Questions about Braces with Dr. David Herman Farmington

Question: How does your office prevent white spots around braces?

Answer: At my office, patients who are at risk for white spot lesions receive fluoride varnish around their brackets every 6 weeks. Studies show that applying a fluoride varnish around the brackets every 6-8 weeks reduces a person's risk to white spot lesions by 70%. I also offer dental exams and cleanings at my office. My team removes the orthodontic wire before cleaning which allows for a more thorough cleaning. All of my patients are required to have a dental cleaning and exam every 6 months. My goal with these practices is to significantly reduce my patient's risk to gum disease, cavities and white spot lesions

Dr. David Herman, Four Corners Orthodontics & Dental

Dr. Herman: Four Corners Orthodontics & Dental

Question: I know that poor brushing while wearing braces can cause white spots around the braces. What causes the white spots to form? Are these cavities?

Answer: White spot lesions are not cavities. Poor brushing leads to plaque accumulation around the brackets. The most abundant accumulation is between the bracket and the gum tissue. The plaque contains bacteria that produce acid. A person's saliva normally neutralizes or buffers this acid. However, if there is more acid produced than the saliva can buffer, demineralization of enamel begins. If demineralization occurs for a long enough period of time then white spots appear. My office is one of a few orthodontic practices in the country that has an onsite dental hygiene department to attempt to minimize a patient's risk of getting white spot lesions and make it convenient for a patient to maintain great oral hygiene during orthodontic treatment. Call 1-800-4-BRACES for a free consultation.

-Dr. David Herman, Four Corners Orthodontics & Dental

My son has crooked front teeth. Does he need to lose all his baby teeth before he visits an orthodontist?

No, but I do recommend patients lose their lower first baby tooth molars before beginning orthodontic treatment. These teeth usually fall out between ages 8-10 with girls losing them before boys. They are the teeth behind the canines, and the teeth that replace them are called first premolars. I try to have most of my patients’ orthodontic treatment completed in two years or less. I find that in most cases, waiting until the lower primary first molar falls out helps me achieve this time period. I always offer free consultations, regardless of age or number of baby teeth remaining. Please call 1-800-4BRACES to discuss how orthodontic treatment can improve your son’s smile.

Someone told me that if my child gets braces as a young teenager, he will need braces again as an adult. Is this true?

Retreatment is only needed when retainers are not worn as instructed and teeth shift. If a person’s teeth move too much, a tune-up would be recommended to get them back to the finished result. I provide tune-ups at a reduced fee. Most of my patients who have tune-up treatment only need to wear braces for a year or less. When I finish treatment, I place a double retainer to ensure the most stable result-- a wired retainer glued on the back of both upper and lower front teeth, as well as clear, removable aligner retainers. If you need an orthodontic tune-up, call 1-800-4Braces today for your free consultation.

I had an overbite that was corrected with braces at age 12. My 6 year old daughter looks like she will also have an overbite. What causes an overbite?

The main cause of an overbite is heredity, so if a parent had an overbite, there is a good chance a child will also have an overbite. Another common cause is a prolonged finger sucking habit. A recent study found that 20-30% of the U.S. population has a mild to severe overbite. Overbites are a result of either the front teeth sticking out too far, the lower jaw being too small and too far back, or a combination of both. I have achieved good results on patients with an overbite without removing any teeth. In cases when the overbite is caused by the lower jaw being too small or too far back, I do not recommend extracting upper teeth. While this plan fixes the overbite, it can create a very flat facial profile. For a free consultation, please call 1-800-4Braces.

I went to another orthodontist for a consultation and told him I was concerned about having teeth pulled. He told me that he extracted teeth only when absolutely necessary and that orthodontists who rarely remove teeth are treating all patients all the same. Is this true?

I am an orthodontist who rarely removes teeth, and I can assure you that all patients I treat have an individualized plan for treatment. If an orthodontist wants to extract teeth from you or your child, I always recommend that you get a second opinion from an orthodontist known for not removing healthy teeth so you can make the decision that is best for you or your child. Call 1-800-4Braces for a free consultation.

If I don't wear my retainers for a couple of days my teeth start to move. My friend never wears her retainers and her teeth have not moved. Why is that?

Orthodontists and researchers have tried for years to explain this stability issue and the answer remains the same. We cannot predict with any degree of certainty how stable a person's result with be over a long period of time. We can say that if you wear your retainer for a certain amount of time, your result will be pretty much remain stable. Our bodies are constantly changing, and the forces on teeth are constantly changing, which cause teeth to shift. Teeth shift even if you never wore braces. Orthodontic patients should always wear retainers as instructed to ensure the most stable result possible.

My 7 year old son is getting bullied at school because his front teeth stick out. Should I start braces early to help reduce the bullying?

I am asked your question frequently. Bullying behavior about dentofacial features is widespread and has been for years. Before making a decision about early treatment, I recommend you ask yourself these questions: How bad is the dentofacial problem? How much is the bullying affecting the child? How much is the bullying worrying you as the parent? I do recommend early treatment for psycho-social reasons. When I do this treatment the goal is very specific: align the four front teeth, place a wired retainer behind the teeth, then let the child grow another year or two and reevaluate if further treatment is required.

I have obstructive sleep apnea. My doctor told me my tongue is too big for my mouth and is causing the obstruction when I sleep. Can this be a result of having four teeth removed when I had braces as a teen?

Yes. Extracting four permanent teeth does reduce the volume of your mouth. In other words, your tongue had to move toward the back of the throat, reducing the airway space. The extractions can be responsible for you now having sleep apnea. Instead of extracting teeth to relieve crowding, I widen the arch of the mouth using the high-tech H4 system of braces. This increases the volume of the mouth and decreases the chances of obstructive sleep apnea. If you want to correct crowding problems without extractions, call 1-800-4BRACES for your free consultation.

My son has a palatal expander to help make room for his teeth and to fix a cross bite. Tonight I turned the expander as instructed and I heard a pretty loud pop. What was that pop?

What you heard was most likely the sound of the palate splitting down the middle. The split also occurs in other bones of the face as well. This is not dangerous and is the purpose of the expander. However, it is not the only way to fix a cross bite. Today, there are much gentler and less invasive means to gain space and fix cross bites. I have not used an expander in almost a decade. If an expander is part of your child's treatment plan, please call 1-800-4braces for a free second opinion.

I am looking for a job, and I feel that my crooked teeth are affecting my chances of getting the jobs that I want. Have you found this to be true?

A recent study asked large companies this question. The companies were asked to look at 100 photos of individuals with all types of smiles and select the ones they were most likely to hire. People with more ideal smiles were selected as being the most likely to be hired. One of the most common reasons is the companies believed they looked more intelligent. Having a good-looking smile can change a person’s perception of you. If you would like to improve your smile and overall appearance, call 1-800-4BRACES for your free consultation.

How do braces move teeth?

The human body is constantly responding to external stimuli. Just like pupils contracting with bright light, braces place an external stimuli, pressure, on teeth. When pressure is placed on a tooth, the bone around it to reacts and reshapes. Bone is resorbed on the side of pressure and added on the side opposite the pressure. This process is called osteogenesis. Teeth move faster and with far less pain if the pressure on the tooth is light. Heavy pressure, like that found in traditional braces, causes more pain and produces slower movement of teeth. In general, the body typically does not respond well to heavy pressure. I use the high-tech H4 system of braces, which allows for gentle tooth movement. Call 1-800-4Braces to find out all of the benefits of H4 braces.

My child needs braces. I had braces for three years as a teen and had a palatal expander and teeth removed. I was disappointed when an orthodontist presented a treatment plan for my child that was almost the same plan I had 20 years ago. Has orthodontic technology changed at all?

I can assure you that technology has improved. You do not need expanders, tooth extractions or prolonged years in treatment. I use new technology, the high-tech H4 system of braces, which allows me to get great results while being far less invasive. My goal is to make the process of orthodontic care as easy for the patient as possible and completed as fast as possible. Not all orthodontic care is the same. Call 1-800-4Braces to find out for yourself how the high-tech H4 system of braces can improve your child’s orthodontic treatment.

A friend told me I needed to get my top braces and bottom braces on at different times so it’s easier for me to get used to the braces. Is this necessary?

No, there is no need for you to come in twice to get your top and bottom braces placed. Some offices require two appointments for the braces to be placed. There are also additional fees charged at these appointments making your total down payment for braces more than expected. At my office, you can get top and bottom braces the same day as your free consultation! During the month of October, you can start the high-tech H4 System of Braces for just $143 with monthly payments of $189 or less! For a free consultation, please call 1-800-4Braces.

How do I know everything that was promised to me will be kept once I start braces?

Researching the orthodontic office by visiting its website is a good start. I understand that parents are busy and can’t spend a lot of time on the phone, so everything is available on our website. We list information about our fees, payment structure, what to expect at your first visit, how long it will take, etc. Word of mouth from current patients is also a great source of information – your friends will be sure to tell you if there were any hidden fees or surprises along the way. Trust is another element to choosing an orthodontist—it’s important for patients and parents to feel comfortable that their child will have a positive treatment experience.

I was told that if I get my wisdom teeth removed there is a chance of nerve damage. What is nerve damage?

It is true that there is a risk of damage to the nerve that provides sensory information to the lower part of the face, lips and tongue. For most patients, this risk is very small. The loss of sensory information can have an impact on one's ability to eat, drink, shave, kiss or play a musical instrument. There are three types of nerve damage. The first is Neuropraxia, or temporary interruption with full recovery in 4-6 weeks. Axonotmesis is more permanent with decreased sensation of feeling. Neurotmesis is a physical separation of the nerve with complete and permanent loss of sensory feeling. Because of the nerve damage risk, removal of wisdom teeth should be done only when impaction is a big concern.

My 8th grade son is in braces. I am constantly reminding him to brush his teeth. The dental assistants have gone over how to brush with him several times, and his orthodontist told him that if he keeps brushing poorly it could add 6 months to a year to his treatment time. I was shocked to hear this. How does poor brushing make treatment longer?

Poor brushing may not necessarily make treatment longer, but it does increase chances of gingivitis, cavities and white spots. In severe cases, oral hygiene problems caused by poor brushing can prolong treatment. An orthodontist may even recommend removing the braces until severe oral hygiene issues are resolved in order to best care for the teeth. Broken brackets and poor rubber band wear can also prolong treatment.

It seems that all orthodontists offer a free consultation. What makes your consultation different?

My staff and I provide a comprehensive consultation so that patients can make fully informed decisions about their orthodontic care. You will receive all X-rays needed for me to make a comprehensive diagnosis and treatment plan specific to your needs. You will have as much time as you need with me and my staff to have all of your questions answered. I will also give you a detailed explanation of my treatment plan and the high-tech H4 system of braces. Finally, I will show you photos of my finished patients with similar orthodontic problems so that you can get an idea of your outcome. Call 1-800-4BRACES today and see for yourself why my office was voted the best in the Four Corners.

I’d like to get information about the cost for braces but don’t want to come in for an appointment right now. Can I find out the cost for braces without coming in for an appointment?

Yes! I believe in transparency in fees, so I make it easy for people to find out how much braces cost. You can get a realistic picture of your total cost with just one visit to my website. I work hard to make my website relevant and informative for my patients. Our Getting Started page includes affordable payment options and gives you an accurate picture of your cost. Our Current Promotions page features the exact cost for you to start braces for that month. You can also call our office and speak with one of our friendly team members to find out the cost of treatment. Please call 1-800-4Braces or visit Herman4Braces.com for more information.

My child has a narrow palate and a small lower jaw. I’m concerned his narrow palate is preventing his lower jaw from growing. Can orthodontic treatment help bring his lower jaw forward?

Yes, widening the palate allows the lower jaw to move forward. I use the high-tech H4 system of braces to gently widen the palate and to create wide beautiful smiles without removing teeth. I do not recommend using screws or palatal expanders to widen the palate because I feel that the forces used with this kind of treatment are too strong. I prefer to use a much gentler method to widen the palate. Please call 1-800-4BRACES for your free consultation.