Orthodontics and Braces

Orthodontics is the treatment of improper bites (malocclusions) and crooked, misaligned teeth. Orthodontic treatment can focus on tooth misalignment only, can deal with the control and modification of facial growth, or can be carried out for purely aesthetic reasons with regards to improving the general appearance of your teeth.

Most often, children our evaluated periodically during their formative years, and this gives us the opportunity to report to the parents on their childʼs oral growth and dental development. Dr. Smunt is a member of the American Orthodontic Society which accredits and sponsors continuing orthodontic education. He has been performing regular orthodontic services since 1990.

Timing is everything! Should an early problem arise during the normal growth and development of your child, we can take

appropriate measures to diagnose, plan, and treat it. This interceptive approach can help minimize future orthodontic problems. Most orthodontic problems related to growth are genetic in nature. Sometimes a problem is acquired as a result of premature loss of teeth.

In many situations, a childʼs developing orthodontic problem is not severe enough to warrant interceptive treatment. We will

continue to observe and report on their development during periodic evaluations until the time in which they are ready to proceed with comprehensive orthodontics. This time is approximately at the point where all baby teeth have been replaced by their
permanent successors.

Proper diagnosis and planning is essential for predictable results. Prior to the start of comprehensive treatment, we will gather necessary pretreatment records and data. The usual records include full mouth and cephalometric radiographs, plaster study models, and documented measurements of initial conditions. This information enables us to form our treatment plan, and arrive at a reasonable fee for orthodontic services.

Photo courtesy of  Hakan Svensson

Comprehensive orthodontic treatment most commonly uses metal wires inserted into orthodontic brackets (braces), which can be made interact with the brackets to move teeth into the desired positions.

Expansion appliances, may also be used to move teeth and jaw
bones, and are mostly used in growing patients (age 5 to 14) with
the aim of modifying the jaw dimensions.

When orthodontic treatment is limited to minor tooth movement, such as slightly rotating teeth and closing small gaps, clear plastic, elastic aligners can be successful. These clear aligners, MTM Aligner™ or Invisalign™, blend with the natural tooth color for undetectable wear.

After a course of active orthodontic treatment, patients will
typically wear retainers which maintain the teeth in their improved positions while surrounding bone reforms around them. The retainers are generally worn full-time for a short period, perhaps six months to a year, then part-time (typically, nightly during sleep). It is possible for the teeth to stay aligned without regular retainer wear. However, there are many reasons teeth will crowd as a person ages, whether or not the individual ever experienced orthodontic treatment; thus there is no guarantee that teeth will stay aligned without retention. For this reason, we prescribe part-time retainer wear for many years after orthodontic treatment. Common retainers used are removable Hawley, removable Essex™, and fixed, bonded wire.

The Hawley retainer includes a metal wire that surrounds the teeth and keeps them in place.


Hawley retainers are the most common type of retainers.

This picture shows retainers for the top and bottom of the mouth.


The Essex retainer is transparent plastic that fits over the entire arch of teeth. It is vacuum formed on a plaster mold of the teeth. A fixed retainer typically consists of a passive wire bonded to the tongue-side of the incisors. Unlike the previously-mentioned retainer types, fixed retainers cannot be removed by the patient. We prescribe fixed retainers regularly, especially where active orthodontic treatments have effected great changes in the bite and there is a high risk for reversal of these changes. It is often kept in place for life.

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