Dr. Donna S. Bautista, DDS, completed her undergraduate studies at the University of California, San Diego with a bachelor of arts in biochemistry and cell biology. During her time at UC San Diego, she was involved in basic research including studying processes related to DNA transcription in the field of molecular biology. Upon graduation, she went on to attend dental school at the University of California, San Francisco. In addition to her formal dental training, she provided dental care for underserved communities in the Bay Area through clinics and health fairs. She also worked toward mentoring high school students interested in the field of dentistry.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dental braces are devices that are placed directly on teeth in order to move them. For most of us, braces are the most common method for achieving optimally aligned teeth. Aside from straightening teeth, braces are used to improve the relationship of how our teeth come together between the upper and lower jaws. Braces for tooth movement fall under the dental specialty of “orthodontics” which is the study and treatment of improper bites (malocclusion). Orthodontic treatment with braces is used for cosmetic as well as functional improvement in respect to teeth position.
The “braces” are the actual devices that are attached to teeth. They usually consist of “brackets” that are bonded to the teeth and a metal wire that is inserted into the brackets. The metal wires are “tightened” and work together with the brackets to move teeth into the desired positions. There are other components that are also used in conjunction with braces to move teeth, jaw, and bone such as headgear and expansion devices. While orthodontics work on teeth movement, it sometimes involves working with one's facial bone growth to achieve favorable jaw dimensions and relationship.
Braces can be for any age group, but there are optimal times to begin treatment. These days, it is recommended that children have an orthodontic evaluation at the age of 7 to determine if early intervention is needed or advantageous. If recommended, early intervention optimizes results by taking advantage of a child's skeletal bone growth and may require two-phase orthodontic treatment. The first phase (“phase-one”) is considered interceptive orthodontic treatment as it addresses overcrowding of teeth or bite problems at an early age. As an example of interceptive treatment, a narrow upper jaw that has crowded teeth and does not fit correctly with the lower jaw can be widened with an expansion device called a “palatal expander.” This lets the upper jaw line up better with the lower jaw and allows room for upper teeth to fit in alignment. Widening the palate can only occur during a small window of time in a growing child before the bone becomes too developed to change. During “phase-one,” braces may or may not be used depending on the specific situation. After “phase-one,” there is a resting period to allow most or all of the permanent teeth to come in.
Around the age of 12 or 13, “phase-two” treatment may begin. During this phase, the alignment of all the permanent teeth is addressed using full braces.
If the window of time for two-phase orthodontic treatment has already passed, results can still be achieved with only one phase of treatment. However, if there is significant crowding of teeth, dental extractions may be required to create room for teeth to move into alignment. Another method for creating room for teeth movement is called “interproximal reduction” (IPR). IPR involves minimal removal of tooth structure on the sides of the teeth to create more room. This method is limited to mild teeth crowding.
Essentially, anyone who desires to have straighter teeth or improve their bite may be a good candidate for braces. A thorough evaluation with a qualified clinician is very important in determining whether one is a good candidate for braces.
Hyperdontia is an oral condition characterized by having an excess number of teeth. The standard number of primary teeth is 20 and the standard number of permanent teeth is 32. Primary teeth are the first set of teeth that erupt in a person's mouth, generally by the age of 36 months, and are shed by the time the person is about 12 years old. Permanent teeth then take the place of the primary teeth and are usually fully erupted by the time the person reaches 21 years of age. A person who develops more than 20 primary teeth or more than 32 permanent teeth has hyperdontia. The additional teeth are referred to as supernumerary teeth.