Welcome to Embassy Row Orthodontics

Opening Hours : Monday to Friday - 9am to 5pm
  Contact : Call: 202-518-5910

What is early treatment?

Early orthodontic treatment, also called phase I, refers to orthodontic treatment done while there are still primary (baby) teeth.

What are the benefits of early treatment?

Early phase treatment can reduce the need for extraction of permanent teeth.  Twenty to thirty years ago, orthodontists rarely saw children until around age 12. In those days, American orthodontists extracted two to four permanent premolar teeth in about 60% of orthodontic patients. Today, we extract in less than 5% of our patients. This is partly due to the selective use of early phase treatment.

Early phase can create space for teeth to erupt more ideally instead of being stuck or erupting out of place.

Another aspect of early phase is the use of orthopedic appliances to change the jaw structure. These include expanders, night braces and “retainer-type” appliances that harmonize the growth of the upper and lower jaws, reducing overbite and underbites. After growth is completed, orthopedics is very limited, leaving only surgical options for jaw changes.

What are the steps of early treatment?

The first step is an orthodontic consultation in order to see if early phase is needed. If so, the consultation will tell you why early phase is needed, and to what extent the orthodontic case is. Typically, the next step, if needed, is expansion. Expanders look like retainers with an expansion mechanism that is slowly turned to widen the jaw over several months. After expansion, we use either braces or Invisalign to use the space to align the teeth. When the teeth are aligned, they lock in their space and prevent further loss of space; otherwise, the back teeth will drift forward. Lastly, we will use some type of retainer to wear after the early phase treatment, which is usually 12 to 18 months.

Does it actually work?

Some children can benefit greatly from early phase treatment. For other children though, it may be more practical to wait. We aim to be as efficient and cost-effective when performing orthodontic care for children, so we will only recommend early phase when appropriate.

How do I know if my child needs early treatment?

The best way to know if your child needs early treatment is to have an orthodontic consultation. Your dentist may be able to give recommendations about orthodontic needs, and many dentists routinely refer children to an orthodontist at age 7 for a consultation.

How much does early treatment cost?

Early treatment will reduce the treatment cost of final phase orthodontics. However, the cost of two phases will most likely be more than one-phase of treatment, since there is more time and effort involved and possibly a better result as well. For some children the early phase may be more valuable than the final phase and sometimes a second phase is not needed.

How old does my child have to be?

The American Dental Association and The American Association of Orthodontists recommends age 7 for a consultation. Your dentist may refer your child anytime from ages 7 to 9, for early phase. You may also call us directly anytime if you have any concerns.

What types of conditions benefit from early treatment?

Early treatment allows us to correct the following conditions:

  • Spacing
  • Crowding
  • Overbite
  • Underbite
  • Deep bite
  • Open bite
  • Impacted teeth
  •  Toot misalignment resulting from thumb, finger and/or tongue habits

What are braces?

Braces are small metal, tooth-colored, or clear brackets that are bonded to the teeth. They are designed to place gentle forces on the teeth when thin flexible wires are tied or otherwise engaged into the brackets. Over time, these forces work to gradually improve the alignment of your teeth.

What are the benefits of braces?

Braces straighten teeth. The benefits of straightening teeth (with braces or Invisalign) include better appearance, more stable positions and better gingival health. Additionally, periodontal health has been associated with cardiovascular health.

When should I get braces?

Orthodontic treatment may be indicated at any age. An early consultation is recommended at age 7. Final phase orthodontics is typically around age 12. Adults may get braces or Invisalign at any age for appearance or dental health.

What does Phase I and Phase II treatment mean?

Phase I, or early phase, is orthodontic treatment while there are still some primary (baby) teeth, typically in the 7 to 9 year-old age group.

What kinds of braces are there?

Braces may be fixed (bonded to the teeth) or removable (like Invisalign or retainers).

How long does my treatment take?

Treatment time varies with the type of problems and the magnitude of the problems. Average time with braces is two years. Average treatment time with Invisalign is about a year. We also have new orthodontic acceleration techniques to stimulate the bone to remodel faster. This can be a very gentle vibration device (Acceledent) used for 5 minutes per day and/or a micropuncture technique similar to acupuncture (Propel).

How much do braces cost?

The cost of orthodontics varies according to the difficulty of the case. Like other professional services it may also vary relative to the level of experience and personalized care. New technology, dental insurance, pre-tax health savings accounts and payment plans have helped make orthodontics affordable for more people.

How often do I need to come in for visits?

Due to new technology, intervals between appointments are much longer and appointments are shorter these days. Super-elastic wires work for up to 12 weeks with braces. Our standard interval for Invisalign is also only every 3 months.

Are there any restrictions on what I can eat and drink?

Patients are recommended to avoid sticky foods that may get stuck in the braces. However, brushing after eating anything sticky can be sufficient in maintaining good dental hygiene.

How do I care for my teeth with braces?

Brushing after eating will help maintain good dental hygiene, and it is recommended to spend extra time and attention to brush around every brace.

Do braces hurt?

The brace technology today is much more gentle than it used to be. Super-elastic wires put more gentle forces on the teeth. Teeth actually move faster with lighter forces because the force is just stimulating the bone around the roots to remodel.

What is Invisalign and how does it work?

Invisalign is a series of aligners that are made with computer modeling and computer assisted manufacturing. It works like braces by putting gentle but very accurate forces on the teeth. The force is transmitted to the bone. The bone around the roots of the teeth is very responsive to light forces. The bone remodels lettings the teeth move in the direction of the force

How often must I wear my aligners?

We find that aligners are most effective when worn 20 to 22 hours per day and removed only for eating, drinking, brushing and flossing.

How often must I come in to Dr. Hickory’s office for an appointment?

We schedule regular appointments usually about once every 12 weeks. The goal of these visits is to ensure that your treatment is progressing as planned. We will also provide you with your next few sets of aligners.

What are attachments and what is their purpose?

Depending on your specific treatment, some of the movements may require either “attachments” or “ridges” to help the aligner grip the teeth. These bumps, or wells, are where the aligner grips the attachment the doctor places on your teeth. The attachments are actually small pieces of enamel-colored composite the doctor affixes to your teeth that are then gripped by bumps on your aligners. The ridges are slim indentations in your aligners. Your doctor will use one or both of these features to attempt to achieve the desired tooth movement.

What is Interproximal Reduction (IPR) and what is its purpose?

Interproximal reduction (IPR) is a quick and easy procedure during which your orthodontist uses some very precise tools to change the shape and size of your teeth, primarily on the sides where they touch each other. This is done for three reasons. First, the upper or lower sets of teeth may be naturally the wrong size and don’t fit together well. Second, the shape of individual teeth may not allow them to lay next to each other ideally. This can adversely affect the appearance of a smile even though the bite may fit perfectly. Third, IPR is used in cases of mild crowding so that the removal of teeth can be avoided.

Can treatment be accelerated?

As a practice that prides itself on having cutting-edge orthodontic treatment options, we offer a few different techniques to accelerate tooth movement: AcceleDent and Propel.

  • AcceleDent: By inserting a mouthpiece and turning on the Activator for 20 minutes a day, AcceleDent will generate small vibrations, called micropulses, to stimulate bone movement. This in turn may reduce your treatment time by up to 50%.
  • Propel: Frequently described as “dental acupuncture,” Propel stimulates the bone around specific teeth with micro-punctures to release stubborn tooth movements and fast-track treatment.

To learn more about how to shorten your treatment time, visit our Accelerated Treatments page.

What ages are eligible for Invisalign?

As a Super Elite Provider of Invisalign, Dr. Hickory has the breadth and depth of experience needed to treat all orthodontic cases. We are delighted to offer Invisalign to children, teenagers, and adults of all ages.

Will Invisalign treatment be painful?

While Invisalign moves your teeth without the pain and anxiety metal braces can cause, some people experience temporary discomfort for a few days at the beginning of each new stage of treatment. This is normal and is typically described as a feeling of pressure. It’s also a sign that Invisalign is working as it moves your teeth to their final destination. This discomfort typically goes away in a couple of days.

How long will treatment take?

The length of treatment depends on the severity of your case and can only be determined by your doctor; however, the average case takes about 12 months for adults. The length of time necessary for a teen patient may vary and can be determined by your doctor.

Are there restrictions on what I can eat and drink during treatment?

Thanks to the removable nature of the aligners, you can eat and drink whatever you want while in treatment. There is therefore no need to restrict your consumption of any of your favorite foods and snacks unless you are instructed otherwise by your doctor. Also, it is important that you brush your teeth after each meal and prior to reinserting your aligners to maintain fresh breath and proper hygiene.

How do I clean my aligners?

The best way to clean your aligners is to use the Invisalign Cleaning system, available for order at www.invisalignstore.com. As a secondary method, however, your aligners can also be cleaned by brushing them and rinsing them in lukewarm water.

What does it cost?

For more than 10 years we have charged the same for Invisalign as braces. Insurance covers Invisalign the same as braces. However in some plans participating doctors may give an added discount for metal braces.

With any orthodontic treatment, the fee is based on the difficulty of the individual case. We give complementary consultations, so you can an exact quotation of the cost as well as estimate of treatment time. We offer payment plans so the fee can be paid monthly over the treatment time. We also will help coordinate any insurance benefits.

We know cost is a big question for anyone considering orthodontic work. In most cases, Invisalign treatment is comparable to the cost of traditional braces. However, as with other medical treatments, only your Invisalign-trained doctor can determine the cost, based on your specific needs. Other factors may include your treatment goals, the difficulty of your case, how long you are in treatment, where you live, and additional factors determined by your dentist or orthodontist. Also, check your dental insurance plan—Invisalign treatment is covered by many dental insurance policies. And many doctors can offer flexible and affordable monthly payment plans as well.