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If you want to improve the look and feel of your smile, than any age can be a great age to visit the orthodontist. The AAO recommends that children first visit an orthodontist by the age of 7. Early evaluation provides both timely detection of problems and a greater opportunity for more effective treatment. Orthodontic treatment is not exclusive to children and teens. Approximately 1 in every 5 orthodontic patients is over the age of 21.

The American Association of Orthodontists recommends that the initial orthodontic evaluation should occur at the first sign of orthodontic problems or by age 7. The permanent first molars and incisors (front four teeth) are in by this age and crowding, crossbites, deep and overbites along with growth problems can be evaluated. When necessary treatment is delivered at an early age, the orthodontist has the opportunity influence jaw growth and guide erupting permanent teeth. A child’s growth potential can be maximized to improve the malocclusion and give their permanent teeth the best chance of erupting into an ideal position. Treatment at this age can also address deficient growth of the upper jaw, gain space for permanent teeth, avoid the need for permanent tooth extractions, and reduce the chances of permanent tooth impactions. Early treatment can simplify later treatment or allow Dr. Bradley to achieve results that may not be possible once a patient has finished growing. This type of treatment is termed Phase I or interceptive orthodontic treatment and is usually recommended for patients with more severe orthodontic problems. Your family dentist may suggest an orthodontic evaluation for your child, but a direct referral is not necessary. At this early age, orthodontic treatment will most likely not be needed but Dr. Bradley will carefully monitor your child’s growth and development to determine the best time to begin treatment.

Phase I treatment reduces the growth and development differences between the maxillary (upper) and mandibular (lower) jaws to improve a patient’s malocclusion and oftentimes give the permanent (adult) teeth the best chance to erupt into an ideal position. Phase I treatment enables a patient to achieve results that are not be possible once the child has finished growing. Dr. Bradley will only recommend interceptive treatment when the same result CANNOT be achieved if treatment is delayed until all or most of the permanent teeth are in place. Phase I is the first phase of an anticipated two-phase treatment plan. It usually does not eliminate the need for further treatment to align all the permanent teeth

Typical Developmental Issues that are best addressed at an earlier age with Phase I Treatment

Open bite

Deep bite



Phase II treatment is the alignment phase of treatment. Phase II includes the placement of braces on all of the permanent teeth and is usually completed in 12-20 months.

Adult Treatment- orthodontic treatment can be successful at any age and adults especially appreciate the results and benefits of orthodontics treatment. Orthodontic treatment as an adult can dramatically improve your personal appearance and self-esteem, but improving the health of your teeth and gums is equally important. Your general dentist may have recommended orthodontic treatment to improve the fit and function of your teeth, or you may have wanted to improve your smile for years. In our office many parents have been so impressed with the changes they have seen in their own children that they have decided to pursue orthodontic treatment for themselves. One out of every five orthodontic patients is over 21. If you want to improve the look and feel of your smile, than any age can be a great age to visit the orthodontist. The AAO recommends that children first visit an orthodontist by the age of 7. Early evaluation provides both timely detection of problems and a greater opportunity for more effective treatment. Orthodontic treatment is not exclusive to children and teens. Approximately 1 in every 5 orthodontic patients is over the age of 21.

Retention- Keep your new smile for a lifetime! Teeth can shift in everyone throughout life regardless of how well the teeth are aligned or whether an individual’s teeth are naturally or orthodontically straight. As we get older, our body continuously changes and our teeth are no exception. Usually these changes will be within normal limits and should be expected. The goal of retention is to minimize changes and maintain the functional alignment you have achieved with your orthodontic treatment. Continued wear of your retainers will minimize these long-term changes. When retainers are not worn properly or as prescribed shifting can occur beyond these normal limits then costs for additional orthodontic treatment can occur.

Always bring your retainers with you for your appointments. If your retainer is lost or broken, please call us immediately. Again, if you do not have your retainers your teeth will move back. Replacement retainers cost $95.00 each if your teeth have not moved.

Retainer Wearing Time and Appointments- The retainers must be worn as prescribed by Dr. Bradley and her staff. Removable retainers must be worn every night for at least 8-10 hours for the first year…minimally!! Dr. Bradley may increase your individual wear time, if needed. If you miss a night, wear your retainer FULL TIME. Make sure your retainer is completely in, this may cause your teeth to be sore but they should realign. If they don’t, call our office immediately. After the first year Dr Bradley typically reduces the required wear time to nighttime wear (1 to 3nights per week), or wear as needed.

Fees During Retention- In most cases the initial retention appliances are included in the original treatment fee and we anticipate approximately 3 to 4 routine retention visits provided on a complimentary basis, generally falling within 18 to 24 months after the braces are removed. There will be charges associated with lost retainers, retainers needing repair, replacement retainers or additional orthodontic treatment needed due to lack of wear and excessive shifting, and any additional treatment due to excessive facial or jaw growth.

Care and Maintenance of Your Retainers- removed your retainers with two fingers (thumb for the bottom retainer), begin in the back and then move forward. Clean your retainers daily with a toothbrush. Hold the retainer with only two fingers while cleaning. Do NOT place it in the palm of your hand, you will squeeze and crack the retainer in half. Do not place your retainer in hot water or near any type of heat source (edge of sink where hair dryers used, nightstand with light, etc) as this will warp the retainer. When your retainers are not in your mouth they need to be in your retainer case. Do not leave your retainers lying around the house as pets love to chew on them. Do not wrap them in a papertowel…you WILL accidentally throw them away. It is your responsibility to take care of your retainers. If for any reason your retainers are irritating your mouth, don’t try to adjust them yourself. Contact our office.

Getting familiar with your braces-

“The” brace

Archwire- Removable wires that fit into the slots of the braces and move your teeth into position. Archwires are made from different alloys such as stainless steel. Many of the new high tech wires are made from a material that has "memory". When the archwire is distorted from its “U” shape, like braces on crooked teeth, the "memory" in the wire restores itself and allows the wire to return to its original shape slowly over time and moving your teeth with it.

Hooks- Some brackets have hooks built into them for elastic wear. Hooks can also be attached to the archwire. (Elastics help to correct how the upper and lower teeth bite together. Everyone at some point during treatment will wear elastics.)

Ligature (Tie)- the ligature holds the wire into the slot of the brace. Ligatures can be colored, stainless steel or Placed on the four front teeth. Strictly for show of color if desired by patients. Some elastic ligatures are connected like a chain.

Soreness of teeth is to be expected for a few days, even up to a week is not unusual. Tylenol, Advil or any other pain medicine used for your discomfort is helpful. Peroxyl or warm salt-water rinses will help the inside of your lips and cheeks become used to the braces. Also, use wax as necessary. Give your mouth some time and your lips and cheeks will soon adjust to your new braces.

Visit your dentist at least every 6 months during orthodontic treatment- it is very important for all orthodontic patients to continue to visit your family dentist at least once every six months, even during active orthodontic treatment, for dental cleanings and checkups.

Orthodontic brushing and flossing techniques: Clean teeth move faster!!! On a soft bristled toothbrush, apply pea size amount of toothpaste. In a small circular motion, brush your teeth back to front all around the brackets; focus on the gumline, not your teeth. Angle your toothbrush up and down to get between the wire and braces. Using a floss threader ( if helpful) take a piece of floss, pull it through the loop. Aim the pointed part of the floss threader up under the wire, pull through until you reach the floss. Gently pull the floss up between the two teeth. Wrap the floss around the tooth so that you’re almost forming a letter ‘c’ around one tooth.. Then do the same to the tooth beside that one. Do not floss straight up and down, this can damage your gums.

**We recommend using a soft bristle toothbrush. Any brand is fine. Electric toothbrushes can also be used. The important thing is that you use your toothbrush the proper way to insure that you are getting your teeth and the braces clean. Toothbrush bristles will wear out much faster when you have braces.

Adult Oral Home Care Instructions (for our adult patients) Our adult patients must maintain a very strict regiment of excellent oral hygiene. The soft tissue supporting structures of adult teeth are much more susceptible to disease and damage during orthodontic tooth movement than a child's dentition. Subsequently, the following suggestions are made for our adult patients:

1. Take time to clean your braces at least 2 times per day.

2. Alter your routine 6 month tooth cleaning appointment with your family dentist to a 3 month schedule.

3. If you wish additional cleansing of the teeth, utilize a Water Pik irrigating device.

4. Please let your general dentist or us know of any areas of your gum tissue that bleed.

Following the above suggestions will help maintain your gum tissue in a healthy state during orthodontic care. Even with good home care, it frequently becomes necessary to have gum tissue treatment by your dentist or periodontist.

Rubber Bands

What are rubber bands? Rubber bands are small elastics that create a continuous force causing the upper and lower jaws to align together properly.

When should you wear them? Unless advised by the Doctor, you need to wear your elastics 24 hours a day, 7 days a week. You may remove the elastics only when brushing but they must be replaced immediately afterwards. day you get your braces off!! Good luck!

Understanding Your Palatal Expande


A Palatal Expander is an appliance that is custom made for you. It fits in the roof of your mouth and is cemented in place. This appliance will widen the roof of your mouth (palate), to help improve and correct the way your upper and lower jaws fit/bite together. Although the expansion will occur within the first few weeks of having the expander, the expander will remain in your mouth for about 3 to 4 months.

Symptoms to Expect…

-Talking, swallowing and chewing to sound and feel awkward for the first few days.

-The patient will feel pressure over the bridge of the nose when the key is activated.

-Spend more time brushing to insure a clean expander.

-A space may form in between your 2 front teeth. The space is temporary and will close when expansion is completed.

-Soreness of your tongue.

Activating Your Palatal Expander

-You will use the blue key to turn the expander.

-There is a hole at the front of the expander that the tip of the blue key will fit into.

-Fully insert key and then push so that the hole begins to turn toward the back of the patient’s mouth.

-When you can see a new hole open, then you have completed the turn, and you will let the key fall out of the hole that is now in back.

-Always turn key from front to back of patients mouth.

-Never pull forward on key to remove as this may cause the expansion to reverse.