Purcellville, VA  540-579-0559
Frederick, MD  301-694-7100
Germantown, MD  301-540-3600

About Orthodontics for Children and Adults

Orthodontics for Children

The American Association of Orthodontists recommends children to be examined by age 7 to advise if orthodontic treatment is required and is the best time for that patient to be treated. The first permanent molars and incisors have usually come in by that time and crossbites, crowding, and other problems can be evaluated. When treatment is begun early, the orthodontist can guide the growth of the jaw and guide incoming permanent teeth. Phase I or Early Interceptive has been one of Dr. Pierce’s special concentrations for 25 years. Early treatment can also regulate the width of the upper and lower dental arches, gain space for permanent teeth, avoid the need for permanent tooth extractions, reduce likelihood of impacted permanent teeth, correct thumb-sucking, and eliminate abnormal swallowing or speech problems. In other words, early treatment can simplify later treatment. As we say, It puts the young patient “in the ball park” so that lengthy treatment and possible extractions are not needed later. Shaping the smile can be best achieved when the bones and teeth are easily moved.

Orthodontics for Adults

Another special focus of Dr. Pierce’s career has been the wide variety of different adult therapies. Orthodontic treatment can be successful at any age and adults especially appreciate the benefits of a beautiful smile. One of every five patients in orthodontic treatment is over 21. Clinical experience is the key to the orthodontist guiding adult orthodontic care. Many aspects are different due to the maturity of the bone, jaw position and detailed aesthetics. Dr. Pierce has treated hundreds of adults and believes through his own university research that “conservative is best”. Adults also may have experienced loss of their teeth and supporting bone and may require periodontal treatment before, during, and/or after orthodontic treatment. Bone loss can also limit the amount and direction of tooth movement that is advisable. An experienced orthodontist will constantly evaluate this as treatment proceeds. Molar tooth uprighting is a common orthodontic preliminary treatment before implants or bridgework for missing teeth. General alignment is also required for adults before intricate and expensive cosmetic dentistry. Occasionaly, tooth and bite alignment, and facial cosmetics are best achieved with braces and jaw (orthognathic) surgery. The braces prepare the teeth for the surgeon to place the facial bones and teeth.

Why Braces?

For most people, a beautiful smile is the most obvious benefit of orthodontics. After your braces come off, you'll feel more self-confident. During your treatment, we want you to feel as comfortable as possible. Dr Pierce’s decades of experience with adult patients proves that adult patients appreciate the magical result SO much more.

How Orthodontic Treatment Works

Orthodontic appliances can be made of metal, ceramic, or plastic. They may be removable or they may be brackets bonded to the teeth. By placing a constant, gentle force in a carefully controlled direction, braces slowly move teeth to a corrected position. This is a great time to wear braces! Gone are the days when a metal band with a bracket was placed around each tooth. You can choose brackets that are clear or metallic color. You can choose the color of the ties that hold the wire in brackets. Wires are also less noticeable than they used to be and the latest materials move teeth faster with less discomfort to patients.

Duration of Treatment

Dr Pierce knows from experience that the shortest treatment time possible is what is best for the teeth and gums. Treatment time typically ranges from one to three years, depending on the growth of the patient's mouth and face and the severity of the problem. Patients grow at different rates and will respond variously to orthodontic treatment, so the time to case completion may differ from the original estimate. The patient's diligent use of any prescribed rubber bands or removable appliances is an important factor in achieving the most efficient treatment. Interceptive, or early treatment procedures, may take as few as six months.

Two Phase Treatment

What is the advantage of two-phase orthodontic treatment?

Two-phase orthodontic treatment is a very specialized process that encompasses tooth straightening and physical, facial changes. The major advantage of a two-phase treatment is to maximize the opportunity to accomplish the ideal healthy, functional, aesthetic result that will remain stable throughout your life. Dr Pierce was able to utilize very specialized training in Phase I/Phase II treatment while in Orthodontic training.

What if I put off treatment?

The disadvantage of waiting for complete eruption of permanent teeth and having only one phase of treatment for someone with a jaw discrepancy is facing the possibility of a compromised result that may not be stable and/or facial features and profile that cannot be improved.

First Phase Treatment

Your foundation for a lifetime of beautiful teeth

The goal of first phase treatment is to develop the jaw size in order to accommodate all the permanent teeth and to relate the upper and lower jaws to each other. Children sometimes exhibit early signs of jaw problems as they grow and develop. An upper and lower jaw that is growing too much or not enough can be recognized at an early age. If children after age 6 are found to have this jaw discrepancy, they are candidates for early orthodontic treatment.

Planning now can save your smile later

Because they are growing rapidly, children can benefit enormously from an early phase of orthodontic treatment utilizing appliances that direct the growth relationship of the upper and lower jaws. Thus, a good foundation can be established, providing adequate room for eruption of all permanent teeth. This early correction may prevent later removal of permanent teeth to correct overcrowding and/or surgical procedures to align the upper and lower jaws. Leaving such a condition untreated until all permanent teeth erupt could result in a jaw discrepancy too severe to achieve an ideal result with braces.

Making records to determine your unique treatment

Orthodontic records will be necessary to determine the type of appliances to be used, the duration of treatment time, and the frequency of visits. Records consist of models of the teeth, x-rays, and photographs.

Resting Period

In this phase, the remaining permanent teeth are allowed to erupt. Retaining devices are not usually recommended since they may interfere with eruption. It is best to allow the existing permanent teeth some freedom of movement while final eruption of teeth occurs. A successful first phase will have created room for teeth to find an eruption path. Otherwise, they may become impacted or severely displaced.

Monitoring your teeth's progress

In other words, at the end of the first phase of treatment, teeth are not in their final positions. This will be determined and accomplished in the second phase of treatment. Selective removal of certain primary (baby) teeth may be in the best interest of enhancing eruption during this resting phase. Therefore, periodic recall appointments for observation are necessary, usually on a six-month basis.

Second Phase Treatment:

Stay healthy and look attractive

The goal of the second phase is to make sure each tooth has an exact location in the mouth where it is in harmony with the lips, cheeks, tongue, and other teeth. When this equilibrium is established, the teeth will function together properly.

Movement & Retention

At the beginning of the first phase, orthodontic records were made and a diagnosis and treatment plan established. Certain types of appliances were used in the first phase, as dictated by the problem. The second phase is initiated when all permanent teeth have erupted, and usually requires braces on all the teeth for an average of 24 months. Retainers are worn after this phase to ensure you retain your beautiful smile.