Real questions, straight answers
The questions patients ask in the chair, and the ones people type into a search bar at midnight, answered plainly, including the answers that don't end in a sale.
Looking for a word? Orthodontic terms, explained.
My jaw clicks. Is that bad?
A clicking jaw is not how it should normally function — but it does not necessarily indicate a progressive or destructive process. The clicking cannot always be reversed, but it may be able to be stabilized.
Everyone says it's stress. Is it stress?
Stress can cause clenching and grinding of the jaw, which can have an impact on the temporomandibular joint. However, there can be other causes as well.
Is it too late for me? I'm 41.
It is never too late to be more comfortable.
I grind my teeth. Is a night guard enough?
A night guard will protect your teeth from excessive wear while it is worn. It will not stop you from grinding. Botox can sometimes help to minimize grinding.
Invisalign wrecked my bite. Can it be fixed?
Teeth can always be moved.
Seven seems young. Is it?
It all depends on their dental development and whether certain teeth have erupted. And not all children require early interceptive treatment.
Why does my kid need braces twice?
They may or may not. I treat every phase I as fully as possible to lessen the likelihood of needing a phase II — however, most children do. The goal is to lessen the severity of what would need to be done.
How do I know if an orthodontist is any good?
You don't. Go with who you are comfortable with, who answers your questions. Reviews can be helpful.
Will my kid have to wear a retainer forever?
Retention should be lifelong, as teeth always move. People who continue to wear a retainer a few times a month usually maintain straight teeth.
What happens if we just wait?
Sometimes nothing. But sometimes space cannot be made and extractions are necessary. Sometimes growth has ended and oral surgery is necessary.
What does it actually cost? All in.
Cost depends on the severity of the case and the length of treatment, as well as the mode of treatment.
Does insurance cover any of this?
If you have an orthodontic benefit, we will apply it to the treatment cost.
Does my child need braces?
Does my child need braces? What are the signs?
Signs worth a look: crowded or overlapping teeth, front teeth that stick out, top and bottom teeth that don't meet, baby teeth lost very early or still there very late, mouth breathing, thumb sucking past about age five, or a jaw that shifts to one side when closing. None of these means braces for certain. An orthodontic check is how you find out, and many children just get watched.
What age should a child first see an orthodontist?
Around age seven. By then the first permanent molars and front teeth are in, so the bite and the room for the teeth still to come can be read, while there is growth left to work with. Most seven-year-olds need nothing yet; the visit tells you what to watch and when to come back.
My child's teeth are crooked, crowded or overlapping. Will they straighten out on their own?
Some mild crowding eases as the jaw grows. A lot of it does not, and the space has to be made or managed. A check tells you which kind yours is, and whether waiting is fine or costs something later.
Overbite, buck teeth, underbite, crossbite, open bite. What do they mean?
An overbite is top front teeth sitting far down over the bottom ones; “buck teeth” is top teeth that stick out forward; an underbite is lower teeth sitting in front of the upper; a crossbite is some top teeth biting inside the bottom ones; an open bite is front teeth that don't meet when the back teeth are closed. Each is a bite pattern an orthodontist looks for, and some are easier to guide while a child is still growing.
Thumb sucking, and losing baby teeth early. Does it matter for the teeth?
Thumb sucking past about age five can push the front teeth forward and change the shape of the bite. A baby tooth lost very early can let the neighbours drift into its space. Both are reasons for an earlier look, not for alarm.
My child grinds their teeth at night.
Common in children, and often outgrown. It is worth mentioning at a check if the teeth look worn, your child wakes with a sore jaw or headaches, or it goes on for years.
My child's jaw clicks, or hurts.
Jaw joints can click in children too. Clicking with pain, a jaw that locks, or trouble opening wide is worth an exam. Dr. Khan looks at the joint, the muscles and the bite together, and tells you what she finds.
Could a lisp or a speech problem be about the teeth?
Speech is mostly the tongue, the lips and habit, but gaps, an open bite or front teeth that stick out can play a part. Dr. Khan can tell you whether the teeth are likely involved and when a speech therapist is the right call.
My child breathes through their mouth. Does it matter?
It can. Mouth breathing is often allergies, enlarged tonsils or adenoids, or a habit, and over the years it can affect how the upper jaw and the bite develop. Dr. Khan looks at the palate, the bite and the signs around the airway, and tells you when a pediatrician or an ear, nose and throat doctor should look too.
Snoring, restless sleep, mouth open at night. Could it be sleep apnea?
It could, in children and in adults. Loud snoring, pauses in breathing, restless sleep and daytime tiredness are for a physician to hear about; sleep apnea is diagnosed by a doctor, usually with a sleep study, not by an orthodontist. Where the orthodontist comes in: a narrow upper jaw or a small, set-back lower jaw can leave less room for the airway, and guiding the jaws while a child is still growing is sometimes part of the plan the physician and Dr. Khan make together. Mention it at the check, whatever your age.
Pain, clicking, headaches
Why does my jaw hurt in the morning?
Morning jaw pain often points to clenching or grinding during sleep, which overworks the muscles that close the jaw. It can also involve the joint itself. An exam sorts out which, and what to do about it.
My jaw clicks or pops when I chew, gets tired after eating, or locks.
Clicking is usually the small disc inside the joint moving out of place and back. Tiredness after eating is the muscles. A jaw that locks, open or closed, is worth a prompt look. Dr. Khan examines how the joint moves and where it catches, and is straight with you about what she can and cannot help with.
How do I know if I have TMJ, and how is it treated?
The TMJ is the joint; a TMJ disorder is when it or the muscles around it are not working comfortably. Common signs: pain in front of the ear, clicking, limited opening, headaches, ear pain, worn teeth. Treatment depends on the cause: habit changes, an oral appliance, physical therapy, therapeutic Botox for overactive muscles, orthodontic treatment when the bite is part of it, or a referral when something else is.
What kind of doctor treats jaw pain?
Several can: a dentist, an orthodontist, an oral surgeon, a physician, a physical therapist. Dr. Khan is a specialist in Orthodontics and Dentofacial Orthopedics, which means the joint, the muscles and the bite are looked at together, where many jaw problems sit. If the answer is someone else, she says so.
Morning headaches, temple headaches, tension headaches. Could it be clenching?
It can be. The temporalis muscles at the temples help close the jaw, and when they are overworked by clenching they ache, often worst in the morning. An exam of the muscles and the bite can show whether clenching is part of your headaches.
I grind my teeth at night, and my teeth look flat or worn.
Worn, flat edges are often the first sign of grinding, since most people don't hear themselves do it. A night guard protects the teeth while it is worn; it does not stop the grinding. Dr. Khan looks at the muscles and the joint for what is driving it.
Does Botox help TMJ or clenching?
For some patients whose pain comes from overactive jaw muscles, therapeutic Botox placed in those muscles, not in the joint, can reduce the clenching and let the area relax. It is not for everyone with TMJ symptoms, and only after an evaluation. More on the Botox page.
Do I need braces as an adult? My teeth are shifting back after braces.
Teeth move throughout life, and shifting after braces is common, especially without a retainer. If the movement is slight, a new retainer may be enough; if it is more, limited treatment with aligners or braces can bring it back. Dr. Khan looks and tells you honestly which.
Cost, insurance, Invisalign or braces, how long
How much do braces cost, and does insurance cover them?
Cost depends on the case, the length of treatment and the method. You leave the free consult with your own number, in writing. Many dental plans with an orthodontic benefit cover part of it; if yours does, we apply the benefit to your cost and bill the insurance for you. Every option is on the cost page.
Are there payment plans for braces?
Yes. A down payment, then monthly payments split over the course of treatment at zero interest; third-party financing if you want it spread longer; and up to 5% off for paying in full. Details on the cost page.
Invisalign or braces. Which is better?
Neither is better for everyone. Aligners are removable and discreet and need consistent wear; braces stay on and give precise control for bigger movements. Dr. Khan tells you which she recommends for your case and why, and if both would work, she says that too.
How long do braces take?
It depends on how far the teeth have to move, how the bite fits, whether there is growth to work with, and how well appointments and instructions are kept. Dr. Khan gives you an estimate for your own case at the consult, and tells you what could change it.
Why do I need X-rays?
Dr. Khan does not believe in unnecessary exposure, however imaging is often required in order to diagnose properly. We use low dose digital X-ray machines. Less radiation than a flight to New York. We refer out for more detailed imaging only if necessary.
My wedding is coming. Can my smile be ready, and how soon should I start?
Come in as soon as the date is set; the earlier you start, the more Dr. Khan can do. What is realistic depends on how far the teeth have to move: a small shift may need only a few aligners or a new retainer, and bigger movement takes longer. She tells you at the consult what can be done by your date and what cannot, so nothing is rushed and nothing is promised that will not happen. Whitening comes last, and we do it here, once the teeth are where they belong and any attachments are off.
Have a question of your own? Ask her.
Tell us what's going on in the consult form, in your own words. Dr. Khan reads it before you come in, so your first visit starts with your question, not with paperwork.