We love to make you smile!

Why Braces
Why Braces

For most people, a beautiful smile is the most obvious benefit of orthodontics. After your braces come off, you’ll feel more self-confident. During your treatment, we want you to feel as comfortable as possible.

How Orthodontic Treatment Works

Orthodontic appliances can be made of metal, ceramic, or plastic. They may be removable or they may be brackets bonded to the teeth. By placing a constant, gentle force in a carefully controlled direction, braces slowly move teeth to a corrected position. This is a great time to wear braces! Gone are the days when a metal band with a bracket was placed around each tooth. You can choose brackets that are clear or metallic color. You can choose the color of the ties that hold the wire in brackets. Wires are also less noticeable than they used to be and the latest materials move teeth faster with less discomfort to patients.

Duration of Treatments

Treatment time typically ranges from one to three years, depending on the growth of the patient’s mouth and face and the severity of the problem. Patients grow at different rates and will respond variously to orthodontic treatment, so the time to case completion may differ from the original estimate. The patient’s diligent use of any prescribed rubber bands or headgear is an important factor in achieving the most efficient treatment. Interceptive, or early treatment procedures, may take as few as six months.

Two-Phase Treatment

What is Two-Phase Orthodontic Treatment?

Two phase treatment is a specialized treatment process in which children receive orthodontic treatment in two separate phases. The first phase of treatment occurs when the child still has multiple primary or baby teeth present in the mouth. The second phase of treatment occurs when all permanent teeth have erupted into the mouth (usually around age 11-13).

Why Does My Child Need Two Phase Treatment?

The major advantage of a two-phase treatment plan is to maximize the opportunity to accomplish an ideal functional and aesthetic result that will result in a healthy stable bite for a lifetime. If Dr. Periago has recommended two phase treatment for your child, she will have done so after thorough review of orthodontic records including photos and digital x-rays. The major goal of this phase of treatment is to create a better environment for your child’s permanent teeth…sometimes treatment at this time can avoid growing problems in the development process.

Phase I Treatment:

A First Phase of Treatment is recommended by Dr. Periago in order to:

  • Prevent a problem from occurring (preventive treatment)
  • Intercept a developing problem (interceptive treatment)
  • Guide the growth of the jaw bones that support the teeth (growth modification)

The objective of first phase treatment is to develop the jaw size in order to accommodate all the permanent teeth and to relate the upper and lower jaws to each other. If left alone, early orthodontic tooth and skeletal problems can create an unhealthy environment for the growth and development of your child’s teeth, gums, jaws and face. Phase I treatment is timed to predictable stages of dental development to provide the greatest potential for improvement and correction of your child’s malocclusion (bad bite).

Resting Period:

After phase one treatment is complete, Dr. Periago will continue to monitor your child at six month intervals on our growth and guidance program. During this resting phase the permanent teeth are allowed to erupt into the mouth. Retainers are sometimes indicated during this phase and sometimes they are not. Dr. Periago will recommend whether your child should wear a retainer or if it is in his/her best interest to go without. These observation appointments are important because they allow for evaluation of your child’s dental development and the eruption of the remaining permanent teeth into the mouth.

Phase II Treatment:

Most patients will require a second phase of treatment often with traditional braces to complete the tooth and jaw alignment that was started during the first phase of treatment. The goal of this second phase of treatment is to make sure that each tooth has an exact location in the mouth where it is in harmony with the lips, cheeks, tongue, and other teeth. Many times this second phase of treatment is shorter than what it would have been if phase I treatment would have not occurred.

How Do I know If Two-Phase Treatment is Right For My Child?

Orthodontic treatment is not a “one size fits all” approach. Each patient has a unique set of problems which requires a unique treatment plan. Dr. Periago is committed to a full and individualized diagnosis for each and every one of her patients. This diagnosis will determine which individualized and customized treatment plan is best for your child. What is right for one child may not be right for another. Dr. Periago will discuss your child’s problems set as well as what treatment modalities would be best at your initial consultation.

Potential Candidates for
Two-Phase Treatment
crossbite of back of teeth

Crossbite - Back of Teeth

Incisor Crossbite

Incisor Crossbite

open bite

Open Bite





Braces for Adults
Adult Orthodontics

Orthodontic treatment can be successful at any age, and traditionally adults especially appreciate the benefits of a beautiful smile. Nationwide one of every five patients in orthodontic treatment is over 21. The physiology of tooth movement is the same whatever the age. The primary difference between adult and children’s treatment is associated with jaw growth available. Therefore, in a growing child, the orthodontist can modify how the jaws grow and develop, whereas in a non-growing adult with an excessive skeletal discrepancy jaw surgery or extractions may also be required. Additionally, adults who have experienced breakdown or loss of some of their teeth and supporting bone may require restorative and/or periodontal treatment prior, during, and/or after orthodontic treatment. Depending on severity, bone loss may also limit the amount and direction of tooth movement advisable. Aside from achieving a beautiful smile, orthodontic treatment helps align the teeth, allowing for the future placement of “ideal” restorations planned by your dentist.

Surgical Orthodontics
Surgical Orthodontics

What is surgical orthodontics?

Just as orthodontics repositions teeth, surgical orthodontics (also known as orthognathic surgery) corrects jaw irregularities to improve the patient’s ability to chew, speak, and breathe and for improved facial appearances. In other words, surgical orthodontics straightens your jaw. Moving the jaws also moves the teeth, so braces are always performed in conjunction with jaw correction. This helps make sure teeth are in their proper positions after surgery.

Who needs surgical orthodontics?

Your orthodontist will consider surgical orthodontic treatment for non-growing adult patients with improper bites and those with facial aesthetic concerns. Jaw growth is usually completed by age 16 for girls and 18 for boys. All growth must be completed before jaw surgery can be performed. However, the pre-surgical tooth movements can begin one to two years prior to these ages.

How does it work?

During your orthodontic treatment, which usually lasts 6-18 months, you wear braces and will visit your orthodontist for scheduled adjustments to your braces. As your teeth move with the braces, you may think that your bite is getting worse rather than better. However, when your jaws are placed into proper alignment during orthognathic surgery, the teeth will then fit into their proper positions.

Surgery is performed in the hospital with an oral surgeon and can take several hours, depending on the amount and type of surgery needed. In lower jaw surgery, the jawbone behind the teeth is separated and the tooth-bearing portion is moved forward or backward, as needed. In upper jaw surgery, the jaw can be repositioned forward or backward, or the jaw can be raised or lowered. Certain movements may require the jaws to be separated, with bone added/removed to achieve the proper alignment and stability. Other facial bones that contribute to alignment may also be repositioned or augmented.

When you have completed surgery, you should be able to return to school or work within two weeks. After the necessary healing time (about 4-8 weeks), your orthodontist “fine-tunes” your bite. In most cases, braces are removed within 6 to 12 months following surgery. After your braces are removed, you will wear a retainer to maintain your beautiful new smile.

Ask the Orthodontist
Ask the Orthodontist

What is orthodontics?

Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention, and treatment of dental and facial irregularities.

What is an orthodontist?

An orthodontist is a specialist who has completed an advanced education program following dental school to learn the special skills required to manage tooth movement and guide facial development.

What are some possible benefits of orthodontics?

  • A more attractive smile
  • Reduced appearance-consciousness during critical development years
  • Better function of the teeth
  • Possible increase in self-confidence
  • Increased ability to clean the teeth
  • Improved force distribution and wear patterns of the teeth
  • Better long term health of teeth and gums
  • Guide permanent teeth into more favorable positions
  • Reduce the risk of injury to protruded front teeth
  • Aids in optimizing other dental treatment

What are some signs that braces may be needed?

  • Upper front teeth protrude excessively over the lower teeth, or are bucked
  • Upper front teeth cover the majority of the lower teeth when biting together (deep bite)
  • Upper front teeth are behind or inside the lower front teeth (underbite)
  • The upper and lower front teeth do not touch when biting together (open bite)
  • Crowded or overlapped teeth
  • The center of the upper and lower teeth do not line up
  • Finger or thumb sucking habits which continue after six or seven years old
  • Difficulty chewing
  • Teeth wearing unevenly or excessively
  • The lower jaw shifts to one side or the other when biting together
  • Spaces between the teeth

At what age should orthodontic treatment occur?

Orthodontic treatment can be started at any age. Many orthodontic problems are easier to correct if detected at an early age before jaw growth has slowed. Early treatment may mean that a patient can avoid surgery and more serious complications. The American Association of Orthodontists recommends that every child first visit an orthodontist by age 7 or earlier if a problem is detected by parents, the family dentist, or the child’s physician.

What is Phase I and Phase II treatment?

Phase I, or early interceptive treatment, is limited orthodontic treatment (i.e. expander or partial braces) before all of the permanent teeth have erupted. Such treatment can occur between the ages of six and ten. This treatment is sometimes recommended to make more space for developing teeth, correction of crossbites, overbites, and underbites, or harmful oral habits. Phase II treatment is also called comprehensive treatment because it involves full braces when all of the permanent teeth have erupted, usually between the ages of eleven and thirteen.

Would an adult patient benefit from orthodontics?

Orthodontic treatment can be successful at any age. Everyone wants a beautiful and healthy smile. Twenty to twenty five percent of orthodontic patients today are adults.

How does orthodontic treatment work?

Braces use steady gentle pressure to gradually move teeth into their proper positions. The brackets that are placed on your teeth and the archwire that connects them are the main components. When the archwire is placed into the brackets, it tries to return to its original shape. As it does so, it applies pressure to move your teeth to their new, more ideal positions.

How long does orthodontic treatment take?

Treatment times vary on a case-by-case basis, but the average time is from one to two years. Actual treatment time can be affected by rate of growth and severity of the correction necessary. Treatment length is also dependent upon patient compliance. Maintaining good oral hygiene and keeping regular appointments are important in keeping treatment time on schedule.

Do braces hurt?

The placement of bands and brackets on your teeth does not hurt. Once your braces are placed and connected with the arch wires you may feel some soreness of your teeth for one to four days. Your lips and cheeks may need one to two weeks to get used to the braces on your teeth.

Will braces interfere with playing sports?

No. It is recommended, however, that patients protect their smiles by wearing a mouth guard when participating in any sporting activity. Mouth guards are inexpensive, comfortable, and come in a variety of colors and patterns.

Will braces interfere with playing musical instruments?

No. However, there may be an initial period of adjustment. In addition, brace covers can be provided to prevent discomfort.

Should I see my general dentist while I have braces?

Yes, you should continue to see your general dentist every six months for cleanings and dental checkups.