Our Goal      Our goal is to provide our patients with the best possible orthodontic treatment based on a scientifically valid foundation.   Our diagnoses and treatment plans are designed to attain the best results possible as seen in a beautiful smile, a stable and functional occlusion and an esthetic facial profile.

Our Philosophy       The most important variable in determining the success of any orthodontic treatment is patient cooperation. With cooperative patients we can accomplish many wonderful things. With uncooperative patients, treatment results may be compromised and treatment times lengthened.  Educating our patients to understand their treatment and the importance of their part is our responsibility. Understanding and following the instructions is the patient's responsibility.
As parents often  play an important, supportive role in their child's treatment, they are allowed and encouraged to be present at any appointment. They may ask questions regarding the treatment or the instructions given to the patient  either at the appointment or later by phone. While the office can appear very busy, enough time has been allocated during your appointment to answer your questions. Please feel free to ask.  To minimize confusion, we communicate with you (parents and patients) and your dentist by letter whenever necessary.

Our doctors do not pledge allegiance to one type of orthodontic appliance only. Even the most recent discovery will eventually become obsolete. Each patient is unique in his/her own orthodontic needs, and so every one of our patients will receive the orthodontic appliance that is customized to the individual orthodontic problem. 

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ORTHODONTICS FOR ADULT PATIENTS

Adults generally consider  orthodontic treatment for two reasons: esthetics to align their teeth and create a better smile and  hygiene concerns to help keep their teeth longer. They are usually interested in achieving the most correction in the least time and with the most esthetic appliance. For those reasons, treatment plans for adults address these concerns and considerations are made for special circumstances.

Adult treatments are not necessarily longer than a child's treatment. The difficulty of the problem and the goals of the treatment are more important in determining the length of treatment than the patient's age.

Through new and improved techniques, orthodontists have developed treatments to correct malocclusions and crowding in adults that address their unique concerns.

 Invisalign is a system of removable appliances that can correct many orthodontic problems. The concept is that a series of clear, removable appliances are made using a computer program which simulates small, incremental tooth movements that over time effect most of the same changes that can occur using normal braces. Besides the esthetics of being removable, this technique allows the patient and the doctor to see the predicted result before treatment begins.

Using conventional orthodontic treatment (braces), adults may choose to have clear bonds placed on their teeth. The improved esthetics from clear bonds is dramatic and the newest bonds are very color stable (they do not yellow) and treatment friendly.

DO I NEED ORTHODONTIC TREATMENT?

There are many reasons you may need orthodontic treatment. Some orthodontic problems are functional and some are cosmetic. You can check yourself in the mirror for some of the more common problems we see to begin understanding your own problem.

The following terms and descriptions describe problems associated with a poor occlusion. These are conditions that when corrected will create a more functional and stable occlusion and  a healthier oral environment.

overbite: Everyone should have an overbite. The proper overbite is when the top  front teeth overlap (cover) 10 to 20% of the lower front teeth.

protrusion: A normal protrusion is when the top front teeth are slightly in front of the lower front teeth.

crowding: The teeth should line up next to each other without overlapping, rotations or significant  height discrepancies.

crossbite: All of the top teeth should be outside the bottom teeth.

Esthetic concerns are also correctable by orthodontic treatment.  Examples of this are:

1. Your upper teeth may be flared and push your upper lip too far forward.  This would affect  your facial profile and make it hard for your lips to close while at rest. Flared upper incisors are also more susceptible to damage from accidents. 

2. Showing too much of your gums when you smile is unattractive and is often caused by the upper teeth and jaw being positioned down too far.

3. A retruded lower jaw.

 WHEN SHOULD I SEE AN ORTHODONTIST?

INTERCEPTIVE TREATMENT

The American Association of Orthodontists recommends seeing an orthodontist  by age 7.  There are many reasons for considering interceptive orthodontic treatment at so young an age. At 7 years old, the permanent first molars have usually erupted so we can evaluate the anterior/posterior and transverse relationships of the occlusion, incisors are also erupting  so problems with crowding  and facial disharmonies are able to be diagnosed. We also evaluate if treatment is necessary to correct harmful oral habits or to reduce the risk of trauma to protruded upper incisors. 

Interceptive treatments are used to treat these problems and to reduce the severity of many others.  By controlling the size, shape and relative position of the jaws and the eruption pattern of the permanent teeth, we can minimize and simplify the orthodontic treatment needed later by decreasing the severity of the problem(s), reduce the risk of developing other problems  and sometimes improve facial esthetics. 

Preventive treatments are usually short term and followed by orthodontic supervision  until a decision is made regarding the need for a second phase.  

Along with orthodontic concerns, we consider if your child is emotionally ready to cooperate in their treatment. Rarely is the need for treatment so immediate that treatment needs to begin without the patient's willing participation.  

If your dentist refers your child for a consultation, he or she realizes that your child is developing  a problem and that the benefits from interceptive treatment are in your child's best interests.

Finally, parents benefit from early orthodontic screening by knowing that if treatment is indicated you are providing the best treatment for your child. If treatment is not indicated, you gain peace of mind.

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NOW THAT I HAVE BRACES

There are many common questions that all patients ask regarding  their orthodontic treatment.  Some soreness is normal. The soreness from getting used to the braces and to your teeth moving is worst the day after your braces are placed and decreases each day afterward. The best ways to reduce your soreness were discussed when we placed your braces. These include eating only soft food for the first few days, alternating Tylenol and Advil every two hours starting right away, brushing your teeth, massaging your gums with your toothbrush as often as possible, flossing and using wax as needed. Some patients find that warm water rinses with or without salt helps reduce soreness.

Often the back teeth will not meet for the first few days because the front top teeth will bite against the braces on the lower front teeth. This is by design to help reduce your overbite and to minimize the forces needed to align the teeth. In  a few days the back teeth will meet again.

Any irritations from sharp edges will usually resolve themselves in a few days but it is possible that we can help you if the cause is a wire or hook. See emergencies  Please call us if you have a sharp edge that emergency treatments do not help, we can usually determine on the phone if  you should come in.

The most important thing to remember is that the soreness from your initial appointment is worse than any other visit.  You will feel very little discomfort from your regular adjustments. 

It is normal for your teeth to feel loose. The teeth move by pressure pushing or pulling them through the bone and until the bone hardens the teeth will feel loose. Dr. Santoro uses the wires and elastics to place pressure on the teeth: too much pressure and the teeth will not move as the bone reacts to it as trauma, too little pressure and the bone will not resorb at all and again the tooth does not move. While some looseness is normal, excessive looseness may be a sign of a developing problem. If you are concerned, call for an appointment  for an evaluation by Dr. Santoro.

If you expect to get elastics, they will probably begin at your third appointment.

Gums that are sore, red, swollen or bleeding means that you are not massaging them with your toothbrush either often enough or long enough. The brushing and massaging on your gums replaces the normal friction from the lips and cheeks rubbing against the gums.  

If your gums are so swollen that they are inflamed or infected, we will recommend rinsing with a mouth wash.  This will resolve the inflammation and then normal oral hygiene will be enough to maintain your tissues in good condition.

ELASTICS

Follow the instructions given in the office for wearing your elastics. The elastics are prescribed to correct your orthodontic problems and wearing them in the proper position and with the proper force is critical to their success. If you have any questions, please call the office.

Inaddition to not correcting your problem as quickly, easily and completely as possible,  there are significant risks from not wearing your elastics as directed.   

RETAINERS

There are many different types of retainers.  As a group, retainers are removable appliances. They are made by prescription in special orthodontic laboratories from impressions taken in the office. Some retainers function to move teeth or to widen your jaw or to coordinate the position of one jaw to the other. Other retainers are designed to hold spaces until your permanent teeth erupt.

Wear your retainer as directed when it was first inserted. 

Please make sure that each and every time you remove your appliance it is kept in a retainer case so it will not be lost or broken.