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You might be surprised to see one of your second grader’s friends with a dental appliance. Isn’t orthodontic work just for teenagers? And, if not, should your seven-year-old be sporting braces right now? The answer to both of those questions is “Not necessarily.” Two-phase treatment is a process designed to correct issues that arise during different times in your child’s life.

First Phase Treatment

We recommend that every child have an orthodontic evaluation around the age of seven to determine if there is a problem that would benefit from early treatment. First phase orthodontics is not the same as orthodontics for older patients. The focus here is on the developing bone and muscle structures which form your child’s bite and provide space for the permanent teeth when they arrive.

There are some clear-cut orthodontic goals that are much easier to attain when children’s bones are still growing.

• Reducing Crowding

If your child’s mouth is small, the permanent teeth will have little room to fit in when they arrive. We may recommend gently enlarging the upper dental arch with the use of a palatal expander. This device will provide room for the adult teeth, and could potentially shorten second phase treatment time. Sometimes the extractions necessary to create more room for permanent teeth in later years can be avoided, as well as the possibility of an impacted tooth—one which doesn’t erupt because it is blocked by other teeth.

• Dealing with Jaw and Bite Concerns

Bones and muscles do not always develop properly, leading to problems with jaw and facial structure. Your younger child still has growing bones, so this is a great time to gently re-form the jaw into a healthy shape. Problems caused by crossbites, underbites, open bites, and other malocclusions can be reduced with early treatment.  

• Protecting Teeth

If your child has protruding front teeth, these teeth are more likely to be damaged in falls, at play, or while participating in sports. We can gently reposition them.

Second Phase Treatment

Second phase treatment is designed for your older child. After a resting period, when the permanent teeth finish erupting, we should see your child to evaluate any further orthodontic needs. This is the time to finish the process of straightening the teeth and making sure that each tooth fits together properly for a comfortable and healthy bite. This phase usually makes use of braces or aligners, and can take approximately 12-24 months.

Two-phase treatment is not necessary for every child. But there are some unique reasons that early orthodontics might be recommended for your child, even if it’s clear that more orthodontic work will be needed later. Make an appointment with Dr. Joseph Brogan at our Philadelphia, PA office, and let’s evaluate your child’s orthodontic needs, whether now or in the future, for a lifetime of beautiful smiles.

These days, it’s become more common to see adults at our office getting their teeth straightened with Invisalign clear aligners . . . that is, if you can see them! Whether they are seeking to overcome the stigma that “braces are just for kids,” or simply want straighter teeth without a mouth full of metal, Invisalign is an effective and easy solution.

According to the American Association of Orthodontists, from 1994 to 2010 the number of adults 18 and older who request braces increased by 58 percent: from 680,000 to 1.1 million a year. Many adults enjoy how discreet the aligners are and that the user doesn’t need to avoid any foods or make dietary changes the way you would with traditional braces. Also, each treatment is unique to the patient.

With an Invisalign treatment, you can expect to enjoy the following benefits over traditional braces:

• The total treatment time is more precise with Invisalign because your treatment is modeled by a computer. Traditional braces depend more on an estimate and aren’t as exact.
• You’ll make fewer trips to our Philadelphia, PA office, since you’re able to change your trays on your own every few weeks or whatever is prescribed.
• Without brackets to place over your teeth, there’s less risk to the health of your tooth enamel.
• Invisalign aligners are clear and practically invisible, so most people won’t even know you’re wearing them!

If you’re interested in Invisalign as a treatment option, please let Dr. Joseph Brogan know. We’d be happy to help you on your journey to a straighter, healthier smile!

One of the many benefits of your clear aligners is that you can remove them to eat. You should brush after every meal, just like you would with traditional braces, but cleaning your teeth is much easier without having to work around and between brackets and wires.

But when you wear your aligners 22 hours a day, you might be tempted to leave them in when you’re just having a sip of something when you’re thirsty. Unless you’re drinking water, please don’t.

What’s the problem with a can of cola or a cup of coffee?

• Staining

The virtue of your clear aligners is that they are, well, clear! Probably one of the reasons you decided on this method of treatment was because you liked the idea of an inconspicuous appliance.  Unfortunately, dark beverages such as colas, coffee, tea, and red wine can stain your aligner, making it more visible.

• Warping

Very hot beverages might actually affect the shape of your aligners. Since they are formed using heat, it makes sense that heat can also de-form them. If hot teas and coffee drinks cause a change in the shape of your aligners, they will not move your teeth the way they were meant to.

• Affecting Tooth Health

Even though our enamel is very strong, sugary and acidic drinks can damage it. Acidic foods can erode enamel, and the sugars in our diet provide food for cavity-causing bacteria, which then produce acids that erode enamel.

Normally, saliva provides some protection from acids and sugars by diluting them and washing them away from the teeth. When you drink a cola or an orange juice with your aligners on, some of the liquid will get in them, and can stay in them until the aligners are removed. You will actually give these problem beverages the opportunity to bathe your teeth in sugar and acid over a longer period of time, without exposure to saliva to help offset potential harm. And after all your work to create a beautiful smile, you certainly don’t want new cavities!

How to protect your aligners and keep them their cleanest—and most invisible?

• Take your aligners out before drinking beverages that can stain them, or, if you can’t, try using a straw. Clean your aligners according to Dr. Joseph Brogan and our team’s instructions to keep them as clear as possible.
• Don’t drink very hot beverages with your aligners in place. Try icing your coffee and tea if you can’t remove your aligners. And if you think your aligners have changed shape, please give us a call.
• Drink water! Water hydrates you, doesn’t damage enamel, and keeps your aligners clean. Tap water is your best option, as even bottled waters can be acidic.

If your aligners should become stained, remember that you change them frequently, so the staining can be a temporary problem. If you do have a drink of something hot and your aligners feel “off,” give our Philadelphia, PA office a call. We’ll let you know if you need to replace them.

But prevention is always best! Avoid staining from the start by removing your aligners before you drink dark beverages. Don’t expose your aligners to heat. Think about replacing unhealthy drinks with water. And certainly brush right away, or rinse with water if that’s not possible, if you drink a sugary or acidic beverage. These simple precautions will help keep your aligners, and, most important, your teeth, looking their best.

By now, you’re very familiar with the basic building blocks of your braces. Brackets, wires, and ligatures are no mystery to you. But suddenly, you’re hearing a brand new term—“power chains.” What exactly are these power chains, and why does your orthodontist think you need them? Let’s see how power chains are *linked* to your orthodontic treatment.

• First, why power chains?

They’re not really chains in the necklace or bike chain sense—in fact, they’re only very rarely made with metal. These chains are most often a string of O ring loops just like your elastic ligatures, attached in a row to resemble a chain.

Chain lengths are tailored to your specific needs. Dr. Joseph Brogan will attach each individual loop in the chain around a single bracket, linking selected teeth together. Chains might stretch across a few teeth, several teeth, or your entire upper or lower arch.

• Second, why power chains?

Because these chains are usually made of the same elastics that your ligatures, or bands, are made from, they want to hold their original shape. They will try to return to that original shape even as they are stretched between your brackets. As they contract, they help move your teeth together. 

Over time, just like an over-stretched rubber band, they lose their elasticity, and won’t work as effectively. That’s why you’ll probably get a new power chain whenever you come in to our Philadelphia, PA office for an adjustment.

• Third, why power chains?

This is the most important question. How can a power chain improve your smile?

Usually, power chains become part of your treatment after the first phase of alignment. They can be used to help align your teeth or correct your bite, but are most often used to close gaps between the teeth.

You might have a gap after a tooth has been extracted. Or, as your teeth move into their new positions, you might suddenly see noticeable spaces between them. Power chains move the teeth closer together to eliminate these gaps, and do it more quickly than brackets and wires alone can do.

• How long will you need them?

This is something Dr. Joseph Brogan will discuss with you. Whether it’s a matter of weeks or months, your treatment plan is designed to move your teeth into their best positions, and to do it carefully for a lasting, healthy alignment.

• Power chain options

Depending on the size and spacing of your teeth and your treatment plan, these chains usually take one of three forms: closed/continuous, short, and long. The only difference is the distance between the rings.

We will choose the type of chain that’s best for your treatment. Your contribution is to personalize your power chain. Power chains come in a rainbow of colors, allowing you to mix and match. You can even coordinate with your ligatures if you have ties as well as chains. If your goal is to have your braces blend in, various shades of white, silver, or clear colors are available. Want to mix things up? Choose a different color with every adjustment.

• Anything else?

You might experience some discomfort for the first few days with a new power chain, just as you might with any adjustment. Dr. Joseph Brogan will have suggestions for making those first days as comfortable as possible.

Also, like brackets and ligatures, power chains can trap food particles, so be sure to follow our instructions for keeping your teeth and your braces their cleanest.

Now that you’re all caught up on what power chains are and what they can do for you, let’s mention one more benefit. This is a process where you can actually see the gaps between your teeth closing over the weeks you wear your power chains. Keep a selfie record of your progress as you create your beautiful, healthy smile. That’s an em*power*ing experience!