Orthodontics

LUCKY SEVEN

For seven-year-olds, teeth are a “hot topic” everywhere; friends are losing teeth, there are tooth charts at school, and The Tooth Fairy is making frequent visits. It's a big deal for them, and a great time for parents to inculcate proper oral care. 

"It’s a great hallmark stage to see exactly where the patient is at and rule out potential issues requiring early intervention.” - Dr. Gordon Dixon, San Diego orthodontist.

At their first orthodontic visit, we enjoy talking with patients and parents about the exciting changes that are occurring as the permanent teeth begin to erupt. Additionally, we will observe and review the following:

• Growth and development of teeth
• Bite/Occlusion/Function
• Facial harmony
• TMJ Health
• X-rays (if needed)
• Baseline and measurements of spacing/crowding

Our pediatric dentists and orthodontists work closely together as a team to facilitate the care for our patients. If the pediatric dentist sees a potential issue like an impacted, crowded, or poorly positioned tooth, they may have the orthodontist come over immediately to check it out.
Also, when a child with braces comes in for a cleaning, the orthodontist can easily remove and put back on the wires or appliance for a more thorough cleaning. We believe our team approach is a huge benefit and convenience for our patients.

The goals of early treatment are to correct severe growth disturbances of the jaw (overbite, underbite, crossbites) and re-establish harmony in facial/skeletal growth. Early treatment also helps make room for permanent teeth to come in properly, lessening the chance for extractions in the future.

As an ounce of prevention, early orthodontics can improve the following imperfections:

• Early or late loss of baby teeth
• Difficulty chewing or a shifting bite
• Prolonged thumb, finger, or tongue habits
• Crowded, misplaced, or blocked out teeth
• Speech problems
• Biting of the cheeks or roof of the mouth
• Protruding teeth
• Teeth that don’t meet or meet abnormally
• Facial imbalance or asymmetry
• Grinding or clenching of teeth
• Inability to comfortably close the lips
• Alterations in skeletal/jaw harmony

If you recognize any of these problems, San Diego orthodontic experts Dr. Thurston and Dr. Gordon Dixon can provide a comfortable solution for your child.

DOES MY CHILD NEED TWO-PHASES OF TREATMENT?

Not necessarily. Some children can benefit from early orthodontic treatment (also called Phase I Orthodontic Treatment). For example: if your child has severe crowding of the permanent teeth, aesthetic concerns, jaw growth discrepancies, space loss in one or both dental arches, or functional problems (crossbites, deep bites, underbites, or protrusions), then it's reasonable to address these problems early on to avoid future expenses and further damage in the teen-adulthood years. 

HOW LONG DOES IT TAKE?

An average two-phase treatment plan consists of the first phase of approximately 12-18 months of active orthodontics in the mixed dentition (permanent and baby teeth are present) at an average age of 7-9 years. 

This is usually followed by a period of wearing retainers as the remaining permanent teeth erupt. The second phase of active orthodontic treatment follows the intermediate retention period once all of the permanent teeth have erupted, and takes approximately 1 ½ years. 

WHAT IF I NEED TO PUT OFF TREATMENT?

Your orthodontists in San Diego, Dr. Thurston and Dr. Gordon Dixon understand life's circumstances may require delaying appropriate treatment for your child. They will discuss with you the advantages, disadvantages associated with them so that you may make an informed, educated treatment decision for you or your child.

Again, not all children will require early phase orthodontics. But as mentioned, treatment of severe crowding or functional problems at an early age will allow the orthodontist to utilize the patients’ active growth as well as produce benefits such as:

• Decreasing the risk for dental trauma due to a protrusion or “buck teeth"
• Decreasing the need for extractions of permanent teeth to align crowded teeth
• Controlling harmful habits
• Shortening the treatment for full braces during the critical “teen” years
• Facilitating proper jaw growth and enhancing the facial profile (proper growth relationship of the upper and lower jaws to each other)
• Customized program flexibility for both children and sometimes even adults

The total active treatment time for two phases of treatment is approximately 2 – 3 years split into two time periods to optimize long-term stability and harmonize aesthetics.

Whether it is a big dance, senior pictures, or a family event, we know teens are motivated to complete any needed orthodontic care as quickly as possible. But we can't give you a beautiful smile without your cooperation!

When we consult with the parent and teen, we present a time frame for orthodontic treatment. Please note the following factors may affect the length of time and end result of treatment:

• Growth & development of individual patient
• Good oral hygiene techniques and habits
• Patient cooperation
• Keeping regular scheduled appointments

At each appointment, we will review your child’s oral health and hygiene to see if improvement is needed. We'll also offer suggestions to speed up treatment along the way!

Whether it is preparing for a complex restorative procedure or creating a beautiful smile to make the best of your facial features and personality shine through, we will help. We can work closely with your general dentist and the finest specialists to give you an outstanding result!

Notice some of the cosmetic benefits of adult orthodontics:

• Increased confidence and self-esteem
• More attractive, younger looking appearance
• Smile Rejuvenation (“Brace lift”)
• Facial harmony and beauty

Notice some of the functional benefits of adult orthodontics:

• Improved chewing and eating
• Improved speech
• Relief from jaw or TMJ pain
• Improved hygiene and dental health
• Protection from grinding or clenching
• A more balanced bite

“We are happy to offer a good emergency call system to our patients because in certain instances, there is only a window of time where we have the best chance for saving a tooth.” – Dr. Amodeo

• Loose Bracket: The loose bracket usually remains connected to the main wire. You may use tweezers to reposition the brace or gently slide the brace over next to an adjacent brace. Wax may be placed to hold the loose brace in position. Please call our office so we may schedule an appointment to repair the broken bracket and restore comfort.
• Poking Wire: A wire can typically be covered with wax for comfort or you may gently slide the wire around until it is not poking. An eraser end of a pencil or a Q-tip is often handy if you need to push gently on a wire so that it is not poking. Please call our office to schedule a time for us to repair your wire.
• Loose Main Wire: If the main wire has come out of the tube on your back molar tooth, you may attempt to insert the wire with your finger, a pair of needle-nosed pliers, or tweezers. If the wire is not poking you, place a piece of wax over the area. If the wire is poking you and wax does not help, the wire can be cut with a small wire cutter or fingernail clipper close to the back of the last brace (this is a last resort). Please call our office so that we may schedule an appointment to make you comfortable and repair the broken appliance or wire.
• Sore Teeth: If your teeth are sore after your adjustment or initial placement of braces, you may take Tylenol (acetaminophen) or Advil (ibuprofen) as prescribed by the doctor or as directed on the medication by age and weight. It is not uncommon to have a generalized tenderness after a wire adjustment. This soreness will decrease over 3-4 days. Cool foods (smoothies, ice cream) soften the wire and are effective at relieving discomfort as well. A bite wafer has also been included in your new patient kit. Some patients find clenching into this soft wafer an effective way to minimize any discomfort. It is unusual for patients to have unexplained tooth discomfort several weeks after your last regular visit. If your teeth suddenly get sore between visits, please call our office.
• Impacted Food: If food becomes stuck between your teeth, use dental floss or a proxy brush to dislodge the food.
• Missing Spacer or Separator: Use a double thickness of floss to check the area. If the double thickness floss catches between the teeth, call our office so we may help you schedule an appointment to replace the spacer. If the double thickness of floss does not catch between the teeth, it means there is adequate space and the spacer does not need to be replaced. Please do not hesitate to call if you have questions or are uncertain about the space.
• Swallowed Appliance: First, remain calm. Using the diagram provided in your new patient kit, you may determine what piece may have been swallowed. This will usually go into the stomach, passing out of the body in a bowel movement. If you should experience difficulty in breathing, coughing, or choking, you should seek immediate medical attention. X-rays may be taken to determine the location of the swallowed piece. Please inform one of the doctors if you swallow any piece of an orthodontic appliance.
• Broken Retainer: Remove the retainer from your mouth and bring all the pieces to our office for laboratory repair.
• Cut Gums/Tongue/Cheek: Apply gentle pressure with a tissue or gauze to the bleeding site for several minutes. Be aware that a small amount of blood in your mouth may appear larger in your mouth because of the presence of saliva. If the bleeding does not stop, call your orthodontist, pediatric dentist, or general dentist.

An orthodontist is a dental specialist who has received two to three years of additional intensive training, study, and experience exclusively in orthodontics. Your orthodontist is able to straighten teeth, correct misaligned jaw structure, improve the function of your smile, and create facial beauty.

• ALWAYS remember to brush your teeth after every meal and floss at least once a day.
• Make sure to use toothpaste that contains fluoride and ask your orthodontist or family dentist if you need a fluoride rinse. This will help prevent cavities!
• During your treatment, try to avoid foods with a lot of sugar. Sugar increases the ability of plaque (bacteria) to cause cavities and gum disease.
• Avoid sticky and chewy foods (caramel, chewing gum, gummy bears), hard foods (hard candy, nuts, ice cubes), or any goods that could get stuck in your braces (corn on the cob, ribs, taffy, etc).
• Be sure to schedule your routine checkups with your family dentist or pediatric dentist. It is recommended that you continue to visit the dentist every six months.