1. At what age should my child be seen by Dr. Crise?
2. What are the benefits of early orthodontic treatment for my child?
3. How do I know if my child is in need of orthodontic treatment?
4. What are the early signs of orthodontic problems?
5. What causes a Malocclusion or facial irregularity?
6. Why should I be concerned about a bad bite or misfit of my child's teeth?
7. Will additional jaw growth allow for self-correction of crowded teeth or other bite problems?
8. What is Phase I (early/interceptive) treatment?
9. Does everyone need a Phase I treatment?
10. Can I wait on Phase I/interceptive treatment until my child is older?
11. Is it required that I be referred by my family dentist to schedule an appointment with Dr. Crise?
12. What will happen at the initial examination appointment?
13. What will I learn from the initial examination?
14. Is there a cost for the initial examination?
15. How do I schedule an appointment for an initial exam?
16. What orthodontic records are essential to properly diagnose and treat each patient's individual orthodontic problem and construct a treatment plan?
17. Will my child have to have any teeth removed for braces?
18. Will my child need an expander?
19. What is Phase I (early) treatment? What is the length or duration of Phase I/early treatment?
20. If my child has early treatment, will additional treatment be necessary?
21. How much will braces cost? Are financing options available? How does my insurance work?
22. How often will my child have appointments?
23. Can my child have all his/her appointments after school?
24. Can I drop my child off for an appointment?
25. How do braces work?
26. Do braces hurt?
27. Can my child return to school the same day he/she receives his/her braces?
28. Do you give shots?
29. Do you use recycled braces?
30. Can my child play sports and/or musical instruments while wearing braces?
31. Does my child need to see our family dentist while wearing braces?
32. Are there foods my child cannot eat while he/she has braces?
33. How often should my child brush his/her teeth while wearing braces?
34. What is an emergency appointment? How are those handled?
35. What if the emergency occurs after normal office hours?
36. Will my child have to wear retainers?
37. Can orthodontic correction occur while a child still has some baby teeth?
38. Will my child need full braces if he/she has Phase I treatment?
39. What is Phase II treatment?
40. Why should you select Dr. Crise to be your child's orthodontic specialist?

1. At what age should my child be seen by Dr. Crise?

The American Association of Orthodontists recommends that your child be evaluated around age seven. Early detection of some orthodontic problems is important in order to take early corrective action and avoid more difficult treatment and even surgery later. Although not all children will require orthodontic treatment early, it is important that your child be checked early. There are many problems that can be corrected at this time that cannot be as easily corrected later. So don't wait!! If Dr. Crise determines your child does not need early treatment (Phase I), she will not recommend treatment at that time.

Full braces (Phase II) are usually begun around age twelve when all the permanent teeth have erupted. Adult treatment can begin at any age.

2. What are the benefits of early orthodontic treatment for my child?

The benefits of timely orthodontic treatment for your child may include the following:

• Reduce or eliminate the need to extract permanent teeth
• Influence growth of the jaws in a positive manner
• Improve your child's psychological self-image and self-confidence
• Preserve or gain space for erupting permanent teeth
• Improve the width of the dental arches
• Correct harmful oral habits
• Reduce the likelihood of impacted permanent teeth
• Improve speech and the ability to chew food efficiently
• Reduce appearance-consciousness during critical developmental years
• Improve access for oral hygiene to prevent the development of cavities and gum disease
• Reduce tooth wear by placing teeth in better positions for those patients who clench and/or grind
• Reduce the tendency for progressive shifting of teeth
• Reduce potential for damage to jaw joints
• Guide permanent teeth into more favorable positions
• Improve lip closure and reduce lip strain
• Take advantage of cooperation before the late teenage years
• Lower the risk of injury to protruded front teeth

If you or your dentist notices a problem with your child's teeth, it is recommended that you bring them to an orthodontist. It is in your child's best interest to make the appointment. If no orthodontic action is taken, treatment options become limited, more difficult, and the long-term stability may be compromised. In addition, it may lead to extractions, oral surgery and increased costs.

Everyone wants and deserves a beautiful smile, as well as a healthy one. We can be reached at 972 529-9700 if you would like to inquire further about the process.

3. How do I know if my child is in need of orthodontic treatment?

It is usually difficult for you to determine if treatment is necessary because there are many problems that can occur even though the front teeth look straight. Also, there are some problems that look intimidating and complex which will resolve on their own. Asking your general dentist is a good reference, but we are your best resource since orthodontics is our specialty and that is all we do. With Dr. Crise, we are more than happy to see you or your child to make any necessary recommendations, and your exam is completely complimentary.

4. What are the early signs of orthodontic problems?

Although determining if treatment is necessary is difficult for you to assess, the following symptoms may help in prompting you to seek our orthodontic advice. Ask your child to open their mouth, and let you look at their teeth. If you see any signs of crooked teeth, gaps between your child's teeth or overlapping teeth, your child may need orthodontic treatment. Ask your child to bite all the way down, but keeping their lips open so you can see their teeth. Do the front top teeth line up with the bottom teeth? Do the top teeth protrude out away from the bottom teeth? Do the top front teeth cover more than 50% of the bottom teeth? Are the top teeth behind the bottom teeth? All these are indicators for potential orthodontic treatment. Look at the alignment of your child's jaw. Does the jaw shift off center when your child bites down? If you see any misalignment, shifting or asymmetry of the jaw, your child may have a skeletal problem that requires early orthodontic intervention. When looking at your child from the side, does your child's lower jaw line up with the upper jaw? Is it farther behind or in front of the upper jaw? This problem is more difficult to determine and is really best for the orthodontist to diagnose. Jaw problems are best treated early, so an early exam is recommended.

These are only some of the symptoms of orthodontic problems.

5. What causes a Malocclusion or facial irregularity?

Malocclusions are inherited (genetic) or acquired (resulting from events after birth).

Inherited problems include:

• A discrepancy between the size of the jaws and the size of the teeth, resulting in crowding or spacing
• Extra or missing teeth
• Jaw growth problems; when one jaw grows more or less than the opposing jaw
• Cleft palate and other jaw or face irregularities

Acquired problems include:

• Premature loss of primary or permanent teeth
• Dental disease
• Thumb or finger sucking
• Tongue thrusting
• Breathing problems caused by enlarged tonsils and/or adenoids

6. Why should I be concerned about a bad bite or misfit of my child's teeth?

Bad bites can be detrimental to a patient's dental health by possibly causing premature wear on the teeth, asymmetrical jaw growth, difficulty in oral hygiene, or a malfunctioning bite. Orthodontics will align your child's teeth for optimum function, hygiene, appearance, and long-term stability.

7. Will additional jaw growth allow for self-correction of crowded teeth or other bite problems?

Typically, this does not occur for the front teeth. In most children, the available space decreases as larger permanent teeth erupt. The jaws do, however, grow in the back to allow for the eruption of the 12-year molars and wisdom teeth.

When left untreated, orthodontic problems usually become progressively worse. Orthodontic treatment to correct bite problems is often less costly than the additional dental care required to treat the more serious problems that can develop later in life.

8. What is Phase I (early/interceptive) treatment?

Phase I or Interceptive Treatment usually starts while the child has most of their baby teeth and a few of their permanent front incisors. This stage in development is usually about the age of seven (7) to ten (10). The goal of Phase I treatment is to intercept a moderate or severe orthodontic problem early in order to reduce it's severity. In most cases where early orthodontic treatment is recommended, the immediate treatment objective will be one of the following:

• To correct jaw disproportion before aligning teeth
• To manage crowding and prevent permanent tooth extraction, whenever possible
• To prevent injury to protruded front teeth
• To eliminate damaging oral habits
• To improve a child's psychological self-image and self-esteem/self-confidence

With these problems, timely treatment takes advantage of the early growth spurt and turns a difficult orthodontic problem into a more manageable one. This helps reduce the need for extractions or surgery and delivers better long-term results and treatment options.

9. Does everyone need a Phase I treatment?

Absolutely not! Only certain bites require early intervention. All others can, and should, wait until most or all their permanent teeth erupt. Dr Crise is very conservative about Phase I treatment and she will not recommend Phase I unless it is absolutely necessary.

10. Can I wait on Phase I/interceptive treatment until my child is older?

This is not recommended. If your child needs Phase I treatment this usually means that he or she has a difficult problem that requires attention now. If no orthodontic action is taken, treatment options become limited, more difficult, and the long-term stability may be compromised. In addition, it may lead to extractions, oral surgery and increased costs.

11. Is it required that I be referred by my family dentist to schedule an appointment with Dr. Crise?

No. Many patients have concerns about their health and appearance and want to be evaluated as to the need for orthodontic care. These patients take the initiative themselves to schedule an initial examination.

12. What will happen at the initial examination appointment?

Dr. Crise will conduct a thorough examination of the patient's mouth to determine if there is a need for orthodontic treatment. She will be looking to determine if there is enough room to accommodate all the teeth; if the top teeth are lined up correctly with the bottom teeth; if any teeth are crooked or not growing in the right position; if there are missing or extra teeth and if there are any jaw growth problems.

13. What will I learn from the initial examination?

There are five important questions that will be answered during the initial examination:

• Is there an orthodontic problem and if so, what is it?
• What must be done to correct the problem?
• Will any permanent teeth need to be removed?
• How long will the treatment take to complete?
• How much will the treatment cost?

In addition to these, Dr. Crise will take the time to answer any other questions you or your child may have.

14. Is there a cost for the initial examination?

No. There is no cost for the initial examination.

15. How do I schedule an appointment for an initial exam?

If you think you or your child would benefit from orthodontic treatment, simply call our office at 972 529-9700 and we would be happy to schedule an appointment for you. During the call to schedule your appointment, our administrative staff will gather some very basic information regarding you or your child.

16. What orthodontic records are essential to properly diagnose and treat each patient's individual orthodontic problem and construct a treatment plan?

Orthodontic Records

Orthodontic records include a panoramic x-ray, a cephalometric x-ray, models of the teeth, 3 facial photographs and 5 intra-oral photographs. Pre-treatment orthodontic records are essential for Dr. Crise to properly diagnose and treatment plan each patient's individual orthodontic problem and treatment needs. Some orthodontic records may be taken again during the course of treatment or after the completion of treatment.

• Panoramic x-ray
• Cephalometric x-ray
• Impressions
• Facial Photographs
• Intra-Oral Photographs

Panoramic X-Ray

A panoramic x-ray enables Dr. Crise to see the roots of the teeth and the position of any unerupted teeth. Any missing or extra teeth will be identified on this x-ray. Panoramic x-rays are an excellent way to determine the best time to begin your orthodontic treatment.

Cephalometric X-Ray

Cephalometric x-rays are used by Dr. Crise to make angular and linear measurements of a patient's hard and soft tissue utilizing various landmarks. Examples include the angles of the teeth in relation to the skull and jaw structures and the assessment of the facial profile. Each patient's measurements are compared to normal values. These values help Dr. Crise to determine the best treatment approach for you or your child.

Impressions

Impressions are molds of the patient's teeth that are used to make plaster study models. Dr. Crise uses the models to help in treatment planning. Impressions are almost always made before and after orthodontic treatment. Orthodontic appliances such as expanders and retainers are made on models of your teeth.

Facial Photographs

Facial photographs enable Dr. Crise to identify and analyze various features of the face and smile. Facial asymmetries, "gummy" smiles and profile imbalances are identified using facial photographs. These pre-treatment facial photographs also provide a way to assess the progress of treatment.

Intra-Oral Photographs

Photographs of the teeth are used, along with study models, to help Dr. Crise accurately evaluate the malocclusion. These photographs are also extremely valuable to assess the progress of treatment.

17. Will my child have to have any teeth removed for braces?

Today's treatment technology combined with earlier treatment (age 7-9 years) greatly reduces the chances of having to remove teeth. However, removing teeth is sometimes necessary to get the best orthodontic result. Straight teeth and a balanced facial profile are always the goal.

18. Will my child need an expander?

This question will be answered by Dr. Crise at the completion of the initial examination.

19. What is Phase I (early) treatment? What is the length or duration of Phase I/early treatment?

Phase I treatment is usually initiated for children between the ages of seven (7) and ten (10). The objectives of Phase I treatment include the correction of harmful habits (e.g., thumb/finger sucking, tongue thrusting), the correction of skeletal relationships (crossbites, overbites, underbites, open bites, etc.) between the upper and lower jaws, the development of space to accommodate the permanent teeth, and improvement in a child's psychological self-image and self-esteem. Generally, Phase I/Early Treatment lasts for 6 to 18 months, or slightly longer, depending on the age of the patient, the severity of the problem, the patient's cooperation, and the degree of movement possible.

20. If my child has early treatment, will additional treatment be necessary?

In most cases, yes. After the permanent teeth have erupted, treatment is usually necessary to complete the work that was started in the earlier phase. The objective of continued treatment is to place the permanent teeth in positions of optimal function, comfort, esthetics and long-term stability.

21. How much will braces cost? Are financing options available? How does my insurance work?

It is impossible to give an exact cost for treatment until Dr. Crise has actually examined you or your child. The exact cost and financial options will be discussed at the initial examination. We have many financing options available to meet most needs and will be happy to review them with you. We do file insurance on your behalf and we also offer a courtesy (discount) for fees paid in full as well as family discounts. Proper orthodontic treatment to correct a problem is often less costly than the additional dental care required to treat the more serious problems that can develop in later years.

22. How often will my child have appointments?

Appointments are scheduled according to each individual patient's needs. Most patients in braces will be seen every six to ten (6-10) weeks. Patients in expanders are usually seen on a three to four (3-4) week interval in the beginning and then are placed on a six to eight (6-8) week cycle later. If there are specific situations that require more frequent monitoring, appointments may be scheduled more often.

23. Can my child have all his/her appointments after school?

This is a very common question. Unfortunately, we cannot schedule all appointments for all student patients for after school hours. However, because most appointments are scheduled eight to ten weeks apart, most patients miss very little school because of orthodontic appointments. We reference all of the area school calendars at the front desk and try very hard to help in all possible ways to assist patient scheduling. We also have lunchtime appointments available daily and after 5:00 p.m. appointments available on Mondays.

24. Can I drop my child off for an appointment?

We are very understanding of busy schedules and working parent's desires to run errands while their child is at our office; therefore, we provide pagers to our parents to enable them to maximize their time. We will page you when it is time to return to our office. On some occasions Dr. Crise may want to speak with you after your child's appointment, so please, we request that parents check in with the front desk staff as they schedule their next appointment.

25. How do braces work?

Braces are bonded (cemented or adhered) directly to each tooth and archwires connect all the braces. Contrary to what most people think, it is the archwire that does the work — the braces merely serve as handles! The wires use a gentle, continuous pressure to move teeth into their proper positions. Much like moving a stick through sand, as the tooth moves, bone gives way on one side and fills in on the other side. It is truly amazing! Elastics (rubber bands) are usually worn near the end of treatment to help the wires do their job to align the upper teeth with the lower teeth.

26. Do braces hurt?

With the latest technology, many of our patients do not report any soreness at all following the majority of their visits! For some visits, however, teeth may be sore for a day or two. In these situations, discomfort can be managed with medications such as ibuprofen (e.g., Advil, Motrin) or acetaminophen (e.g., Tylenol). We often remind our patients, it does not have to hurt to work!

27. Can my child return to school the same day he/she receives his/her braces?

Yes. There is no reason to miss school because of an orthodontic appointment. Usually soreness will last approximately 1 to 7 days after the initial placement of the braces depending on the patient. Pain medications such as ibuprofen (Advil or Motrin) or acetaminophen (Tylenol) can be used to ease discomfort.

28. Do you give shots?

No. No shots are necessary in orthodontic treatment.

29. Do you use recycled braces?

Absolutely not! It is our belief that patients should be provided with their own braces to achieve the very best orthodontic result possible. Dr. Crise would never use worn, used or recycled braces!!

30. Can my child play sports and/or musical instruments while wearing braces?

Yes! We will provide you with a mouthguard for all sports. If you play an instrument such as a trumpet or saxophone, we will provide you with a "lip protector" that works very well to cushion your lips from your braces or wax can be used. Please inform us when you need a mouthguard or lip protector.

31. Does my child need to see our family dentist while wearing braces?

Yes. Regular checkups with your family dentist are very important while in braces. Your family dentist will assist in determining how often you should be seen for cleaning appointments while you are in braces (usually every six months).

32. Are there foods my child cannot eat while he/she has braces?

Yes. Once treatment begins, very complete instructions and a comprehensive list will be provided regarding foods to avoid. Some of those foods include: ice, hard candy, gum, popcorn and all sticky foods, i.e. caramel, taffy, etc. Many emergency appointments to repair broken or damaged braces can be avoided by carefully following instructions regarding foods.

Click here to view a list of FOODS TO AVOID while wearing braces.

33. How often should my child brush his/her teeth while wearing braces?

Patients should brush their teeth 2 to 3 times each day: after breakfast, lunch (or as soon as they get home from school) and before going to bed. We will show each patient how to floss their teeth with braces on (a Waterpik may be used if flossing is too difficult). We will also provide a prescription fluoride rinse to help protect the teeth during orthodontic treatment.

34. What is an emergency appointment? How are those handled?

If something happens and your child's braces are causing pain or if something is broken, you should call our office (972) 529-9700. We are available to take your emergency call 24 hours a day 7 days a week. In most cases, we can address most issues over the telephone.

35. What if the emergency occurs after normal office hours?

Our office is available after normal working hours. Simply call the office and wait for the answering machine to answer. The recorded message will give you the emergency pager number where we can be reached.

36. Will my child have to wear retainers?

Orthodontics is a process of moving teeth through the bone into their new positions. Once the teeth have been moved into their desired positions, retainers will be placed to maintain the correction. Once stabilization occurs, we encourage our patients to continue to wear their retainers nightly for the first year to maintain their beautiful smile. Each patient will be taught how to wear the retainers less and less over time in order to maintain correction.

37. Can orthodontic correction occur while a child still has some baby teeth?

Yes. This is called Phase I treatment. However, we do not require braces for every patient who visits our office. Some orthodontic problems are significant enough to require early intervention. However, if a patient is not yet ready for treatment, we will follow that patient's growth and development until the time is right for treatment to begin.

38. Will my child need full braces if he/she has Phase I treatment?

It is best to assume that your child will need full braces even after Phase I treatment. The period of time following Phase I treatment is called the "maintenance phase" during which growth and tooth eruption are closely monitored. Throughout this period, parents and patients will be kept informed as to any future treatment recommendations.

39. What is Phase II treatment?

Phase II treatment usually occurs a couple of years following Phase I and involves "full" braces on the upper and lower teeth. Typically, we are waiting for 12-16 more permanent teeth to erupt before Phase II begins. This most commonly occurs between the ages of 11-13. The goal of Phase II treatment is to achieve an ideal occlusion (bite) with all of the permanent teeth. Achieving this produces optimal function, esthetics and long-term stability of the teeth.

40. Why should you select Dr. Crise to be your child's orthodontic specialist?

Teeth and sometimes entire facial structures are permanently changed by orthodontic treatment; therefore, it is very important that the treatment be appropriate and properly completed. Dr. Crise graduated valedictorian from Baylor Dental School and also completed 2 ½ additional years of orthodontic specialty training, also at Baylor to become an orthodontist. She is certified by the American Association of Orthodontists, the only certifying organization recognized by The American Dental Association, and she has successfully provided orthodontic treatment to hundreds of patients. Since 1997, she has published research in several orthodontic journals, has been interviewed by ABC News, and uses the best high-tech up-to-date treatment techniques.

Best of all, Dr. Crise is a warm and caring doctor who loves to be with people and especially children.