Make Room for Forever Smiles!

While all our patients know Dr. Razdolsky is the best Orthodontist for Children and Adults, but what many of you may not realize is that Dr. Razdolsky also works very closely and collaboratively with other interdisciplinary specialists in the diagnosis and treatment of dentofacial

orthopedic abnormalities. Sounds pretty complicated, and it is! But dentofacial abnormalities are not always so easy to spot and, in some instances, patients and their families do not even see or recognize there is a problem.

While there are many orthodontic appliances available to correct problems like crooked or misaligned teeth, sometimes these appliances need a more solid foundation in order to be truly effective. The palatal area at the roof of the mouth, for example, must be also be considered. The palate, jaw and the available space required to properly align teeth is often an issue which must be addressed long before a patient can even have braces. This is why Dr. Razdolsky and the Forever Smiles team advocate early diagnosis and treatment because, in the case of dentofacial orthopedics, pre-adolescent treatment is more often the least invasive and offers the greatest opportunity for successful orthodontic treatment when the time comes.

We have shared with you the negative consequences of a small upper palate; however, growing evidence suggests that maxillary constriction left untreated can also be a factor in airway restriction starting in childhood and continuing through adulthood. It is even suggested that the effects of a maxillary or palatal expansion through treatment with a rapid palatal expander (RPE) can help increase nasal airway and improve overall respiratory function including air intake, better sleep, and even long-term health.

“We place great emphasis on early detection and prevention,” said Dr. Razdolsky. “I have been in practice for 32 years and would estimate we have treated more than 40,000 RPE cases to date.”

In its earliest development, the palatal area at the roof of the mouth of a pre-adolescent is still adaptable with hardening into bone only beginning and continuing throughout the teens. Therefore, the roof palate of younger patients is much more responsive to the orthopedic treatment with an appliance and less pressure is needed to achieve the desired result. When less pressure is used, we reduce the risk of negative consequences.

For example, use of an expander while a patient still has some baby, or primary teeth along with permanent teeth, allows the use of the baby teeth to serve as anchors for the expansion appliance. You see, expansion appliances use the strength of the roots and surrounding bone of the teeth to which they are attached. It is those teeth and supporting bone that carries the lateral pressure of the expansion as the palate opens. When baby teeth are used to support the expander, the newly-erupting adult teeth do not bear any of the expansion pressure and instead receive benefit from the additional space.

In most cases, the reason for expansion is because of a crowded upper roof palate resulting in crooked or protruding teeth, jaw misalignment or crossbite. New and permanent teeth that come into the mouth with adequate bone and soft tissue support benefit from the ideal scenario for long-term stability and more sound periodontal health. For patients with a crowded, developing mouth, the plan is to create space for the teeth to come in straight without the risk of future gum-related issues or tooth damage. In treated patients, an expansion appliance is placed into the roof of the mouth as high as possible without negatively affecting palatal tissues. As a result, patients sometimes experience temporary difficulties with speech and swallowing, similar to that caused by a retainer. This inconvenience usually passes quickly as patients grow accustomed to the device.

“This is an exciting time,” said Dr. Razdolsky. “My colleagues and I are discovering many new treatment options for what in the past had been deemed too challenging or even hopeless cases. We have attended several conferences and poured over hundreds of clinical studies. The interdisciplinary approach to oral treatment and study means so much more is being explored.”

“In fact, I have some very significant findings I am to present to my colleagues at a seminar in May regarding this very topic,” Dr. Razdolsky added. “I look forward to sharing it with my patients as well, so keep an eye out for that!”

The result of all this collaborative effort said Dr. Razdolsky, is a more successful treatment and better long-term results for a lifetime of beautiful Forever Smiles.