Child Orthodontics

So you are getting ready to make your first visit to the orthodontist.  What will happen at this visit? Will it hurt? Will it take a long time?

Due to the fact that we don’t know what type of orthodontic problems you will have or how many questions you might have about your treatment, we typically schedule one hour for a new patient consultation. Every new patient will meet personally with Dr. Budd and have an opportunity to have all their questions answered.  Here is what you can expect:

1. The first thing we will do is gather information regarding your medical and dental health history, insurance information (the initial consultation is complimentary but we want to be able to give you an accurate out-of-pocket cost for any treatment we recommend), and a brief description of what you hope to accomplish with your orthodontic treatment. This information can be completed prior to your visit or upon arrival. A parent or guardian must accompany any patient under 18 years old for the initial consultation.
2. Photographs will be taken of your face and teeth. These photographs will be reviewed together with Dr. Budd to make it easier to discuss and visualize any recommended treatment. Dr. Budd may also recommend radiographs (X-rays) if there is additional information to be learned that might affect his recommendation for your treatment.
3. Dr. Budd will then perform an examination to determine what your treatment options would be given your specific orthodontic needs. He will create a smile design recommendation for you and answer any questions you might have about the recommendations.
4. You will receive information regarding the cost of your proposed treatment, any insurance coverage, payment options including payment plans, and available appointment times for starting treatment if treatment is recommended.

Give us a call if we can be of service!  We look forward to meeting you!

A frequent concern of many parents who notice that their child's teeth are not growing in correctly is - when is the right time to see the orthodontist?  The American Association of Orthodontists recommends that children be seen for an initial screening exam at age 7.  Phoenix orthodontist Dr. John Budd explains that many children will not require treatment at this age. However, many of the permanent adult teeth will have started to erupt by this age and more significant problems can be discovered and avoided with timely orthodontic treatment.

Some of the problems that might require treatment at an earlier stage, sometimes referred to as Phase I treatment include: crossbites, underbites (the lower teeth in front of the upper teeth), severe crowding, bites that present a risk of damage to the gum tissue or severely protrusive teeth to give a few examples.  An orthodontist can determine which problems will benefit from preventive treatment and which can wait for the eruption of all the adult teeth.

The best way to determine if your child would benefit from orthodontic treatment is to see an orthodontist for a screening exam. Budd Orthodontics offers free consultations to assist parents in determining if now is the right time to begin treatment with braces or Invisalign or if waiting for more dental development would be more beneficial.

Does my child need to wear a mouthguard when playing sports with braces on?  This is a question I am asked several times each week.  The simple answer is yes.  In fact, whether your child is wearing braces or not, mouthguards are a great idea to protect the health of your teeth while playing any sport in which there is the possibility of injury to your mouth.

Ironically, wearing braces actually helps protect your teeth from injury during sports in a way.  I have seen several cases where a child has been elbowed or hit in the mouth, and were it not for the braces, they would have likely lost a tooth.  The braces act as a splint for the teeth and provide “strength in numbers”.  Instead of one single tooth absorbing the force of the blow, the force is spread across multiple teeth, thereby reducing its harmful effects.  However, the effect the braces have on your lips and cheeks if you get hit in the face can be more damaging, then it would otherwise be without braces.  A mouthguard will help protect your lips and cheeks from being cut or bruised in case of a sports accident and will also help provide the splinting effect to soften the blow.

There are a variety of different sports mouthguards available.  The “boil and bite” mouthguards should be avoided while wearing braces.  They will actually hinder the movement of the teeth and may pull some of the braces off during placement and removal.  There are mouthguards designed specifically for use with orthodontic appliances and only these mouthguards should be used during treatment.  Most orthodontists have orthodontic mouthguards available at their offices, or they can also be purchased at most sporting goods stores.

With the proper protection, you can continue to enjoy all the same activities you enjoyed prior to beginning your orthodontic treatment and keep your teeth healthy, safe and beautiful.  If you have any questions about mouthguards for orthodontics, please visit our website or contact our office.

What are my braces going to feel like?  Are my braces going to hurt?  What foods can I eat?  These are some of the typical questions patients ask on the day of their appointment to get braces placed on their teeth. They are all very good questions and important to answer to help patients feel at ease about the changes they will experience while receiving orthodontic treatment.

Wearing braces has become a relatively straight forward process with minimal discomfort compared to twenty years ago.  While this is true, you are still going to experience some changes that will take a little getting used to.  Your mouth is an incredibly sensitive place – you can feel the thickness of a hair in your mouth immediately and braces are much thicker than a human hair.  Just like a new pair of shoes, your new braces may initially rub and cause an irritation to your lips and cheeks until your mouth gets used to having braces.  The first few days are an adjustment period, but after the first week your braces start to become a new part of your mouth and are pretty easy to manage.

Wearing braces does require some minor modifications to the foods you eat and the liquids you drink.  The adhesive used to place braces is designed to be strong enough to withstand chewing, but not so strong that it damages your teeth when the braces are removed. This is the reason for the need to be a little bit careful about eating really hard or really sticky foods. For example, ice chewing should be avoided whether you have braces on or not. If you would like to eat an apple, it is better to cut it into slices instead of biting into the core.  Similar modifications can be made for most foods. Excessive drinking of soda – diet or not- should be avoided.

Braces will cause some slight discomfort the first few days as your teeth begin to move into alignment.  There is a cartilage ligament around the root of each tooth that allows the orthodontist to mold the teeth into a better position.  This process of molding the bone around the roots of teeth causes a slight amount of inflammation and is the source of sore teeth when braces are placed or tightened.  Over the counter medications such as ibuprofen (Motrin or Advil), acetaminophen (Tylenol) or naproxen (Alleve) are generally sufficient to make you comfortable while you go through the adjustment period with braces.  Anti-inflammatory medications such as ibuprofen or naproxen will generally be more effective than acetaminophen for tooth pain.

If you have any additional questions about what to expect with braces, please feel free to call one of our offices at Budd Orthodontics to schedule a free consultation.  The adjustment period that braces require is totally worth it for the beautiful new smile you will enjoy!

Let’s be honest, seeing a one or two year old sucking their thumb is kind of cute.  It makes you want to pick up the baby and give it a big hug and a kiss.  However, thumbsucking is not limited to infants and toddlers.

 

As an orthodontist, I have had patients as old as 50+ who are thumb suckers.  These patients relate to me that the thumbsucking is soothing and just helps them relax, especially when it is time to fall asleep.  I have no problem with thumbsucking in regard to the social and emotional benefits it provides to some patients.  We all have different ways of relaxing and easing the stresses of daily life.  Who am I to judge?

The problem with thumbsucking from an orthodontic perspective lies in its effect on the movement of the teeth and the growth of the jaws.  Prolonged thumbsucking over months and years will guarantee the need for braces and probably an expander in the future. The suction your mouth creates as you suck your thumb pushes your cheeks against your upper back teeth and splays your upper front teeth forward and your lower front teeth backward.  The classic thumb sucker has a narrow palate with a crossbite on both sides and their front teeth stick out and don’t touch.  The longer the thumbsucking goes on, the more exaggerated are the effects - especially once the permanent teeth start to grow in.

With my own children, I encourage the use of a pacifier to help the babies fall asleep and then when my kids have turned two, the “binky” fairy comes and takes away their binky to give it  to another deserving child and leaves an exciting toy to replace it.  They struggle for a few nights and then usually settle in without missing a beat.  Thumbs are a lot harder to get rid of.

Treatments are available to help with the cessation of thumbsucking.  I will usually recommend a product called Mavala (purchased on Amazon) as a first line of defense and then a habit appliance for patients who continue to struggle.  If you need help easing your child away from their thumbsucking habit, or if you yourself have desires to move on from thumbsucking, please contact our office.  Your orthodontist can definitely be a huge help in avoiding more serious orthodontic problems down the road.

You may have been told by your orthodontist that your child needs a space maintainer to help make room for adult teeth that are still growing in, but are crowded. You might ask - Why wouldn't there be enough room for the teeth that are growing in? Shouldn't the adult teeth just be replacing the baby teeth that were already there?

Baby teeth are often not the same size as the adult teeth that replace them.  Your front adult teeth are quite a bit wider than the baby teeth that they replace. The opposite is true for your back teeth. The back adult teeth are smaller than the baby molars that they replace. This size difference is what can make a space maintainer very useful. This situation combined with the fact that you may get large teeth from your mom and small jaws from your dad (or vice versa) can cause erupting adult teeth to run out of room.

Orthodontists commonly use an appliance known as a space maintainer while children still have adult teeth that are growing in. There are many uses for a space maintainer, but the most common is insufficient spacing for the adult teeth. There are also many types of space maintainers, but the most common is called a lower lingual holding arch. This appliance takes advantage of the size difference between the adult premolars and the baby molars to save room for crowded front teeth. This appliance can make the time spent in braces shorter or even not necessary.

If your child's front teeth appear to be overlapping or too crowded, check with your orthodontist to see if a space maintainer might be a good option. At Budd Orthodontics, we offer free consultations to discuss concerns you might have with your child's dental development. Give us a call! We would love to meet you.

So your orthodontist said your child needs a palatal expander?  Here is some helpful information to become familiar with what to expect moving forward.

How does it work?

Palatal expanders are a commonly used appliance in orthodontics to make room for crowded teeth, correct crossbites, increase the size of the airway and/or widen a narrow upper jaw. Many of us have held a newborn baby and felt the “soft spots” on their tender little heads. Those “soft spots” are cartilage sutures that have not yet closed in their developing skulls. In much the same way, each of us has a cartilage suture in our upper jaw that splits the upper jaw into two halves. At the onset of puberty, that suture starts to fuse together into one bone. However, prior to the fusion of the bone the upper jaw can be expanded significantly using a palatal expander. As the palate expands, the cartilage is stretched and stimulates bone to fill into the space created by the expander. If given enough time to stabilize, the jaw will then fill in with bone at the new “corrected” width. Pretty amazing!

Interestingly, the lower jaw does not have a suture to match the upper jaw, which limits the amount of expansion you can achieve on your bottom teeth.

What does it look like?

 

The expander connects to your top molar teeth with little metal rings called “bands”. Wires connected to these bands rest gently on the teeth. There is an activating mechanism in the center of the expander that can easily be turned with a “key” that is given to each patient. Your orthodontist will show you how to use the key – it is really easy! The key will slowly and gently widen the jaw with each activation about 0.25 mm. In our office, one activation is recommended each night before bedtime. Over the course of each 4 day period, the jaw widens just 1 millimeter. While this may not seem like much, within just a few weeks you will have created much more space for the teeth to fit into. You may experience some slight discomfort as the suture starts to open, but this process is relatively pain-free.

As the suture opens, you will often see a space open up between the two front teeth. This is normal and is evidence that the expander is doing its job. After your expansion is complete, the space will naturally start to close as the crowded teeth unravel. Any residual space will be closed with your braces.

How do you maintain the expander?

Keeping your teeth healthy while going through treatment with a palatal expander is pretty easy – it just takes a little extra time and effort when you are brushing and flossing your teeth. Your orthodontist will likely give you some extra little brushes to help you clean well around your expander and show some spots that are commonly missed. A Waterpik or similar device is also a helpful tool to clean around the expander. You should brush your expander the same way you would brush your teeth - until it looks clean and shiny with no white “fuzzies” (plaque) sitting on it.

Before you know it, you will have the stunning smile you have always wanted. Good luck! If you have any questions regarding expanders or orthodontic treatment, give our office a call.

As an orthodontist I am often asked questions from worried parents about teeth that haven’t grown in yet.  As parents we have all been there in one way or another – our child’s friends may seem to walk, talk, throw a ball, or lose a tooth earlier than our child and we want to make sure there is no cause for concern.  We want to be assured we are giving our children all the care they need to be successful in life.  There is nothing wrong with this and it’s only natural to want to be certain that all is well.

When it comes to tooth eruption, there can be significant variation from one child to another.  Below you will see a diagram created by the American Dental Association that gives a pretty good guideline for when normal eruption patterns usually occur.  However, 6-12 months beyond the guidelines below would still fall into what I would consider a very normal range.

There are two main reasons why there is such a wide age range for normal tooth eruption. First would be the fact that girls tend to develop physically faster than boys on average.  It is not uncommon in my orthodontic office to see girls who have lost all their baby teeth and have all their permanent teeth (with the exception of wisdom teeth) erupted by age 9 or 10.  It is also not uncommon to see boys who still have permanent teeth that have not erupted at age 14 or 15.  The second main reason for a wide age range of permanent tooth eruption is genetic variation.  Among both boys and girls you will find “late bloomers” or precocious growers.  This does not indicate there is something wrong, just that we are all unique.

While most cases of teeth “growing in late” are harmless, there are situations where there may be some cause for concern.  One of the most common I see as an orthodontist is a permanent tooth growing in “on top” of a baby tooth that was supposed to be “pushed out” by the permanent tooth but seems to be anchored firmly in place.  This situation can cause the permanent tooth to grow into a much different position than it normally would and further disrupt the sequence of eruption for other teeth that still need to grow in.  We refer to this situation as ectopic eruption. Usually I would want to have the child’s dentist “wiggle out” the baby tooth so that the permanent tooth can grow into its proper position. Another common situation orthodontists encounter is baby teeth that are present long after their counterpart on the other side of the mouth has exfoliated.  This is usually indicative of a more serious problem – that child is usually either congenitally missing a tooth (born without it) or has an impacted tooth (the tooth is stuck and can’t erupt). These situations almost always benefit from orthodontic intervention.

If you are concerned about your child’s dental development, follow the recommendation of the American Association of Orthodontists and have your child evaluated by an orthodontist at age 7. By this age, permanent teeth are starting to erupt and problems that might become severe in the future can often be treated early with a more simple solution.  Please come visit us at Budd Orthodontics for a complimentary consultation to learn more about orthodontic treatment for your child.

Two-phase orthodontic treatment generally means that part of the orthodontic treatment is completed while the patient still has some baby teeth.  This part of the treatment is referred to as Phase I and is usually completed sometime between ages 7-10.  After the eruption of the remaining adult teeth, the second phase of orthodontic treatment involving full upper and lower braces is completed.  This part of the treatment is referred to as Phase II. The idea behind this type of treatment is that some of the more severe orthodontic problems can be treated more effectively by treating them in two stages.

Some examples of problems that can be treated effectively by doing two-phase orthodontic treatment are:

• Creating spacing for severely crowded teeth or repositioning teeth that are developing incorrectly
• Creating facial balance through influencing jaw growth
• Reducing the risk of fracture or uneven wear to protruding teeth or teeth in crossbite
• Preserving space for teeth that have not erupted
• Correcting harmful habits like thumb sucking
• Preventing damage to gum tissue around teeth that are erupting outside of a normal position

The type of appliances that are used in Phase I while patients still have baby teeth varies a lot.  It can be as simple as a special retainer to correct one tooth that is really crooked or as complicated as partial upper and lower braces with a palatal expander.  If a Phase I treatment has already been completed, Phase II is generally more straightforward involving traditional braces or Invisalign as most of the more severe orthodontic problems have already been corrected in Phase I treatment.  Minor problems like mild spacing or crowding, mild overbites, and mild to moderate misalignment can generally be treated just as effectively with a single phase treatment at around age 11-13 depending on the age of eruption of the adult teeth.

Ideally, everyone would be able to wait until all their baby teeth were gone to begin needed orthodontic treatment, and more often than not, this is the right course of action.  This allows for shorter treatment times and less patient burn out.  However, there are certain problems that if addressed in earlier stages of growth tend to result in better overall outcomes.

Once a patient is done growing or growth has slowed significantly, some options for achieving a great smile simply don’t work as well.  Also, early orthodontic treatment – sometimes referred to as Phase I treatment – makes sense to protect the teeth from chipping, breaking, or wearing unevenly as in the case of severe protrusion of the front teeth.

Other common reasons for Phase I treatment include certain types of crossbite, underbites, severe crowding, and unusual eruption patterns of adult teeth.  Each child is unique, and therefore it is impossible to generalize what will be the best plan for everyone.

We offer free initial examinations to patients, so they can get the information they need to be informed without worrying about the cost.  If you are concerned or even just curious about your child’s orthodontic needs, contact Budd Orthodontics so you can make the right choice for your child’s smile.

Your smile is the centerpiece of your face. It will be your social signature for the rest of your life. Orthodontic treatment is one of the most valuable gifts you can give to your children. Because of this, many parents wonder if their child will need braces and, if so, when is the ideal time to see an orthodontist?

The American Association of Orthodontists recommends that children be seen at the first sign of an orthodontic problem but not later than age 7. Most children will not require orthodontic treatment at this age, but there is enough dental development to spot problems early and evaluate the growth of the jaws and the spacing available for erupting adult teeth.  If no treatment is needed, your orthodontist will likely recommend that your child be reevaluated periodically to ensure proper growth and development.

Budd Orthodontics will complete a free initial consultation to allow parents to receive information regarding their child's dental development before having to commit to any treatment. This is an opportunity to learn if treatment is needed and, if so, how long it would take and how much it would cost.  We also believe it is important for families to have an opportunity to have all their questions answered regarding any recommended treatment so they can feel confident about making an informed decision. Having your child evaluated at the right time will give you peace of mind regarding one of your chid's  most important characteristics - the development of a healthy, beautiful smile.

Your child’s dentist has called you into the office to recommend orthodontic care for your child. While your child is all smiles, enjoying their sugar-free treat or sticker, your head is spinning with common orthodontic-related questions. This guide may help you explore the world of child orthodontics.

Why an orthodontist and not my routine dentist?
As aforementioned in an earlier blog, orthodontists receive additional training beyond that required to become a dentist. The extra residency training adds on two to three years of orthodontic expertise. The residency training is additionally backed by the American Dental Association, and orthodontists become members of the American Association of Orthodontists upon completion of their residency training. Most dentists receive very little training in dental school related to orthodontics.  This makes specialty training particularly important in the field of orthodontics.

Did I do something wrong with my child’s teeth? Should I have done something differently to prevent the need for braces?
Every mouth is different, and while some habits can play a part in teeth development problems, orthodontic problems are mostly a cause of genetics or unforeseen developmental issues. Orthodontic treatment can also be completed as interceptive treatment. It can help correct crowded teeth, jaw growth or development problems, ectopic tooth growth, gaps, overbites, late-bloomer tooth eruption and more.

What age do I need to start my child’s treatment?
While your dentist monitors your child’s teeth and jaw development, the American Association of Orthodontists recommends that each child have an initial orthodontic consultation when your child is seven years old. Most initial consultations are free or reduced cost. The assessment is intended to be educational, not a scare tactic. If your child is not ready for treatment or has no need of treatment at that time, your orthodontist will typically continue to monitor their development until all of their adult teeth are fully erupted.

 

How long can I expect my child to need corrective dental care?
Just like stated earlier, every case is different because of the variety of orthodontic problems that need to be considered. Most children, however, complete their orthodontic care within about two years. Upon the completion of braces, it is highly recommended to wear a retainer to continue to hold the teeth in their final position. Many adults require orthodontic treatment a second time even if they already had treatment as a child because they stopped wearing a retainer. Bonus: If there was early orthodontic care in your child’s life, the second phase of treatment will usually be a shorter time frame.

What are braces going to cost me?
Each child has individualized needs, and those costs are approximated at their initial consultation. Invisalign and clear braces provide additional options to traditional metal braces, so the cost can vary significantly depending on the treatment options chosen.
Money-saving tips:
1. Get second opinions
2. Look for incentives including low-interest financing and discounts for payment in full.
3. Compare insurance plans and get the plan which provides the best orthodontic benefits by seeing an in-network provider.

Orthodontic treatment does not have to overwhelm you. We welcome any inquiries, and you can trust us to be honest with you. We welcome second opinions because we feel confident in the value we provide to our patients for their orthodontic treatment. We provide free initial consultations and are happy to discuss treatment options with you.  We ultimately are here for you and your child to help you be healthier  and achieve your dream smile.

Budd Orthodontics services both Phoenix and Scottsdale and focuses on child and adult orthodontics.  For your free consultation, call either the Phoenix location at 602.956.4530 or the Scottsdale location at 602.493.3338 to reserve your appointment time!