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Micro-Esthetics in Orthodontic Treatment – Achieving the Best Results

Posted on by Dr. Jared Gianquinto

Achieving the best orthodontic treatment results often involves more than just alignment orthodontist-bakersfield-best-resultsof teeth. Sometimes, the shape of teeth themselves will not allow for ideal placement, or supporting gum tissues are insufficient for optimal esthetics. In these cases, changes on a very small scale can make noticeable differences in the end result.

Our patient was very concerned about the “dark triangle” on his gumline at the beginning of treatment. “Dark triangles” are most often seen in adult patients with minor bone loss between the front teeth, or teeth that are overlapped prior to orthodontic treatment. In order for gum tissue to fill the space, adequate bone support is necessary, and does not always form, and the “dark triangle” is even accentuated once teeth are aligned. In younger patients, “dark triangle” is usually due to the shape of teeth. The more triangular the teeth are, the more likely a “dark triangle” will result.

“Dark triangle” is easily managed in patients with triangular teeth. Slight reshaping of the contact between the two front teeth allows them to be placed closer together, moving the contact closer to the gum tissue, allowing the gum tissue that is already present to fill the space.

Our patient was thrilled with his new smile, as were we! However, we could not have achieved such amazing results without comprehensive treatment planning, and clear visualization of the patient’s treatment goals.

If you are interested in learning more about Invisalign in Bakersfield, CA, please give us a call at our office to schedule your initial consultation.

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Orthodontics and Cosmetic Dentistry – Achieving the Best Results

Posted on by Dr. Jared Gianquinto

Invisalign and Cosmetic Dentistry TreatmentOrthodontic treatment can work wonders, but pure movement of teeth into better positions cannot address cosmetic and structural issues of the teeth themselves, such as uneven tooth wear, damage, or staining. At the same time, addressing these concerns purely through restorative dentistry techniques can require extensive reduction of tooth structure, root canals, crowns, and gum surgery. When the two disciplines are combined, excellent long-term results can be achieved with conservative procedures.

Our patient presented with uneven tooth wear caused by years of function with moderate anterior crowding. He had discussed a purely cosmetic treatment with his general dentist, but was concerned about the long-term durability of porcelain veneers, which would not address his lower crowding.  His dentist suggested orthodontic correction that would allow composite restorations to be placed instead, and referred him to us for Invisalign and tooth whitening. Our patient reported back to his general dentist for bonding immediately after his Invisalign attachments were removed, and new retainers were made.

Our patient was thrilled with his new smile, as were we! However, we could not have achieved such amazing results without comprehensive treatment planning, solid communication, and coordination of care between offices.

If you are interested in learning more about Invisalign in Bakersfield, CA, please give us a call at our office to schedule your initial consultation.

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Dr. G Accepts Ice Bucket Challenge!

Posted on by Dr. Jared Gianquinto

Dr. G has accepted the Ice Bucket Challenge from Thank you to Charlie Mecadon of the National Federation of Independent Business! Charlie was kind enough to nominate Dr. Gianquinto along with his daughter Anitra Mecadon of the DIY show MegaDens, and the music group Lucy Angel in his challenge. Dr. G donated $100 to both ALS research and the OrthoArts Charity of the Month, Marley’s Mutts. Thanks for the challenge, Charlie!

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Quarterly Drawing Winner – June 2014

Posted on by Dr. Jared Gianquinto

 

Quarterly Drawing Winner, June 2014

Thanks to everyone who participated in our quarterly drawing for 4 Magic Mountain tickets! Keep brushing, flossing, bringing your retainer to your appointments (if you have one), and avoiding broken brackets and wires for more chances to win! Next up is a pair of Beats headphones 🙂

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Orthodontic Treatment Transfers

Posted on by Dr. Jared Gianquinto

Orthodontic Treatment Transfer Q &A with Bakersfield Orthodontist Dr. Jared R. Gianquinto DMD, MS

 

Families sometime have to relocate during orthodontic treatment, and that brings up a lot of questions! Dr. Jared R. Gianquinto, DMD, MS, your Bakersfield orthodontist has the answers!

 

 

How do transfers work?

How long is it going to take to finish treatment?

Can I keep the same braces, or will I need new ones?

We’re moving away in the middle of treatment! What do we do?

We’re moving to Bakersfield in the middle of treatment! What do we do?

How do transfers work?

We would love it if all of our families could stay in one place for the entire duration of orthodontic treatment, but relocations happen. Families move, and usually the move is far enough that finishing treatment with their original orthodontist just isn’t practical. Luckily, we handle transfers of treatment all of the time. Most of the time we can pick up right where the original orthodontist left off and finish up treatment with minimal interruption. If you’re considering switching orthodontists for whatever the reason, the American Association of Orthodontists has a transfer form that gives the new orthodontist the original findings, treatment plan and summary of progress notes that helps keep treatment moving in the right direction. Every orthodontist has different ways of straightening teeth, different staff, different offices, different locations, and different additional services they offer. As a result, treatment fees vary from place to place, and office to office. In our office, our fees are based on levels of complexity and types of appliances needed.

How long is it going to take to finish treatment?

Every orthodontist has different eyes and different ways of achieving the same end result, even with the same schooling and training. There are also many different systems of braces, wires and methods of moving teeth. Think of any road trip. There are lots of ways to get to your destination, but the driver may be a lot more comfortable taking one route over another. Now imagine having to find a new driver in the middle of the trip. First, you have to find a new driver you’ll feel comfortable driving your car. He or she will have the same destination in mind, but might be more accustomed to a different kind of car, and might want to take different route that could take longer, but be safer, have less traffic, etc. No matter how you look at it, switching drivers in the middle means the trip will take longer. Switching orthodontists is the same thing.  Invariably, orthodontic treatment will take a few months longer than the initial estimate by the original orthodontist if the treatment must be finished by another provider.  Every orthodontist has different ways of straightening teeth, different staff, different offices, different locations, and different additional services they offer as well. As a result, treatment fees vary, and treatment will most likely be more expensive overall if a transfer is necessary.

Can I keep the same braces, or will I need new ones?

During my orthodontic residency at Temple University, we were fortunate enough to be trained in just about every contemporary orthodontic system available, and even some more antiquated ones! This not only allowed us to determine what systems worked best in our hands, but also to address the reality of transfer patients. Some bracket systems and methods of tooth movement are more efficient than others, and while they might look the same, braces actually have specific prescriptions built into them to help teeth move where they are supposed to go. In certain situations, the braces may have to be replaced with what we use here in our office to get the best results in the shortest amount of time.

We’re moving away in the middle of treatment! What do we do?

We’re going to miss you! And don’t panic. Every patient that starts treatment with us is provided with our transfer policy and the formula we use to balance your account with us before you leave. Sometimes there is a small fee, sometimes a refund. Every situation is different and we’ll be happy to work with you! We also know a lot of good orthodontists around the country with similar systems in their offices. Chances are we can make a recommendation to make the transition as seamless as possible.

We’re moving to Bakersfield in the middle of treatment! What do we do?

We’d love to meet you! And again, don’t panic. Be sure to let your original orthodontist know you’re leaving, and get copies of the original treatment records before you move if you can. Once you’re here, give us a call for a free consultation. We’ll take a look and see what needs to be done to get to the finish line, how long it will take, and what the fee will be. It’s a lot easier to determine where the finish line is if we know where the journey started, so if you have the initial records, bring them to your appointment. If you don’t, we’ll contact your original orthodontist and get them for you.

In short, it’s treatment is always faster and less expensive if you can complete the entire journey with the same orthodontist. If that’s not practical or possible, there are lots of options to achieve the smile you’ve always dreamed of.  Give us a call for a free consultation!

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PROPEL Accelerated Orthodontics

Posted on by Dr. Jared Gianquinto

PROPEL Accelerated Orthodontics in Bakersfield, CA

Perhaps the most popular question in any orthodontic treatment consultation, “How long is it going to take?” Weddings, senior photos, proms, formals, quinceneras and lots of life events can happen in the course of a normal comprehensive orthodontic treatment time of 27 months. Advances in bracket design, wire technology and Invisalign have made the actual movement of teeth more efficient, but not necessarily faster since speed of tooth movement has always been dictated by the biological processes that actually allow them to move.

The answer to faster tooth movement lies in stimulation of the bone remodeling and healing processes themselves, rather than a new brace, wire, or method of applying force to teeth. All sorts of stimulation methods have been explored, ranging from vibration and ultrasound to low-level laser light and hormone therapy, without much promise. Adjunctive surgical procedures have proven effective in accelerating tooth movement and are nothing new. However, that have typically involved multiple visits to periodontists or oral surgeons for invasive and uncomfortable procedures carrying the risk of gum recession after treatment. These procedures typically involved opening up the gum tissue to place small perforations in the surrounding area. These perforations increase blood flow and levels of healing factors in the tissues supporting the teeth. This leads to increased rates of bone remodeling and faster tooth movement. For a vast majority of patients, these procedures were not worth the discomfort or expense regardless of the decrease in treatment time.

What if the same induction of healing factors and increased blood flow could be stimulated without the invasiveness and discomfort of traditional gum surgery? Thanks to the new PROPEL® system, similar results can be achieved with a simple procedure in our office with minimal discomfort and little to no recovery time.

PROPEL® works with the your own biology to stimulate the bone surrounding your teeth; helping the teeth to move faster and more predictably into their ideal position so we can reveal your new smile faster and in fewer visits to our office.

We provide PROPEL® for Invisalign and braces, offering complimentary consultations to all. If you would like to accelerate your orthodontic treatment today, then ask us about  PROPEL®!

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Best Lost Retainer Story To Date

Posted on by Dr. Jared Gianquinto

We have a policy in our office that the first time a retainer is lost, broken, damaged, or generally needs replacement for some reason, our patients are given the opportunity to do a creative writing assignment describing how their retainer was lost in lieu of a replacement fee. The stories are posted in our office, and we have quite a collection!

We are continually amazed by the originality and creativity of our patients! Our best story to date was recently submitted our friend Jackson N, who wrote 3 chapters detailing his retainer’s dreams of becoming a Broadway star, leaving him for new adventures in New York City:

Thank you Jackson for your awesome story!

 

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Troubleshooting Palatal Expanders

Posted on by Dr. Jared Gianquinto

Palatal Expander Troubleshooting

Palatal Expander

We’ve had quite a few parents asking about palatal expanders recently. During the delivery appointment, there’s a lot of information provided and even though we walk every parent through turning the expansion screw, oral hygiene instructions and the do’s and don’ts of orthodontic treatment, it’s handy to have a quick reference once you get home.

1. I can’t find the hole for the expander key.

The holes for the expander key may be difficult to see, but they are there! It is easiest to see the appliance while sitting on the couch with the child’s head in your lap, and having a helper with a flashlight can be very useful until you get the hang of it. Sometimes the appliance screw can turn backward. In that case, the hole may be further back on the appliance. To correct this, insert the key in the hole facing the back of the expander and push it in the direction of the arrow (toward the throat) until the next hole is visible at the front of the appliance.

2. How do you turn the expander?

You should be able to see the hole for the expander key at the front of the appliance. Insert the key carefully into the hole and push gently to make sure the key is fully inserted. Push the key in the direction of the arrow (toward the back of the mouth) until the next key hole is visible. It is very important that you turn the key in the right direction to keep treatment moving forward and minimize discomfort. Remove the key by gently pulling the key directly downward without turning the screw.

3. One of the bands is loose.

This rarely happens. But if the appliance is loose, it is important to stop activating and contact our office as soon as possible for an appointment, and keep the area clean. We will need to check the appliance and possibly re-cement it. If the appliance comes out completely, be sure to bring it to the appointment!

 

As always, if you have any questions or treatment, be sure to contact us at 661-829-7970. We’re here for you!

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Does My Child Need A Palatal Expander?

Posted on by Dr. Jared Gianquinto
Palatal Expander

Palatal Expander

One of our most popular questions from concerned parents is, “Does my child need a palatal expander?”

Many times, our answer to the expander question is “No,” which is difficult for some parents to take in after hearing other opinions on the subject. In fact, many parents aren’t exactly clear on what a palatal expander actually does. What do they do?

Palatal expanders widen an upper jaw that’s too narrow,  which is great when there’s a discrepancy between the width of the upper and lower jaws.

Unfortunately, we hear about expanders being used as Phase I appliances for all sorts of things they weren’t designed to, and cannot correct. Some common examples are to “create room” for teeth in crowded arches, “prevent the need for extractions”, “widen the smile”, or “shorten the time in braces”. We hear these claims all too often, but the in the era of evidence-based orthodontics, the scientific research in peer-reviewed orthodontic journals just isn’t there to support them.

The evidence-based indications for palatal expansion are limited and very clear. Simply put, if  a jaw is too narrow, an expander can make it wider. If the jaw is too “short”, as in cases of severe crowding, widening the jaw won’t make it any longer, and use of an expander is not indicated.

We treat quite a few patients with upper jaws that are in fact, too narrow. In these cases, the upper molars erupt inside the lower molars into what we call a posterior crossbite, which is easily corrected with an expander. Other indications include patients with asymmetrical growth patterns or craniofacial anomalies where expansion is necessary for correction. Correction of these conditions is most stable when completed at a young age, before the two halves of the upper jaw fuse together. New research also supports the use of expansion to correct eruption paths of upper permanent canines that are at risk of becoming impacted.

Posterior Crossbite Corrected with Palatal Expander

Posterior Crossbite Corrected with Palatal Expander

Unnecessary expansion can lead to a host of future complications ranging from increased orthodontic treatment time and periodontal problems to loss of supporting bone. In extreme cases, aggressive expansion can even widen the face and bridge of the nose. Regardless, all orthodontic treatment is highly patient specific, and palatal expansion is no exception. When necessary, expansion is most successful when completed quickly at a young age, before the two halves of the upper jaw have fused, in conjunction with orthodontic treatment in specific cases.


If palatal expansion is recommended for you or your child, be sure to ask what research supports its use. As always, we are happy to answer any questions you might have.

Q: So do you guys recommend expansion?

A: We sure do, when it’s needed.

And when expanders are needed to correct posterior crossbites, they are the most effective appliances to achieve that correction. For a stable long-term result, brackets and wires usually won’t cut it.

Fortunately, we are able to treat all of these bite problems, and most of them are most easily corrected before all of the adult teeth have erupted. If you suspect you or your child has a bite misalignment, we encourage you to come in for a complimentary consultation. By starting early, you can make sure you or your child avoid years of pain and self-consciousness.

Call 661-829-7970 or for your complimentary initial exam and get started today.

NOTE: The author, Dr. Jared Gianquinto, is an orthodontist in the private practice of orthodontics and dentofacial orthopedics in Bakersfield, CA. He was trained at Temple University and Naval Medical Center San Diego, completing orthodontic and dentofacial orthopedic specialty training at Temple University Kornberg School of Dentistry. Dr. Gianquinto’s unique combination of extensive past general/cosmetic and current specialty orthodontic practice qualify him an expert in two-phase treatment, extraction and non-extraction treatment, clear aligners (Invisalign and ClearCorrect) and multiple bracket systems. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.

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Lost Retainer Story of the Week

Posted on by Dr. Jared Gianquinto

As inconvenient as retainers may be, they’re a necessity for successful orthodontic treatment. Without them, all of the hard work that went into that beautiful smile can start to relapse. But sometimes retainers are lost, stolen by leprechauns, eaten by monsters, run over by tanks, and obliterated by laser beams. The first time a retainer is no longer serviceable for whatever reason, our patients have the opportunity to take on a creative writing assignment with a fantastical explanation of how it happened in lieu of a replacement fee. Our patients have amazing imaginations!

Here is our Lost Retainer Story of the Week:

By Kenna:

How I Lost My Retainer

One day I was reading a book on George Washington and how he had several false teeth. I though to myself, “What if he had retainers like me?” I bought myself a time machine on Ebay and when it finally arrived, I quickly grabbed my retainers and went back in time. I went all the way back to 1789, when he was president. Then I ran right over to President Washington and asked him, “Do you have retainers like me?” He looked at me like I was insane.
“Pardon me?” He asked, after staring at me for a long time.
“Retainers. They go on your teeth to keep them straight. Dr. G gave them to me. Keep them.”
Before Mr. Washington could reply, I stuck my retainers in his pocket and sat back down in the time machine to go home. The next day, my mom was looking for my retainers.
She yelled from the bathroom, “Kenna! Where are your retainers?”
I giggled and replied, “I lost them.. It’s a long story.”

 

Thanks for the story!

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