For many problems of the teeth, jaw and neck, it simply gets worse if you do not make it better. Malocclusion, or misalignment, is not just an aesthetic problem-it contributes to diseases of the teeth and gums, and causes discomfort that can express itself in fitful sleep, neck and back pain, bad posture, headaches, the inability to concentrate or worse. Proper alignment and function create greater resistance to disease, and form the foundation of both a beautiful smile and a sense of wellbeing and confidence.

We individualize our approach to each patient, considering both aesthetic and functional-structural principles when planning treatment. Bioesthetic orthodontics, combining both biologic form and functional occlusion goals, can provide a more holistic and pleasing solution. We work to ensure that form can follow function and function can follow form.

Our planning encompasses the airway, breathing function and craniofacial development, which are interconnected and interdependent during growth. It is imperative to normalize form and function as early as possible so that function is optimized for life. In our planning, we also consider temporomandibular joint (TMJ) dysfunction. By arranging the teeth to work with the alignment of the jaw joints, a more stable result can be attained.

A highly sophisticated practice, we employ digital low-radiation scans and x-rays and the latest advances in the orthodontic medicine field, including self-ligating metal, clear brackets, Incognito lingual appliances (braces that go behind the teeth), and articulators (jaw simulators) to study each patient's malocclusion. We also work with other highly certified specialists, including periodontists, oral surgeons and restorative dentists, to treat more complicated cases.

We are boutique practice. All the work is done by Dr. Karpov, with the support of her highly trained staff. Dr. Karpov and her staff take continuing education classes to keep pace with the latest developments in orthodontic science and treatment.

When is it right?

Age 7

The American Association of Orthodontists recommends that all children have an orthodontic evaluation no later than age 7. Certain conditions, such as a malformation of the palate, habits can be treated most effectively at this age. If you have any questions, ask your dentist or call us directly.

Age 12-13

Full orthodontic treatment usually starts when all or most permanent teeth are erupted including what are known as the 12-year-old molars. This is around age 12 or 13.

When You're Ready

Healthy teeth can be adjusted and realigned at almost any age. For adults, orthodontia can be transformative, not just for your appearance, but your wellbeing and outlook on life.

Early Treatment

Seek treatment earlier than age 7 if your child has:

Difficulty chewing
Open-mouth breathing
Thumb or finger sucking
Overlapping or crowding of erupting permanent teeth
Jaws that click or pop
Biting of the cheek or into the roof of the mouth
Speech problems
Grinding or wearing down of teeth
Obvious abnormal bite development of any kind

Warning signs in 7-year-olds

Do the upper teeth protrude?
Excessive protrusion of the upper front teeth is a very common problem in orthodontics

Is there a deep bite?
The upper front teeth cover the lower front teeth too much

Is there an "underbite" ?
The upper teeth fit inside the arch of the lower teeth

Is there an open bite?
There is a space between upper and lower front teeth when the back teeth are together

Is there too little room for the permanent teeth?
Crowded upper or lower teeth.

Do the front teeth line up?
The spaces between the two upper front teeth and the two lower front teeth should line up with each other. If they do not, the probable cause is drifted teeth or a shifted lower jaw.

Is there a crossbite?
The upper back teeth fit inside of the lowers.

Adolescent Treatment

Most permanent teeth erupt around age 12 or 13, including what are called 12-year molars. This is when full orthodontic treatment for adolescents usually starts. Duration of full treatment can be anywhere from 18 to 36 months. 24 months is common. Treatment time depends on many factors such as the difficulty of the case, patient compliance, hygiene, and so forth.

The braces we use are the newest technology. They are "self-ligating" which means they do not need to be tied in with elastic ties. Instead, they have a little clip that snaps into place. In the early stages of treatment this reduces friction, which allows teeth to move faster with minimal force and discomfort. Clear brackets are also available. We also have an option of digital treatment with Insignia. We use Insignia software to personally design each patient's smile for precise, comfortable tooth movement.

Adult Treatment

Crowded teeth and a "bad bite" can contribute to gum and bone loss, tooth decay, abnormal wear, headaches and jaw joint (TMJ/TMD) pain. Many orthodontic problems can be corrected as easily and as well for adults as children. Orthodontic forces move the teeth in the same way for both a 75-year-old adult and a 12-year-old child. Some factors, such as lack of jaw growth, may create special treatment planning needs for the adult. Orthodontic treatment in adults can restore good function, increasing the health of the teeth, gums and jaw joint while improving personal appearance and self-esteem, no matter the age.

The new techniques and appliances we use greatly reduce discomfort levels, decrease the frequency of visits, and shorten treatment time. Your options may include metal braces, ceramic (tooth colored) braces, lingual braces (Incognito) or clear aligners (Invisalign) that can be worn to improve mild cases of misaligned teeth. We also can provide clear aligners as a service to our patients. This technique is basically a series of computer generated, clear, trays that fit over the teeth. The patient wears the trays ("aligners") full time except to eat, and changes them approximately every two weeks. Each tray moves the teeth a small amount. The teeth are aligned in a stepwise process.

TMJ Dysfunction

Headaches, facial or neck pain can be a sign of Temporomandibular Joint Dysfunction or TMJ. Other symptoms include muscle pain, limitation of jaw movements, tooth wear, receding gums, notching of the teeth at the gum line, and adverse bony changes within the joint. TMJ dysfunction can be caused by disharmony between teeth and jaws. Treatment can reduce or eliminate the possibility of further damage. When a patient shows signs or symptoms of TMJ dysfunction additional records may be ordered for a complete diagnosis, such X-rays or a CT scan. Treatment for TMJ dysfunction usually involves splint therapy. The splint is a very effective appliance that is custom made for each individual. The splint is adjusted as needed to reduce painful symptoms and stabilize the entire chewing system.

Orthognathic surgery

The upper and lower jaws are the bases upon which the teeth are aligned. When the jaws are too short or long, or too wide or narrow, the proper bite often cannot be achieved with braces alone. The orthodontist together with an oral surgeon formulates a combined treatment plan. In some severe cases orthodontics and orthognathic surgery may be the only treatment option.

Bioesthetic Orthodontics

Often times patients have teeth that in addition to being misaligned are not the proper shape and form. Although the teeth can be orthodontically straightened, proper function is unachievable due to inadequate tooth form. Proper form can be reestablished with restorative dentistry followed by orthodontic treatment. Teeth with the proper form are not only more beautiful, but function together better. Bioesthetic orthodontics is based on a combination of biologic form and functional occlusion goals.