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Eight Measurable Goals

How can you tell the difference between a Roth/Williams graduate and other orthodontists?

A Roth/Williams trained orthodontist, like Dr. Chira, commits themselves to an additional 2-years of advanced learning that teaches the Roth/Williams Philosophy of Orthodontics. This philosophy carefully considers the tooth to jaw joint relationship (TMJ) from the beginning to the end of orthodontic treatment. As a result, Dr. Chira’s orthodontic practice can be differentiated from other orthodontists by the tooth alignment practice and whole body approach in a number of ways.  

One way is through the patient’s initial exam. Dr. Chira does not use the initial exam appointment for the placement of braces or other appliances, as is popular in many orthodontic offices. Instead, she takes the time to study necessary records prior to explaining the individual treatment plan and treatment options in a formal consultation. Dr. Chira will not present a treatment option if the outcome is not predictable. At Chira Orthodontics, we are dedicated to a relationship with patients based on fulfilling expectations and informed consent. This is why we will typically schedule two to three separate appointments before starting full treatment.

Secondly, in accordance to the Roth/Williams method, Dr. Chira will mount study models of the teeth on an instrument called an articulator. The articulator is a three-dimensional bite simulator that provides a crucial added dimension to diagnosis that goes far beyond the traditional static hand-held model used by most dentists and orthodontists to look at a patient’s bite. With an articulator, Dr. Chira is able to extract and replicate the dysfunction of the entire gnathostomatic (jaw) system, including the relationship of the temporomandibular joints, muscles of mastication, teeth, and supporting structures. Two-dimensional hand-held models are incapable of showing this degree of diagnosis. 

Most orthodontic failures are due to an incomplete diagnosis and not determining the origin of the malocclusion or misalignment before treatment. By utilizing an articular, Dr. Chira is able to practice complete dentistry with a whole body approach based upon the execution of a complete and thorough examination of the patient’s jaw, teeth, and joint relationship to determine needed changes and adjustments before actual treatment.

Additionally, and perhaps most importantly, Dr. Chira and her team are committed to….

The Eight Measurable Goals of Roth-Williams Orthodontic Treatment

  • Patient's Chief Complaint: While many aspects of the patient's oral health and function are addressed, it is important to address the chief complaint of the patient; these are the issues that they are concerned about regarding their teeth.

  • Temporomandibular Joint Health: Every effort is made to ensure that the temporomandibular joints or jaw joints are healthy, free of pain and other symptoms, and seated in their most orthopedically stable position. It is the job of the orthodontist to ensure these conditions exist before, during, and most importantly, after orthodontic treatment. Healthy and properly positioned jaw joints are critical to the long term stability of a completed orthodontic case.

  •  Facial Esthetics: During the course of diagnosis and treatment planning it is of utmost importance to pay close attention to and design a plan that will improve or enhance facial balance and esthetics for the patient.

  • Periodontal Health: It is a general goal in all aspects of dentistry to help the patient obtain and maintain healthy teeth and gums (the periodontium). This is mostly accomplished through patient education, i.e., teaching the patient how to care for their mouth. Another aspect of periodontal health involves the proper positioning of the teeth within the bone that supports them. This is the job of the orthodontist.

  • The Dentition: One of the most obvious goals of orthodontic treatment is the alignment of the dentition – straight teeth! The teeth should be perfectly aligned, free of rotations, spacing or crowding thus providing the patient with a healthy, esthetic smile.​

  • Function: A functional bite is a major goal of orthodontic treatment. Specifically, this means even contact throughout the dentition when biting down, as well as how the teeth glide off of one another during functional movements (eating, chewing and even speaking). Having the dentition in the proper functional relationship increases orthodontic stability, reduces tooth wear and damage, and increases the overall longevity of the teeth.

  • Improve or Maintain Airways: An addition to the Roth-Williams original 7 measurable goals, proper airway function comes from the Arnett/Gunson FACE/FAB philosophy of orthodontics. Having appropriate airflow through the nasal passageways and the posterior pharyngeal passageways is very important to facial growth and the individual’s general health. If the palate is narrow, the nasal opening will also be narrow, restricting the airflow. If the lower jaw is too far back, it can have a significant effect on the airflow in the posterior pharyngeal passageway. In some severe cases, this may be the primary cause of sleep apnea. Each patient’s airways will be evaluated, and this information will be important in determining the best treatment approach. 

  • Stability: If all of these goals are kept in mind during the diagnosis, treatment planning and the delivery of care, the result is a very high quality orthodontic finish that is not only esthetic, but is engineered to provide the patient with a stable bite designed to last a lifetime with minimal tooth wear, damage, and optimal oral health.

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