Frequently Asked Questions

Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention and treatment of dental and facial irregularities. The technical term for these problems is “malocclusion,” which means “bad bite.” The practice of orthodontics requires professional skill in the design, application and control of corrective appliances (braces) to bring teeth, lips and jaws into proper alignment and achieve facial balance.

How do I maintain good oral hygiene with braces?

The biggest enemy of your teeth is plaque and the most common and effective means of removing plaque from your teeth is regular brushing and flossing.

Specifically, here are some tips for brushing technique:

• Hold the brush at an angle and press firmly against the teeth, flexing the bristles.
• Move the brush in small circles, cleaning the tooth surface.
• Brush above the archwire and below it.
• Brush the backside and chewing surfaces of all your teeth.

• Sticky Foods
• Caramels
• Taffy
• Chewing gum
• Hard Foods
• Hard candy
• Raw carrots
• Popcorn
• Pizza crust

It is important to eat a healthy, well-balanced diet, including plenty of fruits and vegetables. Even if some foods are hard and crunchy – an apple, for instance – you can cut them into small pieces. Also remember, unless you can brush immediately afterwards, sugary foods should be avoided.

Your braces may cause some discomfort during the first few days of treatment and after some subsequent adjustments. There are several things you can do to minimize this problem:

• Eat soft foods for the first few days.
• Use warm saltwater rinse, as needed.
• Take aspirin or an aspirin substitute, as needed.
• Put wax over any problem areas.

By actively taking part in your treatment, you, your orthodontist and the office staff will develop a mutual confidence, and together you’ll advance step-by-step towards your ultimate goal . . . a beautiful, healthy smile.

An orthodontist is a specialist who specializes in the diagnosis, prevention and treatment of dental and facial irregularities. All orthodontists are dentists but only about six percent of dentists are orthodontists. Admission to orthodontic programs is extremely competitive and selective.

Orthodontists regularly treat young children, teens and adults. Selecting an orthodontist who is a member of the American Association of Orthodontists (AAO) is your assurance that you have chosen an orthodontic specialist. Only orthodontists may be members of the AAO.

It takes many years to become and orthodontist and the educational requirements are extensive. An orthodontist must complete college requirements before starting a three- to five- year graduate program at a dental school accredited by the American Dental Association (ADA). After dental school, at least two or three academic years of advanced specialty education at an ADA-accredited orthodontic program are required to be an orthodontist. The demanding program includes advanced education in biomedical, behavioral and basic sciences. The orthodontic student learns the complex skills required to manage tooth movement (orthodontics) and guide facial development (dentofacial orthopedics). Only dentists who have successfully completed these advanced specialty education programs may call themselves orthodontists.

Most orthodontic problems are inherited. Examples of these genetic patterns are crowding, spacing, protrusion, extra or missing teeth and some jaw growth problems.

Other malocclusions (bad bite) are acquired. In other words, they develop over time. They can be caused by finger or thumb sucking, mouth breathing, dental disease, abnormal swallowing, poor dental hygiene, the early or late loss of baby (primary) teeth, loss of permanent teeth, accidents, poor nutrition, or some medical problems. Whatever the cause, we are usually able to treat most conditions successfully.

Upper and lower jaws are the foundation upon which teeth are supported. Crooked and crowded teeth are hard to clean and maintain. Such problems can contribute to tooth decay, gum disease and tooth loss. A bad bite can also cause abnormal wear of tooth surfaces, difficulty in chewing and/or speaking, excess stress on supporting bone and gum tissue, and possible jaw joint problems sometimes leading to chronic headaches or pain in the neck. Straight teeth are less prone to decay, gum disease and injury. Straight teeth collect less plaque, a colorless, sticky film composed of bacteria, food and saliva. Decay results when the bacteria in plaque feed on carbohydrates (sugar and starch) we eat or drink to produce acids that can cause cavities. Plaque can also increase the risk of periodontal (gum) disease. When teeth are properly aligned and cared for, these risks decline. As for injuries to teeth, protruding upper teeth are more likely to be broken in an accident. When reposition and aligned with other teeth, these teeth are most probably going to be at a decreased risk for fracture.

For problems related to jaw formation and misalignment (skeletal problems,) other dental specialists, such as an oral surgeon or periodontist, may be needed

Apart from the functional aspect of your teeth and jaws, there’s the emotional side of an unattractive smile. An attractive smile is a wonderful asset. When you’re not confident in the way you look, your self esteem suffers. Children and adults whose malocclusions are left untreated may go through life feeling self-conscious, hiding their smiles with tight lips or a protective hand.

Finally, without treatment, many problems become worse. Orthodontic treatment to correct a problem may prove less costly than the additional dental care required to treat the more serious problems that can develop in later years.

When most people think of orthodontics, they think of teenagers. And the fact is most orthodontic treatment begins between the ages of 9 and 14. However, by age 7, most children have a mix of adult and baby teeth. For this reason, the American Association of Orthodontists recommends that all children get a check-up with an orthodontist no later than age seven. While your child’s teeth may appear to be straight, there could be a problem that only an orthodontist can detect. Of course, the check-up may reveal that your child’s bite is fine, and that can be comforting news. Even if a problem is detected, chances are we will take a ‘wait and see’ approach and check on your child periodically as the permanent teeth come in and the jaws and face continue to grow.

Although only a few orthodontic problems need correcting at that age, an early exam allows the orthodontist to offer advice and guidance as to when the appropriate age to start treatment would be. Let your orthodontist guide you as to when to start treatment. Feel free to ask questions about the timing of treatment.

Early treatment may prevent more serious problems from developing, and may make treatment at a later age shorter or less complicated. Typically, early intervention involves the use of orthodontic appliances, which may be removable, to guide the growth of young bones, create a better environment for adult teeth as they emerge and to guide them into a more favorable position. In some cases we will be able to achieve results that wouldn’t be possible once the face and jaws have finished growing, often allowing us to avoid removal of permanent teeth and jaw surgery.

Here are some examples of signs that your child may have an orthodontic problem:

• Early or late loss of baby teeth
• Difficulty chewing or biting
• Breathing through the mouth
• Thumb sucking and tongue thrusting
• Extra teeth, large teeth or missing teeth
• Crowded, misplaced or blocked-out teeth
• Jaws that are too far forward or back
• Biting the cheek or biting into the roof of the mouth
• Protruding teeth
• Upper and lower teeth that don’t meet, or meet in an abnormal way
• An unbalance facial appearance
• Grinding or clenching of teeth
• Inability to achieve lip contact when the lips are relaxed
• An unsightly display of gum tissue above the upper front teeth

Even if your child is past age 7, it is important to have an orthodontic check-up as soon as possible. The fact is that most orthodontic patients begin active treatment between ages 9 and 14. Of course, every case is different. But generally speaking, because children are still growing, this age range is optimal for achieving the best possible results from orthodontic treatment.

Orthodontic treatment is a change for the better, no matter what your age. It can give you the confidence and pride that come with straight teeth and a healthy smile. But we have another important treatment goal-to improve the health of our teeth and gums. Sometimes a parent whose child is being treated will choose to correct his or her bite at the same time. The fact is, braces can improve a person’s smile-and confidence-at almost any age. More and more adults are turning to orthodontic treatment to correct a smile that’s been bothering them most of their lives. With the help of your dentist and orthodontist, you can have a healthy, beautiful smile. And with todays smaller, less visible, and more comfortable braces, plus the affordable payment plans that we offer, adults are finding braces more appealing than ever.

A consultation is the best way to determine if you can benefit from orthodontic treatment. The condition of your teeth gums and supporting bone is the most important factor in determining the potential for improving your smile and dental health. Remember, the biological process involved in tooth movement is the same in both adults and children.

After an initial examination, we will be able to tell you what your treatment will involve and its approximate cost. If you decide to proceed, we will usually take diagnostic records of your mouth. These may include molds of your teeth and special x-rays and photographs.

Every person’s malocclusion is different. After carefully analyzing the nature of your needed correction, we will recommend the best course of treatment for improving your smile

You’ll be pleased to learn that braces will work with your current lifestyle. You can do almost anything with braces – sing, play a musical instrument, dine out, kiss, and even have your picture taken. Today’s technology makes people wearing braces feel better about how they look. Metal brackets are much smaller than they used to be. Even less noticeable are braces made of ceramic or plastic. And lingual braces (ones that go behind your teeth) may be appropriate in some cases. We will tell you which of these options are best for you.

No matter what type of braces you wear, you’ll have to make some adjustments to eating habits and dental care. But if you’re like the vast majority of adult patients, you’ll adjust quickly. Chewing ice and certain treats, such as caramel and peanut brittle, will be off limits. Also, your mouth and teeth may be a little tender after adjustments. And, of course, it will be especially important that you visit your family dentist for regular check-ups.

The good news is that the new techniques and materials that the orthodontist uses today have made wearing braces more comfortable for adults and teens.

Without doubt you will have many questions for us at this visit. It is our sincere wish that you feel comfortable and confident that we are the best office for you.

This is the time for us to listen to your concerns and to provide an orthodontic examination. We will be able to indicate to you whether or not treatment is needed, and if needed, when the best time to start treatment would be. Typical steps prior to beginning treatment would include gathering orthodontic records to provide specific information to tailor a treatment plan for that patient.

Diagnostic records include photographs of your face, your smile and your teeth, followed by impressions of your teeth, and various radiographs of your head and teeth as indicated. This appointment will take approximately one hour. Once the records have been completed, a consultation appointment will be scheduled after two weeks which will allow Dr. Batastini the time to review and study these records.

The consultation appointment is where we will discuss the why, what, when and how of the treatment. Our patient and their family are directly involved in this discussion and we hope to answer many of your questions.

Once we analyze and determine the exact nature of the problem, we will propose a treatment plan, often with alternate approaches. If you agree to our proposed treatment plan and are a patient for conventional braces, treatment will be started at the following appointment. On Invisalign patients, we make precise impressions of the teeth to be used to generate 3D images of your teeth and to custom-fabricate the Invisalign trays.

Treatment is more affordable than ever. The cost of orthodontic treatment will depend on many factors, including the severity of the problem, its complexity and length of treatment. We will be glad to discuss the cost before treatment begins. It is also our pleasure to offer reduced plans for parents and children who have treatment at the same time, or families who have more than one child in treatment at the same time.

In addition, many dental insurance plans now include orthodontic benefits. Dollar for dollar, when you consider the lifetime benefit of braces, they are truly a great value.

If you are lucky enough to have dental benefits which include orthodontics, we will work with you to help you maximize your benefit and submit forms on your behalf where necessary. This information will be thoroughly discussed with you at our consultation appointment.

Although we are a participating provider with some dental insurance carriers, ultimately the relationship is between you and your insurance carrier. It is in your best interest to contact your human relations co-coordinator to gain the best understanding of how your benefit applies to your particular circumstance.

First and foremost, orthodontic treatment involves the patient. To achieve the desired results, the patient must diligently follow the orthodontist’s instructions about wearing orthodontic appliances and practice good oral hygiene.

Dr. Batastini provides custom-made braces, retainers or other corrective appliances, according to the problem being treated. Whether they’re ‘removable’ or ‘fixed’ into the mouth, whether they’re made of metal, ceramic or plastic, all orthodontic appliances have a common purpose – to use gentle pressure to move teeth and jaws into their proper positions. Today’s patients benefit from techniques and materials that enhance the comfort of orthodontic treatment.

There are many different kinds of braces. Some are clear, nearly invisible, while others are made of stainless steel and may or may not have colored elastics around them. Some are ceramic or porcelain (for front teeth only) or even gold. All braces are designed to move teeth in three dimensions. The mechanics or techniques used for moving teeth vary as well.

“Self-ligating” braces use a different mechanism than elastics to achieve results; while this is not a new technology, only Dr. Batastini can determine whether they are appropriate for your particular case.

“Invisalign” is a patented system which uses a series of custom-fitted, clear aligners to move your teeth over a period of time. The teeth move very slightly with each change of aligners. Invisalign can be a great alternative to traditional braces for many people. Ask Dr. Batastini if you are an appropriate candidate for Invisalign.

Although materials may vary, the science remains the same; to move teeth over time using light pressure.

Although every case is different, generally speaking, patients wear braces from one to three years. Treatment times vary with factors that include the severity of the problem being corrected and how well the patient follows our instructions.

Patients who brush and floss routinely, see their family dentist regularly, avoid hard and sticky foods, wear their rubber bands and/or headgear as instructed, and keep their appointments usually finish treatment on-time with good results.

After the braces are removed, most patients wear a retainer for some time to keep or ‘retain’ the teeth in their new positions.

Because dental hygiene is so important, regular visits to the family dentist must continue every six months during orthodontic treatment (or more often, if recommended.)

Achieving healthy, beautiful smiles is a team effort that involves the orthodontist, the family dentist, the patient (and the parents, if the patient is young) and, as needed, other dental specialists. The orthodontist provides the expertise, the treatment plan and the techniques to straighten teeth and align the jaws. Your family dentist helps make sure that teeth and gums stay clean and healthy. The patient must cooperate by following the dentist’s and the orthodontist’s instructions carefully so that the teeth and jaws move in the way desired and on the prescribed schedule.

Teeth move in 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 tiny bracket attached to the front of the teeth and connected by an arch wire. Periodic changing of the wires puts pressure on the teeth. At different stages of treatment your child may wear headgear, elastics (rubber bands), a positioner or a retainer. Most orthodontic appointments are scheduled 4 to 6 weeks apart to give the teeth time to move.

When teeth are first moved, discomfort may result. This usually lasts about 24 to 72 hours after an appointment. Patients report a lessening of pain as the treatment progresses. Pain medications can help relieve the discomfort; ask Dr. Batastini for his recommendation in your particular case. If the gums or cheeks become raw or irritated from rubbing against the brackets, we can provide wax to smooth things over until the tissue heals.

Most patients will benefit from an active corrective phase followed by a retention phase. Some patients will benefit from two active treatment phases often referred to as two-phase treatment. The goals of each phase should be discussed with Dr. Batastini so that patients and/or parents have realistic expectations.

It is important to be aware that not every patient needs two active phases of treatment.

Phase One : Functional: (growth) appliances and/or limited braces:

In the first phase, the focus is the position and symmetry of the jaws, spacing of the teeth, breathing and other oral habits which may affect facial development. This phase of treatment could last from just a few months to over a year

Phase Two : Braces

In the second phase, the doctor will be looking at how your child’s teeth and jaws fit and work together. Your child’s teeth will be straightened and their occlusion (bite) will be properly aligned. Attention will be given to the jaw joint (TMJ) the facial profile, and gum tissues. This phase may take from one to three years.

The timing of treatment is different in every case. Dr. Batastini will discuss treatment timing at your consultation appointment.

Sometimes it is necessary to remove teeth before or during orthodontic treatment. Rest assured that in the event this becomes necessary, you will know well in advance. The sequence and timing of any surgical procedure will be explained to you by Dr. Batastini, who will refer you to either your family dentist or an oral surgeon.

Now that the active phase of treatment is complete, your retainers will give your teeth the support they must have to remain in their new position until the bone has adapted. We have all worked hard to attain a good result and now the most important part of treatment is beginning.

The process of moving teeth orthodontically involves the breakdown and redeposition of bone. That is why your teeth have become loose and sensitive. This is normal, and it will take several months for the bone to completely reorganize and hold the teeth in their new positions.

Although wearing a retainer is simple, it is a very complex and powerful appliance. There are a variety of retainers, some are removable and some are fixed. We will provide the kind of retainer that best maintains the new position of your teeth.

In order to be effective, initially retainers must be worn at ALL TIMES except when brushing. Later, Dr. Batastini will tell you we you can reduce the number of hours you must wear your retainers each day and when they can be discontinued completely.

Initially we will see you relatively often to construct and place your retainers, and to make post treatment records which will include models and radiographs similar to those made at the beginning of treatment. The frequency of your visits will then decrease as the retention period progresses.

After one to three years of wearing retainers, the teeth are usually as permanent as can be expected. Any relapse after that time is due to natural causes and minor shifting is expected. Therefore, slight irregularity, particularly of the lower front teeth, may sometimes be accepted as the best for the particular circumstance.

If your retainers are to do their important job, you must do three things:

1. Wear them as directed
   Retainers are effective only if you faithfully follow our instructions for wearing them. And remember they’re doing their jobs only when they’re in your mouth; not your pocket or purse.

2. Keep them clean
   If you’ve been fitted with a removable retainer, it’s easy to clean when you take it out. We will show you how.If your retainer is attached to your teeth, it’s important to brush thoroughly after meals and clean under the wire with dental floss at least once a day. We will teach you how to care for your fixed retainer. If you can’t brush after a meal, be sure to at least rinse your mouth out with water until you have a chance to brush thoroughly.Whether your retainer is fixed or removable, remember to see your dentist at least every six months for a cleaning.

3. Handle them with care
   Remember, when your retainer is not in your mouth, it should be in its case for safety. Retainers are easier to lose than you think, and they are expensive to replace. They fall out of pockets and purses. If you take your retainer out to eat and wrap it in a napkin, you may accidentally throw it away. When they’re just lying around, retainers have a way of falling on the floor and being stepped on, or even being picked up by pets.