When you have a malocclusion, that means your teeth, lips and/or jaws don't line up the way they should. As a result, your teeth may be crooked, your bite may not work correctly and your jaws may look unbalanced.

To fix bad bites, orthodontists - dentists who are specially trained - use braces and other corrective procedures, including materials often called "appliances" to achieve tooth and jaw alignment. This correction of the teeth and their supportive structures makes for a healthy, attractive smile.

It takes many years to become an orthodontist and the educational requirements are demanding.

Only dentists who have successfully completed advanced specialty education programs may call themselves orthodontists. Dr. Gittess is Certified as a Diplomate of the American Board of Orthodontists, an orthodontist with special recognition by other orthodontists.

Other malocclusions are acquired. In other words, they develop over time. They can be caused by thumb- or finger-sucking, mouth breathing, dental disease, abnormal swallowing, poor dental hygiene, the early or late loss of baby (primary) teeth, loss of permanent teeth, accidents, poor nutrition, or some medical problems.

Sometimes, an inherited malocclusion is complicated by an acquired problem. But, whatever the cause, we are usually able to treat most conditions successfully.

Then there's the emotional side of an unattractive smile. When you're not confident in the way you look, your self-esteem suffers. Children and adults whose malocclusions are left untreated may go through life feeling self-conscious, hiding their smiles with tight lips or a protective hand.

Finally, without treatment, many problems become worse. Orthodontic treatment to correct a problem may prove less costly than the additional dental care required to treat the more serious problems that can develop in later years.

It is for this reason, that the American Association of Orthodontists recommends that all children get an orthodontic screening no later than age 7. While your child's teeth may appear to be straight, there may be problems that only an orthodontist can detect. Of course, this check-up may reveal that your child's bite is fine.

Even if a problem is detected, we may not recommend immediate treatment. Chances are we will take the "wait and see" approach, periodically monitoring your child's jaw growth and dental development. Dr. Gittess will determine the right time for treatment to begin in order to achieve the best results.

In some cases, Dr. Gittess may find a problem that can benefit from early treatment. Early treatment (also known as Phase I or interceptive treatment) may prevent more serious problems from developing and may make treatment at a later age shorter and less complicated. Treatment typically involves braces, or appliances that may be removable, to guide the growth of young bones and create the optimum environment for the emerging permanent teeth. In most Early Treatment cases, Dr. Gittess will be able to achieve results that wouldn't be possible once the face and jaws have finished growing.

We provide custom-made braces, retainers or other corrective appliances, according to the problem being treated. Whether they're removable or "fixed" into the mouth, whether they're made of metal, ceramic or plastic, all orthodontic appliances have a common purpose - to use gentle pressure to move teeth and jaws into their proper positions. Today's patients benefit from techniques and materials that enhance the comfort of orthodontic treatment.

Patients who brush and floss thoroughly and regularly; avoid hard and sticky foods; wear their rubber bands and/or headgear as instructed; and keep their appointments usually finish treatment on-time with good results.

After the braces are removed, most patients wear a retainer for some time to keep or "retain" the teeth in their new positions. We will determine how long the retainer needs to be worn. Most patients remain under our supervision during the retention phase to ensure that the teeth stay properly aligned.