Orthodontic FAQs

Is Invisalign as good as braces?

Invisalign and braces can treat a wide number of cases equally well. There are still lots of situations where Invisalign, or clear aligners, are not as effective as braces. The important take-home point is to understand whether braces are just a little better for your case or braces are a lot better than Invisalign for your case. Sometimes, the difference between Invisalign and braces is either inconsequential or is not important to the patient, therefore Invisalign is the appropriate choice in the case.

Does having phase I treatment eliminate the need for phase II?

In very rare instances, phase I treatment will eliminate the need for phase II. However, in the majority of cases, the phase I treatment then a second phase is necessary when all permanent teeth have erupted.

Do all orthodontists have the same goals for treatment?

Surprisingly, the answer is no. There is no “gold standard” for orthodontic treatment. Orthodontists’ preferences can vary widely in how the outcome looks. If patients get multiple opinions, it’s important to understand that different treatments will yield completely different results.

What’s the difference between Smile Care Direct and getting Invisalign from the orthodontist?

There are too many differences to list. Because Smile Care Direct does not use attachments or IPR, the treatment is limited in the direction and amount that teeth can be moved. Another major difference is how your bite will fit together. It’s impossible to adequately finish a bite (or treat occlusion) with unsupervised clear aligner treatment.

Does orthodontic treatment increase the chance of getting sleep apnea later in life?

There is currently no evidence that suggests orthodontic treatment of a child leads to a greater likelihood of sleep apnea in adulthood. There are multiple respected studies in peer-reviewed journals that show no connection between the two. Because sleep apnea involves the tongue, many people have incorrectly assumed that the teeth can play a role in where the tongue goes. While this is partially true when the mouth is closed, it is not true of an open mouth. Sleep apnea and other sleep disorder breathing events almost always occur when the mouth is open. There is no possible way that the teeth can play a role during these events.

Do I have to keep going to the dentist while I’m wearing braces?

Yes! Regular dental checkups and cleanings are necessary to maintain good oral health, even while your teeth are being moved.

How can orthodontics save me money?

Sometimes, when people are missing permanent teeth, instead of having bridges or implants to replace the teeth, orthodontists can move surrounding teeth into that space. Since the average cost of replacing a tooth is $5000, preventing the need for replacing one or more teeth can actually make orthodontics the cost-saving treatment.

Will my teeth stay straight after braces?

How well your teeth remain straight depends on two factors. The first, and most important, is whether the orthodontist chose a treatment plan that emphasizes stability of the result, even if retainers are not worn consistently. The second factor is about retainers – the retainer should be worn as the orthodontist recommends. Patient compliance is key to success. Each case is different, and for some people, retainer wear is critical, and for others, their teeth will remain straight without retainers. Dr. John discusses these aspects with every patient he treats.

Do wisdom teeth cause front teeth to get crooked?

The surprising answer is no, they do not CAUSE front teeth to become crooked. The reason teeth get more crooked as people age is much more complicated than just wisdom teeth. We know this because people who genetically do not have wisdom teeth have the same increase in crowding as those with all four wisdom teeth. Research has also shown that removal of wisdom teeth in the late teenage years can decrease the amount of crowding that a person experiences with age.

Questions About Children’s Habits

When should a child stop sucking their thumb?

Dr. John believes that getting a child to stop sucking his or her thumb needs to be done carefully, with love and a positive reinforcement plan. To achieve those goals, Dr. John feels that the child must be at least six years old to be able to actively participate in the very difficult choice to stop thumb sucking. Some children may be mature enough to make the decision at an earlier age, and that can be determined at your child’s initial exam. Dr. John cannot emphasize enough the need for a positive approach that will empower the child and lead to success.

When should a child stop using a pacifier?

Pacifier use after the age of six should be discouraged. Most will switch to their thumb, if a sucking need exists.

Can I get braces if I’ve had root canals?

Yes. Teeth that have had root canals can be moved the same as teeth that have remained healthy.

Can crooked teeth cause TMJ pain?

There are some specific types of bite that have been shown to increase the likelihood of developing TMJ pain, both in the joint and the muscles of the jaw. These cases are relatively rare. However, crooked teeth can be a contributing factor to TMJ symptoms and correcting crooked teeth can be the least invasive solution to help a patient reduce or eliminate TMJ pain.

Why does my child have such horrible teeth when my spouse and I have great teeth?

Orthodontic problems come from a collision of genetics. The upper jaw comes from one set of genes, the lower from a separate set of genes, and the size of the teeth comes from yet another set of genes. If a mom has small jaws and a dad has great teeth, but the child ends up with that mix, his or her teeth will be crowded, even though both parents’ teeth didn’t need braces.

Is there a way to make my teeth move faster?

As of 2019, there is only one method that has been shown to slightly speed teeth movement. The procedure is called osteo perforation. Small pinholes made between the teeth spur the body into a “healing” mode that has the side benefit of creating faster teeth movement. At this time, no vibratory method or laser or ultra-violet light method has been shown to decrease treatment time in orthodontics.

DO some braces move teeth faster than others?

Many braces manufacturers have claimed that their braces are “faster” than the competition. This question has been widely studied, and it has never been shown in split-mouth, side-by-side clinical comparisons on average groups of patients. In fact, the advertising regulatory commission of Great Brittain ordered the manufacturers of the Damon System bracket to cease and desist false advertising, because they could offer no evidence that Damon brackets move teeth faster.

Questions About Extractions and Orthodontics

Are tooth extractions necessary for orthodontics?

Before we can say anything about extraction of teeth, understand that if extractions are involved in an orthodontic case, it’s always harder for the doctor. Orthodontists want to avoid extractions just as much as you do! Having said that, extractions are still necessary in between 20-30% of cases (nationwide average according to surveys by the American Association of Orthodontists).

If extractions are recommended and I chose not to have them done, what will happen?

Moving crooked teeth without making room for them to straighten can lead to severe gum recession, as well as root canals and even loss of teeth. The result will be more forward in the mouth and may prevent the lips from coming together in a natural way. And finally, if extractions are indicated and not done, teeth are more likely to return to their initial positions – crowded and crooked.

Can the brand of braces the doctor uses reduce the need for extracting teeth?

The simple answer is no. Braces are literally small pieces of stainless steel that act like handles on teeth, allowing the orthodontist to use wires to move them into alignment. Teeth do not know what kind of braces they’re wearing. Anyone who tells you that different braces create different results should be viewed with a high degree of suspicion.

Do extractions for orthodontics change people’s faces?

No. The extractions themselves have nothing to do with the face. Facial change in orthodontics is determined by the position of the front teeth, because they support the lips. If orthodontics changes a person’s face, it’s only because the orthodontist him or herself moved the front teeth in a way that creates the change. The key to achieving the facial outcome that the patient wants is to choose an orthodontist capable of moving the front teeth for the best support and esthetics of facial structures.

Which teeth are usually extracted in conjunction with orthodontic treatment?

There are a wide variety of extraction patterns that are used in orthodontics. Sometimes just one tooth needs to be removed; sometimes four or more need to be removed. Each case is unique and depends on the facial and dental needs of the patient and the treatment goals of the doctor.

Do extractions make treatment easier for the orthodontist?

When extractions are involved in a patient’s orthodontic treatment plan, it’s always a more difficult case to manage for the orthodontist. As mentioned earlier, orthodontists want to avoid extractions as much as you do.

Can expansion prevent the need for extractions?

Only in a limited number of cases. Expansion is only possible for the upper jaw, not the lower. The amount of expansion is limited based on the size of the lower jaw. (Think of the lower jaw as a yogurt container and the upper jaw as the lid.) We can only make the upper jaw as big as the lower jaw allows. If expansion is overdone in an effort to “prevent extractions,” serious gum recession can occur later in life.