How to choose the right orthodontic treatment for your desired smile

By Dr. Rucker

Today we will speak with Dr. Rucker of Rucker Orthodontics in Temecula, California. We will delve into specifics on how Dr. Rucker helps new patients understand their smile and how treatment can lead to optimal results.

Q: Introduction Statement: Thank you for taking the time to speak with us today. Could you give us some insight into your background and professional experience?

A: Hello! I completed dental school at the Medical College of Virginia in 2010 and completed my post graduate orthodontic residency in 2012 at St. Louis University. I’ve been practicing orthodontics for nine years now and have treated over 7200 cases. I have completed 80% of those cases with the Damon™ System braces exclusively, and the remaining 20% with clear aligners.

Q: Can you please speak in some detail about how different smile types are obtained? If you want to achieve certain smile types, are there any particular advantages in having braces versus aligners?

A: The very first thing I look at when deciding between braces and aligners is the arch form. I look at how the smile relates to that specific patients’ facial features. If I see the patient has a narrow arch, I automatically recommend Damon Braces to widen their smile. Typically, I recommend clear aligners to adult patients that may have had braces before but have had a relapse in crowding or another non-major issue. I also recommend clear aligners for our responsible teen patients that lack severe bite related issues or smile width concerns. These are the types of patients I prefer to treat using aligners where treatment time can be estimated to be around 6-8 months.

Q: Are there any potential customization options that may help achieve a desired smile outcome? Do braces treat specific malocclusions better than aligners, or vice versa?

A: For the more complex cases I prefer braces – and not just traditional braces, but the Damon System braces more specifically. I find that the malocclusions better treated with braces are: transverse issues (width), smile arc needs, as well as moderate to severe patients with Class II and Class III issues. I have, however, treated every malocclusion type with clear aligners and Damon Braces. Although the need for permanent tooth removal is rare, certainly less than 5%, we do prefer Damon Braces to treat extraction cases over clear aligners. I choose clear aligners when I’m looking at Class I with minor to moderate crowding and insignificant smile design issues or concerns. I also tend to stay away from treating gummy smiles when using clear aligners. Overall, I am very proud to say that in our practice we have not needed any expanders and rely completely on sound Damon System mechanics to achieve beautiful outcomes. We have not left a single crossbite in post treatment, so the use of rapid palatal expanders is, in our opinion, an archaic treatment approach. Our patients appreciate that. Furthermore, as compared to traditional braces, our clinical efficiencies are significantly better, which translates into less time in braces for our patients and in turn helps us keep our treatment fees affordable.

Q: Can you please talk about the importance of doctors and patients being on the same page at the start of their treatment plan? How do you speak with patients about their expectations and desired results for a smile goal?

A: At the end of the day, patients are looking for uncomplicated treatment that makes sense, achieves their desired outcome, and is affordable. The patient experience and connection with our office is important from the get-go. We strive for a positive experience overall – from the initial phone call, to office paperwork and overall practice workflow, and so much more. I would say our team approach is similar to playing volleyball. “Bump, Set, Spike” – if you don’t have a good bumper or setter, which is the responsibility of the admin team prior to the initial exam, you are going to be recovering from that point forward and the spike is going to be challenging. So, in my practice, we work together for the ultimate patient experience, and we work hard from the initial phone call through the end of treatment and beyond. As far as the initial exam is concerned, I look to identify no more than three major issues. That way, the patients have an easier time understanding what obstacles are in the way of their desired outcome. We will show before & after pictures that help patients to really visualize the bite issues they have and see their transformation needs. In many cases, getting lost in too many diagnostic details or what bracket systems we are going to use can overwhelm new patients and cause an analysis paralysis. To avoid this, we keep it focused, simple, and affordable.