Did you know that the American Association of Orthodontists (AAO) recommends your child visit an orthodontist for an evaluation at 7 years of age?
PHASE I TREATMENT: Dentofacial Orthopedics
As children grow and develop, they may exhibit early signs of jaw problems. For instance, too much or too little jaw growth results in an incorrect jaw relationship, which in turn affects the profile and bite. Improper jaw growth can also result in incorrect function. In many instances, crowding of the teeth will be evident at a young age (even before all the baby teeth are lost), and this affects proper permanent tooth eruption.
The goal of Phase I is to “level the playing field” by harnessing growth potential so that nature is given the best chance at developing a smile that is both functionally correct and cosmetically pleasing. Because children grow so rapidly, they can greatly benefit from Phase I appliances that are able to affect the relationship between the upper and lower jaws, as well as tooth relationships. Hence, the first phase may involve limited orthopedic (jaw-related) correction, as well as orthodontic (tooth-related) movement. Completion of Phase I may eliminate the need for removal of permanent teeth and/or the need for jaw surgery in the future. Waiting for all of the baby teeth to be lost can result in a tooth/jaw discrepancy that is too severe to be resolved by braces alone.
Observation (“Resting”) Period
During this time, the last of the baby teeth will be lost and the remaining permanent teeth will erupt. A successful first phase will result in increased space for the permanent teeth, often preventing SEVERELY crowded or IMPACTED teeth. Periodic visits are scheduled in order to monitor growth and development. At times, selective removal of baby teeth may be necessary in order to guide or enhance the eruption of the permanent teeth.
PHASE II TREATMENT: Full Braces
The nature of treatment in this phase is more tooth-related (orthodontic) than jaw-related (orthopedic). The goal is to achieve a pleasant smile and a bite in which the teeth function properly, not only with each other, but with the lips, tongue, and cheeks as well.
Orthodontic records are again taken prior to beginning Phase II in order to evaluate the patient’s current status following growth and development (“puberty”). The second phase may involve wearing full braces anywhere between 9 – 24 months, depending on the complexity of the case and the compliance of the patient. After treatment is completed, the braces are removed, and custom retainers are fabricated and worn as prescribed (indefinitely, as teeth tend to shift with aging).
Advantage to Two-Phase Treatment
Two-phase orthodontics is a specialized process that involves both tooth straightening and physical changes in facial bones and soft tissues. Due to previous improvement in jaw size and relationship, less actual tooth movement is usually required in Phase II. Often, in this phase, the “detailing” work is accomplished.
You may be wondering, “What is the problem with waiting until all the permanent teeth come in before starting treatment?” The answer is that waiting until this time has allowed the full expression of the problem(s) and now leaves only one chance to correct it. For instance, in the case of a jaw discrepancy, there is now the possibility of needing braces and jaw surgery in order to correct it. In addition, removal of permanent teeth may now be unavoidable, and attractive facial aesthetics (profile) may be compromised. The emphasis today on living longer, staying healthy, and looking attractive requires optimum treatment skills. Two-phase orthodontics maximizes the opportunity to achieve both a healthy and pleasing smile.
Dr. Pincofski’s specialty training includes three years of residency following the completion of four years of dental school. Her specialty training enables her to diagnose and treat the misalignment of teeth and skeletal discrepancies of the jaw. Know that Dr. Pincofski will develop a comprehensive treatment plan to give you the best care possible.
When it comes to giving your child a beautiful smile, traditional braces are still the most effective treatment technique. There are many different options, including silver, gold, colored, and clear braces! Your child will appreciate the opportunity to choose which braces they prefer. Colorful bands are changed at every visit in order to progress treatment. There are over 20 colors to choose from to suit every child’s personality! Many patients like to coordinate their colors with favorite sports teams, upcoming events, and holidays. Treatment time with full braces varies with respect to the specific problems and the necessary treatment. No two mouths are alike, so they shouldn’t be treated as if they are! And, a beautiful smile is a lifelong enhancement!
Although retainers may be used for specific purposes during “Phase I” (Interceptive Treatment), they are typically worn after the removal of full braces in order to prevent relapse. Once Dr. Pincofski designs the retainer, the patient customizes it based on their color and style preferences. Retainers are typically worn full-time for six months following brace removal in order for the teeth to stabilize in their new positions. After that, they are usually worn at bedtime. (Check-out some of the coolest retainers ever on our Facebook page!)
Should you need to contact Dr. Pincofski after hours, call our office, and a message will provide you with the number at which she can be reached. In the rare event that Dr Pincofski is away, she will have arranged for another doctor to care for your emergency. Please call the office, and you will be instructed on how to proceed.
Wow! Your tongue is strong!
“What is a tongue thrust?”
Simply stated, it is an abnormal swallow pattern (placing the tongue between the teeth before and during swallowing).
Did you know…?
- According to recent literature, as many as 67-95% of the children 5 to 8 years old exhibit tongue thrust which may be associated with, or which may contribute to, an orthodontic or speech problem! Throughout the country, from 20-80% of orthodontic patients have some form of tongue thrust.
- You swallow 2000 times a day (capable of exerting 1-6 pounds of pressure against the teeth and jaw).
- Thrusting can move teeth and create growth distortions of the jaw.
- There are different types of tongue thrusts (including anterior and lateral thrusts).
- Thrusting can prevent braces from effectively positioning the teeth.
- Once the braces are removed, a tongue thrust can cause the result to relapse, even with 24/7 retainer wear! The tongue is more powerful than the retainer!
The following may cause tongue thrusting:
- Thumb sucking
- Allergies /nasal congestion
- Large tonsils/adenoids
- Large tongue
- Hereditary factors
- Neurological/muscular abnormalities
What to do?
- Dr. P may recommend a consultation with a Speech Therapist (specializing in diagnosing the particular type of thrust present) who will then prescribe specific exercises to eliminate it.
- In some cases Dr. P may recommend Appliance therapy (tongue crib) which serves to remind the patient to correctly position the tongue while swallowing.
Do you or your child ever wake up feeling as though you never even got a good night’s sleep? Both children and adults may suffer from “sleep apnea” − a condition in which breathing periodically stops during sleep… sometimes as often as every few minutes! If left untreated, the quality of sleep tremendously decreases, which may increase the risk of medical issues, including: high blood pressure, stroke, and heart attack! Loud snoring/snorting, insomnia, and/ or gasping for breath during the night may indicate the presence of apnea. In addition, sleep apnea may also cause you to wake up with a headache or feel drowsy during the daytime.
“Obstructive” sleep apnea is the most common type and may require removal of enlarged adenoids and/or tonsils in children. In adults, the most common culprit is the lower jaw falling backwards while sleeping, thereby reducing the airway. An appliance can be worn at night in order to position the lower jaw forward, thereby increasing the air flow during sleep. Dr. Paul Pincofski
The technology utilized in the diagnosis and treatment of orthodontic issues/concerns has changed dramatically over the years. Now, more than ever, “state-of-the-art” technology assures that you and your child will receive high quality care that is both comfortable and effective. Dr. Pincofski has invested in this technology for the benefit of her patients. She and her team regularly attend continuing education courses to keep abreast of current techniques and technology.
i-Cat® 3D Imaging
Patients today are better-informed than ever and take a more active role in their health care. This breakthrough technology enables patients to better understand their treatment options.
What is it?
3-D Imaging is the new frontier for digital x-ray: designed specifically to visualize the head and jaws. It’s the difference between viewing a photo of a patients head and going inside and taking a virtual tour! THIS IS NOT THE SAME TECHNOLOGY AS A MEDICAL (HOSPITAL) CAT SCAN
Why is it better?
Conventional orthodontic x-rays have varying degrees of distortion and magnification error. The 3-D imaging system is 100% accurate with less radiation exposure! Compared to medical scanners, the iCAT imaging system is 10 times more accurate with 95% less radiation. Dental and medical professionals can easily share 3-D data using iCAT software.
What is it used for?
- Airway/sleep apnea assessments
- TMJ evaluations
- Precise location of impacted/extra teeth
- Evaluation for implant placement
- Treatment planning of surgical cases
While seated in an open, non-invasive environment, an 8-second scan (of which the x-ray is on for only 3.5 seconds) produces multi-dimensional images in one minute.
The type of radiation produced by the iCat is no different than that produced by any other x-ray machine. The real issue is the AMOUNT of radiation utilized for orthodontic diagnostic purposes. A 3D scan is recommended to provide the best in orthodontic care. A single scan provides more information than numerous digital x-rays. This helps with a precise individualized diagnosis so an effective treatment plan with optimal results can be designed for each patient. Before the iCat was introduced, the typical orthodontic diagnostic workup consisted of a Panorex, a Lateral Cephalogram (head film) and various periapical x-rays. One iCat scan replaces all of these x-rays with LESS radiation. Dr. Pincofski will NOT retake the 3D scan after the initial diagnosis has been made! Any follow-up x-ray is a digital Panorex (which the machine is also capable of producing).
There have been many patients who have been made aware of medical issues (not just dental issues) as a result of their children having received a 3D scan: issues that would not have been discovered with tradional x-rays! A few have even required surgical intervention. As you would expect in these cases, the parents are very grateful for this technology. We welcome the opportunity to dialogue with you about any concerns or questions you may have regarding how this technology used.