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Is there a difference between a dentist and an orthodontist?

An orthodontist is a dentist who has graduated from an orthodontic residency program where he or she has received extensive specialist training after dental school. Orthodontic residency programs are typically 2-3 years in duration, are full time, and are devoted to straightening teeth, correcting bites and correcting jaw discrepancies with brackets and wires, appliances, and clear aligners. After completing a residency, an orthodontist dedicates his practice only to orthodontics and treats hundreds of orthodontic patients each year. Orthodontics is a specialty of dentistry which means that every orthodontist is a dentist, but not every dentist is an orthodontist. Most dental schools teach a very limited amount of orthodontics, but a general dentist is still allowed to legally practice orthodontics, as long as he doesn’t call himself an orthodontist or advertise as a specialist in orthodontics. It can be a confusing task to determine who has the additional orthodontic residency training and who does not, but if in doubt, ask the doctor if he is a true specialist in orthodontics or a general dentist practicing orthodontics. This way you can make an informed decision about where you would feel most comfortable receiving orthodontic treatment.

Do I need a referral from my general dentist to see you?

Not at all! If there is something about your teeth or smile that concerns you, call us and we can see you for a complimentary consultation. The consultation includes x-rays and oral photographs that will allow us to explain the different treatment options available to you that can meet your goals. Our office can work together with any dentist to make sure your teeth are as healthy, clean, and beautiful as possible.

Are self-ligating brackets like Damon better or faster than traditional brackets?

Quite simply put, No. In systematic review studies that combine all the research comparing Damon and other self-ligating brackets to conventional brackets, the results do not support the claim that Damon brackets treat cases faster. Nor does the research support claims that Damon brackets achieve more/better expansion or that they “grow” bone while expanding. Damon brackets are often called “friction free.” This may be true in specialized lab settings, but in real life clinical settings (i.e. an actual patient’s mouth) it is not accurate. In fact, if there was no friction, then forces from the wire could not be transmitted to the bracket and tooth, and the result would be zero tooth movement. The claim that Damon brackets use lighter forces is also not supported, and in fact at some points in treatment they may actually use higher forces. Claims that Damon brackets are less painful are also not supported by strong evidence. Claims that Damon brackets are cleaner than conventional brackets are also not accurate. The bottom line is that there are a number of claims made by the companies that market and sell self-ligating brackets to orthodontists, and orthodontists that use the brackets make these same claims to the patients they are trying to sell treatments to patients. However none of these claims can really be supported by quality research, and some claims are quite clearly false.

Source Research:

Shih-Hsuan Chen S. Systematic review of self-ligating brackets. American Journal of Orthodontics and Dentofacial Orthopedics 2010; 137: 726.e1-726.e18

Marshall SD, et al. Self ligating bracket claims. American Journal of Orthodontics and Dentofacial Orthopedics 2010;138:128-31

Do you use the Damon bracket system?

The Doctors at Webb & Goldsmith Orthodontics are trained with this system, as well as many others, and we can certainly use it.  However, it is important to us that we not mislead our patients into thinking they are getting better or faster treatment because they have a magical bracket glued to their teeth.  Damon brackets are neat brackets, and it is a system that has some merits.  It can straighten teeth just as well as many other systems, but not better or faster. We do not make claims that cannot be supported by quality evidence and the general consensus of our profession when we use any bracket system.  Others should adhere to this principle as well, for the good of all patients, and the good of our profession.

We use the Empower self-ligating bracket that is similar to the Damon bracket system. However, we don't use it because of any of the false claims or marketing hype. We use it because of its quality design and the ability to simply "click" a new wire into the brackets which makes it easier on us and can shorter your appointment time that day and allow you to get in and out as easily as possible (but we'll be only saves about 1 minute!).

I have seen dentists advertise "6 month braces."  Can an orthodontist complete treatment in this amount of time?

That depends.  If you have minor issues with crowding or rotations, your treatment could be fairly short.  However, the advertised 6 month treatment programs you are likely asking about may seek to treat every case in 6 months no matter the severity. Most often, there appears to be a great improvement after initial tooth alignment at 6 months.  But initial alignment is only the first part of an orthodontist's job--and probably the easiest.  If we stopped treatment at 6 months in every case, not only would we be leaving the job incomplete in most cases, but many times we would be making matters worse.  The bite may be worse, the result would likely be unstable and prone to relapse, the teeth and surrounding tissues could be damaged, and even though the teeth may be lined up well, they may not even look better!  Although a cosmetic improvement is a major focus for patients, an orthodontist must focus both on cosmetics and function.  If we rushed orthodontic treatment in order to finish in 6 months, often we would be doing a great disservice to our patients.  If we told you we could give you a haircut in 10 seconds, would you let us?  Of course there are conditions that could be treated in 6 months, and an orthodontist can best determine this for you.  An orthodontist spends an additional 2 to 3 years in a post-dental school residency specializing in how to diagnose and treat malocclusions, and this allows him or her to properly diagnose and treatment plan your case in YOUR best interest.

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