General
Questions

Why should you choose an orthodontic specialist?

Orthodontists are dental specialists who diagnose, prevent, and treat dental and facial irregularities. To be called an orthodontist, you need to attend an additional two to three years of specialized education beyond dental school to learn the proper way to align and straighten teeth. Teeth, and sometimes entire facial structures, are permanently changed by orthodontic treatment. Only orthodontists may be members of the American Association of Orthodontists (AAO). Dr. Varghese has achieved this specialization and is an active member of the AAO.              (read our blog)

Who needs orthodontics?

No one can deny the importance of a stunning smile. It promotes self-esteem and is valuable to social and career success. Orthodontic treatment is important not only for a great smile and improved self-confidence, but important for optimum dental health. Creating beautiful smiles is what Varghese Orthodontics is all about. We have provided treatment to children as young as seven and to patients who have already retired. Dr. Varghese can examine your smile, and help you determine the options that you may have to get the smile that you have always wanted. No matter who you are, or how old—or young—From your children, to teens, to adults, Dr. Varghese considers beautiful, healthy, and happy smiles our specialty.

Why is treatment so important?

Crowded teeth make the surfaces harder to brush and keep clean, which can lead to tooth decay, cavities, and gum disease. Improper bites can also cause abnormal wear of tooth surfaces, difficulty in chewing and/or speaking, and excess stress on supporting bone and gum tissue. Without treatment, many problems become worse and can require additional dental care later in life.

Do I need a referral from my general dentist to make an appointment?

No, you never need a referral to see Dr. Varghese. Click here for more information on scheduling your complimentary consultation.

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 Dr. Varghese to effectively evaluate your orthodontic condition. Please schedule your child’s complimentary exam today!  (for more info, read our blog on why age 7)

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.

What is phase one treatment?

Phase one or early interceptive treatment, if necessary, is usually initiated on children between the ages of 7 and 10. Phase one treatment lasts about 10-12 months. The primary objective for phase one treatment is to intercept significant problems to prevent them from becoming more severe and to improve self-esteem.

Can I get braces that are less noticeable?

Absolutely! We offer different options that are more discreet. Invisalign is a popular option because it uses a clear plastic trays to apply pressure to straighten your teeth. Another popular esthetic option are ceramic braces.  It is very similar to the Damon or traditional metal braces where brackets and wires are used to guide your teeth to the correct position. However, instead of stainless steel, the brackets are white ceramic that better blend in with your teeth. Our Damon Clear is one of the highly esthetic options available in the field of orthodontics.

How much do braces cost? Are there financing options available?

The cost of braces will vary depending on the nature of the treatment plan. You may be surprised to discover that orthodontics is less expensive than you thought. Dr. Varghese offers various financing options to help meet individual treatment needs. Of course, it is important to keep in mind the lifetime value that orthodontic treatment provides can offer payment plans that can work with your budget and get you the orthodontic care you need. Contact us to learn more!

 Why should you choose an orthodontic specialist?
 Who needs orthodontics?
 Why is treatment so important?
 Do I need a referral from my general dentist to make an appointment?
 At what age should I schedule an appointment for an orthodontic screening?
 Can orthodontic correction occur while a child has baby teeth?
 What is phase one treatment?
 Can I get braces that are less noticeable?
 How much do braces cost? Are there financing options available?

Braces
Care

What foods should I avoid while I have braces?

There are certain foods to avoid that may damage the brackets:

  • Chewy foods such as beef jerky or bagels
  • Highly crunch foods like raw carrots, chips, raw celery, and popcorn (the kernels will get lodged between the bracket or band and your gums)
  • Sticky foods like caramel and licorice
  • Very hard foods like hard candy or pizza crust
  • Any food you have to bite into such as apples or corn on the cob. You can still enjoy these foods by slicing the apples or removing the corn from the cob!

(read our blog on braces-friendly foods)

How do I brush my teeth with braces?

Before brushing, do a quick rinse with water. This will dislodge any food particles stuck between the wires or brackets. Brush beginning at the gum line, using a 45-degree angle of approach. As you move towards the brackets brush from both the top and the bottom, ensuring that the bristles reach under the wires and around the brackets. This process may take some extra time in the beginning, but once you are used to it, it will be routine for you. Follow up with a thorough flossing. You will need to use a precise and careful flossing technique to make sure you do not dislodge or loosen the brackets or wires.  (read our blog on brushing/flossing with braces)

How often should I brush my teeth while in braces?

Patients should brush their teeth at least three to four times each day – after each meal and before going to bed. If you can’t brush right away after a meal, be sure to at least rinse your mouth well with water until you can brush.

Carry a travel toothbrush so that you can brush when you aren’t home. Before going to bed, brush your teeth and braces thoroughly until they are clean, and then floss using a floss threader or an air/water flosser. (read our blog on brushing)

Does orthodontic treatment hurt? How do I ease the discomfort?

Braces may leave you sore for a few days, but they shouldn’t be painful. The soreness is normal, and it will not last long. A saltwater rinse can help relieve the soreness and inflammation. Dissolve a single teaspoon of salt in a full cup of lukewarm water and swish around your mouth for a few minutes. Whatever soreness you experience can also be relieved with over the counter pain such as ibuprofen or Tylenol. If you experience lip, cheek, or tongue irritation in the weeks after getting braces, some wax can alleviate the problem. Your team at Varghese Orthodontics uses are braces that are smaller, more precise, and more comfortable thanks to technological improvements. (read our blog on orthodontic discomfort)

How often will I have appointments?

Our office average is 6-8 weeks between visits. At the beginning of treatment, some patients need to be seen more frequently, while others have long (10-12 weeks) intervals between appointments. As we get closer to finishing your treatment, appointments become more frequent. When we factor all visits together, we average about 6 weeks between appointments.

How long will I have to have braces?

The amount of time that you will need braces will depend on the severity of your orthodontic problem. Most patients need to wear braces for 12 to 24 months, but this can be shorter or longer depending on your case. Dr. Varghese will gladly meet with you to discuss your bite and your available options.

Will braces interfere with my school activities like sports or playing an instrument?

No, they shouldn’t. It may take a few days to get used to the braces, but our patients are usually able to continue participating in sports and playing their musical instruments during treatment without any problems. If you happen to be involved in some kind of accident during your athletic activity, check your appliances and your mouth immediately. If the appliances appear damaged or the teeth loosened, schedule an appointment.

If you play an instrument, you may find it a little challenging to become adjusted to playing with your braces. It’s normal to have some difficulty with proper lip position! Sores can also develop, but the use of wax and warm salt-water rinses will help your lips and cheeks toughen up pretty quickly!

Do I need to wear a mouthguard for sports with braces?

Dr. Varghese stresses to get in the habit of wearing a mouth guard for the sake of protecting your smiles from any damage or injury. 10-20% of all sports-related injuries are maxillofacial injuries according to the American Dental Association. Playing sports with braces could be a risk if you do not have mouth protection. Mouthguards help cushion a blow to the face, minimizing the risk of broken teeth and injuries to your lips, tongue, face, or jaw.              (read our blog on mouthguards)

Do I need to see my dentist while in braces?

Yes! Regular checkups with your dentist are important while in braces. Your dentist will determine the intervals between cleaning appointments while you are in braces. (read our blog on the importance of dental checkups)

What is a Herbst appliance and do I need it?

If your child has a significant overbite, simple treatment with braces will not correct the problem. The Herbst appliance, usually in conjunction with braces, is used to help the lower jaw develop in a forward direction. This eventually leads to an ideal bite. Left untreated, an improper bite may threaten the long-term health of your child’s teeth, gums, and jaw.

A Herbst appliance has crowns that are cemented to your child’s molars. It includes a metal tube that connects the upper and lower jaw. By adjusting the tube, Dr. Varghese is able to control the jaw’s position in relation to the upper teeth. The typical treatment time with a Herbst appliance is 12 months.

What is my role to obtain optimal results?

Orthodontic treatment is a partnership between the doctor and patient. Dr. Varghese provides custom-made fixed or removable appliances that use gentle pressure to move teeth into their proper positions. If you follow Dr. Varghese’s instructions, keep scheduled orthodontic appointments, and maintain excellent oral hygiene, you will get optimum results. Don’t forget to see your regular check-ups with your general dentist.  (read our blog on staying on track)

 What foods should I avoid while I have braces?
 How do I brush my teeth with braces?
 How often should I brush my teeth while in braces?
 Does orthodontic treatment hurt? How do I ease the discomfort?
 How often will I have appointments?
 How long will I have to have braces?
 Will braces interfere with my school activities like sports or playing an instrument?
 Do I need to wear a mouthguard for sports with braces?
 Do I need to see my dentist while in braces?
 What is a Herbst appliance and do I need it?
 What is my role to obtain optimal results?

Retainer
Questions

Will I have to wear a retainer after my braces come off?

In caring for your smile post-orthodontic treatment, retainers are not an option, but a necessity. Retainers can be fixed or removable.  Retainers work to keep your teeth in position as the tissues and bones in your mouth adapt to their treatment. Without the use of a custom retainer, your teeth will relapse. Relapse can occur once your braces are removed if retainers are not worn as prescribed. (read our blog on retainers)

How long will I have to wear a retainer?

Teeth will always have an inherent tendency to shift. The period just after your braces are removed is when your teeth are most at risk of shifting. This is because the fibers in the gums are still remodeling to the new teeth positions. Retainers are for life. As long as you would like to maintain your perfected smile, you should wear retainers. Dr. Varghese’s long term removable retainer protocol is “night time, lifetime”.  Retainers will also be a much more cost-effective and health-effective solution long-term than letting your teeth shift back to undesired positions. (read our blog on retainers)

Why is a fixed retainer important?

Your Questions A fixed retainer is a small piece of wire that is bonded to the backside of your teeth. Bonded lingual retainers are cemented directly to the inside surface of your lower incisors and canines. This is one of the best ways to prevent your lower teeth from shifting as it is permanently attached! (read our blog on tools for flossing with a fixed retainer)

How do I take care of my retainers?

Similar to braces, it is important that you maintain your appointments with Dr. Varghese so that he can check for an unexpected shifting of your teeth and that proper stabilization. Caring for retainers is relatively easy, and consists of keeping them clean and safely putting them in their case when you’re not wearing them so that they don’t become damaged. (read our blog on how not to forget your retainer)

How long do retainers last?

With proper care, your retainers might list several years. For others, they may have to replace them every 6 months. Retainers are similar to any other device and likely will need to be replaced over time. Clear retainers tend to get worn down over time, especially in the areas covering the biting surfaces of the teeth. If you grind or clench your teeth at night, you may find that your clear retainers wear out faster and will require more frequent replacement retainers. We may need to go to a nightguard if grinding or clenching is severe.

HOW LONG DO FIXED RETAINERS LAST?

Your lower retainer may be a fixed retainer bonded onto your teeth. Dr. Varghese attaches the fixed retainer to the teeth the same way braces are attached. The retainer wire can break or the dental cement can detach from the tooth surface with hard foods over time. They will last as long as you take care of them. Remember to use the floss threader to clean under the wire. Teeth can move very quickly, so it is important to reattach the retainer as soon as possible.

What long term options do you have for retainers?

When your treatment is complete, ask us about a Presurv retainer. Presurv retainers are cost-effective, custom-made retainers made at our lab after getting scanned with our Itero Element scanner.  The lab-fabricated Prezurv system provides multiple sets of retainers to assure teeth stay in their optimal position.   Once your scan has been made, you can order future retainers by calling our office (as long as your current one is fitting properly).

To learn more about the Presurv retainer and all your orthodontic treatment options, please feel free to schedule an appointment at our office.

What happens if I lose my retainer after orthodontic treatment?

Accidents happen. If you do lose your retainer, please contact our office as soon as possible to schedule to get a replacement. Depending on the type of retainer needed, replacements can be made as quickly as a few hours or the following day.

WHAT ARE SOME IMPORTANT TIPS FOR RETAINERS?

Always keep retainers in their cases when they are out of your mouth.  If you wrap your retainer in a napkin during meals, it may be easy for your waiter or you to throw it in the trash accidentally.

Avoid leaving your retainer in a hot environment, such as a windowsill or a hot car. It will melt or wrap. Never put it in boiling water; you may think that boiling it is a great way to make it as clean as possible, but the heat will ruin it.

Keep you retainer away from pets.Yes, you love your furry best friend, but they have a special ability to snack on retainers.

Carefully put on and take off your retainer.  When removing it, do not twist it with your tongue or pull it to one side. The retainer may get damaged. Loosen your retainer in several places starting from the back when you remove it and then ease it off.

What are my options if I broke, lost, or stopped wearing my removable retainer a while ago?

Since it has been a while since you have worn your retainer, the chances are high that there has been some form of relapse of your teeth in the form of crowding, spacing, or rotations.  Your options may include:

  1. Have limited orthodontic treatment to fix your teeth,
  2. Create a new retainer to hold the current position of your teeth, or
  3. Do nothing, with the risk of continued shifting of your teeth.

Regardless of what you decide, it is best to contact Dr. Varghese as soon as possible to discuss your options

 Will I have to wear a retainer after my braces come off?
 How long will I have to wear a retainer?
 Why is a fixed retainer important?
 How do I take care of my retainers?
 How long do retainers last?
 HOW LONG DO FIXED RETAINERS LAST?
 What long term options do you have for retainers?
 What happens if I lose my retainer after orthodontic treatment?
 WHAT ARE SOME IMPORTANT TIPS FOR RETAINERS?
 What are my options if I broke, lost, or stopped wearing my removable retainer a while ago?

Surgical
Orthodontics

What is surgical orthodontics?

Surgical orthodontics, also known as orthognathic surgery, is a type of orthodontic treatment used to correct severe cases that include malocclusion, jaw bone abnormalities, and constricted airways. If you need surgical orthodontics, Dr. Varghese will work with an oral and maxillofacial surgeon to ensure that you receive optimal care. After Dr. Varghese will level and align the teeth in the jawbone, the oral surgeon positions the jaws into a more normal position to allow the bite to come together ideally. This procedure results in the improved ability to chew, speak, and breathe, while also delivering tremendous facial aesthetics.

When might surgical orthodontics be needed?

Surgical orthodontics may be used to treat adults with improper bites or other aesthetic concerns. Typically, jaw growth stops by age 16 in females and 21 in males. In order to receive orthognathic surgery, the jaw must be done growing. The need for surgical orthodontics occurs when the jaws do not line up correctly, and a proper bite cannot be achieved with orthodontic treatment alone. Orthognathic surgery will help properly align the jaw, and orthodontic braces will then be used to move the teeth into their proper position.

How does orthognathic surgery work?

Dr. Varghese will align your teeth before the surgery.  An oral and maxillofacial surgeon will perform your orthodontic surgery in a hospital. Orthognathic surgery can take several hours, depending on the case. Once the surgery is complete, you’ll have about a two-week rest period.

Since orthodontic surgery is a major treatment, we recommend scheduling some time away from work or school during the healing process. After surgery, you’ll have to wear braces for 6-12 months to finish the alignment. After your braces are removed, you’ll wear a retainer prescribed by Dr. Varghese to help maintain your new smile.

 What is surgical orthodontics?
 When might surgical orthodontics be needed?
 How does orthognathic surgery work?