Lionville Professional Center
145 Dowlin Forge Road
Exton, PA 19341

Gap Business Center
Route 30
Gap, PA 17527

The Best Time for Treatment


Brace Yourself Mom and Dad
Crossbites - Timely Treatment is Important
Extractions: Should Permanant Teeth be Removed?
Serious Problems Require Early Treatment
When is the Best Time for Treatment?
Why Are So Many Younger People in Orthodontic Treatment Now?


Brace Yourself Mom and Dad

According to the American Association of Orthodontists (AAO), over one million adults are wearing braces - twice the number from just fifteen years ago. We've experienced this trend in our office as well, particularly with adults choosing to have treatment at the same time as their children. One of our adult patients commented, "It's easier when you're going through braces together - I know first hand what my son is going through."

Often times, it is a son or a daughter who motivates their parents to seek treatment. Parents notice the fast improvement and see that their child adapts quite easily. Other motivators seem to be crowded teeth, a bad bite, jaw joint (TMJ) pain, and the overall appearance of the smile. Left untreated, these problems can worsen, and lead or contribute to more serious conditions including gum (periodontal) disease and tooth loss.

During the past ten or so years, hi-tech advances have truly made orthodontic treatment more "patient friendly." Braces are smaller, smoother, easier to have placed, healthier for the gums, and the clear braces are nearly invisible. These clear braces that blend in with your tooth's natural color have really made adult treatment more appealing. Newer still, is Invisalign, a system to move teeth without any braces. While Invisalign has its limitations, for uncomplicated cases, it can be very beneficial, and it looks great.

The archwires that help braces improve teeth today are more comfortable than ever, using lower energy levels over longer periods of time. Some orthodontic wires even use the warmth of your mouth to activate tooth movement. These combined hi-tech improvements have greatly decreased orthodontic discomfort and reduced the number of office visits and your overall time in treatment.

The actual process of tooth movement in children and adults is the same. However, treatment for a parent is usually a bit different than their child's for two reasons - gum disease and growth.

According to the American Dental Association (ADA), three out of four adults have some form of gum disease by the age of 35. Kids are far less likely to have problems here. Periodontal disease, if left untreated, can damage the supporting gum and bone tissue. With healthy gum and bone strength, there is no age limit for a better, straighter smile. We recently treated a 76 year old grandmother. She looks terrific!

Because adult facial bones are finished growing, there could be some treatment limitations, although this is usually not the case. Some large bite corrections may require a combined team approach and involve orthodontics and jaw surgery. Because young children are actively growing, we are able to work with, and even enhance their natural growth. This usually eliminates the need for future jaw surgery, even with severe orthodontic problems.

Orthodontic treatment is always a change for the better, regardless of age. Due to hi-tech advances in treatment, esthetics, and comfort, the trend of more parents and children in treatment together will likely continue to increase.

Back to Top


Crossbites - Timely Treatment is Important

A crossbite, or “reverse bite” as it is sometimes called, is a condition that affects many young people and is best treated as early as possible.

What is a crossbite? The most common type of crossbite occurs when one or more upper teeth are behind or inside of the lower teeth. When this occurs in the front, significant wearing away of the teeth usually occurs. Unfortunately, even at the age of 7, this often involves the front permanent teeth. Besides tooth wear, these front teeth are placed at greater risk of damage in a fall or accident since they are reversed from their normal, safer position.

When a crossbite affects the back teeth, significant tooth wear occurs as well. Even more serious than this is the potential for improper jaw growth. Obviously, this can create a serious condition with negative long-term effects.

Crossbites can be caused by several things including extended thumb or finger-sucking habits. The longer the habit persists, the more likely a crossbite will result. A prolonged thumb or finger-sucking habit usually causes other bite and esthetic problems as well. Crossbites can also be inherited, usually from a parent or grandparent. Amazingly, even long-term mouth breathing (different from breathing primarily through the nose) or oversized tonsils and adenoids can change a child’s growth and create crossbites as well.

Crossbites can be corrected with several orthodontic “retainers” and appliances, ranging from the very basic to the elaborate. Some minor crossbites can even be corrected at home, with little or no orthodontic intervention. Naturally, the earlier the condition is noticed, the faster and easier it is to correct. Most crossbite corrections should begin as soon as it is noticed, starting at about 7 years of age.

As always, early detection and correction will help avoid bigger problems in the future. So, if you or your dentist notice a crossbite or “reverse bite”, see an orthodontist right away.

Back to Top


Extractions: Should Permanant Teeth be Removed?

To extract, or not to extract? That is the question.

Did you ever notice that some orthodontic patients who receive braces are able to keep all of their permanent or adult teeth, and some are not? Historically, this debate has raged within the orthodontic profession for decades. In fact, early in the history of orthodontics, two schools of thought emerged. One school felt that even with slightly crowded teeth, some permanent teeth should be removed along with the braces treatment. The other felt that even with the most severe crowding, permanent teeth should never be removed.

Even today, statistics show that extraction rates vary from one orthodontist to another and it can be to a significant degree. Yet the basic principle remains a simple one -- Try everything possible to help the patient maintain all of his or her permanent teeth, unless this produces an unstable or “re-crowded” result.

The good news is that the vast majority of orthodontic patients today can be treated to a stable final result, keeping all of their permanent teeth. The key is having an early orthodontic examination. Some crowding of teeth is normal at certain stages of development, but if the crowding is moderate or severe, or if there is a significant bite problem, earlier intervention could be crucial in achieving the best possible orthodontic result. This is why the American Association of Orthodontists recommends a child’s first dental exam be performed at age 2 and their first orthodontic exam at age 7.

The progressive orthodontist has many treatment options available today to avoid the need for permanent tooth extractions that at one time were routine. If you or your family dentist see something that doesn’t appear normal - for example, a crowding or significant bite problem - see an orthodontist right away.

Back to Top


Serious Problems Require Early Treatment

A common question in our office is, “Do you think it would have been better to see you earlier?” Families usually ask this question after our findings reveal a serious orthodontic condition. Sometimes, the patient’s family dentist referred the patient to see an orthodontist months, or even years earlier. However, for a variety of reasons, the patient was unable to see us right away. Often, your dentist simply wants you to have an early evaluation to be sure that everything is normal. Other times, they may notice a problem that requires immediate attention. This is why the American Association of Orthodontists (AAO), the only orthodontic association fully recognized by the American Dental Association, recommends that a child’s first visit to the orthodontist be at age seven.

Orthodontists have different philosophies about early treatment. Some believe that any crowding, spacing, or jaw growth discrepancies should be treated as soon as they are noticed. Others believe patients should wait to be treated until all the primary (baby) teeth are lost, and all permanent teeth are in place. Research shows that the best long term results are achieved by following a philosophy that is specific to each person’s individual needs, rather than trying to treat every person in exactly the same way.

Patients who receive limited, earlier treatment often require braces as well at a later age. Therefore, it is important to be sure that treatment is truly necessary for early intervention. Here’s a “Top Ten” list of conditions that could require earlier treatment:

  1. Protruding upper teeth
  2. Underbite (lower teeth in front of upper teeth)
  3. Crossbites of any kind in the front or back (usually, top tooth trapped behind a lower tooth)
  4. Moderate to severe crowding (minor crowding is often a normal condition when primary and permanent teeth are together)
  5. Extended thumb or finger sucking habits (it’s best to help a child end this habit at 5-6 years old)
  6. Missing teeth
  7. Extra Teeth
  8. Impacted teeth
  9. Ankylosed teeth (teeth fused to the jaw bone)
  10. Tooth wear, especially in the permanent teeth

Other conditions may benefit from earlier treatment as well, so ask your dentist, or see an orthodontist yourself if you are not sure. An orthodontist can locate and intercept certain problems with early treatment before they cause permanent damage or other serious issues. Many children need only to be supervised, and not treated until most or all of the permanent teeth are in place. A progressive AAO orthodontic specialist can help you with this important family decision.

Back to Top


When is the Best Time for Treatment?

An orthodontic specialist can improve a person's smile at any age, but there is usually a best age for treatment to begin. Thus the old adage "Timing is everything" applies to orthodontics.

Beginning a corrective program too soon among children can create "tired" patients who lose the necessary motivation to cooperate. Yet starting too late can create its own set of troubles, including the need for permanent tooth extractions that might have been avoided with earlier intervention.

How can you be sure that it is the "best" time to begin a corrective program? Some young people have a full set of permanent teeth before they turn 10 years old, while others still have primary, or baby , teeth at 15 and older.

The American Association of Orthodontists (AAO), the only orthodontic association fully recognized by the American Dental Association, and the only organization that represents fully trained certified orthodontic specialists, recommends that children should visit an orthodontist for the first time at age 7. This early intervention allows us to determine how and when a child's individual problem should be treated to achieve an ideal improvement in the shortest period of time, and with the least expense.

Naturally, the majority of children require no treatment at age 7, but for some, limited interceptive treatment can help prevent more serious problems as they get older. Uncorrected orthodontic problems can affect young people in many ways, including their self-esteem, speech and even general health. Thus, if your family dentist notices a problem, or if you are concerned about something regarding your child's teeth, have an orthodontist help with an evaluation, and do it as early as possible. The benefits of an early evaluation could make orthodontic treatment much easier for the patient.

Back to Top


Why Are So Many Younger People in Orthodontic Treatment Now?

Many parents bringing their first child in for orthodontic treatment today wonder why so many children around them are wearing braces or retainers at such a “young” age. They often say, “I didn’t get my braces until I was in high school.”

This is very true for many parents today, and the question is a valid one. Why are so many younger children in orthodontic treatment these days?

The main reason is growth. Boys and girls have an adolescent “growth spurt” well before high school. This time of rapid growth is usually the best time for full orthodontic treatment because it keeps treatment time shorter and fees lower. Treating during this time can also improve treatment stability. This is why the American Association of Orthodontists (AAO), the only orthodontic association fully recognized by the American Dental Association, recommends that a child’s first visit to the orthodontist be at age seven.

Waiting until someone is 14 or 15 years old to begin treatment is often after the growth spurt is complete. For some at this age, jaw growth may even be finished -- particularly in girls. While orthodontic treatment can certainly help at any age, it is possible that the time to achieve the best end result in the easiest way may already have passed by. This is especially true if the orthodontic condition involves a jaw growth problem.

Another reason that continues to emerge from the literature is patient cooperation. Good patients get good treatment results. Without a high level of patient help, many orthodontic treatments will fall short of an ideal result. Recent studies indicate that pre-adolescents are more easily motivated to cooperate with an orthodontic treatment plan than older adolescents. Earlier treatment, in select cases, is more likely to produce the best possible result.

Orthodontists have different philosophies about early treatment. Some believe that any crowding, spacing, or jaw growth discrepancies should be treated as soon as they are noticed. Others believe patients should wait to be treated until all the primary (baby) teeth are lost, and all permanent teeth are in place. Research shows that the best long term results are achieved by following a philosophy that is specific to each person’s individual needs, rather than trying treat every person in exactly the same way.

Patients who receive limited, earlier treatment often require braces as well at a later age. Therefore, it is important to be sure that treatment is truly necessary for early intervention. Here’s a “Top Ten” list of conditions that could require earlier treatment:

  1. Protruding upper teeth
  2. Underbite (lower teeth in front of upper teeth)
  3. Crossbites of any kind in the front or back (usually, top tooth trapped behind a lower tooth)
  4. Moderate to severe crowding (minor crowding is often a normal condition when primary and permanent teeth are together)
  5. Extended thumb or finger sucking habits (it’s best to help a child end this habit at 5-6 years old)
  6. Missing teeth
  7. Extra Teeth
  8. Impacted teeth
  9. Ankylosed teeth (teeth fused to the jaw bone)
  10. Tooth wear, especially in the permanent teeth

    Other conditions may benefit from earlier treatment as well, so ask your dentist, or see an orthodontist yourself if you are not sure. An orthodontist can locate and intercept certain problems with early treatment before they cause permanent damage or other serious issues. Many children need only to be supervised, and not treated until most or all of the permanent teeth are in place. An AAO orthodontic specialist can help you with this important family decision.

    Back to Top





    Home | About Dr. Virgulti | About our Staff | About our Office | Treatment
    Our V Buck Program | FAQ | Orthodontic News | Directions | For Kids
    Employment | Contact Us



©2006 Dr. Virgulti, DMD. All Rights Reserved.
Site design and hosting provided by Chester Springs WebTech.