I recently was paging through the Southern Association of Orthodontists newsletter and saw a great handout. There are two similar handouts with the picture of a woman on one and a little girl on the other. It reads: "You wouldn't want an orthodontist to perform your face lift. So why consider anyone but an orthodontist for your family's orthodontic therapy?" On the back is a checklist of pertinent points on the qualities and qualifications of an AAO member orthodontist. What a great idea! I am going to order a ton of these and give them out in all of my new patient handouts and keep them at the front desk. What I really ought to do is mail them to all those quasi-educated dental professionals (and I know who they are in my area) that are doing their patients an injustice by trying to treat them after taking their morning certification for clear aligners or their weekend motel ortho course.
Speaking of weekend ortho courses, I just received an email about a 2 day orthodontic course for general dentists using passive self-ligation brackets. A two day course to do ortho! I must be an idiot. I had to go through a residency and have spent over 15 years in practice and I am still learning. And you know what is worse? The course is sponsored by a major orthodontic company. That's right. The same company that has spent megabucks promoting its self-ligating brackets to anyone who will listen. I guess a lot of orthodontists are not listening anymore and they have decided that a two day ortho-educated general dentist will. Oh, I could have a field day with this. Is it any reason that this company has lost so much credibility?
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Hi doc. Can I ask you something? It goes like this...
A year ago I started to wear braces because some of my teeth were "out of place". I also had a barely noticeable overbite (maybe 1mm? LOL). Today, after 1 year, my teeth are perfectly aligned! I'm so happy. BUT the problem is that the small overbite got WAY WORSE! My orthodontist says that it is a normal process blabla, but I just can't believe him, since that with each passing month is getting worse. Could you tell me if it is true? Is the increasing of the over bite a natural process when your teeth are being aligned? Please help me, I don't want my face to look ridiculous!
Thanks.
a,
I am going to assume that you really mean "overjet". That is the amount your upper front teeth "jet over" your lower front teeth and not how deep your bite is. Overjet is a horizontal measurement and overbite is a vertical measurement.
If your upper front teeth were crowded it is very likely that they moved forward as they straightened out. If the lowers were not that crowded then you would see that overjet increase. To complicate it a bit, if the upper arch was too far forward to begin with (and your teeth were inclined back which would have masked the jaw relationship to your eyes)then the overjet would become very visible to you. The rest of your treatment would then be correcting your bite into a Class I relationship. Straightening your teeth is the easy part while correcting your bite is the challenge.
You trusted your orthodontist when you started treatment. Continue to do so. Ask him if it was your teeth that were out of position, your jaws or a combination of the two. He can then explain it to you more fully.
Take care and keep smiling.
Hi Doc,
Firstly love the new posts, I have been telling my 'braced' friends about your blog and lot of them seem to love your sense of humour.
On an another note I wanted to ask you about the validity and skill level of these "orthodontic assistants" who work on my teeth more than my ortho, I mean $6000 and I get less than 2 minutes with my ortho and rest with these assistants. Is this common practice ? What diffrentiates the ortho from his/her assistants if they are capable of carrying over more 95% of the treatment? Its just that I chose this ortho because he seemed experienced and not because he is well staffed.
Kishore,
In the US, in states that I am aware of, the assistants have to pass a test certifying that they are able and qualified to perform certain orthodontic tasks. You would have to check the state dental laws to determine which tasks your assistants are allowed to perform.
As an orthodontist, I rely heavily on my chairside assistants to perform certain tasks. And they are quite capable at doing this. But they are not diagnosing and they are not treatment planning the case. They also are not determing the next stage of treament or what needs to be done at your appointment. In the two minutes that your orthodontist sits down and looks at your teeth, he/she is able to determine what needs to be done, how treatment is progressing and what instructions to give.
If you think of the orthodontist as the architect and the assistant as the laborer it will make more sense.
Hi i have to get 4 premolars out to straighten my bottom teeth and push back a moderately sticking out mouth,but because i have a small chin and high cheekbones i am afraid in case i could end up with a receded chin ,flat profile or saggy or slimmer face after treatment,i have read of these things happening to people on the web,will my orthodontist know by my face if any of the above could happen , any information will be great ,thanks.
Charlie,
In my opinion there are times when you have to have teeth removed. This does not mean that your face is going to ruined or your profile "dished in". In fact, I have seen many extraction cases where the profile and facial harmony has been vastly improved because teeth were removed.
Your orthodontist is extremely careful when it comes to having teeth removed and will have looked at a number of factors to insure that your facial balance is maintained or improved.
Speak to your orthodontist about your concerns and I am sure he will calm your fears.
Keep smiling!
I don't think most patients realize how little training certification in, say, Invisalign involves.
Invisalign does seem to emphasize the importance of an experienced provider, by publsihing a list with various designations, "elite", "preferred",...
Unfortunately, even that seems more geared toward sales than poniting consumers toward an experienced provider.
The problem is that these designations can change from year to year, being based only on the last year's number of cases the provider has "sold". So an experienced provider, with 300 cases but fewer than 10 in 2010, would be designated nothing, compared to a less experienced provider, with 50 cases but more than 10 in 2010.
Hi doc.. Question about my braces...
I've had them for four years. I was suppost to have them for two. I hae been going to the ortho ever two weeks since last september and i SILL HAVE THEM ON! He's told me plenty of dates when i should get them off, and obviously he was not correct.
The problem now is that my bite does not line up. My top teeth do not hang over my bottom ones on the one side
I currently have a spring in to try to aline my teeh and have had a spring in the same spot plenty of times.
My bottom teeth appear to be slanted forward and I dont know what to do anymore.
My doctor has said "for SURE before christmas" and i have grad pictures in january so i'm hopinghes right.
Should he be doign something else? Should i be wearing elastics? Should i point out the slant in my teeth to him?
Anything woudl be helpful now.
I'm kinda desprate.
Thanks.
JJ
JJ,It is really difficult to give you an answer without knowing a lot more about your case. Usually when I have a case that treatment is extended (and it is not due to lack of cooperation on the part of the patient)it is because the patient has hit a growth spurt that is either unbalanced (asymmetrical) or in the wrong direction (either horizontally or vertically). Attempting to correct the bite in the face (excuse the pun) of this "bad growth", the orthodontist and the patient can get really frustrated. In some cases the original treatment plan has to be adjusted in both time and/or treatment type and may even include surgery in more extreme cases.
It sounds like your orthodontist is really trying to make things work and is being quite conscientious seeing you every two weeks for such an extended time. If the slant in your teeth is of concern to you it is your right as a patient to ask him about it, and you should to alleviate your own concern.
Hang in there. I know it is tough at this point to be patient.
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