Ortho Topics

Treatments & Procedures

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When to start orthodontic care

According to the American Association of Orthodontists, children should see an orthodontist no later than age seven. The orthodontist can identify and correct any potential issues with jaw and tooth development before they become major problems. Issues with tooth alignment, crowding, spacing, jaw growth, and bite positions are more easily treated before or during adolescence while your child is still growing. By visiting an orthodontist early, you can help your child’s smile grow healthy and avoid having to do major corrections later.
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Adult orthodontics care

It’s never too late to correct problems with your teeth and bite. Adult orthodontic treatment can also work in cooperation with other dental specialists to improve problems that may have developed with the gum and bone support of the teeth or due to worn or lost teeth. During your office visits, we will explain the best procedures and cleaning schedules to help you maintain healthy gums and teeth.
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Your first visit

During your child’s first orthodontic visit, we will perform a diagnostic exam that includes a panoramic x-ray and several measurements. This visit is very simple and comfortable for the patient. We will discuss with you and your child what we see and recommend any orthodontic treatment that is right for them. We will give you an estimate of the cost and length of the treatment and schedule you for more extensive diagnostic records. These records typically include models of the teeth, photos of the patient’s face and teeth, and an additional x-ray, if needed. We use this information to develop a custom treatment plan, suited specifically for you or your child’s teeth and bite alignment.
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Appliance Options

In addition to the traditional metal braces, we also offer more cosmetic options such as clear ceramic braces or Invisalign for a less visible alternative for straightening teeth.
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Phase 1 Orthodontic Treatment

Some patients benefit from some orthodontic treatment before they have all of their permanent teeth. This is referred to as Phase I or First Phase orthodontic treatment. This phase of treatment aims and addressing any problems that could affect the development of the jaws, teeth, or bite down the road. When Phase I orthodontics is recommended, it is usually aimed at a specific problem that needs to be addressed. We will explain what might be recommended and why in addition to what problems might be encountered if Phase I orthodontic treatment does not happen. Phase I orthodontics can prevent problems that can be much more severe if not addressed early. Most patients that have Phase I orthodontics will benefit from a second phase when all of their permanent teeth have grown in.
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Office visits

Applying orthodontic appliances (braces, expanders, etc.) generally takes 1-2 hours. After this visit, we will schedule shorter checkups every 4-8 weeks. These visits generally take about 30 minutes. We do our best to be on time for our scheduled appointments and ask that our patients show the same courtesy by showing up on time. If you or your child will be unable to keep an appointment, please let us know as soon as possible.

Life with Braces

Will it hurt?

will it hurt icon Some soreness is to be expected, particularly when the braces are first put on and after some adjustments. Your child’s teeth, lips, and cheeks, will become more used to the braces over time and the soreness will fade. If the soreness is uncomfortable, you may want to give them an over-the-counter pain medicine (whatever they generally take for headaches or other pains). If the braces rub against the cheeks or tongue, rinse with warm salt water (1 tsp. salt dissolved in 1 cup of water) to clean and soothe the area. They can also use the wax we’ll provide you to cover rough edges and prevent the braces from rubbing on your mouth. If your child experiences severe pain or has a problem that you don’t know how to deal with at home, call our office so we can help you resolve it.


wax icon We will give your child a packet of wax that can be used to help make the braces more comfortable. This wax is safe to be used in their mouth as much as needed and is effective at preventing soreness and irritation. If the end of the wire or particular brackets are rubbing against your child’s cheek or tongue, use the wax liberally to cover the areas that are irritating them. Wax sticks better on dry surfaces, so before applying, have them swallow any extra saliva and keep the area dry.


food icon While wearing braces, your child should avoid sticky food like gum, taffy, and caramel as they will get stuck to the braces and can damage the intricate parts of the braces and wires that are important. Also avoid hard food like ice, croutons, nuts, hard candy, and popcorn because they can break the wires and other appliances. Do not let your child chew on fingernails, pencils, or other hard objects, since this can also break the braces and result in extra expense and more trips to the orthodontist to fix them. It is a good idea to cut up fruits and vegetables like apples, corn on the cob, and carrots and eat them in small bites.

Elastics (rubber bands)

food icon It is important that your child wear the rubber bands on their braces exactly as directed (we generally recommend that they are worn always – day and night, but check with your orthodontist if you are not sure). Neglecting to wear the rubber bands for even one day can allow your child’s teeth to drift back to their previous positions. Not wearing your rubber bands regularly will extend the treatment time. Though rubber bands can cause some soreness at first, this soreness will go away as they are worn and your child’s teeth adjust to the pressure. By not wearing the rubber bands, the soreness may return. Your child will receive elastics during their office visits. If they run out, you can stop by our office to pick up more or you can call us and we will mail some to you.

Cleaning & Care

Brushing & Tooth Care


While wearing braces, your child should brush thoroughly three times a day for 4-5 minutes each time. They should also floss once each day. They should pay special attention to removing food particles from between the braces and their gum line. Have them look closely in the mirror after brushing and brush again if they see any food or white, fuzzy plaque. During your orthodontic visits, we will show you some tools your child can use to thoroughly clean their teeth and braces.

Mouth Guards


If your child plays sports, they should wear braces-specific mouth guards to protect their teeth, the braces, and the other players. Our office prefers Shock Doctor braces mouth guards. If they are hit in the mouth, they should check the braces and appliances to see if anything is loose. If a piece does come loose or is damaged, call our office to schedule an appointment to fix it.

Retainers and follow up

After finishing treatment with braces or other orthodontic appliances, your child will probably be given a retainer to wear to help prevent the teeth from shifting back to their original positions. Retainers are worn for a lifetime to maintain the position of the teeth. Even after many years, the teeth will shift if retainers are not worn each night. Like the rest our body, the teeth always change over time, and consistent retainer wear is the only way to keep teeth straight.

Your child should remove the retainers when eating or swimming. It is important to always put retainers in their case and not forget them at the end of a meal.

Retainers should be treated with care so they don’t break. Keep them away from excessive heat, washing machines, and pets. If your child loses or breaks their retainer, call us immediately to get another one so their teeth do not shift.

Retainers should be brushed once a day with a toothbrush and warm (not hot) water. This removes plaque and germs and will help prevent odors. You can also purchase Retainer Brite online to remove any tartar that may begin to form on retainers.

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Our Washington orthodontics offices generally follow up with their patients and their retainers for the first year or two after braces are removed. Even after that time, you may schedule appointments with us if you would like us to check your retainer or if you would like to purchase a new one.

Surf and Smiles

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