Pittman Family Orthodontics

We offer a few convenient ways to schedule your new patient appointment. You can call our office line during business hours at 919-762-3001. You can also schedule online through our website at the ‘Book Online’ link.

Prior to your appointment, we need you to complete an online health history. You can find the link on our website or we are happy to email you the link. When booking your appointment online, a link to the questionnaire is included in the confirmation page. We will ask for information about the patient’s dental insurance so have that information ready.

Yes! After Dr. Pittman performs an exam and reviews your records, he will discuss the findings and present your treatment options. He will explain the advantages and disadvantages of the different options and answer any questions you may have.

Fortunately, the radiographs required for orthodontic treatment have minimal radiation when taken with modern radiograph units. The amount of radiation is roughly equivalent to riding on an airplane.

We are in-network with most dental insurances and file claims for all dental insurance networks except Medicaid. Prior to your visit we will check your insurance benefit and review this information with you at your appointment. We typically receive payments directly from your insurance company throughout treatment. Unfortunately most dental insurance orthodontic benefits do not cover the full cost of braces, but we do offer interest-free financing.

Yes! Some patients choose to pay in full, but most take advantage of our in-house financing. We offer a low down-payment and a bank draft or credit card automatic monthly payment.

Absolutely. We are happy to work with you to ensure you are utilizing these accounts as much as possible.

Yes. Most patients have a few options for treatment. Our goal is to help you choose by giving you the information you need to make a wise decision. Of course, if one specific treatment approach will be more effective, we will let you know.

Usually we are able to begin treatment the same day as your new patient appointment if you are ready to move forward!

We realize it’s a big decision! And it can be confusing if you’ve received a different treatment plan from another provider. Consider these questions. Am I comfortable with the provider’s communication style? Do the credentials of the provider indicate they practice evidence-based orthodontics? Is the provider board-certified? Do I like the treatment plan? Were my questions answered? Do the scheduling options work for me? Will the care be consistent? Is the administrative work done at the office or at another center? Fortunately there are a lot of great orthodontists in our area. However, we are proud of the excellent experience you will have at our office.

Our new patient exams and growth and observation checks are complimentary!

There are a few reasons why we have primary, or baby, teeth removed. Primarily it is done to facilitate better eruption of the successive permanent tooth. Other times it is done as a way to temporarily manage severe crowding.

Extracting teeth falls outside the parameters of the orthodontic specialty. Your dentist or pediatric dentist will typically extract primary teeth, although you have the option to see an oral surgeon.

Yes! We may still decide it makes the most sense to monitor growth and eruption versus addressing the crowding early. However, it is good to explore your options. More importantly, sometimes addressing crowding early will make future treatment much easier.

No! In fact most kids do not.

Usually yes. Early treatment is done as efficiently as possible to address specific problems that need to be corrected early. Comprehensive orthodontic treatment is more holistic in it’s goals and as a result takes more time and is more effective when all permanent have erupted. Some patients do have amazing transformations with early orthodontic treatment and we are honest in letting you know if comprehensive treatment is elective. Generally it is best to assume comprehensive treatment will be required.

Most kids have early treatment sometime between the ages of 7 and 10.

Early orthodontic treatment usually lasts a year or less.

Yes! Or discuss your concerns with your pediatric dentist. We have a detailed blog post on some strategies to use as a parent to address this habit. We recommend beginning with some at-home strategies such as sticker charts or sleeping with gloves or socks on your hands. If those approaches are unsuccessful we recommend seeing an orthodontist for a habit appliance.

Phase 2 treatment is typically done when all permanent teeth have erupted or when a patient is entering their pubertal growth spurt. The best time to begin really depends on the patient. For most teens it is between the ages of 11 and 13 and most patients have 1-3 years between their two phases of treatment.

Phase 2 treatment is comprehensive orthodontic treatment that is done on a patient that received phase 1 treatment. Other than that they are the same!

Definitely not! A thorough understanding of the patient’s chief complaint, orthodontic problems, dental health, goals for treatment and lifestyle are all factors in deciding the best approach to their case.

Since comprehensive treatment is comprehensive in its goals, treatment is longer than other types of orthodontics and varies significantly based on the treatment plan. Treatment usually lasts between 1 and 2 years.

Limited orthodontic treatment addresses specific problems and is typically done on either the top or bottom arch. For example, lower incisor crowding or spacing between the front teeth. If limited treatment is an option we let patients know; however, usually patients require or choose comprehensive treatment. Comprehensive treatment is often necessary for us to fully correct the patient’s chief complaint even if it is just one tooth. This is because the top and bottom teeth fit together like a puzzle. The technical term for this is occlusion. In limited treatment we must work within the existing occlusion since we are only moving teeth in one arch. In many patients this can compromise the results since misalignment on the opposing arch, deep bites and overjet issues can prevent tooth movement or cause unstable results. Also most patients choose comprehensive treatment even if limited treatment is an option. You’ll be coming to see us anyways and following the rules on being an all-star orthodontic patient. Most adhere to the logic that if you’re going to do it, do it right!

Possibly but unlikely. For a minority of patients, extractions during orthodontic treatment will lead to the most ideal result. We thoroughly review complete records and if extractions will be best, discuss the rationale when finalizing our plan. We realize when we recommend extractions, patients are NOT excited. Fortunately not many require extractions and patients that need extractions are not surprised. More often, patients are surprised they do not need extractions! Keep in mind that at the end of treatment, only you and your dentist will be able to tell teeth were removed since we close those spaces during orthodontic treatment.

Typically wisdom teeth do not impact our orthodontic treatment plan. As part of the diagnostic records we take a panoramic radiograph and review their position. Occasionally we recommend their removal if they will prevent alignment of other teeth, have a cavity or are positioned in a way that makes it difficult to keep them clean.

Most definitely yes! It is even more important to have professional cleanings while in orthodontic treatment because it is more difficult to keep your teeth clean. Maintain your normal cleaning schedule or consider increasing the frequency of cleanings. It is also important for your dentist to continue to check for cavities during treatment.

It depends. Any active decay or disease is almost always addressed prior to orthodontic treatment. Typically crowns, veneers and removable appliances are done after orthodontic treatment. We stay in communication with your dentist before, during and after orthodontic treatment so that the sequence is clear and everyone is on the same page.

Not everyone is a candidate for a limited treatment, and a thorough exam with records will answer your question. Sometimes it is not possible to address a patient’s chief complaint without correcting other orthodontic problems.

For a limited treatment, it is important that the final position of the teeth is harmonious with the bite. When occlusion is proper the results are more stable. With all orthodontic treatment we recommend a few months of full-time retainer wear and then wearing your retainers at night for life.

There are a lot of different types of retainers, each with advantages and disadvantages. For certain types of cases, one style of retainer may be better. At our office we customize retainers based on your case, and will give you the option to choose as well. Clear retainers provide the most stability for front teeth, but are least durable. Hawley retainers hold width changes well, can be adjusted for new crowns or fillings and are most durable. However, some patients find them uncomfortable and they are not invisible. Bonded retainers require the least compliance but can break and are difficult to clean.

For comprehensive treatment, we include four retainers at the end of treatment.

It is important to take good care of your retainers so that they last as long as possible. However, at some point you will need replacement retainers. It is much cheaper to get new retainers than to let your teeth shift and need orthodontic treatment again! We include four retainers in our comprehensive package so you have a replacement if one breaks or is lost. If you do not have a replacement, see an orthodontist as soon as possible!

After comprehensive treatment, we recommend four months of full-time wear. During full-time wear you should have your retainer in your mouth for about 20-22 hours/day. Remove your retainer if you are eating or drinking anything other than water and when brushing and flossing. After the full-time wear period, you will transition to night-time wear, which means wearing your retainers at night while you are sleeping. Maintaining your ideal results is a lifetime commitment. Pressures on teeth change with age which can lead to relapse. That’s why we recommend nighttime for lifetime. Once you are in the habit of wearing a retainer at night it will feel weird to sleep without them!

Clear retainers often work great as bleaching trays for whitening!

Yes, and you should! It requires more effort since you have to thread the floss under the wire. We typically place lower bonded retainers that are only glued to the canines as opposed to every tooth. As a result, they are much easier to clean.

Nightguards typically function as a retainer for one arch. Keep in mind though that the opposing arch will still need a retainer to maintain alignment.

A tight retainer either indicates the retainer was distorted or your teeth have shifted. Often increasing the frequency and length of retainer wear will help your teeth shift back to their correct position!