Orthodontic Cases

When you choose treatment with us, you choose to work together with us as a team.  Our appointments are custom-scheduled depending on individual treatment progress so we reduce as little ‘downtime’ as possible when there is no effective tooth movement.
 
You may notice that a few of the examples below have been treated with orthodontic extractions.  The decision to extract is never one we undertake lightly, and this is discussed with you prior to any treatment.  We try to avoid extracting teeth unless absolutely necessary.  However, the decision to extract is made only after careful analysis with regard to the appearance of the smile, the appearance of your lips and profile, jaw alignment, how your teeth function, how much growth you have left, as well as the final stability of the orthodontic result.
 
Individual results are ultimately dependent on mutual cooperation.  We will give our best effort and we ask that you give yours.  Cooperation with instructions (such as wearing elastics), keeping to scheduled appointments and good oral hygiene habits are what will give you exceptional results in a short amount of time.  We are proud of how quickly our patients complete treatment because of their confidence in us, and their efforts in working with us.
 

Important Information

Dr Jennifer Lim is an experienced general dentist (2004 Sydney University) who has been providing orthodontic treatment for over ten years.  She is interested in ongoing developments in general dentistry and the area of orthodontics.  She is not an orthodontic specialist, but holds a 2-year Graduate Diploma of Orthodontics with Distinction from James Cook University.  You are free to seek a second opinion.  
 
The Dental Board requires that risks are explained prior to treatment.  All treatment involves some form of risk.  If you wish to discuss braces, two appointments are needed.  The first is for records, photos, x-rays, cephalometric analysis, and a follow-up appointment for treatment options, suitability and risks to be explained.  This is documented in a treatment plan letter to be signed off prior to treatment commencement.  Total cost for both appointments is $200.  Please advise the receptionist on booking as we may need to send you for x-rays prior.  These x-rays are bulk-billed if you hold a Medicare card.  
Case 1

Crowding + deep overbite

Age group: Adolescent
Treatment modality: Braces and no extractions
Treatment time: 12 months
Concern/s:
– Crowding
– Excessive overlap of the front teeth (deep overbite)

This was a team effort with staff and the patient (and parents!). The result is a neater, broader smile, with correction of the deep overlap of front teeth and bite correction. If you look carefully at the drape of the smile muscles, the patient wasn’t used to smiling before treatment began – coaxing a smile for the camera was actually hard work! By the time we took the ‘after’ photos, the tension in the smile muscles had naturally disappeared. The result is a confident and relaxed smile.

Case 2

Severe crowding + Ectopic Canines

Age group: Late Adolescent
Treatment modality: Braces and 4 extractions
Treatment time: 18 months
Concern/s:
– Severe Crowding
– Abnormally positioned (ectopic) canines

Prescribing orthodontic extractions has often courted controversy, even among some dentists and orthodontists.  Opponents dogmatically declare that a narrow smile and a damaged side profile is the result of orthodontic extractions.  The case here tells a different story.  The patient’s smile has also actually broadened after orthodontics, in spite of extractions (note the reduction in the shadowing at the corners of the smile).  The profile has improved.  Fullness in the lower face has been effectively tempered, resulting in a more angular look which is currently in vogue.  Had orthodontics been undertaken without extractions, lower lip and facial fullness would have been even more exaggerated.

Case 3

Anterior Open Bite + Spacing

Age group: Adult
Treatment modality: Braces and no extractions
Treatment time: 18 months
Concern/s:
– Anterior open bite (front teeth not meeting when biting down)
– Spacing

The main concern here was the front teeth not meeting together – this sort of problem can affect speech, eating (think about biting into a lettuce leaf!) and swallowing.  
With orthodontic treatment, we managed close spaces, and improved the overlap of the front teeth.  The patient noticed a marked improvement in speech and eating by the end of treatment.  Plus we think his new smile looks great too! 
Case 4

Spacing + Increased overjet + Class II malocclusion + Deep overbite

Age group: Adolescent
Treatment modality: Braces and 2 extractions
Treatment time: 25 months
Concern/s:
– Spacing
– Increased overjet (upper incisors significantly in front of lower incisors)
– Class II malocclusion (bite problem where upper teeth are too far ahead of the lower teeth)
– Excessive overlap of the front teeth (deep overbite)

The main concern of the patient was the alignment of the upper front teeth.  We found there were other more significant bite issues which required the extraction of two upper premolars to resolve.  Whilst two teeth were removed, the patient finished with a broader smile than she had to begin with.  Treatment resulted in a lovely arc in the front teeth following the curve of the lower lip, where previously the teeth appeared ‘flat’ in the smile.  The result?  Youthful vibrance every time she beams.
Case 5

Crowding + Edge-to-edge incisors + Class III malocclusion

Age group: Adult
Treatment modality: Braces and no extractions
Treatment time: 11 months
Concern/s:
– Crowding
– Edge-to-edge incisors
– Class III malocclusion (bite problem where lower teeth are ahead of the upper teeth)

Our patient was bothered by the appearance of her teeth, being particularly conscious as she worked in the dental industry.  Due to the long narrow facial type of the patient, there was a risk that the overlap of the incisors would be lost and an open bite would result – or creating a situation where the upper front teeth bite behind the lower teeth!  As this was an adult case with thin gums, we had to be particularly careful not to aggravate the receding gums by applying only gentle pressure on the teeth.  We set out with the aim of completing treatment as quickly as possible so oral hygiene was not unduly compromised.  
 
The result is a pleasant smile with the alignment of teeth harmonious with the lip curves.  The bite has been corrected and there has been no measured gum damage.  An added bonus was the reduction of the black triangles between the lower front teeth.  
Case 6

Malpositioned upper canines + Anterior crossbite + Narrow upper Jaw

Age group: Adolescent
Treatment modality: Expander, braces and no extractions
Treatment time: 20 months
Concern/s:
– Malpositioned (ectopic) upper canines
– Anterior crossbite of the upper lateral incisor (upper tooth biting behind lower)
– Narrow upper jaw

As the upper jaw was narrow to begin with, the lower back teeth were biting on the inside of the upper teeth.  Part of the treatment involved a custom-made expander to broaden the upper arch to enable a proper bite and wide smile.  The upper canines were gently guided into position.  If you look closely at the muscles around the mouth, you can see just how much more naturally confident this patient is smiling after braces have been removed.  We do not and cannot force this natural spontaneity in our photos.  The result speaks for itself.
Case 7

Crossbite + Mild crowding

Age group: Adolescent
Treatment modality: Braces and no extractions
Treatment time: 18 months
Concern/s:
– Crossbite in the left canine region (right side of picture) – upper canine biting inside lower canine
– Mild crowding

The crossbite and alignment of the teeth on the left side (right side of picture) was the main concern here.  There were also some minor bite problems which needed resolving.  Orthodontic treatment addressed all these issues – and we managed to broaden the smile, reducing the shadowing in the corners of her smile.  We were thrilled with the result, as was the patient.  It was a pleasure treating her, seeing treatment progress with each appointment and just watching her grow up!

Case 8

Misalignment of lower incisor + deep overbite

Age group: Adult
Treatment modality: Lower braces only and no extractions
Treatment time: 4 months
Concern/s:
– Misalignment of lower incisor
– Excessive overlap of the front teeth (deep overbite)

Relapsed orthodontic cases are quite common.  The importance of wearing retainers was not as well understood or appreciated as it is today.  We commonly see cases like this one as we see our patients regularly over the course of many, many years.  Often the decision to undertake treatment for orthodontic relapse is something adult patients have thought about for some time, before they finally (usually after many years of indecision!) bite the bullet.  
 
A few decades after the original braces were taken off the teeth have drifted to where they are.  The only thing that was troubling this patient was the misalignment of one of the lower incisors.  As the teeth are situated in a dark cavern (also known as the mouth), not a lot of natural light gets in except through the front!  Lower front teeth especially which are positioned behind the other teeth, can look like they are missing when smiling, due to the shadowing caused by the other oral structures  
 
We had to take extra care with this case as he had ongoing periodontal (gum) disease and the loss of supporting bone holding the teeth.  All orthodontic forces applied were gentle.  An efficient biomechanical set-up meant we completed the case in 4 months with lower braces only.  There was no measured decline in gum health.  Alignment issues were resolved, and vertical control was maintained despite braces only being placed in the lower arch only.  This resulted in an ideal overbite (overlap) of the incisors.