Treatment Options
It takes special training and experience to match the best treatment options to the individual.
Many people “do braces.” Unfortunately, not everybody who does has had the extensive training of an orthodontic specialist! Some practitioners may have taken a weekend course on orthodontics and have decided to “give it a try.”
Which Plan?
An important key to long stability is choosing the most appropriate treatment for an individual. There is no such thing as a “one size fits all” treatment plan. No two individual cases are alike. There are many variables that contribute to an orthodontic problem. Unless these variables are incorporated into the treatment plan, long-term stability may be disappointing.
Not all treatment plans are created equal. For example, a common orthodontic problem is the protrusion of the upper teeth (buck teeth). Often this problem is due to an imbalance in jaw growth. The upper jaw may grow too much or the lower jaw may not grow enough. If there is an imbalance in jaw growth, in a growing individual, our preferred treatment is to use a nightbrace. A nightbrace is worn in the privacy of the home and works by slowing the forward growth of the upper jaw and teeth. This allows the lower jaw and teeth to grow forward and “catch up.” The advantage of this approach is that it corrects both the dental and facial imbalances. The disadvantage is that it requires the use of the nightbrace 10 to12 hours per day.
Another option to treat protruded (buck) teeth is to accept the facial imbalance and remove two upper side teeth. The space gained by removing the teeth is used to move the upper front teeth back into contact with the lower teeth. The advantage of this approach is that it does not require the use of a nightbrace and it can be used in a non-growing patient. The disadvantages are that it requires the removal of two teeth and does not resolve the underlying facial imbalance, if one exists.
In a growing patient, with a facial imbalance, we prefer the use of a nightbrace because it results in a more complete treatment. Many orthodontists do not use a nightbrace because they do not want to rely on patient compliance. Our philosophy is to present both options to the patient and parents or guardian and explain the advantages and disadvantages and let them decide.
Surgery
Most often surgery in conjunction with orthodontic treatment is done in non-growing (adult) patient cases. Surgery is typically used to correct an underlying imbalance in the growth of the facial bones. Occasionally, minor surgeries are done to uncover unerupted teeth or place dental implants.
If a case could benefit from a combination of orthodontics and surgery the patient will be made aware. Unfortunately, certain surgeries are not covered by major medical insurance. The insurance companies frequently consider these procedures “cosmetic.” Due to cost considerations, it may not be feasible to do surgery. As a result, both surgical and non-surgical options will be explored.
New Techniques
New treatment options and products are constantly being introduced into the orthodontic profession. Some of these represent a definite improvement over existing techniques. Others do not. Our philosophy at Haas Orthodontic Arts is to investigate these new options. If a new technique represents an improvement over an existing technique, it will be adopted. If the new technique represents an inferior choice, we will not offer it. Following is an example of each.
Dental/Orthodontic Implants: Recently, the use of small titanium posts placed into the bone, called implants, has been introduced. The use of implants to replace missing teeth and the use of implants to aid orthodontic tooth movements is a truly revolutionary and exciting advancement. As a result, we are incorporating the use of implants, especially in the adult patient, in ever expanding numbers.
Invisalign®: This recently introduced technique involves the use of multiple “aligners,” which have the appearance of a clear plastic mouthguard. The technology to produce the aligners is very cool, cutting edge and expensive. However, in our opinion, the tooth movements typically produced are questionable in terms of long-term stability. Due to this concern and the fact that many other techniques are available to duplicate these movements in less time and at far less expense, we have chosen not to incorporate Invisalign® into our practice.
Our Mission Statement
Treatment Timing
Treatment Options
Long-Term Retention
Conclusion
