Initial Visit

Do you charge for an initial visit?

No, As a courtesy to you and your family dentist, we will always discuss the feasibility of braces or tooth straightening without charging a fee. There may be a co-payment for x-rays and other diagnostic procedures.

At what age do you start seeing patients?

As a rule of thumb, we like to evaluate young patients after the 6-year molars erupt and the front permanent teeth just start to appear. This is usually between the ages of 6 and 8.

Why do you evaluate patients so young?

The purpose of early evaluation is to inform and observe more than to start treatment. At this early age, the eventual needs may be identified and discussed. A small percentage of this young group may need some form of intervention. Habits are evaluated, medical issues are discussed and an observation schedule is arranged.

How long will the first visit take?

The first visit can last anywhere between 15 minutes and 1 hour depending on how ready the patient is for treatment. We may just do a visual exam and explain the situation or we may suggest one or more x-rays and complete diagnostics including casts of the teeth with photographs. This would be followed up with a more complete consultation and review of the findings.

Do you take patients transferring from out of town?

Yes we do. We handle a patient transferring into our office from another city just like a new patient. We gather complete diagnostic records to show the current status and propose treatment to complete the work that has been started. Unlike most practices, we do not ask for a large down payment but merely assess a monthly fee to complete the treatment in progress.

Do you have any adult patients?

Absolutely, a growing percentage of our patients are adult. New more cosmetic appliances are making adult treatment much more comfortable and convenient.

What is the difference between an orthodontist and a dentist?

An orthodontist is a general dentist that has had at least 2 more years of full time training in orthodontics resulting in a nationally accepted specialty certificate. The orthodontist then limits his practice to straightening teeth and dentofacial orthopedics. Many orthodontists including Drs. Grob and Donovan continue past the specialty certificate to complete and publish an original research project resulting in a Masters Degree. Additionally, some like Drs. Grob and Donovan become specialty board certified.

Where is your office?

Our east side location is on the NE corner of Pantano and Broadway behind the Yokahama Rice Bowl
Our southwest side location is on the North side of Valencia just west of I-19 On the northwest side we have a beautiful office on the south side of Orange Grove between La Canada and La Cholla Roads.

Hours

What are your hours?

Monday through Friday from as early as 7:00 a.m. until 4:45 p.m.

Can I make all my appointments in the afternoon?

In order to have early and late appointments available for the majority of patients, some procedures need to be accomplished during the hours of 9 and 1. Generally speaking, approximately 1 out of 5 or 6 appointments are made during the morning or early afternoon.

Do you see patients for emergencies?

Yes, Both doctors as well as staff have their contact information posted on the web site as well as the phone answering machine.

Financial

Can we make payments?

Yes, Whether or not you have insurance or a dental plan, we will structure a convenient payment plan that will allow you to pay for necessary services over a period of time that usually coincides with your treatment plan.

How do you handle insurance?

After verification of coverage, we will agree to bill and collect from an insurance carrier. However, we ask patients to understand that if coverage ceases or changes, the patient is still responsible for the agreed upon fee.

Do you take American Express, Master Card and/or Visa?

Yes, we accept all major credit cards.

Do you have direct deposit?

Yes, we have arrangements for direct debit, charge card posting as well as payments over the internet.

Do you charge interest?

No we do not.

Do you give family discounts?

We have special programs and fees for multiple patients from the same family?

Types of Treatment

What is phase 1 treatment?

Phase 1 treatment is delivered early and before all permanent teeth have erupted. The purpose of this early care is to start correcting harmful malocclusions that may be more difficult or impossible to correct later. Phase 1 treatment does not eliminate the need for conventional orthodontics done during adolecense. Examples of phase 1 treatment include correcting individual tooth or jaw crossbites and severe underbites and overbites where function, esthetic or psychological concerns are identified.

What is phase 2 treatment?

Phase 2 treatment is conventional orthodontic treatment. It may start while the last baby teeth are falling out and continue until the 12 year molars have been evaluated or straightened. This treatment usually lasts between 2 and 3 years.

How do I know if Phase 1, 2 or both type of treatments are necessary?

An early visit is suggested. About 10 to 20 percent of young patients may benefit from phase 1 treatment. Most other patients are observed until the appropriate time to initiate care.

Does early treatment ensure a better result?

Not always. Experience and research shows that early treatment achieves meaningful goals but the quality of the result is determined at the end of care. For this reason, we do not encourage early treatment unless significant benefits can be achieved.

Expanders and/or Removal of Teeth

Do teeth need to be removed for orthodontics and straight teeth?

Not always. The decision to remove teeth is made after analyzing the jaw structure, the face muscles and the gums holding the teeth in position as well as the size and shape of the teeth.

If baby teeth are removed and then permanent teeth are removed can braces be eliminated?

Rarely. Removing teeth creates room for teeth to get into the mouth but they are usually not as straight as they should or can be.

Can jaw expanders be used instead of removing teeth?

Expanders are helpful in eliminating tooth removals in individuals who are expected to grow into their teeth. Some individuals have jaw growth patterns that do not compliment expanded jaw structures. These growth patterns are estimated and discussed during the diagnostic process.

Can expanders be used on adults?

Yes, however sometimes surgical assistance is necessary.

Can you always plan for tooth removals at the beginning of treatment?

No. Sometimes, even with the best intentions and planning, situations arise requiring tooth removals. These situation relate togrowth, tissue response and cooperation and habits among other things.

How about interproximal reduction (removing enamel) in between teeth?

In order to make room for aligning teeth when removing teeth or expanding is not indicated, small (less than .5mm) amounts of enamel can be removed without sensitivity or worry about future decay.

Moving of teeth (Mechanics)

How long do braces take?

Complete treatment can usually be accomplished in 2 to 3 years of active tooth movement. Sometimes, this active movement is divided into two or more periods of time with a rest of 6 to 18 months in between. (See phase 1 and 2 treatment above).

How do braces work?

Quite simply, crooked teeth are gradually moved into desired positions by taking shaped wires and attaching them to brackets on the teeth.

How come only the upper front braces are applied initially?

For most patients, initial treatment is limited to the front four and back teeth. This allows for development of the anchor teeth and aligns the upper front teeth. Decisions are made after this point regarding more braces and removal of teeth.

Why do I need to have bottom braces put on if they are already straight and only my upper teeth are crooked?

Once the upper teeth have been arranged, they will not fit in the same manner as in the beginning. Also many times we need to use rubber bands to mesh the bite together. The lower teeth are used as an anchor to hold on to the rubber bands.

Why are only the colored ties changed and not the wire?

The wire is still capable of moving teeth, and the new ties re-energize the wire.

How often should patients be seen? Would anything be hurt if a patient went longer, say 10 weeks for an adjustment? Likewise, would it help to come in more often say every 3 or 4 weeks?

It depends on the procedure being done. Early on and in the middle of treatment, probably not, but during the countdown to deband(removal of braces), one needs to be seen more often for subtle detailed adjustments.

How do headgears work?

Headgear works by slowing the upper jaw from growing too much and allowing the lower jaw to keep growing. Headgear also may move the upper teeth back slightly. Depending upon the shape of the jaw and direction of expected jaw growth, headgears may fit behind the neck or over the back of the skull. In some situations headgears are fit to the forehead and chin. Success is dependant on cooperation, amount and direction of lower jaw growth.

Do you use recycled braces?

Do you do lingual or invisible braces?

We utilize Invisalign but we do not treat with lingual braces. Practices that have excellent results with lingual braces have devoted their entire team and facility to lingual braces.

Invisalign

How does Invisalign work?

Invisalign is started by making imprints of the teeth and bite. The imprints are then changed into digital images on a computer. These images are then aligned in .25mm increments to straighten teeth. The number of .25mm increments needed to align the teeth corresponds to the number of aligners needed to complete treatment.

Who can be treated with invisalgn?

Generally speaking, patients who have completed skeletal growth and dental development are good candidates. Some patients have problems too severe for invisalign, likewise, some patients are best treated with invisalign.

Can Invisalign be used with braces?

Yes, In fact, the invisalign company suggests this with many situations. Braces may be utilized at the beginning, middle or completion of treatment.

Retainers

Do retainers need to be worn after braces?

Yes, Retainers are worn full time for about 2 to 3 months followed by nighttime wear indefinitely.

Why do teeth get crooked after wearing braces or aligners?

Teeth are crooked in the first place because of imbalances of jaw sizes, facial and tongue muscles and heredity and habits. Aging can change any of these factors plus initiate many others. Straightening teeth is an attempt to fool mother nature. Sometimes we need to keep fooling her for many years.

How about retainers glued to the backs of teeth?

For some patients, permanent retainers are attached to the back of lower teeth to keep them in place. This requires special hygiene procedures and regular recalls to the family dentist.

Wisdom teeth (Third Molars)

Do wisdom teeth cause teeth to get crooked?

Research has shown this not to be true.

Why do wisdom teeth need to be removed?

Wisdom teeth do not cause crooked teeth but they can cause gum problems, swelling and infection. It is much nicer to plan for their removal rather than have them removed under emergency conditions.

When is a good time to have wisdom teeth removed?

The best time according to oral surgeons is when approximately 2/3 or so of the root is formed. Some time after age 16 or 18 seems to be the average.

Temporomandibular Disorders (TMJ)

Can Braces or orthodontic treatment treat or cause TMJ problems?

Scientific literature has documented that there is not a direct link between orthodontic treatment or occlusion and TMJ. Problems with the TMJ can be present or absent is the presence of all types of good and bad bites.

Oral hygiene, diet and daily maintenance

Are patients ever allowed to chew gum?

Gum chewing on an occasional basis may be helpful in relieving discomfort after brace tightening. Sugarless of course!!!

What can and can't you eat?

Common sense tells you to eat healthy food and avoid as many crunchy and hard things as possible. The most important thing is to avoid excessive sweets such a soft drinks and cut things into small pieces.

What do you think about electric toothbrushes?

They are nice but certainly not necessary. Many studies have been done on tooth brushing and braces and they all conclude that pressure and technique are the most important variable in removing plaque around braces.

Do clear braces turn yellow?

No, but they will allow any food or debris remaining on the tooth to be highly visible.

Health impact

What are the health benefits of wearing braces?

Orthodontics helps to improve the comfort of the bite, make hygiene easier, and many times helps to balance the facial musculature. The positive self-esteem benefits are immeasurable.

How do adenoids affect braces?

Mouth breathing as a result of enlarged adenoids or tonsils may cause vertical growing that can lead to protrusion elongated facial form resulting in crowding. Many times this crowding may require tooth removals.

How does a tongue thrust or low tongue posture affect braces?

The effects are similar to enlarged adenoids. Plus, the pressure on front teeth from the tongue thrusting can aggravate protrusion and spacing.

I need to be pre-medicated for the dentist. Do I need to take my medicine for the orthodontist?