tell us just as an introduction a little about yourself maybe some of your education where your office is located and maybe even a telephone number if somebody has a question they might be able to call you  you since one nine hundred ninety nine i also teach part time in the orthodontic professions also if you have any questions you can always call it for one two eight three three three nine two two and today we're going to talk about early braces or what a lot of people call phase one or or early intercept of orthodontics you know the interesting thing dr so laney is the orthodontics you know over the years people have just said well it's a cosmetic orthodontics is not cosmetic at a certain percentage of it is for sure cosmetic but what i'm finding more and more is if teeth are not corrected they're harder the keep clean the heart of the brush because of the becomes an issue that way and also protruding teeth oftentimes with can get people can get hurt to get their teeth broken or that kind of thing so orthodontics is more is just as much a function as it is a static so and i appreciate the fact that you're here talking about early intercept of orthodontics now we're talking about what age group here you're looking between the ages of seven and ten a lot of the individual still has baby now and a common question that you and i were discussing is why are so many children treated before all the permanent teeth erupt as you can see on the slide and we always say the upper jaw can be narrow or setback giving an underbite and like you just mentioned dr so caskey to prevent injury to the pretreated upper front teeth also we've learned over the past ten fifteen years and the gross studies out of the university of michigan you can help some crowding issues between the ages of seven and ten and a common thing that we've learned for years we try to manage habits some habits finger habits as you can see from the slide so if you catch the child early enough you can if the teeth are crowded and crooked you can more or less grow the jaw to a certain degree with certain appliances to make the teeth fit in to eliminate the need or the possibility of having an extraction after the job is grown to  you know to a more mature level and you need space than extract it mitigates the need to extract teeth oftentimes also i think dr salinity the issue with if you go back to that last slide the finger in habits if those aren't corrected at an early age and we see that often in my office and i have and you've helped us out tremendously with certain habits some habit or finger habit will cause an open b now an open bite functionally is a problem because your teeth don't meet but also you become a mouth breather because and the tongue thruster when you swallow because of this open body and if that's not corrected you have that through your whole life this open bite and some of the ramifications of having the open bite or dry mouth and also you can see if you have braces and the teeth are corrected but you don't correct this tongue thrusting or finger sucking issue that makes your teeth separate up or a cut in the teeth will relapse and will be an open bite again so that's the one of the key things that i see is a general dentist that life and like you just mentioned the benefits of the early intervention between the ages of seven and ten the upper jaw is still developing so you can do some intercept of you can modify you can change some things that you couldn't do years ago and we just didn't know like you said before will prevent the need to have permanent teeth pulled between one thousand nine hundred five one of when most of us were you know in school one out of every two people that would come into the orthodontic office were having teeth pulled as of i think two thousand and five when they did the last survey it's gone down to about twenty percent so one not even one out of every four having tea pulled so we've done a lot of things from the studies at a michigan pit west virginia and one big thing that we didn't realize years ago was when you do strain the teeth prevents some protrusion it does have a positive effect on someone's social so they feel a little bit better about themselves you know this the idea of pulling teeth saves the need for oral surgery who wants to have teeth pulled you know good teeth so to speak to make room that's the early intervention need for you know possibilities to expand that josser the teeth fit in so you don't have to have extraction and then go back to the other slide or something i want to copy this is an interesting thing the simple five or shorten the treatment time now i've seen doctors so laney's patients have an incredibly short period of time for the actual braces because of a short period early on for the early intervention where you see a patient at a young age you expand their jaws now you wait a little while after the expanded the braces go on instead of for a long long time for a very short time because the expansion is there and then all you need to do is move the teeth minimally so early intervention literally saves time and i do believe it saves money over a period of time we hope it always does and not all not all the cases are like we say cookbook about but majority of an eighty percent usually cheat out fairly well when you have the early intervention and when you look at this first slide now we have on the screen you can see here on the right side on the left side of the screen of the patient's right we have what is called a cross bite it's a narrow upper jaw and when you look at it from the side you can see the upper teeth are inside the lower teeth and you can also see a tooth is blocked out and when you look at the left side you also didn't have room for a tooth so as a general dentist when i see a patient like this doctor i see inadequate shewing and i see a face that on the right side is fully developed on the left side because it's locked in correct into this cross quite where the top teeth are actually inside the bottom i see a face that is less developed so that is one of the key  absolutely that i say get to this early intervention get this i corrected right away to correct a growth if your son or daughter has and their upper jaw the teeth don't fit properly together get it evaluated and what we usually do is we we have an expander and this is what i just what the expander looks like it fits to the upper teeth you have rings around the back teeth we show you how to turn it in over the course of six to twelve months you get something that looks like this and then the right is nice thing about this doctor is now when the time comes to put braces the correct any misalignment it's a very quick and easy case and the thing that will say here before we go to break is at this age the upper jaw is developing the bone is still  fully mature it's easier to correct at that age so when you look at the before and after pictures that's what we call a nice face water early intervention we're going to take a short break dr celeb dr salamis and orthodontist office right  and what can you do like all young people with disabilities should grow if expecting to work and succeed for more information visit what do campaign dot org boule sure make our lives easy but a tool is only as useful as the hand that holds it when it comes to straightening crooked teeth and misaligned jaws orthodoxies have all the right tools in their tool box they're the most skilled professionals to oversee  have the expertise that comes with two to three years of specialized education beyond dental school they know best which instruments to use when correcting problems with your smile in the right hands is it braces dot or individual that the upper front teeth are in front of the lower teeth and when you look at the case here on the screen you have an individual with some spacing and when you look at them from the sides you see some patrician how the front teeth are in front of the lower teeth and we talked about earlier we know from the studies done back in the ninety's from pan north carolina and florida that one the protrusion is greater than seven millimeters the front teeth are at an increased risk to being traumatized by thirty percent and the studies found that that was significant and also the thing that we were never taught that the studies have shown kids become very self conscious of this especially the spacing and how the front teeth look so as a general thing although i have to tell you that's the one issue the kids have the most sensitive are the above is that right lucky experience so you're saying an intercept of orthodontics you catch an early age it's a very mild relative treatment to get that bucky beaver thing erected that's correct when you look at this case just to close the spaces and bring them back a little bit you're looking at about eight to ten months at the most a year now the thing that we always tell  patients and every with adonis will tell you eighty percent of the time they're going to need the full set of braces usually when puberty begins because we have to rely on lower jaw development so this intervention is just bringing the front teeth back and protecting them getting it underneath seven millimeters and also to close the space so the individual feels a little bit better about their smile and when you look at it from the sides you see the overbite now when you look at the front view this was the end of the phase one they portrait but it's less than seven millimeters so we know we're protecting them from any injuries and we've closed the spaces and then when the patient hits puberty about a couple things you see anywhere from two to three years later we put the full set on and we get that so when you look at the sides we've gotten rid of the over jet or the patrician and this is kind of a snapshot in time this is when they came in around nine years old this was about ten and this was when the individual was done around fourteen of dr so late when the age that we do this again oh you don't even have to be a dentist or an orthodontist when you have when you see a child of seven your usual seven to seven to ten you know the key is seven to ten years old optimum time to have this treated correct and it's not treated with actual bonbon braces it's usually one how is it three well this one we did we to do we did that we did limited braces or was about four to six braces on the front and two anchors on the back and we just bring him together and pull them back to get there we still have an overbite but it's less than seven millimeters and then when all the permanent teeth are in and we know that they're hitting their growth spurt we put the full set on and we finish it because we have the help of lower jaw development we know when the long bones of the body as you're getting taller the lower jaw develop me at the same time the teeth are the permanent teeth are erupting at the same time and at the optimal time to correct this type of growth pattern the thing that we tally everybody on this is it's all about timing this is the litmus test i mean you don't even have to have your i tell you if this bothers you you can do some things but i said you're most likely eighty percent of the time going to need two sets of braces and that's the only thing that sometimes people get confused about the early intervention here is doing two things preventing any trauma and helping them to feel better about their parents and it's a seven to ten years old is the key for the american association of orthodontists recommends that you're evaluated between the ages of seven and ten out of that group only twenty anybody that deals with kids if you have kids were in the profession i mean we all have kids we want our kids to be treated the same way we would treat them so most of all with a dinosaur going to do that and even our general dentist colleagues we're all going to just help help our adolescent because we all have kids it's a time for well just keep on going to the next one we're three minutes to go so let's go on the next slide now this is a separate case altogether now me to try al anon family understand my feelings better i didn't want to go because i didn't want to get into another argument with my boyfriend but i'm glad i'm starting to understand that i didn't cause his anger it didn't cause his drinking it's a great relief when you're finished with your food or beverage cartons toss it in the recycling because every card is recycled and you turned into useful paper products nine so we're talking about intercepting orthodontic at a younger age to prevent growth abnormalities from continuing in to in to are overlapping the lower teeth it's an underbite we always say unfortunate coach cowers not coaching anymore but this is the coach cower the jay leno the lower jaw is in front of the upper teeth and when you look at this this is something that you know we strongly recommend early intervention peter universe us from west virginia university there's another gentleman mcnamara james james magnum out of michigan they've done extensive studies on this and now we know if we catch this early enough we can prevent jaw surgery  the future and when you look at the slides as you can see there's an underbite when you look at it from the side there it is so it's essentially one the bottom teeth are protruding not the top to correct the bottom teeth are way out here  thought that this was due to the excess lower jaw growth the lower just not developing much at this age it's a deficiency in the opera jock and you can see here we'll show you this type of it's an expander but it's glued in the upper teeth and you wear at night brace and the age again is very important any time between seven and ten you've got to catch just because the upper jaw is developing and you can see these metal hawks here there is where you attach the last x and i'll show you the picture and this is after about after about four or five months of just this appliance a cemented to the teeth and wearing the night brace and there's what it looks like cemented to the roof of the mouth you have plastic here that covers the teeth and you have this little expansion screw that you need to do and here's what the head gear where as you just wear it when you sleep you don't wear it out in public and after about six four to six months of treatment this is what you get so you worried at night that's correct you don't have to and after  said this was only in about six months some people keep it in longer i try not to keep it in longer than six to eight months because it's tough to keep it clean and when you look at the side here we've already corrected the jay leno bite  you can see how the plastic covers the teeth and helps open the bite and there's what you get so so this means of they won't be able to be football coaches are going to yeah they won't have a direct now that they're the most visible people that have that prominent lower job so this is one if you catch it early enough you can you can correct it if left untreated you're basically saying you're going to have just urge you to later age and the one thing i try to explain still when these cases we treat them some of them are still out of a percentage still about ten or ten or twelve percent ten to fifteen percent still may require jaw surgery in a future but we definitely decrease the need to have just surgery that's ten years which is here's what the before and after when you see in a say this is more orthopedics than it is this is then a facial orthopedics but this is something you catch in an early age i can't stress enough this is something that when i was at pitt twenty years ago we weren't really fully trained on this this was something our colleagues from west virginia michigan and university san francisco did a lot of research on and it's now being taught at every university so this is something you want to intervene it's not something it's something that as a dental appliance to help expand the upper jaw and go up and grow proper and correct but the most important thing is you have to wear that night brace the last case we want to go over bill's is a as a crowd in case an eight year old female with some chronic twenty years ago when i was at tate you can see teeth are blocked  we would have just started pulling teeth and it's still not a bad option it's still been done we teach it or at the university we still teach this but the university of michigan has done some growth studies where if you catch this early enough with some expansion and limited upper braces you can get a pretty nice result as you can see here from the side the laterals do not have enough room to come in as you can see the latter own sizers don't have enough room in the end what we're talking about earlier expanding the job  is giving growth a kicking about as we say and at the end of the early intervention was it was exactly one year treatment we made room for the lateral incisors upper and lower it was an expanded with about six upper and lower braces was about a year treatment and that's what you got now down the road they still may desire the full treatment to make it perfect and this individual did and you'll can see right there she has her full treatment this was done when she was about fourteen and the bite is good as you talk about the bi how the teeth fit nicely in between on both sides and i always like this slide that to recap this this case you had some crowding you did some early intervention and then when she was twelve or thirteen a desire to full braces to accommodate it all we see a lot in general dentistry with teeth that are look and and and have a kind of crowding as they're hard to brush hard to keep clean subtlety where they're overlapping you start to get cavities gum disease and it's just so much easier to brush your teeth when they're even and straight than it is on all those different angles so it not only aesthetically functionally but also longevity it makes you keep your teeth brushed your live because they're so much easier to floss and take care of  to be able to understand and to really manage their own you know children in terms of what they like to see in terms of the way the teeth look and function together doctor so late your telephone numbers four one two eight three three three nine two two three nine two two and dr sellers available for consultation as a as a as a special treat if you call him and mention peters township i'm sure he'll it'll be a no charge console just two or a second opinion whatever you you know desire that way and i want to thank you let's talk downstream peter sounds it is it is a great program of information i want to thank the  students here peter's timeship and their mentor robin were put on such a nice program i think this is very much on president of anywhere frankly in the country and it's a it's a great