For doctors

In most cases, the patient does not need anything special from you. We only ask for a referral with the contact details of your practice. Of course, we welcome any additional information relevant to the patient's treatment.

For more complex cases where interdisciplinary cooperation is required, it is a good idea to provide the patient with a medication report. In it, we need to know your idea about the further treatment and restoration of the tooth, the time schedule and, if necessary, the prognosis of the damaged teeth (paro, endo, trauma...). In case of complex cases or uncertainties, we will contact you by phone.

No. Only if the patient has had OPG x-rays taken in the last 6 months, we ask that they be borrowed or sent to us so that we do not unnecessarily blind the patient for the same examination again. However, in addition to the OPG, we also need the scan in a special kephalometric projection to create a treatment plan. This image is always provided by us. Therefore, if the patient does not come from you with a fresh OPG, we will take both of these images at the same time in our office.

We usually require the patient to be fully sanitized and have a good level of oral hygiene. It is highly advisable to take preventative bite-wing x-rays and sanitize any cavities. In fact, these images cannot be taken while fixed appliances are in the mouth. There are a few exceptions to the requirement for complete rehabilitation:

• If any of the teeth are due for endodontic treatment or extensive and challenging reconstruction, it is advantageous to refer the patient before this treatment. If extractions are necessary for orthodontic reasons, we will of course have this tooth extracted.
• If you are planning treatment with crowns or bridges, it is advisable to consult an orthodontist before grinding for definitive work. Bonding locks to crowns (especially ceramic crowns) risks damaging them. In addition, the orthodontist can improve the conditions for prosthetic treatment with his treatment. We adjust the inclination of the pillars, their placement for optimal aesthetic and functional correction, etc.
• If an endodontic treatment has been performed on a tooth with an impaction, we can move this tooth orthodontically only after 6 months from the treatment. Otherwise, there would be a risk of acute deterioration of the condition. If it is not necessary to move this tooth during orthodontic treatment, it is of course possible to straighten the other teeth immediately.

In very young children in temporary dentition and in early mixed dentition up to about 7 years of age, we can address a single defect, namely habits (thumb, pencil, tongue).

After eruption of the sixes at 6-7 years, we address premature loss of the molars (fixed space) and semi-eruption of the sixes by temporary fives.

Only after the upper two teeth are cut to half (usually at the age of 8-9 years) do we deal with malocclusion, crossbite, reverse bite, pronounced overbite if it causes social and psychological problems, etc. We also usually address incisor retention and overbite at this time. If possible, we will resolve the acute problem as soon as possible, usually within 4-6 months. Further treatment, if needed, follows in adolescence.

We always aim for the most effective treatment, i.e. a quality result in the shortest possible treatment time. We are aware that orthodontic treatment limits the patient to a certain extent. We do not want our patients to live their entire childhood with a removable appliance and then several years of adolescence with a fixed appliance. For this reason, we usually postpone treatment until the growth spurt (12-14 years) when treatment is most effective.

There is no upper age limit. In adult patients, the only limit is the poor condition of the teeth and gums.

The oldest patient in the world was 98 years old when braces were fitted. Therefore, it can be said with exaggeration that it is never too late for orthodontics. However, adult treatment has its own specifics.

The patient does not grow, which is advantageous in the treatment of some defects, but not in others.

Adult patients often have teeth that are damaged, extensively rehabilitated, with crowns, etc. In general, bonding locks to prosthetic work is problematic. If possible, we try to arrange a definitive prosthetic restoration with the treating physician after the orthodontic treatment has been completed.

Adult patients also often have damaged braces with various manifestations of periodontitis. As long as the patient does not have acute inflammation and has good hygiene, orthodontic treatment can be safely performed even with significantly wobbly teeth. Orthodontic tooth movement creates bone, not destroys it! Therefore, we often work with periodontists to improve the alveolar bone level and optimize the bite and aesthetics of the teeth. In general, patients should not have teeth larger than 5mm before treatment. Otherwise, they must first undergo periodontal treatment.

The treatment technique is slightly different in adulthood. We use more complex appliances and very gentle forces. Adult patients also prefer different variants of less visible braces. We offer clear locks (ceramic) or even better removable invisible foil braces.

A distinctive feature of adult treatment is also their interest in treatment, motivation and awareness. Patients are often thoroughly familiar with the possibilities of modern orthodontics and often request treatment of even the smallest details. Every such patient is a pleasant challenge for us.

Health insurance companies partially cover orthodontic treatment. The amount of reimbursement does not differ significantly between children and adults. The price for treatment, which is paid by the patient in the office, varies according to the amount and type of material used. For small defects treated with a few bonded locks, the cost is in the order of several thousand. On the other hand, for a complete treatment with ceramic or even lingual locks, the cost is in the tens of thousands.

On the contrary! We often cooperate with periodontists. Some defects, such as single-walled and double-walled bone defects, where guided tissue regeneration methods are ineffective, can only be satisfactorily resolved in collaboration with an orthodontist. We are still approached by periodontal patients whose treatment has not been recommended by their doctor with the words "your teeth are wobbling, braces would finish them off". We are still fighting these prejudices of uninformed doctors. Yet it is well known, and has been published many times, that if a patient does not have acute inflammation, has had the calculus removed (even subgingival calculus) and has a good level of hygiene, then orthodontic treatment is not a risk to them. On the contrary, the aesthetic and functional benefits are enormous in the paro patient.

All patients are made aware of the need to attend their dentist for preventive check-ups and ozk even with ortho braces fitted. If any part of the orthodontic appliance will need to be removed (performed) for any rehabilitation, this should only be for a necessarily short period of time, 1-2 days max.

Bite-wing X-rays cannot be taken during treatment with fixed appliances. Therefore, we ask for as precise a restoration as possible before starting active orthodontic treatment.

Yes, but with sensitivity :-)

Stripping is a method used for decades to gain space in the dental arch or to compensate for the disproportion between the width of the upper and lower teeth. It is 100% proven that stripping, if done lege artis, does not affect the level of tooth decay. Studies comparing caries in stripped and unstripped teeth 20 years after the procedure have clearly confirmed this (Zachrisson). Usually, in the frontal part of the dentition, the teeth are ground down on each side by 0.1 - 0.25 mm. If the teeth are markedly triangular, more is possible. In the lateral section of the dentition, the teeth can be reduced by up to 0.4 mm on each side. The condition is that the teeth are polished with absolute precision after stripping. Electron microscope studies have shown that the tooth surface is even smoother after stripping than "naturally" (Marek, Miethke). There is therefore no need to worry about plaque retention sites and thus increased decay. Exceptionally, increased tooth sensitivity may be noted, but this will disappear within 1 month. The entire procedure is performed at medium speeds of up to 20,000/min with vigorous water cooling.

Careful execution is of course essential for a perfect result. But this is the same as for any other dental treatment.

Up to 60% of the population has a disparity in the size of the upper and lower teeth leading to crowding in one jaw or gaps in the other. This situation needs to be resolved by stripping or completing the teeth. The decision depends on aesthetic criteria and tooth morphology.