Braces are a great investment that will last a lifetime.  So let’s start with the good news.  The cost of braces since 1980 has increased by approximately 75-80% whereas the cost of an average new car has gone up four fold.  Improved materials have led to more affordable and gentler treatment. 

The average cost of full braces ranges depending on the level of complexity.  You can expect to find a range of $4000-8000.  Orthodontic treatment is not a commodity so carefully research the credentials of your orthodontist and that they are using the most current materials and technology to properly diagnose and treat you or your child’s case.

Most offices now offer flexible payment plans with no interest.   If you have dental insurance it may cover a portion of the treatment.  In our office, we check for those benefits during the new patient consultation and include that in the estimate of treatment costs.

Straight teeth contribute to healthy teeth and gums.  There have been many studies that demonstrate how properly aligned teeth and jaws can decrease the likelihood of TMJ, sleep apnea, and even heart disease.  Having a beautiful smile elevates self-esteem, self-confidence, and self-image.  We have seen many of our patient’s lives transformed from having their teeth straightened.  Their heightened self-confidence improved their social lives, careers, and general attitude towards life.

Teeth that are well aligned are less prone to decay, gum disease, and injury.  Straight teeth collect less plaque.  Decay starts when the bacteria in plaque feed on simple carbohydrates (sugar and starch) and produce acid resulting in cavities.  Plaque accumulation also leads to increased risk for periodontal disease.  Proper alignment of the teeth decreases the risk by creating improved access when cleaning.  Finally, protruded teeth can be unattractive and at risk for trauma.  When repositioned the upper front teeth are protected from accidental damage.

Interproximal reduction (IPR) is the removal of small amounts of the outer enamel tooth surface between two adjacent teeth. It is a means to create space to eliminate crowding and establish a healthy position for the teeth in the bone.  This technique is used for patients in full braces as well as Invisalign.

The benefits of IPR include: creating space to improve tooth alignment; assisting in bite correction; improving the appearance of the teeth by reshaping them for a better esthetic outcome; decreasing the “black triangles” which are created by the absence of gum tissue (gingival papilla) between the teeth; eliminate the need for permanent tooth extractions; and reducing the tightness of the contacts between the teeth to increase the long-term stability

Dr Walkow carefully identifies which teeth need IPR through clinical examination and reviewing the radiographs.  Dr Walkow uses a painless technique that does not require anesthetic.  Only 0.25-0.5mm of enamel is removed per surface.  Research studies have shown that reduction of this level does not lead to long term sensitivity or increased risk of decay.   

There are several factors an orthodontist must consider to determine if IPR is appropriate treatment: the size and shape of the teeth, position and alignment of the teeth, and patient’s facial features and profile.

Thumb sucking is a common habit in young children and can be associated with hunger, fatigue, stress, sleep, teething, and shyness.  The intensity of the thumb habit and pattern of jaw growth determines whether dental problems develop.   Thumb habits after the age of three can result in reshaping of the jawbone (narrow upper jaw), flaring of the upper front teeth, poor tongue placement, speech issues, overbite and openbite, and airway issues.

It is important to stop the thumb habit BEFORE the permanent teeth erupt.  Once the permanent first molars erupt (usually age 6), there can be changes to the direction of the growth of the jaws.    If your child cannot stop by age 4, I recommend a few things.  First, talk to them about the reasons for stopping the habit and encourage them when they do not suck their thumb.  Set up an incentive system to reward their progress.  At bedtime try taping the thumbs, duck taping a sock on their hand, or nail polish designed for this purpose.

If the thumb habit is still present at age 6, there may be some orthodontic issues developing so I recommend a consultation to find the most appropriate method for addressing the problem and reversing the dental effects.

First, welcome to the Walkow Orthodontics blog!

This is a question I get on the soccer fields, school events, cocktail parties, and a variety of other community gatherings.

The American Association of Orthodontics (AAO) recommends that all children receive an orthodontic screening by age 7.  The permanent teeth generally begin to come in at age 6 or 7.  It is at this point that orthodontic problems become apparent.  Because the bones are still growing, it is an ideal time to evaluate a child and determine a long-term treatment plan to achieve the optimal result.

Orthodontic treatment in young children is known as interceptive or Phase 1 Orthodontics.  At this age, the teeth are still developing and the jaw is growing making certain conditions easier to address.  Before the permanent teeth come in, it may be possible to guide their eruption into better positions.    For instance, a few decades ago, the solution to crowding was to extract permanent teeth.  Today, we take advantage of the jaw growth potential and use a palatal expander to create the necessary room which reduces the need for extractions.  Increasing the amount of bone and gum tissue also leads to a decreased incidence of gingival recession as an adult.  In general, children who are candidates for early treatment have the opportunity to receive an improved long-term result and less invasive treatment during the full braces stage (Phase 2).