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A beautiful smile can light up a room, and achieving that perfect set of pearly whites often involves a decision between two popular orthodontic treatments: clear aligners (i.e. Invisalign) and traditional braces. In this blog post, we'll delve into the pros and cons of each option, helping you make an informed decision on the journey to a straighter smile. Invisalign: The Invisible Solution Aesthetics: One of the most significant advantages of clear aligners is their nearly invisible appearance. They are custom-made to fit your teeth snugly, making them a discreet option for those who may feel self-conscious about wearing braces. Removability: Perhaps one of the most appealing features of aligners is their ability to be taken out. Patients can take out the aligners when eating, brushing, and flossing, allowing for more flexibility and convenience in daily life. This also means fewer food restrictions compared to braces. Oral Hygiene: Maintaining oral hygiene is easier with aligners since they can be removed for regular brushing and flossing. This reduces the risk of plaque buildup and tooth decay often associated with traditional braces. Braces: Tried and True Effectiveness: Traditional metal braces have a long track record of successfully correcting even the most complex orthodontic issues. They are a reliable and effective method for achieving straighter teeth and a properly aligned bite. Continuous Treatment: Once braces are attached, there's no temptation to skip a day of treatment. This constant application ensures a consistent and effective approach to teeth straightening. This is often advantageous for teens who are not quite responsible enough to wear aligners as prescribed and can make treatment times shorter since they are worn 24/7. Conclusion: clear aligners, like Invisalign, and traditional braces each have their unique set of advantages, and the choice ultimately depends on individual preferences, lifestyle, and orthodontic needs. Aligners offer a discreet and comfortable experience with the flexibility of removal, while traditional braces provide a reliable and effective solution that has stood the test of time. Consultation with an orthodontic professional, like Dr. C.J. here at Park Circle Orthodontincs, will help determine which option aligns best with your smile goals, ensuring you embark on a journey to a straighter, more confident grin.

Your go-to reference for x-ray safety when considering or undergoing orthodontic treatment X-rays (also called radiographs) are an essential part of accurate diagnosis, treatment planning, and treatment outcomes for orthodontic treatment. In today's post, we'll cover the various types of dental x-rays you may undergo, their common intended uses, and the safety considerations for you or your children. Types of Dental X-Rays 1) Panoramic Radiograph: This type of x-ray captures all of the teeth and supporting bone circumferentially and displays these structures in a flattened or "panoramic" view, hence the name! This can best be thought of as a zoomed-out overview of all of the teeth, including any teeth that have not erupted into the mouth (i.e. baby teeth, adult teeth, and wisdom teeth). Used by: All dentists and most dental specialists Structures evaluated: Erupted teeth, unerupted teeth, wisdom teeth, tooth root structure, supporting bone, nerve locations, TMJ (jaw joint) anatomy, nasal structures and airway Orthodontic purposes: Eruption status or problems of primary teeth ("baby" teeth) and adult teeth Eruption status and space for wisdom teeth Tooth root shape and length for risk of root resorption Supporting bone level TMJ (jaw joint) symmetry or signs of TMJ arthritis Nasal airway opening and nasal bone/septum injury 2) Lateral Cephalometric Radiograph: This type of x-ray captures all of the teeth and supporting bone from a side or lateral view. This can best be thought of as a profile view of the head, neck, jaws, and teeth. Although orthodotic treatment is often offered at the general dentist office or through at-home services (i.e. Smile Direct or Byte), this x-ray is typically only taken at an orthodontist office. If provides a wealth of information that is important for optimal orthodontic diagnosis and treatment. Used by: Orthodontist and Oral Surgeon Structures evaluated: Teeth, supporting bone, jaws, facial skeleton, vertebrae, nasal and oral airway Orthodontic purposes: Tooth and jaw position Bite evaluation Jaw growth and overall bodily growth status Bone support of the upper and lower front teeth Openness of nasal and oral airways 3) CBCT Radiograph: Also called a "3D" x-ray, the full name of this x-ray is a cone beam computer tomography (CBCT) scan. This type of x-ray captures the full three-dimensional information of the area of interest. Depending on the type of machine, it can capture small isolated areas of just a couple of teeth, or it can also capture the entire head and neck. It is a more detailed 3D view of the head, neck, jaws, and/or teeth. Although it's a higher-level x-ray than the types of x-rays mentioned above, it's still not as detailed as a medical or CAT scan x-ray of the head and neck because the areas of interest do not require as much detail. Used by: Dentist, Orthodontist, Oral Surgeon, Periodontist, Endodontist, Prosthodontist Structures evaluated: Teeth, bone, jaws, facial skeleton, nerve canals Orthodontic purposes: Tooth and jaw position Position of impacted teeth Bite evaluation Jaw surgery planning Jaw growth and overall bodily growth status Bone support of the upper and lower front teeth Openness of nasal and oral airways 4) Bitewing and Periapical Radiographs: These x-rays are routinely used by general and pediatric dentist to evaluate individual teeth and/or smaller groups of teeth. If you visit your dentist for routine checkups or treatment such as fillings or crowns, you have surely undergone one or both of these types of x-rays. These can be thought of as zoomed-in x-rays to allow for proper diagnosis of cavities, infections, and the status of fillings or crowns. Typically, a bitewing x-ray evaluates teeth for possible cavities, where as a periapical x-ray evaluates for signs of health or infection around the roots of the teeth. Used by: Dentist, Pediatric Dentist, Periodontist, Endodontist, and Prosthodontist Structures evaluated: Teeth, Supporting Bone Orthodontist purposes: None (usually) X-Ray Safety Considerations Are dental x-rays considered safe to undergo when recommended? The short answer is yes, but let's cover the basics about radiation dosages and precautions. Radiation Background Whenever any type of x-ray is taken, it involves the use of a specialized form of radiation that is intended to expose certain parts of the body. This exposure of radiation to the intended body structure(s) is necessary to visualize the internal parts of that structure, such as bones or teeth. In general, dental x-rays require significantly lower levels of radiation to obtain useful images than do medical x-rays. That being said, the amount of radiation used depends on several factors, including but not limited to the following: Type of x-ray needed X-ray machine type or age of the machine Body structure of interest Level of detail needed Radiation in Everyday Life X-rays are not the only things that expose you to radiation. In fact, radiation can be found in a variety of places or situations that you may not realize, including the environment/air, common foods that are high in potassium such as bananas and leafy vegetables, cell phones, power lines, Wi-Fi, modes of transportation such as planes and cars, airport scanners, tanning beds, microwave ovens, and more. Don't feel scared though! There has been much research into how much radiation our bodies can safely handle. The rest of this post will show you exactly where dental x-rays fit into that research. Dosages Levels of Radiation Below is a helpful chart to show the relative levels of radiation given off by various x-rays, as well as everyday sources. Note that the "Sievert" (Sv) is one of the commonly used units of measurement of radiation levels, similar to how we use ounces for fluid levels or inches for measurement. The "Sievert" unit is particularly helpful because it takes into account the amount of radiation produced as well as the type of body structure(s) affected by that type of radiation. Timing and Frequency of X-rays As we mentioned, x-rays play an important role in planning and carrying out successful orthodontic treatment. Below is a timeline of when various types of x-rays are often used or required during your orthodontic treatment: Consultation Visit or Pre-treatment At this appointment, Dr. C.J. evaluates a ton of information from both x-rays and a clinical evaluation. Depending on the age and dental development stage of the patient, the following x-rays are often required: Panoramic X-ray Cephalometric X-ray CBCT - this may be taken instead of, or in addition to, the first two x-rays to evaluate specific problems that are more complex, such as the location of an impacted tooth. Mid-treatment or Progress Evaluation During treatment, a detail-oriented orthodontist should often use one or multiple "progress" x-rays to evalute the movement of teeth so far, which also includes the positioning of the roots of all the teeth to make sure they are properly aligned. Progress x-rays may also be used to evalute growth changes during treatment and/or plan for adjunctive treatments, such as orthognathic surgery. The following x-rays are often taken during the middle to later stages of treatment: Panoramic X-ray Cephalometric X-ray End of Treatment Lastly, post-treatment x-rays are required to serve as records for the end of orthodontic treatment. In addition, orthodontists like Dr. C.J. will routinely compare the pre-treatment post-treatment x-rays to continuously learn and improve treatment outcomes. This is one of the hallmarks of board-certified orthodontists, who are experts at evaluating and understanding treatment effects or results. The following x-rays are required at the end of active orthodontic treatment: Panoramic X-ray Cephalometric X-ray X-ray Shielding In the past, you may have worn a shield or "apron" while undergoing dental x-rays. Essentially, these shields are thin, but heavy coverings made of lead covered with a wipeable fabric. The purpose of the lead shield was to reflect or block x-ray beams that "scattered" away from the intended area to be evaluated. FAQ: Do I or does my child need to wear an x-ray shield or lead apron during dental or orthodontic x-rays? In modern practice, the short answer is "No", but let's explain that a bit more. Historically (i.e. in the first half of the 1900's), x-ray shielding was recommended because of the relatively primitive technology used to generate x-rays. The shields helped to reduce the radiation dosage received by the patient. Thanks to dramatically improved x-ray technology as well as a profound increase in the understanding of x-ray timing and effects, the radiation dosages received by patients are incredibly lower than they have ever been. In fact, current research has found that x-ray shielding now has negligible effects in reducing radiation dosage during dental x-rays - this is because the current dosage levels are already low enough to not be further reduced by additional shielding. Source: Benavides et al. (2023) "Patient shielding during dentomaxillofacial radiography: Recommendations from the American Academy of Oral and Maxillofacial Radiology." Journal of the American Dental Association (ADA). X-rays in Pregnancy Modern research shows that all dental x-rays are considered safe during pregnancy. The American College of OB/GYN endorses this position and encourages expectant mothers to pursue regular dental exams, x-rays, or treatments as-needed. The one difference is for pregnant patients is shielding -- it is still recommended to utilize shielding of the abdomen and thyroid gland for pregnant women as an addition measure of safety for the mother and developing baby. If you want more information regarding dental x-rays, feel free to visit the American Dental Association's guide to dental x-rays linked below: https://www.ada.org/en/resources/research/science-and-research-institute/oral-health-topics/x-rays-radiographs

Can you start or continue braces or Invisalign while being pregnant? The short answer is, "Yes!", but let's review some helpful info for expectant mothers who are either considering or going through orthodontic treatment. A common question from younger female patients considering orthodontic treatment is, "Can I start or continue braces or Invisalign treatment if I'm pregnant?" Yes, orthodontic treatment is considered safe while you are pregnant, trying to get pregnant, and when nursing. But there's more to know about your pregnancy, your oral health, and potential treatments. Here are a few takeaways: Routine dental and orthodontic evaluation and treatments are considered safe during pregnancy You should feel comfortable scheduling and undergoing orthodontic and dental treatment while pregnant or trying to become pregnant. Considerations: Altering the way treatment is delivered may be recommended to keep the mother's posture safe and comfortable. This may mean to keep patients "half-reclined" at 45 degrees instead of fully reclined, especially during the third trimester. This is very doable for most orthodontic appointments. Dental treatments requiring local anesthetics are permitted during pregnancy because of the low dosage levels of epinephrine used in dental anesthetics. Luckily, routine orthodontic treatment does not require any administration of anesthetics! Dental radiographs (x-rays) are considered safe during all stages of pregnancy This is true of all types of dental x-rays, not just those used for orthodontic evaluation and treatment. The reason for this is that dental x-ray machines require much lower radiation dosages to obtain diagnostic images of the areas of interest than do medical x-ray machines. Considerations: For comparison, a panoramic dental x-ray uses about 40 times less radiation than a mammogram, and nearly 200 times less radiation than a medical head CT scan. Some expectant mothers may choose to defer dental x-rays during the first trimester, although it is still considered a safe time. If needed, we can typically take the required orthodontic x-rays either before or after the first trimester. Changes to your oral health are possible during pregnancy The most common change to oral health seen during pregnancy is a temporary flare-up of the gums with possible redness and/or swelling -- this is often called "pregnancy gingivitis" due to the timing and symptoms. This doesn't happen to all expectant mothers, but when it does, it occurs independently of whether or not the mother is undergoing orthodontic treatment Considerations: The best prevention and management of pregnancy gingivitis to excellent oral hygiene at home. Ask us if you need help with brushing or flossing techniques with or without braces! Some expectant mothers may choose to have more frequent cleaning appointments during pregnancy, such as every 3-4 months, then return to their regular cleaning frequency after delivery. For patients who may struggle to keep their teeth clean with braces, clear aligner treatment (i.e. Invisalign) may be a better treatment style because it may allow for easier home oral hygiene. ____ Want more information about pregnancy and dental health or treatment? Visit the American Dental Association's (ADA) online overview below, or feel free to call or email us with questions! https://www.ada.org/en/resources/research/science-and-research-institute/oral-health-topics/pregnancy

Your favorite B-Day is coming up... No, it's not your birthday, we're talking about Braces Bonding Day! By now, you have probably either heard (a) A LOT about braces from friends, family members, Tik-Tok, YouTube, or (b) nothing at all about this big addition to your teeth. Regardless of how much or little you know, let us help you understand exactly what to expect the day you get your braces starting from your first few steps in the office and going all the way through your first couple of weeks with your new hardware. Step 1 - Photos & Records At your consultation appointment, you may or may not have had "formal" records taken. If not, we'll capture the following records to have so that we can compare your teeth, bite, and smile before, during, and after treatment. If you need a new Christmas card photo, Twitter avi, or LinkedIn profile photo, we got you covered: Facial portrait photos Dental photos (close-up) Digital dental scan Step 2 - Braces Bonding This is the part you've been waiting for! (And also the reason you opened this blog post). Putting braces on your teeth is done using a "bonding" process. It involves a cleaning or polishing of your teeth, priming the outer surfaces of your teeth, positioning the braces, and finally "curing" them into place. Here's breakdown of each of these steps: 1. Cleaning or Polishing Orthodontic research has shown that bonding braces is most successful if it is done on freshly polished teeth. We use a polishing paste that's similar to the minty or fruity pastes used at your regular cleaning visits. 2. Isolating and Drying of Teeth Bonding requires your teeth to be very dry, which means we need to prevent ALL saliva and water from touching the other surfaces of your teeth! We use cheek retractors and other rubbery or plastic guards to hold your lips, cheeks, and tongue out of the way. 3. Priming of Tooth Surfaces The outer layer of your teeth need to be "primed" before placing the braces. In our office we use three layers to help prime your teeth. Each of these three layers is applied with the smallest and most adorable paint brushes you've ever seen. 4. Placement and Positioning of Braces Braces (or brackets) are placed onto your teeth with a small layer of clear glue between the bracket and your tooth. That glue starts off as a paste, which allows Dr. C.J. to move and adjust the position of each bracket. Dr. C.J. takes great pride in trying to achieve the precise location and orientation of your braces, which can really speed up your treatment! 5. Light Curing Once the brackets are properly positioned, the small glue layer must be exposed to a bright blue light. This light turns the glue from a paste material into a firm hard glue. This process is known as "light curing". It's the same idea as curing nail polish under bright lights or lamps. Step 3 - Wires and Colors For most patients, you will have your first set of wires placed into your braces after all the brackets are light cured into place. The wire the most common tool used to apply the forces to start straightening your teeth. In order for the wire to stay in-place within your brackets, color ties and/or power chain are placed around the outside of each bracket. Whether you have the singular o-ties or power chain depends on the type of tooth movement that Dr. C.J. determines is appropriate for that visit. Don't stress too much over picking the "right" color because you can usually pick 1-2 colors each time you come in for your regular adjustment appointments! And if you don't want bright colors, we have plenty of darker neutral colors including silver to help blend in with your braces. Step 4 - Cleaning and Eating Instructions Life with braces attached to your teeth is a little different than a life with plain teeth! We dedicate the last part of your bonding day appointment to explain how to best take care of your shiny new braces. Two parts to this include cleaning and eating with braces: Cleaning -- We will show you techniques and give you new teeth-cleaning tools to help clean above, below, and in-between your braces. Poorly cleaned teeth and braces can actually make your teeth move slower and may result in quickly-forming cavities. If the teeth and braces cannot be kept clean, we may have to end treatment early before the teeth are fully straightened. So, listen closely during this part of the bonding day! Eating -- When placed correctly, braces are bonded quite strongly to your teeth. However, they aren't invincible! Foods that are crunchy, sticky, or that require large or forceful bites can result in "broken brackets", which is when the bracket pops off of the tooth. If this happens, it can REALLY slow down your braces treatment because teeth need their braces to be attached in order for them to move and get straighter. We'll go over what types of foods avoid and habits to help prevent broken brackets so that your treatment can go as quickly as possible. Step 5 - What to Expect in the First Few Days & Weeks If this is your first time having braces, you and your teeth will be experiencing the feelings of tooth movement for the very first time. You might experience and notice some of the following: Tooth or mouth soreness -- This is most noticeable in the first 1-3 days after getting braces. It should not be a sharp pain and should go away soon. When teeth move, they must move through and within the gums and bone that holds them in place. This is why you may experience soreness for a short period of time. If needed, we often recommend taking Tylenol (acetaminophen), or whatever over-the-counter pain reliever works best for headaches. Lip and cheek contacts -- Your lips and cheeks are very accustomed to resting against your teeth. Now that you have braces, it will take some time for your lips and cheeks to accustomed to the feeling of resting against braces. We will always make sure that there are no sharp or pokey areas on your braces and wires before you leave each appointment! Step 6 - Tell & Show Your Friends and Family Don't be afraid to show off your new braces and colors! We are just a little biased, but we think braces are pretty "in" right now... and always. Ask people for input on what colors you should get at your next appointment! If you had fun getting your braces tell your friends that they might find it fun too! Some of our favorite patients are the ones who are sent to us by our already-favorite patients!

So, your first orthodontic consultation appointment is coming up soon. Or, you just visited the orthodontist and want to know what Dr. C.J. or his team were saying about your teeth, smile, etc. Was it good? Was it bad? Were you just in a foreign-speaking country, or the orthodontic office? Like many other healthcare settings, there are likely many words you just don't know or understand. In this post, we will discuss some of the common words your orthodontist will use. We will describe what they mean, alternate or interchangeable words, and, when appropriate, what constitutes good versus improvable. By the end of this post, your Tik-Tok-based orthodontic lingo repertoire will be much more than just "overjet" and "power chain." Words to describe your teeth, smile, and dental health: Orthodontics - the diagnosis and treatment of abnormalities of tooth alignment, occlusion (bite), the upper and lower jaws, and facial proportions or balance. Primary Tooth (or Baby Tooth or Deciduous Tooth): A tooth that is part of someone's "first set" of teeth. Primary teeth begin forming in the womb and typically erupt into the mouth between the ages of 6 months and 3 years old. Primary teeth normally fall out between the ages of 6 and 12 years old. Important to know: It's normal to have spaces between primary teeth - this space is usually needed by the larger adult teeth that replace the primary ones. Permanent Tooth (or Adult Tooth or Succedaneous Tooth): A tooth that is part of someone's "second set" of teeth. Permanent teeth begin forming in the first 6 months of life and typically erupt into mouth between the ages of 6 and 12 years old. All adult teeth except the last molars (2nd molars) serve as replacements for primary teeth. When permanent teeth are erupting, they normally reduce the roots of the primary teeth and help push the primary teeth out. That's why primary teeth usually get very loose before falling out! Wisdom Tooth (or Third Molar) - If present, it's the third and typically last molar tooth in the back of the mouth. Some people are born without one or more wisdom teeth, which means that they are congenitally missing. If present, wisdom teeth begin forming around age 7-9 and may attempt to erupt around age 17-21. Most people don't have enough space in the back of their mouth for their wisdom teeth. Due to this lack of space, wisdom teeth are sometimes only partially visible when they erupt, or instead they may not be visible at all. If they are present but cannot be seen, they are said to be "impacted." Compared to other impacted teeth, impacted wisdom teeth are usually not brought into the mouth and are instead extracted at an appropriate time. Dr. C.J. will evaluate your wisdom teeth before and after treatment and may recommend to have them removed based on the spacing of your individual mouth. For teenage patients, this usually involves having the wisdom teeth evaluated and extracted after orthodontic treatment is finished. Crowding - When the teeth are overlapping or occupying some or all of the same space. Alternatively, a tooth may so crowded that it is "blocked out" from the arch, or even "impacted." Many dentists or orthodontists will tell you if your teeth are crowded. The amount of crowding is sometimes characterized is mild, moderate, or severe. In general, if your crowding is mild to moderate, your orthodontists can likely straighten your teeth without removing any other teeth. If your crowding is moderate to severe, one or a few teeth may need to be removed (or "extracted") to straighten your teeth in a healthy and appropriate way. Want to know more about this topic? Check out the blog post "Why do I have to have teeth taken out for braces?" Spacing - The opposite condition of crowding. Similar to crowding, spacing with your teeth can be described as mild, moderate, or severe. Cases of mild to moderate spacing, can usually be easily treated with orthodontics by simply closing the spaces. Cases of moderate to severe spacing are quite rare. The excessive spacing might actually be due to other problems, such as a missing or impacted tooth. Lastly, one of the most common instances of spacing is a gap between the top two front teeth. This gap is called a diastema. These gaps can be caused by many things, and can be difficult to close in some instances. See our blog post "Diastema: What to know about the gap between your teeth" for more learning about that topic! Occlusion (or Bite) - The relationship between the upper and lower teeth when biting together. Because the upper and lower teeth are housed in the upper and lower jaw bones, respectively, your occlusion involves the positions of both your teeth and jaws. Your occlusion belongs to one of three categories, or "classes": Class 1 - The upper and lower teeth and jaws are positioned normally relative to each other. Importantly, it's normal in a "Class 1" bite for your upper teeth to be positioned just ahead of your lower teeth. Class 2 - The upper teeth and/or jaw is positioned too far forward, or more commonly, the lower teeth and/or jaw is positioned too far backward. Patients with this occlusion may notice they have an increased overjet (see below) with their front teeth sticking out Class 3 - The upper teeth and/or jaw is positioned too far backward, or the lower teeth and/or jaw is positioned too far forward. Patients with this occlusion may notice they have an "underbite" (see below). Overbite - The amount of vertical overlap between the upper and lower front teeth. This is usually expressed as a percentage of the lower front teeth that are covered by the upper teeth. It's actually normal to have some overlap, or overbite. In fact, 20-30% overbite is normal. More overbite is referred to as a "deep bite", whereas an "open bite" is when the front teeth do not overlap at all. Many patients use this term when they are really referring to their "overjet" (see next). Overjet - The amount of forward-to-back distance between the upper and lower front teeth. Put another way, it's how far front the upper teeth are from the lower teeth, or how far back the lower teeth are from the upper teeth. Overjet is normally stated as a number in millimeters, with normal being 2-3mm. Patients with a larger overjet may feel like their front teeth "stick out" a lot. That may be the case, however it could also be due to the lower teeth/jaw being positioned too far back. Patients with a negative overjet may find that their top teeth bite behind their bottom teeth, which is called an "underbite" by many doctors and patients. Crossbite - When the bite between the upper teeth and lower teeth is "crossed over." Normally, when biting down, the upper teeth are supposed to fit just outside of the lower teeth. By contrast, a crossbite is when the lower teeth fit outside of the upper teeth when biting down. When a crossbite is present with the front teeth, it is sometimes called an "underbite." Why might crossbites happen? (1) It may be a tooth or dental problem, where just one or a couple of teeth are in a crossbite relationship. (2) Alternatively, it may be a skeletal problem where the entire upper jaw and upper row of teeth are too narrow. Don't worry, both types of problems can be fixed with orthodontic treatment. However, it may require additional methods such as an expander (see below) or other procedures. Erupt (or Eruption) - The process of a tooth moving from the gums and bone into the mouth. When a tooth has erupted enough to be visible above the gums, it is considered to be "Emerged." Teeth begin their formation within the jaw bones. When they are about 1/2 to 2/3 of their full-grown size, teeth begin the process of eruption. An erupting adult or permanent tooth will help to "push out" or loosen the primary or baby tooth that is directly overlaying. There are normal times for teeth to erupt, and Dr. C.J. will check to see if the teeth are early, on-time, or delayed. More important than timing is the sequence and symmetry of erupting teeth. Unusual orders or differences in eruption between the right and left sides may require special attention. This is why the American Association of Orthodontists recommends children to be seen by an orthodontist by age 7. This allows us to evaluate the eruption of adult teeth and catch problems early, and to strategically plan the timing of observation visits if your child doesn't need treatment at that early age. Impacted tooth (or Impaction): A tooth that is present and visible in X-rays, but is not visible in the mouth long after it should be. Impacted teeth are either (a) covered by the gums (called a soft tissue impaction), or (b) still within the jaw bone (called a bony or hard tissue impaction). The cause for an impacted tooth is often unknown, but it can be related to many things, such as: (1) Not enough space for the tooth (2) Another tooth blocking the impacted one (3) Early loss of a baby tooth in the same area (4) Genetics (5) Other systemic health factors. Orthodontic treatment for impacted teeth is often longer than regular treatment, and can often require additional dental procedures to help guide the tooth into place. Need more info on this? Check out the blog post "Impacted teeth: Where they are and where they're going" to answer more of your questions! Ankylosed Tooth (or Ankylosis or Submerged Tooth) - A tooth that becomes anchored to the surrounding jaw bones. When this occurs, the tooth is usually no longer able to be moved with orthodontic treatment. An ankylosed tooth also cannot erupt any further than it has at the moment it becomes ankylosed. Since our teeth continue to erupt well into our adolescence and early adulthood, an ankylosed will appear to be progressively submerged relative to the teeth around it. Usually, ankylosed teeth are not viable long-term teeth and are removed when their condition is discovered. The cause is usually unknown and typically only affects 1-2 teeth when present. However, some rare forms of ankylosis can affect groups of teeth and require special attention and an individualized treatment plan. Gummy Smile (or Vertical Maxillary Excess or Excessive Gingival Display) - When an excessive amount of upper gum tissue is showing when smiling. It's normal for a small amount of our upper gums to show when we smile, especially when we have a really good laugh. Some patient's, however, show too much of their gums when smiling. There are a few different possible causes for this, with each cause having a distinctly different treatment plan to address. If this is a main concern for you or your child, please don't be afraid to bring it up during your first visit consultation. Dr. C.J. will identify cause(s) and the appropriate options to address your concerns. Stay tuned for a future blog post dedicated to this topic to better understand the different causes and treatments of a gummy smile. Cavity (or Dental Caries) - Infection and subsequent breakdown of tooth structure that progresses from out-to-in. The current understanding of cavities is that the cause is "multifactorial," meaning many factors go into process of cavities forming. Some of these factors include diet, oral hygiene, genetics, habits, and local host factors. Each individual is affected differently by these factors, which helps to explain why some people are more susceptible to cavities than others. When small, cavities are treated with fillings (or restorations). When larger, cavities may have to be treated with crowns, buildups, root canals, or extractions. Dental caries is believed to be a disease process and should not be thought of an an isolated problem. This means that fillings or crowns address the sequelae of the disease process, but it is up to the patient, dentist, and hygienist to devise a plan to stop the disease process by altering diet, oral hygiene, and any other involved factors. In order to start orthodontic treatment, regardless of whether that's done with Invisalign or braces, a patient's mouth must be disease-free. That includes being cavity-free with healthy gum tissue! Gingivitis and Periodontitis - Oral disease processes that are characterized but inflammation and possible breakdown of the gum and bone surrounding the teeth. Common signs of gingivitis include gums with: redness, swelling, bleeding, tenderness, or sensitivity. The most common cause of gingivitis is poor oral hygiene, which can involve not brushing and flossing enough, or not brushing or flossing correctly. For this reason, there is never any shame in asking us for help or tips for how to brush or floss with good technique. A person with poor oral hygiene and gingivitis can experience significant improvements in the health of their gums in just 2-3 weeks with good and frequent oral hygiene. If gingivitis progresses to the point where the gum tissue and bone starts breaking down, the name changes to periodontitis. This is a more advanced disease that requires special evaluation and treatment with a periodontist. As with cavities, a patient must not have gingivitis or periodontitis in order to begin orthodontic treatment. Root Resorption - A decrease in length or width of a tooth's root. When root resorption occurs, the root either gets shorter and/or thinner. There are different types of root resorption, but the most commonly discussed type is the shortening of root length. Root resorption can happen to any patient before, during, or after orthodontic treatment. The causes are not well-understood by the dental community, but can be related to: previous tooth trauma, genetics, systemic diseases or hormone levels, or excessive orthodontic forces. Although root resorption is unpredictable, Dr. C.J. will evaluate your roots on an x-ray before treatment and explain your possible risk level for resorption. He will also take a progress x-ray to check on the health of your roots during treatment and ensure that the force placed on your teeth are within a safe range. The vast majority of patients don't experience any noticeable amount of root resorption during orthdontonic treatment, but if you do, Dr. C.J. will notify you as soon as its observed so that you can make a plan together to maintain the health of your roots. Equipment and diagnostic tools: Impression (or Mould) - An exact imprint of your teeth and gums. These can be done using one of two methods: (1) Trays filled with rubbery impression material, which is the older conventional method; (2) Digitally with an intraoral scanner (see below!). Regardless of how they're done, impressions are transformed into an exact replica of your teeth and gums, called a "model," which can then be used to make retainers, aligners, and appliances for current or future orthodontic treatment. Scanner (or Intraoral Scanner or 3D Scanner) - A wand-shaped dental camera that captures all sides and surfaces of your teeth and gums by taking a running stream of photos and videos. Using this information, the scanner recreates a digital 3D model of your teeth. This is the digital version of an impression (see above) and can be used for the same things that conventional impressions are used for. In our office, digital scans are used to: Capture the position of your teeth before, during, and after treatment Plan the movements of your teeth, especially when using clear aligners Generate a 3D-printed physical model of your teeth for retainers Radiograph (or X-ray) - Image that captures and displays the teeth and bones in the area of interest. Usually, two types of x-rays are used for orthodontic purposes to help with diagnosis and treatment planning: Panoramic Radiograph (or Pan) - An x-ray that captures all of the teeth by circling around the patient's head. This type of x-ray is used to evaluate which teeth are present, as well as the eruption of teeth. Cephalometric Radiograph (or Ceph) - An x-ray taken from the side that captures the forehead, nose, upper jaw, upper teeth, lower jaw, lower teeth, part of the airway, and upper vertebrae. This type of x-ray is used to evaluate the positions of the teeth and jaws relative to the rest of the head, as well as to help assess the current growth status of the patient. Orthodontic Materials: This includes braces, aligners, and the commonly used supplies that are attached to your teeth or braces. Brackets (or Braces) - The small rectangular appliances that are bonded (or glued) to each individual tooth. Each bracket has a slot in the middle where the wire is inserted. The interaction between the wire and the bracket is what creates the forces to move and straighten your teeth! There are many different types of brackets made with different features and materials, but they all work equally well. Check out our blog post about the different types of braces/brackets to learn more about what we offer at our office, as well as what you might find at other offices! Band - Metal rings that are placed circumferentially around the sides of the teeth. Bands often had brackets attached to them. They are a substitute for brackets and are used in larger appliances that are attached to the teeth, such as an expander or Herbst appliance (see below). They are also used instead of brackets for the molar teeth in patients who are undergoing surgical orthodontic treatment. Wire - The metallic thing inserted into each bracket that looks like, not surprisingly, a wire! The wire is what applies the forces to the brackets that are necessary for tooth movement. Wire comes in many different sizes and materials, and orthodontists strategically pick certain wires to accomplish certain tasks. In general your wires in the early part of treatment will be smaller and more flexible. As treatment progresses, your wires will progress to larger and stiffer to help finalize your alignment. Aligners (or Clear Aligners) - Customized clear trays that apply forces to move (or align) your teeth. Essentially aligners can be thought of as clear removable braces. Aligners are made in stages and are worn for 1-2 weeks at a time. Each stage is made with your teeth progressively straighter, so that as you progress through each stage of aligners, your teeth move into a better alignment and bite. Aligners often require the use of "attachments" placed onto the teeth to give the aligners a better grip (see below). The most well-known brand of clear aligners is Invisalign, although there are many other brands available. Aligners are so fascinating that we blog post(s) dedicated to them. Check out those posts to learn more! Attachment - Bumps, buttons, or hooks bonded (or glued) to the teeth in addition to or instead of braces. Tooth-colored attachments are most commonly used with clear aligners. They act as extra surface area for the aligners to grip and move the teeth. When used with aligners, the aligners are made to fit around the tooth-colored attachments. Attachments are usually necessary for successful and efficient treatment with aligners, especially with teeth that require complex movements. Other types of attachments may be silver or white and may be used to attach rubber bands or power chains. O-ties (or Ligature Ties or Colors) - Tiny donut-shaped elastic rings that wrap around the brackets to hold the wire in place within the brackets. O-ties are made in many different colors, and can be changed at each visit! Alternative to o-ties include steel ties and power chain (see below). An o-tie or one of the alternatives are needed on each bracket to prevent the wire from coming out. Power Chain - An elastic strand of multiple o-ties connected together. When stretched, power chain tried to return to it's initial length. Due to this property, power chain is used to: (a) actively close spaces between teeth, or (b) prevent teeth from separating and therefore prevent space from opening. Similar to o-ties, power chains are made in different colors and can be changed from one appointment to the next. Spacers (or Separators) - Small donut-shaped elastic rings that are thicker than o-ties and placed in between two teeth. After sitting between two teeth for a few days, spacers temporarily create a small amount of space between your teeth. This can be used to fit bands or appliances around the teeth, or can be used to give the teeth a little breathing room to be straightened. Coils (or Coil Springs) - Small springs that resemble a small slinky that are placed on a wire between teeth. There are two types of coils that may be used with your braces: Open Coil Springs - These are made as if they are permanently stretched open. When compressed, they want to spring back open to their naturally open state. These are used to create space between teeth, much more space than spacers provide. Closed Coil Springs - These are made is if they are permanently compressed together. They are used to maintain an exact amount of space between two brackets. Elastics (or Rubber Bands) - Small, circular rubber bands that are usually hooked to a few upper and lower teeth. They are placed and removed daily by the patient at home, school, or work. The main purpose of rubber bands is to apply forces achieve changes that the braces and wires cannot achieve by themselves. In order for teeth to be moved by rubber bands, they must be worn for 20+ hours a day. Because of that, they are typically worn all day and night, except when eating. Elastics can be hooked up in many different configurations. Dr. C.J. and his team will explain how and when to wear your rubber bands, what they are trying to accomplish with your teeth, and exactly what to expect or look for while wearing them. Orthodontic Appliances: This includes devices that attach or grasp onto multiple teeth or gums. They are typically larger than braces and used for specific purposes along with braces. Rapid Palatal Expander (or Expander or RPE) - Stationary/fixed device that attaches to multiple upper back teeth that helps to expand the upper teeth and upper jaw. The middle of an expander sits in the roof of the mouth and includes a small key hole that is used to "turn" or "open" the expander gradually. As the name implies, expanders rapidly correct problems such as crossbites or narrow upper jaws. Conventional expanders are most successful under the age of 14. If an expander is needed later in the teenage years, Dr. C.J. will talk through other options at your consultation. Lower Lingual Holding Arch (or LLHA or Space Maintainer) - Stationary/fixed space maintainer and anchor for the lower teeth that holds the position of the lower first molars. In our office, it is most often used in two situations: (1) During observation periods before full orthodontic treatment if some baby teeth are lost earlier than expected; or (2) During full orthodontic treatment that involves extractions of 1-2 lower permanent teeth. Trans-palatal Appliance (or TPA or Nance) - Stationary/fixed space maintainer and anchor for the upper teeth that holds the position the upper first molars. It is analogous to a lower lingual holding arch (see above) and serves the same purposes, except it is attached to the upper teeth instead of the lowers. Herbst Appliance - Stationary/fixed device that connects to both the upper and lower teeth simultaneously and helps to push lower teeth/jaw forward. It is used in patients whose lower jaw (mandible) is positioned too far back, and therefore have a severe Class 2 occlusion (see above). The most appropriate time to use a Herbst is just before and during the biggest growth spurt, usually around age 11-13. However, sometimes the big growth spurt comes earlier than average. For that reason, Dr. C.J. closely evaluates the growth status of patients that may benefit from a Herbst appliance, so that treatment is timed for the highest chance of success. There are other types of appliances that are very similar that you may hear or encounter at other offices, such as a Forsus, MARA, or Twin-Block. Our office prefers to use the Herbst, but Dr. C.J. can explain the differences between the others if you're interested! Carriere Motion Appliance (pronounced carry-air) - Stationary/fixed device that involves separated attachments for upper and lower teeth, which are then connected by rubber bands. Similar to the Herbst, this helps to correct problems where the lower teeth are positioned too far back, or also too far forward, depending on the type of Carriere appliance used. It differs from the Herbst in a couple of ways: (1) It is more appropriately used in patients with less severe bite or occlusion problems, as well as patients who are past their growth spurt; and (2) It requires the patient to wear rubber bands. With excellent patient cooperation wearing rubber bands, the Carriere can produce noticeable bite corrections in a short period of time. Dr. C.J. will always give you his best recommendation for which appliance best suits your needs. Temporary Anchorage Device (or TAD or Mini-screw) - Small dental-specific screw that is placed into the upper or lower jaw bones to serve as additional anchorage with braces or aligners. Although they sound scary, rest assured that the vast majority of TAD's are placed by Dr. C.J. himself and only require local numbing/anesthetic - in other words, patients do not need to be put asleep for this. TAD's are relatively new to orthodontics and greatly widen the scope of problems that can be improved with braces or aligners. The main purpose of TAD's is to act as extra anchor(s) to move teeth with less unwanted side effects. If indicated, Dr. C.J. will explain at your treatment consultation exactly how your benefit may benefit from TAD's. If you want to learn more in the meantime, check out our biog post titled, "A Tad about TAD's"! Retainers: Quick descriptions of the retainers offered in our office. For a deeper dive, check out the dedicated blog post "Retainers: What you need to know" Essix - Removable clear retainer that fits around all three surfaces of your teeth (inside, outside, and biting surface). They look just like clear aligners (e.g. Invisalign), but do not move teeth and are typically made with a thicker material. Hawley - Removable retainer made of acrylic and stainless steel wires that fits around the inside and outside surfaces of your teeth. Hawley retainers differ from Essix retainers in that they are not clear, are usually more bulky, but are made of stronger materials. They also do not cover the biting surfaces of your teeth, which makes them more appropriate for some patients and less appropriate for others. Bonded (or Fixed or Bar) - Stationary/fixed retainer that involves a wire glued to the inner (or back) surfaces of the teeth. These retainers are not removable and typically connect the front 4-6 teeth together. Some people refer to them as "permanent" retainers, however they are not truly permanent because they can break and must be cleaned and cared for in order to stay in place. Other Dental Professionals: Descriptions of other types of dentist, some of which specialize in treating certain dental problems or areas of the mouth. They're listed in the order of most to least frequently involved with orthodontic treatment. General Dentist (or Restorative or Cosmetic or Family Dentist) - A dentist who is responsible for routine exams, cleanings, and provides a wide scope of treatments such as sealants, whitening, fillings, crowns, root canals, extractions, implant crowns, dentures, and more. Each general dentist determines their own scope or niche of dental services ranging from limited cosmetic treatments to extensive and large-scale treatments. General dentists are able to provide treatments in all sub-specialties of dentistry listed below, including orthodontic treatment, but are held to the same standards as those specialists. Pediatric Dentist (or Pedodontist) - A dental specialist who focuses on dental diagnosis and treatment for children. Pediatric dentists see children as young as 1 year old to monitor the eruption of primary teeth, followed by many years of routine exams, cleanings, and any necessary treatment. As children begin to get their permanent teeth around age 6-8 years old, pediatric dentists often refer children to the orthodontist to evaluate any problems with the eruption or alignment of the permanent teeth. Oral Surgeon (or Oral and Maxillofacial Surgeon) - A dental specialist who focuses on oral and sometimes facial surgical procedures. Most oral surgeons provide treatments such as removal of wisdom teeth, implant placement, exposure of impacted teeth, and oral biopsies or tissue removals. Some oral surgeons perform procedures to move the jaws in conjunction with orthodontic treatment, which is called orthognathic surgery. Periodontist - A dental specialist who focuses on the diagnoses and treatment of the periodontium, which includes the gums and bone surrounding the teeth. Periodontists are trained to do a wide variety of procedures that help manage or treat advanced gum disease (a.k.a. periodontitis). They also are trained to place dental implants, perform exposures of impacted teeth, and do cosmetic gingival procedures, such as a gingivectomy and frenectomy. Endodontist - A dental specialist who focuses on the diagnoses and treatment of the tooth pulp, which is the innermost area of a tooth that contains the tooth's blood supply and nerves. They also evaluate and treat the area of the bone just outside the tooth root. The most common procedure performed by an endodontist is a root canal (or root canal therapy), which cleans out the pulp of an infected or traumatized tooth. Prosthodontist - A dental specialist who focuses on the replacement of partial tooth structure, single or multiple teeth, and/or other oral structures. Prosthodontics have extensive training in occlusion (bite), dental function, smile esthetics, and the supporting oral structures. Prosthodontists may perform a wide range of procedures, such as crowns, implants, bridges, dentures, implant-supported dental prostheses, and more. Prosthodontists and orthodontists may work together for patients who need teeth moved prior to restoring some or many missing teeth, or in some cases planning movement of the jaws prior to large-scale restorations. You should always feel comfortable to ask if you don't understand something about your teeth or smile, regardless if it's your 1st or 10th visit to the office!

Your first orthodontic visit is a complimentary consultation where you'll get to meet Dr. C.J. and his team and get a tour of the office. It's important to us that you feel comfortable with our team and office. At Park Circle Ortho, orthodontic treatment involves a relationship built on feelings of trust, understanding, and comfort. After introductions, Dr. C.J. will evaluate your teeth, jaws, and smile both clinically and radiographically (i.e. x-rays). Equally importantly, he will also evaluate the way your teeth bite together. Most importantly, he will evaluate any issues that you the patient or parent feel are your main concern(s). Using information from the exam, he will create an appropriate and personalized treatment plan just for you. That plan may involve a strategic observation period of growth and tooth eruption, or a detailed plan for full orthodontic treatment. If more information or time is needed to examine the complexity of the concerns or problems, he will let you know while sharing as much information as possible at that time. You will learn about the timing and length of treatment that best suits you or your child. In addition, you will learn if any additional treatment is recommended, such as an expander, tooth extractions, tooth buildups, or other adjunctive dental or surgical procedures. If there are multiple treatment plans that are appropriate for you or your child's specific case, you will learn about all of those options and their respective advantages or disadvantages. We will also explain all of the pros and cons of different "styles" of braces (Invisalign or metal braces). After understanding this, you and Dr. C.J. will decide together the treatment plan and style of braces that are best to achieve your desired results. As always, we want you to feel comfortable, so we encourage all patients and parents to ask questions and express concerns. Our office staff will verify insurance and discuss finances to find a payment plan that best suits you and your family. We want you to have a full understanding of orthodontic treatment and how we can make your smile the best it can be! If time allows and you are ready to commit to orthodontic treatment that day, Dr. C.J. and his team might be able to start treatment immediately. That may involve: Digital scan of your teeth to: Start the process of designing your aligners (e.g., Invisalign, Spark, etc.) Help plan more involved or complex treatment types Bonding some or all brackets to teeth Placing spacers between some teeth to make room for future appliances Regardless of whether you're itching to start treatment ASAP, or simply just need to know if you or your child is ready for treatment, call us to schedule an appointment! We're so excited to meet you!