Meadows Orthodontic Blog

I recently returned from the American Association of Orthodontists annual meeting and convention held in Orlando, Florida. In addition to teaching the national board preparatory class to practicing orthodontists and residents working towards becoming board certified by the American Board of Orthodontics, I was able to attend several very interesting and informative lectures by some of the leaders in our profession. Of special note was the lecture (orthodontists were spilling out of the lecture hall to hear this presentation) by Dr. Kevin O’Brien entitled “In the Land oUncertainty is Salesman King?”. Dr. O’Brian is a professor of orthodontics and researcher at the School of Dentistry at the University of Manchester, UK. and has been a clinical orthodontist and researcher for about 30 years, with the research directed at the outcome of orthodontic treatment using randomised trial methodology.

I have included below a link to one of his articles that was discussed in his lecture, which describes the current state of research on self-ligating brackets (braces that include the brands Damon, Smartclip, Empower…). To summarize, the incoming credible research is showing the claims being made by the companies (and orthodontists) marketing these brackets are not supported. The public should be aware that aggressive direct to consumer marketing by manufacturers, which is then incorporated into many orthodontists websites, is just that- a marketing pitch without backing (and now contradictory) evidence. When these products involve making a claim of superiority (and an increase in cost), candor should be used when presenting the option of these brackets to our patients. As it stands now- there is no evidence of faster results, less sensitivity, superior results, cleaner teeth, or any of the major claims for using these brackets and their systems.

Does this mean that these braces are a bad option, or worse than traditional brackets? Of course not- I actually offer them as an option to my patients because they are very nice brackets (braces). I am just up front with patients in informing them that there is no evidence that they provide better results or a better experience than “traditional braces” (which manufactures also make unsubstantiated claims about in competition with one another, and the new technologies incorporated into them!). I believe my job as a professional is to keep up with current technology, but to be completely candid with my patients about the most current evidence if we are going to choose to use a product. Please read the article in the link below, and feel free to look up Dr. Kevin O’Brien’s blog for many valuable articles on the latest research involving orthodontics controversies, products, and treatments.

Dan Rejman, DDS, MS

Self Ligation: Another nail in the coffin?

Last Wednesday I finished up the sky and touched up the stadium on the wall of our exam room. Thank you for your help Leela! We added a special touch in the sky with the Air Force Thunderbirds doing a flyover. For you flight geeks (me!) the actual Thunderbird maneuver they are doing in the mural is called the “Delta Burst” with the two outside F-16’s rolling away from the middle four. Our kids and adults are loving this room when they are getting their braces! Remember- Orthodontics is an art!

-Dr. Dan

Dr. Dan Rejman is the owner of Meadows Orthodontics in Castle Rock, CO. We have two locations in Castle Rock – in the Meadows close to CV High School, CRMS and Aspen View Academy, and another office near Founders, Terrain, Franktown and southern Parker (close to DC and Ponderosa High Schools and Sage Canyon Middle school).

Tomorrow my family, staff and I will be heading down to the annual American Association of Orthodontists (AAO) national convention in Orlando, Florida. I will be busy with responsibilities for my position on the College of Diplomates of the American Board of Orthodontics. Additionally, there is the opportunity to catch up with the latest technology available in orthodontics, and the decisions that follow of whether to implement this new technology into Meadows Orthodontics. There are also hundreds of lectures and continuing education classes to choose from for myself and our staff. I thought I would highlight some of the things I will be doing and checking out at the convention.

• I will spend the entire day Friday as the instructor of the preparation course for the American Board of Orthodontics (ABO) Exam. I will be teaching two sessions to orthodontists and orthodontic residents who are preparing and studying to be Board Certified. Becoming Board Certified is important for our profession, and helping others with this process not only helps relieve some of the stress they are feeling through the long preparation process, but is also an opportunity for me to remain as sharp as possible (I study several times a year to prepare to teach the course).
• On Sunday morning I will be judging over 400 finished braces cases submitted by residents from programs across the country. The competition involves accessing quality of finish of the completed cases (patients that have been treated with braces), taking into account the difficulty of the case and the severity of the initial misalignment of the teeth and jaws. It is always inspiring to see our future orthodontists striving to attain such a high level of quality in treating patients.
• We have had an optical- digital scanner that replaces most impressions needed in our office (reducing the amount of goopy impressions needed), but there is a new generation out that we will be receiving soon that is multiple times faster and smaller. For those of you that have had this scan, it takes the scan time down from about five minutes to well under one minute!
• There are numerous lectures and research presentations on a technology that has been out for a while- using specific frequencies of vibrations to accelerate tooth movement- that I will be looking into. Many offices across the country offer this technology, but the problem has been a lack of credible evidence of it’s effectiveness, and a very steep price that is transferred to patients. I will look into the latest evidence and cost-benefit for my patients.
• And of course, we will spend several days at Disneyworld while we are there!

Dr. Dan Rejman is the owner of Meadows Orthodontics in Castle Rock, CO. There are two convenient Castel Rock locations- one in the Meadows, and one near Founders/Terrain and  close to Parker.

I see many patients that have been informed that they have what is called a “tongue thrust”, and that it is causing issue with their teeth and bite. Specifically, tongue thrust has been claimed to be the cause of open bites (front teeth that are separated from one another), and front teeth that are excessively proclined (tipped forward). I would like to present the key points from an article by Robert M. Mason, D.M.D, Ph.D. from the International Journal of Orofacial Myology, titled, “Myths that Persist about Orofacial Myology”. The key question is- can tongue thrusts move teeth?

• A tongue thrust is different than the resting posture of the tongue. Tongue thrusting is an opportunistic behavior, that finds and fills spaces available in the dentition (such as existing open bites), sometimes when swallowing. There is no proof that tongue trusting causes malocclusions, or misaligned teeth. However, there is much data to support the relationship between abnormal resting posture of the tongue with misaligned teeth and malocclusions.
• A tongue thrust when swallowing does not move teeth! Moving teeth in humans requires a minimum of approximately six hours of continuous pressure. Even if you were to swallow thousands of times a day where the tongue pressed forward against (or between) the teeth, this is not nearly enough to make teeth start to move. Biochemical studies of Davidovich and colleagues demonstrated that hours of continuous forces against the teeth are required for significant amounts of specific enzymes to built up, which activate sequences of periodontal activities that result in tooth movement. Intermittent pressing motions of the tongue, no matter how strong, do not move teeth or cause open bites.
• If the tongue rests in a forward position between the teeth for long periods of time, this continuous position can absolutely cause open bites and protrusion of the front teeth. The key is that the force is continuous, even if the pressure exerted is very light (this is how braces work!). The same can be said for thumb sucking – hours of constant pressure can move teeth dramatically.

If you have any questions about your child and the position of their tongue, please feel free to contact me. Often this is something that can be addressed very successfully. More persistent cases may require the help of an orofacial myologist.

Dr. Dan Rejman is a Board Certified orthodontist, and is the owner of Meadows Orthodontics in Castle Rock, Colorado. There are two locations to serve the residents of the Castle Rock area, one in the Meadows, and one near Founders/Terrain. 

Image source: healthline24x7.com

Getting your teeth aligned can change your life in so many positive ways. At Meadows Orthodontics we talk with new patients every day who are both excited and nervous about which type of braces (or invisalign) they should choose. We work with each patient individually to help decide what will be best for their bite, and what will fit best into their lifestyle. The most important thing to remember is that braces, invisalign, and orthodontic devices of any type are only as good as the orthodontist using them. We all have different preferences-in general it is the decisions we make and mechanics we use that determine the quality of your outcome, not the braces themselves! Here is a guide to the orthodontic choices that are currently available.

Metal Braces:  These are the “traditional” braces that most of us think of when we picture braces. Metal braces are very popular because of their small size and low profile, and the fact that kids (and some adults) love choosing the color ties that hold the wire part of the braces in. At every appointment with us, these color ties are changed, and there is an opportunity to “refresh” the look of the braces.

• Effectiveness:  Braces of all types (metal, ceramic, and self-ligating) are usually the gold standard in getting the best results for most types of bite and misalignment problems.
• Esthetics:  Metal braces bring the bold fun factor, as kids really look forward to the thousands of color combinations that can be used with the ties. Silver and clear ties can be used if you want a less colorful look. They are very noticeable though, and adults and older teens often will often opt for a less noticeable option.
• Relative cost: Metal braces offer a great value as far the unbeatable result you will get for the relatively lower investment in the actual braces.

Ceramic Braces: Often called “clear braces”, these braces are made of ceramic, composite or crystal materials. They are usually clear or tooth colored, and look amazing.

• Effectiveness: For the majority of patients, ceramic braces are usually just as effective as metal braces and the same great results are expected. There are some exceptions: For patients with deep bites (lower teeth that are largely hidden behind the upper teeth) or with patients that grind their teeth heavily we have to decide individually if ceramics can be worn on the lower teeth. The goal is to prevent wear on the biting edges of the upper teeth in these cases. Even these patients can usually wear ceramics on their upper teeth though.
• Esthetics: Ceramic braces are know for their discreet, sophisticated look that adults and older teens often gravitate towards. These braces are the best option for a highly esthetic look, with all the mechanical advantages of traditional braces. Because they are clear or tooth colored, we have patients that often go for months before co-workers notice they are wearing them!
• Relative cost: Ceramics braces usually cost more to manufacture than metal braces, and depending on the case may cost slightly more than traditional braces (although usually not as much as invisalign).

Self-ligating braces: Common brands of self-ligating braces include Smart-clip, Damon, Harmony, and Speed, among many others. Self-ligating braces use various types of sliding doors or clips to hold the archwire into the braces instead of the color ties, and can be made of metal, ceramics, or a combination of the two. Although these braces work just as well as traditional or ceramic braces, patients must be very wary of marketing claims made by the manufacturers and dental providers regarding the “advantages” of these braces. Most credible, peer-reviewed research (summarized by a recent article by the American Association of Orthodontists’ Council of Scientific Affairs in the American Journal of Orthodontics and Dentofacial Orthopedics), is showing that there is no statistical difference between traditional braces and self-ligating braces in overall treatment time, faster alignment, reduced forces, patient comfort, or improved hygiene- basically, all the important reasons these brackets have been marketed. However, these are all great brackets, and I offer these brackets in my practice- I am just very up front with my patients that they only differ by the way the braces hold onto the archwire, they cost more, and results are the same as traditional or ceramic braces (the vast majority of my patients choose traditional or ceramic after learning this!).

• Effectiveness: Self ligating brackets are just as effective as traditional braces, and the same treatment time and results can be expected.
• Esthetics: These braces can be metal, ceramic, or a mixture of the two, and the size varies depending on the manufacturer.
• Relative cost: The moving parts within these braces make manufacturing them more costly, and this may be passed on to the consumer. Like always , this varies case by case.

Invisalign:  Invisalign is a series of clear plastic trays that are changed at a prescribed period of time in order to make many incremental movements to your teeth. There are many things that invisalign does as well as braces, and some things that it struggles with in comparison. For the things that invisalign tends to have a harder time correcting, orthodontists must use adjuncts that would normally be used with braces: elastics, bite planes, in addition to what are called “attachments”, or composite bumps that are bonded to the surface of the teeth in order for the trays to “grip” onto. Also, patients and parents must consider that the ability to remove the trays at any time is both invisalign’s greatest advantage (for eating, brushing, special events such as playing an instrument in concert, etc…), and its greatest disadvantage (if they are not worn consistantly, they do not work!).

• Effectiveness: After years of using invisalign and braces, I have a good sense which bites are corrected really well with invisalign, and which ones are not. Of all the treatment types described here, Invisalign is the most important for this early case selection and identification of limitations of treatment. I actually prefer to use invisalign on some cases, and on others would not attempt to use it. I will discuss the pros and cons at your initial appointment!
• Esthetics: One of the advantages of invisalign is the clear nature of the trays, and often it is close to being undetectable to the public. However, it is very common to need the bonded attachments to your teeth. Some patients would rather have ceramic braces than these attachments, while others do not mind them at all. It is important to be comfortable with what they will look like before we get started, and I will review with you where each attachment will be, and if rubber bands will needed.
• Relative cost: On the average, invisalign tends to cost more than the other options, and this reflects the relatively large fee we pay in order to use invisalign’s technology. Again, there is a large variation in cost due to case complexity and expected treatment time.

Alignment with retainers:  Minor movements are possible within retainers that are made by our office. The key word is “minor”, as retainers are designed to retain, or hold the teeth in place. Small areas of pressure, or even a spring-loaded wire  can be added within a retainer that can push an area of a tooth a small distance.

• Effectiveness: Only for very minor movements, and the retainer must be worn steadily for the desired movements to occur.
• Esthetics: It appears that you are wearing your retainer, whether it be a clear vacuum formed tray, or a Hawley type retainer with acrylic and wire across the front teeth.
• Relative cost: The cost is usually proportionate to the minor movement that we are trying to achieve.

Call me at any time at Meadows Orthodontics, and we can discuss which option is best for you or your child!

Dr. Dan Rejman is a board certified orthodontic specialist, with two Castle Rock locations. Our original location in the Meadows right next to Einstein’s/Caribou, and our new location near Founders and Terrain, in the Founders marketplace.

This week we we were happy to welcome a local high school student who will be working part time in our office. She has shown interest in becoming an orthodontist in the future, and wants to jump right in and see first hand what my day to day life is like at Meadows Orthodontics. I worked as a dental assistant when I was curious about the dental profession, so I think it is really neat that she wants to work with us at such a young age (much younger than when I started thinking about my long term career!) I thought I would write a bit about my profession and experiences as an orthodontist, and hopefully it may help kids who are considering a career as an orthodontist.

I think what our new friend is doing is the best way to see if orthodontics is a good fit. A question I am asked frequently is, “How can you work in people’s mouths all day long?” I explain to kids that the majority of health care professions deal with the human body, whether it be the mouth, feet, growths on skin, backs/spines, etc… I think it is important to work part time or as an intern in the field that you are considering, because yes, you may not be comfortable working in these situations. Nothing worse than going to more than 8-12 years of college before finding out that mouths, eyeballs, or rashes skeeve you out! My brother in-law is an ER doc, and although it is a really interesting job, it is not something that I would be comfortable with day in and day out. For me, working with peoples teeth is just the opposite- it is just a natural fit for me.

Another thing to consider is how involved and visible you want to be within your community. When I go to the grocery store, out to eat, or run an errand in Castle Rock, I almost always run into and end up talking with a number of patients or their parents. As an orthodontist you get to know thousands of people- it is not the best job for introverted personalities! I personally like seeing people I know all over town, but if you prefer to be more “anonymous”, this profession may not be a good fit, or you may consider living in another community from where you work.

During the workday itself, I there is rarely a moment when I am not talking to patients, kids, parents, or my staff. It is a job where you are “on” nearly all the time, as far as being in front of people (my wife was a teacher and she says it is similar in this regard). Again, I really like this about my career, while others may find it exhausting. Really think about your personality and if this seems like a fit for you.

Other components of my profession include:

Creativity- there is rarely a day that I am not challenged to figure out a mechanical, physical, aesthetic, or administrative issue that presents itself.

Working with your hands/artistry: I gravitated to orthodontics largely due to the artistic component that is involved with aligning peoples teeth and creating an optimal aesthetic appearance. This is a passion for me personally, and is what makes me love going to work each day!

Entrepreneurship: Most orthodontists own their own businesses, and there is no preparation or training for this part of my job in all the schooling I have done. It is learn as you go, and luckily I have my wife who has helped tremendously with the day -to -day adventures of running a practice. This includes hiring, training and managing a staff of assistants and administrators, doing payroll, taxes, filing and checking insurance claims, advertising, paying bills, keeping up with and enforcing HIPPA and OSHA regulations, maintaining professional and business insurances, licences….it goes on and on! Running a business is hard work (but also rewarding) and having the right people around you to help has been the key for me. If this is really unappealing to you, there are options to become an orthodontist and work for larger, corporate dental chains that allow you to largely not be involved with the administrative or business aspects of dental care.

As always, I welcome anybody young or old who is interested in a career in orthodontics to come in and speak with me. I did not start dental school until I was 29, so it is never too late!

Dr. Dan Rejman is a board certified orthodontist who is the owner of Meadows Orthodontics in Castle Rock, Colorado. He has two offices located within Castle Rock, and is a specialist in braces and invisalign for children, teens and adults.

Meadows Orthodontics second location in Castle Rock is now officially open in the Founders, Terrain, Pradera, and Crystal Valley area of Castle Rock, in the Founders Marketplace! I will post pictures soon of the new office (it is amazing!), but after the Broncos’ Super Bowl win this past Sunday, I wanted to get a picture up of the Mural I have been painting in our new treatment room, as well as some additional pictures of Broncos Spirit from around town. It has been quite an amazing week, and our staff is proud to be from Castle Rock and the Denver area!

This is the new treatment room where we will be placing and removing braces, seeing new patients, and celebrating Denver’s win in Super Bowl 50! What a nice coincidence that I got this far painting the mural just before the big game. I still have a ways to go, but the scene from inside Sports Authority Field is looking better and better!

Broncos orange, blue and white were VERY popular the last two weeks as color choices for ties on braces. This is my son showing off his colors (I think he needs to get brushing!).

This is the sculpture heading east on 5th in downtown Castle Rock. I’m not one for messing with sculptures and art, but this orange shirt placed on the cowboy was playful, fun, and showed the spirit we all had this past week!

I’ve been wearing that tie way too much this past week.

My boxer, Stanley, with his Bronco jersey!

Amazingly, we had what is known as a “Broncos Sky” Saturday night before the game, and this proved to be a good omen. Well, it has been a fun several weeks at Meadows Orthodontics and in Broncos Country. I will get pictures up of the new office soon.

Dr. Dan Rejman is one of the few orthodontists that are Board Certified in Douglas County and the Castle Rock, CO area. For a list of orthodontists in your area that are Board Certified, go to AmericanBoardOrtho.com

We are excited to be opening our second office in Castle Rock! In addition to our office in the Meadows, Meadows Orthodontics will be open the first week of February in the Founders Marketplace on Ridge Road (near King Soopers). Why are we opening two locations in Castle Rock? Convenience! Starting orthodontic treatment usually means seeing us every month or two for a year and a half  for adjustment visits for braces and Invisalign. Most all Castle Rock area residents have noticed how increasingly challenging and time consuming it can be to cross I-25 with all the new construction (and soon to be Mall!). We decided to make our offices super convenient for residents of both sides of I-25. Our original West office in the Meadows near Einsteins/Carribou  is really close for residents of the Meadows, Red Hawk, etc…, while the new East office in Founders Marketplace will be close to Terrain, the Founders, Crystal Valley Ranch, Plum Creek, and downtown areas. the East office will also be much closer for our patients from Elizabeth, Franktown and Parker.

Construction started several months ago, and is nearing completion (I am
posting several pictures of the progress that is being made). The new office is very similar in size to the Meadows location, but has a slightly different layout and feel. One nice thing about opening this location is that it has inspired me to start painting like crazy again. I am trying to get 4-6 new oil paintings completed and on the walls before the grand opening the first week of February. Here are a couple pictures of the progress of the paintings (the one with the plants is 36″x 36″ and is taking a while- I am having dreams about swiss chard!).

We hope you will enjoy the new location and the convenience it will provide busy families who have kids in braces! I will follow up with more pictures when the office is complete.

Dr. Dan Rejman is a Board Certified Orthodontic specialist who lives and practices in Castle Rock, Colorado. Meadows Orthodontics specializes in Braces, Clear Braces, and Invisalign.

One of the challenges that parents of of children or teens in braces deal with on a daily basis is getting the child to wear their elastics, or rubber bands, consistently. I commonly hear, “We know they should be wearing their rubber bands all day and night, but when they go to school or to bed, they take them off or don’t remember to put them on.” The situation can get very frustrating for parents, as they feel powerless as their child’s orthodontic treatment extends much longer than was originally planned.  Not wearing rubber bands consistently and as asked by your orthodontist WILL make treatment take longer, which in turn increases the risk of permanent staining of the teeth around the braces (called decalcification), and increases the risk of root shortening and gum disease. What can you do if your child is just not showing interest in cooperating with elastic wear? Here are some tips.

• Remind them of the biggest benefit of wearing elastics as asked.  The biggest benefit is usually what kids want about half way through their treatment- to get them taken off! I constantly remind kids that wearing the rubber bands is usually the only way to move teeth as we want, and wearing them close to all day and night makes things go really fast. Parents, remind them of this often.
• Go to google images, download and print out a picture of “braces decalcification”. Tape it to the childs bathroom mirror as a reminder of what may happen if braces are on too long.
• Similarly, tape a paper saying ‘Remember your elastics” to their mirror, refrigerator, or computer so they are constantly reminded.
• Try positive reinforcement- bribery works well for encouraging consistent wear (I know- three of my own children are currently in braces!  Reward great elastic wear weekly with a treat from their favorite restaurant, pizzeria, or ice cream. Movies, I tunes points and video games are great rewards to work towards. Every child or teen has specific wants and interests that can be used to your advantage!
• Keep a calendar that you fill out together every day, coloring the day in with blue for great wear (20-24 hours a day), yellow for so-so wear (14-20), and red to indicate insufficient wear (under 14 hours). Make it clear every red day means an entire extra day in braces!
• From my own experience, sometimes taking something away may work well if the above ideas do not work. My oldest daughter responds well to several days without her cell phone. Taking away video game or computer time may work well, as could assigning chores or not being able to attend an event (although offering to take them to a movie or an event for great wear usually works better).

Try these tips, and remember that most parents feel similarly and go through some struggles with motivating their children. It is important to remember that most children and teens do not have a fully developed sense of long term consequences and responsibility as most adults do. Give us a call at any time if you feel you need additional help.

Dr. Dan Rejman is an orthodontist in Castle Rock, CO, and currently has three children of his own in braces!

This is the second part of my article explaining some common misconceptions or myths about braces and Invisalign. These are things that I hear and see on a daily /weekly basis and that patient often misunderstand.

1. When patients come to see me for a consult and are interested in Invisalign treatment, there are differences that braces that they need to be aware of. First, there are some tooth movements that Invisalign just is not good at. Often times to approach the same quality that you receive from braces, elastics (rubber bands) must be worn, bumps called attachments may need to be bonded to the face of your teeth, and “ramps” on the back of your upper trays may prevent you from closing your back teeth together. I like patients to be aware if these adjuncts are needed before deciding between braces and Invisalign. The relative advantages of Invisalign (aesthetics, the ability to remove them) can then be weighed against the disadvantages (also the ability to remove them, sometimes  limitations in correcting the bite, and usually an increase in cost). I will be glad to help you decide which option is the best for your smile and your lifestyle.
2. “I would like clear braces, but I heard that they can discolor or stain.”  For years now, the clear ceramic braces that I use at Meadows Orthodontics do not stain or discolor! The small clear ties that hold in your arch wire can discolor (especially from coffee, tea, red wine and curry), but these are changed to brand new ties at each visit, so they never really get the chance to be noticeably discolored. It is really nice that the clear ceramic braces have advanced to the point that this is no longer an issue!
3. “If I double up on the elastics that I was asked to wear, I will get my braces removed faster”  Kids- do not do this! Wearing double the rubber bands will not speed up your treatment, and could likely break the brackets off your teeth, cause pain, and slow down tooth movement! There are many sizes and strengths of elastics, and I choose the most efficient ones for you to wear (if needed) at every visit.
4. “I heard that Damon (or self-ligating) Braces will speed up my treatment, or are more comfortable.” Damon braces are one of MANY brands of braces, and each manufacturer touts the merits of the product that they are selling. The fact is teeth do not know what brand of braces is on them, and it is mainly the decisions of the orthodontist that determines the quality and length of your treatment. Damon is a really nice system of braces and I offer self-ligating braces as an option to my patients, but I am honest with them and explain that the latest research (and my own clinical experience) do not support the above claims from the manufacturers. Please see my blog article from August 21st, 2014 for more detailed information on this topic.
5. “Phase 1 (or early) treatment will eliminate the need for braces later on, or reduce the total time in orthodontic treatment.”  In general this is not the case. The majority of children do not need early intervention, but it is very important to identify the children that do.  If I have informed you that your child needs early or Phase 1 treatment, it is because of one of the following: 1). If not treated now, there is a window that will be missed that will negatively affect his/her future outcome,  2). If two phases are done a better or more stable outcome will be attained, or 3). The appearance, function or health of the patient will be improved as an adult if treated in two phases versus one phase.  Because the need for early treatment is very specific, you should have a full understanding of WHY early treatment is needed and why it is not advised to wait until one complete set of braces (which I prefer if possible). Phase 1 treatment is limited treatment before all the permanent teeth have erupted, is very specific in its focus, and the limited braces are are usually removed after 9-12 months.  Because there are so many baby teeth present during phase 1 treatment, full alignment of the teeth is not the intention of this early phase. The term “Phase 1” implies that there will be another second phase of treatment, when a full set of braces is placed  to align the permanent teeth when they have erupted. Usually the time in treatment of Phase 1 and Phase 2 added together is longer than most one phase comprehensive cases, so this should be made clear also.

Dr. Dan Rejman is an Board Certified orthodontic specialist, and exclusively treats  patients with braces and Invisalign in his Castle Rock Colorado practice. Meadows Orthodontics is located in the Meadows community, and will soon open a second Castle Rock location in the Founders Marketplace (in February 2016)!