Thanks Tekya!

Costs are hard to quote, because there are many variables that go into determining treatment costs. The complexity of the case is a major determinant. Then some patients have insurance that reduces the cost. Some insurance benefits can be $1500 - $2000. Some PPO insurance plans limit the fee that the a participating orthodontist can charge often reducing fees by 20-30%. The Journal of Clinical Orthodontist surveys orthodontists and list average case fees by region in the United States. I've seen average fees in recent surveys being in the $6000 + range for permanent dentition full cases. This is the full fee-for-service cost assuming no insurance benefits or reduced fee schedules. Upscale markets like Manhattan, Los Angeles or Washington DC could be considerably more. Most orthodontists offer financing plans that can be customized making orthodontic treatment affordable for almost any budget. A beautiful healthy smile is one of the best investments you can make for yourself and/or your children!

Hey Sam. Not sure how you could reduce that severe dento-alveolar protrusion with an expander. Do you have any examples of this being done? Dr. B

@@barronorthodontics445 yes, I do, there are many cases that Dr, mike Mew has brought the maxilla forward creating space for the teeth with protrusion. Removing teeth is so last decade, and unnecessary.

Hi jL. Great questions. When properly applied, Low force/ Low friction braces like the Damon System do deliver less force to the teeth. This has been shown in a variety of studies. In contrast, studies have shown that heavy forces are associated with root resorption. In my 25-year experience using the Damon System I have seen very few patients with root resorption post-treatment. The few patient's that did experience some, typically had a history of prior trauma or injury to the teeth, or were treated previously with heavy force braces. As for stability, it takes many studies with large numbers of subjects to definitively make statistically valid claims about stability. Though I can say that, in my realm of experience, stability in my practice is superior to the long term results before I used the Damon System. This may have something to do with the retention procedures that I've been using since beginning the Damon System. I place bonded wire retainers on the back of the upper and lower front teeth that stay on for at least 2 years post-treatment. In addition, patients wear clear removable retainers evenings and sleeping. Dr. B

@@barronorthodontics445 thanks for the detailed explanation. So after Damon braces, do we have to wear retainer for life (every night during sleep) ? Or is it possible to reduce the frequency of wearing to maybe 1-2 nights per week after a number of years post-braces.

Hi jL: What I typically tell patients is this: The first 2 years post treatment is a critical time for stability. We'd like to leave the bonded retainer wires on and wear the clear removable retainers 10-12 hours per day, usually evenings and sleeping. After 2 years, the bonded lingual wires can be removed if the patient desires. I recommend leaving the bonded wire retainers in longer if the patient started with significant anterior crowding or spacing. Some patients prefer to leave the bonded retainers in long-term, and I'm OK with it. I tell the adolescent patients to keep wearing the removable clear retainers while sleeping through the high school years. After 2 years I instruct adults to go to two nights per week with the removable retainers, with discretion- if they start to fit tight it means teeth are trying to shift, then wear them more than two days. Long-term, years down the road, they might try 1 or 2 nights per month (with discretion.) It is a long-term "insurance policy" that teeth won't shift in any major way.

@@barronorthodontics445 i saw some people feedback that wearing retainers post braces cause them to have gum recession. What is your opinion about this ? What can we do to reduce this gum recession risk when wearing retainers ?

@@jL-zc4bw Properly fabricated and properly fitting retainers will not cause recession.

Much appreciated!

Hi Lee. Thanks for commenting. I thought it was incredible, too when I first saw it on this patient over 3 years ago. Now it is fairly routine. It requires selecting the right patient. One who can tolerate being open on the bite ramps for 8 weeks and who will also wear the elastics full time except when eating and brushing. I don't have 30 years of stability to show with this technique, however, I just posted a video on this channel titled - Damon Ultima Braces: Straight Teeth That Stay Straight - showing remarkable post-treatment stability for this patient 3 years later. Check it out if you haven't already. Dr. B

I might add, I was 40 years old when first treated. I'm now 76. Haha

Hi Imogen: It is not possible to predict the length of treatment for a patient that I haven't seen and completed a formal diagnosis and treatment plan on. Furthermore, other factors such as patient compliance with appointments and breakage and elastic wear, or the efficiency of the providing doctor can affect the length of treatment. As the video states the average length of treatment with braces as reported in studies is around 22 months. Though there are no published studies, yet, that I am aware of to support that the Damon Ultima System can treat cases faster, in my realm of experience, which includes being one of the first group of orthodontists in the world using the system, a significant amount of cases treated in my office finish between 14 - 18 and months of treatment with the Damon Ultima System. Many will finish even sooner, especially compliant patients with less severe malocclusions. Hope that helps and good luck with your treatment! Dr. B

Excellent question! Non-surgical, pure unilateral, (one-side) jaw widening is technically not possible to achieve. When we're talking about "jaw" widening in this context, we're referring to dento-alveolar widening of the dentition and the alveolar bone that immediately surrounds the roots of the teeth. The dento-alveolus "sits" on the basal bone of the maxilla & mandible. Unilateral dentoalveolar widening can appear to occur, however, in the following example: If the dental arch form is collapsed on one side of the upper arch, where posterior teeth are tipped lingually (toward the tongue-side) causing a cross bite with the lower opposing teeth, simply uprighting the teeth and creating a symmetric arch form can achieve uni-lateral "widening" and correction of the posterior cross bite. This can be supported by posterior cross elastic wear on the side of the unilateral posterior cross bite. The elastics are worn from lingual (inside) attachments on the upper posterior teeth to buccal (outside) attachments on the opposing lower posterior teeth. Hope that helps to answer your question. Dr. B

@@barronorthodontics445 Thank you for the reply! What about Invisalign for uni lateral jaw widening doctor?

@@sanskritibisht1356 Regarding clear aligners- the same is true as above for braces. Dr. B

Hi George: It is often difficult to establish a cause and effect regarding prior orthodontic treatment and TMD (Temporo-Mandibular Joint Disfunction) because TMD usually has a multi-factorial etiology. In general, if a patient presents with TMD, it is important to have a work-up with a doctor competent in TMD & Myofacial pain diagnosis and treatment. There are some dentists out there who have undertaken substantial training in this area and whom have limited their practices to TMD/Myofacial pain. Not every area has such doctors, so an oral surgeon is the next best option. It is important to establish your true jaw position (technically known as centric relation) before embarking on tooth movement. It is also important to have a multi-specialty treatment team consisting of general dentist, TMD/Myofacial pain clinician, and orthodontist for coordinated, optimized treatment. A corrected bite to your true jaw position typically will improve TMJ stability which can lead to an improvement in symptoms. Dr. B

Hi r8222. Thank you for your comments. The anterior teeth were corrected to age, race and sex normal values. The significant bimaxillary protrusion, which was the patient's chief complaint, was reduced according to her preferences. A non-extraction approach (or no treatment at all - which was discussed) would have: a) Not addressed her chief complaint, b) left her with a significant bimaxillary protrusion, and c) left her with missing upper first bicuspids that would have required replacement with costly dental implants. Dr. B

Thanks Peggy. Dr. Damon is certainly a rockstar in orthodontics! Dr. B

Yes. "early" inter arch elastics can be used on the initial NiTi wires as long as they are short and light force, typically 2 oz. Dr. B

sir how long it should be worn

and how long have you placed the bite turbo sir

@@dentalpediadr.leeseasydent182 24/7 except eating and brushing

@@dentalpediadr.leeseasydent182 I leave the bite turbos until enough bite opening has been achieved to prevent the patient from biting on the lower braces. It varies from patient to patient. Generally 4 to 6 months.

Hi Stephanie: I do not have a pre and post treatment frontal cephalometric films nor Frontal CBCTs. That would be the only way to definitively answer the question. Significant improvement in facial asymmetry would require jaw surgery. The patient was unwilling to accept surgery and was willing to accept the asymmetry. Dr. B

Hi Merril: Using the Damon System of low friction, low force braces we can treat cases with significant crowding without extracting teeth as you've seen in my videos, however, there are crowded cases that still require extraction. If the teeth are protruded forward excessively, or if there is thin bone surrounding the teeth, then removal of teeth are necessary. Consultation with an experienced Damon provider to assess your specific case will detect these issues. Dr. B

Hi: Yes- the Damon System of low friction and low force braces can achieve widening of the teeth and bone that surrounds your teeth. In adults with extremely severe constriction of the upper jaw may require surgically assisted expansion, though. Consult with an orthodontist experienced with the Damon System to evaluate your specific condition. Dr. B

Hi pinaka23: Yes the Damon System is appropriate for adults of all ages. Lighter force is particularly important in adult patients. Patients of all ages will good dental health do not have to worry about tooth loss caused by treatment, unless they have significant pre-treatment bone loss due to periodontal disease, or significant pre-treatment root resorption or short roots. Consultation with your general dentist prior to orthodontic tooth movement is advised. If your dentist or orthodontist detect any problems in this regard, they may have you see a specialist such as a Periodontist or Endodontist before beginning tooth movement.

Thank you Dr Barron

Dr Barron- I have one more question- we have Brava Brius braces - like lingual braces but no wire - they say it moves individual teeth so shorter times and less painful - do you know of any advantages of the Damon self lighting braces over the brius - again for women in late 50 to early 60 - thank you for time

@@pinaka23 I am not familiar with Brava Brius braces

Hi HSINDU: Great question! Any time that you move teeth with any technique, you must provide some type of retention to minimize relapse. In my 20 years of using the Damon System, even in cases with significant lateral development or widening of the dental arches, it is no less stable than any technique that I've ever used. Regarding stability of upper arch widening with the Damon System, Dr. Damon hypothesized that when the upper arch is widened, the tongue repositions more superiorly in the oral cavity and can help stabilize the expansion. Dr. B

Hi Zbeast: It is amazing how quickly you can notice results during the first few months of treatment. I'm glad to hear that you are doing well and noticing improvements! Dr. B

Hello: Yes, I plan on adding more "How To" content for my orthodontic colleagues in the near future. Dr. B

Hi Kevin: Some cases are more complex than others. Some people have slower tooth movement. Some cases require slower tooth movement. There are a lot of variables. In general I've found treatment with Damon Ultima braces is significantly faster in most cases. Dr. B

@@barronorthodontics445 Ya, I like them because less pain than traditional and widen the smile, worth it!!!!!

The most important thing at least to me is that Damon Ultima is definitely the fastest option with also the best possible teeth correction.

I agree!!!@@mma48578

Hi David. It is a very small amount and does not damage the teeth, nor make them more susceptible to cavities. Dr. B

It has been my experience that torque control with the new Damon Ultima Appliance is superior to all other fixed appliances. Establishing proper torque is important when treating incisor protrusion. Significant reduction in protrusion generally requires spacing in the arch in order to retract the teeth. If there is no space in the arch, or worse, if there is crowding along with protrusion, often extraction of teeth is necessary. Dr. B

I have the same exact question! Sucks no one has answered your question.

Hi @mma: Yes, Damon Ultima can widen the alveolar bone the same as earlier versions of the Damon System. Dr. B

@@barronorthodontics445 ok, thank you for your response.

Hi Ivette. Great question! I can design cut-outs in the aligners for elastics to hook to, and I can bond buttons on teeth to attach the elastics. I place small tooth colored retentive attachments on adjacent teeth to prevent the aligners from lifting with the elastic force. Dr. B

Hi TrueFact92. Yes, IPR was performed on this patient's anterior teeth. Dr. B

Hi Erica. Thanks for your feedback and comments. You bring up an important point for discussion. I was careful to title this video "Why I use FEWER Expanders with the Damon System," because there are severe situations where I do use them. I believe that routine use of expanders, that split the maxillary mid-palatal suture, is not necessary in many cases, when upper arch development can be achieved by less invasive means. This is why an accurate diagnosis and clinical experience is important. Your case may have been in that severe category where the prognosis for a stable correction was not favorable. There are other factors involved as well. If your back teeth were tipped out laterally, that is not so stable and prone to relapse. In some cases, if jaw growth continues after the treatment has been completed, your bite has a greater tendency to return to its original form- so timing is important. In regard to timing - you mentioned that you were a teen when your initial treatment was done. Following puberty, the mid-palatal suture closes and is not amenable to separation with an expander. If this was the case, your orthodontist may have attempted to develop your upper jaw to try and avoid surgery. In all cases following a proper post-treatment retention program, with follow-up appointments, is important for stability of the correction. Even when a surgical widening is done in an adult, like in your present case, a proper retention program is critical to maintain stability. Thanks again for sharing your experience, viewers will benefit from it. Dr. B

Just a palate expander if your planning on widening your maxilla. The surgery will just make the process quicker but the expander will work just at a slower process but still does wonders

@@MMA-rc3mv it doesn’t work for adults unfortunately :(

@@thekillererica who told you it doesn't work for adults.....because I'm 33 yrs old and have a palate expander braces right now and its doing wonders it's widening my maxillia arch it just take a slower process then the surgery but it will get the job done just slower.

Hi Jasmine. That's great to hear! Go to Damonbraces.com and click on the Find a Doctor link to find a Damon provider near you. Dr. B

Dis you get your braces? I got my Damon braces put in on the 19th of December 2023.

@@barronorthodontics445 how often do they need adjustment? Would you take an out of state patient?

@@Starts_like_this Hi K. Thanks for commenting. Full treatment with Damon Passive Self-Ligation braces typically require 8-10 week appointments for the bulk of treatment. Sometimes when space closure is being done with elastomeric chain, shorter appointment intervals may be necessary in the 4-5 week range. Though I have several patients that travel long distances to be treated in my office, it can be problematic if, for instance, a bracket breaks or a wire pokes and an emergency appointment is required. For the patient's convenience, it is preferable to be treated by a doc in close proximity to where they live. A good place to start a search for a doc is on damonbraces.com. Use the Find a Doctor link for your area. Dr. B

Hi Deja. It is very hard to give an accurate opinion without examining a patient in person. If its a question of extraction versus non-extraction in a crowded cases, I would need at a minimum, good photos of the teeth & bite, a panoramic x-ray and a lateral cephalometric x-ray. You could go to my website barronbraces.com and through the virtual consult pop-up upload these for me to review. Dr. B

When properly used, they definitely can! Dr. B

​@@barronorthodontics445nah never mind I have regular braces ans my ortho said no special appliance on the palate even tho he saw my photos and sees I have A narrow upper palate and he said it will help

Mine is wider for sure at 52 yr old

Its not possible to give an opinion on a specific case without examining the patient. It also depends on the expertise and experience of your orthodontist with the Damon System. Dr. B

@@barronorthodontics445 it doesn't matter anymore I have traditional braces without an expander and he said the archwire will widen it and my parents won't let me get a second opinion and they will get mad. For now I don't know what to do I'm stuck with a narrow palate and I livs in israel

Hi CB. Yes braces can fix those problems. Studies have shown that the average length of treatment for traditional braces is 22.4 months. Damon Ultima braces are consistently faster in my practice. Dr. B

Hi. Yes, when the dental arches are widened, there is typically noticeable widening of the mid face. Dr. B

@@barronorthodontics445 thanks for the reply Dr.Barron..🥰

Hi Dr. S. No bother at all. You could wait to bond second molars, but then you will have to drop back to lighter wires to engage them and then work your way back up to larger wires. I find it more efficient to bond the second molars in the beginning. I don't engage them until the 018 CN wire. Then I can progress through my wire sequences uninterrupted. It probably saves 2 appointments. As for the turbos, very many cases, even without deep bites, crossbites (or open bites where molar intrusion is desirable) require turbos because of impingement of the bite on the lower second molar brackets. There is also an argument that disarticulation, in general, facilitates tooth movement by eliminating intercuspation which can have an inhibitory effect on movement. Just be mindful of molar turbos in deep bite cases. If left in place for too long, they will work against your deep bite correction. I hope that explanation is helpful! Dr. B

@@barronorthodontics445 thank you very much Dr for valuable information that helped me alot in my research .About bite turbos if the case required classII elastic or class III elastic can I use it as anchorage unit to maintain the vertical dimension ?

@@barronorthodontics445 Many thanks and appreciation for you Dr

Hi Dr. Sarah. The turbos will increase the vertical dimension and this is often desirable in deep bite cases. Then the inter- arch elastics can erupt posterior teeth to the new vertical dimension. It is not desirable in vertical/open bite cases to erupt the posterior teeth with inter-arch elastics. Dr. B@@dr.sarahalkhateeb8991

@@barronorthodontics445 Thank you very much Dr for the valuable information

Thanks Barb! With the Spark technology and a super compliant patient, remarkable results can be achieved!