Timeless Smiles for Children, Teens and Adults

Kyle S. Wendfeldt, DDS, MS
Board Certified Orthodontic Specialist
American Board of Orthodontics

1937 Central Avenue
Ashland, Ky 41101

Phone: (606) 329-0038
Fax: (606) 329-0058
Email: info@ashlandfamilyortho.com

Office Hours:
Monday-Friday
8 a.m. to 5 p.m.

Privacy and Health Insurance and Accountability Act (HIPAA) Information

Treatment

Early Treatment

When is the best time to begin orthodontics?

Though an orthodontist can enhance a smile at any age, there is an optimal time period to begin treatment. Beginning treatment at this time ensures the greatest result and the least amount of time and expense. The American Association of Orthodontists recommends that the initial orthodontic evaluation should occur at the first sign of orthodontic problems or no later than age 7. At this early age, orthodontic treatment may not be necessary, but vigilant examination can anticipate the most advantageous time to begin treatment.

Why is age 7 considered the optimal time for screening?

By the age of 7, the first adult molars erupt, establishing the bite of the back teeth. During this time, an orthodontist can evaluate front-to-back and side-to-side tooth relationships. For example, the presence of erupting incisors can indicate possible overbite, open bite, crowding or gummy smiles. Timely screening increases the chances for an incredible smile. For most, the principal immediate benefit is a parent's peace of mind. A family dentist who makes timely referrals is rightly regarded as informed, caring and concerned for the total well being of the patient.

What are the benefits of early orthodontic evaluation?

Early evaluation provides both timely detection of problems and greater opportunity for more effective treatment. Prudent intervention guides growth and development, preventing serious problems later. When orthodontic intervention is not necessary, an orthodontist can carefully monitor growth and development and begin treatment when it is ideal.

For those patients who have clear indications for early intervention, early treatment presents the opportunity to:

• Improve aesthetics and self-esteem
• Improve some speech problems
• Creating facial symmetry through influencing jaw growth
• Influence jaw growth in a positive manner
• Harmonize width of the dental arches
• Improve eruption patterns.
• Creating room for crowded, erupting teeth
• Reducing the risk of trauma to protruding front teeth
• Preserve or gain space for erupting permanent teeth
• Reducing the need for tooth removal
• Correct harmful oral habits
• Simplify and/or shorten treatment time for later corrective orthodontics
• Reduce likelihood of impacted permanent teeth

Adolescent Treatment

If you are a pre-teen or teenager you have probably wondered if you are going to need braces. Modern orthodontic treatment performed by a trained and experienced orthodontic specialist can be a pleasant experience. These are not the painful, bulky braces your parents wore in the 1960's or 1970's! Today's braces can be decorated with cool elastic colors, be nearly invisible,or completely clear (InvisalignR). Microscrew Temporary Anchorage Devices (see Braces and Today's Technological Advancementsin the Treatment section) as an alternative to external headgear is the latest technology we provide to make your orthodontic experience efficient and more socially acceptable. We are committed to helping you achieve the smile you deserve - a healthy, beautiful one that is truly remarkable!

Adult Treatment

Are you a candidate for orthodontic treatment?

Orthodontics is not merely for improving the aesthetics of the smile; orthodontic treatment improves bad bites (malocclusions). Malocclusions occur as a result of tooth misalignment or jaw discrepancies. Malocclusions affect the way you smile, chew, clean your teeth or feel about your smile.

Why should malocclusions be treated?

Braces aren't just for kids anymore. Tooth alignment can be changed at any age if your gums and bone structure are healthy. We offer a variety of treatments that are designed for different age groups - including adults. A new smile can begin today.

Numerous clinical research trials have demonstrated that untreated malocclusions can result in a variety of problems. Crowded teeth are more difficult to properly brush and floss, which may contribute to tooth decay and/or gum disease. Protruding teeth are more susceptible to accidental chipping. Crossbites can result in unfavorable growth and uneven tooth wear. Openbites can result in tongue-thrusting habits and speech impediments. Ultimately, orthodontic treatment does more than make a beautiful smile- it creates a healthier, better functioning bite.

Orthodontic treatment at later stages in life can dramatically improve your personal appearance and self-esteem. Improving the health of your teeth and gums is equally important. Crooked teeth and a bad bite can contribute to gum and bone loss, tooth decay, abnormal wear of tooth enamel surfaces, headaches, and jaw joint (TMJ/D) pain. Good news! The new techniques and appliances we use greatly reduce discomfort levels, decrease the frequency of visits, shorten treatment time, and may allow you to choose from several options. Your options may include metal braces, clear braces, or transparent aligners to improve mild cases of misaligned teeth.

During the initial examination, we will be able to determine the best possible treatment for your individual needs. During this initial examination, we can outline the treatment plan, time of treatment expected and the approximate cost.

Having served in the US Air Force, Dr. Wendfeldt's has treated hundreds of routine and complex adult orthodontic and surgical cases. Careful coordination between dental and medical specialists may be required yet rest assured that Dr. Wendfeldt has the experience and expertise to coordinate the replacement of teeth that have been missing for many years. It's never too late to improve your greatest asset - a healthy, beautiful smile. Please see Before and After in the Treatment section for examples of truly remarkable smiles that Dr. Wendfeldt has created for his patients.

Retention

Removing braces signals the start of the retention and observation period of orthodontic care. Please remember that this part of your orthodontic treatment is just as important as the active movement phase in determining the ultimate success of your treatment. Once the teeth have been moved into their desired positions, a period of time is needed to stabilize the teeth so that the surrounding bone and soft tissue can conform to your new dental alignment. When braces are removed, it is a good time to review several important aspects of care.

Patients in the retention phase are seen periodically in our office during the first year after braces are removed. Patients will continue to see Dr. Wendfeldt until he feels they can be dismissed from treatment. It is then the patient's responsibility to wear a retainer as prescribed. Please call our office if you have any concerns regarding your retainer.

Typically, a removable retainer is worn at night only. A bonded retainer may be used on the inside of the lower front teeth and, in some cases, on the inside of the upper front teeth. This bonded retainer is designed to allow for easy flossing and brushing and can be worn indefinitely. If a decision to remove your bonded retainer is made, a removable retainer may be fabricated and be worn while sleeping.

For lasting success from orthodontic treatment:

• Wear your retainer as prescribed.
• Don't let your retainer become distorted, bent, or otherwise damaged.
• Call for a repair appointment if your retainer is damaged or loosened.
• Keep your retainer clean and floss regularly.
• Keep your retainer in its case when not being worn.
• Be committed to maintaining your beautiful smile

Braces and Today's Technological Advancements

Modern orthodontic appliances are not like the bulky and painful appliances of the Olden Days. Technological advancements in biologically compatible materials and improved manufacturing techniques have made today's braces smaller, smoother, faster to finish, and less painful than appliances were even 5 years ago. Esthetic brackets and wires have opened a world of possibilities to image conscious adults who would not even consider the large and unsightly braces of the 1960's - 1990's.

In early 2001, Align Technologies Inc., patented a method for making clear plastic "aligners" that could progressively move teeth without orthodontic brackets and wires. We are committed to providing definitive solutions to give you a beautiful, healthy smile...even if you aren't interested in today's esthetic orthodontic appliances. Invisalign® and Orthoclear® are both invisible orthodontic appliances we can provide for you to correct minor orthodontic problems such as rotations and slight to mild crowding or spacing.

Microscrew temporary anchorage devices are miniaturized titanium screws that serve as absolute anchors to move other teeth against. First, a topical anesthetic is given to temporarily numb the gum tissues then your oral and maxillofacial surgeon will gently rotate the titanium screw into position. Other than occasional minor soft-tissue irritation for 24 hours after placement no other complaints of pain has been reported. These microscrew anchors can be used instead of the old mainstay- high pull headgear. Although biomechanically acceptable many patients do not like the unacceptable social appearance of high pull headgear. Microscrew anchors can perform the same functions as high pull headgear without anyone else knowing because all devices are hidden inside the mouth. The microscrew is simply removed with a counter-clockwise motion when orthodontic treatment is complete. Usually no anesthesia is required for removal.

Common Orthodontic Problems- A Guide to Detecting Bite Problems

An orthodontist reviews many factors when first making an evaluation. Although treatment plans vary from patient to patient depending on the position and size of the jaws and teeth the following facts are noted during your evaluation. Please take a few minutes to review the diagrams below to help your orthodontist find answers to your bite problem.

Frequently Asked Questions

1. Why should you choose an orthodontic specialist?

   Teeth, and sometimes entire facial structures, are permanently changed by orthodontic treatment. It is important that the treatment be appropriate and properly completed. Orthodontic specialists have extensive and specialized training in growth and development, biomechanics, dental materials, and esthetic reconstruction that enables them to provide their patients with professional, personalized treatments. For more information see http://www.americanboardortho.com/about/ , http://www.braces.org/knowmore, or http://dentistry.ky.gov/specialists_information/.

2. Is it required that my family dentist schedule my appointment with the orthodontist?

   No. Although we strongly recommend patients be referred by their family dentist, many patients take the initiative to schedule an examination themselves.

3. At what age should I schedule an appointment for an orthodontic screening?

   The American Association of Orthodontists recommends an orthodontic screening at age 7. By this age, several permanent teeth in most children have erupted, allowing us to effectively evaluate your orthodontic condition.

4. Will my teeth straighten out as they grow?

   No, they will not. The space available for the front teeth does not increase as you grow. Facial width increases until age 8-9 years. In most people, after the permanent molars erupt at age 6-7 years, the space available for the front teeth decreases with age.

5. How do I schedule an appointment for an initial exam?

   If you or your child can potentially benefit from orthodontic treatment, simply call our office, send us an e-mail, or fill out our appointment request form online in the Contact Us section of this website. We will be happy to schedule an appointment for you. When you call to schedule your appointment, our front office staff will request some basic information from you.

6. What will happen at the initial examination appointment?

   Upon arriving, each patient and parent will be seen by the staff and doctor who will welcome you to our office and prepare for the initial exam. We will take the necessary photographs and X-rays to allow us to make a proper diagnosis. The doctor will then complete a brief, but thorough, exam. See Your First Visit at the beginning of the Treatment section of this website.

7. What will I learn from the initial examination?

   There are five essential questions that we will cover during the initial examination:

   • Is there an orthodontic problem, and if so, what is it?
   • What must be done to correct the problem?
   • Will any teeth need to be removed or surgery performed?
   • How long will the treatment take to complete?
   • How much will the treatment cost?
8. Will I need to have teeth extracted for braces?

   Removing teeth is sometimes required to achieve the best orthodontic result. Straight teeth and a balanced facial profile are the goal of orthodontics. However, new technology such as microscrew temporary anchorage devices has made treatment possible today that was not available in the late 1990's. Removing teeth is not always necessary for orthodontic treatment.

9. How long will it take to complete treatment?

   Treatment time obviously depends on each patient's specific orthodontic problem. In general, treatment times range from 12 to 30 months. The "average" time frame a person is in braces is approximately 22 months.

10. How much will braces cost? Are financing options available? How does my insurance work?

    It is impossible to give an exact cost for treatment until we have examined you. We will cover the exact cost and financial options during the initial examination. We have many financing options available to accommodate your needs, and we will review these with you. We will also review your insurance policy to help maximize your benefit and file your claims.

11. How often will I have appointments?

    Appointments are scheduled according to each patient's needs. Most patients in braces will be seen every five to ten weeks. If there are specific situations that require more frequent monitoring, we will schedule appointments accordingly.

12. Can I schedule all of my appointments after school?

    Unfortunately, we cannot schedule all appointments for students during after-school hours. However, because most appointments are scheduled five to ten weeks apart, most patients will miss minimal school due to their orthodontic treatments. We will, however, make a sincere effort to meet your scheduling needs.

13. Can I drop my child off for an appointment?

    Yes. We understand your busy schedule, and we are happy to help you make the most of your time. On some occasions, we may request to speak with a parent when they return, so we ask that parents check in with the treatment coordinator before dropping off their child.

14. Do braces hurt?

    Generally, braces do not "hurt." After certain visits, teeth may be sore for a few days. In these situations, pain medications such as Advil or Tylenol will ease the discomfort. However, after most visits, patients do not feel any soreness at all! We often remind our patients, "It does not have to hurt to work!"

15. Can I return to school or work the day I receive my braces?

    Yes. There is no reason to miss school or work because of an orthodontic appointment.

16. Do you give shots?

    No. Local anesthetic injections are not necessary in orthodontic treatment.

17. Do you use recycled braces?

    Absolutely not! It is our belief that each patient should be provided with their own braces to achieve the best orthodontic result possible.

18. Can I still play sports?

    Yes. We recommend a mouth guard for all sports.

19. Do I need to see my family dentist while in braces?

    Yes! Regular checkups with your family dentist are important while in active orthodontic treatment. Your family dentist will determine the intervals between cleaning appointments while you are in braces, however, we recommend at least 2-4 visits per year for examinations, fluoride treatments, and cleanings.

20. Are there foods I cannot eat while I have braces?

    Yes. Once treatment begins, we will explain the complete instructions and provide a comprehensive list of foods to avoid. Some of those foods include: ice, hard candy, raw vegetables and all sticky foods (i.e. caramel and taffy). Please see the Foods to Avoid list at the end of this websites Treatment section. You can avoid most emergency appointments to repair broken or damaged braces by carefully following our instructions.

21. How often should I brush my teeth while in braces?

    Patients should brush their teeth at least four times each day - after each meal and before going to bed. We will show each patient how to floss their teeth with braces and may also provide a prescription for a special fluoride, if necessary. Please see Brushing and Flossing with Braces at the end of this websites Treatment section for effective oral hygiene techniques.

22. What is an emergency appointment? How are those handled?

    If your braces are causing extreme pain or if something breaks, you should call our office. In most cases, we can address these issues over the telephone. If you require an emergency appointment, we will set aside time for you. Please see Emergencies at the end of this websites Treatment section if you're not sure if you have an orthodontic emergency.

23. Can orthodontic correction occur while a child has baby teeth?

    Yes. Some orthodontic problems are significant enough to require early intervention. However, if a patient is not yet ready for treatment, we will follow that patient's growth and development until the time is right for treatment to begin.

24. What is Phase One (early) Treatment?

    Phase One treatment, if necessary, is usually initiated on children between the ages of 7 and 10. Phase One treatment lasts about 6-12 months. The primary objective for Phase One treatment is to address significant skeletal problems to prevent them from becoming more severe. This is typically reserved for width discrepancies between the two jaws, bony asymmetries (e.g. right side bigger than left side), or dental midline shifts. Another significant objective of Phase One Treatment is to improve self-esteem and self-image.

25. Will my child need full braces if he/she has Phase One treatment?

    It is best to assume that your child will need full braces even after Phase One treatment. The period following Phase One treatment is called the "resting period," during which growth and tooth eruption are closely monitored. Throughout this period, parents and patients will be kept informed of future treatment recommendations.

26. Will my child need an expander?

    At the completion of the initial examination, we will determine whether a patient will need an expander to correct the width of a narrow upper jaw bone.

27. Is it too late to have braces if I am already an adult?

    No. A surprising percentage of our patients are adults. In fact, 25 percent of all orthodontic patients are adults. Health, happiness and self-esteem are vitally important to adults. No patient is "too old" to wear braces!

28. Can I wear braces even though I have crowns and missing teeth?

    Yes. A tooth with a crown or root canal will move just like a tooth with a simple filling. When teeth are missing, orthodontic treatment will aid in the alignment of the remaining teeth so that cemented bridge work or dental implants can replace missing teeth.

Braces Glossary

Archwire
Wire applied to two or more teeth through fixed attachments (usually brackets) to cause or guide orthodontic tooth movement.
Band (orthodontic)
A thin metal ring, usually stainless steel, which serves to secure orthodontic attachments to a tooth. The band, with orthodontic attachments welded or soldered to it, is closely adapted to fit the contours of the tooth and them cemented into place.
Bracket
A small metal, ceramic, or plastic attachment that is chemically bonded to the tooth in order to hold the archwire
Full-archwire
An archwire extending from molar region to molar region.
Gingiva
The tissue that surrounds the teeth consisting of a fibrous tissue that is continuous with the periodontal ligament and a mucosal that is continuous with the lining of the mouth.
Hygiene
The practice of measures designed to attain and preserve health.
Ligature
A tie used to secure individual teeth to an orthodontic archwire, typically made of wire or elastic material.

Eating with Braces


Do I Have to Be Extra Careful When I Have Braces?
Although there are many factors that determine how long you have to wear braces (case difficulty, rate of tooth movement through bone, adequate nutrition, etc.) the most frequent complication that prolongs orthodontic treatment is loose or broken brackets and wires. Most patients progress throughout treatment without any broken appliances. Unfortunately a loose bracket or broken wire that goes unnoticed can delay treatment for 3-6 months. Inspecting your braces after every meal and notifying your orthodontic staff of any broken appliances immediately will keep you on time to finish your treatment. Hard, crunchy, crusty, or sticky foods are most frequently responsible for breaking appliances, however, improper brushing technique or oral habits like biting on pens, pencils, sewing needles, etc can do almost as much damage.

Loose Orthodontic Brackets Prolong Treatment Time

Foods to Avoid While You Have Braces
In addition to the following list of no-no foods, please be aware that you must eat foods differently when you have braces. Instead of biting into sandwiches, apples, carrots, or pizza with your front teeth you must force yourself to cut or tear your food apart and place it onto your back teeth for chewing. The following list is not all-inclusive, so if you’re not sure whether or not you should eat a particular food please use a little common sense and avoid it.

Hard/Brittle	Crunchy	Crusty	Sticky/Gooey
Ice	Potato Chips	Pizza Crusts	Caramels
Nuts- Peanuts, Almonds	Tortilla Chips	Toasted Bagels/Breads	Chewing Gum
Jolly Rancher Candies	Fried Chicken	Apples with Front Teeth	Starburst
Pens and Pencils	Fried Oysters	Fresh Carrots	Sugar Daddies
Snickers or similar	Pretzels	Kaiser Dinner Rolls	Jelly Beans
Corn on the Cob	Hard Taco Shells	Popcorn	Licorice

Beverages to Avoid While You Have Braces
High sugar or acidic drinks can cause cavities anytime, especially when they have braces to stick onto. Avoid all soda pop (Mountain Dew, Dr. Pepper, Big Red, etc), juices (Hi-C, Sunny-D, Kool-Aid, etc), and teas to prevent permanent scarring of your enamel.

Emergency Information

What to do in case of emergency
Call our office as soon as possible if you break or loosen any of your appliances. Please do not come directly to the office. By calling us, you will allow us to create a time to see you. Even if you have a regular appointment scheduled, call us immediately to notify us if you need your braces repaired.
Loose brackets or bands
Call our office immediately for advice if a bracket or wire is loosened. The bracket may need to be re-fitted as soon as possible. You may have a situation that requires cutting a wire or sliding a bracket off a wire at night or over the weekend. If you need to cut a wire in case of emergency, you may use heavy fingernail or toenail clippers that have been washed and sterilized in isopropyl (rubbing) alcohol. Please call our office the next business day, so that we may schedule an appointment for you.
Wire irritations
Sometimes discomfort caused by a wire on your braces can be resolved by moving the wire away from the irritated area with a cotton swab or pencil eraser. If the wire will not move, try covering the end of it with a small piece of cotton or a small amount of wax. If the wire is painful, you can cut it with nail clippers or scissors that have been washed and sterilized in isopropyl (rubbing) alcohol. If you cannot resolve the wire irritation, call our office for an appointment.
Lost separators
Most patients lose elastic separators during their treatment. Do not worry about losing a separator, but call our office to see if it needs to be replaced.
What Can I Eat If My Teeth Are Sore?
Your teeth will be tender to biting pressure for about 3-5 days after you visit the orthodontist. You will quickly notice that soft foods like pasta, rice, mashed potatoes, and soup are easily tolerated but a thick chewy steak is not. There is no reason to torture yourself by trying to eat stiff or chewy foods. Steamed vegetables are usually soft enough to eat and ensure that you get enough vital nutrients to maintain a healthy diet.
What Can I Do For My Sore Teeth?
The amount of discomfort that most orthodontic patients experience is usually mild and of short duration. This low-grade dull ache is caused by irritation in the ligament that surrounds the tooth. Tooth discomfort is highly individual yet most patients achieve effective pain relief from 400-800 mg of an anti-inflammatory drug like ibuprofen (Advil or Motrin), naproxen (Naprosyn), or aspirin. Check with your doctor for potential side effects with other medications first or if you have a suspected allergy to any of these drugs. Typically, 400 mg every six hours is effective for patients weighing less than 135 lbs. For those over 135 lbs, effective pain relief can be achieved with 600-800 mg every eight hours. This medication is usually not required and not recommended for more than 3-5 days after a visit to the orthodontist. Efficient tooth movement can be delayed if anti-inflammatory pain medication is taken for too long a period of time and kidney and liver damage has been found in patients taking these medications continuously over a long period of time without a doctor's supervision.