Andolino Orthodontics

Frank C. Andolino, DDS (212) 753 - 5575
41 East 57th Street - New York, NY 10022

What is orthodontics?

Q: What is an Orthodontist? stock photo young middle-class couple
A: An orthodontist is a dental specialist who has successfully completed at least two academic years of continuous advanced studies in an orthodontic program of a dental school or institution approved by the American Dental association. This advanced training includes such diverse studies as physics, embryology, genetics, human growth and development, cephalometrics, biophysics and mechanical engineering. Only dentists with this advanced education can announce that they are orthodontists.
Q: What is Orthodontics?
A: The term itself comes from two Greek words:“ orthos,” which means right or correct and“ odon,” which is the Greek word for tooth. Orthodontics is a special kind of dentistry involving the diagnosis, prevention and treatment of dental and facial irregularities. The technical term for crooked, crowded or protruding teeth is“ malocclusion,” which means“ bad bite.” The practice of orthodontics involves the design, application, and control of corrective appliances, commonly called braces, to treat and correct these problems.


Brief History of Orthodontics

Origins of today's orthodontics extend back to the dental practices of ancient times. References to correcting irregularities of the teeth can found in the medical writings of ancient Rome and Greece.

However, it wasn't until about 1830 that a French dentist named Lefoulon began to call his work with crooked teeth “orthodontisie.” Around the time of the Civil War, appliances used to move teeth were becoming more refined, but worked simple on individual teeth, and there was no attempt to treat the dental arch as a unit.

Sometime around 1880, a system for classifying specific cases and terminology for diagnosing irregularities was developed by Dr. Edward Angle. Dr. Angle is generally considered the father of modern orthodontics. In 1899, he founded a school in St. Louis, Missouri to teach orthodontics. A few years later, Dr. Angle and others founded the American Society of Orthodontists, which later became known as The American Association of Orthodontists. By the mid-1920's major colleges and universities throughout the country offered advanced training in orthodontics.

Causes of Orthodontic problems and Need for Treatment

There are two general causes of malocclusions. Most malocclusions are inherited, such as crowding, spacing, extra or missing teeth, cleft palate and certain irregularities of the jaws and face. Acquired causes may include thumb or finger sucking, tongue thrusting, breathing restrictions by tonsils and adenoids, accidents involving the teeth and face, dental disease and premature loss or primary or permanent teeth. Many of these problems affect facial appearance, as well as teeth.

Restoration of the teeth, good dental care and fluoridation can help control some of these problems, as well as contribute to general dental health.

A 1977 study by the U.S. Department of Health and Human Services, formerly HEW, showed orthodontic problems to some degree affected 89% of American children 12 or 17 years of age. Of that 89%, 29% were classified as severe cases in which treatment is considered either highly desirable or mandatory.

Results of Untreated Problems

Untreated orthodontic problems may cause tooth decay, diseased gums, bone destruction, joint problems and loss of teeth. (More adults lose their teeth because of periodontal problems than because of decay.) Protruding teeth are more susceptible to accidental chipping and other forms of dental injury. Sometimes, the increased cost of dental care resulting from an untreated malocclusion far exceeds the cost of orthodontic care.

When to Visit an Orthodontist

Orthodontists can improve most malocclusions at any age, but the best age to receive treatment is determined by the amount of improvement that can be achieved in the least amount of time and with the least expense to the patient. The best age will vary from patient to patient, and a complimentary consultation or exam will help determine when treatment will become necessary. The AAO recommends that a child have the first orthodontic examination at age seven. The orthodontist, who will ultimately be responsible for treatment, is the person best able to evaluate the timing of any treatment that may be required.

An initial visit provides the orthodontist with the opportunity to evaluate your child's health and provides you with the opportunity to inquire about anything relative to treatment. In determining the optimum time for treatment, the orthodontist will give consideration to such factors as the greatest effectiveness in moving misaligned teeth, the minimum time required and the least expense for the patient or parent. Since the orthodontist knows what to look for based on his training and experience, parents should not rely on their own judgment or that of friends.

Treatment for adults is possible at any age

In addition, if left untreated, malocclusion may result in harmful effects on the general health of the patient, including speech defects, psychological and emotional disorders. Naturally, you feel better when you look better, and a pleasing appearance is a vital asset to one's self-confidence and self-esteem. Often a person's self-consciousness disappears as orthodontic treatment brings teeth, lips and face into proper position.

Cost of Orthodontic Treatment

Fees for treatment vary widely, depending on the severity of the problems, length of the treatment time, and with some geographic differences. Many cases may require limited treatment at relatively expensive fees. The orthodontist welcomes the opportunity to discuss fees on individual basis.

While orthodontic treatment may involve several years of treatment time, payment usually can be extended over the years required for care. Some dental insurance plans have orthodontic benefits, which will further reduce the cost of treatment.

Orthodontic Insurance

Orthodontic coverage is being included in more and more insurance plans every year. Increasingly, employers and unions realize that orthodontic care is an important health concern of workers. Actuarial information for 1981 shows that an orthodontic benefit as much as $1,500 per insured can be added to an existing dental insurance plan for as little as $2.41 per month for a family. (This figure would cover all family members under age 19. Adults in the same family could be covered in the same plan for an additional 36 cents per adult.)

The American Association of Orthodontist welcomes prepaid orthodontic care because it encourages better dental health care through increased availability. However, the quality and cost of orthodontic insurance varies greatly among the many prepaid insurance plans. For this reason, the AAO has developed a nationwide program to council companies and unions on the health benefits of orthodontic care, as well as helping them get the best possible benefits at the lowest premium costs.

The AAO believe that there should be no age limit applied to orthodontic coverage. This view is in response to the increasing number of adults who have become aware of the benefits of having orthodontic treatment.

Adult Orthodontics

Orthodontic treatment can be successful at any age. Recent years have seen tremendous increase in adult patients. In fact, today one out of every five patients is an adult.

There was a time when most people believed orthodontic care was for children, but the tissues involved in the movement of teeth are the same in adults as in children. However, in adults the lack of growth may be a slight limitation. The health of the teeth and supporting structures will also determine the prospects for improvement.

Spaces between the teeth, protrusion of teeth, tipping of teeth into a space that was not kept open after premature extraction or loss of a tooth and teeth that, for any reason, have moved into abnormal position all can be helped by adult orthodontics.

The health aspect of orthodontics is often the primary consideration for adult treatment. Crooked teeth can put extra stress on supporting tissue. Failure to correct the problem might cause weakening of support tissue, thereby causing gum disease, loss of teeth and eventual need for dentures.

Surgical Orthodontics

Surgical orthodontics involves a team effort of the oral surgeon and orthodontist in solving dental and facial problems requiring a combination of skills. The two, by working together, are able to treat jaw and tooth abnormalities that could not be treated by either the orthodontist or oral surgeon alone.

Four basic problems are usually corrected by surgical orthodontics, including a protruding or recessed upper jaw or a protruding or recessed lower jaw.

The knowledge impart by the orthodontist is vital to the oral surgeon because of the orthodontist's special training in determining the proper placement of teeth prior to surgery. The most important aspect of a team approach is an understanding of the placement of the teeth with respect to facial proportions, as well as understanding the stress that facial muscles exert on new jaw relationships.

Temporomandibular Joints (TMJ)

The Temporomandibular Joints (TMJ), which connects the lower jaw to the base of the skull, may be the reason an estimated 50 million people suffer from chronic headache, earache, and facial pain. No other joints are subject to such a precise discipline as that of the meeting and biting of the teeth.

Symptoms frequently associated with this problem are popping, clicking, or grinding noises of the jaw joints when eating or opening the mouth, soreness and limitation of opening the mouth, stiffness of the neck and shoulders, ringing of the ears, dizziness, nausea and periodic blurriness of vision. The bizarre and seemingly unrelated combination of symptoms makes diagnosis difficult for both the medical and dental communities since many other diseases may cause similar symptoms.

The cause, in most cases, is a disharmony of joints, muscles and teeth. Emotional stress, which may cause an increase in clenching and grinding of the teeth, is seen as a common factor in many TMJ cases. A muscle or skeletal imbalance can occur as the result of improper jaw development, misalignment of the teeth, a blow to the face, loss of teeth, recent dental work, improper oral habits, and even poor body posture.

The first step in treatment is symptomatic care, which usually consists of (1) a soft diet, (2) mild anti-inflammatory agents, (3) moist heat pack and/or ice, and (4) voluntary self-disengagement of the teeth. For many patients this may be the only treatment necessary to relieve their symptoms.

In serious cases, splints may be used to reposition the upper and lower jaws. Behavior modification in the form of biofeedback, acupuncture, hypnosis and psychotherapy may be used. In extreme cases, jaw surgery may be indicated.


Common Misconceptions About Orthodontics

Q: There's More Tooth Decay With Braces
A: The truth is that tooth decay is a result of poor dental hygiene, with or without braces. Having braces in the mouth means you must brush and floss more carefully. The issue is not that braces might cause enamel scarring or decay, but whether you take the additional time to clean your teeth properly.
Q: You Can Get Radio Signals on Your Braces
A: It makes for a good story in the high school cafeteria, but the truth is, you'd have to carry a transistor radio if you want to listen to your favorite station, not your braces!
Q: If You Kiss Someone Who Also Wears Braces Your Braces Might Lock Together
A: Although it makes for a funny story, your braces are made in such a way that this myth just can't happen.

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About Us

Dr. Frank Andolino provides quality orthodontics for children, teens, and adults in New York City, Manhattan NYC, and the Upper East Side. Dr. Andolino specializes in adult orthodontics, offering Incognito lingual braces and Invisalign invisible braces. Contact our office to schedule your orthodontic consultation at (212) 753 - 5575.

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