The Who, What, Where, When and Why of HEADGEAR

WHO?

Usually headgear is recommended for the younger patient.  Headgear works best while a patient is still growing so it can be used to guide jaw growth in the right direction.

WHAT?

Headgear is a removable orthodontic appliance worn to retract the upper molars and restrict excessive growth of the upper jaw.

WHERE?

Bands with tubes are placed around the upper permanent molars.  The headgear fits inside the tubes and attaches with a strap either around the neck, around the head or a combination of both.  Which type of strap is determined by the orthodontist and depends on the direction of force that is deemed most optimal.

WHEN?

Headgear is usually only worn at night while sleeping. During the day, the headgear is left at home and all that remains are the small bands around the patient’s upper permanent molars.  The orthodontist may recommend wearing it during the day (while at home) for some patients but we would NEVER ask a patient to wear the headgear while at school.  It’s ok for patients to skip the headgear for sleepovers and other special occasions as long as it’s worn all the other nights.  Most patients adjust to sleeping with the headgear within a few nights.

WHY?

Headgear is recommended when the upper molars are forward of their proper position because the upper jaw is growing too much.  Wearing a headgear works both orthodontically and orthopedically.  Orthodontically, the forces of the headgear move the upper molars back.  Orthopedically, the forces of the headgear restrict growth of the upper jaw while the lower jaw continues to grow normally.  Wearing a headgear will not eliminate the need for braces but will make the braces easier.  If an early headgear is indicated but the patient (and parents) elect not to proceed, then the upper molars will likely be even further forward once it’s time for braces and the options for treatment might be more limited.

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PATIENT PROFILE: ADULT/INVISALIGN

I remember meeting this patient and her husband on the day they came in for her initial consultation with Dr. Coombs. She was in her mid-sixties and finally ready to deal with her crooked, crowded teeth.  Because her bite was off, she was also dealing with some dental/periodontal issues.  With coordination from her dentist to deal with these issues, we made a plan to start Invisalign.  Still a bit hesitant, she and her husband came in for a second consultation.  We reviewed her Invisalign clincheck to ensure she was ready to proceed and would be happy with the final result. The Invisalign clincheck is a 3-D animation of the patient’s teeth that digitally morphs to show expected progress and final results.  She made the decision to proceed and we took a couple of x-rays and Invisalign impressions.  About two weeks later, we had her back to bond the Invisalign attachments and start the process.  Invisalign attachments are small, tooth-colored buttons bonded onto the teeth, as needed, to help the trays get a better grasp of a specific tooth/teeth.  Her treatment progressed on the timeline we initially expected.  Treatment time usually depends on the complexity of the case.  The more complex, the longer it may take.   Her treatment is now complete.  As you can see, her results are amazing and she is thrilled!



It’s never too late to consider Orthodontic treatment.  If you’ve always wanted to improve your teeth and smile, call us!  The initial evaluation if free.  The treatment options and fees may be easier than you imagined.

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When Should My Child See The Orthodontist?

The American Association of Orthodontists recommends that children be evaluated by an Orthodontist at age 7

7 is the age when children begin to get their adult teeth.  Of course we can see a child younger than 7 if there is an issue of concern.

Taking your child to the Orthodontist will not necessarily result in orthodontic treatment.

If no treatment is indicated then we will just keep an eye on your child with periodic evaluations.

Bringing your child to the orthodontist is a preventative measure, similar to well-checks with the pediatrician.

Future treatment may be indicated.  If so, we will monitor your child periodically until the time is right to get started.

Sometimes all that’s needed is a simple deciduous tooth extraction to improve an issue or help a permanent tooth erupt.

Our office does not charge for the periodic office visits to monitor a patient’s growth and dental development.

If there is an issue to treat, it’s better to know about it sooner than later.

Some treatments (like <a href="https://adaycoombs.com/blog/page/4/#iLightbox

palatal expansion with an expander) can only be done while a patient is growing, so you don’t want to miss the opportunity for a simple preventative course of treatment.

If early treatment is indicated, it will only be because the problem cannot wait to be treated later or may cause harm if not treated early.  Our doctors are very conservative in their recommendation for early treatment. Our goal is to ONLY recommend treatment that has significant value and to avoid or prevent ALL unnecessary procedures.  We understand that two-phases of orthodontic treatment can wear out the patient’s enthusiasm, can be more expensive and can exhaust insurance maximums.

You don’t need a referral from your dentist to see the orthodontist, just call us to schedule a complimentary new patient appointment.  We look forward to meeting you!

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Please click BOTH links below to print the necessary forms.  Complete both the COVID questionnaire and consent forms and bring them with you to your appointment.  It will be necessary to complete new forms for each appointment.  

Click To Link to COVID Questionnaire Form

Click To Link to COVID Consent Form

 

 

Our Goal Is To Keep Everyone Safe

The health and safety of our patients, their families, our staff and the general public is our primary concern.  We continue to practice standard precautions as we always have, with added precautions due to the COVID-19 virus.  Rest assured knowing we are practicing in accordance with the guidelines put in place by the NM Dental Association, American Dental Association, American Association of Orthodontists and the Centers for Disease Control.

 

Our Protocols

Patients should call our office upon arrival to our parking lot for instructions on entering the office.

Patients (Parents) will be asked to sign an extra consent form and health screening questionnaire regarding COVID-19 (forms are linked above).

Everyone (including staff and doctors) entering the office will be screened for fever and illness.   Anyone presenting with a fever equal to or above 100.4 degrees will be asked to reschedule.

We are limiting the number of people in our office to only those necessary.

We ask that all people entering our office wear a face covering.

Everyone will be asked to use hand sanitizer upon entering our office.

Patients will need to brush their teeth at home prior to their appointment as we no longer allow for teeth brushing in the office.

Patients will be asked to use an oral anti-microbial rinse prior to their appointment.

We will escort patients in and out of the office to maintain social distancing.

 

Our Office

We’ve added physical barriers in certain areas.

We continue to follow OSHA and CDC universal precautions regarding PPE, instrument sterilization and appointment protocol.

Our office has installed a new HVAC system that utilizes high-output germicidal UVC lights combined with a MERV 13 filtration system to prevent the spread of germs.

We have closed our kid’s play area and eliminated magazines.

You may need to wear a sweater, we’re keeping our office fairly cold.

 

Thank You For Understanding

We recognize some of our increased safety measures and new protocol may present an inconvenience.  We appreciate your patience through all of this.  We truly have the BEST patients!

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What Is Two-Phase Orthodontic Treatment?

 

Two phase orthodontic treatment consists of an early, interceptive (preventative) course of orthodontic treatment that is later followed by a second (final) phase of treatment, full braces.  One phase orthodontic treatment usually consists of just full braces.

 

Why not just wait for full braces?

If an early phase of orthodontic treatment is recommended that means there is an issue that is either not treatable with full braces, can’t wait to be treated until it’s time for full braces or shouldn’t wait to be treated until it’s time for full braces.  The goal of early treatment is to prevent a bigger problem and to avoid unnecessary procedures.  An early phase of orthodontic treatment does not necessarily eliminate full braces but should make them simpler and shorter.

Let’s delve a little deeper into those issues that might warrant early treatment…

Crowding

Whether the jaws are small or the teeth are big or a combination of both, crowding occurs when there is not enough space to accommodate all of the teeth. Without enough space, the teeth will either erupt out of place, erupt rotated or possibly become impacted (fail to erupt).  Sometimes crowding is mild and can wait to be treated in full braces.  However, if the crowding is more severe it might be better not to wait.

The benefits of dealing with crowding early is that you can often prevent teeth from becoming impacted by making room for them to erupt.  You can prevent the teeth from erupting very rotated or outside of the arch. It’s good to do this because If the teeth are left in a crooked position, they will develop some memory in that crooked position then become more difficult to align and more difficult to keep aligned (harder to hold).  Also, creating space early can minimize the risk of having to extract permanent teeth in order to make space.

 

Narrow Maxilla

Maxilla means upper jaw.  If the upper jaw is narrow, sometimes the upper teeth will sit inside of the lower teeth which is called a cross bite.   If it is necessary to widen the maxilla, this can be accomplished rather simply while a child is young and their bones are still growing with an appliance called a Rapid Palatal Expander (RPE for short). This appliance can widen the maxilla up to 11mm in only a few weeks.  It is imperative to correct a narrow maxilla when a patient is young.  Once the facial bones are not growing any longer, widening the upper jaw can only be accomplished with surgery.

 

Cross Bite

A cross bite is when a tooth (or teeth) fit either too far to the inside or too far to the outside of their proper positions.  A cross bite of one tooth can often be corrected, in a very short amount of time, with an appliance called a bite jumper.  If only one side of the teeth are fitting in a cross bite (unilateral cross bite), it can sometimes lead to lopsided jaw growth if left untreated.  A cross bite can also lead to recession, unusual wear of the tooth surface and possibly TMJ issues as the jaw is forced into an abnormal position.

 

Jaw Discrepancies

Sometimes there is a discrepancy in the way the two jaws fit together.  Maybe the upper jaw is forward of its proper position or the lower jaw is back.  Maybe it’s the opposite and the lower jaw is too far forward or the upper jaw is back.  Our efforts to help these issues are preventative.  Early orthodontic treatment aims to guide the jaws as they grow and prevent either a long course of braces or jaw surgery or both.  We also aim to keep the teeth out of harm’s way.  If the upper teeth are protrusive, they run the risk of being broken or knocked out.

 

Extra Teeth or Missing Teeth

If a patient is missing permanent teeth or has extra permanent teeth, it is good to discover this early in order to plan the treatment and prevent complications.

 

 Thumb/Finger or Tongue Habits

Thumb (finger) sucking can sometimes have an adverse effect on the teeth and jaws.  If so, we may need to help gently encourage the patient stop the habit before too much harm has occurred.  Tongue thrust can cause an “open bite” where the front teeth are apart making it difficult to bite off food and can interfere with speech.  Learning the correct tongue position through speech therapy can correct an open bite.

 

Ultimately, some orthodontic problems are easier to correct when they are found and treated early.  At Aday & Coombs Orthodontics, our goal is to ONLY recommend treatment that has significant value and to avoid or prevent ALL unnecessary procedures.  Follow the American Association of Orthodontist’s recommendation to have your child’s first orthodontic visit by the age of 7.  We do not charge for the initial consultation or any office visits to monitor a patient’s growth and development so give us a call.  You know what they say about prevention, an ounce of it is worth a pound of cure and that is certainly true when it comes to orthodontic treatment.

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10 Things To Know About Orthodontic Insurance

Every plan is different so read the details of your policy carefully and remember we are here to assist you.  Give us a call, we are happy to help you navigate through the details of your orthodontic benefits!

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But Mom, I Don’t WANT Braces!

What if the orthodontist recommends braces for your teenager but your teenager is less than enthusiastic…are there other options?

Well, you could force them into treatment with the ‘ole “I know what’s best for you” or “you’ll thank me one day” arguments.  Those arguments, while probably true, may not convince your teen.  It’s important to understand where your child’s concerns are coming from.  Is it fear of discomfort? Concern about the appearance? Concern about the cost? Braces are a team effort between the patient, parent and orthodontist so cooperation is a must. At Aday & Coombs Orthodontics, we respect the concerns of our teenaged patients.  We understand that school is hard enough without adding to their stress.  For this reason, we’re happy to offer a potential solution to this dilemma, it’s called Invisalign Teen®.

There are many benefits to Invisalign Teen®…

It’s cool, the latest technology in orthodontic treatment.

It’s discreet.  If your child is self-conscious about wearing braces, the trays are hardly noticeable.

It’s more comfortable than traditional braces.  There are no brackets and no wires.

There’s no need for them to restrict their diet, the trays are removed when eating so they can eat as usual.

It’s easier for teens in band to adapt to playing an instrument with Invisalign® as compared to traditional braces.

There is no added risk should they bump their cheek or face when playing sports.

It’s easy to clean.  There’s no need to clean around braces, the trays are removed so that they can brush and floss as usual.

It’s not more expensive than traditional braces.

It doesn’t show in pictures and the trays can be removed for picture taking (like senior pictures).

Of course, Invisalign® requires compliance.  The trays have to be worn 22 hours a day so it may only be a good choice for the self-disciplined teen.  However, the trays do have indicators that allow the orthodontist to track a patient’s compliance.  So, if your child is hesitant about traditional braces, consider the option of Invisalign Teen®.  Call us, schedule a free initial consultation today.  Let’s see if Invisalign Teen® might be the right choice for you and your teen.

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Understanding Dental Crowding

Whether the jaws are small or the teeth are big or a combination of both, crowding occurs when there is not enough space to accommodate all of the teeth. Without enough space, the teeth will either erupt out of place, erupt rotated or fail to erupt (become impacted).

Treatment  

There are two ways to deal with crowding; either make space with dental extractions or create space with an orthodontic appliance.

Timing

Sometimes crowding can wait to be treated in full braces but often crowding is better dealt with at a younger age.  Early, interceptive treatment can prevent the teeth from erupting rotated or out of position in the first place.

How

If the upper jaw and palate are narrow, this can cause crowding.  Widening the upper jaw with an orthodontic appliance will improve spacing. Sometimes partial or full braces are used to improve spacing issues.  Other orthodontic appliances such as headgear can also be used to create space.

Sometimes, when the crowding is severe, permanent teeth are extracted to create space. Several factors are taken into careful consideration when making the choice to extract permanent teeth; position of the jaw bones, profile and facial balance to name a few.  Having permanent teeth extracted to create space may be the perfect option, however, the decision should be made with careful consideration.

Benefits

The benefits of dealing with crowding early is that you can often prevent teeth from becoming impacted by making room for them to erupt.  You can prevent decay since crowded teeth can be hard to clean. You can prevent the teeth from erupting very rotated or outside of the arch.  If the teeth are left in a crooked position for long, they will develop some memory in that crooked position and may become more difficult to align and more difficult to keep aligned (harder to hold).  You can reduce the risk of recession which sometimes occurs when the teeth are crowded. Also, creating space early can minimize the risk of having to extract permanent teeth in order to make space.  The American Association of Orthodontists recommends each child have an orthodontic evaluation by the age of seven. If you are concerned about dental crowding, contact us to schedule a consultation.

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Ideally, the upper jaw should be wide enough so the upper teeth sit outside of the lower teeth.  If the upper jaw is narrow, then the upper teeth may sit directly on top of the lower teeth or they may sit inside of the lower teeth which is called a cross-bite. Sometimes a cross-bite can be improved with braces but if the narrowness is significant, then it may be necessary to widen the maxilla (upper jaw) bone. This can be accomplished with an orthodontic appliance called a Rapid Palatal Expander (RPE).

 

The Appliance

The RPE is a custom-made appliance which mounts with bands around the upper permanent molars.  The RPE goes across the palate but does not touch the palate.  In our office the RPE is a fixed appliance, not removable.   The RPE has a small screw in the center.  The screw is turned as instructed at home by the patient or parent with a key. Turning the screw puts gentle pressure on each side causing the maxilla to gradually and gently expand in width.

 

 

 

 

Benefits

The RPE improves crowding by creating a wider arch for the teeth to sit in.    With adequate space, the teeth can erupt in more ideal positions. A wider arch allows space for the tongue to rest in a proper position.  The RPE improves the fit of the upper jaw to the lower jaw. When the jaws fit together properly it encourages them to grow more normally.  The roof of the mouth is also the floor of the nose so widening the upper jaw improves the airway. Correcting a narrow palate while a patient is young eliminates the need for surgical correction as an adult to resolve this problem.  Also, it improves aesthetics by widening the smile.

 

Risks

If a cross-bite is left untreated, it can lead to lopsided jaw growth, recession of the gum tissue, abnormal wearing of the enamel surface of the tooth (teeth), and TMJ problems.  If a narrow maxilla is not treated while the bones are still growing then surgery becomes necessary to correct this problem.

 

Good News

While a patient is young, widening the maxilla can be accomplished easily with a Rapid Palatal Expander.  Before growth is over, the maxilla has a soft suture in the center.  Gentle pressure from the RPE allows the soft suture to separate and the bone to widen.  The palate can be widened up to 11mm at a time (that’s a lot!).  It’s fast; all of the widening occurs in just 4 weeks!  The appliance then remains in place for another 3-4 months to allow the bone to heal. It’s preventative; once growth is over, widening the palate becomes a surgical event.

If your child needs orthodontic treatment, please contact our office to schedule an appointment.  We are happy to provide a free initial consultation.

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How Much Do Braces Cost?

The question, “How much do braces cost?”, is one we’re frequently asked.  There really is no set answer to this question. The cost of treatment varies depending on the complexity of each individual patient’s case.  Good news is, braces are probably more affordable than you think…

Here at Aday Orthodontics, we offer budget-friendly payment options.  If you choose to pay in full, we offer a discount.  If you prefer to pay over time, we offer payment plans with zero interest.  Often times we don’t even require a down payment.

When you think about it, considering all of the time and treatment involved in a course of braces, they’re more economical than many other dental procedures.  In our office, the fee for braces includes pre-treatment records,  office visits throughout the time you are in treatment, a set of retainers and follow up visits to check those retainers.  Usually, the fee for full braces includes over two years of treatment!

Additionally, having a good bite improves your overall dental health (and general health) alleviating the risk for certain dental problems throughout your life which saves you money in the long run.  There is also the life-long boost in self-confidence that comes with a beautiful smile.   The payoffs of a boost in self-confidence are immeasurable!

Yes, braces are an investment.   At Aday Orthodontics, it is our goal to help make this investment affordable for you.

Does Invisalign cost more?

Generally, in our office, if the treatment time is the same with either option then the cost is the same with either option.  However, if you choose a bonded brace with clear brackets, the clear brackets are an up charge.

Will insurance cover braces?

Many dental plans provide coverage for orthodontic treatment.  Most of the time, insurance covers a percentage of the total cost up to a lifetime maximum amount.  We are happy to check your coverage for you.  Just call us, provide us with the information we need and we’ll look up your benefits for you.

Does insurance cover Invisalign the same as it does bonded braces?

YES!

Does your office offer any discounts?

YES!  We offer discounts to fire, police, teachers and military.  Oh, and let’s not forget about the family discount too!

Orthodontic treatment is an investment in your overall health and well-being.  If we can give you one piece of advice when considering orthodontic treatment, it’s to choose your orthodontist wisely!  Ask your dentist, ask your hygienist and ask your friends who they would recommend.  Better yet, ask who they (and their children) have personally gone to for their orthodontic treatment.  If you see someone with a beautiful smile, ask them where they were treated.  Do your research and never let lowest cost be your guide.  You want to pay for braces one time and have the results last throughout your lifetime.  At Aday Orthodontics, we offer the highest quality treatment at a reasonable price and we make it affordable.  Ultimately, orthodontic treatment will provide a return in your investment through better dental health and a boost in your self-confidence!  So, what’s stopping you?  Call us!  Schedule your free initial consultation today!  We can answer the question “How much do braces cost?” at your initial visit.  See you soon!

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