The initial step in orthopedic orthodontics is to properly balance the function of the temporomandibular (jaw) joints.  Sometimes this is fairly simple, and sometimes long term problems, wear and tear, injury and/or disease processes may compromise a perfect result.  This is a paramount reason that a thorough and accurate diagnosis be achieved first.  Nonetheless, in all cases, we strive for perfection. 

After jaw joint stabilization and increased function with decreased symptoms are achieved, if a determination is made in a Phase II evaluation of treatment that tooth movement is necessary, the exact approach needs to be outlined and specific goals set.  More often than not, the first step involves removable oral dental appliances that help move and direct bone support as well as move teeth, while at the same time supporting the work already done to stabilize the jaw joints.  The final stages generally involve fixed orthodontic appliances (braces).  All along treatment, the jaw joint function and jaw joint health need to be monitored at each appointment.  Upper and lower retainers are generally used at the end of treatment in the vast majority of cases.

It is not a prerequisite of jaw joint problems for a patient to be a candidate for orthopedic orthodontics.  Those who specifically desire treatment for esthetics, and those children and young people requiring treatment also deserve the same quality treatment approaches.  Often, intermittent treatment throughout the growing years can allow more normal development of the jaws and alignment of the teeth at an earlier age.  This approach if far preferable and easier on the patient than waiting until late adolescence and trying to “unravel” everything.