Many of these adults had braces as teenagers and either stopped wearing or lost their retainers that were given to them at the end of their active orthodontic treatment. Their teeth have moved significantly and they are seeking orthodontic treatment in an effort to bring back the smile that they once had.

The other group of adults has never had braces or retainers and always wanted straighter teeth but for various reasons never went through orthodontics as a teenager or young adult. Now they are seeking treatment before their orthodontic problems get worse.

Many adults find that as they age their teeth have moved and shifted forward. This is normal and part of the aging process. Lower front teeth that might have been slightly crooked are now very crooked and hard to floss.

Many adults also find that they have bite problems that they have been able to live with all these years, but now find they are having trouble chewing properly, are having pain and clicking in their jaw joints or headaches that are constant. While these symptoms may not all be related to a bad bite, they could be a factor and a consultation with an Orthodontic Specialist is recommended.

Fortunately, if you find out that you need orthodontic treatment as an adult (and grandparent!) you will find that there are many cosmetic options available to you today.

Rather than walking around with metal braces and looking like a teenager again, you can opt for the newest clear braces made out of porcelain. Unlike earlier clear braces that were made of plastic and picked up stains from coffee, tea and red wine, today’s clear braces are made of porcelain so they do not stain and maintain their color throughout your treatment.

An even better cosmetic choice is Invisalign. These are clear, removable aligners that are worn about 22 hours a day. Basically they are removed only for eating and brushing.

They are customized for each individual patient and the aligners are changed every 2 weeks. The teeth are moved in a prescribed fashion that has been set up by an Invisalign-Certified Doctor. Each set moves the teeth about ¼ of millimeter. While the movements appear small in size, they are very effective and targeted.

The clear aligners also are more comfortable and there is minimal discomfort compared to braces that are fixed to the teeth. A big plus is that they are virtually invisible!

There are also other removable choices available depending on the problem and goals of treatment.

Seeking a consultation with an Orthodontic Specialist is the best way to find out all your options as an adult. Make sure that the Orthodontic Specialist has significant experience with Invisalign if you prefer that option. Ideally a doctor with the designation as a Premier Provider or Elite Premier Provider will have the experience to determine if Invisalign if the best choice for you and if it is, be able to provide an excellent result for you.

Now with Invisalign Teen, teenagers do not need to have fixed braces placed on their teeth during their most self-conscious years and can still achieve a beautiful, healthy smile.

A survey done by Align Technology found that 94% of teens prefer Invisalign over braces.  Our experience in our offices verifies this fact:  Teens want a beautiful smile, but they DO NOT WANT braces.

As a practicing Orthodontist for over 27 years, I have finally realized this to be true. (I can’t believe it took me this long!)  While most children under the age of 12 are very excited about silver braces and all the great colors that go on the teeth, by the time these children reach middle school, the excitement about silver braces or even clear braces has all but disappeared.

Besides the fact that teens do not want fixed braces on their teeth, there are some significant advantages to Invisalign for the parents of these teenagers.

Most parents are both working or have other children that need to be driven to sports practices, music lessons and school events.  With Teen Invsialign, there are no more broken brackets at 8pm at night or a wire that is poking through the cheek at 7am.

Parents will not need to make extra time for emergency visits to get a bracket replaced or a wire trimmed.  Another huge advantage is sports.

Your average teenager today is involved in sports that often means travel out of the area.  What do you do when you are 100 miles from home and it is Saturday at the basketball tournament and your son just got hit in the face with a ball and half his braces are hanging out of his mouth?

With Invisalign the aligners can be worn during all sporting activities and can actually protect the teeth from injury.  No need to worry about a Saturday night visit to the emergency room to get braces removed that have been embedded into your child’s cheek.

Another big advantage for the parents and teens with Invisalign, is the fact that you do not need to change your diet.  No special foods or dinners need to be prepared for your child during his or her Invisalign treatment.  They take out their aligners and eat their favorite foods, brush their teeth and put them back into place.

Since they are removable, oral hygiene is a breeze and the permanent stains that can sometimes occur with fixed braces, will not happen with Invisalign due to ease of brushing and flossing.

In general, you will have less visits and less time spent in the Orthodontist office and your end result will be as good if not better than fixed braces.

Why do parents still choose fixed braces for their teens?

One reason is the perceived cost.  When Invisalign first came out in 1999 it was very expensive compared to fixed braces.  Since that time, the technology has improved and the costs have come down significantly to where in most offices nationwide, it is the same price as fixed braces.

A second reason, is that parents are worried their child will not wear them or lose their aligners.  Company wide, 1000’s of doctors who have be polled about this have all had the same experience like we have had, the teens wear their aligners better than most adults and they rarely misplace them.

The good news is that up to 6 aligners can be reordered at no charge if needed.  We often find this not to be necessary as the patient has worn the misplaced aligner long enough to just move forward to the next one a few days early.

We believe that clear removable braces, like Invisalign, are the future of Orthodontics and the best choice today for both Teens and Adults seeking a beautiful, healthy smile.

In our practices, we currently have patients in Orthodontic treatment as young as 6 years of age and the oldest patient is 81.  I know if you are reading this, you are thinking why would we treat a patient as young as 6 since they do not have all their adult teeth and on the other hand, why would someone 81 years old want braces?

I will explain both situations to you and share with you the options that are available at any age to improve your smile, make room for adult teeth, correct severe bite problems and eliminate jaw pain and excessive wear on your teeth and even help your heart!

Early interceptive Orthodontic treatment at ages as young as 6 or 7 is needed when patients have severe crowding (to prevent future extraction of perfectly healthy adult teeth) or to stop a bad thumb or finger sucking habit.  In some cases a severe underbite or overbite will also necessitate early orthodontic treatment.

Many adults, who did not have the financial ability as a child or teenager, now want to have a beautiful smile.  Fortunately, most adults can now have that picture perfect smile without braces!  Invisalign, a series of removable clear aligners, will move both adult and teen teeth effectively and predictably based on a computer-generated model of the teeth moving in stages.  Each stage of movement is a new set of aligners. No “metal mouth” and best of all less pain and typically treatment is completed sooner than with traditional braces.

Besides having a beautiful smile, straight teeth are easier to keep clean which greatly enhances the overall health of your gums and teeth.  Studies done in both medicine and dentistry have shown a link to cardiovascular disease and periodontal (gum) disease.  So straight teeth that are easy to floss and brush with also improve your heart health.

Clinical symptoms of untreated sleep disordered breathing (SBD) may include, excessive daytime sleepiness, bed-wetting, behavioral problems, failure to grow and in some cases heart complications.  If left untreated, these heart issues can become even more problematic in adulthood.

The dental signs of SBD are extreme wear of the teeth (due to grinding), cheek biting, narrow arches with severely crowded teeth or teeth in cross bite.  (A cross bite can be noticed when the child bites down and his or her jaw shifts to one side when closing or chewing.) Another common sign of SBD is abnormal tongue swallowing and positioning.  Often these patients breathe chronically through their mouth and position their tongue in a forward position to allow for mouth breathing to occur.

There are an increasing number of children with behavioral problems that are diagnosed as Attention Deficit Hyperactivity Disorder ( ADHD).  Many studies have shown that a large number of these children diagnosed with ADHD were later shown to have a sleep disorder that caused them to exhibit behavior problems during the day, due to lack of adequate sleep at night.

What should you as a parent do?

See your pediatrician and tell them about your concerns.  They will most likely evaluate the tonsils and adenoids and make a recommendation if they feel it is necessary, to have an evaluation by an ENT (Ear, Nose and Throat) Specialist.

Your family dentist is also a good source for referral to an Orthodontic specialist who can help your child increase their nasal breathing, correct the severe crowding and narrow jaws and eliminate the cross bites through the use of maxillary (upper jaw) palatal expansion.

An an Orthodontist , in practice for over 25 years, we have seen thousands of patients, some as young as 6 years of age,  who had expansion appliances placed in both upper and lower jaws, and all snoring and teeth grinding disappeared along with  cross bites and severe crowding.

Furthermore, numerous studies done mostly by the medical community have shown time and time again, the health benefits of maxillary palatal expansion. Some studies have also shown that problems such as bed wetting, excessive daytime sleepiness and even behavioral problems all are resolved with a change in the jaw size, shape and function and a substantial increase in nasal breathing through palatal expansion.

In summary, if your child has any of the following symptoms, they may be a candidate for tonsil and adenoid removal, as well as an evaluation by an Orthodontic specialist for maxillary palatal expansion.

• Continuous load snoring
• Chronic mouth breathing
• Excessive daytime sleepiness
• Frequent headaches
• Grinding and excess wear of the teeth (especially the baby teeth)
• Behavior problems such as not paying attention, aggressiveness and hyperactivity
• Enlarged tonsils and adenoids
• Problems sleeping, bed wetting and sleep walking

If you have concerns that your child may have SDB, a call to your pediatrician is the next step.  We also offer a free consultation to have your child evaluated to determine if their persistent snoring, teeth grinding or daytime sleepiness, could be due to narrow jaws, severe crowding, a cross bite or mouth breathing.   You can call Margaret at 916-435-8000 (Rocklin) or 530-432-3483 (Penn Valley) to schedule a complimentary evaluation.

 ~ Evan Esar

Technology has come such a long way in the last few decades.  Most people today know that we now have cars that start at the push of a button, computers that require a fingerprint scan, and cell phones that allow you to track the real-time locations of friends and family (Uh, oh! Your teenager may not like this one!).  Just as technology has advanced our lives in so many ways, it has also tremendously improved the design, shape and function of today’s modern braces.

Modern braces are individually designed to move each tooth in your mouth in a very specific manner.  In other words, each tooth in your mouth has a brace or “bracket” that is specific to its shape, size and form.  Many years of research and development have determined the accurate amount of tip, the perfect angulation and the ideal final position of each tooth.

The design and specifications of these braces came about in the late 1970’s.  Prior to this, the braces that were placed on patients’ teeth were not specifically designed for each tooth and did not have built-in angulations or ideal positions for the teeth.  Orthodontists were required to place bends in the wire to get the teeth to move into the correct position.

The “wire bending” that occurred essentially gave Orthodontists the name “Wire Benders.”  Imagine having that catchy title on your business card!  With today’s technology, Orthodontists rarely need to bend a wire.  The sophisticated braces that are used in modern Orthodontics provide a carrier for the wire.  The wire is engaged into the “bracket” slot and the actual slot has been machined in a specific way to move that particular tooth.  The wire then does its job of moving the tooth into its ideal position.

There have been many advances in wire technology that have helped improved tooth movement.  The wires that are used today move teeth more efficiently, with less discomfort and often in less time.  This is because of space age technology.  In the late 20^th century, scientists at NASA developed a metal to be used in outer space.  The result was a metal that changed Orthodontics forever: heat-activated nickel-titanium alloy wires.  Translation:  Wires that react to body temperature and move in a more flexible manner, compared to ordinary metal wires.  This meant that Orthodontists didn’t need to “bend wires” as much.  Thank goodness!  So when you get braces and people finally start to tell you that you have a spectacular smile, you can tell them that thanks to NASA, your smile really is out of this world!

The beauty about this type of wire is that it has the characteristic of maintaining its shape, no matter how crooked or twisted a patient’s teeth are.  This is what allows a patient’s teeth to move more efficiently and consistently over time.  Because of this constant force, the wires are less heavy than traditional wires and therefore cause less soreness.

If you’re wondering what holds the wire in place once it’s placed through the bracket, think of a color catalogue.  Why?  Because tiny orthodontic rubber bands are used to hold the wire in place – and these rubber bands come in different colors, which allow you to have fun with your braces!  Now you can choose rubber band colors to match your hair, outfit, mood and individual personality!

This is quite different from the way wires were held in place during early Orthodontics.  Back then, the wires were tied into place with a smaller, thinner wire called a ligature tie.  These were “spun” down and often patients could feel the wire tightened down on the bracket as the ligature tie was tightened down.  These are still used today for certain “stubborn” teeth and are still very effective in moving teeth.

A more recent development called self-ligation allows the wires to be held in place by a hinge type mechanism.  Despite what the term suggests, self-ligation does not mean that the patient may freely remove and replace his or her own dental wires just for fun (although patients have been known to remove their wires!)

Self-ligating braces basically have brackets with built-in clips or hinges, which essentially hold the wire in place.  This design is very clean and efficient (compared to colored rubber ties) because less food gets trapped around the brackets, making your braces easier to maintain.

As with most elastic products, the Orthodontic rubber bands will break down and lose their elasticity after a few weeks and so the wire is not engaged into the bracket as securely;  tooth movement is not as continuous and constant as it is with self-ligating braces.

However, with a wire clipped into place (such as that with self-ligation), there is continuous force placed on your teeth, which allow your teeth to move more efficiently and quickly.  There are several manufacturers of self-ligation braces:  Damon, SPEED, In-Ovation R and In-Ovation C, just to name a few.

Here’s what a patient said about his experience with self-ligating braces:

“The day I got my braces on I thought, ‘What the heck have I done?!’  I could not imagine 18 months of the discomfort and silly looking braces.  Thanks to SPEED Braces and the kind, happy and supportive staff, I look back now with pure gratitude. It only took 12 months (and I was prepared for 18 months!)  Overall I am glad I did this!”  Mark S (Age 50)

As the aforementioned testimonial states, self-ligating braces (in this patient’s case, the brand of his braces was SPEED Braces) move teeth continuously with constant force.  With self-ligating braces, it is quite common for patients to finish their Orthodontic treatment ahead of schedule.

Do robots that bend dental wires really exist?  Yes, it is true!  There is a company that gives Orthodontists a special machine unlike any other Orthodontic machine.  First, this machine scans a patient’s teeth after the braces are placed.  Then the scan is downloaded onto a special software that simulates the ideal position and bite of the patient’s teeth.  This program tracts and analyzes the movement pattern of each tooth before it enables a small “robot” to basically bend the wires, which are customized to each patient’s desired results.  This truly is a high tech (and as you can imagine) upscale method of straightening your teeth.

Another recent Orthodontic innovation is known as lingual braces.  These braces are placed behind the teeth.  Many patients opt for these braces because they do not want their braces to be seen.  For business purposes, it is typical for aspiring celebrities (and even existing celebrities) to choose these braces.  While you may not be a celebrity being interviewed on TV, you can have a CELEBRITY smile and with the many options available today, what are you waiting for?

If you or your loved ones have ever been a little unclear as to exactly what an Orthodontist is, the following thought may have crossed your mind: “Will someone please tell me who this person is, dressed in a Doctor’s white coat, fashioning a bright blue latex glove on each hand, and who is ready to poke and probe at my teeth?!”

The interesting truth is that an orthodontist is a dentist who, in addition to 4 years of pre-dental school and then 4 years of actual dental school, has taken 2 to 3 more years of specialized training in Orthodontics – a branch of dentistry that deals specifically with the correction of misaligned teeth. So the next time you meet an Orthodontist, know that he or she was required to read mountains and mountains of books – many of which probably featured a lot of words ending in “-ist!”

A dentist must attend an accredited Orthodontic school full time in order to become a specialist in Orthodontics. In 1900, the specialty of Orthodontics was established in St. Louis Missouri and the first association of Orthodontics came to be known as The American Society of Orthodontics. It was not until 1937, however, that the association name changed and is now known today as the American Association of Orthodontists, of which there are currently 15,000 members in the United States and Worldwide.

The work of an expert Orthodontist differs greatly from the work of a dentist, mainly because orthodontists are extensively and uniquely educated in tooth movement as well as jaw and facial growth and development. During the 2 to 3 years of Orthodontic school, an Orthodontist-to-be will study the growth and development of teeth, the biology and physics of tooth movement, the aging of teeth, gum diseases, the various methods of tooth movement, and different types of braces and retainers. Orthodontists in training also learn about the different types of functional orthodontic appliances and they are taught early interceptive treatment for children as young as five years old. But in reality, Orthodontists are trained to treat patients of all ages; an Orthodontist can have a morning appointment with someone who is forty-five years old and by noon, have an appointment with someone in the third grade.

Orthodontists study temporomandibular joint disorder (or TMJ Syndrome), which is a disorder that causes severe pain in the jaw and can be mistaken for an earache. Disorders of teeth, including misalignment, can worsen TMJ Syndrome. Orthodontists are experts at diagnosing jaw joint problems that may require braces and/or corrective surgery to alleviate the jaw misalignment problem. In separate cases that involve complicated treatment plans, an Orthodontist will collaborate with a Periodontist and a Prosthodontist to care for a patient who will need extensive restorative work after the braces are removed.

A Periodontist is a dentist whose area of expertise is in the prevention, diagnosis and treatment of disease in the gums and supporting dental bone structure. A Prosthodontist, on the other hand, is a dentist who specializes in restoring a patient’s teeth; these are usually cases that require fixed bridgework, porcelain veneers, dental implants, crowns, dentures or partial dentures. And then there is the branch of dentistry that entails the care and treatment of children’s teeth (often, these are children with special needs); a person who is an expert in this field is known as a Pedodontist.

A wealth of knowledge is bestowed upon Orthodontic residents during Orthodontic school. This wealth of knowledge is set forth by full time and part time professors and clinical instructors, many of whom run their own Orthodontic practices. With an abundance of new information and technology appearing daily on the market, Orthodontic specialists are now able to stay on the cutting edge. They are able to quickly deliver the newest treatment modalities with the best results. Since Orthodontists are trained to focus on straightening your teeth, they are the most qualified to give you the smile and jaw alignment that you and your family desire.

Below, I will outline the 5 top reasons YOU SHOULD get your smile straightened.

Number one would be appearance. Straight, white teeth are more attractive than crooked, yellowed and broken down teeth. Along with the straight teeth comes an improved bite. Various bite problems from overbite to underbite can cause excessive wear of your teeth, possible jaw joint problems and even problems breathing. Crowded teeth, crooked teeth, overjet and overbite can all lead to swollen, red, bleeding gums because it is difficult to brush and floss around them. This leads to next reason to get your teeth straightened.

Straight teeth are healthier teeth. Straight teeth get fewer cavities, are less likely to have problems with discoloration, uneven wear and fractures. The gums are healthier too and therefore you are less likely to develop periodontal (gum) disease. Straight teeth and healthy gums mean you can chew anything you want. Your teeth are less likely to be sensitive to heat or cold and you lower your risk of painful and expensive dental problems.

The number three reason to straighten your teeth is simply that you will feel better about yourself. True be told, appearance does matter. Studies have proven over and over again the advantages of an attractive appearance and smile as it relates to job opportunities. The amount of money you make and even the people you attract into your life. Like it or not, your smile is a reflection of you.

A fourth reason to get your teeth straightened is that it could potentially help you live longer. There are well known studies that prove that people who floss daily will live an extra 7 years longer. Flossing is fun when you have room for the floss and not so fun when your teeth are crooked and crowded. A study done in 2009 and published in the American Journal of Cardiology showed that people with gum disease are 24 -35 percent more likely to suffer coronary artery disease. As mentioned above, straight teeth are easier to keep clean and therefore you are less likely to have gum disease and heart disease too!

Finally, the fifth reason to get straight teeth is to prevent your teeth from getting fractured. Protruding (buck) teeth are easily broken from an accidental fall, sports related injury, car accidents and schoolyard brawls. During my 25 years in practice, I have seen this happen on many occasions to patients. By getting your teeth straight and your protruding teeth back inside your mouth, you will find that you have a better chance of keeping them from injury. Of course, if you do play contact sports, we always recommend a mouth guard to protect your teeth during orthodontics and after they are perfectly straight.

These are the top five reasons you should consider straightening your teeth or your children’s’ teeth. For more information about the various options available to you to get the desired smile you want read more about braces for adults or give us a call at (916) 435-8000.  To find out about options for your children, read more about braces for kids.

While the majority of children at this age do not need any Orthodontic treatment, there are a significant percentage that do need “early interceptive orthodontic treatment.”

The key word here is “interceptive,” meaning that orthodontic treatment at this early age is intercepting a problem that left untreated would require more extensive treatment later or not be able to be treated with orthodontics alone.  By correcting a problem early, you can avoid more extensive treatment later that may include extractions and possible jaw surgery.

The majority of the problems that are treated early are due to a “growth problem.”  The upper and lower jaws are not growing at the same rate or in the same direction, or one is too small or one is larger than the other.  These types of problems are the reason we treat children as early as age 7.

Here is an overview of the problems that would be best corrected early (before all the adult teeth are in place.)

1. Severe crowding of the teeth. Your child has lost some baby teeth and the adult teeth that are coming in are sideways, up to high, behind other teeth or maybe not coming in at all. Instead of removing baby and adult teeth, your child can have early treatment that will make room for all the adult teeth and therefore save them from any extractions of baby and adult teeth.
2. A crossbite. This is when the lower jaw shifts to one side.  You may notice that your child chews funny or that when they are biting down their face appears slightly off center.  A crossbite is usually a problem with the growth of the upper jaw and is best corrected before age 10.
3. An underbite. The lower jaw bites in front of the upper jaw.  This type of bite problem is caused by a growth problem in the upper jaw and is best corrected during a child’s active growth phase.  This type of problem in particular, if not treated early will often result in jaw surgery as a young adult.
4. A thumb or finger sucking habit, severe tongue thrust or other oral habits. Most children who suck their thumbs and/or fingers for a prolonged period of time, will cause some deformation of the shape of the upper jaw.  This alteration in the shape of the upper jaw can cause crowding problems, airway problems and bite problems.  A simple, fixed appliance is generally used to correct this persistent habit.
5. Severe mouthbreathing, grinding of the teeth, or airway issues. All these are related to your child’s jaw growth and development.  Again a growth problem that is best corrected early while your child is still growing.
6. Severe overbites. Depending on the severity of your child’s overbite, this can be corrected early with the use of removable retainers.  With excellent cooperation, these removable retainers will often eliminate the need for more extensive orthodontic work later.

If your child has any of the above problems, you do not need a referral from your family dentist.  You can call an Orthodontist directly and make an appointment for a consultation.  Even if you are not sure, a consultation with an Orthodontic Specialist will give you an overview of your child’s current growth and development and give you valuable insight into any future orthodontic needs that your child may have.

Needless to say, we do know how Orthodontics can impact your child and you too, forever! Modern Orthodontics can change your smile in as little as 6 months. Some of the newest advances in “braces” today are totally invisible and perfect for any adult or teen who wants a fabulous smile that can last a lifetime.

One new innovation in invisible braces in the past 8 years is Invisalign. Invisalign Orthodontic treatment involves wearing a series of clear removable aligners ( they resemble a very thin mouthguard) approximately 22 hours per day. They are removed for eating and toothbrushing. The aligners last about two weeks, then you switch to another set for another 2weeks. This process continues until your teeth are aligned and your smile is fabulous!

The technology that goes into the making of the aligners is quite sophisticated. An impression or “mold” of your teeth is taken and then sent to Invisalign. The mold of your teeth is scanned and then digitized. A computer generated sequence of tooth movements is then put into place for approval by the treating Orthodontist. Once the Orthodontist approves the final result and how the teeth are moved and aligned, the clear aligners are fabricated and sent to the Orthodontist for delivery to the patient.Invisalign treatment is invisible and virtually pain free.

More recently, braces that go behind the teeth called “lingual braces” are increasingly popular especially for adults who are in sales or speaking careers. The braces that go behind your teeth (lingual) are completely invisible and work in a similar fashion to the braces that go on the front of your teeth. The Dallas Cowboy Cheerleaders are spokeswomen for the company known as “I Braces” that manufactures these custom made braces. The Cowboy Cheerleaders are known for having a Half-Time contest asking the audience to guess which cheerleaders have braces on!

One question that comes up regarding the “I Braces” is a concern about the potential irritation of the tongue by the braces. Whether the braces are on the front of your teeth or on the back, there will 2 weeks of some adjustment either by your cheeks or your tongue.

If you are not opposed to having braces on the front of your teeth, but you still want a no metal option, then newest type of braces, called Innovation-C are the choice for you. These braces have the advantage of never discoloring (they are made of ceramic) and move the teeth more efficiently and quickly without the associated pain and discomfort of traditional metal braces. They have a clip that holds the wire in place rather than a clear or colored elastic tie. This allows the wire that is attached to the brace to be constantly active. These type of braces work best with light wires and therefore, light but consistent force on the teeth. Studies have shown that the time spent in braces can be decreased by 25% with these new type of clip braces.

Invisalign, “I Braces” and Innovation-C braces, are just some of newest innovations in Modern Orthodontics today.

Studies have shown that your physical appearance does effect your economic status. According to Danile Hammermesh and Jeff Biddle, two economists with the National Bureau of Economic Research, they have found the more attractive your appearance, the more money you will make. Orthodontics is truly an investment in you and your family’s future.

Drs. Cater and Galante are a husband and wife team of Orthodontists who have been in practice together for over 15 years. They have over 45 years of combined experience in Orthodontics and are Premier Providers of Invisalign ( top 5% nationwide).