What is an Orthodontic Technician, and Why are They Special?

We are so lucky at Meadows orthodontics to have such great technicians, which are also called orthodontic assistants. The vast majority of orthodontic offices employ these professionals, who perform a large variety of tasks every day. They wear so many hats in our office, and our patients often become very close and form great relationships with our technicians! Because they are so important to me, and work by my side every day, I thought I would share a bit of what they do during a typical day, and describe what skills are required for their profession.

Before patients arrive in the morning, technicians arrive and open the office, turn on the computers, make sure their stations are fully stocked with all the items that we use during the day (there are hundreds!), sterilize the instruments that we use daily, and check that sterilization is working properly.

At our daily meeting, each tech has differing responsibilities to report on:

  • One tech reports on the list of patients that we will be seeing that day. She checks that we are all prepared for any special procedures that we may be performing during the day, new patients that are visiting, patients that we are placing braces on for the first time, and patients that we will be removing braces for that day.
  • One tech is in charge of keeping track of invisalign cases, and submitting them to the invisalign site after we have taken digital impressions of patients teeth from our iTero scanner. She informs me when the cases are ready for me to work up and “design”, and if there are any complications with delivery dates, etc.
  • One tech is also a laboratory technician, and she makes most of the retainers, expanders, space maintainers and thumb habit guards that we use. She creates these appliances, solders and welds them, and has me check them before we deliver them to our patients.

Once we start seeing patients, their duties include:

  • Greeting the patients, asking them about their day and lives, seating them in the treatment chairs, inquiring if they have any concerns with wearing rubber bands, if there are any loose braces, and making sure that all is comfortable.
  • They untie and remove the wires from the braces, check oral hygiene is acceptable (and give coaching if it is not!), then inform me that the patient is ready.
  • When I arrive to great the patient, they give me a summary of the patient’s progress, then record on the computer all the changes and adjustments that I perform, along with any conversations that I have with the patient or their parents regarding their dental development.
  • They them retie in the wire to the braces, and show the patient how to wear elastics as I have requested, and help them set up their next appointment with us.
  • When braces are first being placed, they clean and prepare the tooth surfaces, and help me place the braces on the teeth. I then place the braces in their final position and light cure (bond) them to the teeth.
  • When the braces are removed, they usually remove the majority of the braces, and remove the cement from the teeth. I then do the final polishing and finishing of the enamel surfaces.
  • They take radiographic images (they are all certified with radiography), take a series of photographs of teeth both before and after treatment.
  • They take impressions of patient’s teeth, using both traditional impression trays, and digital iTero scanning. These impressions are used for diagnosis and creating retainers and expanders.
  • They clean, disinfect, and sterilize the office, including our instruments, chairs, and treatment cabinets/surfaces.
  • Just as importantly, they comfort our patients if they are nervous, and create a caring, fun atmosphere that makes visiting our office a special and positive experience.

As you can see, this is a very hands-on, technical, and very social job. I hope you appreciate all that they do- I sure do!

Dr. Dan Rejman

 

Dr. Dan Rejman is the owner of Meadows Orthodontics in Castle Rock, Colorado. He currently has five orthodontic technicians on his team, who are all wonderful, dedicated professionals!

Some Statistics on the Benefits of Wearing a Sports Mouth Guard

Youth sports are so popular here in Castle Rock (and around the country), and all of us at Meadows Orthodontics think it is important for kids and their families to be aware of the benefits of wearing a sports mouth guard if they play a contact sport. If your child wishes to have a custom fit, professional quality sports guard, please contact our office – we will happily make one for them! Here are some items of interest and statistics regarding sports injuries.

  • More than 5 million teeth are injured or knocked out every year, resulting in nearly 500 million dollars spent on replacing teeth.
  • Up to 39% of all dental injuries are related to sports
  • Sporting activities account for the greatest percentage of traumatic dental injuries in teens
  • 50% of all children and teens will suffer at least one traumatic injury to a tooth by the time they graduate from high school
  • Broken teeth and other oral related injuries account for more than 600,000 emergency room visits a year
  • Sports related injuries account for 3 times more facial and dental injuries than violence or traffic accident

Now the good news!

  • Athletes are 60 (!!!) times more likely to suffer harm to their teeth when not wearing a mouth guard. Mouth guards work amazingly well when worn!
  • 80% of traumatic dental injuries occur to the top front teeth, which are usually covered by a mouth guard.
  • An estimated 200,000 oral injuries are estimated to be prevented annually in the U.S. by wearing mouth guards
  • Mouth guards help to prevent injuries to the teeth, lips, tongue and cheeks.

Can wearing a custom mouth guard help reduce the risk of sports related concussions? More peer- reviewed research is needed regarding this question, as some research has shown evidence that it does help, while other research is inconclusive. They certainly do not increase the risk, and if one is being worn to protect teeth, a side benefit may be reduced concussion risk. I will be watching for new, more conclusive research!

 

Dan Rejman D.D.S, M.S. is a board certified orthodontist in Castle Rock, Colorado. His children play sports in the area, and he has been instrumental with fitting their teams with custom mouth guards for years!

Does your child have an underbite? An effective new treatment option now exists (miniplates)!

I have previous blog entries about the difficulty of treating underbites, which can be the result of the upper jaw (maxilla) not growing enough, the lower jaw growing too much, or a combination of both. It is vital that underbites be identified as early as possible, as successful  treatment of this type of bite is often largely dependent on a patients age. We are often trying to eliminate the need for a surgical correction later in life by identifying the problem and treating it appropriately at the correct age. For decades, the standard of care for treating underbites was the use of a facemask, or reverse pull headgear. miniplatesMost studies have shown that the most successful results occur when treatment is started before the ages of 8 or nine (with the exception of severe cases, which should be identified early as needing surgical intervention at a later age). Some  problems with this treatment option are: 1) If the child is brought in for an exam at a later age, say 12-14 years old, often a window for successful treatment may have been missed. 2) There are issues with children being compliant with wearing the facemask appliance (even if only at night), as there are obvious social concerns, and comfort issues. 3) Due to these social concerns, the realistic hours of using this appliance outside of school hours is inherently limited. 4) The appliance is removable, and can be removed easily even if parents check that it is being worn when they take a look at bedtime.

Recently, devices called miniplates have started to be used as an alternative to facemask therapy. Miniplates are biocompatable, titanium attachments that can be fixed to the upper or lower jaws. An oral surgeon uses very small screws to attach the miniplates to the upper and back areas of the upper jaw (usually at the zygomatic butress), and also to the more forward area of the lower jaw. Of course, this occurs under anesthesia, and this is a relatively non-invasive out patient visit. The orthodontist can then attach elastic rubber bands from the upper miniplate to the lower miniplate. Advantages of this treatment option, as contrasted to facemask treatment, include:  1) Research is supporting the idea that miniplate treatment is ideally started at a later age (around the age of 11-14) than facemask therapy, when the density of the maxillary bone has increased. 2) The social stigma is reduced, as the mini plates are located intraorally, and are quite small as they emerge from the gum tissue. 3) Due to the applaince being located entirely in the mouth, elastics can be worn 24 hours without concern about them being noticeable or looking “out of place”. 4) The miniplates are semi-permanantly fixed until they are removed by the oral surgeon. Largely due to these reasons, recently published research is showing impressive results using this method vs. traditional facemask treatment. In summary, orthodontists have another great option to help achieve more successful cases, and to reduce the number of surgeries needed to treat these cases.

There are some obvious downsides to using this technology that must be considered. Miniplates require two visits to the oral surgeon; one for having them placed, then another for removal after orthodontic treatment is complete. There is also the additional asscoiated cost of having an oral surgeon perform these procedures. As with any treatment, dental or medical, the advantages must be weighed against disadvantages, and risk vs. reward. I have been having these conversations with families of children with underbites, and each conversation is as unique as the child’s unique facial structure. Please g ive me a call if you have any questions regarding underbites, and we will determine if miniplates are an appropriate option for your family member.

 

Dr. Dan Rejman is the owner of Meadows Orthodontics in castle Rock, Colorado. He is Board Certified by the Amerivcan Board of Orthodontics.

 

Have a Merry Christmas, from Meadows Orthodontics

fullsizerender-2From all of us here at Meadows Orthodontics, I would like to wish the Castle Rock community a wonderful Christmas season. We really enjoy this time of year in our office, and we have several traditions that we continue to carry on in both our Meadows, and Founders/Terrain locations. The first is that we continue to be a drop off location for the Toys for Tots program, which is very active here in Douglas County. Toys for Tots is a program organized by the U.S. Marine Corps Reserve, which collects and raised funds to purchase new toys for less fortunate children in local communities. It is a very well run program, and I encourage our neighbors to consider dropping off toys in our Meadows location for this cause. We will get your donations to to the program in time help make the holiday season a bit nicer for a number of local families!

We also have a tradition of “decking the office”, where we decorate both offices the weekend after Thanksgiving.  The Christmas tree in the Meadows office is special to me, as it is mostly decorated with MacKenzie- Childs ornaments and ribbons. MacKenzie- Childs is handmade, eclectic artisan pottery and decor company located in Aurora, N.Y. near where I was raised. In 1993, I had a back surgery and was unable to work on our family’s dairy farm due to the physical labor required.  While I  was recovering, I worked at MacKenzie-Childs, where I hand painted plates, bowls, serving platters, and more. Now 23 years later (ugg I’m getting old!), it is a tradition to decorate this tree in the whimsical style of this company that reminds my wife and I of where we grew up. Fell free to stop by and take a look.

Well, Merry Christmas, Castle Rock- we are all merry here, are placing LOTS of red and green colors on kid’s braces, and we look forward to seeing you this season.

Dr. Dan Rejman

 

Both locations of Meadows Orthodontics are located in Castle Rock, CO. We are open 5 days a week here, including every other Saturday!

 

Are bonded retainers good for my teeth after braces?

downloadSometimes while I am surfing the web, I will check what is “floating around” the internet regarding orthodontic topics. I talk to my patients often about retainer options when their braces are removed, and I was surprised to see the amount of information and discussions out there regarding bonded retainers – small wires that are bonded to the back side of front teeth (usually lowers) – after braces have been removed. Like most topics, there is a large amount of credible information available, and an equally large amount of…how shall I put this…baloney? If you are wondering about if bonded retainers are right for you, here is my take on the subject.

First a little about my overall orthodontic philosophy. There are many ways to treat patients orthodontically. There are many MANY appliances, manufactures of braces, wires, instruments, elastics, etc… that all claim to be the best.  There are a large number of “systems” that practitioners can choose to follow exclusively, and there are different types of retainers and retention protocols that orthodontists can choose to offer to their patients. Personally, I choose to be educated and aware of all the options that are available to my patients (both cutting edge and traditional tried-and-true), and do my best to make decisions whenever possible according to evidence based practices (from scholarly peer reviewed journals of our profession) mixed with years of clinical experience. Borrowing from Dr. William Proffit’s article about using research to guide clinical decisions:

An orthodontist, like all health care providers, wants to know three things about the treatment he or she is providing: its

  1. effectiveness (how well it works, i.e., how effective it is in dealing with the patient’s problems, taking into account possible negative side effects),
  2. efficiency (how cost-effective it is, with cost in its broader sense to include time and effort for the provider and impact on the patient), and
  3. predictability (the amount of variation in patient response).

Lets look at bonded retainers in light of these three factors.

  1. Are bonded retainers effective?  Meaning, do they work well? Bonded retainers can work extremely well, and I have found there are two main factors that will determine how well they work. Fist, the patient must be determined to be an excellent candidate for the responsibility to have a bonded retainer. After carefully observing the patient’s habits (oral hygiene, their tendency to keep braces intact or to break them often, and overall compliance and responsibility with treatment), I usually have a good idea if a bonded retainer will work well for them. If a patient does not have excellent hygiene practices, I personally will not recommend a bonded retainer until they prove otherwise. Poor hygiene around bonded retainers is asking for failure, with periodontal health risk. On the other hand, excellent awareness and hygiene usually leads to favorable long term prognosis. The second factor is how well the bonded retainer is applied to the teeth by the orthodontic office. I think properly bonding a retainer is one of the most technique sensitive things that I do day to day, and therefore I exclusively place all bonded retainers in my practice. I know this is not the norm, and not efficient for my practice in the short (see #2!)term, but I have found massive gains in effectiveness since I started doing the bonding myself.
  2. What about efficiency? As stated above, I spend A LOT of time making sure bonded retainers are placed just right. This not cost efficient for my practice short term, but have found that long term the increase in effectiveness and predictability (see #3!) make this overall very efficient. Much fewer re-treating with braces, much fewer failures, and much happier patients!
  3. Are bonded retainers predictable? In other words, how much variation is expected in how patients respond to the bonded retainers? This is obviously very dependent on the factors that I described above. I find that if I am selective with who are proper candidates for bonded retainers,and treat each patient on an individual basis, bonded retainers are very predictable. Having said that, I can predict that at some point they will fail (break) and will need maintenance. Just like a car, your furnace, or your roof, a retainer needs proper care, maintenance, and sometimes replacement to work properly. Some people will need to wear the bonded retainers for life to maintain aligned teeth, while others may wish to have them removed at some point in favor of removable retainers. It is all individual, and each individual should be treated according to their unique lifestyle, habits, and wishes.

I hear often from patients who come to see me for re-treatment (their teeth have shifted after orthodontic treatment in the past), ” My previous orthodontist never offered me bonded retainers! Why not?” Honestly, I cannot answer that question. Maybe they found that in their practice they were not effective, efficient, or predictable, and never offered then to anyone. Why? Maybe in the past their staff members placed the retainers and they failed often (By the way, some staff members in practices I know are great at placing bonded retainers!). Maybe they did not choose wisely in who are and are not good candidates for bonded retainers, and they failed often. Maybe they did offer bonded retainers in their practice, but choose not to offer one to you based on your hygiene or compliance issues. Or maybe they just liked removable retainers better to avoid the possible negative side effects that some patients can experience with hygiene, maintenance, etc…The important thing is for me to consult with you in the present, and to engage in an honest discussion about the pros and cons of bonded retainers (and the pros and cons of removable retainers), and then determine if they will be effective, efficient, and predictable for you.

 

Dr. Dan Rejman is the owner of Meadows Orthodontics in Castle Rock, CO. He has been board certified by the American Board of Orthodontics since 2007, and is in his third year serving as the councilman representing the Rocky Mountain and Southwest Orthodontic Societies for the College of Diplomates of the American Board of Orthodontics.

What works best to keep teeth clean while wearing braces?

A questions that I am often asked by patients and their parents is, “What works best to keep teeth clean while wearing braces?”  My reply is “whatever works best for you as an individual”.  Many patients do really well with traditional toothbrushes, while others respond really well with to electric brushes. There are also many adjunct devices that help clean between teeth and reach spaces that may be hard for brushes to contact (especially with braces on). With so many choices available when you walk through the dental section of supermarkets and drug stores, here is a guide to help find what will work best for you.

Traditional manual toothbrushes:  As I stated, many orthodontic patients do a fantastic job of keeping healthy teeth and gums using traditional toothbrushes. After braces are placed, our assistants at Meadows Orthodontics review brushing techniques one on one with our patients, as braces add an additional challenge to the brush reaching the surfaces that need plaque removal. I stress to my patients that the most commonly missed areas are where the teeth and gums meet, both below the braces of the lower teeth, and above the braces on the upper teeth. wire. Try to allocate more time to these areas, starting at the back teeth, then working around the mouth one tooth at a time, making sure not to skip any, until you reach the back teeth of the other side. I describe this to kids as “driving around the race track”, as this ensures no areas are missed. Likewise, try to avoid random movements that jump from one part of the mouth to the other- people often get into patterns where some areas are cleaned really well, while other areas are totally skipped over. What about circular motions vs. up and down, vs. side to side? Just like washing a car, as long as all surfaces are cleaned, I tell my patients that they can use whatever motion is the most effective for them! If you want to use trapezoid movements and are good at it… fine!

Use a toothbrush with soft bristles, and avoid stiff  bristles. This will help reduce the chance of brushing causing gingival recession (where the gum recedes to expose the roots of the teeth). As far as all the different bristle shapes, designs, colors, etc…use what is comfortable for you! The one that you use well, consistently and with the correct technique is the best one. At each return visit to have braces or Invisalign checked and adjusted, we will grade your oral hygiene, and give you tips and encouragement if needed.

imagesElectric toothbrushes:  Having said all the above about manual toothbrushes, electric toothbrushes are also a great option. Two of my own kids were not doing well on their own with traditional manual toothbrushes (my third one does amazing with a manual brush), so I got them an electric model. Bingo! they love to use it, and their was a big difference in keeping their teeth clean. A large part of it for them is using something technological and fun, which they responded to immediately.

The biggest difference with a high quality electric brush is that the “scrubbing” movement is taken care of by the brush itself. Children and the elderly especially may lack the coordination for these fine movements, and electric brushes area great option for them. Patients, especially kids, need to be aware that the bristle head still needs to be placed in the correct locations to get the teeth cleaned. Reaching these places is just as described above for the manual brushes. Which brand should you purchase? I recommend both Oral-B and Sonicare brushes. They each claim the superiority of their product, but they are both amazing and your teeth will be happy with either brand. Also, each brand has several levels of brushes. The mechanism and effectiveness is the same for each model, but the more expensive ones have more gadgets built in such as timers, bluetooth tracking for parents, etc… choose the model that has the extras that interest you the most.

Plastic pics, floss, interdental microbrushes, etc.. : The dental aisle usually has many accessories that can be very helpful in cleaning your teeth )I like plastic dental pics, and use them while I am watching TV). Again, choose what you like and what you are comfortable with. They are usually very inexpensive, can be purchased in bulk, and help to clean in areas that brushes cannot reach (in between teeth, under and around braces if food becomes trapped). Flossing will require the use of “floss threaders”. We review how to use these with every patient after braces have been placed.

Waterpiks:  Waterpiks are a great option to use in conjunction with brushes, as the bursts of water are great for flushing out debris and plaque from hard to reach areas, and from around devices such as expanders. You cant go wrong with the Waterpik brand, which is very popular with my patients.

I hope these suggestions help, and if you ever have questions, feel free to ask me, or call Meadows Orthodontics at 303-660-0112.

 

Dan Rejman, D.D.S., M.S. is the owner of Meadows Orthodontics. There are two locations in Castle Rock, CO for local families: One in the Meadows, and one in the Founders and Terrain area.

 

Why is Excellent Oral Hygiene While Wearing Braces Important?

Good oral hygiene has many benefits, whether you’re in braces or not.  Removal of plaque is very important to help prevent tooth decay. Braces provide more surface area for plaque to cling to and hide behind, so it is important to be aware of techniques to clean around these additional surfaces.  Plaque that remains around braces (or anywhere on the tooth) for too long can cause white spot lesions, which is the initial stage of tooth decay.  These spots are the result of demineralization of the tooth surface and are a permanent stain the tooth surface. White spot lesions can then progress to dental caries, or cavities. “Fillings” are required to restore cavitated or demineralized areas that have progressed to the point that tooth structure needs to be replaced.

Plaque that is not removed can also cause gingivitis, which is inflammation of the gum tissue.  Signs of gingivitis include swelling, redness, and bleeding gums.  Gingivitis can progress to periodontal disease with progressive bone and gum tissue loss.  It is important for people to understand that poor oral hygiene is a major cause of bad breathe (halitosis).  Most often, a person’s senses becomes accustom to their own bad breath and they are unaware that it even exists.  However, people in their vicinity are usually well aware of this condition.  When this is explained to teens, it can often be news to improve their oral hygiene.

The good news is that tooth decay, demineralization, gingivitis, and halitosis are easily preventable. In the next blog entry I will review the best tips and techniques to keep these conditions away from your mouth!

 

Tips for Making Braces More Affordable

At Meadows Orthodontics, we work really, really hard to make the process of aligning your teeth as affordable as possible.  I thought it would be helpful to list the things that we do for our patients, and the things that our patients can do independently to help with the finances involved with this important investment.

  1. The best way to keep costs under control is to have orthodontic treatment only once in your life, and the best way to ensure this is to have it done properly the first time around. Do your homework when choosing an orthodontist!  This is the most important part, and it is important to understand that braces are not a commodity. That is, two orthodontists can use the exact same braces, and the patient may end up with radically different results. The orthodontist’s decisions ultimately determine the quality of care that you receive (not the braces or brand of braces). Check the American Association of Orthodontists (AAO) website and the orthodontist locator to make sure that the professional you have choosen is an actual orthodontist (an orthodontic specialist) at mylifemysmile.org. You can then check if the orthodontist is Board Certified by the American Board of Orthodontics (ABO) at www.americanboardortho.com/portal/public/.
  2. Take full advantage of  Health Savings Accounts (HSA), or Flex Spending plans. These can be set up through your employer’s human resource dept., or can be set up through a local bank. The power of using these accounts is that they allow you use money that you earn without paying taxes on the amount that is used for braces or invisalign, which could save you well over 20%! Our staff will help you set up your plans, and will help you with proper timing in starting treatment to take full advantage of HSA and Flex benefits.
  3. Take advantage of our 0% interest in house financing plans.  We will gladly extend fees into monthly payments for the length of your treatment. Since there is no interest and is financed 100% through our practice, this really helps most families. We also offer discounts if you wish to pay in full at the start of treatment. Either way, we will always find a way to make things very comfortable for your family and your lifestyle.
  4. Make sure you wear your retainers after orthodontic treatment is completed. I see hundreds of adults that had braces as teenagers, had amazing teeth, then stopped wearing their retainers in their late teens. Over the years, their teeth have become more and more misaligned, and they often come in for orthodontic treatment again. These days we strss the importance of lifetime retention to keep your teeth straight. We will discuss the various retainers available (which can be permanently fixed or removable), and help you decide what will be comfortable and predictable for the long run. I love seeing my patients, but I do not want to treat them a second time later in life!
  5. We offer discounts for multiple family members, and discuss the differing costs for different types of braces, clear braces, and clear aligners. We are also kind to those who serve our country in the Armed Forces, and the police officers and firemen who protect us. Give us a call- you will be surprised how easy it is to get an amazing smile very affordably!

Dr. Dan Rejman is the owner of Meadows Orthodontics, which has two locations within Castle Rock, Colorado. We are open five days a week in Castle Rock, and are open evenings and every other Saturday for the convenience of the busy people in our home town!

 

 

Back to School Time Reminders for Braces!

IMG_5820I still have not quite become used to my kids going back to school in early August, as my childhood memories are of returning after Labor Day. But, all three of my kids are back on the school time schedule, and all three of them are in braces. With their minds on school, class mates, getting up and getting ready earlier, I thought now would be a good time to give them and my patients a pep talk to keep up the effort in taking care of their teeth and braces that will continue moving them forward to the end result of an amazing, finished smile. Here are some tips and reminders for all of you heading back to school, and for the parents of these kids:

 

  1. In the morning rush of getting ready, reserve a nice amount of time to brush really well around your braces! Not only will this help eliminate permanent staining and gingivitis, but it will help in another area that youngsters and teens seldom think about- it will improve your breath! Kids with poor oral hygiene rarely can detect that their own breath is noticeably smelly, but those around them certainly can!
  2. Parents- help your kids with the above! My wife an I do a quick check on our kids before they head out the door. Yes, even an orthodontist’s kids are not self motivated to always keep their mouth clean. Oral hygiene, especially with braces added into the mix, is a challenge for most kids and teens, and it need to be a team effort. I tell parents all the time that they are not alone with non-compliant kids… we have three of them that need constant reminding and encouragement. I also commonly hear “They are old enough to remember to do it on their own!”. After treating thousands of patients through the years, I have found this to not be the case. Kids and Teens usually are just not  wired like adults when it comes to personal hygiene! Keep the effort up mom and dad- it will pay off, and use the bad breath warning- teens are usually responsive to this based on what others are perceiving of them.
  3. Now that we are on the school year schedule, parents and all of us here at Meadows Orthodontics have scheduling challenges of our own. Our after school appointments are obviously the most popular for most people, and we have responded by being open an (unheard of!) average of five days a week for after school (and Saturday) appointments in Castle Rock. You will notice a large crowd during these hours, and I am putting in a tremendous effort to be open during these convenient hours as much as possible to accommodate our patient’s busy lives, while keeping care extremely personalized. Every now and then, I will ask for patience if it gets really busy, as I will never reduce the amount of time I need to appropriate to each patient. Every now and then, I may request that we schedule an appointment during the school day for procedures that require even more time than the busy after school appointments will allow. This is our way of giving you the attention you need, while keeping the after school hours free for the larger number of your (and the rest of our patient’s) more numerous “traditional” appointments. Thank you! Just a tip- if you or your child are the type to enjoy a much more quiet atmosphere, the hours from 10-2:00 are much more “calm”! Let us know what hours fit your needs best, and we will make it work.
  4. Keep wearing your rubber bands as directed! Again, with the rush of starting a new grade, don’t let the task of wearing your rubber bands as much as possible delay your date of getting braces removed. Not wearing your rubber bands during school hours will greatly increase the time that you are in braces, often by many months.
  5. Don’t forget to keep your appointments with your general dentist for cavity checks and cleanings. Especially when you have kids in braces, it is important to have your professional keeping a close eye on their teeth.

Dr. Dan Rejman is the father of three children (and soon to be a fourth!) in Castle Rock, and understands our local families’ busy schedules. Meadows Orthodontics offers appointments five days a week, all in  two Castle Rock locations, and Saturdays also!

Continuing Orthodontic Education in Asheville, North Carolina

I returned today from five great days of continuing education and meetings in Asheville, North Carolina. This meeting and the scientific programs (lectures and continuing education) are the centerpiece of the College of Diplomates of the American Board of Orthodontics annual meeting, and the board meetings are part of my responsibilities as the councilor for the Rocky Mountain and Southwestern Orthodontic Societies. I always like to publish the latest in orthodontic research and advancements that are being made in the field of orthodontics, and what I can incorporate into my practice here in Castle Rock.

Of great interest was the procedures being performed by Dr. Flavio Uribe and his team of orthodontists at the University of Connecticut. Patients who have bites and facial appearances that are severely deviated (usually due to an underlying skeletal imbalance of the upper and/or lower jaws), traditionally require about a year of orthodontics followed by orthognathic surgery (performed by an oral surgeon to re-position the upper and lower jaws), and another 9-12 months of orthodontics to fully correct the bite and skeletal imbalance of the jaws. Dr. Uribe and team are now performing the surgical portion of treatment immediately after the braces are placed, and orthodontics follows this surgery to correct the bite and imbalances. They are finding a greatly reduced time that the patient spends in braces with this method, along with avoiding the transient time period where traditionally the patient’s teeth were “decompensated” prior to the surgery. Decompensation of the teeth is where the teeth are initially placed in a more ideal position for after the surgery, but usually makes the teeth look more unattractive during the period before surgery. It also makes the planning for insurance coverage more precise and predictable. This is certainly something that I will discuss with the oral surgeons that I use for surgical/orthodontic cases in the Castle Rock area, as with selective cases this appears to be a win- win for myself and my patients.

As far as the yearly report from the American Board of Orthodontics, there continues to be a rise in the number of young orthodontists that are putting in the time to become board certified, which is encouraging for our profession. Becoming board certified is not only requires hundreds of ours and dedication to prepare for, but also raises the level of care for the public that we serve across the country.

Dr. Dan Rejman is the owner of Meadows Orthodontics in Castle Rock, CO, and has been Board certified by the ABO since 2007.