Blog - Warsaw Orthodontics

May 21, 2020 by Dr Watson

Amaya’s Story: Watch Her Grow!

Amaya started coming to my office when she was almost 8 years old. She had undergone part of a phase I treatment before I started seeing her. This first photo was taken six years ago. One thing I know for sure is that I did not see then, what I see now!

Now, I see that her lips are apart, tongue likely rests down and between her teeth, not up at the roof of her mouth, and her lower jaw is recessed or set further back than the upper jaw. She has a V shaped upper arch because she mouth breathes, so her tongue rests in the down position which has the effect of widening her lower jaw instead of her upper jaw.

At the time, the treatment that was done moved her upper jaw back to correct her overbite, instead of bringing her lower jaw forward. Unfortunately, with a lot of orthodontic appliances today, the upper jaw still is still pushed back.

So, in the second photo, when Amaya finished her first phase of treatment, her overbite was in fact corrected. It was also likely easier for her to bring her lips together, although I now notice that she is straining her chin in order to achieve this. Did her upper jaw grow forward? No. Did her lower jaw grow forward? It looks like it did a little bit.

Through photos like these, I’m hoping that you begin to understand why I talk to all of my patients about mouth breathing, lip posture, tongue posture, and straining in the chin muscles. Each of these elements impact a child’s growth pattern. It can cause downward and backwards growth, leading to an overbite, or the lower jaw can grow forward excessively, leading to an underbite.

A year after her braces were removed, I saw her to monitor her growth and to see how her teeth and jaws were developing. My notes from this visit say Amaya was still tongue thrusting (despite using an appliance to keep her tongue back during the first phase). We tried to remind her to keep her lips together when swallowing and the tongue to the roof of her mouth. I see now, her head posture is forward to help her breathe better. She still had mentalis strain, indicating that she was still mouth breathing. Now, both her upper and lower jaws were growing backwards. We took additional photos and I saw mom and Amaya back a month later.

What was my treatment plan at that time? I discussed with Amaya and her mom, the only way to correct her profile and bite at that time was orthognathic surgery. I was going to send her to the oral surgeons and have her undergo surgery to bring both her upper and lower jaws forward. Luckily, at this appointment, Amaya’s mom also shared with me Amaya was having trouble sleeping. She was very restless at night. This improved once her tonsils and adenoids were removed, but since then had gotten worse. She was also having some TMJ pain.

Around this same time, I luckily started taking courses and learning about airway health and reasons kids grow the way they do, instead of just looking at trying to get their teeth to fit together without taking into consideration their profile. I also referred Amaya to Dr. Dan Klauer to address her TMJ issues. After one year of working with Dr. Klauer and doing myofunctional therapy, her lip and tongue posture was better. Mom reported she was doing much better, with less pain. She denied the orthognathic surgery option, which we are both thankful now, she decided not to move forward with that route.

Almost 3 years after her braces were taken off for Phase I, she was ready for the next phase. This was just the amount of time I needed to take several courses focused on airway health alternatives to traditional orthodontics that can help patients grow in a more forward direction.

The two photos below were taken 6 months into Amaya’s treatment. WOW! Amaya, her mom, and our entire office was thrilled with the amazing changes. Amaya had to put in a lot of effort with myofunctional therapy as well as becoming mindful about nasal breathing, keeping her lips together, and her tongue in the roof of her mouth. At this point, she still had a little strain to her chin and we discussed this.

Amaya continued her hard work. The photos demonstrate a more relaxed profile. Mom reported that Amaya was more relaxed, sleeping better, breathing better, and more confident!

Amaya and Denise, thank you both for your trust and allowing me to be a part of Amaya’s orthodontic journey. I will be forever grateful to have a part in Amaya’s beautiful smile and profile. She is one of the many reasons I love what I get to do each day.

“Do the best you can until you know better. Then when you know better, do better.”

– Maya Angelou

May 8, 2020 by Dr Watson

WHAT IS EARLY TREATMENT PART II

In a previous blog post I discussed the benefits of early orthodontic treatment, and answered the question I hear most often, “Why are we starting treatment when my child still has baby teeth?” A question I get asked almost as frequently is, “Why are we starting treatment when my child ONLY has baby teeth? Currently, the youngest patient in our practice is three years old and we have a two-year-old joining the ranks soon! So, why start orthodontic treatment on patients this young? For all the same reasons I listed in the previous blog post: https://warsaworthodontics.com/what-is-early-treatment/

1. 1. Does the child have a thumb sucking habit?
  2. Is the child a mouth breather?
  3. Does the child have a tongue thrust?
  4. Is there anterior and posterior crossbite?
  5. Does severe crowding exist?
  6. Can we intervene to change the child’s growth pattern?

Thumb sucking, mouth breathing, tongue thrusting, anterior and posterior crossbites, and severe crowding. All of these things change a child’s growth pattern whether they have all baby teeth, some baby teeth and some permanent teeth, or all permanent teeth.

What changed my treatment philosophy from the standard, not starting treatment until age seven, to sometimes starting treatment when they are as young as two? Several years ago, I traveled to a course with a colleague. The doctor teaching this course was starting treatment on two and three year old children. That course was the beginning of my journey to where I am today. I went on to take many more courses addressing this subject. I also began to question the growth and development of my own two children. I firmly believe that the earliest intervention is the best intervention for long-term health. My first teacher in this method often says, “If a child needs glasses, do we wait until a certain age to get them glasses so they can see better? No. So why should we wait to treat children until some permanent teeth or all of their permanent teeth are in?”

I have learned that children are much more resilient than we give them credit for. When I started my own daughter at age four, I was more nervous than she was! Grace has done wonderfully! I am so thankful that I have changed the direction of growth now, rather than waiting for it to progress necessitating more extensive treatment later.

The following photos are progress photos that show correction of an underbite when a child has all baby teeth. Also note the dramatic changes to the facial structure.

Early Treatment Progress Photos

Treatment time: 3 out of 18 months

Treatment time: 6 out of 18 months

April 24, 2020 by Dr Watson

Important Updates for Upcoming Appointments

Dear Patients and Families of Warsaw Orthodontics,

Our office will reopen for appointments beginning on Monday, May 4, 2020. As we prepare to provide treatment again, we would like to share with you the protocol that we will be implementing. Please know that the health and safety of our patients, families, and staff, is our top priority. We want to be able to provide continuity of orthodontic care in the safest way possible. Much of our new protocol will look similar to the way we operated shortly before we closed in March. We have always and will continue to adhere to the recommendations and guidelines provided by OSHA and the CDC.

All areas in the office considered to be “high touch,” will be out of use for the time being. This includes the coffee bar, water dispenser, IPADs, toys, and toothbrushing stations.

Prior to the patient’s appointment

We will be sending an Informed Consent (COVID-19) and Health History form to fill out and return at least 24 hours prior to the appointment (Click Here to complete them online)
Please brush your teeth prior to arriving to our office

Once you arrive at our office

Text or call (574)269-3621 to let us know that you have arrived
When we are ready for you, our Front Desk Coordinator will text/call back to let you know that you can come into the office
- We are asking that only the patient enter our office unless you are coming for a new patient exam. This greatly reduces the amount of foot traffic in our office and helps to create a safe environment for our staff and each of you.
- Should a parent need to join their child for the appointment, we are asking that you please wear a face mask in order to help us keep our environment as safe as possible
A team member will greet you in our vestibule where we will take your temperature and dispense hand sanitizer. The team member will be wearing goggles, a facemask, and a lab coat.
The patient will then be escorted to the clinic area for their appointment
Once the appointment is complete, a staff member will walk the patient back to the front of the office. Our front desk coordinator will call the parent to discuss the visit and schedule the next appointment. We will also have the patient use hand sanitizer again prior to leaving.

After Your Appointment

For the safety and health of our patients and staff, we are kindly asking that you monitor your own health of that of your close contacts for a period of two weeks following your visit to our office. During that two week period, should you or someone that you have had contact with, develop symptoms of Covid-19, please call our office and report this so that we can take appropriate precautions.

Regarding scheduling

Please know, we understand there is some urgency with wanting to continue your treatment and we want to be able to provide that for you. While the nature of our services does not allow for social distancing between clinician and patient, we are practicing social distancing between patients and keeping foot traffic in our office to a minimum. Therefore, it is necessary that we limit the number of patients that we see in our office at any given time. In light of these changes, it may take longer to get your appointment rescheduled. Patients who have appointments previously scheduled in May will receive a phone call to reschedule their appointment for a different day or time.

We are looking forward to seeing everyone again, welcoming you back to our office, and having fun giving you a beautiful smile!

-Dr. Watson and staff

March 20, 2020 by Dr Watson

What I Learned This Week

This week has been a blur. I have been trying to remember the actual day I realized that I was going to have to close my practice for at least two weeks, and I honestly can’t remember at what time I thought that was even a possibility. Now, it’s even a possibility we may close for months or indefinitely as governors all over the states are mandating dental offices to close except for emergencies. If someone had told me a month ago I was going to have to close my office, I wouldn’t have believed you.

A couple of months ago when everyone kept saying a recession was coming, I asked my financial advisor what was the plan if we entered a recession? How was I going to pay my practice loans and student loans? I couldn’t have fathomed that anything of this magnitude was coming.

Each day this week was filled with the unknown. Every minute that passed, emails were filling my inbox with information on how COVID-19 was going to affect us. Ultimately, the American Dental Association recommended all dentists close their offices and only see patients with dental emergencies. In orthodontics, much of what we do is considered “elective.” First they recommended we close for three weeks. As of last night, the ADA president was recommending three months.

Niki, Bre, Nichole, Doris, Mary, Jess, Kyra, Ana, Myra, Brook, Emily, Gina…my team, my work family. The group of people I spend most of the hours of my week with. Every day, there were questions and issues to work through with my consultants. The thing that was on my mind all day while seeing patients, when I was trying to sleep at night, and the first thing when I woke up in the morning was my team. What would I do about our team if the office had to close? For anyone who has been in our office, I’m sure you can see and feel that our team has great chemistry. We always help each other and have fun and joke almost the entire day! No matter what is going on, my team will say to me, “whatever you need me to do, just tell me and I’ll do it. I’ve got you,” and I say the exact same thing back to them.

Each morning we have a huddle and I typically end it with some type of positive quote about teamwork, great attitudes, what we need to bring to our patients each and every day, etc. But, this week, the only quotes I had were bible verses. Prayer and finding my favorite bible verses gave me the strength and peace to know that I was doing the right thing for my team.

What is the silver lining? Life is so busy, and I constantly say I wish I could spend more time with my family. Well, here is the moment and my opportunity to do so. I have no control over this situation. All I can do is trust that we will get through this and cherish the time I have to spend with my family.

Philipians 4:6-7 Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. And the peace of God, which surpasses all understanding will guard your hearts and your mind in Christ Jesus.

March 15, 2020 by Dr Watson

Coronavirus Protocol

The Coronavirus/Covid-19 has given us all cause for concern. We want you to know that the safety of our patients and families is always our primary concern. We also know that continuity of care is critical for successful orthodontic treatment. As always, we regularly disinfect our treatment area, all public surfaces, and follow the most stringent sterilization protocols in the industry. We continue to utilize hospital grade disinfectants to clean all treatment areas, door handles and public use areas in our office. We have removed all magazines, books, brochures, iPads, and temporarily disabled the video games in the waiting area for your protection.

We kindly ask that you adhere to the following protocol that our practice has established in order to keep our patients and staff healthy:

Please reschedule your appointment if anyone in your household has a fever or other signs of illness
Please do not arrive early for your appointment. Arrive on time and text our office at (574)269-3621 from your vehicle to let us know you have arrived
A member of our team will text you back to let you know when your treatment area is sterile and ready for you to be seen by the doctor
If you do not have texting capability, either call our office when you arrive, or come in to the front desk to check in
Unless you have an initial consultation with our office, we are requesting that only patients enter the office during this time. We ask that parents and family members wait in their vehicles during the appointment in order to decrease traffic in our office
Upon entering our office, patients will be directed to our brushing station where we ask that you brush your teeth, use the mouth rinse provided and thoroughly wash your hands before taking your seat in the treatment area.
We ask that all patients wash their hands again upon leaving the office
A member of our team will call you following your child’s appointment, update you on their progress and schedule the next appointment

Because we are all unsure of what the next days and weeks will bring us, we ask you to be patient with us as we may have to cancel appointments or move appointment times. We care deeply about our patients and every decision will be made with your best interest in mind!

We sincerely thank you for trusting us with your care and working with us to limit the spread of the virus! Please call our office with any questions!

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