Moving with Kids in Braces?

Summer is the time that we see many kids and adults with braces moving into, and out of, Castle Rock. If you are one of these families, here are some tips to make your transition to an orthodontist in a new city as easy as possible.

  • cover-final - CopyLet your current orthodontist know that you will be moving as far ahead as possible. Getting informed by families of a move early allows me to prepare for your move.
  • If your treatment is nearing completion, I can plan accordingly to get your braces removed, and get you into the proper retainers before you move!
  • If there is more time left in your treatment, we prepare a transfer form from the American Association of Orthodontists (AAO) that will give your new orthodontist information on your original diagnosis, treatment plan, expected length of treatment, current status, and anything about your case that is unique or that needs special care.
  • I gather copies of your records for your new orthodontist, including all of your pre-treatment and current photographs and radiographs.
  • I will help you select a new orthodontist in the city that you are moving to. Like most professions, it is a small world, and I have many contacts around the country to help find a great match in your new hometown. I can look up information that will let you know if they are board certified, use similar braces, and have a good reputation in general.
  • An early warning that you are moving helps you transition financially. Time is often needed transitioning insurance benefits, adjusting payment plans that you may have, or prorating your balance if you have paid in full. We want your move to go as smooth as possible, both treatment-wise, and financially!
  • While on the subject of finances, the AAO transfer form mentioned above outlines  the financial arrangement of your orthodontic treatment, and this (hopefully) will give your new orthodontist a guideline to treat you fairly in your new location. Unfortunately, there are often extra costs to transfer to a new office, and if moving from Denver to a metropolitan area that has a higher cost of living (most of the east and west coasts), your new contract may reflect this.
  • Always feel free to call us after your move if you have any questions at all. Once you have started with us you are family, and we will help make your move as smooth as possible!

Dr. Dan Rejman is the owner of Meadows Orthodontics, which has two convenient locations in Castle Rock, CO. Our West Castle Rock office is in the Meadows right next to Firehouse and Einstein’s, and the East office is in Founders Marketplace near the King Soopers Plaza (near Terrain and Founders).

 

Face Painting at Castle Rock Festivals!

IMG_5739Summer is the time of year when Meadows Orthodontics sponsors many local events in Castle Rock. Being at these fun events get us out in the community, gives us an opportunity to interact with kids and their parents, and allows us to answer many questions parents have about orthodontics, braces  and invisalign.  We approach these events a bit differently – we like to have fun! I am an avid painter (oil painting local landscapes and scenes), and for several years I have been face painting at these events (note the serious painting face I’ve got going above!). This year Meadows orthodontics will be sponsoring and painting at all the Music in the Meadows events, Red White and You Fourth of July Celebration, PumpkinFest, Holiday in the Meadows, and the Starlight Movies at Festival Park in Downtown Castle Rock. I customize the face painting for each event to keep things fresh and fun for the kids (and young at heart adults!), and I really have a good time contributing to the wonderful small town feel of Castle Rock. Come out for these events, and make sure to stop by and see us!

Dr. Dan

More Evidence Regarding the Use of Self- Ligating Orthodontic Brackets (Braces)

I recently returned from the American Association of Orthodontists annual meeting and convention held in Orlando, Florida. In addition to teaching the national board preparatory class to practicing orthodontists and residents working towards becoming board certified by the American Board of Orthodontics, I was able to attend several very interesting and informative lectures by some of the leaders in our profession. Of special note was the lecture (orthodontists were spilling out of the lecture hall to hear this presentation) by Dr. Kevin O’Brien entitled “In the Land oUncertainty is Salesman King?”. Dr. O’Brian is a professor of orthodontics and researcher at the School of Dentistry at the University of Manchester, UK. and has been a clinical orthodontist and researcher for about 30 years, with the research directed at the outcome of orthodontic treatment using randomised trial methodology.

I have included below a link to one of his articles that was discussed in his lecture, which describes the current state of research on self-ligating brackets (braces that include the brands Damon, Smartclip, Empower…). To summarize, the incoming credible research is showing the claims being made by the companies (and orthodontists) marketing these brackets are not supported. The public should be aware that aggressive direct to consumer marketing by manufacturers, which is then incorporated into many orthodontists websites, is just that- a marketing pitch without backing (and now contradictory) evidence. When these products involve making a claim of superiority (and an increase in cost), candor should be used when presenting the option of these brackets to our patients. As it stands now- there is no evidence of faster results, less sensitivity, superior results, cleaner teeth, or any of the major claims for using these brackets and their systems.

Does this mean that these braces are a bad option, or worse than traditional brackets? Of course not- I actually offer them as an option to my patients because they are very nice brackets (braces). I am just up front with patients in informing them that there is no evidence that they provide better results or a better experience than “traditional braces” (which manufactures also make unsubstantiated claims about in competition with one another, and the new technologies incorporated into them!). I believe my job as a professional is to keep up with current technology, but to be completely candid with my patients about the most current evidence if we are going to choose to use a product. Please read the article in the link below, and feel free to look up Dr. Kevin O’Brien’s blog for many valuable articles on the latest research involving orthodontics controversies, products, and treatments.

Dan Rejman, DDS, MS

https://kevinobrienorthoblog.com/self-ligation-another-nail-coffin/

Mile High Orthodontic Exam room is almost finished!

Last Wednesday I finished up the sky and touched up the stadium on the wall of our exam room. Thank you for your help Leela! We added a special touch in the sky with the Air Force Thunderbirds doing a flyover. For you flight geeks (me!) the actual Thunderbird maneuver they are doing in the mural is called the “Delta Burst” with the two outside F-16’s rolling away from the middle four. Our kids and adults are loving this room when they are getting their braces! Remember- Orthodontics is an art!

-Dr. Dan

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Dr. Dan Rejman is the owner of Meadows Orthodontics in Castle Rock, CO. We have two locations in Castle Rock – in the Meadows close to CV High School, CRMS and Aspen View Academy, and another office near Founders, Terrain, Franktown and southern Parker (close to DC and Ponderosa High Schools and Sage Canyon Middle school).

 

 

 

 

 

 

 

 

 

 

 

What I Will be Doing at the American Association of Orthodontists National Convention this Week

th42ULD9S0Tomorrow my family, staff and I will be heading down to the annual American Association of Orthodontists (AAO) national convention in Orlando, Florida. I will be busy with responsibilities for my position on the College of Diplomates of the American Board of Orthodontics. Additionally, there is the opportunity to catch up with the latest technology available in orthodontics, and the decisions that follow of whether to implement this new technology into Meadows Orthodontics. There are also hundreds of lectures and continuing education classes to choose from for myself and our staff. I thought I would highlight some of the things I will be doing and checking out at the convention.

  • I will spend the entire day Friday as the instructor of the preparation course for the American Board of Orthodontics (ABO) Exam. I will be teaching two sessions to orthodontists and orthodontic residents who are preparing and studying to be Board Certified. Becoming Board Certified is important for our profession, and helping others with this process not only helps relieve some of the stress they are feeling through the long preparation process, but is also an opportunity for me to remain as sharp as possible (I study several times a year to prepare to teach the course).
  • On Sunday morning I will be judging over 400 finished braces cases submitted by residents from programs across the country. The competition involves accessing quality of finish of the completed cases (patients that have been treated with braces), taking into account the difficulty of the case and the severity of the initial misalignment of the teeth and jaws. It is always inspiring to see our future orthodontists striving to attain such a high level of quality in treating patients.
  • We have had an optical- digital scanner that replaces most impressions needed in our office (reducing the amount of goopy impressions needed), but there is a new generation out that we will be receiving soon that is multiple times faster and smaller. For those of you that have had this scan, it takes the scan time down from about five minutes to well under one minute!
  • There are numerous lectures and research presentations on a technology that has been out for a while- using specific frequencies of vibrations to accelerate tooth movement- that I will be looking into. Many offices across the country offer this technology, but the problem has been a lack of credible evidence of it’s effectiveness, and a very steep price that is transferred to patients. I will look into the latest evidence and cost-benefit for my patients.
  • And of course, we will spend several days at Disneyworld while we are there!

Dr. Dan Rejman is the owner of Meadows Orthodontics in Castle Rock, CO. There are two convenient Castel Rock locations- one in the Meadows, and one near Founders/Terrain and  close to Parker.

The Myths about “Tongue Thrust”, and the Tongue’s Influence on the Teeth

I see many patients that have been informed that they have what is called a “tongue thrust”, and that it is causing issue with their teeth and bite. Specifically, tongue thrust has been claimed to be the cause of open bites (front teeth that are separated from one another), and front teeth that are excessively proclined (tipped forward). I would like to present the key points from an article by Robert M. Mason, D.M.D, Ph.D. from the International Journal of Orofacial Myology, titled, “Myths that Persist about Orofacial Myology”. The key question is- can tongue thrusts move teeth?

  • speech10A tongue thrust is different than the resting posture of the tongue. Tongue thrusting is an opportunistic behavior, that finds and fills spaces available in the dentition (such as existing open bites), sometimes when swallowing. There is no proof that tongue trusting causes malocclusions, or misaligned teeth. However, there is much data to support the relationship between abnormal resting posture of the tongue with misaligned teeth and malocclusions.
  • A tongue thrust when swallowing does not move teeth! Moving teeth in humans requires a minimum of approximately six hours of continuous pressure. Even if you were to swallow thousands of times a day where the tongue pressed forward against (or between) the teeth, this is not nearly enough to make teeth start to move. Biochemical studies of Davidovich and colleagues demonstrated that hours of continuous forces against the teeth are required for significant amounts of specific enzymes to built up, which activate sequences of periodontal activities that result in tooth movement. Intermittent pressing motions of the tongue, no matter how strong, do not move teeth or cause open bites.
  • If the tongue rests in a forward position between the teeth for long periods of time, this continuous position can absolutely cause open bites and protrusion of the front teeth. The key is that the force is continuous, even if the pressure exerted is very light (this is how braces work!). The same can be said for thumb sucking – hours of constant pressure can move teeth dramatically.

If you have any questions about your child and the position of their tongue, please feel free to contact me. Often this is something that can be addressed very successfully. More persistent cases may require the help of an orofacial myologist.

Dr. Dan Rejman is a Board Certified orthodontist, and is the owner of Meadows Orthodontics in Castle Rock, Colorado. There are two locations to serve the residents of the Castle Rock area, one in the Meadows, and one near Founders/Terrain. 

Image source: healthline24x7.com

Which Type of Braces or Aligners Should I Use to Straighten My Teeth?

Getting your teeth aligned can change your life in so many positive ways. At Meadows Orthodontics we talk with new patients every day who are both excited and nervous about which type of braces (or invisalign) they should choose. We work with each patient individually to help decide what will be best for their bite, and what will fit best into their lifestyle. The most important thing to remember is that braces, invisalign, and orthodontic devices of any type are only as good as the orthodontist using them. We all have different preferences-in general it is the decisions we make and mechanics we use that determine the quality of your outcome, not the braces themselves! Here is a guide to the orthodontic choices that are currently available.

braces 22Metal Braces:  These are the “traditional” braces that most of us think of when we picture braces. Metal braces are very popular because of their small size and low profile, and the fact that kids (and some adults) love choosing the color ties that hold the wire part of the braces in. At every appointment with us, these color ties are changed, and there is an opportunity to “refresh” the look of the braces.

  • Effectiveness:  Braces of all types (metal, ceramic, and self-ligating) are usually the gold standard in getting the best results for most types of bite and misalignment problems.
  • Esthetics:  Metal braces bring the bold fun factor, as kids really look forward to the thousands of color combinations that can be used with the ties. Silver and clear ties can be used if you want a less colorful look. They are very noticeable though, and adults and older teens often will often opt for a less noticeable option.
  • Relative cost: Metal braces offer a great value as far the unbeatable result you will get for the relatively lower investment in the actual braces.

downloadCeramic Braces: Often called “clear braces”, these braces are made of ceramic, composite or crystal materials. They are usually clear or tooth colored, and look amazing.

  • Effectiveness: For the majority of patients, ceramic braces are usually just as effective as metal braces and the same great results are expected. There are some exceptions: For patients with deep bites (lower teeth that are largely hidden behind the upper teeth) or with patients that grind their teeth heavily we have to decide individually if ceramics can be worn on the lower teeth. The goal is to prevent wear on the biting edges of the upper teeth in these cases. Even these patients can usually wear ceramics on their upper teeth though.
  • Esthetics: Ceramic braces are know for their discreet, sophisticated look that adults and older teens often gravitate towards. These braces are the best option for a highly esthetic look, with all the mechanical advantages of traditional braces. Because they are clear or tooth colored, we have patients that often go for months before co-workers notice they are wearing them!
  • Relative cost: Ceramics braces usually cost more to manufacture than metal braces, and depending on the case may cost slightly more than traditional braces (although usually not as much as invisalign).

images (1)Self-ligating braces: Common brands of self-ligating braces include Smart-clip, Damon, Harmony, and Speed, among many others. Self-ligating braces use various types of sliding doors or clips to hold the archwire into the braces instead of the color ties, and can be made of metal, ceramics, or a combination of the two. Although these braces work just as well as traditional or ceramic braces, patients must be very wary of marketing claims made by the manufacturers and dental providers regarding the “advantages” of these braces. Most credible, peer-reviewed research (summarized by a recent article by the American Association of Orthodontists’ Council of Scientific Affairs in the American Journal of Orthodontics and Dentofacial Orthopedics), is showing that there is no statistical difference between traditional braces and self-ligating braces in overall treatment time, faster alignment, reduced forces, patient comfort, or improved hygiene- basically, all the important reasons these brackets have been marketed. However, these are all great brackets, and I offer these brackets in my practice- I am just very up front with my patients that they only differ by the way the braces hold onto the archwire, they cost more, and results are the same as traditional or ceramic braces (the vast majority of my patients choose traditional or ceramic after learning this!).

  • Effectiveness: Self ligating brackets are just as effective as traditional braces, and the same treatment time and results can be expected.
  • Esthetics: These braces can be metal, ceramic, or a mixture of the two, and the size varies depending on the manufacturer.
  • Relative cost: The moving parts within these braces make manufacturing them more costly, and this may be passed on to the consumer. Like always , this varies case by case.

imagesInvisalign:  Invisalign is a series of clear plastic trays that are changed at a prescribed period of time in order to make many incremental movements to your teeth. There are many things that invisalign does as well as braces, and some things that it struggles with in comparison. For the things that invisalign tends to have a harder time correcting, orthodontists must use adjuncts that would normally be used with braces: elastics, bite planes, in addition to what are called “attachments”, or composite bumps that are bonded to the surface of the teeth in order for the trays to “grip” onto. Also, patients and parents must consider that the ability to remove the trays at any time is both invisalign’s greatest advantage (for eating, brushing, special events such as playing an instrument in concert, etc…), and its greatest disadvantage (if they are not worn consistantly, they do not work!).

  • Effectiveness: After years of using invisalign and braces, I have a good sense which bites are corrected really well with invisalign, and which ones are not. Of all the treatment types described here, Invisalign is the most important for this early case selection and identification of limitations of treatment. I actually prefer to use invisalign on some cases, and on others would not attempt to use it. I will discuss the pros and cons at your initial appointment!
  • Esthetics: One of the advantages of invisalign is the clear nature of the trays, and often it is close to being undetectable to the public. However, it is very common to need the bonded attachments to your teeth. Some patients would rather have ceramic braces than these attachments, while others do not mind them at all. It is important to be comfortable with what they will look like before we get started, and I will review with you where each attachment will be, and if rubber bands will needed.
  • Relative cost: On the average, invisalign tends to cost more than the other options, and this reflects the relatively large fee we pay in order to use invisalign’s technology. Again, there is a large variation in cost due to case complexity and expected treatment time.

Alignment with retainers:  Minor movements are possible within retainers that are made by our office. The key word is “minor”, as retainers are designed to retain, or hold the teeth in place. Small areas of pressure, or even a spring-loaded wire  can be added within a retainer that can push an area of a tooth a small distance.

  • Effectiveness: Only for very minor movements, and the retainer must be worn steadily for the desired movements to occur.
  • Esthetics: It appears that you are wearing your retainer, whether it be a clear vacuum formed tray, or a Hawley type retainer with acrylic and wire across the front teeth.
  • Relative cost: The cost is usually proportionate to the minor movement that we are trying to achieve.

Call me at any time at Meadows Orthodontics, and we can discuss which option is best for you or your child!

Dr. Dan Rejman is a board certified orthodontic specialist, with two Castle Rock locations. Our original location in the Meadows right next to Einstein’s/Caribou, and our new location near Founders and Terrain, in the Founders marketplace.

Thinking About Becoming an Orthodontist?

This week we we were happy to welcome a local high school student who will be working part time in our office. She has shown interest in becoming an orthodontist in the future, and wants to jump right in and see first hand what my day to day life is like at Meadows Orthodontics. I worked as a dental assistant when I was curious about the dental profession, so I think it is really neat that she wants to work with us at such a young age (much younger than when I started thinking about my long term career!) I thought I would write a bit about my profession and experiences as an orthodontist, and hopefully it may help kids who are considering a career as an orthodontist.

I think whatIMG_3643 our new friend is doing is the best way to see if orthodontics is a good fit. A question I am asked frequently is, “How can you work in people’s mouths all day long?” I explain to kids that the majority of health care professions deal with the human body, whether it be the mouth, feet, growths on skin, backs/spines, etc… I think it is important to work part time or as an intern in the field that you are considering, because yes, you may not be comfortable working in these situations. Nothing worse than going to more than 8-12 years of college before finding out that mouths, eyeballs, or rashes skeeve you out! My brother in-law is an ER doc, and although it is a really interesting job, it is not something that I would be comfortable with day in and day out. For me, working with peoples teeth is just the opposite- it is just a natural fit for me.

Another thing to consider is how involved and visible you want to be within your community. When I go to the grocery store, out to eat, or run an errand in Castle Rock, I almost always run into and end up talking with a number of patients or their parents. As an orthodontist you get to know thousands of people- it is not the best job for introverted personalities! I personally like seeing people I know all over town, but if you prefer to be more “anonymous”, this profession may not be a good fit, or you may consider living in another community from where you work.

During the workday itself, I there is rarely a moment when I am not talking to patients, kids, parents, or my staff. It is a job where you are “on” nearly all the time, as far as being in front of people (my wife was a teacher and she says it is similar in this regard). Again, I really like this about my career, while others may find it exhausting. Really think about your personality and if this seems like a fit for you.

Other components of my profession include:

Creativity- there is rarely a day that I am not challenged to figure out a mechanical, physical, aesthetic, or administrative issue that presents itself.

Working with your hands/artistry: I gravitated to orthodontics largely due to the artistic component that is involved with aligning peoples teeth and creating an optimal aesthetic appearance. This is a passion for me personally, and is what makes me love going to work each day!

Entrepreneurship: Most orthodontists own their own businesses, and there is no preparation or training for this part of my job in all the schooling I have done. It is learn as you go, and luckily I have my wife who has helped tremendously with the day -to -day adventures of running a practice. This includes hiring, training and managing a staff of assistants and administrators, doing payroll, taxes, filing and checking insurance claims, advertising, paying bills, keeping up with and enforcing HIPPA and OSHA regulations, maintaining professional and business insurances, licences….it goes on and on! Running a business is hard work (but also rewarding) and having the right people around you to help has been the key for me. If this is really unappealing to you, there are options to become an orthodontist and work for larger, corporate dental chains that allow you to largely not be involved with the administrative or business aspects of dental care.

As always, I welcome anybody young or old who is interested in a career in orthodontics to come in and speak with me. I did not start dental school until I was 29, so it is never too late!

Dr. Dan Rejman is a board certified orthodontist who is the owner of Meadows Orthodontics in Castle Rock, Colorado. He has two offices located within Castle Rock, and is a specialist in braces and invisalign for children, teens and adults.

 

Our New Broncos Mural Room, and Congratulations Denver for Winning Super Bowl 50!

Meadows Orthodontics second location in Castle Rock is now officially open in the Founders, Terrain, Pradera, and Crystal Valley area of Castle Rock, in the Founders Marketplace! I will post pictures soon of the new office (it is amazing!), but after the Broncos’ Super Bowl win this past Sunday, I wanted to get a picture up of the Mural I have been painting in our new treatment room, as well as some additional pictures of Broncos Spirit from around town. It has been quite an amazing week, and our staff is proud to be from Castle Rock and the Denver area!

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This is the new treatment room where we will be placing and removing braces, seeing new patients, and celebrating Denver’s win in Super Bowl 50! What a nice coincidence that I got this far painting the mural just before the big game. I still have a ways to go, but the scene from inside Sports Authority Field is looking better and better!

 

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Broncos orange, blue and white were VERY popular the last two weeks as color choices for ties on braces. This is my son showing off his colors (I think he needs to get brushing!).

 

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This is the sculpture heading east on 5th in downtown Castle Rock. I’m not one for messing with sculptures and art, but this orange shirt placed on the cowboy was playful, fun, and showed the spirit we all had this past week!

 

 

 

 

I’ve been wearing that tie way too much this past week.

 

 

 

My boxer, Stanley, with his Bronco jersey!

 

 

 

 

 

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Amazingly, we had what is known as a “Broncos Sky” Saturday night before the game, and this proved to be a good omen. Well, it has been a fun several weeks at Meadows Orthodontics and in Broncos Country. I will get pictures up of the new office soon.

 

 

 

Dr. Dan Rejman is one of the few orthodontists that are Board Certified in Douglas County and the Castle Rock, CO area. For a list of orthodontists in your area that are Board Certified, go to AmericanBoardOrtho.com

 

We are Opening Our Second Location in Founders Marketplace Soon!

IMG_3396We are excited to be opening our second office in Castle Rock! In addition to our office in the Meadows, Meadows Orthodontics will be open the first week of February in the Founders Marketplace on Ridge Road (near King Soopers). Why are we opening two locations in Castle Rock? Convenience! Starting orthodontic treatment usually means seeing us every month or two for a year and a half  for adjustment visits for braces and Invisalign. Most all Castle Rock area residents have noticed how increasingly challenging and time consuming it can be to cross I-25 with all the new construction (and soon to be Mall!). We decided to make our offices super convenient for residents of both sides of I-25. Our original West office in the Meadows near Einsteins/Carribou  is really close for residents of the Meadows, Red Hawk, etc…, while the new East office in Founders Marketplace will be close to Terrain, the Founders, Crystal Valley Ranch, Plum Creek, and downtown areas. the East office will also be much closer for our FullSizeRenderIMG_3406patients from Elizabeth, Franktown and Parker.

Construction started several months ago, and is nearing completion (I am
posting several pictures of the progress that is being made). The new office is very similar in size to the Meadows location, but has a slightly different layout and feel. One nice thing about opening this location is that it has inspired me to start painting like crazy again. I am trying to get 4-6 new oil paintings completed and on the walls before the grand opening the first week of February. Here are a couple pictures of the progress of the paintings (the one with the plants is 36″x 36″ and is taking a IMG_3432while- I am having dreams about swiss chard!).

We hope you will enjoy the new location and the convenience it will provide busy families who have kids in braces! I will follow up with more pictures when the office is complete.

 

Dr. Dan Rejman is a Board Certified Orthodontic specialist who lives and practices in Castle Rock, Colorado. Meadows Orthodontics specializes in Braces, Clear Braces, and Invisalign.