Richmond Virginia Orthodontics: Dr. Brent A. Rusnak, DDS, PC & Dr. Casagrande

Dr. Brent Rusnak, D.D.S., P.C.
2314 East Parham Road
Richmond, VA 23228
(804) 262-1060

How Orthodontic Treatment Works

Orthodontic appliances can be made of metal, ceramic, or plastic. They may be removable or they may be brackets bonded to the teeth. By placing a constant, gentle force in a carefully controlled direction, braces slowly move teeth to a corrected position. This is a great time to wear braces! Gone are the days when a metal band with a bracket was placed around each tooth. You can choose brackets that are clear or metallic color. You can choose the color of the ties that hold the wire in brackets. Wires are also less noticeable than they used to be and the latest materials move teeth faster with less discomfort to patients.

Duration of Treatment

Treatment time typically ranges from one to three years, depending on the growth of the patient's mouth and face and the severity of the problem. Patients grow at different rates and will respond variously to orthodontic treatment, so the time to case completion may differ from the original estimate. The patient's diligent use of any prescribed rubber bands or headgear is an important factor in achieving the most efficient treatment. Interceptive, or early treatment procedures, may take as few as six months.
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• Orthodontics For Children

It's best for the orthodontist to see children by age 7 to advise if orthodontic treatment is required and it is the best time for that patient to be treated. The first permanent molars and incisors have usually come in by that time and crossbites, crowding, and other problems can be evaluated. When treatment is begun early, the orthodontist can guide the growth of the jaw and guide incoming permanent teeth. Early treatment can also regulate the width of the upper and lower dental arches, gain space for permanent teeth, avoid the need for permanent tooth extractions, reduce likelihood of impacted permanent teeth, correct thumb-sucking, and eliminate abnormal swallowing or speech problems. In other words, early treatment can simplify later treatment.

Dr. Casagrande believes in a "non-extraction" approach. This means he will attempt to treat patients without the removal of permanent teeth if it is possible. This reduces the possibility of future negative changes in lip posture and profile flattening. Early treatment can help to achieve these goals.
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• Orthodontics For Adults
Orthodontic treatment can be successful at any age. One out of every five patients in orthodontic treatment is over 21. More and more adults are seeking care because of the aesthetic and comfortable options we can offer you. Dr. Casagrande is very experienced with appliances such as Invisalign and porcelain self-ligating braces. It's never too late to correct your bite and enhance your smile.
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What is surgical orthodontics?

Just as orthodontics repositions teeth, surgical orthodontics (also known as orthognathic surgery) corrects jaw irregularities to improve the patient's ability to chew, speak, and breathe and for improved facial appearances. In other words, surgical orthodontics straightens your jaw. Moving the jaws also moves the teeth, so braces are always performed in conjunction with jaw correction. This helps make sure teeth are in their proper positions after surgery.

Who needs surgical orthodontics?

Your orthodontist will consider surgical orthodontic treatment for non-growing adult patients with improper bites and those with facial aesthetic concerns. Jaw growth varies from person to person, but is usually completed around age 16. All growth must be completed before jaw surgery can be performed. However, the pre-surgical tooth movements can begin one to two years prior to these ages.

How does it work?

During your pre-surgical orthodontic treatment, which usually lasts 6-12 months, you wear braces and will visit your orthodontist for scheduled adjustments to your braces. As your teeth move with the braces, you may think that your bite is getting worse rather than better. However, when your jaws are placed into proper alignment during orthognathic surgery, the teeth will then fit into their proper positions.

Surgery is performed in the hospital or outpatient setting with an oral surgeon and can take several hours, depending on the amount and type of surgery needed. In lower jaw surgery, the jawbone behind the teeth is separated and the tooth-bearing portion is moved forward or backward, as needed. In upper jaw surgery, the jaw can be repositioned forward or backward, or the jaw can be raised or lowered. Certain movements may require the jaws to be separated, with bone added/removed to achieve the proper alignment and stability. Other facial bones that contribute to alignment may also be repositioned or augmented.

When you have completed surgery, you should be able to return to school or work within two weeks. After the necessary healing time (about 4-8 weeks), your orthodontist "fine-tunes" your bite. In most cases, braces are removed within 6 to 12 months following surgery. After your braces are removed, you will wear a retainer to maintain your beautiful new smile.
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• Invisalign®
Invisalign® is the clear alternative to straighten your teeth without metal braces. Invisalign® uses a series of clear removable aligners that are virtually invisible. You can take them out for daily necessities like eating, drinking, brushing and flossing. Because the aligners are comfortable and complimentary to your smile, Invisalign® is a great alternative to traditional braces.
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