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Orthodontics 101

We’ve created a comprehensive guide to help you better understand what the best orthodontic care really means.

Could you repeat that question
  1. In-person consultation with an orthodontist: moving teeth affects the position of your nose, lips, and chin. To truly optimize a person's smile within their individual facial features, an in-person assessment by an orthodontist is needed.

  2. Treatment plans: an orthodontist must create a treatment plan, not simply approve it. Based on an in-person assessment, your orthodontist will engineer a plan that moves your teeth into the ideal position, taking into account your facial and specific teeth features. More comprehensive cases will require the use of tooth buttons (more on those below). Your treatment will require a specific amount of clear aligners tailored to your needs, to be used over time.

  3. Tooth buttons: think of these as handles for the clear aligners to efficiently move slippery teeth. The size, shape, and location are prescribed by an orthodontist, and placed as strategically as possible (meaning: you won’t be stuck with a mouth full of tooth buttons). 

  4. Progress check-ups: while most of the art of clear aligner treatment goes into the planning phase for orthodontists, high quality care requires continual check-ups. At least once throughout treatment, aligners stop fitting perfectly, which requires a new 3D scan and the manufacturing of new aligners based on new treatment plans. We check in on you throughout your journey to make sure you're staying on track.

  5. Dental health check-ups: moving teeth can exacerbate any underlying dental problems, which means patients should be diligent with their dental check-ups during their clear aligner treatment. We collaborate with your dentist to make sure you're getting the best care.

Both dentists and orthodontists are dental school graduates, and both provide dental services. Your dentist may even offer orthodontic services, leading you to assume that they’re an orthodontist. But here’s the difference:

Dentists are concerned with overall oral health. They usually provide services such as crowns, veneers or bonding to improve the appearance and function of teeth that have extensive decay, or are misshapen or broken. Dentists look for abnormalities in the mouth and teach patients how to prevent dental disease.

Orthodontists, meanwhile, specialize in tooth movement to maximize an individual's smile and function. By studying biomechanics, orthodontists have the skillset to move teeth into their optimal position within a person's jaws and facial proportions to create the most beautiful smile and healthy bite in the safest way possible. Becoming an orthodontist requires a three-year residency in addition to four years of dental school.

Orthodontics at its core is the art of tooth movement. Whether you pursue orthodontic treatment with braces or clear aligners, an orthodontist is needed to provide the highest level of care.

Yes. Your Two Front Care Team takes every precaution necessary to ensure we’re delivering the highest level of care and safety during COVID-19.

Here are the precautions we’re taking:

No busy clinics

With our in-home appointments, you don’t have to step into a busy clinic ever again. Note: A clinic has an average of 12 people providing care, while we have two. 

Pre-screening

Before your in-home appointment, we’ll send you a COVID-19 safety screening survey that ensures you’re not experiencing any symptoms. Note: we won’t enter your home if this survey isn’t complete.

Antibody tests

Our doctors and Care Managers take antibody tests regularly.

Temperature checks

We take our temperature — and yours —  before every in-person appointment. 

Advanced cleaning and sanitizing procedures

In addition to our normally rigorous cleaning protocols, we sanitize all equipment used after each patient visit using disinfectants that are EPA-approved for COVID-19. We also regularly sanitize shared surfaces, as well as our chair and dental tray. 

Personal Protective Equipment

Our doctors and Care Managers wear and provide PPE at every visit.

Remote Check-Ins

Not every appointment requires an office visit. After the application of your tooth buttons, we’ll check in monthly to make sure you’re staying on track though our telehealth portal. We’ll only schedule in-person visits if needed.

Great news! It's a myth that you need to have all of your permanent (or adult) teeth in order to start your orthodontic care (whether it’s with braces or clear aligners).

Ideal timing for orthodontic care should start in pre-teen or teenage years, while kids and teens are growing. At a younger age, bones are softer, which allows us to move teeth faster, easier, for a more beautiful and more stable smile as a result. Bones get harder as we age, and moving teeth in adults takes more time. 

The best time to get started is when kids are in their 'late-mixed dentition' — which means that they have a few baby teeth left. While your 'dental age' doesn't necessarily correlate with your actual age, this is generally between 10-13 years old.

An in-person visit with your orthodontist will be the best way to determine the right course of action.

The short answer is YES. Clear aligners and braces are both appliances in orthodontic treatment — but you need an in-person assessment and a treatment plan created by your orthodontist for best results. Orthodontists are the specialists in tooth movement, and they have the knowledge and skillset to use either appliance to get you the smile you want. When your clear aligner treatment plan is created for you by an orthodontist who uses tooth buttons, clear aligners can replace braces for good

Unfortunately, there are no regulations around who can do your orthodontics — meaning that dentists  and non-dentists have the legal ability to try to enhance your smile using braces or clear aligners. Orthodontists spend an additional 3 years specializing in tooth movement — that means they’re trained to take your individual smile and facial aesthetics, the health of your teeth, and your rate of tooth movement into consideration. 

We urge you to become an informed patient before making your decision about clear aligner treatment. Make sure you read through our resources for more.

In order to get a beautiful smile in a healthy and timely way — whether through braces or clear aligner treatment — you need an orthodontist.

Clear aligner treatment has been around for two decades, but it’s not always applied successfully. 

Creating a treatment plan isn't as easy as playing a video game with your teeth — there is underlying biomechanics and facial aesthetics knowledge needed (which requires an in-person appointment with a specialist, which is an orthodontist). The safest way to ensure your teeth are moved properly, safely, without hurting your roots, and without relapse with clear aligners is to have your treatment plan created by an orthodontist who uses tooth buttons. Half the battle in orthodontics is not just making sure that your teeth move, but that the roots move along with the crown, so that you only have to go through treatment once.

Here is something to watch out for: some clear aligner companies use the word “orthodontist” liberally, because they have an orthodontist only 'approve' a treatment plan — not create one. The art in making a beautiful smile is in knowing the steps necessary in creating the perfect outcome.

The short answer is no — but this is only true if an orthodontist is moving your teeth.

The rate of tooth movement is a biological function. Teeth move by having cells in front of the area of tooth movement eat away the bone (osteoclasts) and cells behind the area of tooth movement build bone (osteoblasts). This process is enhanced through enzymes surrounding the teeth and bone.

Speed of tooth movement is one of the most studied subjects in orthodontics, and while there are several appliances that are under study to speed up the rate of tooth movement, including an invasive procedure called micro-osteoperforations (small cuts in one's bone) and vibratory devices. This means that only an orthodontist can move your teeth efficiently.

A lot of direct-to-consumer clear aligner companies advertise smiles in 'six months or less', and while we hate to be the bearer of bad news, this is simply impossible.

Orthodontic offices are small businesses, and if they offer a clear aligner brand, the price of treatment is influenced by several factors:

First and foremost, orthodontists (and dentists) are charged a fee starting around $1900 per patient to use their software to create a treatment plan and manufacturing facility to create their aligners. On top of this, providers have to factor in their overhead (office, payroll, equipment, bills) before factoring in a price to create a profit.

We've standardized our prices and made them more affordable than the average price for clear aligner treatment by a specialist, by eliminating our brick and mortar overhead costs and creating a digital platform for unnecessary in-person appointments.

Yes — clear aligners are an orthodontic appliance, just like braces. When paired with a treatment plan following an in-person assessment with an orthodontist alongside tooth buttons, they can be just as effective as braces, too. There are a few benefits: no more brackets and pokey wires, which prevents unnecessary emergency visits to the orthodontist, no dietary restrictions, better hygiene, and no more metal. 

By the way, for parents who pursue clear aligner treatment through Two Front, you avoid going to the orthodontist altogether — we come to you for the two in-person appointments necessary to start clear aligner treatment, and follow up with any in-home visits as needed.

Our clear aligners are BPA-free and safe for kids.

Yes! Orthodontists have found that kids are fully dedicated to getting a beautiful smile, and are actually *more* responsible at wearing their aligners than adults are.

Additionally, at Two Front we have created a user experience — and product! —  that makes wearing and taking care of clear aligners actually *gasp* enjoyable.

While there is no actual pain with clear aligner treatment, there is definitely pressure. Let's dive into what you can expect.

Pain: pain is an uncomfortable sensation that can be experienced from either infection or something sharp. For example, the wires and pokey edges of orthodontic brackets (aka metal braces) can cause pain.

Pressure: pressure is some mild discomfort. Moving teeth — when done in a safe way by an orthodontist who understands the forces that should be applied to teeth depending on the complexity of the patient’s issues — should only cause pressure.


Remember, there are no legal requirements that regulate who can provide orthodontic services — with some clear aligner companies, people who are not even dentists can prescribe the tooth movement that each clear aligner carries out. This can be incredibly dangerous. Orthodontics, whether through braces or clear aligner treatment, is not only an aesthetic adjustment, it's a medical procedure. As a patient, we urge you to educate yourself before choosing the right clear aligner provider for you.

Speed of treatment is entirely dependent on the person, and the complexity of their case, along with several other biological factors including age and health of teeth. After an in-person assessment, your orthodontist will tell you how long your treatment will be.

Each aligner is designed to move teeth a maximum of 0.25-0.3 mm over a 2-week period. Your orthodontist will make sure to create a treatment plan to move your teeth efficiently in the correct order, while making sure to avoid creating any underlying problems in your roots, bone, and gums.

Clear aligners need to be worn for 22 hours a day to give you the best results. Moving your teeth requires a persistent force to help the little cells in your bone, called osteoblasts (bone building cells) and osteoclasts (bone eating cells), to move your crown (the part of your tooth that you can see) and roots (the part of your tooth that anchors the crown in your bone).

We say 22 hours/day, because we understand that you have to take out your aligners to brush your teeth, snack, and eat meals — therefore this is the most reasonable human request.

This concept applies to both the wear of clear aligners and elastics.

Do you have more questions? We're here for you.

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