Examples of Sticky Foods to Avoid:

Gum (sugar-free or regular)
Licorice
Sugar Daddies
Toffee
Tootsie Rolls
Caramels
Starburst

Examples of Hard Foods to Avoid:

Ice
Nuts
Hard taco shells
French bread crust/rolls
Corn on the cob
Apples and carrots (unless cut into small pieces)
Bagels
Chips
Jolly Ranchers
Pizza crust
Uncooked carrots (unless cut)

Minimize Sugary Foods like:

Cake
Ice Cream
Cookies
Pie
Candy

Only Once a Day:

Soda
Sweetened tea
Gatorade
Kool-Aid
Drinks with sugar

In addition to avoiding certain foods, it is also important to avoid bad habits that can break or damage your braces. Fingernail biting, pencil and pen chewing, or chewing on any foreign objects should all be avoided.

It’s important to regularly inspect your braces for bent or lose wires and brackets. If you have a loose/broken wire or bracket, please call our office immediately to arrange a repair appointment and check our emergency page for tips on temporary repairs.

Brushing & Flossing with Braces

We recommend that you brush with a fluoride toothpaste at least two times per day (preferably after meals), for at least two minutes each time. Remember to brush all of the teeth surfaces: the outside, the inside, and the chewing surfaces. Be especially careful to clean the areas between wires and teeth, and between brackets and gums, that’s where food particles can easily become trapped.

Here’s a suggested brushing technique: Begin at the outside surfaces, place the tips of the bristles flat against your teeth, and use small circular motions to gently polish the area clean. For areas between braces and gums, tilt the brush toward the gum line (down for the bottom teeth, up for the top) while keeping up the circular motions. Next, move on to the chewing surfaces of upper and lower teeth, using a firm back-and-forth motion. Finally, finish up by carefully brushing the inside surfaces of the teeth the same way you did the outside surfaces.

Special Brushing Tools

If you’re having trouble cleaning the areas near brackets and wires, there are some special tools that can make the job easier. One is the interdental toothbrush or proxabrush. It has a small tuft of bristles that stick up all around, like a pipe cleaner. Use it gently and carefully to clean the tiny spaces under wires and around bands and brackets.

Another special cleaning tool is the oral irrigator or “water pick.” This device shoots a small stream of pressurized water at your teeth, which can help dislodge bits of food that become trapped in nooks and crannies. While it’s easy to use, an oral irrigator isn’t a substitute for a toothbrush or dental floss. The oral irrigator is meant to be used along with proper brushing and flossing techniques and it can be very effective.

Floss Fundamentals

In order to keep your teeth and gums clean and healthy, you need to floss at least once per day. Now, how do you get floss under the archwire of your braces? You can use a floss threader to complete the task. You pull one end of floss through the threader and then push the threader under the archwire. Then, you pull the floss on each end and slide it up and down the sides of both teeth, and all the way under the gums until you hear a squeaky sound, this is the indicator that the area is clean. Finally, pull it out, toss it, and use a new section of floss for the next area.

Full Disclosure

There’s an accurate way to tell how effective your cleaning techniques are. There are special vegetable dyes called “disclosing solutions” or “disclosing tablets” that highlight plaque and food debris that brushing has missed. You can then easily remove the dyed spots. This exercise will highlight any areas of opportunity for your brushing and flossing techniques.

Keeping your teeth and gums healthy now is an investment in your future. Maintaining good oral health will allow you to get the best results from your orthodontic treatment.

Post-Orthodontic Care

Retention typically involves wearing an orthodontic appliance called a retainer and it is a critical part of your treatment plan. Several different kinds of retainers are available, all of which are custom-made just for you. We will recommend the type (or types) that will work best in your individual case.

Teeth aren’t set rigidly in the jawbone, they’re held in place by a network of fibers called the periodontal ligaments. After your teeth have been moved, it takes several months for the periodontal ligament to adjust to the new position. In order to keep your newly straight smile, it’s essential to wear your retainer as directed.

The same day your braces are removed, you will be fitted for a retainer. Your teeth will be thoroughly cleaned, we may take another set of X-rays and/or bite impressions, to check how well your braces worked and to see how much your wisdom teeth have developed. Then, we’ll discuss your retainer and start getting it ready.

Three Types of Retainers

There are three basic types of retainers available today. The most common is the “Hawley” retainer which is a thin, tongue-shaped piece of acrylic molded to fit your mouth and includes a wire that holds your teeth in position. The Hawley retainer is simple, durable and easily removed.

Another popular style of retainer is a clear aligner-type, which looks similar to the Invisalign® tray system. These retainers are custom-made of thin, transparent plastic which is designed to fit precisely over your teeth. The main advantage of this type of retainer is its virtual invisibility. However, this type of retainer is less durable than the Hawleys and is not recommended for patients who grind their teeth.

Finally, fixed retainers aren’t removable by the wearer but aren’t visible either. Like lingual braces, this system uses a wire which is bonded to the tongue side of the teeth. It may remain in place for months, or longer. This type of retainer is recommended when there’s a high risk that teeth could revert to their former position.

A Period of Adjustment

After a short time, most people adjust quite well to wearing a retainer. Some short-term side-effects include an increased amount of saliva production and temporary speech impairment. Be sure to take out your retainer to eat or brush your teeth, this will be a nice change from braces. Your treatment plan will include a schedule to wear your retainer which will start out as a 24/7 schedule and will slowly shift to just a few nights a week.

Maintaining — and Retaining — Your Retainer

All retainers need proper cleaning. A Hawley-type retainer can be brushed gently with a regular toothbrush. Denture cleaners, in powder or tablet form, as well as special retainer cleaners, can be used to clean most removable retainers. Fixed retainers are cleaned by brushing and flossing; a floss threader or interproximal brush can be used when needed. Avoid excess heat from very hot water or leaving your retainer close to a heat source. The heat will warp your retainer and render it useless.

TMJ Disorders

TMD is an abbreviation for Temporomandibular disorders and is characterized by ongoing pain in the area near your ear, your jaw, or the muscles on the side of your face. Sometimes the pain is accompanied by restricted jaw movement and a popping or clicking sounds. Sometimes people incorrectly use the term TMJ to refer to these problems, when in fact TMJ is the abbreviation for the temporomandibular joint — or jaw joint — itself.

Causes of TMD

The TMJ can be subject to orthopedic problems such as inflammation, sore muscles, strained tendons and ligaments, and disk problems. Research also shows TMD is influenced by genetic predisposition, gender (women appear to be more prone to it), and age. Physical and psychological stress is also a contributing factor.

Signs and Symptoms of TMD

Clicking Sounds — Some people with TMD experience a clicking, popping or grating sound coming from the TMJ when opening or closing the mouth. This can be explained by a shifting of the disk inside the joint. If the clicking is accompanied by pain or limited jaw function such as the jaw getting “stuck” in an open or closed position, for example — this would indicate TMD.

Muscle Pain — The pain may be felt in the cheeks (masseter muscles) and temples (temporalis muscles), where the two big pairs of jaw-closing muscles are located.

Joint Pain — Pain that’s actually coming from one or both jaw joints technically would be described as arthritis of the TMJ. There is no cure for arthritis anywhere in the body, but medication can sometimes help relieve arthritic symptoms.

Relieving the Pain

Once we examine you, we will come up with a strategy for treating your condition and managing your pain. Your treatment plan will include one or several solutions such as a temporary change to a softer diet which can reduce stress on the muscles and joints. Ice and/or moist heat may help relieve soreness and inflammation. Muscles in spasm can also be helped with gentle stretching exercises. Non-steroidal anti-inflammatory medications and muscle relaxants can also provide relief.

Other Treatment Options

Severe TMD cases may require more complex forms of treatment, which might include orthodontics, dental restorations like bridgework, or minor procedures inside the joint such as cortisone injections or lavage (flushing) of the joint. It’s rare for major surgery ever to be necessary in a case of TMD.

The first step is an examination here at our dental office. We don’t want you to be in pain, so please come in and see us. To learn more about the treatment options available, view our Chart on TMD Therapy.

Invisalign®

Invisalign® clear aligners are a popular alternative to traditional metal braces. Invisalign involves using a set of clear aligners that are made of almost invisible polyurethane plastic. The aligners are completely removable since they are not cemented or bonded to the teeth allowing you to remove them for important social occasions, eating, and, most importantly, for tooth-brushing and flossing.

Here are some other upsides of the Invisalign system:

Improved Oral Hygiene — During your treatment, you will be able to continue to clean your teeth as you normally would.
A Discreet Look — Invisalign clear aligners are virtually invisible which means most people won’t even notice you’re in orthodontic treatment.
More Dietary Choices — Since your clear aligners are removable, you will be able to continue to enjoy all of your favorite foods.
Comfort — Invisalign clear aligners are made soft, flexible material which will not irritate the soft tissues of the mouth.
Teeth-Grinding Protection — If you have a teeth-grinding or clenching habit, your clear aligners will function as thin nightguards to protect your teeth from excessive wear.

To find out if Invisalign is right for you, schedule an appointment with Dr. Reddy & Dr. Haverkos.

How Invisalign Works

Invisalign clear aligners to the same type of work as traditional metal braces which are applied carefully controlled forces to teeth to move them into the desired position. However, Invisalign aligners are made of flexible plastic instead of metal like traditional braces.

Here’s how it works: Specialized computer software allows us to custom design a plan for moving your teeth from their current positions into the best possible alignment. This movement will be broken down into perhaps several dozen stages. For each stage, the Invisalign company will manufacture two plastic mouth “trays” or “aligners,” one to fit over your top teeth and one for the bottom. You will wear this first set of trays for two weeks, for a minimum of 20 hours per day. You will then move on to the next set of aligners in your series to accomplish the next stage of gradual movement. You will keep doing this until your teeth are correctly aligned.

This treatment option was previously only available to adults. The manufacturer has added important features to accommodate the needs of teenagers. Special “eruption tabs” were added to hold the appropriate amount of space open for molars that have not fully grown in. Invisalign for teens also comes with “compliance indicators” built into the aligner material, which fade with wear. This feature allows parents, dentists, and the teens themselves, to verify the trays are being worn as prescribed.

Caring for Your Teeth During Invisalign Treatment

One of the main advantages of the Invisalign system is that the trays can be removed for easy cleaning. It is very important to do this! During treatment, you’ll need to brush your teeth after every meal or snack so that food and plaque do not get trapped in the aligners. Your aligners will also have to be cleaned regularly which can be achieved by brushing them and then rinsing them with lukewarm water.

Adolescent Treatment

For many teens, braces are one more example of the changes adolescents they go through during this stage. But is there any particular reason why orthodontic appliances and teenagers seem to go together? In a word: Yes.

Adolescence is the optimal time for orthodontic treatment, though sometimes even earlier intervention is called for. Generally, by the age of 11-13 the deciduous (baby) teeth have been lost, and the permanent ones have mostly come in.

Orthodontic problems don’t improve with age, they only become more difficult to treat. During adolescence, the body is still developing, making it easier to treat many orthodontic problems. If treated during adolescence, we can create an improved appearance and function in a short period of time. In adulthood, when the bones of the face and jaw are fully developed and many conditions become more difficult (and costly) to treat.

The Orthodontic Treatment Process

What should you expect from our office when it comes to treatment? It all depends on what kind of treatment you need. The first time you come in, we will take photos and radiographic (X-ray) images of your mouth, and possibly make a model of your bite. Then, we’ll develop a custom treatment plan. Here are some of the most commonly used orthodontic appliances:

Metal Braces need no introduction. But you might be surprised to find they’re smaller and lighter than ever. They may even offer some customized options, like colored elastic ties on the brackets.

Clear Braces are brackets made of ceramic or composite materials that blend in with your teeth, making them more discrete.

Clear Aligners for teens involve a series of removable, clear plastic trays that gradually straighten teeth as they’re worn (for 22 hours per day). These aligners are virtually invisible.

Lingual Braces offer one of the most unnoticeable forms of orthodontic treatment because they are attached to the back (tongue side) of the teeth.

Other orthodontic appliances may be recommended depending on the individual needs of the patient. For example, a case where a major tooth or jaw movement is needed.

How Long Will I Wear Them?

This completely depends on your individual treatment plan and the steps required to achieve your perfect smile. Generally, however, the active stage of orthodontic treatment lasts 6-30 months. Following the active treatment, you will wear a retainer for another period of months in order to prevent your teeth from shifting back to their original position.

Early Treatment

The American Association of Orthodontists recommends that children receive their first initial orthodontic screening by age 7. Identifying an orthodontic issue early opens up the number of treatment options available.

It’s important to recognize that early evaluation will not necessarily be followed by early treatment. In most cases, if orthodontic work is needed, we simply monitor your child’s growth patterns until we identify the perfect time for treatment to begin.

In most children, the first adult molars have typically erupted by age six. This, combined with other developmental markers will allow us to evaluate the basic alignment of the teeth, from front to back and side to side. At this time, it may also be possible to evaluate if the amount of space in the mouth required for all the permanent teeth is in the correct proportion.

When Earlier Treatment Is Better

Treatment for the most common orthodontic problems typically begins when all the baby teeth are gone and many of the permanent ones are in place, this typically happens between the ages of 9 and 14. However, there are some conditions that are better to treat at an early age.

One of the conditions that benefit from early treatment is a severe crossbite, a condition where the upper teeth close inside the lower teeth. To treat this problem, a device called a palatal expander can be used, to widen the upper jaw while it is still developing and therefore avoid oral surgery in the future.

Another condition that can benefit from early treatment is severe crowding. Severe crowding occurs when the jaws are too small to accommodate all of the permanent teeth. Palatal expansion and tooth extraction are two treatment options that promote the correct eruption of adult teeth. Braces may still be required later but treatment will likely be shorter and less complicated.

Early intervention can be used to solve other orthodontic issues. For example, protruding teeth are more likely to chip or fracture. A severe underbite, which is caused by the lower jaw growing much larger than the upper jaw, will result in serious bite problems. Orthodontic appliances such as braces and headgear can be successfully used to correct these problems during the early treatment stage, increasing the chances that surgery can be avoided during adulthood.

Correcting Bad Habits

There are bad habits that can negatively influence the development and function of a child’s teeth, jaws and mouth. Some examples of these detrimental habits are persistent thumb sucking, tongue thrusting, and mouth breathing.

While the sucking reflex is natural in early childhood; it usually disappears between ages 2 and 4. If it persists much later, the pressure of the digit on the front teeth and the upper jaw can actually cause the teeth to move apart and the jaws to change shape. This can lead to an open bite, and may also impair speech.

Mouth breathing (breathing with the mouth open) can lead to alterations in the muscular function of the tongue and face. These alterations cause the upper and lower jaw to grow abnormally leading to serious orthodontic problems.

Bite Problems and How to Fix Them

Bite problems typically become evident by the age of 7. These bite problems can include underbite, crossbite or excessive overbite, where upper and lower teeth don’t close in the proper position. Open bite is where space remains between top and bottom teeth when the jaws are closed. Crowding or excessive spacing is a condition where teeth are spaced too close together or too far apart.

In order to correct bite problems, teeth need to be moved, this is where orthodontics comes in. Teeth are not in a fixed position on supporting bone. Teeth are held in place by a hammock-like structure called the periodontal ligament. Orthodontic appliances apply light constant pressure to shift teeth into the desired position.

Orthodontics is for Children — and Adults

Beginning your orthodontic treatment journey in childhood is ideal because Dr. Reddy & Dr. Haverkos can take advantage of a youngster’s natural growth processes to help move the teeth into proper alignment. During the growth period, it’s possible (for example) to create more room for teeth in a crowded mouth by using a “palatal expander” to rapidly widen the upper jaw. This phase of growth modification can shorten overall treatment time and ensure the best result if additional orthodontic appliances are needed.

However, healthy teeth can be moved at any age, so it’s never too late for orthodontic treatment. In fact, about one in five orthodontic patients are adults. Tooth-colored ceramic braces, clear aligners and invisible lingual braces have all made orthodontic appliances more discrete, and therefore enhanced the treatment experience for adults.

Types of Orthodontic Appliances

While traditional metal brackets remain a popular style, there are more options than ever before. Today, there are more discrete options such as clear braces that use brackets made of ceramic or plastic, except for the slim archwire. Lingual braces are another alternative to the traditional metal braces. Lingual braces are bonded to the back of your teeth (the tongue side) so that no one can see them.

Removable clear aligners are also a very popular alternative to fixed orthodontic appliances. They consist of a series of clear plastic “trays” that fit over your teeth exactly; each aligner moves your teeth a little bit until they are in the proper position.

Whether fixed or removable, each type of appliance has advantages or disadvantages in particular situations. After a complete examination, we will discuss which treatment options are most recommended for your individual journey.

Retention & Post Orthodontic Care

Once you have completed your orthodontic treatment, it’s extremely important to wear a retainer as directed. Teeth naturally tend to drift back to their original locations and this is the last thing you want to deal with after investing so much to make your smile perfect. Wearing a retainer holds your teeth in their new position long enough for new bone and ligament to re-form around them and therefore prolonging the life of your beautiful smile.

Let’s Make a Plan

Today is an important day where a lot of decisions will be made. We will make a plan on how to treat any problems we find. This will include deciding whether we should begin now or wait until a later time. Our procedure starts by taking a set of regular photographs of the teeth in their present state. Next, we’ll probably take a series of radiographic (X-ray) images. These enable us to see what’s going on underneath the gums: the position and growth of bones and joints, and the teeth that are still below the gum line.

In some cases, we may also take an impression (mold) of the teeth. This allows us to make an exact replica of the bite, which helps us understand exactly what the problem is and how best to treat it. If we require an impression of diagnosis, we will ask you (or your child) to bite down on some soft putty-like material for a few moments; then we’ll remove it and make the mold in our lab.

After that, it’s time for the actual exam. We will look at the records and images, and perform a careful examination. Besides looking in the mouth, the doctor may also ask questions, such as whether the jaws make noise when the mouth is opening or closing, or if there are any problems chewing or swallowing. Taken together, this information will allow the doctor to make a proper diagnosis and finalize our treatment plan at the first visit.

Discussing Your Treatment Options

Following the exam, we may conclude that things are just fine or, that you need treatment. We may recommend that you begin right away or at a later time, depending on the developmental stage of your teeth and jaws. Many times, we’ll advise you to return for a periodic checkup, until we determine that it’s the best time to start. Now that we have a treatment plan, we will also explain what our fees will be, and what payment options are available for you.

Whether you’re starting now or later, this is the best time to ask all the questions about the process. We can talk about available treatment choices, answer general questions about what to expect at the different stages of the process, and discuss any of the following:

Can orthodontic treatment benefit me (or my child)?
What general procedures will be used to correct the problem?
Are any options available (or recommended) for my treatment?
Should I get treatment now, or is it better to wait?
Will tooth extraction be necessary?
How much does treatment cost? Are payment plans available?
How long do you expect treatment should take?

When you leave our office, we think you’ll have a better understanding of how we can help you achieve the best possible smile. Don’t delay your visit anymore, call us today to schedule your initial consultation!

About Dr. Haverkos

Dr. Stephen Haverkos grew up next door to Dr. Reddy and his family. He attended Our Lady of Visitation followed by Elder High School. While in high school Steve was a patient of Dr. Reddy so he knows the value of his outstanding care.

After graduating from high school, Steve accepted an academic scholarship to attend the University of Cincinnati College of Engineering. He was an engineering co-op at Johnson and Johnson in Blue Ash and graduated magna cum laude with a B.S. in Biomedical Engineering. Immediately following, Steve accepted a position at Procter and Gamble in Cape Girardeau, MO as a power and controls engineer and project manager. He managed large construction teams for industrial manufacturing installations. He was promoted and relocated back to Cincinnati where he continued to manage construction projects across the country. He was grateful for his experience at P&G, however after four years he decided to pursue a career that he believed would be more fulfilling. He attended dental school at University of Kentucky College of Dentistry, located in Lexington, KY. He earned his Doctor of Medicine in Dentistry (DMD) in 2017. He completed a Postgraduate Orthodontic and Dentofacial Orthopedics Residency Program from Virginia Commonwealth University in Richmond, VA.

While in residency, Steve served as an orthodontic resident at Children’s Hospital of Richmond in the Craniofacial Center program working with kids with craniofacial developments. Steve passed his American Boards of Orthodontics exam in residency. This is the first step to becoming board certified.

Beyond traditional orthodontics, Steve is experienced with Invisalign, complex interdisciplinary cases, soft tissue lasers, temporary skeletal anchorage devices, orthognathic surgical setups, tooth movement acceleration utilizing micro-osteoperforation, and 3-D printing technologies. Steve leveraged his engineering background to design a new orthodontic bracket with reduced friction to enable more efficient orthodontic care for his master’s thesis.

Steve and his wife Stephanie live on the west side with their three children and three rescue dogs. Steve enjoys spending time with family trying out new restaurants, breweries, and the outdoors. He also enjoys brewing beer, playing golf, dog rescue, and riding bikes.

It is a dream come true for Steve to be working with his former next door neighbor and family friend Dr. Reddy. He looks forward to meeting and working with all of the patients on the west side.

Treatments

Orthodontics

Treatments

Types of Braces

Additional Services

Post-Orthodontic Care