- Loose Bracket
- Poking Wire
- Loose Wire
- Wire Out of Back Brace
- Poking Elastic (Rubber Band) Hook
- General Soreness
- What is Orthodontics?
- What Causes Orthodontic Problems?
- When Should You See an Orthodontist?
- What are the Advantages of Early Interceptive Treatment?
- Are You a Candidate for Orthodontic Treatment?
- How do Teeth Move?
- Will it Hurt?
- How Long Does Treatment Usually Take?
- Do I Stay With My Child During the Visit?
- American Association of Orthodontists
- American Board of Orthodontics
- Dentsply – GAC International
We consider it a privilege that you have chosen our practice for your orthodontic care. You can expect excellence from Dr. Sheer and our entire orthodontic staff in a warm and comfortable environment. We understand the importance of choosing an office that truly cares about the quality of service it provides. Since each smile is unique, we enjoy getting to know the person behind the smile. Your smile is the signature of our reputation and we welcome you to our practice!
Initial Orthodontic Consultation
We look forward to meeting you on your first visit to our office. Your first orthodontic treatment visit is complimentary and Dr. Sheer will complete a thorough exam of your teeth, bite and jaw joints. He will explain his findings, make recommendations on how to correct your specific orthodontic problem, and answer any questions you may have. This visit will determine if this is the proper time to begin treatment.
Generally, orthodontic patients will fall into one of these two categories:
Active orthodontic treatment is necessary and can be started in the near future. Diagnostic records are performed using state of the art technology with iTero Intraoral Scanning. These digital images replace traditional impressions.
- Benefits of early treatment for those patients who have clear indications for early intervention include:
- Influence jaw growth in a positive manner.
- Harmonize width of the dental arches.
- Improve eruption patterns.
- Lower risk of trauma to protruded upper incisors.
- Correct harmful oral habits.
- Improve aesthetics and self-esteem.
- Simplify and/or shorten treatment time for later corrective orthodontics.
- Reduce likelihood of impacted permanent teeth.
- Improve some speech problems.
- Preserve or gain space for erupting permanent teeth.
- Benefits of early treatment for those patients who have clear indications for early intervention include:
- Recall examinations: checking on the patient from time to time as the permanent teeth come in and the jaws and face continue to grow until necessary treatment time is reached.
Orthodontic Emergencies or Problems
As a general rule, orthodontic emergencies are very rare, but when they do occur we are available for you. You should call the office when you experience severe pain or when you have an appliance problem. We will be able to schedule an appointment to resolve the problem.
Loose Bracket or Band
Occasionally, a glued bracket may come loose. If your bracket or band is still attached to the wire, and is not causing any irritation, you should leave it in place and put wax on it. You can remove the loose bracket and save it in an envelope to bring to the office. Call the office as soon as possible in order for us to allow time to re-glue the bracket.
If a wire is poking your gums or cheek there are several things you can try until you can get to the office for an appointment. First try a ball of wax on the wire that is causing the irritation. You may also try using a nail clipper or cuticle cutter to cut the extra piece of wire that is sticking out. Sometimes, a poking wire can be safely turned down so that it no longer causes discomfort. To do this you may use a pencil eraser, or some other smooth object, and tuck the offending wire back out of the way.
Using a tweezer, try to put your wire back into place. You can use a small fingernail clipper to clip the wire behind the last tooth to which the wire is attached. If your discomfort continues, place wax on it.
Wire Out of Back Brace
Please be careful to avoid hard or sticky foods that may bend the wire or cause it to come out of the back brace. If this does happen, you may use needle nose pliers or tweezers to put the wire back into the hole in the back brace. If you are unable to do this, you may clip the wire to ease the discomfort. Please call the office as soon as possible to schedule an appointment to replace the wire.
Poking Elastic (Rubber Band) Hook
Some brackets have small hooks on them for elastic wear. These hooks can occasionally become irritating to the lips or cheeks. If this happens, you may either use a pencil eraser to carefully push the hook in, or you can place a ball of wax on the hook to make the area feel smooth.
You may be experiencing some discomfort after beginning treatment or at the change of wires or adjusting of appliances. This is normal and should diminish within 24-72 hours.
A few suggestions to help with the discomfort:
- If pain persists more than a few days, call our office
- Rinse with warm water, eat a soft diet, and take acetaminophen (Tylenol) or ibuprofen (Advil) as directed on the bottle.
- Chewing on the sore teeth may be sorer in the short term but feel better faster
Financial and Insurance
Treatment fees vary depending on the severity of the problem, the difficulty of the treatment, and the time necessary to complete the treatment. Many options are available for making this investment affordable. We will work with you to fit your individual needs.
- Monthly Payment Plans with No Interest: If you prefer, you may make monthly payments after making the initial down payment.
- For your convenience, our office can arrange for monthly payments to be automatically applied to your credit card each month.
- Online bill payment through PayPal.
- Payment options include the following
- Visa, MasterCard, Discover, American Express
- Online Bill Payment through PayPal
If you have insurance that covers orthodontic treatment, our office will help you determine your insurance benefits. If your insurance covers orthodontic treatment, you will receive the benefit of reduced personal costs. Many insurance policies have a lifetime orthodontic benefit that is distinct from regular dental insurance. Once treatment has started, we will file your claims.
Dr. Sheer is a participating member of the following PPO insurance companies:
- Aetna Dental Access
- Blue Cross/Blue Shield
- Connection Dental/GEHA
- Delta Dental
- Dental Health Center
- Optimum Choice
- United Concordia
- United Healthcare
Please remember that orthodontic insurance is a benefit for you or your child. If, during the course of treatment, your benefits change, you are accountable for all charges.
Separated or Divorced Parents
For separated or divorced parents, the parent who brings the child to the office is legally responsible for payment of fees charged for that child’s care. If another agrees to payment responsibility, that person must provide a notarized acknowledgment in writing of their desire to pay for care. It is the responsibility of the person bringing the child to the office to obtain a written agreement and to inform the other person of care being provided.
Your understanding and cooperation with this matter is greatly appreciated. You are helping to keep our overhead expenses, in the form of direct and labor costs, down. In addition, you are helping keep your fees as low as possible. If you have any questions please feel free to ask our business office staff. Please do not hesitate to ask questions about our financial policy. We want you to be comfortable in dealing with these matters. If you have any questions regarding your insurance, we ask that you contact your company regarding the specifics and details of your plan.
The American Association of Orthodontists recommends all children get a check-up with an orthodontic specialist no later than age 7.
ADVANTAGES OF EARLY TREATMENT
- Orthodontists can spot subtle problems with jaw growth and emerging teeth while some baby teeth are still present.
- While your child's teeth may appear to be straight, there could be a problem that only an orthodontist can detect.
- A check-up may reveal that your child's bite is fine. Or, the orthodontist may identify a developing problem but recommend monitoring the child's growth and development, and then, if indicated, begin treatment at the appropriate time for the child. In other cases, the orthodontist might find a problem that can benefit from early treatment.
- Early treatment may prevent or intercept more serious problems from developing and may make treatment at a later age shorter and less complicated. In some cases, the orthodontist will be able to achieve results that may not be possible once the face and jaws have finished growing.
- Early treatment may give your orthodontist the chance to: Guide jaw growth, Lower the risk of trauma to protruded front teeth, Correct harmful oral habits, Improve appearance, Guide permanent teeth into a more favorable position, Create a more pleasing arrangement of teeth, lips and face.
- Through an early orthodontic evaluation, you'll be giving your child the best opportunity for a healthy, beautiful smile.
It is never too late to be your best and braces are not just for kids anymore. A consultation with Dr. Sheer is the best way to determine if you can benefit from orthodontic treatment. Generally, teeth can be straightened at any age if your gums and bone structure are healthy. Orthodontic treatment at later stages in life can dramatically improve your personal appearance and self-esteem. Improvement in the health of your teeth and gums is equally important. Crowded teeth and a bad bite can contribute to gum and bone loss, abnormal wear of the tooth enamel and surfaces, tooth decay and sometimes jaw joint pain. The good news is that there are new techniques and materials available today. There are several options available--metal braces or translucent braces, and even transparent aligners that can be worn to improve mild cases of misaligned teeth.
Thanks to today’s smaller, less visible, more comfortable brackets, adults are finding braces more appealing. A large percentage of our patients are adults, and they agree it is never too late to improve their greatest asset--their smile.
The retention phase of treatment comes after tooth movements have been completed by your braces, aligners, or other orthodontic appliances. Follow these important tips to protect your hard work and investment made during your active treatment.
- Wear your retainers as Dr. Sheer has instructed.
- Take your retainers out when eating, and always put retainers in their case! (Most appliances are lost in school or restaurants).
- Clean retainers thoroughly once a day with a toothbrush. Brushing retainers removes plaque, and eliminates odors. Efferdent or other orthodontic appliance cleaners can be used, but do not take the place of brushing.
- When retainers are not in your mouth they should ALWAYS be in a retainer case. Pets love to chew on them!
- Initially, you may find it difficult to speak. Practice speaking, reading or singing out loud to get used to them faster.
- Retainers are breakable, so treat them with care. If your retainers are lost or broken call us immediately.
- ALWAYS bring your retainers to your appointments.
- Keep retainers away from hot water, pockets, the washing machine, hot cars and napkins.
Before and After Pics
All treatment performed by Dr. Stuart Sheer
Non-extraction therapy and crossbite correction.
The upper left lateral is narrow and has been cosmetically bonded.
Anterior crossbite correction using a retainer in the upper arch only (note the spontaneous improvement of the alignment and recession on the lower right central).
Correction of the upper front teeth which are behind the lower front teeth.
Early treatment with a habit appliance (no braces) to help an open bite (upper front teeth do not vertically cover the lower front teeth). A second phase is needed as there are 12 baby teeth remaining.
A dental and skeletal underbite corrected with orthodontics and orthognathic surgery.
The upper molars are too far forward, and have been moved back (headgear at night). Note the improvement of the upper front teeth without the use of braces. This type of treatment makes the time in braces much easier and much shorter.
Lateral Open Bite
Lateral open bite correction, the teeth now contact properly when the patient bites down.
Extra teeth are called supernumerary teeth. The upper two front teeth were the extra teeth that were removed, and the other teeth that appear to be blocked out were aligned. A second phase of treatment will be needed when more permanent teeth come in.
This patient did not like her smile, she was only 9 years old and getting teased. 6 months of early treatment to align the upper front teeth, and she was smiling again.
Open Bite and Overjet
A significant open bite and overjet is reduced by the use of a retainer alone. More treatment using braces will be used in the future, when more permanent teeth come in.
General Topics and FAQ's
What is Orthodontics?
Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention and treatment of dental irregularities. Tooth movement is accomplished by light pressure exerted on the teeth. The pressure is applied by a variety of orthodontic appliances. These appliances have progressed by use of space aged research to apply gentle forces over the course of treatment.
What Causes Orthodontic Problems?
Most orthodontic problems are inherited. Examples of these genetic problems are crowding, spacing, protrusion, extra or missing teeth and some jaw growth problems. Some malocclusions develop over time and can be caused by thumb sucking, mouth breathing, dental disease, the early or late loss of primary teeth, accidents, poor nutrition, or some medical problems. Usually an orthodontist is able to treat all conditions successfully.
When Should You See an Orthodontist?
The American Association of Orthodontists (AAO) recommends an orthodontic screening for children by the age of 7 years or earlier if an orthodontic problem is detected by parents, family dentist or physician. By the age of 7, the first adult molars erupt, establishing the bite. During this time, an orthodontist can evaluate front-to-back and side-to-side tooth relationships. Orthodontists can spot subtle problems with jaw growth and emerging teeth while some baby teeth are present. That's important, because some orthodontic problems are easier to correct if they are found early. Dr. Sheer is the specialist who has the knowledge to determine when the time for treatment is ideal for each patient.
What are the Advantages of Early Interceptive Treatment?
In some cases, Dr. Sheer might find a problem that can benefit from early treatment. Early treatment may prevent more serious problems from developing, and may make treatment at a later age shorter and less complicated. Some of the most direct results of early interceptive treatment are:
- creating room for crowded, erupting teeth
- creating facial symmetry through influencing jaw growth
- lowering the risk of trauma to protruding front teeth
- preserving space for unerupted teeth
- reducing the need for tooth removal
- improve the way lips meet
- improve appearance and self-esteem
- reducing treatment time in braces
Are You a Candidate for Orthodontic Treatment?
Orthodontics are not merely for improving the aesthetics of the smile; orthodontic treatment improves bad bites (malocclusions). Malocclusions occur as a result of tooth or jaw misalignment. Malocclusions affect the way you smile, chew, clean your teeth or feel about your smile. Some signs that your bite might not be right:
- Early or late loss of baby teeth
- Difficulty in chewing or biting
- Breathing through the mouth
- Thumb-sucking or tongue-thrusting habits
- Crowded, misplaced or blocked-out teeth
- Jaws that are too far forward to back
- Protruding teeth
- An unbalanced facial appearance
- Grinding or clenching of the teeth
- Upper and lower teeth that do not meet
Ultimately, orthodontics does more than make a pretty smile--it creates a healthier you!
How do Teeth Move?
Tooth movement is a natural response to light pressure over a period of time. Pressure is applied by using a variety of orthodontic hardware (appliances), the most common being a brace or bracket attached to the teeth and connected by an arch wire. Periodic changing of these arch wires puts pressure on the teeth. At different stages of treatment your child may wear a headgear, elastics, a positioner or a retainer. Most orthodontic appointments are scheduled 4 to 6 weeks apart to give the teeth time to move.
Will it Hurt?
When teeth are first moved, discomfort may result. This usually lasts about 24 to 72 hours. Patients report a lessening of pain as the treatment progresses. Pain medicines such as acetaminophen (Tylenol) or ibuprofen (Advil) usually help relieve the pain.
How Long Does Treatment Usually Take?
Although every case is different, patients wear braces from one to two years. Treatment times vary with factors that include the severity of the problem being corrected and how well the patient follows instructions.
Patients who brush and floss thoroughly and regularly; avoid hard and sticky foods; wear their rubber bands and/or headgear as instructed; and keep their scheduled appointments usually finish treatment on-time with exceptional results. Patients remain under Dr. Sheer's care during the retention phase.
Do I Stay with My Child During the Visit?
We strive to make each visit pleasant for every patient. We realize that each child has different needs and anxieties and therefore we have an Open Door Policy. We know that most children are more comfortable when a parent is with them. Parents are welcome to come into the treatment areas and stay with their child during the entire appointment. Although there are times when having the parent wait in the waiting room will help the child focus on the task at hand, we understand that usually the parent wants to be with their child. We also want you to feel comfortable allowing your child to accompany our team through the entire experience if and when they are ready to do so independently.
How are Appointments Scheduled?
We would like to see all school-age patients after school: however, this is not possible. We are aware of school policies which make it more difficult for children to be out of school for any reason. However, MEDICAL and DENTAL appointments are EXCUSED ABSENCES with a doctor’s school pass and signature stating the child was in the office. We will be happy to provide that for you at your request. Missing school can be kept to a minimum when regular dental care is continued.
The office attempts to schedule appointments at your convenience and when time is available. Preschool children should be seen in the morning because they are fresher and we can work more slowly with them for their comfort. School children with a lot of work to be done should be seen in the morning for the same reason. Since appointed times are reserved exclusively for each patient we ask that you please notify our office 24 hours in advance of your scheduled appointment time if you are unable to keep your appointment. Another patient, who needs our care, could be scheduled if we have sufficient time to notify them. We realize that unexpected things can happen, but we ask for your assistance in this regard.
The part of your braces which actually moves the teeth. The arch wire is attached to the brackets by small elastic donuts or ligature wires. Arch Wires are changed throughout the treatment. Each change brings you closer to the ideal tooth position.
Brackets are the “Braces” or small attachments that are bonded directly to the tooth surface. The brackets are the part of your braces to which the dentist or assistant attaches the arch wire.
Occasionally, a bracket may come loose and become an irritation to your mouth. You can remove the loose bracket and save it in an envelope to bring to the office. Call the office as soon as possible and make an appointment to re-glue the bracket.
Elastics (Rubber Bands)
At some time during treatment, it will be necessary to wear elastics to coordinate the upper and lower teeth and perfect the bite. Once teeth begin to move in response to elastics, they move rapidly and comfortably. If elastics (rubber bands) are worn intermittently, they will continually "shock" the teeth and cause more soreness. When elastics are worn one day and left off the next, treatment slows to a standstill or stops. Sore teeth between appointments usually indicate improper wear of headgear or elastics or inadequate hygiene. Wear your elastics correctly, attaching them as you were told. Wear elastics all the time, unless otherwise directed. Take your elastics off while brushing. Change elastics as directed, usually once or twice a day.
Often called a “night brace”. The headgear is used to correct a protrusion of the upper or lower jaw. It works by inhibiting the upper jaw from growing forward, or the downward growth of the upper jaw or even by encouraging teeth to move forward, if that is the case.
Poor positioning of the teeth.
Types of Malocclusion
A Malocclusion where the bite is OK (the top teeth line up with the bottom teeth) but the teeth are crooked, crowded or turned.
A Malocclusion where the upper teeth stick out past the lower teeth.
A Malocclusion where the lower teeth stick out past the upper teeth. This is also called an "underbite".
The alignment and spacing of your upper jaw and lower teeth when you bite down.
Types of Occlusion:
Anterior opening between upper and lower teeth.
Vertical overlapping of the upper teeth over the lower.
Horizontal projection of the upper teeth beyond the lower.
When top teeth bite inside the lower teeth. It can occur with the front teeth or back teeth.
O rings, also called A-lastics, are little rings used to attach the arch wire to the brackets. These rings come in standard gray or clear, but also come in a wide variety of colors to make braces more fun. A-lastics are changed at every appointment to maintain good attachment of the arch wire to the bracket, enabling our patients to enjoy many different color schemes throughout treatment.
A plastic or rubber donut piece which the dentist uses to create space between your teeth for bands.
Fixed and Removable Appliances
Band & Loop (B & L)
A Band & Loop is routinely used to hold space for a missing primary (baby) posterior (back) tooth until the permanent tooth can grown in.
An appliance designed to encourage the lower jaw to grow forward
and “catch up” to upper jaw growth.
Lower Lingual Arch (LLA)
A lower lingual arch is a space maintainer for the lower teeth. It maintains the molars where they are, it does not move them. This is fabricated by placing bands on the molars and connecting them to a wire that fits up against the inside of the lower teeth. It keeps the molars from migrating forward and prevents them from blocking off the space of teeth that develop later. This is used when you have the early loss of baby teeth or when you have lower teeth that are slightly crowded in a growing child and you do not want to remove any permanent teeth to correct the crowding.
An appliance which is placed in the roof of the mouth to widen the upper dental arch. The maxilla, or upper dental arch, is joined in the center by a joint, which allows it to be painlessly separated and spread. Temporarily you may see a space develop between the upper two front teeth. This will slowly go away in a few days. Once this has occurred, the two halves knit back together and new bone fills in the space.
This appliance provides continual, gradual pressure in as many as four directions, to move molars, expand or contract arches or assist in eliminating finger or thumb habits.
An appliance used to expand the lower arch without interfering with tongue posture or movement.
A universally used retainer with many applications; to move teeth, close spaces, maintain alignment during or after treatment.
This appliance maintains the position of the maxillary molars without using any other teeth. The plastic button on the palate provides stability.
At the completion of the active phase of orthodontic treatment, braces are removed and removable appliances called retainers are placed. To retain means to hold. Teeth must be retained or held in their new positions while the tissues, meaning the bone, elastic membranes around the roots, the gums, tongue and lips have adapted themselves to the new tooth positions. Teeth can move if they are not retained. It is extremely important to wear your retainers as directed!
You will be shown the proper care of your braces when your orthodontic treatment begins. Proper cleansing of your mouth is necessary every time you eat. Teeth with braces are harder to clean, and trap food very easily. If food is left lodged on the brackets and wires, it can cause unsightly etching of the enamel on your teeth. Your most important job is to keep your mouth clean. If food is allowed to collect, the symptoms of gum disease will show in your mouth. The gums will swell and bleed and the pressure from the disease will slow down tooth movement.
BRUSHING: You should brush your teeth 4-5 times per day.
- Brush back and forth across……between the wires and gums on the upper and lower to loosen any food particles.
- Next, brush correctly as if you had no brackets or appliances on.
- Start on the outside of the uppers with the bristles at a 45 degree angle toward the gum and scrub with a circular motion two or three teeth at a time using ten strokes, then move on.
- Next, do the same on the inner surface of the upper teeth.
- Then, go to the lower teeth and repeat steps 1 & 2.
Look in a mirror to see if you have missed any places. Your teeth, brackets and wires should be free of any food particles and plaque.
Note: If your gums bleed when brushing, do not avoid brushing, but rather continue stimulating the area with the bristles. Be sure to angle your toothbrush so that the area under your gum line is cleaned. After 3 or 4 days of proper brushing, the bleeding should stop and your gums should be healthy again.
FLOSSING: Use a special floss threader to floss with your braces on. Be sure to floss at least once per day.
FLUORIDE RINSE OR GEL: May be recommended for preventive measures.
Clean the retainer by brushing with toothpaste. If you are wearing a lower fixed retainer be extra careful to brush the wire and the inside of the lower teeth. Always bring your retainer to each appointment. Avoid flipping the retainer with your tongue, this can cause damage to your teeth. Place the retainer in the plastic case when it is re-moved from your mouth. Never wrap the retainer in a paper napkin or tissue, someone may throw it away. Don't put it in your pocket or you may break or lose it. Excessive heat will warp and ruin the retainer.
If elastics (rubber bands) are worn intermittently, they will continually "shock" the teeth and cause more soreness. Sore teeth between appointments usually indicate improper wear of headgear or elastics or inadequate hygiene. Wear your elastics correctly, attaching them as you were told. Wear elastics all the time, unless otherwise directed. Take your elastics off while brushing. Change elastics as directed, usually once or twice a day.
- Avoid Sticky Foods such as:
- Candy bars with caramel
- Fruit Roll-Ups
- Candy or caramel apples
- Gummy Bears
- Avoid Hard or Tough Foods Such as:
- Pizza Crust
- Hard Candy
- Corn Chips
- Ice Cubes
- Popcorn Kernels
- Cut the following foods into small
- Corn on the Cob
- Chicken Wings
- Spare Ribs
pieces and chew with the back teeth: