Orthodontic Process Flow Chart
Orthodontic Process: Before and After

Understanding the Orthodontic Process

The orthodontic process begins with an exam. The exam is complimentary; there is no downside to attending. It is an opportunity to gather information about you or your child's malocclusion, understand treatment options, and learn when it may be appropriate to start recommended treatment.

Generally, there are three possible outcomes that arise from the examination process: recall, treatment is recommended, or no treatment is recommended.

Recall: In the instance of recall, your child may not be ready to commence treatment in which case the doctor will advise you return in the future for a recall appointment to re-assess the your child's growth and changing dentition. These recall assessments are also provided as a courtesy, free of charge. On occasion, a digital film may be recommended if primary teeth are not falling out within a normal time frame, or may be necessary to assess for early tooth removal in some cases of developing crowding. A fee is applied for these digital films.

Treatment/Dx Records: In the instance that treatment is recommended, you or your child will be scheduled an appointment to have diagnostic records taken. These records include imprints of the upper and lower teeth as well as surrounding hard and soft tissues, a bite registration, a panoramic film, a lateral cephalometric film, intra-oral and extra-oral photographs. Following this, the doctor will review the records with you and/or your child and discuss the diagnosis and treatment plan in further detail. You will also be provided with an opportunity to ask questions or have any of your concerns addressed. This appointment is scheduled for one hour so ample time is permitted.

Following this appointment, the doctor will prepare a treatment estimate that is sent to the parent/patient to submit themselves to their insurance carrier if applicable. The insurance company will then provide an explanation of benefits. All payments for orthodontic treatment are made directly to our office by the responsible party and receipts are provided for submission to the insurer for re-imbursement. Our office does not accept payment from third parties. The doctor will also prepare a detailed report to your dentist outlining the diagnosis and treatment plan of your or your child's case.

Braces On/Active Phase: Depending on the type of treatment required the appropriate appointments for appliance placement are made. In the instance of comprehensive adolescent treatment this would involve a 90 minute appointment to place the braces and archwires, receive nutritional advice and oral hygiene instruction. Following this adjustment appointments are scheduled in 4-8 week intervals depending on the nature of treatment. An average orthodontic case will extend approximately 18 months.

Braces Off: When teeth are straight and the bite has been fit into ideal relationships, the patient is scheduled to have their braces removed. At this appointment fixed wires for the upper four incisors and lower six front teeth are custom bent in-office and bonded to the inside surfaces of these teeth. These wires act as semi-permanent retention of these teeth's alignment since these teeth are most sensitive to relapse and aging changes.

Retainer/Retention Phase: An imprint of the entire upper dentition is also taken to have a laboratory fabricated upper removable retainer made. This retainer is fitted to the patient one week later and is necessary for the purposes of stabilizing any expansion changes that were made during treatment. This removable retainer is generally worn full-time for the first six months, nights only for the second six months and three nights per week for an additional three months before it is finally discontinued. Retention checks continue on 3, 6, or 12 month intervals as deemed necessary.

Assess Wisdom Teeth: At the appropriate time, wisdom teeth are assessed with a current x-ray and a referral to an oral surgeon for their removal is made, if appropriate.

Dismissed: Patients are dismissed or as we prefer to say, "graduated" from our office but are always advised to return to our office when necessary or if any problems occur.