Orthodontist Skippack

If you are parent to a child who has a thumb or finger habit, you are in good company. One study indicated that 15-20% of children under age 6 engage in thumb or finger sucking habits. Even orthodontists' children suck their thumbs! (See cover photo to see my daughter in action).

Below are 4 considerations for parents with a child who engages in thumb sucking. All of the following are evidence-based and established by clinical research, to help your child avoid dental health problems while building self-confidence associated with overcoming a challenging task.

Impact on Dental and Facial Growth and Development

After age 6 and with the corresponding eruption of the first permanent teeth, sucking habits will begin to have an irreversible negative effect on the development of the jaws, bite relationship, and positioning of teeth. In most cases, the habit will contribute specifically to a narrow upper jaw (causing crossbite), protruded upper teeth (overbite), and a failure of the front teeth to bite together properly (open bite).

Stopping By Age 6 or 7 Will Minimize Most Long Term Effects

In my experience as an orthodontist, I find that most children begin to establish social awareness of thumb sucking around age 5-6 and develop an internal motivation to cease the habit when it is observed that peers at school are not engaged in the habit. Fortunately for children and parents, this period coincides with the time in development at which irreversible negative effects can by prevented. Research has shown that cessation of thumb and finger habits prior to the eruption of the permanent incisors (central teeth) at age 6 or 7 will prevent lasting negative impacts on the development of the upper jaw and permanent teeth. This key age to stop also aligns with the American Association of Orthodontists' (AAO) recommended age for the initial evaluation of your child (age 7) by an orthodontic specialist.

Techniques for Stopping Thumb and Finger Sucking

The single most important aspect in helping a child to stop sucking a finger or thumb is to determine self-motivation. In the clinical setting, I typically begin by simply asking the child if he or she would like to stop the sucking habit. If your child is not ready and motivated, then it is not time to attempt to stop the habit. It will only lead to frustration and negativity. The focus, instead, should be on education. Explaining to your child how it would be helpful to them to stop and pointing out that others in their social group or class at school may be in the process of stopping. Acknowledging the difficulty in stopping is also very important. For example, if either parent had a sucking habit as a child, explain to your child how you recall how hard it was to stop, but how rewarded you felt once you were able to tackle the  difficult challenge.

Once established that the child is motivated, I recommend the following techniques to positively reinforce stopping the habit:

1. Continuously reaffirm the child's self-motivation and goal to stop. Examples: "That is so great that you set this goal." and "You can do this, we are so proud of you."
2. Set up a reminder system to help the child stop when the body may be unconsciously initiating the habit during sleep. This can include sleeping with glove or bandaid on the sucking hand and using nail polish on the sucking finger (Mavala Stop is one brand name).  The goal is not to physically prevent your child from performing the habit, but helping to provide reminders so they can willfully stop the habit in a positive, supportive environment. Positive reinforcement is the key.
3. Use a reward calendar on the refrigerator. Every full day/night your child goes without engaging in the habit, place a star on the calendar. Arrange for a reward after 14 consecutive days are achieved without the habit. After 14 consecutive days, the chance of relapse of the habit is very small. (Link: I Can Do It Reward Chart)
4. In many cases, early orthodontic intervention will help your child if he or she is actively engaged in a sucking habit over age 7. Most often, a constricted (narrow) upper arch and possible associated crossbite will indicate the need for a maxillary expander to orthopedically widen the upper jaw. In this case, this very common appliance will change the dynamics of the thumb habit just enough to serve as a reminder and aid the child in stopping the habit.

Consider the BIG PICTURE

Your child will overcome this habit. Your role as a parent is to educate, to motivate, and to provide a positive and supportive environment. Keep in mind that this may be the very first conscious, difficult sacrifice your child makes to improve his or her health and well-being. It must be our goal as adults (parents and healthcare providers alike) to foster self-motivation, encourage that little girl or boy that they are up to the challenge, and celebrate with them when they achieve what they set out to do. Comments like "how am I going to get him to stop" or  "she will never stop this" do little to motivate and will undermine the child's self-expectations. This habit should be looked at as a profound opportunity that can be used as a very important confidence builder for a young child. We adults must create an environment that encourages children in our sphere of influence to learn, to set goals, and to succeed- in thumb-sucking and beyond!!

The DCO Team is here to help you. Please email me at any time (info@dco-ortho.com) if I can provide any additional information to help you or your child.

"Everybody has a plan until they get punched in the mouth." -Mike Tyson

(Montgomery County, PA)- Many parents ask whether their child in braces or Invisalign needs to wear a mouthguard while playing sports. Below are some guidelines to help you ensure your child's teeth are protected while playing sports.

Advantages of Mouthguards

1. Cushion any forceful contact to the face, lips, or jaws to prevent injury
2. Prevent teeth from being chipped, broken, or injured when heavy contact is sustained
3. Evenly distribute force when contact is sustained to the mouth, lips, or teeth

Types of Mouthguards

1. Custom Fit Mouthguards (the cream of the crop, best fitting and performing, made by your dentist or orthodontist)
2. Orthodontic Mouthguards (designed to fit around braces, expanders, and other orthodontic appliances and to give teeth the freedom to move while still providing great protection)
3. Boil and Bite Mouthguards (DIY at-home customization, gets the job done but may not fit as well and will be more bulky when compared to a custom fit mouthguard)

When should my child wear a mouthguard?

1. Any sport or activity where forceful contact to the face could be sustained
2. More obvious sports are: football, hockey, lacrosse, field hockey, boxing, martial arts
3. Less obvious sports where facial injuries can occur but mouthguard wear is typically inconsistent and/or not required to be worn amongst players are: basketball, soccer, baseball, softball. In my practice, I have seen the highest amount of significant dental trauma stemming from basketball in instances where a mouthguard was not being worn
4. If there is any chance for contact to the face or teeth, then a mouthguard = your best friend

If you have any questions about mouth protection or prevention of trauma while playing sports, please feel free to email me at info@dco-ortho.com. We are committed to helping you! I hope you found this short article helpful!

Misconceptions exist about the general experience of having braces and are typically based on recommendations, procedures and technologies from decades ago.  New research has enabled advanced technologies that have made the orthodontic experience much better than it would have been even 5 or 10 years ago. This is great news for everybody.

“Can I chew gum with braces?”

This is one of the most common questions we have in our practice. The short answer is yes, if the gum is sugar-free and contains xylitol. Several recent scientific studies have shown that gum with xylitol (examples- Trident, Icebreakers, and many others) have a multitude of benefits:

1. Reduction of Tooth Decay
2. Aids Enamel Remineralization and Repair
3. Increases Salivary Flow
4. Increases Comfort During Tooth Movement

Always follow your specific orthodontist’s recommendations when it comes to the care of your braces.  Each patient’s case or type of braces being used may vary. There are specific cases (TMJ pain/discomfort) when gum chewing is not recommended. However, at DCO, we generally recommend that our patients chew a sugar-free gum that contains xylitol 2-3 times per day.  Invisalign patients may chew gum as well when aligners are removed. The best timing for chewing gum during orthodontic treatment is immediately after a meal.

So, at DCO, you have the OK to chew away!

That service is the noblest which is rendered for its own sake. -Mahatma Gandhi

Last month, Dr. Jeffrey Watson, colleague and close friend of Dr. Cassarella, took part in his 4th annual trip to Guatemala with the F.I.N.N. Foundation team.  During his time in Guatemala, Dr. Watson was able to provide care to those who need it most but are in circumstances that allow no access to the highly specialized care that is required.  Over the course of several years, this team has performed close to 200 surgeries, profoundly impacting the lives of each patient.  This year, his team screened and provided treatment for patients with cleft lip and palate as well as victims of domestic violence (see images below).  In a week full of long days, they changed the course of countless futures by using their skills in a powerful way. We are so proud to share the stories of those like Dr. Watson who utilize rare skills, education and talents to touch those who need it most.  Dr. Jeffrey Watson is in private practice as a facial plastic surgeon in Carlsbad, California.

Before and after photos of a cleft lip repair surgery performed by Dr. Watson and his team.

Dr. Watson pictured with a patient who was an unfortunate victim of domestic violence, which is prevalent in Guatemala.

Busy Operating Room schedule created by Dr. Watson's team after conducting screenings on their first day in Guatemala. Each post-it note is a life to be changed.

F.I.N.N. Foundation. Filling International and National Needs.  Learn more about the F.I.N.N. Foundation

Dr. Watson is a shining example of a highly trained, educated and skilled medical specialist placing a high priority on giving back.  Over the past 16 years, Dr. Watson has performed philanthropic medical work in Papua New Guinea, the Dominican Republic, Guatemala and East Africa.

Learn more about Dr. Jeffrey Watson 

DCO: The Humanized Digital Experience

We are all deeply familiar with the capability of digital technology to revolutionize the way we do things. Twenty years ago, we all would have had trouble believing that most of society would be connected via mini, hand-held computers that magically merged with our phones.  At that point, we were still grappling with the concept of the internet and hoping that the world did not end on “Y2K.”  As we know, in many arenas and in many ways, digitization has spelled dehumanization of experiences for customers.

At DCO, we are constantly seeking to combine the awesome capabilities of digital technologies to enhance the personal experience patients have while in treatment.  Each patient is assigned to a DCO Experience Concierge whose sole mission is to guide individuals through the treatment process. The DCO Experience Concierge ensures seamless coordination, high-quality service, and a personal connection throughout treatment.

Our practice has carefully and deliberately selected technologies that add value to the personal experience of each patient.  Below are three examples:

1. 3D Printing-  A true win-win for patients is technology that improves treatment quality, enhances treatment efficiency, and provides a more comfortable experience. Three-dimensional scanning and printing has allowed us to be extremely precise in creating a digital 3D model of our patients’ teeth to aid us in accurate diagnosis and treatment.  We are able to work with laboratories to 3D print and create accurate appliances like expanders for children and Invisalign aligners for teens and adults.  The upsides to this technology are a huge increase in patient comfort through the elimination of the need for impressions and the improved accuracy of our diagnosis and treatment.  The downsides are none.

1. Digital Workflow- Your healthcare experience will no longer be defined by having to fill out 15 paper forms while the reception staff sits behind a glass partition.  At our practice, from beginning to end, the DCO Experience Concierge is always with the patient along the way, answering questions and lending support. Our digital treatment experience is built around elimination of unnecessary steps, clear communication, and paperless management of each patient’s personalized treatment. We use sophisticated digital diagnostic, practice management and treatment planning software that allows us to make things simple for our patients while leaving a green footprint.  Among these technologies are digital radiographs and three dimensional model generation which provides enhanced comfort to patients, appliances that fit more precisely, and creates efficiencies to allow for fewer visits during treatment for each patient.

1. Invisalign- Clear aligner treatment (Invisalign) has enabled us to make treatment virtually invisible. Additionally, it allows for flexible for adults and has improved the quality of life, function, and confidence for many who would not pursue orthodontic treatment otherwise.  Invisalign’s innovations are centered around using 3D models to virtually move teeth and manufacture clear aligners to be worn sequentially at each stage of tooth movement.  Invisalign's digital technology dovetails perfectly into 3D printing and scanning technological advancements that we have harnessed in other areas of our practice.  Adults are now free to pursue orthodontic treatment with extremely little impact on their lifestyle or work schedule.

The future is here and it is exciting!  At DCO Orthodontic Specialists, we have harnessed the power of digital technology to enhance human interactions, not replace them.

We wanted our very first DCO Orthodontic Specialists blog post to be about you.  That’s right- about YOU!  We are thrilled to be opening our doors in July of 2016 to begin our effort to create an experience for patients that is truly unique in the healthcare space.  We have been focused to build each of our processes around innovation, teamwork, collaboration, and above all else, making the patient’s experience during treatment priority number one.

Every aspect of our practice has been extensively planned, designed and built around making treatment convenient, enjoyable, affordable and rewarding. We set our goals very high, and we are determined that you will look back on your decision to have orthodontic treatment at DCO as one of the best decisions you have ever made- both in terms of the high quality result and the journey we took together to get there.

Some specific ways in which we deliver a treatment experience to you that exceeds your expectations:

1. Communication: We will take the time to listen to you and collaborate with you during treatment so we can help you reach your goals.
2. Comfort: Our office is a warm place and our entire team is determined to brighten your day.  We have a beverage bar, complimentary Wifi, and semi-privacy in all clinical areas. During your visit, you may even forget that you are in a healthcare space.
3. Convenience: We are will work with you to make your treatment process simple and convenient.  We have advanced technologies that can reduce the number of appointments.  We offer early morning, evening, and weekend hours as well.
4. Esthetics: We offer the most advanced and esthetic orthodontic treatment options available. We are equally focused on the needs of young patients and adult patients.

We begin by listening.  It all starts with you.  These are the mantras of our practice.  We will constantly seek feedback from our patients and tirelessly work to continue to improve each day on the delivery of an exceptional experience.  Come and see what we are about.  It would be an honor to have you join the DCO Family.

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ex·pec·ta·tion (Merriam-Webster) noun:  a belief that something will happen or is likely to happen.

Expectations.  They are so important!  “Does it hurt to get braces on?” It is a frequently asked question by patients of all ages.  I love to be the bearer of good news:  Of all of the medical/dental procedures a patient will have performed during the course of his or her lifetime, getting braces on will probably be among the easiest and most comfortable.  Getting braces put on is so comfortable and painless that many patients actually fall asleep during the procedure!

My wife Sarah and I are excited to be expecting our first child in September and we have access to a plethora of information to help us prepare, including the famous book What to Expect When You’re Expecting.  Fortunately, for patients, “what to expect” when getting braces on can be summarized in 4 easy steps:

1. We clean your teeth with a spin brush
2. We put several solutions on your teeth to help the adhesive work
3. The doctor places and carefully positions each brace
4. We shine a light on the brace to dry the glue

The real work is handled by the doctor in advance of your visit to diagnose and plan the best way to align your teeth and bite.  After we wake you up from the nap you likely took while we put your braces on, we then explain the proper way to take care of your braces:

1. We show you a special brushing technique to keep your braces clean
2. We ask you to stay away from extremely hard or sticky foods
3. We show you how to keep everything very comfortable

The process of getting started with Invisalign is even easier- imagine that!  The take home message is that getting braces or Invisalign is an extremely comfortable procedure.  Most orthodontists offer complimentary consultations to children and adults.  At the consultation, the orthodontist will illustrate the specifics of how you can benefit both functionally and esthetically from orthodontic treatment.

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