Ohio.com - Tuesday, 02. Sept 2008 - by Aisha Sultan

Not so INVISIBLE

To some who sign up for Invisalign braces, there's more than what meets the eye, er, teeth

ST. LOUIS: It's a seductive message for adults seeking a perfect smile: an easy, painless and invisible way to straighter teeth.

Christine Raye, 38, of Glendale, Mo., knew she wanted it the moment she saw the TV commercial four years ago. She's not alone. Demand for Invisalign, a system of clear, changeable retainers, has boomed since it was introduced about nine years ago. In 2006, Align Technology, the California-based maker of Invisalign, shipped to 26,000 doctors worldwide, nearly 17 percent more than the previous year.

More than half a million people have used the product, and about 46,000 doctors have taken the half-day training to become providers.

Dr. Jackie Demko of Chesterfield, Mo., says she had three to five Invisalign patients a year when she began offering the product eight years ago. Now, she is up to 100 cases a year.

But despite the widespread use and slick marketing, the way to flawless pearly whites can be filled with surprises.

Hundreds have shared their real-life experiences on a popular Invisalign forum at https://dereferer.me/?https://dereferer.me/?http://bracesreview.com. Many don't learn about the details and common procedures involved with the computer-generated treatment until they've committed thousands of dollars to it.

While the company says its surveys show that 87 percent of respondents are extremely or very satisfied with their treatment, it also does not collect information about bad outcomes or failed cases.

After experiencing the process firsthand and hearing from other Invisalign users, here's the straight talk on getting straight teeth.

Most patients require little button-like attachments bonded to their teeth to hold the aligners in place or pull down or turn a tooth. The number of buttons may vary, and they may be added at various points of the treatment.

Matt Schilling, 25, of Baltimore, learned about the attachments only by visiting the online forums. His trays have the bumps to connect to the buttons, but his orthodontist did not add the composite attachments to his teeth. Still, when he saw the bumps on his new set of trays, also called aligners, he thought, ''Wow. You can really see them. So much for the invisible part.''

Teeth might get shaved

Many adults suffer from crowding in their teeth. The aligners, which are switched out every two weeks, are created


after taking a full mold of the patient's teeth and sending the impression to the company's lab. A computer-generated series of steps predicts how the teeth will move into place with each set of new aligners, which are all created at one time. Often times, the treatment calls for creating space by ''slenderizing'' or making ''interproximal reductions,'' as the company calls it.

Orthodontist Robert Waxler of St. Louis County says studies have shown that removing small parts of the enamel are not damaging to the tooth. But it depends on the skill of the practitioners. One woman posted an entry online in which she describes the ''horse tooth'' she is left with after the provider made gaps she considered too big.

Schilling said the slenderizing was not only surprising, but also painful.

''Some blood comes out,'' he recalled. ''That wasn't expected at all.''

Demko and Waxler say their offices explain these procedures to new patients before taking on cases and that practitioners should include the information in their initial consultations.

First weeks the hardest

After the first set of aligners are inserted, some patients are taken aback by the pain and pressure on their teeth.

''Everybody has some degree of discomfort,'' Waxler said. ''You cannot move a tooth without getting sore.''

Those who have had braces say the discomfort pales in comparison, but newbies might not be prepared. Some take a pain reliever before putting in a new pair of aligners.

Having a hunk of plastic in one's mouth can be a difficult adjustment. Hard plastic edges might dig into gums or the tongue, causing sore spots. Raye cut a jagged piece off with cuticle scissors, and others report using nail files to smooth rough edges. (The company recommends neither technique.)

A few report feeling like their teeth are confined by the plastic trays.

For the first few days, patients speak with a noticeable lisp, which might recur with every new set of trays. Snugly fitting trays can also be challenging to remove until users perfect their technique. The trays must be worn constantly and are only removed for eating, drinking and brushing. One office staffer said a woman returned to the office shortly after getting her first set. She had been unable to take the aligners out and had not eaten for two days. Tray removal can also get messy, with a trail of drool clinging to each aligner.

Those prone to headaches might have worse headache pain after getting new aligners.

Constant wear

Wearing the aligners requires a serious commitment. They won't work and might end up worsening a situation unless they are worn constantly. If a tray gets lost or broken, doctors recommend wearing the previous set until a replacement is sent.

''If you don't wear anything, the teeth will drift,'' Waxler explained. ''If you don't deal with it, and the teeth wander around, then nothing fits, then you're screwed.''

The average length of treatment is about a year, but the doctor might order refinements, which can prolong the process. About half of Demko's cases take a bit longer than originally predicted.

''The computer image is a prediction, and the human body is not 100 percent predictable,'' Demko said.

Most patients don't shop around when starting treatment. Align Technology charges each provider the same lab fee — about $1,500 for full treatment and $750 for shortened, express treatment for minor changes. Doctors' fees typically range from $3,000 to $5,000.

More than half of Invisalign providers are dentists, rather than orthodontists, who have specialized training.

''The price difference can come with different clinical skills,'' Demko explained, noting that a higher cost does not necessarily mean better treatment.

Schilling chose his provider based on recommendations from friends and family and is generally happy with the results, so far. He said he did not shop around, because the orthodontist offered $500 off the price if he signed up the same day as the initial consultation.

Practice good hygiene

Keeping a piece of plastic in your mouth for more than 20 hours a day means odor is inevitable. Most users double the normal daily maintenance, soaking and brushing the plastic retainers, as well as their teeth. Some carry floss to prevent pieces of food from getting trapped in the plastic after eating.

Oh yeah, it doesn't end when the treatment ends. To prevent teeth from moving back, doctors say patients must wear retainers at night for life and that some of them need to be replaced annually.

ST. LOUIS: It's a seductive message for adults seeking a perfect smile: an easy, painless and invisible way to straighter teeth.

Christine Raye, 38, of Glendale, Mo., knew she wanted it the moment she saw the TV commercial four years ago. She's not alone. Demand for Invisalign, a system of clear, changeable retainers, has boomed since it was introduced about nine years ago. In 2006, Align Technology, the California-based maker of Invisalign, shipped to 26,000 doctors worldwide, nearly 17 percent more than the previous year.

More than half a million people have used the product, and about 46,000 doctors have taken the half-day training to become providers.

Dr. Jackie Demko of Chesterfield, Mo., says she had three to five Invisalign patients a year when she began offering the product eight years ago. Now, she is up to 100 cases a year.

But despite the widespread use and slick marketing, the way to flawless pearly whites can be filled with surprises.

Hundreds have shared their real-life experiences on a popular Invisalign forum at https://dereferer.me/?https://dereferer.me/?http://bracesreview.com. Many don't learn about the details and common procedures involved with the computer-generated treatment until they've committed thousands of dollars to it.

While the company says its surveys show that 87 percent of respondents are extremely or very satisfied with their treatment, it also does not collect information about bad outcomes or failed cases.

After experiencing the process firsthand and hearing from other Invisalign users, here's the straight talk on getting straight teeth.

Most patients require little button-like attachments bonded to their teeth to hold the aligners in place or pull down or turn a tooth. The number of buttons may vary, and they may be added at various points of the treatment.

Matt Schilling, 25, of Baltimore, learned about the attachments only by visiting the online forums. His trays have the bumps to connect to the buttons, but his orthodontist did not add the composite attachments to his teeth. Still, when he saw the bumps on his new set of trays, also called aligners, he thought, ''Wow. You can really see them. So much for the invisible part.''

Teeth might get shaved

Many adults suffer from crowding in their teeth. The aligners, which are switched out every two weeks, are created


after taking a full mold of the patient's teeth and sending the impression to the company's lab. A computer-generated series of steps predicts how the teeth will move into place with each set of new aligners, which are all created at one time. Often times, the treatment calls for creating space by ''slenderizing'' or making ''interproximal reductions,'' as the company calls it.

Orthodontist Robert Waxler of St. Louis County says studies have shown that removing small parts of the enamel are not damaging to the tooth. But it depends on the skill of the practitioners. One woman posted an entry online in which she describes the ''horse tooth'' she is left with after the provider made gaps she considered too big.

Schilling said the slenderizing was not only surprising, but also painful.

''Some blood comes out,'' he recalled. ''That wasn't expected at all.''

Demko and Waxler say their offices explain these procedures to new patients before taking on cases and that practitioners should include the information in their initial consultations.

First weeks the hardest

After the first set of aligners are inserted, some patients are taken aback by the pain and pressure on their teeth.

''Everybody has some degree of discomfort,'' Waxler said. ''You cannot move a tooth without getting sore.''

Those who have had braces say the discomfort pales in comparison, but newbies might not be prepared. Some take a pain reliever before putting in a new pair of aligners.

Having a hunk of plastic in one's mouth can be a difficult adjustment. Hard plastic edges might dig into gums or the tongue, causing sore spots. Raye cut a jagged piece off with cuticle scissors, and others report using nail files to smooth rough edges. (The company recommends neither technique.)

A few report feeling like their teeth are confined by the plastic trays.

For the first few days, patients speak with a noticeable lisp, which might recur with every new set of trays. Snugly fitting trays can also be challenging to remove until users perfect their technique. The trays must be worn constantly and are only removed for eating, drinking and brushing. One office staffer said a woman returned to the office shortly after getting her first set. She had been unable to take the aligners out and had not eaten for two days. Tray removal can also get messy, with a trail of drool clinging to each aligner.

Those prone to headaches might have worse headache pain after getting new aligners.

Constant wear

Wearing the aligners requires a serious commitment. They won't work and might end up worsening a situation unless they are worn constantly. If a tray gets lost or broken, doctors recommend wearing the previous set until a replacement is sent.

''If you don't wear anything, the teeth will drift,'' Waxler explained. ''If you don't deal with it, and the teeth wander around, then nothing fits, then you're screwed.''

The average length of treatment is about a year, but the doctor might order refinements, which can prolong the process. About half of Demko's cases take a bit longer than originally predicted.

''The computer image is a prediction, and the human body is not 100 percent predictable,'' Demko said.

Most patients don't shop around when starting treatment. Align Technology charges each provider the same lab fee — about $1,500 for full treatment and $750 for shortened, express treatment for minor changes. Doctors' fees typically range from $3,000 to $5,000.

More than half of Invisalign providers are dentists, rather than orthodontists, who have specialized training.

''The price difference can come with different clinical skills,'' Demko explained, noting that a higher cost does not necessarily mean better treatment.

Schilling chose his provider based on recommendations from friends and family and is generally happy with the results, so far. He said he did not shop around, because the orthodontist offered $500 off the price if he signed up the same day as the initial consultation.

Practice good hygiene

Keeping a piece of plastic in your mouth for more than 20 hours a day means odor is inevitable. Most users double the normal daily maintenance, soaking and brushing the plastic retainers, as well as their teeth. Some carry floss to prevent pieces of food from getting trapped in the plastic after eating.

Oh yeah, it doesn't end when the treatment ends. To prevent teeth from moving back, doctors say patients must wear retainers at night for life and that some of them need to be replaced annually.

-----------------------------------------------
Source: https://dereferer.me/?https://dereferer.me/?http://www.ohio.com/lifestyle/27754769.html

The Niagara Falls Review - 04. october 2008 - by Corey Laroocque

Fixing smiles easier than ever
City's first orthodontist marks 35 years in practice

Any kid who wore braces in the 1970s probably remembers the schoolyard taunts of “tin man” or “railroad tracks.” But that’s all changed now that more kids are wearing them, says Dr. John Doucet, a veteran orthodontist in Niagara Falls.

Braces are now popular among the eight-to-18 crowd, especially because changes over the years mean they’re not as noticeable, the wires are more comfortable and more families are covered by private insurance to defray the cost.

“Kids today want braces. They’re so comfortable to wear. It’s almost a fashion statement,” said Doucet, who was the first full-time orthodontist in Niagara Falls when he opened his practice 35 years ago. “Today, if they don’t have them, they’re left out.”

When he reached that career milestone in August, it gave him the chance the reflect on how much things have changed.

Orthodontics is the “plastic surgery of dentistry,” said Doucet. It’s an area of dentistry that corrects crooked teeth and overbites.

“I liked that part of dentistry – to straighten people’s teeth and improve people’s self-esteem.”

Having teeth straightened is usually done for cosmetic reasons, but people are more aware of the appeal of straight teeth than they were a generation or two ago.

“In the workforce today, it’s nice to have a nice smile. People didn’t place as much emphasis on that in the 1950s,” Doucet said.

The way braces work hasn’t changed. Braces are bonded to the teeth. Wires slide into the grooves. Over time, the wires shift the teeth into a straightened position.

But newer ceramic braces are white, making them less noticeable. Traditional silvery metal braces are still available, but even they are smaller than they used to be.

Recently, the addition of colour to the elastics that hold the wires in place allow patients to make a personal statement.

“They’ll select a colour according to the season. Right now, they’re all asking for orange and black because it’s Halloween.”

At Christmas, they’ll be going for red and green elastics. School colours are always popular colour schemes, Doucet said.

The change to softer nickel-titanium wires from stainless steel has made braces more comfortable. Newer wires are heat sensitive so they stiffen and move as they warm to the patient’s body temperature.

It removes the pain that used to come with the adjustments of the old stainless steel wires.

“There’s hardly any pain compared to 35 years ago,” Doucet said.

Doucet, who grew up on McCrae Street, came back to Niagara Falls in 1973 to open his practice because a survey by a company that makes braces suggested Niagara was an area that needed an orthodontist.

He graduated from the the University of Toronto in 1970 as a dentist, but went back to specialize in orthodontics. In 1973, he thought about opening a practice in the Burlington or Oakville area.

But the NFCVI graduate opted for his hometown instead and Doucet and his wife Marilee returned to Niagara Falls.

He opened on Aug. 28, 1973. The first day he opened shop, he saw 15 new patients, then went across the street to GNGH where his daughter Rebecca was born. She followed her father into dentistry and now works as an orthodontist in San Francisco.

Doucet still works in the professional building on Portage Road, where he started out in the southwest corner of the building’s second floor with an assistant and a receptionist. Over the years, as demand increased, the office expanded. Now, Doucet owns the entire floor.

“We just got busier and busier. We run 10 chairs. Right now we have 18 staff.”

At 64 years old, he said he’s not ready for retirement. Dr. Mike Kamatovic bought into the practice four years ago and will eventually take over the practice. Doucet’s own daughter, a California girl now, has her own practice and isn’t interested in taking over her father’s, he said.

In his 35 years, Doucet estimated he has treated between 15,000 and 20,000 patients. His practice has about 900 patients a year now, compared to about 250 a year when he started out.

“Treatment time is shorter now. It can be 12 to 24 months depending on the problem.”

When Doucet started, his patients used to have to wear braces for as long as three years.

Braces are still a considerable expense for families. The cost of a full treatment is about $5,000 or $6,000. But some private insurance plans cover as much as $2,500 of that.

The increase in the number of people covered by private insurance is another of the reasons Doucet said more people – including adults, who represent about one-quarter of his patients – are choosing to have their teeth fixed.

“The cost is relatively inexpensive today compared to when we started out. There wasn’t the insurance there is today,” Doucet said.

The year he went into business, unionized autoworkers at General Motors had one of the best dental plans in the region – it covered about $500 toward braces, Doucet recalled.

Over the years, more workplaces began adding dental coverage to their employees’ benefits packages.

When he’s not fixing smiles, Doucet is an avid sailboat racer. Over the years he has owned four boats ranging between 36 and 48 feet.

“I like the competition. I’ve raced all over the Great Lakes. I’ve raced in the Atlantic Ocean, in the Gulf of Mexico.”

He competes in about 50 races a year and was ranked first in division on Lake Ontario for the last five years.


----------------------------------------------------
source: https://dereferer.me/?https://dereferer.me/?http://www.niagarafallsreview.ca/ArticleDisplay.aspx?e=1232067

Orange County's News Source, 22. october 2008, by Carine Nadel

Braces make eating Halloween goodies tricky

Treats that can damage wires are to be avoided. So what's left?

If your child wears braces, goose bumps might be raising along the back of your neck right now.

Your child likely knows that the Halloween goodies he craves are a big no-no for kids with braces. Are you dreading the arguments and the broken wires and the brackets that will need to be repaired?

The American Association of Orthodontists urges patients to steer clear of the following Halloween treats or recipes with these ingredients: all hard candies and chewy candies, caramel, nuts, licorice, taffy, jelly beans, hard pretzels, bubblegum, popcorn, taco chips, and ice.

Gee, what does that leave for kids on Halloween?

Irvine orthodontist Dr. John Moutsatson and his dental assistant Candy (yes, this is really her name, but she wishes to otherwise remain anonymous) offered some suggestions on how to deal with this dilemma.


Q. Let's say we've decided to throw a costume party for Halloween this year, what kind of snacks do you suggest be served?

A. Here's our rule of thumb – if it's too hard, too sticky or too sugary, don't eat it! All of these items stick to the teeth, which can cause the wires to bend and break or loosen the bonding that holds the brackets in place.

Some of the worst foods are caramels, Milk Duds, Mike and Ike's, ice cubes, soda and even Gatorade. Although Propel is OK, its sugar content is much less than most athletic drinks.

When the worst happens and a wire or bracket gets damaged, you need to call your orthodontist as soon as possible. If it happens on a weekend, for the broken/bent wires, use your wax. If the brackets come loose, brush extra carefully to keep the area clean.


Q. When damage does happen, what is the result?

A. Believe it or not, even if it's just for a day or two, treatment takes longer, the repairs have to be made and you wind up increasing the time the braces must be worn. Kind of the "two steps forward, one step back" situation.


Q. So what snacks would be great to serve at this year's Halloween bash for those wearing braces?

A. We know that saying serve nutritious things is enough to have most kids start shrieking worse than a werewolf, but it's true.

Outside of the obvious though, try serving fresh sliced fruit, marshmallows, pound cake cubes, pretzel sticks, frozen yogurt or ice cream with granola. Soft pretzels, soft cookies, and sugarless gum are also good choices.

While nuts are usually thought of as a healthy snack, stay away from almonds, hazelnuts and other more dense varieties. Cashews and peanuts are OK. Cereal mixes are also popular and safe party foods.

Have some specialty sandwiches on hand or creatively shaped Jell-O molds. Our favorites are ones in the shapes of human hearts or brains!

----------------------

Braces-friendly recipes
Halloween treat recipes by celebrity chef Michael Chiarello.

Here are some braces-friendly recipes created by celebrity chef Michael Chiarello for the American Association of Orthodontists:

You can tame the sweet tooth monster with these goodies:


Frightfully Fabulous Cupcake Sandwiches

Ingredients:

1/3 cup cocoa powder

1 cup warm water

3/4 cup mayonnaise

1 1/2 teaspoons vanilla extract

1 cup superfine sugar

2 cups cake flour, sifted

2 teaspoons baking soda

1/8 teaspoon salt

1 can of chocolate frosting or store-bought chocolate mousse

1 container of whipped topping

Assorted braces-friendly candy pieces, such as chopped peanut butter cups, chocolate bars and melt-in-your-mouth candies.

Directions:

Preheat oven to 350 degrees Fahrenheit.

Fill a muffin tin with 12 cupcake liners and set aside.

Combine cocoa powder, water, and mix until smooth. Fold in mayonnaise. (Make sure cocoa mixture is not to hot to prevent breaking of mayonnaise). Add vanilla and whisk until smooth.

In mixer, combine sugar, cake flour, baking soda and salt and mix slowly until well incorporated. Add wet cocoa mixture, mix on medium-high until well blended. Scrape down the sides and blend for 30 seconds.

Fill the cupcake liners 3/4 way full of batter. Bake for 30 minutes or until toothpick comes out clean. Remove from oven and allow to cool on rack.

Slice each cupcake in half, horizontally, and serve the halves with chocolate mousse or frosting, whipped topping, and assorted candy pieces. Kids build the sandwiches by spreading one-half of a cupcake with mousse/frosting or whipped topping, sprinkling on candy pieces and placing the other half of cupcake on top.

Makes 12 sandwiches.


Pumpkin Cookie Pops

Ingredients:

3/4 cup unsalted butter, softened

1/2 cup brown sugar, firmly packed

1/2 cup canned or fresh cooked pumpkin

1 tablespoon orange zest

1 egg yolk

1 teaspoon pure vanilla

2 1/4 cups all-purpose flour

1/4 teaspoon ground cinnamon

1/4 teaspoon ground ginger

¼ teaspoon ground nutmeg

Pinch salt

20 wooden sticks (tongue depressors or Popsicle sticks work best)

Directions:

Preheat oven to 350 degrees F.

In a large mixing bowl, combine with electric mixer the butter, brown sugar and orange zest. Add the pumpkin, egg yolk, and vanilla. Mix.

Gradually add the flour and spices. Mix with your hands to create a soft dough. Wrap in plastic and refrigerate for 30 minutes.

Divide dough into two pieces. Roll out each piece to 1/4-inch thickness on a floured surface. Cut into pumpkin shapes with cookie cutters.

Place on ungreased baking sheet and securely insert a wooden stick into the bottom half of each pumpkin cookie.

Bake for 12-15 minutes.

Decorate with favorite frosting.

Adapted from www.pumpkinnook.com


Green Goo Slimedoo (essentially white chocolate fondue)

Ingredients:

2 cups heavy cream

2 ounces sugar

2 ounces butter

2 pounds white chocolate

6 to 12 drops green food coloring

2 bags of thin pretzel sticks, pound cake cubes, orange sections

Strawberries, bananas and thinly sliced apples for dipping

Candy sprinkles

Directions:

In a non-reactive double boiler set over medium-low heat, bring the cream, sugar, and butter to a boil. Meanwhile, chop the chocolate into small chunks - a serrated knife works best for this.

Add the chocolate chunks to the cream mixture in the double boiler, whisking, until it is melted and incorporated into the cream. Finally, add the food coloring until it is the desired shade of green.

Keep mixture warm in a fondue pot. Set out the fruit and the pretzels for dipping with long wooden skewers next to the fondue pot. Guests can dip their pretzels or fruit into the fondue and then roll them in the candy sprinkles, if desired.

Makes 8 servings.

If serving sandwiches aren't what your ghosts and goblins have in mind, try this main dish:


Pasta Pomodorini

Ingredients:

3/4 pound spaghetti or spaghetti

1/4 cup extra-virgin olive oil, plus more for drizzling

1/4 cup sliced garlic

1/2 teaspoon finely minced Calabrian chilies, or 1/4 teaspoon red pepper flakes

1 pint small cherry tomatoes, stems removed, crushed between your thumb and forefinger

Sea salt, preferably gray salt

1/2 cup fresh basil leaves, each torn into 2 or 3 pieces

Wedge of Parmesan cheese

Directions:

Bring a large pot of salted water to a boil over high heat. Add the pasta.

While the pasta cooks, heat the 1/4 cup olive oil in a large skillet over moderate heat. Add the garlic and cook until the slivers are golden brown and crisp, then add the chilies and cook for about 30 seconds. Raise the heat to high and add the tomatoes. Simmer briskly to soften the tomatoes and thicken the juices, about 3 minutes. Season with salt.

When the pasta is al dente, scoop out about 1/2 cup of the pasta cooking water, then drain the pasta. Return the pasta to the warm pot off the heat. Add the sauce and the basil and mix well. Add some of the reserved cooking water if the pasta seems dry. Transfer to a warmed serving bowl and grate Parmesan over the top to taste. Drizzle with a little more olive oil. Serve immediately.

Makes 4 servings.

And last, you'll be needing something ghoulishly good to help wash all this food down with, why not give this one a try?


Slimy Lime Fruit Punch (adapted from Parents Magazine)

Ingredients:

Powdered sugar-free lemonade mix to make 2 quarts

1 peeled and sliced orange

1 sliced lime (approx. 1/8" slices)

1 pint raspberries

2 tubes red decorating gel

1/4 cup sugar

1 teaspoon meringue powder

2 liters seltzer

10 drops green food coloring

4 drops yellow food coloring

Directions:

Squeeze red gel down the inside of 12 small, clear glasses. Let dry about 10 minutes.

In an extra-large bowl, combine lemonade mix, sugar and meringue powder. Slowly pour in seltzer, whisking continually until combined. Stir in green and yellow food coloring. Add sliced fruit and berries for color.

Pour punch into glasses and serve.

-------------

source: https://dereferer.me/?https://dereferer.me/?http://www.ocregister.com/articles/halloween-braces-wires-2202128-kids-hard

readingeagle.com - 18 november 2008 - by Bruce R. Posten

Caernarvon orthodontist offers new system of braces, attached to back of the teeth

pic:  https://dereferer.me/?https://dereferer.me/?http://readingeagle.com/REnetImages/2008/11/11/3549062/Article_3524531.jpg
and: https://dereferer.me/?https://dereferer.me/?http://readingeagle.com/REnetImages/2008/11/11/3549062/Article_3524511.jpg

Orthodontist Dr. Bernice Parisi, 48, of Robeson Township wore traditional labial braces on the front of her teeth as a teenager growing up in the 1970s while attending Holy Name High School.

Her dad, Vincent, was a practicing orthodontist then, now retired, and knew as a father and as a professional what was good for her.

In the early 1990s, Parisi wore lingual braces behind her teeth, too.

They were invisible, hidden really, but aesthetically pleasing.

"I had a difficult time with them, though," she admitted in her Caernarvon Township office along Route 23 near Morgantown at 201 Darby Square. "They weren't that comfortable; they could make your tongue really sore. After my experience, I just had a difficult time recommending them to my patients."

But when it comes to so-called invisible braces these days, Parisi, an orthodontist in practice for 19 years, is in the forefront of local advocacy.

She is now offering iBraces, relatively new, 100 percent customized invisible braces designed for teens and adults as an aesthetic alternative to standard stainless steel or clear, ceramic braces.

Parisi is among the first orthodontists nationwide certified to offer this new system for straightening teeth, one of five orthodontists certified in the iBraces technique in eastern Pennsylvania. The braces are attached to the back of the teeth rather than the front, thus are hidden or invisible.

With such companies as Invisalign marketing teeth aligners directly to consumers, the demand has grown for so-called lingual or invisible braces (brackets, wires and o-rings) placed behind the teeth, she said.

LingualCare, a 3M Unitek company, is the maker of the iBraces Appliance System, originally developed in Europe and widely used in Germany and France and introduced to the United States this year. The company reports more than 20,000 patients worldwide have been treated with the iBraces system.

Bonding appointment

Parisi said her first iBraces patient is scheduled for a bonding appointment in January.

"Many patients, particularly adult professionals and older teens, want to have their teeth straightened, but are not comfortable wearing traditional braces," Parisi said. "iBraces is an option ... particularly good for patients who ask for clear aligners but have more moderate or severe teeth crowding or spacing problems. This (invisible braces) can be a much better alternative."

But these invisible braces are not cheap - $8,000 to $10,000 - compared to other braces that can be obtained for roughly half the price, according to Parisi.

"The treatment period is usually shorter and because the braces are small and so customized with state-of-the-art technology for individual tooth brackets and wires, they are much more comfortable," she said.

Another plus of the new invisible braces, Parisi said, is that they are made of a malleable gold alloy and do not have any nickel content that can sometimes prompt allergic reactions.

"The typical patient is a teenager or adult who does not want to wear braces but needs orthodontic treatment," said Lea Nesbit, chief executive officer of LingualCare. "Patients range from boys and girls who play football and other high-impact sports to corporate executives."

"I'd estimate there are 8,500 orthodontists in the nation and 600 or 700 of them are trained in doing our procedure," she said. "For the past five years, we have been slowly and surely making inroads into the marketplace."

Different instruments

Parisi said the iBraces system requires the orthodontist to have different instruments. She also said the clinical technique of bonding braces behind the teeth can be a little more difficult than frontal teeth procedures.

In the last 50 to 60 years, the quest for improved appearance and healthy function of teeth have been driving forces sending patients to orthodontists. Such trends as having colorful elastic ties on braces, often preferred by children, also have kept the wearing of braces in the spotlight.

"For certain, people have become more aware of their smiles and self-image," Parisi said. "But along with that is the increase in knowledge about the importance in keeping one's teeth healthy and straight, so they are easier to clean to avoid bacteria and periodontal disease. People want to ensure that their teeth keep functioning well into old age.

"Studies have shown that not having good dental health may lead to serious physical problems from hardening of the arteries to strokes to pancreatic cancer."

One of nine siblings, Parisi said she got into the orthodontics field because of her father. She has a sister who also is an orthodontist.

" I saw that my father enjoyed what he did and that's really what drew me to this field," she said.

Parisi said she has about 250 patients and 75 percent are school-aged and 25 percent are adults.

"Ideally, braces are placed on young people when the jaw and teeth are growing, so getting the right alignment is important," she said. "But I also see adults who have had dental issues or never could afford orthodontic work, but now find they want their teeth straightened."




About Dr. Bernice Parisi
Education

•Graduate of Holy Name High School.

•Bachelor of arts degree from Villanova University.

•Graduate of University of Pennsylvania Dental School.

•She completed her dental training at Eastman Dental Center, Rochester , N.Y. in 1989, and also wrote a senior research paper on lingual orthodontics (behind-the-teeth braces).

•She specializes in pediatric, adolescent and adult orthodontics.

•She has been in private practice for 19 years.

Family: Husband, Dean Exas, 51, sales manager of orthodontics products. Three stepchildren.

Hobbies: Playing piano and amateur photography.
 
 
What are invisible braces?
•They are lingual braces bonded behind - and therefore hidden - rather than in front of the teeth.

•Low-profile brackets are 100 percent customized to an individual's teeth.

•The braces are made from a gold alloy with no nickel content.

•LingualCare, a 3M Unitek Company, is the maker of the iBraces Appliance System (so-called invisible or hidden braces). It bills itself as the only company offering the "customized invisible fixed appliance system on the U.S. market today."
 
 
Benefits of invisible braces
•100 percent customized, adapted to a patient's tooth anatomy.

•Aesthetics, braces hidden from view

•Minimal speech interference.

•Minimal tongue irritation.

•Customized wires that do not require adjustments meaning fewer appointments and less discomfort throughout treatment.

•Quicker treatments compared to conventional braces.

•Prevention of white spots caused by decalcification on the front of teeth.

•Touted as an excellent option for adults and teens who are involved in activities where labial (front of the teeth) braces would be problematic such as in band, sports, drama or modeling.
 
 
How are invisible braces made?
•Doctor takes precise impression of patient's teeth and sends the impression to LigualCare., maker of the iBraces Appliance System.

•Models are scanned into a computer where brackets are designed by lab technicians.

CAD/CAM technology is used to design and fabricate customized braces with each bracket and wire to fit each tooth.

•In some cases, the invisible iBraces are 70 percent smaller than regular lingual braces, which promoters say translates to less of a physical impact on tongue and speech.

•Customized braces delivered to the doctor's office for a patient's bonding appointment.

Source: LingualCare, makers of iBraces
 
 
Factors to consider about invisible braces
Costs, comfort and time are all factors to consider when patients opt for teeth-straightening braces, according to Berks County orthodontist Dr. Bernice Parisi.

She is one of hundreds of orthodontists nationwide certified to provide iBraces, so-called hidden or invisible braces bonded at the back of the teeth.

Parisi said regular braces can cost patients anywhere from $4,500 to $5,500 and average treatment time (wearing of braces) can run from two to three years.

The hidden iBraces, with their aesthetic benefit, are more expensive, ranging in price from $8,000 to $10,000, but also are said to cut treatment time down to 15 months to two years.
 
 
Braces can't promise no discomfort
While hidden braces behind the teeth promise patients less discomfort because of their smallness and customization, they don't promise no discomfort.

Those wearing braces are always urged to avoid certain foods - ice, corn chips, hard edges of pizza crust, popcorn kernels caramels, sticky or soft foods, bubble gum, taffy and hard candy.

If a patient's tongue, lips or teeth become sore in the first few weeks of wearing braces, a warm water and salt mixture to rinse the mouth can be used five or six times a day.

If something feels loose or broken in your braces (brackets, wires or o-rings), call your orthodontist immediately.

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Source: https://dereferer.me/?https://dereferer.me/?http://readingeagle.com/article.aspx?id=113355

Columbia Star - 09 January 2009 - by Mike Maddock

Thirty-something speaks
Putting my money where her mouth is

I wore braces for three- and- a- half long years until finally, halfway through my junior year of high school, I begged my orthodontist and my mom to take them off. I had come to the conclusion that if my teeth weren't straight after nearly four years of tightening and re- tightening, then they were simply meant to be crooked. I could live with that, but I couldn't live with all that metal one more second.

My orthodontist had other ideas. He thought one more year would be ideal. Well, his food didn't taste like aluminum foil. Loose wires didn't constantly stab the inside of his mouth, and he didn't have to compete with pearly- mouthed pretty boys for the attention of high school coeds. All my orthodontist had to do was collect a check each week, tighten my wires like he was tightening the lugnuts on his Mercedes, and tell me my teeth were still crooked. Three- and- a- half years of that was enough.

Twenty- two years later my teeth are in fact crooked, and there is very little evidence I ever wore braces, but I can say with no hesitation my final days of high school were eminently better without a mouth full of metal. I don't have the slightest amount of regret for setting my crooked teeth free, even if my mom and her checkbook probably didn't see it that way.

Now I'm on the other side of the equation. My oldest daughter recently got braces. If I'd known then how much braces cost now, I may have kept mine and seen if I could hand them down like some sort of family heirloom. Of course that makes about as much sense as passing down dentures or a pair of socks, but the sticker shock is enough to make one think of such things.

Do they make braces out of platinum now? Why are they so expensive? As far as I can tell, there's more metal in a Coke can. I guess it's like everything else…the materials don't cost much, but the labor will kill you.

Despite my whining, the cost isn't the worst part of this latest entrance into the world of braces, and it's certainly not my daughter's fault she inherited my goofy mouth. The problem is my daughter entered the orthodontist's office as my little girl and came out looking like Miley Cirus. My eleven- year- old suddenly looks like she should be driving…not playing with Barbie Dolls.

Braces did nothing but turn me into the poster child for the awkward teenager. They've had a completely different effect on my oldest daughter. One day she's planning tea parties and the next day after a trip to the orthodontist, she looks like she should be planning her wedding. Braces made me goofy. They're making her old. That's worse than any pain I ever felt in that orthodontist's chair or in my wallet.

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Source: https://dereferer.me/?https://dereferer.me/?http://www.thecolumbiastar.com/news/2009/0109/opinion/014.html

Hmm... Might it be the case that American orthodontists are starting to feel the pinch from the economic downturn and that they are starting to advertise like crazy to set it off? Anyway, thanks, yoghurt, for all your diligent searching!

Indiana's NewsCenter - January 16, 2009 - by Laura Donaldson

Cutting Edge Smile

There's a good chance either you or a family member has corrected your smile with braces. But, who wants to wait the years it takes to get those pearly whites?

In Laura Donaldson’s special report, Cutting Edge Smile, we'll follow one teen through out her braces experience to see if technology can cut the time she wears braces in half.

“I’m getting braces. A full mouth set,” fourteen year old Megan Shultz nervously awaits braces un-like any other.

Megan lies back as hi-tech braces, that are supposed to take roughly half the time as traditional braces, are fitted to her teeth. It’s called Sure Smile. Dr. Ron Cohen is one of a handful of orthodontists in the Fort Wayne area who use the robot technology.

“It’s more predictable I know it’s going to go in where I want it,” said Dr. Cohen.

A tooth scanner creates a three dimensional computerized model of the patient’s teeth. Then the doctor straightens them on a computer and ships them off to Texas where a robot actually shapes the wires. The braces are then mailed back and fitted to the patient.

Megan’s mom loves them.

“She needed braces and I thought man this would be great,” said Kathryn Moriman. “The length of time is short, you know, so it’s perfect.”

But how much do they cost?

On average Sure Smile braces cost $200 more than traditional braces. But Dr. Cohen says convenience is a huge reason people go hi-tech.

“If you add up how much time you don’t have to miss at work, how many tests you don’t have to miss at school, the trips there and back. I would say it’s pretty much of a wash,” said Dr. Cohen.

Cohen says in his 2 years of using the technology he hasn’t seen anything negative. But what does Megan think when she sees herself for the first time?

“They look awesome,” said Megan as she picks at the new bumps on her teeth.

And with a quick visit from the doctor Megan learns the rules of wearing braces and leaves the office with a smile on her face.

“My teeth are going to be a lot prettier and straight,” said Megan. “”So I’m excited.”

A smile we’ll follow throughout her entire experience with braces. We’ll see how long she has to wear them and how much it truly costs to have a cutting edge smile.

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Source: https://dereferer.me/?https://dereferer.me/?http://www.indianasnewscenter.com/news/local/37507984.html

Asbury Park Press - February 17, 2009

More adults are getting cosmetic dental treatment

Linda Noone had awaited this day for a long time. Though excited, the 50-year-old
Indianapolis woman calmly laid back in the dentist's chair at Pritchett Orthodontics and opened her mouth.

One by one, the dental assistant attached a tiny metal bracket to the front of each tooth. An ultraviolet light activated an adhesive to make the brackets stick. Thin wires linked them.

No shots, blood or pain. Yes, her mouth was sore for a few days and likely would be again over the next 18 months or so. But that doesn't matter to Noone.

"I've waited so long, it will be well worth it," she said before her braces were put on. "I've been looking forward to this and saving for years. My two youngest sons had to have braces."

The days when braces were only for affluent kids are gone, says Dr. John Pritchett. More and more adults are deciding it's not too late to transform their smiles for cosmetic reasons or to fix long-standing dental problems.

Adults, in fact, make up 25 percent to 30 percent of the Eastside practice Pritchett shares with his father, Charles.

When some adults come in, they'll say, "I've always hated my teeth, and my parents couldn't afford braces, so I want to do this for myself," according to the younger Pritchett.

A set of braces can cost $5,000 to $6,000. Dental insurance will sometimes, but not always, cover some adult orthodontia costs.

"The baby boomers are just very concerned about how they look," says Bob Bray,
president-elect of the American Association of Orthodontists, who practices near Atlantic City, N.J. "They want to fix or improve whatever they can."

Some believe their teeth's appearance hurts them professionally. "In the job market, you have to use everything, and your smile is one of the first things people notice," Pritchett says.

For others, the motivation is correcting a problem such as a bad bite, which can cause abnormal tooth wear, difficult chewing and damage to bone and gum tissue.

Nationally, one in five orthodontic patients is an adult 18 and older, estimates the
American Association of Orthodontists. More than 1 million adults are getting orthodontic treatment now, up almost 60 percent from 10 years ago. Nearly two-thirds are women.

Among them is Charlotte Lucas, 59, executive vice president of Lucas Oil Products Inc., and wife of Forrest Lucas, the Hoosier motor oil magnate who paid for naming rights to Lucas Oil Stadium, home of the Indianapolis Colts. For her, the decision was a practical one.

"The only reason I got braces was the fact I was losing my bite on the left side. I would always chew on the right."

Lucas, who lives in Marengo in Southern Indiana, said her teeth were misaligned and two front teeth were behind two on either side of them because she had fallen when she was young.

Last November at Pritchett Orthodontics, she had ceramic braces put on her top teeth, with brackets matching the teeth color and small elastic bands holding a thin wire in place.

Metal braces were put on the bottom teeth in March because ceramic braces wouldn't attach to four veneers she has.

Lucas liked that the ceramic braces wouldn't be as visible, as she admits to being a little self-conscious about them.

That's part of what appeals to adults -- more comfort, less visibility.

"That improvement has been huge," says Bray. The wires used are very flexible, the braces are smaller, and they don't wrap around the tooth like they did before, he added.

Another type used for minor alignment problems are invisible plastic braces molded to fit over the teeth.

Called Invisalign, they are replaced every two weeks and removed only for eating and brushing.

About halfway through her treatment, Lucas is pleased with the results so far, even though the braces bother her some days.

"I can tell a major difference," she says. "I can chew on both sides now, and my teeth meet up better."

Adults, like Lucas, looking for better function, or those just seeking prettier smiles can usually get braces without problems. Healthy teeth can be moved at any age.

Adults, however, are more likely to have periodontal (gum) disease or worn, damaged or missing teeth that can make treatment more difficult, a lengthier process or involve jaw surgery. Women, in particular, who suffer from osteoporosis may need a bone mass density test to check bone loss because of the danger of moving bone too quickly.

But Dr. Katherine Kula, chairwoman of the Indiana University School of Dentistry's
orthodontics department, noted that generally, people take better care of their teeth now than 20 to 30 years ago -- aided by the benefits of water fluoridation.

So, that's leading more older adults, even some in their 60s to 80s, to get braces.

"Folks are living so much longer and keeping their teeth longer," says Kula.

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Source: https://dereferer.me/?https://dereferer.me/?http://www.app.com/article/20090217/LIFE/90216049/1006/rss10