The Dangers of Mail Order Aligners…an Excellent Summary from Laster Orthodontics

I have written many blogs over the years about orthodontic issues that are relevant to my patients in Castle Rock, and I recently set out to write an article on Mail Order Aligners (such as Smile Direct), and other aligner options that are increasingly popping up. I ran across an article from Laster Orthodontics in North Carolina that was just perfect. I received permission to direct my readers to their site: https://www.lasterortho.com/blog/the-dangers-of-mail-order-aligners. This is an excellent article, and is a must read for anyone who is thinking about using these mail order services.

THE DANGERS OF MAIL ORDER ALIGNERS

May 6, 2019

Many people want a straighter smile, and they want it fast, discreetly, and easy. Over the past decade, orthodontic treatment has evolved quickly, and today discreet options like clear braces and clear aligner therapy are increasing in popularity. Invisalign and other clear aligner therapy options quickly rose in popularity in most orthodontic offices. However, there is another side to clear aligner therapy outside of the orthodontist office that is causing concern among orthodontists and the American Dental Association (ADA) – mail order aligners.

 

What Are Mail Order Aligners?

Since products like Invisalign can be costly, some companies have started offering cheaper alternatives through mail order businesses (often referred to as teledentistry). Instead of going into the orthodontist and dentist, these direct-to-consumer companies will supply you with an at-home impression kit to take impressions of your teeth. Once you mail them in, they’re reviewed by one of their technicians (usually someone living in a foreign country with a high school or less level of education), who determines if the patient is a candidate for these aligners. If so, aligners are made and sent back to the patient and they are instructed to wear them for a specific amount of time to begin correcting teeth. Since some of these mail order aligners are significantly cheaper than Invisalign, the price is very appealing to consumers. The criteria for being accepted is very loose we literally see pictures every day of patients approved for aligner treatment with active dental decay and/or gum disease or conditions that aligners would never actually work for. These companies have a goal to make money selling people something that really needs to be supervised by a professional, and are willing to severely compromise the standard of orthodontic and dental care in order to sell their product.

Smile Direct Club started the market for mail order aligners, and they continue to be the most popular option. Smile Direct Club is extremely heavily marketed, and they can make you think that they have many satisfied customers. The reality is there are literally hundreds of active lawsuits against Smile Direct Club by dental boards and unsatisfied patients. However, other companies are jumping into the mix after seeing their success. Some of the options available include Smile Direct Club, Candid Co. Clear Aligners, and Byte Aligners. As a consumer just know that any “do it yourself” orthodontics carries many potential risks and is more likely than not to give an unsatisfactory result and possibly make your teeth worse than they started.

 

The Hidden Dangers of Mail Order Aligners

Most dentists, orthodontists, and even the ADA are speaking out against the use of mail order aligners from Smile Direct Club and other similar companies. Why? Because they pose several dangers to patients. Like most things, you get what you pay for, and offering such a discounted service has its downfall. Flaws in the mail order aligner system include:

No Comprehensive Exam Before Treatment

An orthodontist does far more than just help straighten teeth. They identify and treat serious oral health concerns before they even consider offering their patients orthodontic treatment. This is why they do a comprehensive exam before recommending orthodontic treatment. Serious oral health problems, like gum disease or cavities, can be overlooked with home kits because there’s not a whole lot that can be seen from a few photos or putty impressions. An orthodontist typically has many years of post college education to learn to identify oral health problems and best manage them. To do any sort of tooth movement without the supervision of a dentist or orthodontist is extremely risky.

There’s No Real Supervision During Your Treatment

Another danger of mail order aligners is the lack of supervision during treatment. When you are treated with clear aligner therapy in an orthodontist’s office, they require routine appointments to make sure your teeth are moving at the safest, most efficient rate. An orthodontist will adjust your treatment plan as needed along the way, but you won’t get this when you go with DIY, home aligners. With mail order aligners, teeth may move slower or faster than anticipated. You may develop gum disease or cavities during your treatment, with no orthodontist or dentist being able to treat you because they can’t see your teeth. These are both real concerns that a lack of supervision during orthodontic treatment brings to light. I see daily pictures of patients teeth who were damaged and bite ruined by poorly designed mail order aligners that were done at home with no supervision. I would suggest to anyone that no treatment is much safer than unsupervised treatment.

You Risk Your Teeth Being Worse Than Before Your Treatment

Imagine paying for mail order aligners and going through with the treatment, only to have to see an orthodontist in person for more treatment due to the severe damage caused by your mail order aligners. Moving teeth too fast with mail order aligners or poorly fitted aligners can result in serious problems. There have been hundreds of reported Smile Direct Club horror stories that have emerged over time, with some people complaining of poorly fitting aligners that resulted in their teeth falling out, cuts to the gums, an inability to close their mouth or chew properly, and overall claims that their teeth were worse off after going through treatment. Smile Direct Club will have you sign a form before treatment letting you know that all these problems are your responsibility and not theirs, thus, when their aligners don’t work for you there is not much recourse that you have.

The NC Dental Association is Filing Lawsuits Against These Products

The NC Dental Association plans to file lawsuits against these products, and dental associations in other states, the ADA, and the American Association of Orthodontists (AAO) have voiced their distaste or have already lodged complaints against companies offering services like Smile Direct Club, alleging that the company is engaged in an unlawful practice of dentistry.

Aligners Aren’t for Everyone

It’s also important to note that aligners aren’t the right choice for everyone. There are different types of orthodontic treatments on the market, and an orthodontist can decide which one works best for your unique needs. Some patients can wear aligners just fine, and others will need braces or other orthodontic treatment to get their perfect smile. For example, some orthodontists might recommend braces over aligners for younger patients. Mail order kits only provide clear aligners, and cannot cater to everyone’s needs, and they may not be able to determine if you’re a suitable candidate for aligners.

 

According to the American Association of Orthodontists, orthodontic treatment is a medical service – not a device or product. They recommend that consumers only receive clear aligner therapy from an experienced, licensed orthodontist to ensure that they receive the quality, safe treatment they need. Although going with mail order aligners may seem to save money in the short term, it’s a dangerous option that can prove very costly in the long run. If you’re in North Carolina and are ready to enjoy a straight, beautiful smile, contact Laster Orthodontics today to learn more about our orthodontic services.

 

Again, a thank you to Laster Orthodontics for this excellent article!

What happens the day that you get your braces off?

The day has arrived that you will have your braces removed at Meadows Orthodontics…how exiting! Kids and adults alike appreciate knowing what is in store for them on this big day. Here are some things to expect.

Our entire office is involved on this day to make it a celebration! Our entire staff is happy on this day also, as our combined efforts have paid off, and we all get to the the beautiful results! We have many surprises planned for this day (I guess not so much of a surprise if you are reading this :). After your braces are removed, we give you the option of taking pictures with us, complete with confetti, and fun get-up (sunglasses, etc…)if you wish. We have bubbles to run through, and give you some special chewy, crunchy treats (that you were supposed to avoid during braces!).

As far as sensitivity is concerned, everybody is different. The vast majority of people have very little sensitivity while we removed the braces and “cement” that held them on. Some people do have very sensitive teeth, and they are usually well aware of this, as they have been sensitive to cold water, ice cream, etc… for most of their lives. We are very sensitive to this, and we take as many pauses and breaks as needed to get them all polished up and shiny in the most comfortable way.

Believe it or not, we have a number of kids who are sad to have their braces removed, as they have enjoyed using them and the colored elastics as “accessories” to their outfits! However, most people are thrilled to have them removed and to be “free” again. The most common description we hear when braces are first removed is, “My teeth feel so slippery, or slimy”. This is because the  new glassy smooth surface of the teeth feels so different than the braces that were previously there.

After they are all polished up, we take a final panoramic image to check root health, wisdom teeth, etc. I always recommend that they see their dentist soon after the braces are removed for a cleaning and a cavity check. Some patients choose to ask their dentist about whitening options at this point, for an even more eye catching smile. We also fit retainers, and review how important it is to regularly wear them at night. The great thing is that the retainers do NOT need to be worn during the day after braces are removed, like when I was younger.  All in all, it is such a happy and exciting day all around!

 

Dan Rejman, DDS, MS, is an orthodontic specialist with two offices in Castle Rock, Colorado.

Orthodontic Concerns When Your Child Goes to College

I just dropped my daughter off at college a week and a half ago in Arizona. Where has the time gone, and how did my little girl grow up so fast? Being the big tooth dork that I am, I went through a mental dental check list to make sure that she was all set, and hopefully would not have any dental issues to deal with since she is so far away. I thought this would be a good time to write an article on what parents may want to add to their own child’s checklist before their first big move away from home.

  • If they have had orthodontic treatment and their braces have been removed, make sure that they bring their retainers with them! I see patients that return from their first semester of college, and their parents see that they have not been wearing their retainers at night, and their teeth have started to shift and become misaligned. Amid the excitement and stress of being away from home for the first time, it is common for kids to stop wearing their retainers during this period of time. In general, we recommend wearing retainers at night for life, as teeth will most always tend to wander as we age, whether you have had orthodontic work or not. Remind your children who have recently moved to continue their retainer wear, as this will avoid the cost of replacing the retainers, or even having to return to braces or aligners if their teeth have shifted substantially.
  • If they loose or break a retainer while away, call your orthodontist immediately! Depending on the timing and their location, we will help you find the help you need to keep your teeth aligned and protected.
  • We also have young adults who are still in orthodontic treatment when they head off to college. If their school is relatively local to castle Rock and the Denver area, we can continue to see them on a regular basis. We have had several kids who attended a college far enough away that we had to work out a schedule with a more local orthodontist to see them while they were out of state. Of course, we would like to finish them before their big move away, but life does happen, and it is important to make a plan with your orthodontist if college and orthodontic treatment overlaps.
  • It is always a good idea to have a cleaning and dental exam/cavity check before heading off to college. As with retainers, this can be a time in life where the basics seem to slip, and it is important to keep up with proper dental health and regular care.
  • My daughter started to have sensitivity in her wisdom teeth (third molar) areas several months before she left for college. We made an appointment to have a consult with an oral surgeon, and had the wisdom teeth removed several weeks before she left. One think to be aware of: oral surgeons are usually very busy during the summer months, and you may have to wait longer for procedures during this time of the year. We waited a bit to long, and certainly added some stress to my daughter’s life as she had swollen cheeks right up until the day we headed out to college. Your dentist or orthodontist can let you know if getting third molars extracted are recommended or not at this age.
  • This can also be the age where your child may reach the point where they are not covered under your dental health insurance. This could impact your dental, orthodontic, or oral surgery coverage. Insurance plans and coverage vary, so it is a good idea to check how long your children are under your insurance umbrella.

I hope this helps. Having my first child move away was emotional for all of us, and worrying about teeth was the last thing on her mind. But being prepared will help protect your family’s orthodontic investment and beautiful smile!

 

Dr Dan Rejman is an orthodontic specialist in private practice in Castle Rock, Colorado. Four of his own children have had, or are in, orthodontic treatment!

New Board Exam Format for Orthodontic Specialists

I just returned from the American Association of Orthodontists annual meeting (which is massive in size and attendance) which was held at the Los Angeles Convention Center this year. Several highlights: My family ate at the restaurant James Beach, which was featured in my wife’s favorite movie, “I Love You Man”. They serve amazing fish, shrimp, and lobster tacos.  We took our kids to Chinatown, toured several colleges in the area, and we watched real surfers for the first time!

Most of my time however, was spent teaching the new preparatory course for the American Board of Orthodontics Scenario Based Examination. As a councilman for the College of Diplomates of the ABO, one of our responsibilities is to educate our colleagues and the public about Board Certification for our specialty of orthodontics. I have taught the preparatory course since 2014, but this was the first year of the new board examination format, and the course was doubled from 4 hours to 8 hours. It has been very uplifting to watch the very positive response and interest within our specialty to pursue board certification in orthodontics. In an age where seemingly every month there is a new product on T.V. promising “quicker, faster, cheeper, easier” (most of which have no professional supervision, an unfortunate reminder that salesman have such a forum in today’s world), our profession is taking the higher road, and a vast number of orthodontists are renewing or continuing their dedication to providing the highest possible care for patients through education, research, science, and evidence-based techniques… which is what becoming board certified is all about.

During the course this past Friday, I saw the attendees grasp what a difficult examination this would be (a two hour oral examination in front of twelve peers, only after passing a written examination), and embrace the rigorous standards that are expected of them. It will be one of the most difficult things that they will ever have to prepare for, and it will be stressful. But I hope the general public realizes the amount of dedication that most orthodontists pour into this profession every day of our lives to make the quality of care we deliver soar way above what other, non- orthodontic specialty sources provide (especially unsupervised products such as Smile Direct). It was a lot off work on my part to prepare to teach this course, but it was so rewarding to see the continued dedication from my fellow peers.

 

Dr. Dan Rejman has two private practices in Castle Rock, Colorado, and has been Board Certified by the American Board of Orthodontics (ABO) since 2007.

Castle Rock’s Amazing Orthodontic Office…Meadows Orthodontics!

We are so excited and proud to be named a 5280 Top Orthodontist in Castle Rock, now for the eighth straight year! This honor is special, as our dental peers nominate and vote for professionals to receive this honor. As the office manager, and of our orthodontist Dr. Dan Rejman, at Meadows Orthodontics, I would like to praise our amazing staff, our amazing and talented orthodontist, our local dentists that refer patients to our office, and the families of Castle Rock that make it a joy to come to work every day to create stunning smiles. Over the years here, our dedication to the town of Castle Rock has earned a dedicated following, and I would like to list the local and regional honors that we are so grateful to have received over the years:

  • Voted a TOP ORTHODONTIST in Colorado’s 5280 magazine in 2012, 2013, 2014, 2015, 2016, 2017, 2018 and 2019 (voted on by dental peers)
  • Voted Best-of-the-Best, “Best Orthodontist in Castle Rock”  in 2014, 2015, 2016, 2017, 2018, and 2019, Castle Rock News Press (voted by the community)
  • Voted “Best Orthodontist in Castle Rock,” Douglas County’s Finest, 2014, 2015, 2016, 2017, 2018 and 2019.  Douglas County Living Magazine (voted by the public)

 

 

Constantly striving to improve, and consistently trying to provide our patients with the best experience possible has led us to being honored with the above recognition. Thank you Castle Rock!

Julie Rejman

 

Meadows Orthodontics is a privately owned orthodontic specialty practice that is open full time, solely in Castle Rock, CO!

Thank you Castle Rock for a great 2018, from Meadows Orthodontics!

2018 was an amazing year for us here at Meadows Orthodontics. I would like to thank all of our wonderful patients and their families that keep providing myself and my staff with inspiration, great attitudes, nice company and new friendships. I would also like to thank my wonderful staff that does so much to provide excellent care, and makes it fun for me to come to work everyday. Here are some photos from this year- first some before and afters of the last two patients who had their braces removed this year (of almost 500!). The “before” braces pictures are the first and third ones, with the “after” braces just below them -the second and fourth (I am much better with teeth than I am with Word Press laying out blogs!). Just below are a sample of the hundreds of paintings our patients have done for our two Castle Rock offices. This continues to be a really fun tradition, and provides such an inspiring, cute, and interesting decor that keeps getting bigger every week! Below this picture are several fun pictures of patients after getting their braces off, complete with confetti, and a picture of our team on Halloween dressed as Trolls! Enjoy, and see you in 2019!

 

  

Can I Just Get Braces on My Top Teeth, or Just My Bottom Teeth?

Some of my patients that have more mild misalignment of their teeth, or considerable misalignment on the top or bottom teeth only, often wonder if they can just have braces or Invisalign on the top or bottom teeth only. It is a good question, and the answer really depends on the person’s individual issue with their teeth, and their unique bite. Bellow are several useful points and examples to consider if you were wondering about this for yourself or your child.

  • Lets say you had orthodontic treatment in the past, but years later one of your upper front teeth has started to rotate noticeably. Your bite has otherwise remained healthy and stable. This is a case where I very well may be able to treat this issue with braces or a clear aligner limited to the upper teeth only (or lower teeth if the minor movement has occurred here). If the tooth movement can occur without disrupting your bite and will place the tooth in a healthy, aesthetically pleasing position, this is a great and comparatively simple option. Many adults that are noticing teeth starting to shift could benefit from this type of treatment.
  • Now lets say you have noticed a number of your lower teeth are misaligned or have shifted. An important thing to picture is an analogy that I use often. Your teeth should fit together similarly to a shoe box: the upper teeth are the lid, and the lower teeth are the box itself. The lower box needs to fit within the confines up the upper teeth. If just your lower teeth are crowded or overlapped (more than just several teeth merely rotated), aligning these teeth requires gaining more space. Or to use the shoe box example, if we treated the lower only, the box would need to be expanded, and would no longer fit the box lid (the upper teeth. These situations are a bit more involved than the first example above. And this is not a bad thing- read below!
  • I reassure people that I do not set fees by whether we place upper braces, lower braces, or both. Most often , it makes treatment easier, faster, and more successful if we treat both the upper and lower- thus I do not charge more for both than I do for one. Of course, in the first example with the more minor movements, we would want to keep things as limited as possible, and the fee will reflect that.
  • Likewise, Invisalign as a company does not differentiate with their pricing whether we treat the upper, the lower, or both. Invisalign fees are initially set by the number of trays that need to be switched to align teeth on ONE arch, and the other is included. Any more than 10 trays is considered a full Invisalign case, 10 or less is a limited case, of which there are several options.

If you have any questions at all about which options would be best for your teeth, please call us for a complimentary consult.

 

Dr. Dan Rejman is a Board Certified Orthodontic Specialist in Castle Rock, Colorado, and he has treated over 9,000 orthodontic patients!

“My Child is Nervous About Orthodontic Treatment!”

It is very natural for a child to be nervous about their first experiences at the orthodontist. Whether it is the initial exam, getting an expander, or braces, there is a lot of unknowns in their minds and they often fear the worst. Parents also may have unpleasant memories about their own orthodontic treatment from years ago. The great news is that we are very aware of this, many things have positively changed over the years, and once children have started with us they are almost always very relieved and happy to come in for their next appointments. Here are some things to describe how we approach treatment with children, and some things for them to know about their first appointments with us.

  • We are very empathetic! Our staff has a combined 31 children between us, so we are very familiar with children’s feelings and fears. We are in “kid mode” constantly, and all of us truly enjoy helping to put kids at ease. Personally,I was quite anxious as a little one with medical and dental appointments, so I really try to go out of my way to alleviate kid’s fears and make their entire treatment a happy experience.
  • For parents that had a less than stellar experience when they were kids, or had a grumpy or mean orthodontist, I can tell you that your experience here will be soooo much different. I am as patient as they come, and if time is needed to help with anxious youngsters, I understand.
  • We are set up for kids to have fun! We have great choices for colors (over 25)and custom color combinations for kids to choose from for their braces (see the color board to the right). We have a selection of Crazy Aaron’s Thinking Putty for kids to play with to keep them occupied during treatment if they would like to “fidget”. We have a children’s play area with toys, books and movies to set a friendly tone and keep siblings busy. We celebrate the end of treatment with treats, surprises, pictures and confetti! We have fun seasonal contests, decorate and dress up for holidays, and play fun music. It should be an enjoyable experience from beginning to end.
  • There are no shots!! Kids usually are very relieved to hear this. It is extremely rare that we have to use anesthetic, and if we do it is usually a topical paste that is like applying toothpaste.
  • We give a very detailed explanation of treatment that is needed, show kids examples, let them touch and examine appliances that may be needed, and make them feel familiar and comfortable with what we are doing before we do it. Usually placing braces does not hurt at all, and most of the discomfort from braces happens the day after they are placed, at home. The teeth usually feel sore for several days, but is very manageable with Tylenol or ibuprofen. Kids are almost always very surprised at how easy and comfortable their actual appointment with us was.
  • In general we try very hard, and are focused on feelings, not just the “nuts and bolts” or mechanics of orthodontics and braces.

 

If you have any concerns about your child’s dental development, or worries that they may have, please call Dr. Dan Rejman and Meadows Orthodontics in Castle Rock, and we will gladly answer all your questions!

The importance of wearing your elastics (rubber bands) as directed by your orthodontist

One of the most important factors in obtaining a healthy bite when in orthodontic treatment, whether you are in braces or invisalign, is often the use of elastics. We use these rubber bands to correct many types of bites that are not fitting correctly, and to make things as stable and healthy long term. This article is a short guide to help understand what specific elastics do, and why wearing them consistently, and as directed by tour orthodontist is so important.

Always on the mind of patients is, “When are my braces coming off?”. The one thing that impacts the speed of treatment the most is how many hours a day elastics are worn (if directed), and how consistent they wear them from day to day. For example, if I estimate that treatment will take 18-22 months, this is assuming that the patient will be excellent with compliance if we request them to wear elastics 20-23 hours a day (say to correct an open bite- more about this below). If the patient skips several days a week, or only wears the elastics 12, 16, 18… hours a day, the amount of time they will be in braces or invisalign to correct the bite will likely increase significantly. This is so important for a patient (and their parents) to understand from the beginning of treatment. Another important thing for parents to keep in mind; the pre-teen and teen mind is often not wired for truly understanding and grasping the consequences of this concept. I have had four kids of my own in braces. Three of them wore elastics great and finished as estimated or sooner. The fourth struggled with remembering to wear the elastics, and his treatment time was nearly double the others!

Lets go over what elastics are actually doing to correct specific bites. The important thing to remember here is that when you start with elastics, they ARE the treatment- the braces at that point are just a scaffolding while the rubber bands cause the movement.

  • Class II elastics:  These are worn to move your upper teeth back, and the lower teeth forward
  • Class III elastics: These are worn to move the lower teeth back, and the upper teeth forward
  • Box elastics: Move the upper and lower teeth towards one another, often to correct open bites

These are just several of the most common elastics. Other options other than elastics, or used in conjunction with elastics, are fixed springs inside the mouth, headgear, Forsus, functional appliances, and facemasks. I will let you know what will work the best for your specific case if we use more than just elastics. The one common factor in all of these is consistency of wear, so do your part to make your treatment as fast and efficient as possible!

 

Dr. Dan Rejman practices as a full time, board certified orthodontic specialist in Castle Rock, Colorado. Please call if you have any questions about your or your child’s bite, esthetics, or developmental issues.

 

 

What are the options when you have several teeth that that are too small?

It is very common for me as an orthodontist to see teeth that are disproportionately small or large compared to the other teeth in the mouth. I see teeth that are too small much more often, and this is especially common with the upper lateral incisors (the second teeth back in your mouth starting from the front). Several times a week, I see new patients with laterals that are anywhere from a millimeter or two too narrow (which patents often never realized they were small), to ones that are very noticeably narrow, which we call “peg laterals”. When these patients are starting orthodontic treatment with braces or invisalign, it is important to recognize this size discrepancy so that their bite can be planned accordingly to fit ideally when we are finished.

The goal of this article is to explain what is involved with getting the bite to fit properly when there is a tooth size discrepancy, as this concept often can cause some confusion with parents. An analogy that I often use is that your bite is like a shoe box fitting together. The upper teeth are like the lid of the shoe box: they are  broader than the lowers, and they should make a framework around the lower teeth. The lower teeth are like the box itself, which should all fit securely inside the framework of the uppers. Picture what would happen if you took the snuggly fitting cap to a shoe box, and replaced it with a smaller lid (like having several upper teeth that are too small) and tried to place this on the box. If you forced it to fit, the lid would likely tear, and there would be extra space left at these tears when the lid was pushed down. This is what happens in the mouth when there are upper laterals that are too small, and the remainder of the teeth are positioned in a correct bite: there are spaces that are left over where the teeth are narrow, and we are often physically unable to close these spaces anymore (the upper “lid” would become too small and will not fit to the lower anymore).

So what options do we have when this occurs? Here are the three most common:

  1. Leave spaces adjacent to the small teeth at the end of orthodontic treatment, and after the braces are removed your general dentist will restore them to their proper width. I usually recommend this option when the laterals are noticeably small, and the “widening” of these teeth by your dentist results in a much nicer appearance. Your dentist will help you choose the best materials to use, whether it be bonded composite, or ceramic veneers or crowns. There is an extra charge outside of orthodontics for your general dentists to perform this procedure.
  2. Reduce the size of the lower teeth to match the missing width of the upper teeth. I usually recommend this option when the missing upper lateral width is relatively small and the upper laterals appear very nice even though they are a bit smaller. With this option, the front 6-8 teeth are made slightly narrower by sanding between where these teeth meet one another. It basically creates a number of small spaces, after which I close the lower spaces (which creates a smaller “lower box”), which then allows for full closure of the upper spaces (using the existing smaller “upper lid”). The advantage of this option is that no further dental procedures will be needed after orthodontic treatment. The downside is that there will be some removal of enamel- they key is to keep it conservative, and for me to go no where near the point that it causes increased risk of future decay, increased long term sensitivity, or an appreciable loss of tooth structure. If too much tooth reduction or slenderizing would be needed, I always recommend option 1 above.
  3. Leave the lower teeth “back” from an ideal bite. A skilled orthodontist will always try to get your bite as aligned and as healthy as possible, but sometimes this is an option if the size discrepancy of the laterals is small enough, and the bite can be left purposefully off a bit in order to close all the upper spaces. I don’t do this as commonly, but it is another option if patients don’t like the thought of the the other two options above.

Which option is best for you? If you know you have abnormally narrow teeth, I will be happy to help you decide which option is best. Every bite is unique, and we will decide on a custom treatment plan to finish your teeth as healthy and as attractive as possible!

 

Dr. Dan Rejman is board certified by the American Board of Orthodontics, and is the councilor for the College of Diplomates of the ABO for the Southwest and Rocky Mountain regions.