Orthodontic Care from a Team that Cares
With a range of orthodontic treatment options from Alder Orthodontics, we can help you achieve a bright, beautiful smile that will last a lifetime. From regular orthodontic checkups to applying a variety of braces; our orthodontic team will provide you with the quality of care you deserve.
Invisalign®/ClearCorrect Removable Aligners
Having straight teeth is important not only for children, but for adults as well. As we grow older, our teeth tend to grow inward, creating crowding – a common problem for many adults. As a result, it may be difficult to keep teeth clean and healthy. Straightening your teeth with the aligner system can treat the crowding, bad bite relationships, and thereby help you maintain your dental health. It can also help you get the smile you always wanted!
What is Invisalign®/ClearCorrect®?
Invisalign® & ClearCorrect® are both treatments that use a technique to straighten your teeth without braces; a series of clear, removable aligners are custom-modeled to fit your teeth. The virtually invisible aligners gradually reposition your teeth into a smile you will be proud of.
Invisalign® & ClearCorrect® are made to fit your lifestyle:
- Clear, virtually invisible aligners
- Removable, will not get in the way of your activities
- Easy to remove to eat, brush, and floss
- Graduate to a new set of aligners about every two weeks
- Easy to monitor your progress with regular appointments with Dr. Alder
Invisalign has an improved system designed especially for teens. There is some teen treatment that would lend itself well to the Invisalign system. Careful patient selection for this mode of treatment is always indicated.
How Long Will Treatment Take?
Every patient is different and treatment times vary. Treatment time may be comparable to that of traditional braces. It varies, depending on your needs, but in some cases, clear aligners work in less than a year.
Why See An Orthodontist?
Many dentists are now offering clear aligners to their patients. Only orthodontists like Dr. Alder are specialized in the diagnosis, prevention and treatment of dental and facial irregularities. Orthodontists receive an additional 2-3 years of specialized education beyond dental school to learn the proper way to align and straighten teeth.
How Much Does Invisalign®/ClearCorrect® Cost?
Clear aligners are covered by orthodontic insurance the same as standard braces and may cost about the same as traditional orthodontic braces.
Not all patients are candidates for the clear aligner system. Please contact our office to schedule a complimentary consultation with Dr. Alder to see if the clear aligner system is right for you.
Two Phase Orthodontics
First Phase Treatment (Interceptive)
The goal of the first phase of treatment is to develop both the upper and lower jaws sufficiently to accomodate all of the permanent teeth.
Children sometimes exhibit early signs of jaw problems as they grow and develop. An upper or lower jaw that is growing too much or not enough, or is too wide or too narrow can be recognized at an early age. If children over four years of age have these jaw discrepancies, they are usually candidates for early orthodontic/orthopedic evaluation and treatment.
Because children are growing rapidly, they can benefit enormously from an early (interceptive) phase of orthodontic treatment. Orthodontic appliances can be used to correct the jaw shape and direct the growth toward an ideal relationship between the upper and lower jaws. A good foundation can be established thereby providing adequate room for eruption of all the permanent teeth.
Early interceptive treatment may prevent:
Depending on the severity of the problems, interceptive treatment may also decrease the length of time necessary for the second phase of treatment.Leaving a malocclusion untreated until all of the permanent teeth erupt could result in a jaw discrepancy too severe to allow achievement of an ideal result with braces alone.
Diagnostic records will be necessary to determine a treatment plan, the type of appliances needed and the duration of treatment. Typically, Phase One treatment last approximately 12-14 months. Regular check ups are usually 4 to 8 weeks apart.
Intermediate Retention Period
During this period the remaining permanent teeth are allowed to erupt. Retention and /or tooth guidance appliances may be recommended at the end of the first phase. Sometimes retainers are used for a short time only as they may interfere with the eruption of the adult teeth. In this case it is best to allow the existing permanent teeth some freedom of movement while final eruption of the teeth takes place. A successful first phase will have created enough room for the teeth to find an adequate eruption path and prevent impaction and displacement problems.
It is important to understand that at the end of the first phase of treatment, teeth are not in their final positions. This will be accomplished in the second (corrective) phase of treatment.
Selective removal of certain primary (baby) teeth may be in the best interest of enhancing eruption during this resting phase. Should this be necessary , it will be discussed with you and a recommendation will be sent to your dentist. Periodic recall appointments for observation will continue to be necessary throughout this intermediate phase on a four to eight month basis.
Occasionally when a patient is treated with a two-phase treatment program, the permanent teeth erupt more rapidly that anticipated. Should this occur, you will be advised and the patient will continue directly into the second phase of treatment without removal of the orthodontic appliances.
Second Phase Treatment (Corrective)
Each tooth has an exact location in the mouth where it is in harmony with the cheeks, tongue, jaws, jaw joints and other teeth. When this equilibrium is established, the teeth will function together properly. With good home care and retainer wear your teeth should stay healthy, stable, comfortable and look attractive. This is the goal of the second (corrective) phase of treatment.
Updated diagnostic records will need to be taken and a Phase two treatment plan made. Certain types of appliances were used in the first phase of treatment as dictated by the problem. The second phase is initiated when most of the permanent teeth have erupted, and usually requires braces for on all the teeth for a period of 12-24 months. Retainers are worn after this phase to hold the teeth in their new corrected positions.
Advantages of Two-Phase Orthodontic/Orthopedic Treatment
The two-phase orthodontic/orthopedic treatment is a very specialized process that encompasses jaw and facial changes (orthopedics) and tooth straightening (orthodontics). The emphasis today on living longer, staying healthy, and looking attractive requires optimum treatment results. The major advantage of two-phase treatment is to maximize the opportunity to accomplish the ideal healthy, functional, aesthetic and comfortable result that will remain stable.
The disadvantage to waiting for complete eruption of the permanent teeth and having only one phase of treatment is the possibility of a compromised result that may not be functionally healthy or stable and may require preventable adult tooth extraction or jaw surgery.
We hope that this information has helped you understand our "two-phase" philosophy. Please do not hesitate to ask us any questions that may assist you in understanding our treatment concepts.
The Herbst® appliance is designed to correct bites and improve facial profiles. The most common bite problem the Herbst® will correct is when the upper teeth protrude too far beyond the lower. We tend to think that the upper jaw and teeth are too far forward but, more often than not, this condition is due to a small lower jaw that is further back than it should be. The Herbst® will create growth in the lower jaw that was absent genetically. The appliance is cemented and will work for even the most sensitive patient because a constant force is much less painful and disruptive than intermittent forces, like a head gear, and is much more predictable as far as results.
It is often necessary to expand the upper jaw while the lower jaw advances, this is done with the addition of a Palatal Expander. The PSA is turned with a special key until the upper jaw is wide enough. The doctor will advise you about using the key and what to expect from this combination.
The Herbst® appliance can eliminate the need for extracting permanent teeth and/or the need for surgical corrections.
The Herbst® appliance is completely contained in your mouth, and is placed on your upper and lower teeth, staying there until the bite is corrected. At first your mouth will feel full and speaking will be temporarily awkward. You may also notice more saliva than normal, but this will decrease as you become accustomed to the appliance. Even though the Herbst® prevents the lower jaw from moving backward, opening and closing movement still occur easily and patients do not have any problems learning to chew their food with their lower jaw in this new position.
As with all kinds of braces, patients with the Herbst® need to be careful about what they eat. Hard, sticky, chewy and crunchy foods can loosen the cement and pull the braces from the teeth. Don't play with the appliance with your tongue or fingers. More braces are damaged by these careless habits than anything else.
Rubber bands or elastics are an important part of your orthodontic treatment. Rubber bands supply the pressure needed to move the teeth and jaws into the correct position. To achieve the optimal result from your treatment, the rubber bands must be worn as prescribed.
Any time missed wearing your rubber bands will only make your treatment take longer.
You are responsible for placing the elastic on your braces. Be sure to wear them all the time as instructed. Remove them only when you are brushing your teeth. We would like you to wear them while you are eating if at all possible. If you do remove them to eat, replace them immediately after your meal.
Always carry some elastics with you, then if one breaks you can replace it right away. If your supply is low, call the office. We can mail you some, or just stop by. If you forget to put your elastics on one day, don't double up the next day, just follow your regular instructions.
Rubber bands get tired. Change them frequently, at least three to four times a day. When they loose their stretch, rubber bands don't provide the proper pressure on your teeth. So it is very important to change them, even if they are not broken.
The rubber bands will make your teeth and jaws a little sore at first. That is because the teeth are starting to move, which is what we want! Usually the soreness only lasts a few days. Do not stop wearing the rubber bands! This will only make the soreness last longer and delay your treatment.
If you have any problems like frequent breakage, a wire/band or bracket loosening, or a hook breaking off, call the office as soon as possible. Don't stop elastic wear until your next appointment. These problems should be corrected as soon as possible.
Temporomandibular Pain Dysfunction Syndrome
The common term TMJ has become synonymous with many of the pains that occur in the head and neck (occasionally in the back) during lower jaw function or often at rest. The term is an abbreviation for the joint that permits movement of the lower jaw and might be more correctly referred to as TMD or Temporomandibular Disorder.
This condition is characterized by noise in the joints (with or without pain), reduced range of motion, ear pain, frequent headaches, facial or neck pain, and occasionally back pain. Pain or stiffness in these joints upon awakening is often diagnostic for what the lower jaw is doing during sleep.
We believe that we have adequately demonstrated clinically that a bad bite is instrumental in the creation of or the continuation of symptoms. The causes may be macro or micro trauma, and genetic or congenital malformation of one or both of the joints. The former is an accident that affects the head or neck in some fashion, and the second is what happens each time the teeth are put together during eating, clenching, or grinding.
We have been successful in the treatment of this disorder through the use of niteguards, splints, and traditional or clear aligner orthodontic treatment.
NiteGuards and Splints
Both of these devices are used to artificially modify the bite. The niteguard is constructed from a pliable but durable vinyl material, while the splint is classically an acrylic material similar to that used for dentures. Both are therapeutic in treatment of TMJ/TMD pain dysfunction syndrome. Either or both may be used to change the bite during those times that clenching or grinding may be difficult to control. This is especially true during sleeping hours.
We believe the key to the elimination of limited opening, locking (open or closed), pain during eating, frequent tension type headaches, spontaneous pain, pain or stiffness in the jaw upon awakening etc., is to keep the bite well adjusted on whatever appliance may be used. We routinely adjust our niteguards and splints to allow all involved structures (muscles, tendons, and ligaments) to resume their normal length and function.
We will also use niteguards for night tooth grinding (bruxism) as a preventive measure for abnormal wear on the teeth, deterioration of the supporting tissues and TMJ disorders.
The niteguards and splints can be long term appliances or short term appliances to help diagnose bite problems prior to orthodontic tooth movement. In addition, the bite on the teeth is often adjusted to eliminate early or premature contacts or interferences that affect the way the lower jaw functions.
These appliances can also be helpful in the healing process after major trauma to the lower jaw or a whiplash injury.
Why Wear Retainers?
Retainers, as the name implies, retain the teeth in the corrected position. Failure to wear retainers as directed, even for a short period of time, may cause the teeth to shift into pretreatment position. It is very important that you follow the specific instructions given to you to maintain satisfactory results.
- Retainers should not be worn while eating.
- Always bring your retainers with you for each appointment.
- If a retainer is lost or damaged, you will be charged for replacements or repairs.
- If you miss a few nights, wear the retainer full time. The teeth may be a little sore, but should realign in a short period of time. If they do not, call the office for an appointment.
- Do not chew gum – it sticks to the plastic.
Retainers are forever! If you stop wearing your retainers, your teeth may shift to the extent that you may need to be retreated!
Permanent retainers are thin wires bonded to the backs of the teeth the same way the braces are bonded to the fronts of the teeth. Lower permanent retainers are more frequently used than upper permanent retainers due to problems with bite clearance. (The bottom teeth may hit the upper retainer when you bite down) If you are interested in an upper permanent retainer, the doctor will advise you as to whether or not your bite will allow it.
Pros: They are not visible when you smile or speak. Permanent retainers do not impair your speech and you will never forget to wear them.
Cons: Permanent retainers do require special cleaning and care must be taken when eating certain foods. Also, they may require repair at some point, which can be done by your orthodontist or a general dentist.
Removable retainers are made of colored plastic that goes behind the teeth with a wire that goes along the fronts of the teeth. There are many different fun colors to choose from and since they are removable, there are no special hygiene requirements and no restrictions on eating.
Removable Retainer (Hawley) Instructions:
- Upon delivery, your retainers should be worn full time for the first two weeks. Remove it only during meals, active physical sports, and when brushing your teeth. (Always put it in your plastic case.) After the first two weeks, wear it for 12 hours a day.
- The retainer's plastic taste will disappear quickly, and your speech will return to normal after a few days of wearing the retainer.
- Your teeth will be sore for just a few days. If you have a sore spot after four or five days, please give the office a call.
- Clean your retainer with your toothbrush and toothpaste. Occasionally clean it with denture cleaner (Retainer Brite or Efferdent), using warm (not hot!) water.
- When it is not in your mouth, keep your retainer in its plastic case.
- Dogs love to eat retainers, keep it away from your pets!
- Bring your retainer to each visit.
An Essix Retainer is a removable, virtually invisible, plastic device that can be used not only for retention, but also for a variety of functions including tooth movement, bridges, bite planes, stabilizers, fluoride and bleaching trays, and TMJD relief.
The number one reason for retainer loss is pets. If left out, animals will often chew up the appliances. Other causes of retainer loss are due to melting (placing the retainer too close to curling irons and hot curlers) or misplacement (from wrapping the appliance in a napkin that is mistakenly thrown away). To avoid these hazards, always keep your appliance in the case provided.