Patient education

A common question we hear from parents is “what’s right for my teenager – braces or Invisalign?”  They’ve heard conflicting opinions from their friends or their dentist, but at the end of the day, they want to know what will work best for their child. At Zach Frazier Orthodontics, we believe in educating you on the pros and cons of each option so that you can choose what goes into your child’s mouth. 

You know your child better than anyone else, and you should be involved in deciding what treatment is best for them. At every orthodontic consult (that’s a first appointment, and free, by the way) I talk with patients about the advantages and disadvantages of both Invisalign and traditional orthodontic braces based on what I’ve seen treating thousands of teenagers over the past 10 years.

In this post, I will discuss my perspective as well as the merits, drawbacks, and similarities of each treatment.

Traditional Braces

The technology with braces has come a long way in the past 30 years, and our ability to shorten the time wearing braces continues to improve. Traditional braces use brackets cemented to the face of the tooth, and they can be made out of metal or clear ceramic material.  The braces hold a wire that runs lengthwise to apply pressure, moving teeth into place with ties that secure wires to the brackets. A patient sees slight changes over time as the orthodontist makes adjustments every six to eight weeks. 

Invisalign/Invisalign Teen

Invisalign and Invisalign Teen are clear BPA-free plastic appliances that offer patients an alternative to traditional metal and ceramic braces. It is a relatively newer tool for orthodontists as the technology is about 20 years old.  We take a digital scan of the teeth, creating a 3D image that’s used to produce a series of clear trays (aligners) worn by the patient for 22 hours per day (they should only be taken out to eat and brush/floss). Each aligner is configured to adjust the teeth according to a predetermined treatment plan mapped out by me, Dr. Zach Frazier. A patient sees slight changes over time as the aligners are changed weekly, and the progress is checked regularly every 8 to 12 weeks. 

Benefits

Traditional Braces

• Tried and true technology that continues to improve over time
• Participation is virtually guaranteed as there are no decisions about whether to wear or not to wear them 
• Customizable colors! (if you want them)
• May have improved outcome for complex or challenging cases
• Most patients are candidates

Invisalign/Invisalign Teen

• Clear for aesthetic appeal
• Office visits can often be spread out over fewer appointments every eight to twelve weeks
• Easier brushing and flossing
• Most patients are candidates

Drawbacks

Traditional Braces

• Metal (or even ceramic) brackets and wires are visible
• Occasional discomfort from poking wires or brackets that rub the inner portion of the lips
• Broken brackets that cause “emergency appointments”
• Brushing and flossing more challenging

Invisalign/Invisalign Teen

• Participation can sometimes be a challenge – if aligners are not worn, you will see no change
• More limitations for complex treatments and longer treatment plans
• Aligners must be removed for snacking and some teenagers are “always snacking” which reduces their aligner wear time
• Must be removed for eating which can lead to lost aligners

Similarities

• Both will cause some tooth soreness initially as treatment starts
• Both move teeth at the same rate so treatment times are similar
• Both can be used with rubber bands if bite correction is needed
• Both require you to use a retainer when treatment is completed

What’s right for you?

It may be hard to decide on what option to choose - that’s why we offer complimentary consultations!  

We sincerely will never pressure you one way or the other, and we are truly here to help find what option is best for you and your child : )  

I look forward to meeting you!

- Dr. Zach

CLICK BELOW OR CALL US TODAY FOR A COMPLIMENTARY CONSULTATION. 

Is your teen ready to start orthodontic treatment this year? Preparing your adolescent child for orthodontic treatment can help them understand the responsibility and benefits of braces and Invisalign before you start the process. While their friends can tell them what to expect, treatment is individualized to their specific needs so no two journeys are exactly the same. With over 10 years experience as an orthodontist, here are 9 common questions we get from families coming for their first consultation:

Is my child ready for orthodontic treatment? Braces and clear aligners are usually considered when most of a child's adult teeth have grown in, usually around age 11-14. In some cases, braces are needed on younger children (age 7-10) if they have specific bites or complex issues. Every child is different, and we review x-rays and photos to determine if they are ready.

What are the different types of braces available? There are different types of braces, like metal braces, ceramic braces, and clear aligners. Metal braces are the most common and are made of stainless steel. Ceramic braces are less noticeable than metal braces and are made of tooth-colored materials like ceramic. Clear aligners (such as Invisalign) are made of plastic and are removable. You can learn about the differences between braces and Invisalign here.

How long will my child need to wear braces? The length of time your child will need to wear braces depends on their specific dental issues. While it varies person to person, most people wear braces for about 1-3 years, with average cases closer to 18-24 months.

What is the cost of orthodontic treatment? The cost of orthodontic treatment varies depending your child's needs, the appliances used, and length of treatment. It's a good idea to check with your insurance company to find out how much of the cost insurance covers. Our office can also help obtain that information for you at the complimentary consultation.

What can my child expect during the braces process? Getting braces put on doesn't hurt - no shots, no needles, no numbing - but your child may feel some discomfort or pressure for a few days afterward. They need to avoid certain foods that can damage the braces, and they'll need to brush their teeth more carefully to keep their braces clean. Rubber bands are used in most cases for bite correction.

Will my child have to have a gooey mold or dental impression taken? In our office, we use 3D digital scanners to take "digital molds" of their teeth. While some offices still take the old-school plaster impressions, we are in favor of the newest technology to ensure a comfortable experience for your child.

Are there any risks or complications associated with braces? While braces are generally safe, there can be some risks, such as tooth decay, gum disease, or damage to the braces if the braces are not cared for properly. We will talk to you and your child about how to prevent these problems for the best experience possible.

How can I help support my child during orthodontic treatment? You can help your child by encouraging them to follow their orthodontist's instructions and supporting good brushing and flossing habits at home. Additionally, it is important to encourage them that with good cooperation, they will have a better result and reduce their time in braces or clear aligners.

What happens after treatment is completed? After braces are removed or Invisalign is completed, your child will need to wear a retainer to help keep their teeth in their new position. We have options for retainers at the end of treatment, including bonded (fixed) retainers and removable retainers.

We hope this helps you prepare for an upcoming consultation. Still have something you'd like to ask before you commit? Feel free to send us a message here and we'd be happy to help answer your questions : )

Dr. Zach

Hi Downers Grove area parents! I know that many of you are aware of Invisalign®, the virtually invisible way to straighten teeth without metal braces, but I’m often asked for more information about Invisalign® Teen, specifically. Parents are curious about how (and if!) these clear aligners can really work for their teens.

Here’s the short answer (TL;DR as the kids are saying) - rather than wires and brackets, Invisalign® Teen uses a series of clear, removable aligners that have been custom-made for your teen’s teeth, a result of precise images I take with the sophisticated iTero Element Scanner. Your teen simply wears these aligners over their teeth and changes them out for a new set of aligners periodically—most often every week. Little by little, your teen’s teeth gradually shift into place.

For those of you who want more information, here are the answers to the top five questions I’m asked about Invisalign Teen. I hope you find it helpful!

1. INVISALIGN TEEN CAN BE AS EFFECTIVE AS TRADITIONAL BRACES.

When worn according to the customized plan I set in place as your child’s orthodontist, Invisalign Teen can be as effective as traditional braces. In fact, the chances are very high your teen will be a candidate for Invisalign as it can treat many of the common issues we see. Call us at (630) 541-3696 to set up an appointment to find out for sure. And, don’t worry, we’ll never pressure you into a decision - traditional braces are often a great choice as well! 

2. THERE ARE PRACTICAL ADVANTAGES OF INVISALIGN TEEN OVER TRADITIONAL BRACES.

With Invisalign, the aligners are removable, so your teen can play sports, musical instruments and eat their favorite foods without the worry that braces will get in the way. Plus, it’s much easier to brush and floss normally in order to maintain proper oral hygiene. If getting into the hard to reach places is already a struggle for your teen, Invisalign aligners may be a good choice over traditional braces. 

3. INVISALIGN TEEN COSTS ABOUT THE SAME AS BRACES.

In our office, our goal is to make treatment affordable no matter which option you choose. That’s why we are flexible with down payments and offer low monthly payments, regardless which path you choose for straightening your teen’s smile. Because of this, we find that the slight variation in cost of treatment is not a deciding factor for most patients. 

4. YOUR TEEN HAS TO WEAR THE ALIGNERS MOST OF THE DAY.

How many hours does that really mean, you ask? Invisalign Teen is most effective when worn 20 to 22 hours per day and changed approximately every week. Simply put, unless they’re eating or brushing their teeth, your teen should be wearing their aligners. 

5. YOU’LL SPEND LESS TIME AT MY OFFICE THAN WITH TRADITIONAL BRACES.

Invisalign Teen often requires less time with your orthodontist than traditional braces do. After the initial appointment, follow-up appointments are usually less frequent and scheduled every eight to twelve weeks. There are minor adjustments to make, but no changing and bending of wires. 

If you’re interested in learning more about Invisalign Teen, or curious if your teen is a candidate, reach out! At my practice, all consultations are free and we always present your options so that you can make an informed decision about treatment for your child. 

Just click below to schedule that complimentary consultation. I can’t wait to meet you and your teen! 

- Dr. Zach

Hey parents - we get it. Finding room in the family budget for straight teeth is a challenge amongst everything else going on. Sports uniforms, violin lessons, iPhones, vacations - kids sure are expensive. And I totally understand - I have kids of my own, and there always seems to be something coming up.

As we all plan for 2023, I want to help by giving you some honest and actionable advice to help you save on your orthodontic treatment. It may take a little research, but it will be well worth it in the end!

1. EMPLOYER INSURANCE PLANS COVER TWEENS AND TEENS:

If you are looking at plans for 2023 and your employer offers an option with an orthodontic benefit, the best time to plan is now. Schedule a consultation with an orthodontist to see if your child will need braces in 2023. If they do, then you can do the math to see if the extra premium is worth it. If they don't, see if you can get a timeline of when he or she will be ready. This way you only pay the additional premium if you're going to use it. At ZFO we offer complimentary consultations, so there’s no risk of losing cash for the sake of planning ahead - plus, no referrals necessary. : )

2. GO TO AN OFFICE THAT WORKS DIRECTLY WITH YOUR INSURANCE TO SAVE YOU TIME & MONEY:

Many people do not realize it, but not all offices give treat insurance the same. While some offices may work directly with your insurance company to secure your benefit, others will leave you with the responsibility of dealing with the insurance company to collect your benefit. If you go to an office who is not handling your insurance, you will pay more up front for your treatment and be left with the responsibility of doing your own insurance homework. Our office prides ourselves on going above and beyond for your family: we will file the insurance claim, follow up with the insurance, and do all the legwork to ensure your claim is paid to off-set your out-of-pocket cost. Additionally, at ZFO we are in-network with many PPO plans, so you can ensure you are getting the maximum benefit possible for your orthodontic treatment. Call us to see if your plan is one of them. 

3. FLEXIBLE SPENDING ACCOUNTS AND HEALTH SAVINGS ACCOUNTS:

FSAs are a great way to take advantage of your employer benefits to help reduce some out-of-pocket costs on teen orthodontic treatment. Visit your orthodontist before you set your FSA limits for 2023 to find out how you can plan your payments. Our financial coordinators are a great resource! HSAs are also a great way to use pre-tax dollars to your benefit to pay for teen orthodontic treatment.

4. PAYMENT PLANS:

Most orthodontists will offer in-house financing with 0% interest on the monthly payments. This can be a huge advantage for a family trying to budget out the cost of braces or Invisalign® for multiple kids, so be sure to talk with the office to see how the payments can be arranged. You may be surprised to find out that offices like ours are willing to finance beyond the treatment time or accept a small down payment as low as a couple hundred dollars. All you have to do is ask : )

5. SCHEDULE A COMPLIMENTARY TEEN ORTHODONTIC CONSULTATION NOW:

Timing is everything and you won’t know if your tween or teen is ready for orthodontic treatment unless you get them checked out by a specialized practitioner. Orthodontists receive 2 additional years of specialized schooling above and beyond their dental certification, making them the right person to determine timing for orthodontic care. While some kids are good candidates for early orthodontic treatment around age 8, many more begin treatment closer to age 11 or 12. If your child is approaching this age range, schedule a complimentary consultation with us and we can help you plan your timing! You may not need to look into any of the above until late 2023 as you plan for 2024 - but at least you’ll know. 

At Zach Frazier Orthodontics, we take pride in our ability to make treatment affordable while maintaining the highest standards of care and customer service. How do we do it? Well, frankly, we are different than most offices in that we do the following:

• 100% transparency & no pressure – we are not here to sell you anything!
• Complimentary consultations, with no referral needed
• Time and cost efficiency – shorter treatment times equals less cost
• Latest technology and materials for the best results
• Custom payment options to optimize your FSAs and HSAs
• Low down payments on treatment
• Thorough plans and clear communication from start to finish

As a member of the COMMUNITY, I would not be able to do my job any other way. My patients are your friends, your family, and your neighbors; and we are proud of our reputation. Feel free to send us a text or email - we are here to help you : )

#LOVEYOURSMILE

- Dr. Zach

Ever wonder what your smile will look like once you close that annoying gap or fix the crowding? While a doctor can explain the process of straightening your teeth and adjusting your bite, it may be hard to envision what YOUR teeth will actually look like once treatment is complete. Well, at ZFO we have great news for you – we have powerful technology to show you what your future smile will look like! With a clear picture of the expected results, you can  judge for yourself if orthodontic treatment is right for you or your child.

How are we able to show you the result before starting treatment? We use a high-tech iTero intraoral scanner to take a 3D model of your mouth (that’s right – no more goopy impressions!) and then we use software to move your teeth right in front of you on the screen. The software allows us to show you esthetic changes as well as bite correction changes that are needed for an excellent result.

At every complimentary consultation, I use our Smile Simulator technology to show patients what their final outcome will look like. Not only does it help you feel confident that the 6-24 month journey you’re about to embark on will be worth it, but it gives you and/or your child incentive to focus on the end goal with good participation. Everyone knows what we’re working towards from the very start, and seeing is believing.

I became an orthodontist for many reasons, but one of them is that I love building relationships and helping increase their self-confidence in patients. I see providing this glimpse into the future as an important part of each of those journeys. Knowing what our shared goal is helps me connect with you and helps you take pride in the treatment. 

If you’re considering orthodontic treatment for your child, tween or teen (or yourself), we’d love to meet. Zach Frazier Orthodontics is a no pressure practice and all consultations are complimentary. 

Come see us and see what the smile of your dreams might look like today. 

To schedule that complimentary consultation, click or call below.

-Dr. Zach Frazier

CLICK BELOW OR CALL US TODAY FOR A COMPLIMENTARY CONSULTATION. 

We were honored to recently be featured in DMG DENTALPROFILES! You can view it here (page 59) or read below!

Can you share your journey to becoming an orthodontist? 

I started my education here in Downers Grove at Highland Elementary School, Herrick Middle School, and Downers Grove North. Growing up, I never had my thoughts set on being an orthodontist; instead, I thought about doing something that involved healthcare. My parents are both in healthcare, and I had many extended family members involved in that field as well. After high school, I studied molecular biology and Spanish at The University of Illinois, and after graduation, I began working for an oral surgeon. After this experience, I decided to apply to dental school at the University of Illinois at Chicago (UIC), followed by my orthodontic specialty degree from Washington Hospital Center in Washington, D.C. I was drawn to orthodontics in dental school as I felt like it was the “fun” part of dentistry - no numbing, no needles, etc. I enjoyed the cosmetic and artistry part of orthodontics.

What makes Zach Frazier Orthodontics unique?

A few things make us unique. First, our mission is to serve and improve the community, which is why we are so heavily involved in supporting many schools and organizations locally. Internally, we are seriously dedicated to customer service and communication. We believe there is nothing more important to us than making our patients and their families happy, and we are willing to go above and beyond to prove this. Service, communication, and transparency are sometimes overlooked in the medical field, but those are our key priorities. Straight teeth and a healthy bite are the expectation with any orthodontic office, but we strive to make the experience better than anyone else.

As heavily involved in the community as you are, what are some of the organizations you support and why? 

In the six years that we have been in business, we have made over $40,000 in contributions to 36 community groups/schools/organizations. There are so many to name! We have made many contributions to District 58 & District 99 schools and the private schools in Downers Grove. I attended District 58 & 99 schools growing up, and I love giving back to the schools that helped shape my future. We also have provided support for some schools in the towns surrounding Downers Grove. We are a huge sponsor for many Downers Grove area sports clubs, including Roadrunners soccer, Rebels softball, Hitmen baseball, Fury baseball, Longshots baseball, Panthers football, Downers Grove Youth Baseball, and many more. It is an incredible opportunity to support so many kiddos who come into our office and sponsor their teams. Within Downers Grove, we also support many community groups, such as Downers Grove Junior Woman’s Club, Navigate Adolescence, and The Grove Foundation.

Besides bringing beautiful smiles to your patients, what is the most rewarding part about being an orthodontist? 

One of the most rewarding parts is meeting so many great people. Our dental specialty is very social, and seeing families come in over many years is fun. I love seeing old classmates in the office with their kids.

As a native of Downers Grove, what was your experience growing up here? 

I loved growing up in Downers Grove. I grew up watching movies at the Tivoli with my family, getting ice cream at Every Day’s a Sundae, and heading to McCollum for soccer games. There are so many great memories of playing for Downers Grove North soccer at Carsten’s Field. One thing that is awesome about Downers Grove is that many of my friends who share those memories still live here, too, and we are now reliving those memories with our kids. That’s one of the unique things about Downers Grove – people come back here to settle down and raise their kids, and I think that says a lot about the vibe of this town.

CLICK BELOW OR CALL US FOR A COMPLIMENTARY CONSULTATION

Adolescents are active, so it is no surprise that there are plenty of questions about mouthguards when it comes to orthodontic treatment. In general, a mouthguard is a great investment for protecting the teeth, especially in high-contact sports. They should be considered for many sports and activities, even if braces are not being worn. Here are some common questions and answers:

• Can you wear a mouthguard if you have braces?

  Yes, you can wear a mouthguard when you have braces. There are special mouth guards that are made specifically to fit over braces.

• What sports require a mouthguard with braces?

  Many high school sports associations require a mouthguard for football, hockey, field hockey, lacrosse, and wrestling. The ADA also recommends a mouthguard for other contact sports like basketball and martial arts, as well as other limited contact sports such as baseball, softball, and extreme sports.

• Is it recommended to use a mouthguard while in braces?

  Unless specifically required by your sports association, it can be a personal decision based on your comfort level and ability to breath adequately while performing. The benefit of a mouth guard is it will limit damage to teeth and soft tissues around the mouth when worn properly. Not only will it help protect the teeth, but it will protect the lips and cheeks from injury from any orthodontic appliances.

• What is the best mouthguard for braces?

  In our office, we have found that the Shock Doctor Braces Mouthguard has worked well for many patients. It has a strap so that it can be used in sports like football. The strap can also be removed so that it can be used in sports like basketball.

  [caption id="attachment_308" align="alignleft" width="300"] Shock Doctor ® Braces mouthguard[/caption]

• Can you use a boil and bite mouthguard with braces?

  No, you should not use a build and bite mouth guard with your braces. It may wrap around the braces and get stuck in place, or cause damage to the braces. Also, keep in mind that the teeth are continuing to move, so you do not want to have a mouthguard specifically molded to your teeth as they are changing.

• Can I use a custom made mouthguard while in braces?

  No, you will not likely be able to use a custom mouthguard since your teeth are still moving. The mouthguard will not fit for the duration of the treatment, and it may get stuck on the braces if it is forced in place.

• Where can I get a mouthguard for braces?

  You can find a mouthguard for braces online or in some sporting goods stores. Some orthodontists may also have them in their office for patients. At Zach Frazier Orthodontics, we have the Shock Doctor Braces Mouthguard available in office for our patients.

• Can I wear a mouthguard with Invisalign?

  If you are in Invisalign treatment, you should still wear a mouthguard for sports if it is recommended by your association or a sport with significant contact or injury risk (football, basketball, hockey). You can remove your Invisalign and use a general one-size-fits-all mouthguard while playing the sport. You will not be able to use a custom fitting or boil and bite mouthguard as your teeth are still moving. If you are in a non-contact or limited-contact sport, you should continue to wear your Invisalign while you are playing the sport.

• Can I wear a mouthguard with a palatal expander?

  Yes, you can wear a mouthguard with a palatal expander. It will need to be trimmed and adjusted around the expander to allow it to fit properly.

I hope this is helpful to provide some insight on mouthguard recommendations for braces. As always, if you need more information, please reach out to our office anytime - we are happy to help : )

According to the National Institute of Dental and Craniofacial research, the prevalence of TMJ problems (also known as temporomandibular joint and muscle disorder) is between 5% - 12% of the population. It is more common in females than males, and tends to affect younger people more often.

While orthodontic treatment does not cause TMJ issues, studies also show that it cannot prevent or treat TMJ pain either. Here are some common questions that you may have if you are in orthodontic treatment and are now experiencing some jaw joint pain.

What does TMJ stand for and what is it?

• TMJ stands for temporomandibular joint. It is located directly in front of your ears, and it is where your lower jaw hinges upon opening and closing.

What are TMJ problems?

• TMJ problems include clicking/popping joints, painful joints, or restricted jaw movement. TMJ problems may vary in severity from mild pain to severe pain, and the pain may be a temporary pain or a constant pain. TMJ problems may be related to the actual joint (bones and ligaments), or it may be related to the muscles around the joint.

What causes TMJ problems?

• TMJ problems may be caused by an injury to the face or jaw, grind/clenching of teeth, stress, muscle fatigue or overuse of the jaw joint. Additionally, it is linked to hormonal changes in women that cause laxity of the ligaments in the jaw joint. TMJ problems are most common in teenage girls and young women.

What can I do to improve my TMJ problems or TMJ pain?
Most TMJ problems can be managed by these conservative measures:

• Maintain a soft diet, and avoid chewy food and chewing gum.
• Use warm, moist heat on the jaw muscles to increase blood flow and massage the muscles. Alternate the warm moist heat with an ice pack on the joint area which will help reduce inflammation of the joints.
• Use anti-inflammatory medications to help reduce pain and inflammation. Ibuprofen is the most common, but you should consult your physician with which anti-inflammatory medication is best for you.
• Avoid clenching your teeth by setting up reminders to keep your teeth apart and jaw muscles relaxed.
• Monitor your stress and manage it to avoid muscle tension and clenching.

What if my symptoms do not improve with conservative therapy?

• If your symptoms are not improving, a referral will be made to another doctor who specifically manages TMJ problems. They may recommend more diagnostic imaging (like an MRI) to evaluate the jaw joint to find the cause of the problem. In some cases, a night guard may be recommended to help alleviate some pain.

Can I continue my orthodontic treatment?

• In some cases, orthodontic treatment may be paused for a period of time, and occasionally it may be discontinued depending on the circumstances. The recommendations are on a case by case basis.

If you have any other questions, please let your orthodontist know. More often than not, a little patience and conservative measures will improve the TMJ pain, so hang in there : )

Perhaps you have memories of sitting in a dental chair anxiously waiting for a dental impression (dental mold).  Memories of a cold, gooey mixture inching closer down your throat. Memories of drool hanging off the edge of your lip while the mold is held in place. The very thought of it for some people will make them gag!

We have good news for you: meet the intraoral scanner. While this technology has been out for some time, it is still not universally used. Here are some information about what it is and how it will make your trip to the orthodontist much better.

1. What is 3D digital intraoral scanner?

   1. It is a high-tech video camera that captures images of your teeth to create a 3D digital model of your teeth.

2. Does it use any radiation like an x-ray?

   1. No radiation is used - it is simply a video camera that stitches many images together to create the 3D image of your teeth.

3. How long does it take to have your teeth scanned?

   1. It depends on the experience of the user, but in most cases it will take less than 5 minutes to get a full scan of all of your upper and lower teeth.

4. What do you do with the 3D image?

   1. We can use the image in lots of ways. We can use it to diagnose your bite or create 3D printed physical models of your teeth. With the printed models, we can make all sorts of orthodontic appliances and retainers without ever having to take a dental mold.

5. Do you still have to take a mold to get retainers?

   1. No way : ) Our patients do not have to have dental impressions taken at any time.

6. Can this be used for Invisalign clear aligner treatment?

   1. Yes! Additionally the aligners will be better fitting as a 3D intraoral scanner is more accurate than traditional dental molds.

We absolutely love the 3D intraoral scanners in our office. Treatment is dramatically more comfortable for our patients leading to a better experience. Additionally, we are getting more accurate orthodontic appliances which leads to better treatment and reduced time spent at the orthodontist. Finally, it is great form an environmental standpoint as there are fewer steps, fewer appointments, and less waste by using the scanner.

If you're interested in pursuing braces treatment or you are considering Invisalign clear aligner treatment, make sure you visit an orthodontist with a 3D intraoral scanner. You will thank me later ; )

All of us are born with the innate sucking reflex. It is needed to survive as an infant and helps us eat as babies. As we develop, some babies will use a thumb, finger, or a pacifier as a comforting mechanism. However, at some point, this habit can start to cause harm to the developing teeth and bones of the mouth.

At what age do kids need to stop sucking thumbs or using pacifiers?
- Depending on how much sucking pressure your child uses on his thumb or pacifier, you may start to see changes as soon as age 2-4 years old. You may notice flaring of the front teeth and changes to the shape of the smile. Typically, these changes can self-correct if the child is done with the habit by age 6 before the adult teeth start to erupt.

Why do we need to break the habit?
- The habit can permanently change shape of bones of the mouth and permanently change the shape of the smile.  Some long-term habits can cause irreversible changes that cannot be fixed with orthodontic treatment alone. Additionally, it will create issues that can make orthodontic treatment more time-consuming, more complex, and more expensive.

How can we start to break a pacifier habit?
Typically a thumb habit is more challenging to break than a pacifier habit because you cannot take a thumb away : ) In most cases, you will start this process at a younger age while the child is still a toddler, and in many cases they will stop on their own. Avoid harsh words or punishment as this is not effective for this age group. Praise progress and use rewards charts to help encourage them to quit. Beware - in some cases, a new thumb or finger habit may emerge!

How can we start to break a thumb habit?
- Be conservative at first! If your child in pre-school or early elementary school, start by talking about it. Kids must be on board to quit; if they do not want to quit, conservative approaches may not be successful, and you may have to revisit it again after waiting a few months. The earlier you start the conversation, the better of you are since the upper front adult teeth will come in around age 6-7. I recommend starting out with simple reminders such as wearing a Band-Aid on the thumb or finger.

My kid is now on board - what can we do to help him quit his thumb habit?
- While they may relapse at times to find comfort, you may need to use additional items to help kick the habit. You can try a baseball batting glove, thin winter glove, or sock over the hand at night time. You can loosely add medical tape around the wrist to make it more difficult to remove, but please be sure it is not too tight. Another product is Mavala Stop which is a sour tasting nail polish to serve as a reminder. Always remember - couple the reminders with a tracking and reward system to celebrate the small wins. Praise will help keep the kids motivated - remember they want to make you happy!

What if the conservative habit break measures don't work?
- More aggressive physical reminders in addition to the above may be needed. An Ace bandage wrap around the elbow will make it more difficult to bend the elbow which will restrict their ability to bring their hand towards the mouth. You may also consider a wrist guard thumb habit appliance (TGuard brand) that is fixed to the wrist and plastic around the thumb/fingers

What if everything else does not work - what is our last resort?
- Orthodontic appliances are the last resort. If all else fails and we see the habit is causing significant bone changes, we can make what we call a "habit appliance" and cement it to the molars in the mouth. It is like a metal cage that fits near the roof of the mouth and difficult to remove. Typically, we will keep it in place for 9 months, but no less than 6 months in order to break the habit. If this appliance is needed, many times a palatal expander will be needed afterwards to correct the changes that have occurred due to the habit.

Orthodontists are skilled in helping you and your child with their habit issues. Additionally, we are skilled at correcting the problems that prolonged habits may cause. Be sure to talk to your local orthodontist early about breaking the habit - it will certainly make a difference in the long run!

Orthodontic separators (also known as “spacers”) are small latex-free rubber bands that fit in between two teeth to make space in preparation for fitting an orthodontic band or ring around the tooth. These are commonly placed before a palatal expander is placed.

What can my child expect after the separator or "spacer" is placed?

1. Mild soreness from the spacer is expected – use over the counter pain medications as needed.
2. Pressure or feeling of something stuck between the teeth is normal.
3. If the spacer falls out a few days before the next appointment, that usually means enough space has been made.

Tips:

1. Do not try to remove the spacers at home – this may delay fitting the orthodontic band or appliance at the next appointment
2. Avoid sticky and chewy foods that may dislodge the spacer
3. Brush the area normally but do not floss the area with the spacers

If the spacer falls out before your next appointment, the ring around the tooth should still fit in most cases so there is no need to come in for a separate appointment. If you have any questions or concerns about the spacer, please call our office, as we are happy to help!

After being temporarily closed for a long 8 weeks, we are ready to make you smile again! We had to postpone hundreds of appointments, so we have a long road ahead to catch up. Rest assured, we will get there!

As we move forward with some new guidelines, we ask for patience and understanding. The new guidelines are for everyone's benefit in order to have a safe environment for care as well as to provide an efficient way to get everyone back on track.

Here is what you need to know:

APPOINTMENTS AND SCHEDULING:
- PLEASE WAIT FOR OUR OFFICE TO CONTACT YOU FOR AN APPOINTMENT. We have a long list of people to contact, and this will make for more efficient scheduling by our team.
- COMFORT/URGENT APPOINTMENTS: These appointments will still only be seen on an as-needed basis for significant pain or bleeding. For now, broken brackets are not considered urgent comfort appointments. Need advice - click here!
- RETAINER CHECKS: All retainer check appointments will be postponed until the fall with exception of certain cases that Dr. Zach sees necessary; if you have retainer concerns, please call us and we can still schedule an appointment
- GROWTH CHECKS: Growth check appointments will be seen on a case-by-case basis; in many cases, they will be postponed until the fall; if you have concerns and would like to be seen sooner, please call us and we can still schedule an appointment

BEFORE YOUR VISIT:
- PLEASE BRUSH YOUR TEETH THOROUGHLY RIGHT BEFORE YOUR APPPOINTMENT and do not come in with excessive food or debris on your teeth/braces. Our tooth brushing station is closed and is now a designated station for our patients to wash their hands.
- EVERYONE WHO ENTERS OUR BUILDING MUST HAVE A MASK (both patient and parents). Please come prepared.

YOUR VISIT:
- FOR ALL MINORS (18 and younger), a parent must be at the appointment to sign a questionnaire regarding COVID symptoms and exposure. If you cannot come, you must contact our office prior to the appointment for the form and send a SIGNED COPY with your child. Unfortunately, we cannot make any exceptions to this rule.
- PLEASE ARRIVE ON-TIME. We have staggered arrival times to limit the number of people in our building at any given time. Arriving too early will likely lead to waiting, and late arrivals may need to be rescheduled.
- When you arrive, REMAIN IN YOUR CAR AND CALL our office to let us know you have arrived. We will let you know when to come in.
- For any minor patient, ONE parent/guardian should come in to sign a questionnaire form regarding COVID symptoms and exposure. Absolutely no other individuals will be allowed. We encourage that parents return to their car after signing our questionnaire.
- DO NOT COME IF YOU ARE FEELING ILL. Any question indicating recent exposure to COVID-19 or anyone with signs/symptoms will be asked to leave immediately and will not be able to return for at least the specified 14-day self-quarantine requirement.
- THE PATIENT’S TEMPERATURE WILL BE TAKEN using a touchless thermometer. If the temperature is > 100 degrees F, you will be asked to leave immediately and will not be able to return for at least the specified 14-day self-quarantine requirement.
- PLEASE MAINTAIN 6-FOOT SOCIAL DISTANCING guidelines while in the office and seated in the waiting room. Reception furniture has been limited to accommodate this guideline.
- Patients will be asked to wash or sanitize their hands before and after their appointment.
- Patients will be asked to rinse with Colgate Peroxyl mouth rinse at their chair where an assistant will suction.
- We ask for understanding as we try to address all of your needs at your visit. Individuals with multiple broken brackets or issues may not have everything completed during the visit due to strict scheduling times. If you anticipate you or child needs more time for these issues, let us know beforehand.

AFTER THE VISIT:
- DO NOT DRIVE HOME RIGHT AWAY - WE NEED TO SCHEDULE YOUR NEXT VISIT! For child patients, one of our team members will call you to update you on progress and schedule the next appointment. We will not be scheduling at our front desk at this time.
- ADULT PATIENTS – you will be scheduled while seated in the chair.

OUR NEW PROTOCOLS:
- HOURS: Our office hours are now Monday to Friday 8:00am to 4:00pm until further notice. We have extended our clinic hours to space out appointments, catch up on overdue treatment, and allow for extensive cleaning of our office twice per day. We will notify you once normal hours of operation resume in the future.
- BARRIERS: You will notice clear barriers at our front desk as well as in our consult room. Additionally, we have placed barriers between our chairs in the clinic (which are 7 feet apart). We will continue to operate our medical grade HEPA filter in our treatment area (this has been present prior to the pandemic).
- CLEANING: Office cleaning will take place in the morning, midday, and evening.
- RECEPTION ROOM: Furniture has been limited and no magazines or books are available. We encourage non-patients (parents/guardians) to wait in the car or outside.

TEAMWORK:
- OUR TEAM IS SCREENED ON A DAILY BASIS with a questionnaire, and temperature is taken daily. Any team member with COVID symptoms or a fever >100 degree F will be required to go home.
- OUR TEAM HAS BEEN THOROUGHLY TRAINED on the new protocols. Please be patient as things may take more time at first as we are adapting to our new protocols.

Our priority has always been delivering the absolute best orthodontic in a safe and timely manner - that still remains our top priority. We are still committed to this community for the long haul, so while some things will be different about our office in the short-term, our mission has not changed!

Questions or concerns should be addressed by calling or emailing our office - we are here for you. We understand this may be the first time many of you are leaving your home in 8 weeks, so please do not hesitate to let us know how we can make you feel safe and secure. See you soon!

• Dr. Zach