Monday, March 19, 2012

Are all orthodontists board certified?

No.  In fact, only about 25% of all practicing orthodontists are certified by the American Board of Orthodontists as Diplomates.  What does this mean exactly?  Prior to taking the board exam, the candidate must obtain a dental degree and a certificate in orthodontics from an accredited orthodontic specialty program.  This takes 6 years after a 4 year college degree.  The orthodontist must then pass a grueling written exam covering  a variety of topics with a reading list to study of several thousand pages.  The hard part then begins.  The orthodontist must then submit treated cases that fulfill certain criteria.  These cases must have full starting and final records and the orthodontist must discuss the chosen treatment plan and results.  The examiners are some of the most highly revered orthodontists in the world and the exam is extremely thorough.  Therefore,  passing this pressure cooker is quite an accomplishment indeed.  I think what board certification shows is a commitment to a higher standard of patient care and treatment results. The willingness to use free time or family time to study, seek continuing education and submit treated cases for scrutiny shows a dedication above and beyond the norm.  Hopefully my patients see the difference!
  Dr L

Monday, March 12, 2012

What will happen if I don't do orthodontics?

I am writing this post because as hard as it is to believe, some potential patients want to know what will happen to their teeth if they don't proceed with orthodontic treatment.  Truth be told, the only evil influences in the fairytale life of your average molar are bacteria and forces.  Bacteria in the form of plaque causing periodontal breakdown or tooth decay and abnormal forces causing teeth to wear, tip, become loose etc. The bacteria part is easy...just brush, floss, see your dentist every 6mos.  Forces are much more complicated.   Teeth and the supporting structures are designed to handle vertically directed  forces and these are important in maintaining good quality bone.  Lateral forces or forces hitting the teeth at angles can be detrimental and lead to breakdown of the attachment and enamel fracture or wear.  This has a domino effect causing shifts in the bite and possibly jaw joint pain, popping and limited range of motion.  Will this happen to every patient?  Probably not,  but difficult to predict.  It is my job and that of your dentist, to help avoid these problems decades into the future.  So brush up McFly and no clenching or grinding!!!
Dr L

Tuesday, March 6, 2012

Internet Consults

I gotta say, I just love the internet.  It is so easy to use and you can learn so much!  At consultations with new patients, I often hear:  "I was reading on the internet and it said to do this..., or not to do that...".  The medical and dental advice you get is great background info written in terms pretty easy to understand.  However, I would caution you that it is sometimes very misleading and usually not case specific.  In other words,  the internet uses generalities that may not apply to you or your child's specific orthodontic needs or treatment.  I have no problem discussing internet findings with my patients as I find it very interesting, but don't be surprised if I add more appropriate info that may be more relevant to the treatment of you or your child's case.  It's like googling  "board game" versus reading the directions for how to play "monopoly".  Having said that - google to your little heart's content... just beware...big brother's watching you! 
Dr L

Thursday, March 1, 2012


I am frequently asked:  "when should my child see the orthodontist for the first time?"  The American Assoc. of Orthodontists suggests age 7 and I agree.  I would also add - whenever a parent suspects a problem.  The reason age 7 is often cited is that the permanent molars are erupting so I can check their fit and evaluate whether or not any jaw growth abnormalities exist.  The permanent four front teeth are usually in or erupting and problems present as overlapping or spaced teeth, front teeth that protrude beyond the lower lip or teeth that are not able to erupt due to lack of spacing.  Jaw or skeletal growth may also be a problem as one jaw may be too far forward or too narrow relative to the other( usually blamed on the father).  You do not have to be referred by a dentist. If I determine that everything looks normal,  your child will be placed on recall and we will see them in a year or two and re-evaluate.  Simple!
 Major Myth :  You should wait until all the pemanent teeth erupt.  This is unfortunately a common problem and the reality is that eruption of teeth does not always coincide with skeletal growth or even age for that matter.  Jaw growth is so important in correcting overbites or crowding, so for some problems, treatment should be timed with the child's growth spurt instead of whether or not all the permanent teeth have erupted.  This will result in a much more esthetic facial and functional result that we can all be proud of !!!   Dr L