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What We Do

Dentofacial Orthopedics

You may have noticed that Drs. Kirkpatrick and Lai specialize in “Orthodontics and Dentofacial Orthopedics.”  While most people have heard of orthodontics, many are confused by the “dentofacial orthopedics” part of the title.  We can explain!

Every orthodontist starts out in dental school.  Upon completion of dental school, some graduates immediately go into practice as dentists.  Others choose to pursue a dental specialty, which requires additional schooling during a two- to three-year residency program.  There are nine specialties sanctioned by the American Dental Association.  Some you are likely familiar with are Pediatric Dentistry (dentistry for children), Periodontics (dentistry focusing on the gums), and Oral Surgery.

One of the nine specialties is “Orthodontics and Dentofacial Orthopedics.”  You probably know that an orthodontist straightens teeth, and indeed: “ortho” comes from the Greek for “straight” or “correct,” and “dontic” from the Greek for “teeth.”  But what about dentofacial orthopedics?  “Dentofacial” is “teeth” plus “face” while “ortho” again means “straight” and “pedic” is from the Greek for “child.”

Essentially, while orthodontics entails the management of tooth movement, dentofacial orthopedics involves the guidance of facial growth and development, which occurs largely during childhood.  In both cases, appliances are frequently used – the more familiar, braces for orthodontics, and other specialized appliances such as expanders, depending on what facial abnormalities are present. Sometimes orthopedic treatment may precede conventional braces, but often the two are accomplished at the same time.  So if your child gets braces and an expander, he’s undergoing orthodontics and dentofacial orthopedics!

Because Drs. Kirkpatrick and Lai are skilled in both areas, they are able to diagnose any misalignments in the teeth and jaw as well as the facial structure, and can devise a treatment plan that integrates both orthodontic and dentofacial orthopedic treatments.

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, breathe and for improved facial appearances.  In other words, surgical orthodontics straightens the jaw.  Moving the jaws also moves the teeth, so braces are always applied in conjunction with jaw correction.  This helps make sure the teeth are in their proper positions after surgery.

Who needs surgical orthodontics?

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

Surgery is performed in the hospital by 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 or removed to achieve the proper alignment and stability.  Other facial bones that contribute to alignment may also be repositioned or augmented.

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