Orthodontics
Adults & Children
“Orthodontic treatment” focuses on moving the teeth. However, orthodontic treatment can go beyond this by controlling and modifying facial growth. In the latter case this treatment is better defined as “dentofacial orthopedics.”
This means that the treatment takes into consideration the relationship that exists between your bite alignment, the health of your TM joints (TMJ), and your cranial and facial bone growth.
Dr. Giordano’s philosophy is “form follows function.” When the teeth are moved to an ideal functional position (proper bite relationship), the muscles, jaw joints, teeth, cranium, and facial structures will all be healthy and well-functioning. The natural result of healthy function is a beautiful smile. Because of his extensive knowledge of the bite and jaw joints (TMJ), Dr. Giordano is able to align the teeth so that your bite, your TMJs, and your smile are ALL healthy.
With this philosophy in mind, Dr. Giordano uses oral appliances for children, when necessary, to ensure they grow into a healthy bite and jaw position. This can significantly shorten or eliminate the time they will be in braces.
Orthodontics can be done conventionally with braces, or sometimes using clear aligners. The use of clear trays is usually limited to minor tooth movement.
An initial evaluation is recommended to make sure you are a candidate for orthodontics. After the appropriate records have been gathered, you will sit down with Dr. Giordano for a consultation. He will review his findings and recommendations with you and treatment can begin.
FAQs About Orthodontic Treatment
Should teeth be removed prior to orthodontic treatment?
Teeth should ONLY be removed if a great deal of space is needed. The removal of baby teeth is common to help aid proper eruption of the adult teeth, However, it is still a very common practice to remove adult teeth for ease of treatment, rather than need. Unnecessary adult tooth removal can have negative long-term effects. TMJ (temporomandibular joint) problems are very common in these patients, often requiring them to have TMJ therapy and following that, a second round of orthodontics. Being treated by a dentist who takes all structures into consideration before and during treatment, ensures long-term success.
Children: When should an orthodontic evluation be done? How will I know if treatement is needed?
Age 7 is recommended for their first evaluation. Once Dr. Giordano has evaluated your child, he will make recommendations based on that evaluation. Sometimes appliances will be recommended to direct the growth of the jaws. There are times when only interceptive appliances are all a child will need. Braces should only be placed when the roots of the teeth are fully formed. Otherwise, root growth will be stunted.
There are two types of orthodontic problems that need to be evaluated:
- Skeletal
- Dental
Evaluation Checklist:
- To make sure that the jaws are growing normally. Abnormal jaw relationships require early intervention.
- To make sure that all permanent (adult) teeth are present and developing correctly.
- To evaluate existing crowding. If deciduous (baby) teeth are crowded, adult teeth will be crowded.
- To determine if early intervention is needed to prevent injury to protruding front teeth or to prevent impaction of developing permanent front teeth.
When should a Child stop sucking their thumb?
By age 6, before the eruption of their permanent upper front teeth. This will prevent tooth and bone distortion.
What if a child grinds their teeth at night?
It may indicate a skeletal/bone problem or airway issue.
What if a child has a cross bite?
A cross bite means the upper and lower jaws aren’t coming together properly. It could interfere with the development of a proper bite and/or proper jaw growth. Improper jaw growth can sometimes require corrective surgery. Correcting a cross bite early maybe necessary.
What if a child has has a space between their front teeth?
If the space is less than 2mm, it will usually close on its own once the upper canines erupt. If it is greater than 2mm, the space will not close on its own.
Should the gum between the upper front teeth be cut to help close the space?
This procedure is called a frenectomy. A frenctomy is only recommended after the space has been orthodontically closed, so that the scar that forms helps to keep the space closed. This scar tissue formation is also the reason why you don’t want to do it before the space closes. It makes future closure more difficult.
Does playing an instrument harm a child's teeth?
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