Frequently Asked Questions


What is Orthodontics?

Orthodontics is the branch of dentistry that is officially known as Orthodontics and Dentofacial Orthopedics. The purpose of orthodontics is to treat any type of malocclusion. When you have a malocclusion, that means your teeth, lips and/or jaws don’t line up the way they should. As a result, your teeth may be crooked, your bite may not work correctly and your jaws may look unbalanced.

What Causes Orthodontic Problems?

Most Orthodontic problems are inherited. Example problems are crowding, spacing, protrusion, extra teeth and some jaw growth problems.

Other malocclusions are acquired. In other words, they develop over time. They can be caused by thumb or finger sucking, mouth breathing, dental disease, abnormal swallowing, poor hygiene, the early loss of baby teeth, permanent teeth, accidents, poor nutrition, or some medical problems.

Why is treatment so important?

Orthodontic problems can affect dental and general health. If teeth are out of position, they are more difficult to clean. This increases the risk of tooth decay, gum disease and tooth loss. A bad bite can also cause stress on the chewing muscles, and in some cases causes malfunction of the jaw joints. If left untreated, many orthodontic problems worsen over time. Early diagnosis can help guide facial growth and tooth eruption, preserve space for the permanent teeth. Additionally, if treated at an early age it may reduce and prevent more serious problems from developing.

When should a child have an orthodontic evaluation?

It is actually recommended that every child have an orthodontic evaluation by age 7. This does not mean that every child will need orthodontic treatment, but rather it is to assess any problems that may be developing. In many cases, early detection and treatment can reduce or eliminate what could become a more complex orthodontic problem if left untreated. Many children are monitored periodically every 3-6 months in order to watch growth and development, and some may actually end up needing no orthodontic treatment. It is always better to have your child assessed at an early age so that you are fully aware of their needs, whether now or in the future. We would be happy to speak with you today in order to schedule your child’s complimentary orthodontic evaluation, or to answer any questions you may have.

What signs indicate my child is ready for an orthodontic evaluation?
  • Thumb or finger sucking, pacifier
  • Overlapping or crowding of erupting permanent teeth
  • Broken or missing teeth
  • Difficulty in chewing
  • Open mouth breathing, large tonsils
  • Jaws that tend to click or pop
  • Frequent Headaches
  • Ear Problems
  • A developing under bite or crossbite
  • Malocclusion
  • Tongue thrust
What are the first steps to orthodontic treatment?

We are always excited about meeting new patients during their first visit to our office. Your initial appointment will consist of a thorough examination and a discussion of potential treatment options. This 30 minute visit will give us insights into your orthodontic needs. We may need to schedule a second exam for diagnostic records (Orthodontic records).

Orthodontic records are various studies that are made to help to diagnose the problem and to arrive at the best treatment options. These studies will include growth evaluations, facial measurements, photographs, impressions of your teeth for study models, and x-rays of head, jaws and teeth. The orthodontic records appointment lasts approximately one hour and is crucial in order to properly plan an orthodontic treatment. Dr. Kramer studies and reviews the data gathered from the orthodontic records in order to develop a personalized treatment plan.

Dr. Kramer will present the results of the records, her recommendations for treatment, and the estimated length of treatment. She will explain the risks and benefits involved with treating or not treating with orthodontics. Dr. Kramer will also answer all of your questions regarding treatment. We insist that our patients leave with a clear understanding of their specific needs, what the treatment will consist of and how long it will take. We encourage you to ask questions and we are always available to speak with you and address any concerns that you may have.

How are teeth moved into correct position?

Dr Kramer can use a variety of appliances to move the teeth. Some are removable and others are fixed onto the teeth. The choice of the appliances depends on the problem that must be corrected and on the patient’s individual needs. All appliances, whether fixed or removable, put gradual, gentle pressure on the teeth and jaws, causing them to move or stabilize in a particular position.


What is a crossbite and why correct it early?

Typically the lower arch (mandible) is contained within the upper arch (maxilla). Sometimes the teeth in the lower arch will extend out beyond the teeth of the upper arch, either on one side or both or in the front (anterior) teeth. This should be corrected early to prevent the mandible from growing improperly to one side or forward. The earlier the correction the better stability as the years progress.

Why are my child's permanent teeth coming in behind the baby teeth?

Approximately 40% of lower front permanent teeth erupt behind the baby teeth that are still in the mouth. Sometimes the baby teeth need to be helped out by the dentist.

Does my child really need x-rays and why?

Cavity finding x-rays (bitewings) should be taken once a year to check for decay between the back teeth. This will allow the cavities to be detected as soon as possible to allow for the least invasive treatment possible to be done. A panorex or full mouth x-ray is taken every three years to check for missing teeth, extra teeth developing,eruption problems or any other abnormalities that may occur.

Why are my child's permanent teeth so dark compared to the baby teeth?

Permanent teeth are usually darker than primary(baby) teeth,so against the very white baby teeth they appear dark.

Why does my child need a fluoride treatment twice a year at the dentist if they take fluoride at home?

Fluoride treatments in the dental office have a much higher concentration of fluoride and therefore are highly beneficial to strengthen the teeth and help prevent decay.

Why do I have to floss my child's or my teeth?

Brushing alone cannot remove all the plaque in the mouth. Plaque between the teeth can only be completely removed by flossing. This will help prevent decay between the teeth.

Why does my child have bad breath?

Bad breath can be caused by a number of factors including decay, airway problems (tonsils, adenoids, post nasal drip, colds), gastrointestinal issues (reflux), poor oral hygiene, and bacteria on the tongue.

What do large tonsils have to do with facial growth and teeth?

If tonsils are very large all the time, the tongue cannot relax back into the throat so they set forward which can promote the forward growth of the mandible. This will affect the way the teeth and arches meet together.

Why do baby teeth need to be filled?

Baby teeth are not only needed for proper chewing but they hold the space for and help guide the permanent teeth into the proper location.

If a back tooth is extracted, why do I need a space maintainer?

A space maintainer will hold the space open for the permanent tooth that is unerupted. Without a space maintainer the surrounding teeth may drift forward or backward and block the spot that the permanent tooth needs to erupt.

Why a stainless steel crown on a baby tooth instead of a porcelain crown?

A porcelain crown is not cost efficient for a baby tooth that will be lost.

Is a pulpotomy the same as a root canal treatment?

No, with a pulpotomy, only the nerve in the crown of the tooth is removed.

What is Nitrous oxide? Is it safe? Can't we try the appointment without it first?

Nitrous oxide is a relative analgesia(medicated air) which is extremely safe and helps eliminate fear, nervousness, anxiety and helps with the gag reflex. Once a procedure is started without nitrous and a patient becomes anxious etc. especially a child, it is difficult to get the nitrous nose on and the patient will have a hard time getting themselves and their breathing under control.

What's wrong with taking a bottle to bed or having juice(or other sugary drinks) in a sippy cup at my child's reach all the time?

Taking a bottle to bed causes decay because the sugar in the milk or juice pools around the teeth as the child drinks and then falls asleep. The sugar mixes with the plaque, creating acid which eats away at the enamel. The same thing happens with a sippy cup containing juice, milk or other drinks that contain sugar.

What is wrong with fruit roll-ups? Isn't there fruit in them?

Fruit roll-ups do not have fruit in them. They are fruit flavored but are full of sugar as well as being sticky. Any sticky candy is not good for the teeth as they stay in the grooves long after they are eaten and cause decay.

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