Ask the Orthodontist

Orthodontics is a specialized branch of dentistry that focuses on the diagnosis, prevention, and treatment of dental and facial irregularities. These irregularities include misalignment of teeth and improper positions of the jaws in relation to one another and to the rest of the skull.

Dr. Sirena Hsieh is an Orthodontist. Orthodontists are dentists who have also completed an additional 2 to 3 years of training as part of an orthodontic residency program. Out of 100 dental school graduates, typically only the top 6 are able to gain acceptance into an orthodontic residency program. An orthodontic resident spends 3 years full time learning the skills required to manage tooth movement (orthodontics) and to guide facial development (dentofacial orthopedics). Dr. Sirena spent 11 years in training (4 years of college at Princeton, 4 years of dental school at Harvard, and an additional 3 years of orthodontic residency at Harvard and Boston Children’s Hospital) to become an Orthodontist.

• A more attractive smile
• Reduced appearance-consciousness during critical development years
• Better function of the teeth
• Possible increase in self-confidence
• Increased ability to clean the teeth
• Improved force distribution and wear patterns of the teeth
• Better long-term health of teeth and gums
• Guidance of permanent teeth into more favorable positions
• Reduced risk of injury to protruded front teeth
• Aids in optimizing other dental treatment

• Early or late loss of baby teeth
• Difficulty chewing or biting
• Breathing through the mouth instead of the nose
• Finger- or thumb-sucking habits which continue after six or seven years old
• Biting the cheek or biting into the roof of the mouth
• Protruding teeth
• An unbalanced facial appearance
• Grinding or blenching of the teeth
• Upper front teeth that protrude excessively over the lower teeth, or are bucked
• Upper front teeth that cover the majority of the lower teeth when biting together (deep bite)
• Upper front teeth that are behind or inside the lower front teeth (underbite)
• The upper and lower front teeth do not touch when biting together (open bite)
• Crowded or overlapping teeth
• The center of the upper and lower teeth do not line up
• Teeth wearing unevenly or excessively
• The lower jaw shifts to one side or the other when biting together
• Excessive spaces between the teeth

Malocclusions (aka. “bad bites”), like those illustrated below, will benefit from early diagnosis and referral to an orthodontic specialist for full evaluation. If your child has one or more of these dental issues, please contact us by setting up a free consultation. (Please add link to the words “free consultation” to an online form that will be email us their contact information once they hit submit.) We can help give you some peace of mind by discussing your child’s orthodontic options and developing a treatment plan that is customized for your child’s needs.

Orthodontic treatment can be started at any age. In fact, many orthodontic problems are easier to correct if detected at an early age before jaw growth has slowed. Oftentimes, early interceptive treatment can help a patient avoid future extractions of adult teeth, surgery to correct skeletal imbalances, and other more serious complications.

The American Association of Orthodontists recommends that every child visit an orthodontic by age 7 or earlier if a problem is detected by the parents, the family dentist, or the child’s physician.

If you are unsure whether your child needs early interceptive treatment, we encourage you to come in for a complimentary consultation. Many concerned parents are relieved to have some peace of mind after the consultation appointment.

Phase I treatment (also called “Early Interceptive Treatment”) is limited orthodontic treatment when a child still has a mix of baby teeth and adult teeth. Phase I treatment is necessary when your child has dental / skeletal problems that are easy to fix now, but will become more difficult to fix later (for example, requiring more extensive and costly orthodontic treatment, extraction of permanent teeth, or surgery). Phase I treatment, if necessary, is usually started between the ages of 6 and 10. This treatment can make more space for developing teeth to erupt properly, and correct crossbites, overbites, underbites, or harmful oral habits that cause teeth to shift into unhealthy positions. Phase I treatment usually lasts between 6-12 months, longer if the problem is more serious. The primary objective of Phase I treatment is to address significant problems to prevent them from becoming more severe and to improve self-esteem and self-image.

Phase II treatment is also called Comprehensive Treatment because it involves full braces (or Invisalign) when all the permanent teeth have erupted (usually between the ages of 11 and 13).

The period following Phase I treatment is called the “resting period,” during which growth and tooth eruption are closely monitored every 3-6 months. Throughout this period, parents and patients will be kept informed of future treatment recommendations. If your child needs full braces after Phase I treatment, oftentimes it will be shorter, less expensive, and require less invasive techniques than if your child did not undergo Phase I treatment.

Orthodontic treatment can be successful at any age. Everyone wants a beautiful and healthy smile. Twenty to twenty-five percent of orthodontic patients today are adults.

Treatment time depends on each patient’s specific orthodontic problems. In general, treatment time lasts anywhere from 6 to 30 months. The “average” time frame a person is in braces is approximately 18-24 months. Actual treatment time is affected by the severity of the malocclusion, a patient’s rate of growth, and on patient compliance. Maintaining good oral hygiene and keeping regular appointments are critical in keeping treatment time on target.

The placement of brace on your teeth does not hurt. After you get your braces put on for the first time, you may feel some soreness for 1 -4 days as your teeth start to move, and your lips and cheeks may need a week to get used to the braces on the teeth. In these situations, medications such as Advil or Tylenol will often do wonders to ease any mild discomfort. After most visits, however, patients do not feel any soreness at all! Gone are the days of “no pain no gain!” because new orthodontic materials and technology have allowed us to make orthodontic treatment more comfortable than ever before.

No. It is recommended, however, that patients protect their smiles by wearing a mouthguard when participating in any sporting activity. Mouthguards are inexpensive, comfortable, and come in a variety of colors and patterns.

No, but it is recommended that patients protect their smiles by wearing a mouthguard when they participate in any sporting activity. Mouthguards are inexpensive, comfortable, and come in a variety of colors and patterns.

Yes, you should continue to see your general dentist at least every 6 months for cleanings and dental check-ups.

Removing teeth is sometimes required to achieve the best orthodontic result. Straight teeth and a balanced facial profile are the goals of orthodontics. However, since new technology has provided advanced orthodontic procedures, removing teeth is not always necessary.