"The Six Elements of Orofacial Harmony"

Continuing education is important for an orthodontist, for a variety of reasons. One recent CE experience for me was a great opportunity to meet one of the great minds in modern orthodontics: Dr. Larry Andrews. The course was the "The Six Elements of Orofacial Harmony."

Orthodontists treat more than teeth (Element VI), even though most patients who come to see me are concerned with their "overbite, crowded teeth, or gaps." We also need to evaluate (Elements I-V):

 

I. Arch shape and length

II. Jaw Positions

III. Jaw widths

IV. Jaw Heights

V. Chin Prominence

These Elements are routinely evaluated when I see patients, but sometimes not all 6 of these elements contribute significantly to a patient's orthodontic plan.

 

I have described Dr. Andrews' Six Keys to Occlusion many times to patients over the years when reviewing treatment results or discussing planned treatment. Over the two day course I attended earlier this month, it was enlightening to to look at orthodontic treatment records and planning through the Andrews' prism.  After attending the course I have implemented a few of his ideas. His son Will is in practice with him and shares the lecture duties and does a great job describing some of the trickier concepts relating to measuring tooth position based on a patient's forehead. Several orthodontic residency programs - West Virginia and U Penn, for example - are implementing the concepts into the orthodontic curriculum. The residents I met were very enthusiastic in their experiences to-date. Perhaps a visit to the San Diego office to continue my studies is in order? Talk to you next month!

 

                         Above: Dr. Steckel with Dr. Larry Andrews and his son Dr. Will Andrews

National Orthodontic Health Month

We have celebrated National Orthodontic Health Month at OSL for over 10 years.  It's an opportunity for us to remind our patients that some Halloween treats can be harmful to people wearing braces or clear aligners. 

It is possible to enjoy some traditional candies at Halloween without causing problems with orthodontics appliances.  Kids really want to have fun on this holiday and we encourage patients to enjoy treats that are acceptable, rather than feel that they are missing out.  Parents can remind their children that when they are done with orthodontic treatment and they see their new smiles in the mirror, they will feel that any sacrifices they have made were worthwhile.

We have also included a scary hallway and examples of good candy options just for coming in during October.  The looks and responses of disbelief are the norm and we are used to it!

As promised, below are examples of patients who recently finished their Invisalign® treatment at OSL:



 
    After 15 months of aligner wear



   After 17 months of aligner wear

And a short video about the "Efficacy of Invisalign®":

Invisalign: How it Works

Since 1999 using Invisalign®, and more recently Invisalign Teen®, has been a great option for a variety of our patients’ malocclusions.  Adults and teens with:

·         Cross bites,

·         Crowding,

·         Spacing, and

·         Wear on their teeth

Have achieved great orthodontic results!

One of the best outcomes for our patients at OSL has been improved/easier daily brushing and flossing¹ which can have overall health benefits².  The video below is a short introduction and next month I’ll post some before and after images of OSL Invisalign® patients.

¹ Gingival Condition Associated with Orthodontic Treatment. Zachrisson BU. Angle Orthod (1/72)

² Increased Prevalence of Cardiovascular and Auto-Immune Diseases in Periodontitis Patients: A cross-sectional study. Neese et al. Journal of Periodontology (6/2010)

Myths about Braces - CNN Video

On June 29, 2011 CNN interviewed orthodontist Dr. Mark Johnston.  The short clip, which you can view below, is about how the stigma of having braces has changed over the years. Due to smaller brackets and more patients in treatment, children being teased for having braces is a thing of the past. Not to mention, the video states that one in five patients are adult. View the quick video below to hear more.

Dover AFB Dental Squadron Tour

“Wow, what a great service you provide”

It’s an honor to be selected as the 436^th Dental Squadron Honorary Commander this year.  Dr. Eric Cathey – Commander of the 436^th Dental Squadron – joined me at the induction ceremony, along with dozens of newly-selected business professionals and their 436^th and 512^th Air Force partners.  Dr. Cathey is also an avid “triathloner”, so we shared our sports stories as well.

Honorary Commanders are charged to learn more about the US Air Force and the mission of Team Dover, attend squadron functions, and interact with unit personnel.  The events are scheduled through-out the year and the event coordinator does a great job giving notice so even busy people can attend some of the ceremonies held on base.

My OSL team toured the DAFB dental squadron with me on May 5^th.  Dr. Cathey presented on the USAF Dental Service Mission which is to ‘provide the highest quality care to support the 436^th Airlift wing’s mission through dental readiness’.  We attended a true Air Force briefing and got to experience what briefings are like for Active Duty Military.  The staff of the Dental Squadron exhibited great structure and professionalism through the entire visit, beginning with lunch at Grottos and ending with the gift of a coin to all of our attending staff.  We have a staff member, Natalia, whose husband is Active Duty Air Force and she was very interested in experiencing a true Air Force briefing.  She said she enjoyed seeing what her husband experiences on a day-to-day basis.

MSgt. Jennifer Jones – the Superintendent of the Dental Squadron – led the tour and discussed the upgrades in the facility.  It’s great to see the facility getting needed upgrades in technology.  More importantly, both Dr. Cathey and MSgt Jones are passionately committed to their mission and to their team morale.  The team suggestion board and the “Great Patient Award” they give to their great patients demonstrate that excellence is a journey to which they are enthusiastically committed. Lunch at Grotto’s was great too!  We plan on reciprocating with a tour at OSL soon.

Next month, new topic!

Welcome to Dr. Steckel's OSL Blog!

I look forward to sharing orthodontic ideas with you, derived from recent dental/orthodontic research and my experience.

The best time to get an orthodontic evaluation does not always equal the best time to begin orthodontic treatment. Consider the following:

• Appearance concerns
• The patient's unusual skeletal growth, or lack thereof
• The patient's day-to-day diet, homecare and oral habits
• The rate of eruption of permanent teeth and loss of baby teeth

The March 2011 edition of the American Journal of Orthodontics and Dentofacial Orthopedics includes a spotlight article* which discusses preventive treatment to reduce the impactions of permanent canines.  About 1.7-4.3% of the population experiences upper canine teeth impaction.  The upper canines usually erupt about age 11.  Impacted teeth can lead to extensive treament and risk of loss of teeth.

In this study patients aged 8-13 years had an orthodontic evaluation and panorex x-ray to check eruption of developing teeth.  Measurements were made and the patients were assigned into groups.  The patients at risk for impaction were referred for extraction of specific baby teeth and followed.  Those at risk who had specific baby teeth removed experienced successful correction at 78.6% (with 2 baby teeth removed) and 97.3% (with 4 baby teeth removed).

Numerous OSL patients have benefitted from baby teeth extractions when the baby teeth have "overstayed their welcome", or when an unusual eruption pattern is noted on the panorex x-ray.  After periodic monitoring, many were then ready to proceed with treatment such as braces or Invisialign® without needing extensive surgery to correct impacted canines.  The recent spotlight article confirms that a little intervention, at the right time, can reduce the need for extensive correction later.

Talk with you again, new topic!

Dr. Stephanie Steckel

Starting Blog!

We, at Orthodontics on Silver Lake (OSL) are really excited to start up our blog. Check us out, as we talk about our new contests, events, and other happenings at our office.