COMMON PROBLEMS

Crowding occurs when teeth have insufficient room to erupt from the gum. Crowding can often be corrected by expansion, and many times, tooth removal can be avoided.

If you have missing teeth or if your teeth have gaps between them, APDO can help.

If you have missing teeth or if your teeth have gaps between them, APDO can help.

Like protrusion, an overbite can cause the lower front teeth to bite into the roof of the mouth but because the upper front teeth extend out over the lower front teeth.

When your lower jaw protrudes out from your upper jaw, lower teeth will close in front of your upper teeth causing both cosmetic and physical challenges.

If you have an open bite, you may have difficulty chewing your food because the upper and lower front teeth don’t overlap. This can lead to several unwanted habits such as tongue thrusting.

Off-center teeth means the line between your two upper front teeth and your two lower front teeth are not aligned.

INVISALIGN CARE

Any time you take your aligners out of your mouth, rinse them thoroughly under running water. This will rinse away bacteria, saliva, and food particles.

Proper care isn't just about clean aligners — your teeth need to stay clean, too! Be sure to brush and floss your teeth regularly to prevent build up of plaque and bacteria under the aligners.

Proper care isn't just about clean aligners — your teeth need to stay clean, too! Be sure to brush and floss your teeth regularly to prevent build up of plaque and bacteria under the aligners.

This is a great way to keep your aligners free of bacteria and plaque.

Ideally, you want to brush them every time you take them out or put them back in — but be careful, as overzealous brushing can leave visible marks and scratches.

Foods and colored drinks can stain your aligners and leave an unpleasant smell, so stick with water while you're wearing them.

Toothpaste is great for your teeth, but it can harm your aligners. When you brush them, do so gently and without paste.

Using anything but clear soap with aligners can cause them to stain.

In general, you should carry at least three pairs of aligners with you when you travel — your current set, your previous set, and your next set. If you'll be out of town for more than a few weeks, we recommend taking more.

It's easy to lose a case, so we always recommend bringing a backup just in case.

While it's best to brush them every time you take them out or put them back in, at a restaurant in another country, this may not be practical. At a minimum, you can rinse out your mouth and aligners before putting them back in, then brush once you're back in your room.

FAQ

No, it is not. Many of our patients are referred by their family dentist, yet many other patients take the initiative to schedule an examination themselves.

The American Association of Orthodontists recommends an orthodontic screening at age 7. By this age, several permanent teeth in most children have erupted, allowing us to effectively evaluate your orthodontic condition.

No, they will not. The space available for the front teeth does not increase as you grow. In most people, after the permanent molars erupt, the space available for the front teeth decreases with age.

If you or your child can potentially benefit from orthodontic treatment, simply call our office, send us an e-mail or fill out our appointment request form online. We will be happy to schedule an appointment for you. When you call to schedule your appointment, our front office staff will request some basic information from you.

Upon arriving, each patient and parent will be seen by the staff and doctor who will acclimate you to our office and prepare for the initial exam. We will take the necessary photographs and X-rays to allow us to make a proper diagnosis. The doctor will then complete a brief, but thorough, exam.

Removing teeth is sometimes required to achieve the best orthodontic result. Straight teeth and a balanced facial profile are the goal of orthodontics. However, because new technology has provided advanced orthodontic procedures, removing teeth is not always necessary for orthodontic treatment.

Treatment time obviously depends on each patient's specific orthodontic problem. In general, treatment times range from 8 to 30 months. The "average" time frame a person is in braces is approximately 18–24 months.

It is impossible to give an exact cost for treatment until we have examined you. We will cover the exact cost and financial options during the initial examination. We have several financing options available to accommodate your needs, and we will review these with you. We will also review your insurance policy and help to maximize your benefit and file your claims.

Appointments are scheduled according to each patient's needs. Most patients in braces will be seen every five to 10 weeks. If there are specific situations that require more frequent monitoring, we will schedule appointments accordingly.

Unfortunately, we cannot schedule all appointments for students during after-school hours. However, because most appointments are scheduled five to 10 weeks apart, most patients will miss minimal school due to their orthodontic treatments. We will, however, make a sincere effort to meet your scheduling needs.

Yes. We understand your busy schedule, and we are happy to help you make the most of your time. On some occasions, we may request to speak with a parent when they return, so we ask that parents check in with their patient manager before dropping off their child.

Generally, braces do not "hurt." After certain visits, teeth may be sore for a few days. In these situations, pain medications such as Advil or Tylenol will ease the discomfort. However, after most visits, patients do not feel any soreness at all! We often remind our patients, “It does not have to hurt to work!”

Yes. There is no reason to miss school because of an orthodontic appointment.

No. Shots are not necessary in orthodontic treatment.

Absolutely not! It is our belief that each patient should be provided with their own.

Yes. We recommend a mouth guard for all sports.

Yes! Regular checkups with your family dentist are important while in braces. Your family dentist will determine the intervals between cleaning appointments while you are in braces.

Yes. Once treatment begins, we will explain the complete instructions and provide a comprehensive list of foods to avoid. Some of those foods include: ice, hard candy, raw vegetables and all sticky foods (i.e., caramel and taffy). You can avoid most emergency appointments to repair broken or damaged braces by carefully following our instructions.

Patients should brush their teeth at least four times each day — after each meal and before going to bed. We will show each patient how to floss their teeth with braces and may also provide a prescription for a special fluoride, if necessary.

If your braces are causing extreme pain or if something breaks, you should call our office. In most cases, we can address these issues over the telephone. If you require an emergency appointment, we will set aside time for you.

Yes. Some orthodontic problems are significant enough to require early intervention. However, if a patient is not yet ready for treatment, we will follow that patient's growth and development until the time is right for treatment to begin.Patients should brush their teeth at least four times each day — after each meal and before going to bed. We will show each patient how to floss their teeth with braces and may also provide a prescription for a special fluoride, if necessary.

Phase One treatment, if necessary, is usually initiated on children between the ages of 7 and 10. Phase One treatment lasts about 16–21 months. The primary objective for Phase One treatment is to address significant problems to prevent them from becoming more severe and to improve self-esteem and self-image.Patients should brush their teeth at least four times each day — after each meal and before going to bed. We will show each patient how to floss their teeth with braces and may also provide a prescription for a special fluoride, if necessary.

It is best to assume that your child will need full braces even after Phase One treatment. The period following Phase One treatment is called the "resting period," during which growth and tooth eruption are closely monitored. Throughout this period, parents and patients will be kept informed of future treatment recommendations.Patients should brush their teeth at least four times each day — after each meal and before going to bed. We will show each patient how to floss their teeth with braces and may also provide a prescription for a special fluoride, if necessary.

At the completion of the initial examination, we will determine whether a patient will need an expander.Patients should brush their teeth at least four times each day — after each meal and before going to bed. We will show each patient how to floss their teeth with braces and may also provide a prescription for a special fluoride, if necessary.

A surprising percentage of our patients are adults. In fact, 25 percent of all orthodontic patients are adults. Health, happiness and self-esteem are vitally important to adults. No patient is "too old" to wear braces!Patients should brush their teeth at least four times each day — after each meal and before going to bed. We will show each patient how to floss their teeth with braces and may also provide a prescription for a special fluoride, if necessary.

Yes. A tooth with a crown will move just like a tooth with a simple filling. When teeth are missing, orthodontic treatment will aid in the alignment of the remaining teeth.Patients should brush their teeth at least four times each day — after each meal and before going to bed. We will show each patient how to floss their teeth with braces and may also provide a prescription for a special fluoride, if necessary.

Teeth, and sometimes entire facial structures, are permanently changed by orthodontic treatment. It is important that the treatment be appropriate and properly completed. Orthodontic specialists have extensive and specialized training that enables them to provide their patients with professional, personalized treatments.Patients should brush their teeth at least four times each day — after each meal and before going to bed. We will show each patient how to floss their teeth with braces and may also provide a prescription for a special fluoride, if necessary.

Wear your removable retainer full time as instructed. For most patients this is only for 1 month. Once you are given permission to switch to nighttime only wear of your removable retainers, you need to wear them while you sleep FOREVER. We provide a lifetime Retainer Guarantee, which you can read all about here

EMERGENCY INFO

Thankfully, true orthodontic emergencies are exceedingly rare — but they can happen. We can handle most problems over a phone call, but if you have a more serious or pressing issue, we will schedule an emergency appointment ASAP and get you back on track to your new smile. While emergencies can range from minor issues to serious problems, we're here to help you no matter what happens, and the first step is always to call our office.

Oral Hygiene/Prevention

Equally important to brushing is flossing, as only flossing can clean the areas between the teeth. You should start flossing your child's teeth as soon as the spaces between the teeth are too narrow to clean with a toothbrush, which usually occurs around ages 3–4. If your child is wearing braces or has difficulty flossing and is over age 6, there's a Waterpik oral irrigator designed specifically for children that can help.

HABITS

The number one thing to understand is that all of the strategy in the world won't work unless your child wants to stop sucking their thumb or finger. There is no magic solution, silver bullet, or “simple trick” that will break a child’s finger habit for them! Breaking any habit requires willingness and dedication. Your child needs to be at a point emotionally and mentally where they are ready to participate in a habit breaking process. Therefore, your first priority is to get them to want to stop.

Make Them Think It's Their Idea. Nagging your thumb sucker is frustrating for both of you. Instead, encourage him or her to realize how much she has grown and changed. Remind them of the “baby” things they no longer do. Point out that there is no longer a use for diapers, bottles, or high chairs. Let them know how proud you are of that. Ask what else they think they will give up as they grow older. If he or she doesn't say thumb sucking, then you can gently suggest it.

Letting your child know that you notice their positive actions are good too. "Hey, I noticed you didn't suck your thumb on the drive back from the grocery store. Great job — that is really big boy behavior! Would you like a sticker?" One of the most important parts of this process is to ground everything in positivity — positive reinforcement is the most effective way to change behavior.

Once your child has decided they are ready to quit the habit, you can step in as their partner: you're there to help your child succeed. You will not be the evil parent forcing your will upon them — and maintaining this "partner" mindset will make them much more open to trying new tools or programs to help them stop.

SEDATION

Nitrous oxide is a mild sedative delivered as a gas through an oxygen mask. Patients usually remain awake for treatment and can talk to their dentist throughout the process. It's also called laughing gas for a reason — you may notice your child get giggly or start telling stories, and occasionally fall asleep. Once we complete the treatment, we'll turn the gas off, and the effects will wear off almost immediately. Side effects are very rare, but some patients may feel nauseous or have constipation.

This is another easy technique where your child will drink their prescribed medication. We offer a variety of oral sedatives, and we'll select the best one for your child based on their overall health, the severity of their anxiety, and how large of a dental procedure they need. Medications administered orally can take up to an hour to take effect and are usually mild — your child will probably relax and get a bit drowsy, potentially falling into a light sleep that they can be easily roused from. Oral sedation is not intended to make them unconscious or unresponsive. Very rarely, children may have an opposite reaction like crying or agitation.

This procedure will draw your child into a deep sleep. It's often the easiest on the child, and is safe and effective when administered by one of our highly trained, highly accredited professional dental anesthesiologists. The anesthesiologist will contact you prior to the appointment to answer any questions you may have and will take all of your child's information into consideration to develop a tailored anesthesia plan. In cooperation with our anesthesiologists, we look forward to providing excellent care for your child.

FAQ

Pediatric dentistry is a dental specialty that focuses on the oral health of young people. Following dental school, a pediatric dentist has two to three years additional specialty training in the unique needs of infants, children and adolescents, including those with special health needs.

A toothbrush with soft bristles and a small head, especially one designed for infants, is the best choice for infants. Brushing at least once a day, at bedtime, will remove plaque bacteria that can lead to decay.

"First visit by first birthday" is the general rule. To prevent dental problems, your child should see a pediatric dentist when the first tooth appears, usually between 6 and 12 months of age, certainly no later than his/her first birthday.

Baby bottle tooth decay is a pattern of rapid decay associated with prolonged nursing. It happens when a child goes to sleep while breast-feeding and/or bottle-feeding. During sleep, the flow of saliva is reduced and the natural self-cleansing action of the mouth is diminished. Avoid nursing children to sleep or putting anything other than water in their bedtime bottle. Encourage your child to drink from a cup as they approach their first birthday. He/she should be weaned from the bottle at 12–14 months of age.

Thumb and pacifier sucking habits that go on for a long period of time can create crowded, crooked teeth or bite problems. If they are still sucking their thumbs or fingers when the permanent teeth arrive, a mouth appliance may be recommended by your pediatric dentist. Most children stop these habits on their own.

Sealants are clear or shaded plastic applied to the teeth to help keep them cavity-free. Sealants fill in the grooved and pitted surfaces of the teeth, which are hard to clean, and shut out food particles that could get caught, causing cavities. Fast and comfortable to apply, sealants can effectively protect teeth for many years.

The American Academy of Pediatric Dentistry recommends you clean your child's teeth with water and a soft bristled toothbrush up to age 1. After 1 year of age, parents may use a small smear of fluoridated toothpaste on a soft bristled toothbrush to clean their child's teeth. A pea-sized amount of toothpaste may be used after age 2 and parents should supervise brushing to ensure children do not swallow excess toothpaste. See photos under the oral hygiene category.

To comfort your child, rinse his/her mouth with warm salt water and apply a cold compress or ice wrapped in a cloth on your child's face if it is swollen. Do not put heat or aspirin on the sore area, but you may give the child acetaminophen for pain. See us as soon as possible.

Fluoride has been shown to dramatically decrease a person's chances of getting cavities by making teeth stronger. Fluoride in the drinking water is the best and easiest way to get it, but to make sure your child is getting enough fluoride, have your pediatric dentist evaluate the fluoride level of your child's primary source of water. If your child is not getting enough fluoride internally through water (especially in communities where the water district does not fluoridate the water or if your child drinks bottled water without fluoride), your pediatric dentist may prescribe fluoride supplements.

With contemporary safeguards, such as lead aprons and high-speed film, the amount of radiation received in a dental X-ray examination is extremely small. Even though there is very little risk, pediatric dentists are particularly careful to minimize the exposure of child patients to radiation. In fact, dental X-rays represent a far smaller risk than an undetected and untreated dental problem.

A mouth guard should be a top priority on your child's list of sports equipment. Athletic mouth protectors, or mouth guards, are made of soft plastic and fit comfortably to the shape of the upper teeth. They protect a child's teeth, lips, cheeks and gums from sports-related injuries. Any mouth guard works better than no mouth guard, but a custom-fitted mouth guard fitted by our doctor is your child's best protection against sports-related injuries.

At about 6 months, the two lower front teeth (central incisors) will erupt, followed shortly by the two upper central incisors. The remainder of the baby teeth appear during the next 18 to 24 months but not necessarily in an orderly sequence from front to back. At 2 to 3 years, all of these 20 primary teeth should be present.

First of all, remain calm. If possible, find the tooth and hold it by the crown rather than the root. Replace the tooth in the socket and hold it there with clean gauze or a washcloth. If you can't put the tooth back in the socket, place the tooth in a clean container with milk and take your child and the glass immediately to the pediatric dentist. The faster you act, the better your chances of saving the tooth.

Sore gums when teeth erupt are part of the normal eruption process. The discomfort is eased for some children by use of a teething biscuit, a piece of toast or a frozen teething ring. Your pharmacy should also have medications that can be rubbed on the gums to reduce the discomfort.

Usually, the space will close in the next few years as the other front teeth erupt. We can determine whether there is cause for concern.

Primary, or "baby," teeth are important for many reasons. Not only do they help children speak clearly and chew naturally, they also aid in forming a path that permanent teeth can follow when they are ready to erupt. Some of them are necessary until a child is 12 years old or longer. Pain, infection of the gums and jaws, impairment of general health and premature loss of teeth are just a few of the problems that can happen when baby teeth are neglected. Also, because tooth decay is really an infection and will spread, decay on baby teeth can cause decay on permanent teeth. Proper care of baby teeth is instrumental in enhancing the health of your child.

Four things are necessary for cavities to form — a tooth, bacteria, sugars or other carbohydrates and time. Dental plaque is a thin, sticky, colorless deposit of bacteria that constantly forms on everyone's teeth. When you eat, the sugars in your food cause the bacteria in plaque to produce acids that attack the tooth enamel. With time and repeated acid attacks, the enamel breaks down and a cavity forms.

EMERGENCY INFO

Knocking out a permanent tooth is serious for your child and quick reaction and timing is critical. Make sure you retrieve the tooth, and only hold it by the crown or top and not the root end. You should rinse off the tooth but don’t try to clean it and don’t handle it more than necessary. Next, reinsert the tooth in the socket and hold it in place using a clean piece of gauze or cloth. If reinserting the tooth isn’t possible, put it in a cup of milk or water and see us immediately for an appointment with Drs. Anfinson, Wilson, Goldstein or Eardley.

If your child accidentally breaks a tooth, quickly rinse the mouth with warm water and put a cold compress over the injury to relieve swelling and pain. Retrieve any pieces of the broken tooth, if you can and seek immediate dental attention.

If your child has injured his or her jaw or you think they may have broken it, tie the mouth closed with a towel, tie or handkerchief and go immediately to the nearest emergency room.

If your child complains of a toothache, our doctors recommend relieving the pain with acetaminophen, NOT aspirin. It’s also important to keep the area around the painful tooth clean by rinsing with warm salt water. If the face starts to swell, you can use a cold compress to relieve the swelling. Please contact our office for an appointment with Drs. Anfinson, Wilson, Goldstein or Eardley as quickly as possible.

Baby teeth falling out is a natural occurrence and usually exciting if the Tooth Fairy visits your home. However, if your child incurs excessive bleeding after a baby tooth falls out, put tight pressure on the empty cavity with a folded piece of sterile gauze and have your child bite down on the gauze for 15 minutes. If the bleeding doesn’t stop, see a dentist right away.

Children love to play and sometimes accidents may happen that result in them biting or cutting their tongue, lip or cheek. If these injuries bleed, use sterile gauze or a clean cloth to apply firm, but gentle, pressure to the wound. If the bleeding doesn’t stop after 15 minutes of pressure, you should travel to the nearest emergency room. You can also apply ice to any areas of the face or mouth that bruise.

Your child will likely get a cold or canker sore at sometime. While these can be painful, they are not usually cause for emergency concern. Use over-the-counter medications to provide relief from pain and agitation. If the sores linger or recur, give us a call.

It’s possible that you may eat something or have an injury that will cause your braces to break or dislodge. If this happens, remember to only take out the broken brace or wire if it comes out easily. Never try to pull out part of your braces if it is painful to remove or stuck. Instead, cover any sharp edges with wax, cotton balls, gauze or chewing gum. DO NOT try to remove any wires caught in the gums, cheek or tongue; see a dentist right away. For loose or broken braces or wires that don’t cause any pain, an emergency trip to the dentist is not usually required. If you’re unsure, please give our office a call.