Dentofacial Orthopedics

You may have noticed that Dr. Russell Chang's title includes "orthodontics and dentofacial orthopedics." While most people have heard of orthodontics, many are confused by the dentofacial orthopedics part. In short, dentofacial orthopedics is the guidance of facial growth and development — including the bones, muscles, and joints of the face and jaw — and is practiced alongside orthodontic tooth movement to achieve optimal functional and aesthetic outcomes. It is not a separate specialty from orthodontics; every licensed orthodontist completes training in both areas after finishing dental school.

What Dentofacial Orthopedics Actually Means

After graduating from dental school, some dentists go directly into general practice. Others pursue a specialty residency, which typically adds two to three years of advanced education. During that residency, orthodontists study both tooth movement and the broader skeletal structures of the face — that combination is what earns them the full title of "orthodontist and dentofacial orthopedist."

In practical terms, dentofacial orthopedics addresses situations where the problem isn't just crooked teeth but the underlying jaw structure itself. If the upper jaw is too narrow, or the lower jaw is positioned too far back or forward, simply moving teeth with braces won't fully resolve the issue. Dentofacial orthopedic treatment uses appliances designed to influence how the jaws grow, ideally while a patient is still developing.

Who Is a Candidate?

Dentofacial orthopedic treatment is most effective in children and adolescents whose bones are still growing and therefore more responsive to guided change. Common situations that may call for this type of care include:

• A significant overbite or underbite caused by jaw position rather than tooth position alone
• A narrow upper arch that causes crowding or crossbite
• Asymmetrical jaw development
• Difficulty chewing or speaking related to jaw alignment

Adults can still benefit from orthodontic treatment, but skeletal discrepancies in adults sometimes require a different approach, including possible surgical options in more significant cases. An evaluation at Chang Orthodontics will clarify which path makes sense for a given patient's anatomy and age.

How Treatment Typically Works

For growing patients, the process often involves a phase of orthopedic treatment before or alongside conventional braces or clear aligners. Appliances commonly used in this phase include palate expanders, which gradually widen the upper arch over several months, and functional appliances that encourage the lower jaw to position itself more favorably during growth.

A palate expander, for example, is worn full-time and adjusted at home using a small key on a schedule provided by Dr. Chang. Patients typically wear an expander for several months, followed by a period where the appliance remains in place to allow new bone to stabilize in the expanded arch. After orthopedic goals are met, braces or aligners address the remaining tooth alignment.

The total treatment timeline varies considerably depending on the severity of the skeletal issue and the patient's age and growth pattern. An initial consultation includes records — usually photos, X-rays, and a clinical exam — that allow Dr. Chang to map out a realistic sequence and timeframe specific to that patient.

What to Expect at Your Appointment

At a dentofacial orthopedics consultation at Chang Orthodontics in Los Alamitos, the visit typically includes a review of dental and medical history, photographs, and radiographs. Dr. Chang will assess jaw relationships, facial symmetry, and growth stage before recommending any specific approach. There is no obligation to begin treatment at that appointment — the goal is to give the patient and family a clear picture of what is happening and what the options are.

Follow-up appointments for patients in active orthopedic treatment are usually scheduled every four to eight weeks, depending on the appliance and what's being monitored.

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Frequently Asked Questions

**Is dentofacial orthopedics different from orthodontics?** They are closely related and practiced together, not separately. Orthodontics focuses on tooth movement; dentofacial orthopedics addresses the underlying jaw and facial skeletal structures. Orthodontists are trained in both.

**At what age should my child be evaluated?** The American Association of Orthodontists recommends a first evaluation by age seven. At that age, enough permanent teeth have erupted to identify developing jaw and bite problems early.

**Does orthopedic treatment mean my child won't need braces?** Not necessarily. Orthopedic treatment corrects the jaw framework; braces or aligners typically follow to fine-tune tooth position. The two phases work together.

**Are the appliances painful?** Most patients experience some pressure or mild soreness for a few days after an adjustment, particularly with expanders. This typically resolves quickly and is manageable with over-the-counter pain relievers if needed.

**Do adults in Los Alamitos come in for this type of treatment?** Adults can be treated orthodontically, though the skeletal change that orthopedic appliances produce in children is more limited once growth has stopped. Dr. Chang will discuss what is achievable at any given age during a consultation.