Are You Tongue Tied? Would You Benefit From A Lingual Frenectomy?

TEST YOURSELF:   Open wide! Now while keeping your mouth wide open, see if you can touch the roof of your mouth with the tip of your tongue. If you can't, this variation of normal is referred to as "Ankyloglossia" or being "tongue-tied".


  If it is significant enough I sometimes recommended having a procedure called a lingual frenectomy done to improve the range of motion of the tongue to allow the teeth/jaws to spontaneously improve and resume more ideal normal growth. There is also a long-term benefit in promoting long term improved stability after braces.


  The tongue is one of the important muscles that influences the alignment of growing teeth. If it is restricted in its range of motion the upper jaw may develop narrower than the lower jaw causing the back teeth to bite incorrectly in what is called a "crossbite". It may also not push on the back of the bottom front teeth hard enough to balance the pressure from the lower lip, causing them to crowd and twist. 


  In significant cases, a lisp in speech may be audible which frequently improves the same day as the frenectomy is done to correct it.

Below are before and after pictures of Luke, a 7 year old boy who had a moderate case of ankyglossia (tongue-tie).



Moderate tongue-tie which was
 causing his lower teeth to lean inwards.

Because the patient's lower front teeth are tipped backward, the lingual frenectomy allowed the tongue the freedom to rest against them a little harder and push them outwards. The pressure that the tongue naturally places on the front teeth is minimal but constant,  which encourages the teeth to shift forward and improve their positions.
  



Actual picture of Luke 1/2 hour after 
having the procedure.



In this case, the lingual frenectomy was performed with a laser, which resulted in the patient leaving the office with little discomfort, no stitches and no bleeding. One half hour after the procedure, the patient was happily enjoying ice cream and then went to baseball practice.



36 hours post operative. Luke experienced
a slight itching sensation as the tongue healed.



The healing continued throughout the next week with no real discomfort and a minimal itching sensation for about two days. By the end of the second week, the area was completely healed and there was little noticeable evidence that the procedure had taken place. The cells of the mouth completely renew themselves every 2-3 weeks, so there is no scarring.

Insurance Coverage - Are You Getting What You Pay For?

When a parent realizes that their child needs braces, they are usually very happy to find out that they have orthodontic coverage that will pay a portion of the costs. Unfortunately, more parents are now finding out that the rules are changing and if insurance paid a portion of orthodontic treatment for a Phase 1, they will not cover any of Phase 2, which is often more expensive for the parent and the insurance company. Depending on the insurance company and the patient's treatment plan, a 1st Phase of orthodontic treatment may only beneift the patient a few hundred dollars, while a Phase 2 payout by the insurance company may cost the insurance company a couple of thousand dollars.

I was recently speaking to a customer service representative at one of the nation's largest insurance company's, trying to get information on a patient's orthodontic coverage, when I was informed that insurance will no longer cover both phases of orthodontic treatment. I was told that if a patient has Phase 1 or braces on the primary teeth, then insurance won't cover a Phase 2 or braces on the permanent teeth later on if needed.

While on the surface, this may not seem like a big deal to a lot of people and the reasoning behind it is being touted as a way for employees to save money on their dental  premiums, most people who have had a 1st Phase of orthodontic treatment, don't realize that they often continue to pay for benefits that they will not be able to benefit from at a later date.  To compound the problem, the majority of patients that need a Phase 1, need a Phase 2 when the permanent teeth come in. Phase 1 is usually required when there is a potentially destructive dental issue at hand. An example would be a cross bite that can damage the teeth when they hit each other each time the child closes their mouth to chew their food. In this case, without a Phase 1 of orthodontic treatment, there is a possibility that the teeth will chip and/or break.

Lesson learned? If your child had a 1st Phase of orthodontic treatment, verify with your insurance comapny that if your child needs additional orthodontic treatment at a later date, he or she will be covered. If you won't be covered for a second phase, you need to make sure you are not paying for orthodontic coverage that you will not benefit from and you may want to shop around for another dental plan that will help you cover the expense at a later date.

Ever Wonder What Your Smile Would Look Like After Braces?

If you are anything like a lot of other people with crooked or imperfect teeth, you have probably wondered what you would look like if you had braces. Well now is your chance to find out. The American Association of Orthodontists are running a promotion where people can send in a photo of themselves smiling and they will edit the photo to show what you would look like after orthodontic treatment. The promotion is called Virtual Smiles and you can click on the link below to check it out for yourself. It's fun, fast and best of all FREE!

Virtual Smiles Promotion

Special Patients with Special Needs

At Eder Orthodontics, Dr. Eder and his team, work with patients of all ages and needs. These patients often include patients with special needs and disabilities. Dr. Eder is experienced working with these patients, and he and his team work hard to help create a comfortable & relaxing environment for them and their families.

Whether the patient is wheelchair bound due to an illness or accident, or suffers from Down’s Syndrome or other developmental disability, Dr. Eder and his team work hard to accommodate all the needs of all the patients entrusted to his care. It is not unusual for Dr. Eder to set aside extra time to work with some of his special needs patients at the parent’s request, so as to not overwhelm a patient that might not feel comfortable in a waiting room filled with patients.

Dr. Eder’s compassion and experience in working with patients with and without special needs is unsurpassed. He and his staff at Eder Orthodontics treat all of their patients special, regardless of their needs.

Play It Safe and Gear Up with a Sport Mouthguard

At Eder Orthodontics, we know how important it is to protect your teeth and your face while playing sports. With the arrival of spring and summer there is an increase in outdoor activities and a greater chance of damaging your mouth and teeth. Dr. Eder knows that sports-related injuries are very common among children and teenagers alike and is happy to be a part of the AAO "Play it Safe" campaign. The American Association of Orthodontists is promoting their campaign to encourage youth of all ages to gear up and play it safe by wearing mouthguards when participating in any sporting activity.  

The following are some interesting statistics that the AAO has listed on their website and should be considered when deciding if your child needs a mouthguard when participating in their sport of choice.

Injuries can happen at any age or skill level – More than half of the seven million sports and recreation-related injuries that occur each year are sustained by youth between ages 5 and 24. *

• Collision and contact sports have higher injury rates. Baseball, soccer, basketball and football account for about 80% of all sports-related emergency room visits for children between 5 and 14 years of age.*
• Mouth guard use is very low – 67% of parents say their child does not wear a mouth guard – yet, 70% say their biggest fear when their child plays is that they will get hurt.**
• One out of every four (27%) parents say their child has sustained an injury during an organized sport resulting in a trip to the emergency room.**
• Most coaches and leagues are not advising the use of mouth guards – Of the parents whose children do not wear a mouth guard, 84% say it's because the league or coach does not require it.**
• Hard hits occur no matter what the sport – The average high school baseball pitcher can throw a fast ball between 75-85 miles per hour. This compares to being hit in the mouth by a speeding car.***
• Cheerleading is one of the most dangerous sports, accounting for 65% of all injuries in high school girls' athletics.****
• Children with braces need to wear mouth guards – One out of every three (31%) parents say their child has orthodontic treatment or braces while playing an organized sport.*
• Lacerations can occur if an orthodontic patient´s mouth is not properly protected.

* Centers for Disease Control and Prevention
** American Association of Orthodontists
*** eFastball.com
**** MSNBC.com

These are just a few reasons that Dr. Eder and the Eder Orthodontics team are doing our part to spread the word that facial sports injuries can be avoided simply by reminding your kids to wear mouth guards. At our office we have a variety of mouthguards available for patients of all ages. We even has an in-house Jawzz Professional Mouthguard maker that specializes in  mouthguards for professional and amateur athletes of all ages.

                  Click Here to Check Out Some Really Cool Jawzz Mouthguards!

Poking Wires, Broken Brackets and All That Stuff!

Anyone that has had or has braces knows that it is not uncommon to have a poking wire or a broken bracket at some point during treatment. While they can be bothersome and annoying, it is no reason to panic. Poking wires often occur when the wire shifts due to tooth movement or broken brackets. Fortunatley, poking wires can usually be easily fixed by reinserting the wire into the tube on the bracket by using a pair of tweezers to grasp the wire and carefully placing it into the tube. If you are unable to reinsert the wire, you also have the option of clipping the wire with a pair of nail cutters that resemble cuticle cutters. You just need to clip the wire as close as you can to where it connects with the last tooth that it is attached to. By doing this, you can temporarily provide comfort and alleviate the pain that can be caused by poking wires.

Insurance and Braces - Are You Covered?

As anyone with braces can tell you, orthodontic treatment can be very expensive, but dental insurance can help. The trick to getting the most out of your insurance begins with understanding how orthodontic insurance works.

To begin, there are usually limitations on how much orthodontic coverage a person is eligible for. Typically, coverage is limited to 24 months of treatment with an HMO. HMO's also have limitations on which doctor you can see, as they will not pay for treatment if you do not go to one of their participating providers. Fortunately, Dr. Eder participates with most of the major companies and is experienced in jumping through their hoops, to get the most benefit for the patient. This often includes sending in a pre-authorization request before the patient begins treatment.

PPO's on the other hand, usually have Lifetime Maximum payouts. What this means, is that they will only pay a limited amount towards braces, throughout the patient's lifetime. The most common lifetime maximums offered range from $1000 to $1500, but there are plans out there that will pay as little as $500 to as much as $3000. With a PPO plan, you do not have to see an in-network dentist, but you probably won't receive the discounted rates that participating providers usually offer, and once you have used your benefit maximum, you are responsible for all  outstanding charges.

Both the PPO and HMO plans have fee schedules that participating providers must follow when treating patients covered by their respective plans. In most cases, there are some nice discounts, but depending on the plan, they may limit how often a certain procedure may be covered.

Another nice thing about PPO's that differs from an HMO, is that a PPO will usually coordinate benefits with a secondary insurance benefit. Unfortunately, most HMO's will rarely coordinate benefits with another insurance company, unless they are the primary insurance and the PPO is the secondary insurance.

So how do you know which insurance is the primary and which is the secondary insurance when you are covered by 2 insurance policies? With children, the parent whose birth date comes 1st in the year is the primary and the other subscriber whose birthday is later in the year is the secondary. Please note that this does not include the birth year, only the month and day. Which means that if mom's birth date is 6/5/59 and dad's birth date is 7/5/49, mom is the primary and dad is the secondary because mom has her birthday first in the year. There are also exceptions to be made when people share a birthday or when a court orders a certain parent be responsible for primary coverage. When referring to adult coverage, if you have coverage through your employer, you are the primary and your spouse's insurance is your secondary insurance.

To complicate matters even further, insurance companies may  also include a non-duplication clause, which will limit what the secondary insurance pays. In most cases, it means that the secondary insurance company will not pay more than the primary insurance company will pay. So if your primary insurance coverage is for 50% of a procedure up to $1000 maximum and your secondary insurance company benefits are the same 50% up to a maximum of $1000, then the second insurance company will not pay anything towards the procedure. However if the secondary insurance coverage is 80% up to a maximum of $1000, then you should get the benefit of the extra 30% coverage and the secondary company should pay an additional $300.

There are many other situations and clauses that may arise when dealing with dental insurance and orthodontics in particular. One of the main concerns that many people have, has to do with is how and when the insurance company pays for orthodontic treatment. In 99% of the cases, the insurance company will pay for their share of the orthodontic treatment throughout the period that the patient has braces. So if the patient is scheduled to have braces for 24 months, the insurance company will make payments to the doctor, spread out throughout the 24 month period. Unfortunately, this means if you cancel your insurance or lose coverage before the braces are scheduled to come off, the primary subscriber (or patient) is now responsible for paying the doctor whatever amount the insurance company failed to pay.

If you are interested in finding out about your insurance benefits, it is often best to speak to your Human Resource office at your place of business when possible. If it is not possible, I recommend calling the customer service number on the back of your insurance card and asking them to explain your benefits. However, please remember that these customer service representatives are human and can make mistakes, and they will remind you that all benefits quoted over the phone are not a guarantee of coverage. With that said, at Dr. Eder's orthodontic office, we pride ourselves in going that extra mile to help you understand your coverage. To set up an appointment for a Free Consultation, and to have your insurance questions answered please call (561) 737-8776.

Building Relationships at Eder Orthodontics

At Eder Orthodontics, Dr. Eder and his staff pride themselves in building relationships with patients that often lasts long after the braces have come off and orthodontic treatment has been completed. It is not unusual to have patients stopping by just to say hello, even after getting their braces off years earlier.

It is also not unusual for parents to come in for orthodontic treatment after their children are out of braces. The amount of trust that they have in Dr. Eder and the staff is something that we take very seriously and work hard to maintain. One of the greatest compliments that patients give our office, is the referral of their friends and family. Dr. Eder has even had a couple of patients that he treated as teenagers, grow up and start a family of their own and then bring their children for consultations. Now that's a compliment!

To find out more and to schedule a complimentary consultation, please call our office at (561) 737-8776.

American Association of Orthodontists Promotes Free Consultation Campaign!

Starting in February and lasting until June 2011, the American Association of Orthodontists is promoting a Campaign for a Free Orthodontic Consultation. This is the perfect opportuntity for anyone wondering what it would take to have a beautiful smile, do so, without having to pay a consultation fee. During the initial appointment, Dr. Eder will do an exam to determine if any orthodontic treatment is necessary and if so, what type of treatment is recommended. Our staff is also be available to check insurance and discuss possible payment options. If you or anyone you know is interested in finding out how Dr. Eder can help you smile, please call the office at (561)737-8776 and we will be happy to set up an appointment for a Free Consultation. Eder Orthodontics always offers a Free Consultation to their  new patients, so give us a call today!