Two-Phase Treatment
At Gellerman Orthodontics, we believe that early intervention can lead to a lifetime of healthy, beautiful smiles. Two-phase orthodontic treatment is a specialized approach designed to guide jaw development, correct misalignment, and create space for permanent teeth—all before full orthodontic treatment begins. This proactive method can help prevent tooth extractions, surgical procedures, and complex orthodontic issues later in life.
Phase One: Laying the Foundation for a Healthy Smile
The goal of Phase One treatment is to ensure that the jaw develops properly to accommodate all permanent teeth and create a balanced bite. Children often show early signs of jaw misalignment, crowding, or bite issues, and addressing these concerns early can make future orthodontic treatment smoother and more effective.
Why Early Treatment Matters
- Corrects jaw growth issues (such as a too-narrow or overdeveloped upper jaw).
- Helps prevent crowding by creating space for permanent teeth.
- Reduces the need for tooth extractions or jaw surgery later in life.
- Guides proper bite alignment to prevent future dental complications.
- Identify signs of airway obstruction to correct as early as possible
If a child over age six shows early signs of jaw discrepancies or crowding, they may be a candidate for early orthodontic treatment. Common Phase One appliances include expanders, space maintainers, or limited braces to help guide jaw growth and tooth development.
Every child’s orthodontic needs are unique. To determine the best approach, we take detailed orthodontic records, including:
- X-rays to assess jaw structure.
- Models of the teeth to analyze spacing and alignment.
- Photographs to track progress and treatment needs.
Resting Period: Monitoring Growth
After Phase One treatment is complete, the Resting Period allows the remaining permanent teeth to erupt naturally. During this phase:
- Retainers may not be necessary, as they could interfere with natural tooth eruption.
- The jaw is monitored to ensure it continues to develop correctly.
- Baby teeth may be strategically removed if necessary to allow permanent teeth to come in properly.
- Children will have periodic check-ups every six months to track their progress and determine the best timing for Phase Two treatment.
Phase Two: Perfecting the Smile
Once all permanent teeth have erupted, Phase Two begins. This phase ensures that each tooth is aligned for ideal function and aesthetics, creating a harmonious balance between the teeth, lips, cheeks, and tongue.
What to Expect in Phase Two
- Full braces on the upper and lower teeth to fine-tune alignment.
- Treatment typically lasts about 24 months, depending on individual needs.
- Retainers are worn after treatment to maintain results and prevent shifting.
By completing both phases of treatment, patients achieve a stable, well-aligned smile that enhances both function and appearance. Two-phase treatment reduces the risk of future orthodontic complications, ensuring a healthier, more confident smile for life.
Surgical Orthodontics
At Gellerman Orthodontics, we specialize in comprehensive orthodontic care, including surgical orthodontics for patients who need more than braces or aligners to achieve a balanced, functional smile. Also known as orthognathic surgery, surgical orthodontics is used to correct severe jaw misalignment, bite irregularities, and skeletal discrepancies that cannot be fixed with orthodontic treatment alone.
Who Needs Surgical Orthodontics?
Surgical orthodontics is typically recommended for adults and older teens whose jawbones have finished growing (usually around age 16 for females and age 18 for males). This type of treatment is ideal for patients with:
- Severe overbites, underbites, or crossbites affect function and appearance.
- Facial asymmetry or a misaligned jaw structure.
- Difficulty chewing, speaking, or breathing due to jaw misalignment.
- Obstructive sleep apnea or other airway issues.
- Chronic jaw pain (TMJ disorders) related to misalignment.
The Surgical Orthodontics Process
1. Pre-Surgical Orthodontic Treatment
Before surgery, most patients undergo orthodontic treatment with braces or aligners for several months to a year. This phase helps align the teeth so that after surgery, they fit together properly.
2. Orthognathic Surgery
The surgical procedure is performed by an oral and maxillofacial surgeon in a hospital setting under general anesthesia. The surgery involves repositioning the upper jaw (maxilla), lower jaw (mandible), or both to achieve proper alignment. In some cases, additional bone may be added, reshaped, or removed to create a more balanced facial structure.
3. Recovery & Healing
After surgery, most patients take about two weeks off from work or school for initial healing. Swelling, mild discomfort, and a temporary change in diet are common. Complete jaw healing typically takes several months.
4. Post-Surgical Orthodontic Treatment
Once healing is complete, orthodontic treatment continues for a few months to fine-tune your bite. After this phase, retainers are used to maintain your results and keep your smile in place.
Benefits of Surgical Orthodontics
- Improves facial harmony and jaw function for better chewing and speaking.
- Enhances confidence by correcting asymmetry and bite issues.
- Relieves jaw pain and TMJ discomfort associated with misalignment.
- Improves breathing and sleep quality, especially for patients with sleep apnea.
- Provides long-term stability for a lifetime of better oral health.
If you’ve been told that you have a severe bite issue or jaw misalignment, surgical orthodontics could be the solution. At Gellerman Orthodontics, we work closely with expert oral surgeons to create a customized treatment plan that delivers life-changing results. Schedule a consultation today to learn more about your options!
Integrative Airway Orthodontics
At Gellerman Orthodontics, we take a whole-health approach to orthodontic care, especially for growing children. Integrative orthodontics goes beyond straightening teeth — it focuses on jaw development, facial growth, and airway health to ensure proper breathing and overall wellness. Many children with crowded teeth, misaligned jaws, or bite issues may also have airway obstructions that can lead to sleep-disordered breathing, mouth breathing, and other long-term health concerns.
A Holistic Approach to Airway Health
At Gellerman Orthodontics, we take a proactive, whole-patient approach — starting as early as age seven — to support your child’s airway development and breathing. We work closely with ENTs and myofunctional therapists to assess and support healthy nasal breathing and proper oral function.
Why Airway Health Matters in Orthodontics
A properly developed airway is essential for a child’s overall health. When the airway is restricted, children may experience:
- Mouth breathing, which can lead to improper jaw growth and narrow dental arches.
- Snoring or sleep apnea, affecting quality sleep and overall development.
- Daytime fatigue or difficulty focusing, often mistaken for ADHD.
- Frequent allergies, congestion, or ear infections due to poor nasal breathing.
Early evaluation helps us:
- Identify signs of airway obstruction
- Correct harmful habits (thumb sucking, mouth breathing)
- Guide proper jaw growth and facial development
How Orthodontics Can Help Improve Airway Function
By addressing airway concerns early, we can guide proper jaw development and help prevent future complications. Integrative orthodontic treatment may include:
- Palatal expanders to widen the upper jaw and create more room for the tongue and airway.
- Early intervention with functional appliances to encourage proper jaw growth and breathing patterns.
- Myofunctional therapy to retrain oral muscles and promote nasal breathing.
We also help adults who never received early treatment by using the MARPE appliance to gently expand the upper jaw and improve breathing.
Beautiful Smiles Start with a Healthy Foundation
When orthodontic treatment is combined with airway-focused care, children experience better breathing, improved sleep, and healthier facial development. Early screening allows us to identify potential issues before they impact a child’s long-term health.
We believe a truly confident smile begins with healthy airways, balanced growth, and individualized care. Let us help you or your child breathe, sleep, and smile better—for life.
Sleep Apnea Treatment
Quality sleep is essential for overall health, but for many individuals, obstructive sleep apnea (OSA) disrupts breathing during the night, leading to poor sleep, daytime fatigue, and long-term health risks. At Gellerman Orthodontics, we offer airway-focused orthodontic solutions to help patients breathe better, sleep better, and live healthier lives.
Sleep apnea occurs when the airway becomes partially or completely blocked during sleep, causing pauses in breathing that can last from a few seconds to a minute. This can happen dozens or even hundreds of times per night, preventing restful sleep and straining the body’s cardiovascular system.
Common Signs of Sleep Apnea
- Loud snoring or gasping for air during sleep
- Daytime fatigue or difficulty concentrating
- Mouth breathing and dry mouth in the morning
- Frequent morning headaches
- Restless sleep or waking up multiple times at night
- Behavioral issues or trouble focusing in children
- If left untreated, sleep apnea can contribute to serious health problems, including high blood pressure, heart disease, diabetes, and cognitive issues.
How Orthodontics Can Help Treat Sleep Apnea
At Gellerman Orthodontics, we take a proactive approach to sleep apnea by addressing airway structure and jaw alignment. Depending on the severity of your condition, orthodontic treatment can help open the airway and promote healthy nasal breathing.
Sleep Apnea Treatment Options
- Oral Appliance Therapy — A custom mandibular advancement device (MAD) gently repositions the jaw forward, preventing airway collapse during sleep. This is an excellent option for patients with mild to moderate sleep apnea who prefer a CPAP alternative.
- Palatal Expanders for Children — A narrow upper jaw can contribute to airway obstruction. Palatal expanders create more space in the mouth, improving airflow and reducing the risk of sleep-disordered breathing in growing children.
- Jaw Alignment Treatment — Orthodontic treatments such as braces or Invisalign can help reposition the jaw for better airway function and breathing efficiency.
- Collaborative Care — For patients with severe sleep apnea, we work closely with sleep specialists and ENT doctors to provide comprehensive treatment, including CPAP therapy or surgical options if needed.
If you or your child are experiencing symptoms of sleep apnea, we can help determine if orthodontic care is a solution. Our airway-focused approach ensures that we not only straighten teeth but also support healthy breathing and long-term wellness.
TMJ/TMD Treatment & Headache Relief
If you experience jaw pain, frequent headaches, or clicking and popping sounds when you chew, you may have temporomandibular joint disorder (TMD). The temporomandibular joint (TMJ) connects your jaw to your skull and allows for everyday movements like talking, chewing, and yawning. When this joint is misaligned or under stress, it can lead to chronic pain, tension headaches, and even difficulty opening or closing your mouth.
At Gellerman Orthodontics, we offer customized treatment solutions to relieve TMJ-related pain, restore proper jaw function, and help you enjoy a pain-free life.
Symptoms of TMD/TMJ Disorder
- Frequent headaches or migraines
- Jaw pain or tenderness
- Clicking, popping, or grinding noises when moving the jaw
- Difficulty chewing or biting
- Locking of the jaw in an open or closed position
- Ear pain or ringing in the ears (tinnitus)
- Neck, shoulder, or facial pain
What Causes TMJ Disorders?
TMD can result from several factors, including:
- Jaw misalignment or an improper bite
- Teeth grinding (bruxism) and clenching, often caused by stress
- Arthritis in the jaw joint
- Injury or trauma to the face or jaw
- Poor posture that strains the jaw muscles
At Gellerman Orthodontics, we take a comprehensive approach to treating TMJ disorders by identifying the root cause and providing personalized solutions for long-term relief.
- Orthodontic Treatment for Bite Alignment — If a misaligned bite is contributing to TMJ pain, braces or Invisalign can help reposition the teeth and jaw for proper function.
- Custom TMJ Appliances & Nightguards — A custom-fitted oral appliance (such as a nightguard or splint) can prevent teeth grinding and clenching, reducing strain on the jaw joint and relieving pain.
- Bite Equilibration Therapy — This treatment adjusts the way teeth fit together, helping to reduce uneven pressure on the jaw joint and prevent further discomfort.
- Myofunctional Therapy & Stress Management — Addressing oral muscle function and tension habits can play a crucial role in TMD relief. Our team provides guidance on relaxation techniques, and lifestyle adjustments to ease discomfort.
- Collaboration with Specialists — In severe cases, we work with pain management specialists, physical therapists, and oral surgeons to ensure the most effective treatment for long-term relief.
- We use TruDenta System to target the improper muscle forces in the head, neck, and jaw area that cause painful conditions.
You don’t have to live with chronic jaw pain, headaches, or discomfort. If you’re experiencing symptoms of TMD, early intervention can prevent worsening pain and long-term joint damage.
Temporary Anchorage Devices (TADs)
At Gellerman Orthodontics, we use the latest advancements in orthodontic treatment to ensure efficient, precise, and comfortable tooth movement. One of these cutting-edge tools is Temporary Anchorage Devices (TADs) — small titanium implants that provide stable anchorage for shifting teeth into their ideal positions.
TADs are miniature screws placed temporarily in the jawbone to serve as a fixed anchor for certain orthodontic movements. They allow for more controlled and predictable tooth alignment, especially in cases where traditional braces alone may not provide enough force or stability.
During orthodontic treatment, teeth naturally push against each other as they move, which can make certain adjustments difficult. TADs act as a stable support point, helping to:
- Move teeth more efficiently without affecting surrounding teeth.
- Correct complex bite issues that may not be possible with braces alone.
- Reduce treatment time in some cases by creating direct movement.
- Provide an alternative to headgear or jaw surgery for some patients.
Placing a TAD is a quick and painless procedure. A small amount of topical or local anesthesia is applied before inserting the device, and most patients feel little to no discomfort. Once in place, TADs require minimal maintenance and are typically removed once they have served their purpose.
TADs are used for patients who require extra anchorage to correct complex bite issues, such as:
- Severe overbites or underbites
- Gaps between teeth that require significant movement
- Intrusion of teeth (pushing teeth downward into the correct position)
TADs offer a safe, effective, and minimally invasive solution for improving orthodontic results. If you need TADs as part of your treatment, Dr. Gellerman will discuss how they can enhance your smile transformation and ensure the best possible outcome.
Palatal Expansion (MARPE)
At Gellerman Orthodontics, we use the latest advancements in orthodontic treatment to address narrow palates, crowding, and airway concerns. One highly effective solution is MARPE (Minimally Invasive Rapid Palatal Expansion) — a non-surgical method for widening the upper jaw in teens and adults.
MARPE (Miniscrew-Assisted Rapid Palatal Expansion) is an advanced type of palatal expander that uses small, temporary mini-implants (TADs) to gradually widen the upper jaw (palate). This technique is particularly beneficial for older teens and adults, whose jaw growth may have slowed or stopped, making traditional palatal expanders less effective.
MARPE is ideal for patients with:
- A narrow upper jaw, causing crowding or misalignment
- Crossbites (when the upper and lower teeth don’t fit together correctly)
- Obstructed airway issues, such as mouth breathing, snoring, or sleep apnea
- Aesthetic concerns, such as sunken cheekbones or a narrow smile
Unlike traditional expanders that rely solely on dental pressure, MARPE applies gentle force to the sutures of the upper jaw, allowing for safe, natural expansion. The device is placed on the roof of the mouth and anchored using tiny biocompatible screws. Over several weeks, the palate gradually widens, creating space for teeth to align properly and improving airway function.
Some benefits of MARPE include:
- Non-surgical alternative for jaw expansion in teens & adults
- Improves breathing & nasal airflow (reducing snoring & sleep apnea symptoms)
- Creates space for crowded teeth, reducing the need for extractions
- Enhances facial balance for a broader, more symmetrical smile
MARPE is a safe, minimally invasive solution for patients who need jaw expansion without surgery. If you or your child has a narrow palate or breathing difficulties, schedule a consultation today to learn how MARPE can help!
