HI DR. B AND DR. W. I WAS WONDERING IF YOU STILL USE HEADGEAR AND THOSE EXPANDERS YOU HAVE TO CRANK ON EVERY NIGHT LIKE I HAD AS A KID? HAVE THERE BEEN ADVANCEMENTS IN BRACES SINCE I HAD THEM 30 YEARS AGO? I HOPE SO! MIKE N.

Thank you for the question Mike.  Advancements in orthodontics have been quite considerable in the last 10-30 years.  Many advancements have been in the actual materials we use.  Brackets are now smaller and more esthetic, both metal and ceramic (clear braces).  The wires that we use are actually designed using technology from the space program.  These “space age” wires react to temperature and can be cooled so that they become very soft and flexible, causing less tooth discomfort and better tooth movement.  Many advancements have also been designed to help correct bite and jaw discrepancies, which is what headgear was used for.  Now, special in-the -mouth springs attach to the braces and take the place of headgear.  Advancements in alternatives to braces, like Invisalign, have made huge headway over the past couple decades and are now on par in creating the same results as braces (if used by a properly trained clinician like us J ). Digital technologies have reshaped the way we take impressions of teeth by scanning instead of the goopy impression trays, and allow us to take three dimensional x-rays of the teeth and jaw structures. There have also been advancements in the theory of tooth movement and facial esthetics. Thirty plus years ago, it was thought that heavy forces were needed to move teeth. Now, we understand that light, consistent force will create a healthier and more comfortable movement, thus eliminating the old fashioned expanders you had to “crank” at home.  We use a much gentler expansion process to create space for crowded teeth.  Also, it used to be almost standard to have four permanent teeth removed at braces age to make room for crowded out teeth.  Now we have learned that this creates an unaesthetic facial result, as well as a narrow smile.  Therefore, we opt to treat many patients earlier, between ages 7-12, so we can get started on jaw development early on, almost completely eliminating the need to remove teeth.   As you can see, orthodontics has changed dramatically over the years with new materials, technologies, and with a better understanding of facial esthetics.  I can assure you, it’s much easier, quicker, and more comfortable than ever to have straight teeth in today’s modern world!