Initial Visit

What can you expect during your initial visit?
We’d like to think of your first visit as a get-to-know session: we believe it’s important for you to get to know our team and the services we offer; and it is crucial for us to get to know you, your concerns, and the condition of your jaws and teeth.

At Royal York Orthodontics, we believe that communication is key. We are more than happy to answer all of your general concerns and questions about orthodontic care, including braces, during the first visit. We will conduct an examination of the general condition of your jaws and teeth.

If, together, we determine that it’s necessary to proceed with treatment, we’ll book an appointment to obtain full diagnostic records. As well, we may allot time to take X-rays, photographs, and/or moulds (impressions) of your teeth during that first visit. The goal of this appointment is to obtain all the measurements and records required for our orthodontists to decide the best treatment plan for you.

For younger patients who may not need immediate treatment, we’ll set up a recall appointment, which will allow us to monitor your child’s jaw growth and development.

Finally, we’ll draft a letter outlining our preliminary findings, which will then be forwarded to both you and your regular dentist. There is no charge for the initial visit and you do not require a direct referral to set up an initial evaluation.

We agree with the American Association of Orthodontists’ recommendation that children be evaluated at age seven, even if your general dentist has not made such a referral. We believe that this is the ideal time to begin monitoring your child’s growth patterns, which will help us recognize the development of early problems, including small jaw structure and/or improper bites. Some children will benefit from early interceptive treatment. For children who do not require early treatment, full orthodontic care can be started later and accomplished in one, comprehensive, phase.

Office Policies

Booking/Cancelling Appointments
At Royal York Orthodontics, we believe in providing our customers with quality service in a timely and courteous manner. We work to ensure that appointments are appropriate to the treatment required, but we also ask our clients to respect other patients by being on time for their appointments.

We set appointments so that our office — and your treatments — run smoothly and efficiently. In some cases, such as when we’re placing orthodontic appliances like brackets, expanders, and seating Invisalign aligners with attachments, those appointments can take anywhere from 30 minutes to two hours. Other follow-up visits can take as little as 20 minutes.

We kindly ask that all clients show up in advance of their appointments. All appointments will be confirmed with an email or telephone reminder for your convenience. We also request at least 24-hour notice should you need to cancel your appointment.

Feel free to contact Royal York Orthodontics to book your next appointment. We will do our best to accommodate your preferred time and date wherever possible.

Emergencies

It would be nice if orthodontic emergencies could be scheduled in advance or if they occurred only during normal business hours. We know that this is just not the case — and we know that emergencies can be extremely distressing to you.

At Royal York Orthodontics, we set aside specific times within our schedule for emergency appointments for such issues as tissue irritation from appliances or retainers; poking wires causing discomfort; loose or broken brackets or bands; and/or lost or broken appliances or retainers.. We ask that you call our office to see if there’s an opportunity for you to come in.

In certain cases, such as when the office is closed for holidays, we can arrange for one of our staff members to come in to perform urgent care on our patients. We check our voice mail and email messages (Office Manager: jacquiekiss@royalyorkortho.com & Dr. Sky Naslenas: drskynaslenas@royalyorkortho.com) regularly on these days off and are committed to ensuring the satisfaction and comfort of our customers.

Financial Considerations

We know that orthodontic care can be stressful enough, even without bringing up the financial considerations. The cost of orthodontic treatment depends on the severity of your issue and the length of time required to complete the treatment. At Royal York Orthodontics, we’re committed to working with you to develop a treatment plan that’s comfortable — both physically and financially.

We offer various payment options; we will assist you with preparing the necessary forms for coverage approval should you have orthodontic insurance; and, for your convenience, we accept payment by cash, cheque, Visa, Master-card, and debit card.

Please contact us at your earliest convenience to discuss your options. At Royal York Orthodontics, we strongly believe that everyone is entitled to a healthy, beautiful smile.

Emergencies

We know that emergencies don’t always happen during regular business hours. And while we’d always prefer that you leave the orthodontic care to the professionals, there are certain emergency situations that you may be able to act upon in a safe and effective manner.

Ligatures coming off your brace: Sometimes, when eating, the small elastic ligatures used to keep the wire and brace together, can pop off. In this case, carefully use small tweezers to place the ligature back around the brace.

Brace has come detached from your tooth: Although braces are attached to your teeth using a special adhesive, sometimes — whether as the result of being hit in the mouth during sport, eating a hard food, or nightly grinding and clenching — the attachment can become dislodged. In this case, a visit to your orthodontic specialist should be scheduled at your earliest convenience, but in the interim you can attempt to temporarily correct the problem by using tweezers to carefully remove the bracket from the wire, reposition the unattached brace back in place, or simply leave it to slide free on the wire if it is not causing discomfort. A broken bracket is NOT AN EMERGENCY, unless it is causing the patient extreme discomfort that cannot be temporized with orthodontic wax.

Protruding wire: A piece of wire protruding from the end of the last bracket can irritate your lips and/or cheek. Again, we recommend visiting your orthodontic specialist at your earliest convenience, but in the interim you can use orthodontic wax, or a small nail clipper to cut the protruding wire. We recommend using a folded piece of tissue paper to catch the piece of wire when it’s cut.

Food caught between teeth: While not an emergency in the truest sense of the word, this situation can be extremely uncomfortable for the person wearing braces. It can be rectified by using a piece of dental floss, tied with a small not in the middle, or a toothpick to dislodge the food caught between the tooth and braces.

Mouth sores: While not caused by braces, this condition can be irritated by their presence. We recommend using a small amount of topical anesthetic, such as Ora-Gel, directly to the sore (please be sure to use a cotton swab instead of your finger to apply). You can reapply the anesthetic as required. Rinsing with warm salt water will also alleviate discomfort and help the area heal.

Tooth pain following an adjustment: Some patients will experience tooth pain following an adjustment of the braces. While not dangerous, it can make eating more difficult and cause discomfort. Avoiding hard foods can be helpful, as can taking non-prescription pain relievers, such as acetaminophen (Tylenol) or ibuprofen (Advil).

We want to stress that any emergency treatment should only be undertaken if access to an orthodontic professional is not an option, and the patient is in discomfort. Please contact us at Royal York Orthodontics (Office Manager: jacquiekiss@royalyorkortho.com & Dr. Sky Naslenas: drskynaslenas@royalyorkortho.com) should you have any questions about your orthodontics or to arrange for an emergency visit. Your comfort and safety are important to us.

FAQs

We know that you have questions so the experts at Royal York Orthodontics have come up with a list of Frequently Asked Questions that may help you on your search for which braces are right for you.

General FAQ

 

Jaw Growth Modification

  • What is a Xbow appliance and how does it work?

 

Invisalign FAQ


Can you be too old for braces?

There is no age limit for braces. As long as you have good periodontal health, braces can be used to straighten your teeth and correct your bite. More people over age 30 are getting braces today than ever before. Most ArchWired.com readers are between the ages of 25 to 55! However, if you have been on a Bisphosphonate drug for osteoporosis (such as Fosamax or Boniva) you need to talk to your orthodontist or dentist first. Read this article to find out why this is very important.

I wore my retainer for a while when I was younger, but then I stopped wearing it and my teeth shifted years later.  Is this common?

Yes, it is more common than you think. The teeth are actually more dynamic than you’d expect. Sometimes, when wisdom teeth erupt, your bite can change in adulthood. A large percentage of adults in braces are in them for a second time!

My kids just got braces and now I’m thinking of getting them, too. 

Many adults “finally get their teeth done” when their kids go in for orthodontic treatment. It’s more common than you think! Several ArchWired.com readers have an entire family in braces!

What is it like to have braces put on your teeth? Does it hurt?

Getting braces put on your teeth does not hurt, and does not require Novocain injections or anything painful. For a full description of the process, read Braces Basics: When the Braces Go On.

What is the difference between a dentist and an orthodontist?

An orthodontist is a dentist who has taken several years of extra training beyond the basic dental degree. Here is what the American Association of Orthodontists (AAO) says:

“It takes many years to become an orthodontist. As in medicine, the educational requirements are demanding.

First, an orthodontist must complete college.

Next is a three- to four-year graduate program at a dental school in a university or other institution accredited by the American Dental Association (ADA).

Finally, there are at least two or three years of advanced specialty education in an ADA-accredited orthodontic residency program. The program is difficult. It includes advanced knowledge in biomedical, behavioral and basic sciences. The orthodontic resident learns the complex skills required to both manage tooth movement (orthodontics) and guide facial development (dentofacial orthopedics).

Only dentists who have successfully completed this advanced specialty education may call themselves orthodontists.”

What are the “types of bite” and what do they mean?

The most common types of bite problems are:

bite_types
images from http://www.colgate.com 

  • Overbite. Patients with overbites appear “bucktoothed” and have a receding chin. The lower front teeth are positioned too far behind the upper front teeth. This condition can result from a horizontal overdevelopment of the upper jaw or an underdevelopment of the lower jaw or a combination of both.
  • Underbite. Patients with underbites have a strong jaw with a chin that juts straight out. The lower front teeth are positioned in front of the upper front teeth. This condition is caused by the horizontal underdevelopment of the upper jaw, the horizontal overdevelopment of the lower jaw, or most frequently a combination of both.
  • Crossbite. This occurs when the upper teeth are biting inside the lower teeth. This is frequently the result of a narrow upper jaw. Crossbites also occur because of a mismatch in jaw size and position between the upper and lower jaw. Some crossbites also lead to asymmetry of the lower jaw by causing the jaw to be abnormally deflected to one side when closing the teeth together. Proper diagnosis determines how and when a crossbite needs correction.
  • Open bite. This occurs when the upper front teeth cannot meet or overlap the lower front teeth even though the back teeth have closed together. Sometimes this this makes eating difficult. Open bites are caused by the overdevelopment of the back portion of the upper jaw in a vertical direction. As the back portion of the upper jaw grows vertically downward, the lower jaw will open in a clockwise direction. This explains why open bite patients have a long facial appearance.

Can I get braces just on the top or bottom?

That depends on your case. Orthodontics isn’t just about making your teeth straight or making them look better. Most dentists and orthodontists take a lot of things into consideration when recommending treatment, such as:

  • how the top and bottom teeth meet with each other (i.e., your bite)
  • how well you can chew your food
  • whether you have a tongue thrust problem
  • whether extraction or surgery will be necessary to correct your problems
  • whether you will need any appliances in your treatment, such as a palate expander or headgear (yes, some adults do wear headgear)

So you see, it isn’t just a matter of making your teeth look pretty. There are lot of other factors to take into consideration. This is why you sometimes need a full set of braces, even if you think that you only need them on top or bottom. Of course, some people are lucky. Their bites are good and perhaps they only need a bit of straightening. People in this position often can get braces only on top or bottom  

When will I begin to see changes in my teeth after the braces are put on?

According to a recent ArchWired.com poll, most people begin see changes in their teeth in the first 2 to 6 weeks of treatment.

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Jaw Growth Modification

Encouraging lower jaw growth with Xbow appliance http://www.crossboworthodontic.com/

Invisalign FAQ 

Who Is a Candidate for Invisalign® Clear Braces?

Practically all candidates for traditional metal braces are candidates for Invisalign®clear braces. In fact, Invisalign® clear braces make receiving orthodontic care easier and less noticeable than ever before. If you’ve delayed treatment because of the inconvenience associated with metal braces, the Invisalign® system can help you achieve a beautifully, straight smile discretely and comfortably.

What are the primary benefits of Invisalign?

  • Invisalign is clear. You can straighten your teeth without anyone knowing.
  • Invisalign is removable. Unlike braces, you can eat and drink what you want during treatment. You can also brush and floss normally to maintain good oral hygiene.
  • Invisalign is comfortable. There are no metal brackets or wires as with braces to cause mouth irritation, and no metal or wires means you spend less time in the doctor’s chair getting adjustments.
  • Invisalign allows you to view your own virtual treatment plan before you start? So you can see how your straight teeth will look when your treatment is complete.

How old is this technology?

In 1945, Dr. H.D. Kesling envisioned that one day modern technology would enable the use of a series of tooth positioners to produce the kinds of movements required for comprehensive orthodontic treatment. Technology has made this vision a reality. Using advanced computer technology, Align generates Invisalign®, a series of customized clear appliances, called “aligners.” Each aligner is worn sequentially by the patient to produce extensive tooth movements in both upper and lower arches.

How many patients are being treated with Invisalign?

Worldwide, almost 480,000 patients have been treated with Invisalign. The number grows daily.

Do doctors need special training in order to use Invisalign?

While Invisalign can be used with virtually any treatment philosophy, specific training is needed. All orthodontists and dentists interested in treating patients with Invisalign must attend training before cases will be accepted from their office. Close to 30,000 orthodontists and dentists worldwide are certified to use Invisalign.

How does Invisalign effectively move teeth?

Like brackets and arch wires are to braces, Invisalign aligners move teeth through the appropriate placement of controlled force on the teeth. The principal difference is that Invisalign not only controls forces, but also controls the timing of the force application. At each stage, only certain teeth are allowed to move, and these movements are determined by the orthodontic treatment plan for that particular stage. This results in an efficient force delivery system.

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Botox Injection Therapy

Treatment with botulinum toxin type A, which is more commonly known as Botox, is generally associated with cosmetic procedures — to minimize the appearance of fine lines and wrinkles, and to make one appear younger by recreating the firmness of youthful skin.

This is done by effectively paralyzing the muscles in the affected area, and this cosmetic treatment has been shown to have a therapeutic application for the treatment of certain types of migraines.

Botox treatment is effective for tension-type headaches where the pain is caused, in large part, by persistent and chronic muscle contraction. By partially paralyzing the area using Botox injections, a certified practitioner can significantly lessen the pain.

It is important to note that not all headaches and migraines respond as well to Botox treatment. While tension and muscle-related headaches have shown favourable responses, other types (such as those that present with stabbing sensations in the cheek and next to the eye) are not as successfully treated with Botox.

A good rule of thumb is that migraines and headaches that present as an inward pressure (compression, crushing, squeezing sensations) have a much higher response rate (greater than 80 per cent) than those presenting with outward pressure (exploding sensations), which show less than a 15 per cent response rate.

Each case presents differently and we will work with you to develop a treatment plan that specifically addresses the type of migraines from which you suffer and the locations in which they manifest. Our staff are very knowledgeable in the field and will take the time to discuss with you the treatment options available to you and whether you are a candidate for Botox treatment.

Please contact us at Royal York Orthodontics to learn more about Botox treatment of migraine headaches or follow the link to the Botox Information Site botoxtrainingfordentists.ca.

Tension Headaches

It’s safe to say that most people will experience a tension headache at one time or another in their lives — and likely more often than that. While many tension headaches can be treated easily with over-the-counter medications, rest, or relaxation techniques, there are some headaches that are more severe and/or persistent in nature, which may require other techniques to relieve.

Tension headaches, also known as stress headaches, are the most common type of headaches affecting adults. There are two main types of tension headaches: episodic, which are generally mild to moderate in severity and occur less than 15 days per month; and chronic, which occur more than 15 times per month and are identified by pain that increases and decreases in severity, but persists for a prolonged period of time.

Episodic tension headaches tend to be more common and less severe. They are identified by mild-to-moderate pain around the forehead or back of the head and neck. They can last for as little as a half hour or, in more severe cases, can last for days.

Chronic tension headaches generally present around the front, top, or sides of the head. They are identified by a throbbing type of pain and while the pain may subside a bit, it does not actually cease.

What causes tension headaches?

There are a number of factors that can either cause or exacerbate tension headaches. The most common reasons are fatigue, stress, clenching and grinding teeth, and anxiety. Often caused by muscle tension, these headaches can also be related to overexertion and posture issues.

How are tension headaches treated?

Depending upon the severity of the headache, there are a number of ways, both medicinal and environmental, that have proven to be effective.

The most common treatment for many are over-the-counter pain relievers. Acetaminophen (Tylenol), ibuprofen (Advil, Motrin), and Naproxen (Aleve) have all proven to be effective for mild-to-moderate tension headaches.

For more severe or persistent headaches, a complete evaluation of the myofacial tissues is recommended. Based upon these findings, a nightguard, orthodontic therapy, relief of muscle tension with Botox Injections, or combination therapy can be prescribed.

The one thing to stress is that it’s never “just a headache.” Although often described as minor or moderate, tension headaches can be debilitating and impact one’s quality of life. They can cause nausea, sensitivity to light and sound, and impact sleep. Treatment at the early onset of symptoms is always the best strategy, but we strongly encourage anyone who is concerned about the severity or frequency of their headaches to contact a medical/dental professional.

TMJ Disorders

Temporomandibular joint disorder, commonly known as TMJ, can have significant and long-term repercussions both your physical and mental well-being. TMJ disorders, while related to problems with the jaw joint and the muscles of mastication, can also result serious dental damage.

What is TMJ?

Essentially, the temporomandibular joints are those areas directly in front of the ear where your upper and lower jaws meet. You can think of the TMJ as a hinge, allowing the upper jaw to close, but it’s more accurately described as a sliding ball and socket joint, with a disc in between. It’s also a well-used joint, as it’s responsible for moving the jaw when biting, chewing, talking, and yawing. It’s under tremendous stress throughout the day, but when working efficiently, the TMJ allows us to perform all of these actions without pain. However, if something in this complex collection of muscles, tendons, and joints is out of place, then a number of problems can arise.

What are TMJ disorders?

There are a number of conditions that fall into this category: clicking sounds in the jaw, ear pain, headaches, malocclusion (bite issues), and stiffness.

These symptoms, if caused by TMJ disorders, can be chronic and in some cases go misdiagnosed as they are seemingly unrelated to a jaw disorder. For example, approximately half of patients with a TMJ disorder report having ear pain; 40 per cent say they experience dizziness; a third present with either tinnitus (ringing in the ear) or a sensation fullness of the ear. In some cases, patients are misdiagnosed with an ear infection. And, in fact, in many cases TMJ disorders are diagnosed by ear specialists.

What causes TMJ disorder?

There are a number of factors that can lead to the development of a TMJ disorder. These factors can be present for years before the development of any TMJ symptoms and early detection and treatment can help prevent the development of TMJ disorders.

Teeth grinding and clenching are strong contributors to TMJ disorders. What makes these most challenging to combat is that often the patient is unaware of the behaviour. Frequently, it will be a spouse who notices grinding during the night; or a dental professional detecting signs of wear and tear on the teeth.

Bite issues (malocclusion) also can contribute to the development of TMJ disorders. Overcompensating for a deficient bite on one side of the jaw, can tax the other side and result in TMJ problems.

Other contributing factors include: habitual gum chewing/nail biting; jaw trauma, including fractures in the jaw or facial bones; stress, and repetitive occupational behaviours, such as holding a telephone between the head and shoulders.

TMJ disorder treatments

Depending upon the severity of the disorder, treatment for TMJ disorders can range from rest and ice to surgery. From TMJ disorders resulting from bite issues and teeth grinding, a dental professional can help to alleviate symptoms and rectify the contributing factors.

Some disorders can be treated using custom-made appliances, frequently worn at night, to eliminate teeth grinding and/or clenching. Other cases require corrective dental therapy, such as orthodontics, to repair abnormal bites and ensure proper alignment of the teeth. Treatment with Invisalign aligners while eliminating interferences from malpositioned teeth, can also provide relief by acting as night guards. In many cases, injecting Botox into jaw muscles alone or as an adjunct to an orthodontic appliance, may provide dramatic relief to patients.

We strongly encourage anyone who is concerned about TMJ disorders to contact us at Royal York Orthodontics to discuss both diagnosis and treatment options. Our team is happy to answer any questions you may have and explore your options.

Success Stories

We know that the most effective advertisements for the experts at Royal York Orthodontics come from the testimonials of the people we’ve had the pleasure of helping.

Peruse the following success stories from people just like you who turned to Toronto’s leading authority on dental and orthodontic care. We believe that a healthy and beautiful smile can make a world of difference! Please read the following stories and see how we helped these patients put their best faces forward.

“I’ve had migraines for 26 years. I’ve tried every migraine medication with no success. They either didn’t work or the side effects were intolerable. This migraine has lasted 1 year. I received Botox injections and woke up the next morning with no pain. Finally relief with relatively little side effects. I would recommend this to anyone who has minimal relief from typical migraine medications.”

“I had a constant 24/7 headache for two years straight before trying Botox. I tried every other conceivable medication to no avail, but Botox cut my pain to a third of its previous level. I still get injections every four months or so, but it’s been three years and I still have the much lower pain level, can work, and am thankful everyday for Botox.”

“I’m very grateful the FDA approved this! I’ve suffered with debilitating migraines for 25 years now and have tried every medication prescribed and OTC, unfortunately the only thing that would take away the pain are narcotics. Since using Botox treatments my migraines are under control and down to approximately 4-5 a month compared to 20-25. I feel as though I have a life again and not living hour to hour, not having a life in fear of having a migraine. Also VERY grateful to have good insurance that pays for this.”

AcceleDent Aura FAQs

We hear a lot of questions about the remarkable new AcceleDent Aura technology. If you have any questions about your orthodontic treatment, or if you’re curious how AcceleDent Aura can help speed up your orthodontic experience, contact our office!

How does AcceleDent Aura work?

By inserting the mouthpiece around your existing orthodontic appliance and wearing the activator for 20 minutes every day, AcceleDent Aura can speed up tooth movement through the use of SoftPulse Technology’. Faster tooth movement may decrease the duration of your orthodontic treatment and can help make your orthodontic experience more comfortable.

Is AcceleDent Aura safe?

Yes! AcceleDent Aura with SoftPulse Technology has been proven safe through US clinical trials and is cleared by the FDA as a Class II medical device.

accedent

What is SoftPulse Technology and why is it important?

Part of the way your orthodontic treatment works is by changing or remodeling the bones surrounding your teeth. As this remodeling process is accelerated, your teeth move more quickly. That’s where AcceleDent Aura comes in! By using tiny vibrations, or micropulses, SoftPulse Technology speeds up bone remodeling and tooth movement.

How much time will AcceleDent Aura reduce my treatment?

Research has shown that tooth movement is accelerated by 106% during the initial phase of treatment and up to 50% during the subsequent phase of treatment, potentially shortening conventional orthodontic treatment time.

How do I know if I am biting into the mouthpiece correctly and with the right amount of force?

Bite pressure on the mouthpiece should be just firm enough to hold your AcceleDent Aura in place without using your hands. Avoid biting forcibly into the mouthpiece, as that may cause excessive wear.

What is the best way to clean the AcceleDent Aura device?

The mouthpiece should be rinsed well with lukewarm water after each use. You may occasionally use a soft liquid dishwashing detergent, a mild soap, or toothpaste to gently brush the mouthpiece. The activator can be wiped with a damp cloth as necessary. The metal contacts of the activator must be free of any dirt or residue and may be cleaned with a Q-Tip® as needed. It is recommended that you allow your AcceleDent Aura to air dry before being stored in the Travel Shell. Do not place the mouthpiece or the activator in a dishwasher, as this will void the warranty and could cause damage to the product.

Can I use my AcceleDent Aura in the shower or when sleeping?

No. AcceleDent Aura is not water resistant and should not be used in the shower. It is also not recommended to use while sleeping.

Can I sanitize my AcceleDent Aura and share it with a friend or family member who also has braces?

No. AcceleDent Aura is an FDA cleared, single-use prescription device. Sharing the AcceleDent Aura and/or the mouthpiece is prohibited. Based upon your unique orthodontic treatment plan, your orthodontist prescribed AcceleDent Aura for your use only. Use of AcceleDent Aura without the supervision and direction of an orthodontist may result in adverse, unintended consequences.

If I use AcceleDent Aura for more than the recommended 20 minute treatment time, does it add incremental benefit?

No. Additional daily use greater than the prescribed 20 minutes duration is not recommended.

Is there some way that AcceleDent Aura can “track” my usage?

Yes. Docking the activator/travel shell on the charging port also allows the usage history and details to be registered. The amount of usage can then be observed on the smart display.

Can AcceleDent Aura remind me to use it on a daily basis?

No. AcceleDent Aura is not designed to provide reminders. It is recommended that you make AcceleDent Aura part of your daily routine in order to maximize its benefit to you.