We Have the AnswersFrequently Asked Questions

Just as there are specialists in medicine (such as cardiologists, gastroenterologists, neurologists, etc.), there are specialists in dentistry. Orthodontists are dental specialists who dedicate their professional lives to correcting misaligned teeth and jaws. Orthodontists are qualified dentists, who after graduating from dental school, go on to additional full-time university-based education in an accredited orthodontic residency program supervised by orthodontists. That training lasts three academic years. By learning about tooth movement (orthodontics) and guidance of facial development (dentofacial orthopedics), orthodontists are the uniquely trained experts in dentistry to straighten teeth and align jaws. Orthodontists diagnose, prevent and treat dental and facial irregularities. The majority of members of the American Association of Orthodontists (AAO) limit their practices to orthodontics and dentofacial orthopedics. Orthodontists treat a wide variety of malocclusions (improperly aligned teeth and/or jaws). They regularly treat young children, teens and adults. Selecting an orthodontist who is a member of the AAO is your assurance that you have chosen an orthodontist: the dental specialist with three years of post-doctoral, advanced specialty training in orthodontics in a university-based program accredited by the American Dental Association. Specialty education includes the study of subjects in biomedical, behavioral and basic sciences; oral biology; and biomechanics. Only orthodontists may be members of the American Association of Orthodontists (AAO).

Straight teeth help an individual to effectively bite, chew and speak. Straight teeth contribute to healthy teeth and gums. Properly aligned teeth and jaws may alleviate or prevent physical health problems. Teeth that work better also tend to look better. An attractive smile is a pleasant side effects of orthodontic treatment. An attractive smile is a wonderful asset. It contributes to self-esteem, self-confidence and self-image and important qualities at every age. A pleasing appearance is a vital component of self-confidence. A person's self-esteem often improves as orthodontic treatment brings teeth, lips and face into proportion. In this way, orthodontic treatment can benefit social and career success, as well as improve a person’s general attitude toward life. You may be surprised to learn that straight teeth are less prone to decay, gum disease and injury. Straight teeth collect less plaque, a colorless, sticky film composed of bacteria, food and saliva. Decay results when the bacteria in plaque feed on carbohydrates (sugar and starch) we eat or drink to produce acids that can cause cavities. Plaque can also increase the risk for periodontal (gum) disease. When teeth are properly aligned, and less plaque collects, these risks decline. And when teeth are properly aligned it is easier to keep teeth clean. As for injuries to teeth, protruding upper teeth are more likely to be broken in an accident. When repositioned and aligned with other teeth, these teeth are most probably going to be at a decreased risk for fracture. Untreated orthodontic problems can cause abnormal wear of tooth surfaces, inefficient chewing function, excessive stress on gum tissue and the bone that supports the teeth, or misalignment of the jaw joints, sometimes leading to chronic headaches or pain in the face or neck. Treatment by an orthodontist to correct a problem early may be less costly than the restorative dental care required to treat more serious problems that can develop in later years.

Baby molar teeth, also known as primary molar teeth, hold needed space for permanent teeth that will come in later. When a baby molar tooth is lost, an orthodontic device with a fixed wire is usually put between teeth to hold the space for the permanent tooth, which will come in later.

Pulling baby teeth may be necessary to allow severely crowded permanent teeth to come in at a normal time in a reasonably normal location. If the teeth are severely crowded, it may be clear that some un-erupted permanent teeth (usually the canine teeth) will either remain impacted (teeth that should have come in, but have not), or come in to a highly undesirable position. To allow severely crowded teeth to move on their own into much more desirable positions, sequential removal of baby teeth and permanent teeth (usually first premolars) can dramatically improve a severe crowding problem. This sequential extraction of teeth, called serial extraction, is typically followed by comprehensive orthodontic treatment after tooth eruption has improved as much as it can on its own. After all the permanent teeth have come in, the pulling of permanent teeth may be necessary to correct crowding or to make space for necessary tooth movement to correct a bite problem. Proper extraction of teeth during orthodontic treatment should leave the patient with both excellent function and a pleasing look.

Orthodontic treatment and a child’s growth can complement each other. A common orthodontic problem to treat is protrusion of the upper front teeth ahead of the lower front teeth. Quite often this problem is due to the lower jaw being shorter than the upper jaw. While the upper and lower jaws are still growing, orthodontic appliances can be used to help the growth of the lower jaw catch up to the growth of the upper jaw. Abnormal swallowing may be eliminated. A severe jaw length discrepancy, which can be treated quite well in a growing child, might very well require corrective surgery if left untreated until a period of slow or no jaw growth. Children who may have problems with the width or length of their jaws should be evaluated for treatment no later than age 10 for girls and age 12 for boys. The AAO recommends that all children have an orthodontic screening no later than age 7 as growth-related problems may be identified at this time.

Correcting jaw-growth problems is done by the process of dentofacial orthopedics. Some of the more common orthopedic appliances used by orthodontists today that help the length of the upper and lower jaws become more compatible include:

Headgear: This appliance applies pressure to the upper teeth and upper jaw to guide the rate and direction of the upper jaw growth and upper tooth eruption. The headgear may be removed by the patient and is usually worn 10 to 12 hours per day.

Forsus Appliance: The Forsus appliance consists of springs that connect the upper molars to the lower canines and may not be removed by the patient. By putting pressure on the lower and upper jaws, it can help influence jaw growth and tooth positions. The Forsus works on correcting your bite around the clock and can help correct severe protrusion of the upper teeth.

Palatal Expansion Appliance: A child’s upper jaw may also be too narrow for the upper teeth to fit properly with the lower teeth (a cross-bite). When this occurs, a palatal expansion appliance can be fixed to the upper back teeth. This appliance can markedly expand the width of the upper jaw and also push the molars back into a better biting position.

The decision about when and which of these or other appliances to use for orthopedic correction is based on each individual patient’s problem. Usually one of several appliances can be used effectively to treat a given problem. Patient cooperation and the experience of the treating orthodontist are critical elements in success of dentofacial orthopedic treatment.

Yes. Wearing a protective mouthguard is advised while playing any contact sports. Dr. Langberg will provide a complimentary mouthguard after getting your braces.

Playing wind or brass instruments, such as the trumpet, will clearly require some adaptation to braces. With practice and a period of adjustment, braces typically do not interfere with the playing of musical instruments. If you still have a problem after several weeks we can provide you with a lip guard that goes over the braces helping you to adapt to playing your instrument.

Estimates of treatment time can only be that - estimates. Patients grow at different rates and will respond in their own ways to orthodontic treatment. The orthodontist has specific treatment goals in mind, and will usually continue treatment until these goals are achieved. Patient cooperation, however, is the single best predictor of staying on time with treatment. Patients who cooperate by wearing rubber bands, headgear or other needed appliances as directed, while taking care not to damage appliances, will most often lead to on-time and excellent treatment results.

After braces are removed, the teeth can shift out of position if they are not stabilized. Retainers provide that stabilization. They are designed to hold teeth in their corrected, ideal position until the bones and gums adapt to the treatment changes. Wearing retainers exactly as instructed is the best insurance that the treatment improvements last for a lifetimes.

Studies have shown that as people age, their teeth may shift. This variable pattern of gradual shifting, called maturational change, probably slows down after the early 20s, but still continues to a degree throughout life for most people. Even children whose teeth developed into ideal alignment and bite without treatment may develop orthodontic problems as adults. The most common maturational change is crowding of the lower incisor (front) teeth. Wearing retainers as instructed after orthodontic treatment will stabilize the correction. Beyond that period of full-time retainer wear, nighttime retainer wear can prevent maturational shifting of the teeth.

In about three out of four cases where teeth have not been removed during orthodontic treatment, there are good reasons to have the wisdom teeth removed, usually when a person reaches his or her mid- to late-teen years. Careful studies have shown, however, that wisdom teeth do not cause or contribute to the progressive crowding of lower incisor teeth that can develop in the late teen years and beyond. Your orthodontist, in consultation with your family dentist, can determine what is right for you.

Jaw muscle and jaw joint discomfort is commonly associated with bruxing, that is, habitual grinding or clenching of the teeth, particularly at night. Bruxism is a muscle habit pattern that can cause severe wearing of the teeth, and overloading and trauma to the jaw joint structures. Chronically or acutely sore and painful jaw muscles may accompany the bruxing habit. An orthodontist can help diagnose this problem. Your family dentist or orthodontist may place a bite splint or nightguard appliance that can protect the teeth and help jaw muscles relax, substantially reducing the original pain symptoms. Sometimes structural damage can require joint surgery and/or restoration of damaged teeth. Referral to a TMJ specialist may be suggested for some of these problems.

Your dentist is probably recommending orthodontics so that he or she might treat you in the best manner possible to bring you to optimal dental health. Many complicated tooth restorations, such as crowns, bridges, and implants, can be best accomplished when the remaining teeth are properly aligned and the bite is correct. When permanent teeth are lost, it is common for the remaining teeth to drift, tip or shift. This movement can create a poor bite and uneven spacing that cannot be restored properly unless the missing teeth are replaced. Tipped teeth usually need to be straightened so they can stand up to normal biting pressures in the future.