliances are placed.

Q: Do I need to continue seeing my general dentist throughout treatment?

A: It is absolutely necessary for patients to continue seeing their general dentists for regularly scheduled cleanings while undergoing orthodontic therapy.

Q: Are there certain foods I need to avoid when I have braces?

A: Yes. Certain sticky and hard foods need to be avoided in order to minimize the likelihood of breaking the appliances. After placing the braces, we thoroughly review the dietary guidelines and the “do’s and don’ts” of braces in general. Remember that patient cooperation is key to smoothly finishing treatment on time. The more patients break their brackets during treatment, the greater the likelihood the length of treatment will take longer.

Q: What happens if there is an emergency?

A: Orthodontic “emergencies” are rare, however, one of the doctors is always on call during off hours should an emergency arise. You can call the office after office hours for the phone number to call.

Q: Will the braces discolor my teeth or will I have gum problems after treatment?

A: You should not have any tooth discoloration (decalcification) or gum problems after orthodontic treatment if you follow all of our instructions relating to brushing, diet, and regular visits to your general dentist for regular maintenance visits.

Q: What are retainers?

A: Once braces are removed, some form of retention is needed. Retainers are used to maintain the teeth in their new positions. They are an extremely important part of treatment. Retainers are either removable or fixed to the teeth, depending on the severity of the initial condition. The doctors will instruct you as to the specific times retainers should be worn.

Q: I’m very concerned about esthetics and I don’t want metal braces. Are there any other alternatives?

A: Adults and some teenagers choose clear, or esthetic brackets, which are tooth colored and are considerably less noticeable than traditional metal brackets. Additionally, adults and mature teens may opt for the Invisalign System, which uses custom fabricated, clear, removable aligners to gradually straighten your teeth. The system uses 3-D virtual computer technology to move teeth to their desired positions. Both Drs. Russo and Nicozisis are certified Invisalign Orthodontists.

Q: At what age should a child have an orthodontic evaluation?

A: The American Association of Orthodontists recommends that every child receive an orthodontic evaluation at the age of 7. Of course not every child needs treatment at this age, however, it is a good idea to get a recorded baseline of their growth and development. Additionally, it is wise to make sure that there are not any special circumstances that need to be addressed early to decrease their severity as patients mature.

Q: Why is “early treatment” recommended for some patients?

A: In some cases, early diagnosis and treatment can guide erupting teeth into a more favorable position, correct crossbites, preserve space for future permanent teeth, improve the growth and alignment of the jaws, eliminate damaging habits and reduce the likelihood of fracturing protruded front teeth. Drs. Russo and Nicozisis will discuss with you your child’s dental and skeletal development to make the determination as to the need for any early treatment.

Q: If my child has early treatment, will additional treatment be necessary?

A: Although not definite, in most cases, yes. After the permanent teeth have erupted, treatment is usually necessary to complete the work that was started in the earlier phase since only specific problems were addressed in the early stage. The objective of a second stage of treatment is to place the permanent teeth in positions of optimal comfort, function, esthetics, and long-term stability. At the appropriate time, Drs. Russo and Nicozisis will review with you the possible need for further treatment.

Q: What will happen in the time between early treatment and full braces?

A: For most children, this growth and observation period will involve a combination of retaining the correction that has been made, and guiding the erupting permanent teeth into favorable positions. Since the timing of treatment is critical, your child’s growth and development will be carefully monitored during this period.

Q: Why is the growth spurt at puberty so important in orthodontics?

A: This is the time when much of the development of the face occurs. Treatment during this period allows the orthodontist to favorably influence the facial profile in a growing child.

Q: At what age is a patient too old for orthodontics?

A: Patients who have teeth with healthy supporting structures are never too old for orthodontic treatment. Age is not a factor. Many adults are receiving orthodontic care that was not available for them as children. They realize that improving the health of their mouths and the attractiveness of their smiles and facial appearance can result in positive changes in their personal, social, and professional lives.

Q: Will my insurance cover the cost of orthodontics?

A: If you have orthodontic coverage, it can help in reducing the portion of the fee that you are responsible for. Usually there is a lifetime maximum amount the insurance company will pay. We would be happy to assist you in determining your insurance coverage.