Our Blog

Can my child benefit from an Orthodontic Expander?

January 9th, 2020

Can my child benefit from an Orthodontic Expander?

                This is a common question concerned parents often ask.  They also want to know if their child needs an expander then when is the best age to do it. In this blog we will cover these questions.

Upper Expander

                When parents talk about expanders they are usually referring to upper jaw expanders (maxillary expansion). The lower jaw can also be expanded but that is a topic for another blog. We will focus on upper expanders here.

                Let’s answer the age question first. The best time to do an upper expander is between the ages of 6 to 10 years old. The reason for this is the bones through the sutures are very malleable so are easily reshaped. The older a patient gets the harder the bones are to reshape and the less stable they are when you do.

Narrow “V” shaped upper jaw

There are two types of expansion

1. Dental


                The best type of expansion in most instances is skeletal which is where the bones are reshaped because the results are more stable and the teeth are positioned more ideally over the bone which is healthier. So if you want the best expansion as mentioned earlier then do it in the 6-10 year old range. Dental expansion is where the bone stays the same shape and the back teeth are pushed out. This works best when the back teeth are angled inward.

Now, what are the benefits of using an Expander?

  1. More room for the permanent teeth and avoid extractions
  1. By developing more space, the permanent teeth can come in (erupt) into supporting bone which fosters healthy gums (less recession)
  1. Early skeletal expansion is more stable as noted earlier
  1. Promotes improved nasal breathing- being able to breathe through your nose is extremely important in proper facial development
  1. Decreases incidence of developing sleep apnea (OSA)
  1. Decreases “bed wetting” (enuresis)
  1. Possibly improves hearing in children with hearing loss
  1. Helps resolve tongue thrust which can create open bites of the front teeth and speech issues
  1. Can use to resolve thumb habits
  1. Can reshape narrow “V” shaped upper jaws into normal “U” shape which also can reduce protrusion of the front teeth


     Pre expansion                                             Post expansion

  1. Can also correct “underbites” if designed properly


Pre 3D expansion                           Post 3D expansion

  1. If performed properly can significantly reduce the time in braces as a teen

                The key is to have a properly designed expander which can function in 3D. They have to be fixed (removable expanders, ones that can be taken in and out, do not predictably work!) They also should not have slots which need to be turned by you with a key. The slot is usually turned every other day which causes discomfort and is difficult to do.

                Our office specifically designs each fixed expander to fit the needs of each child. Our patented 3D expander can work in all directions to achieve the most effective results. Other expanders only work in one direction. We activate the expander every 6 weeks so instead of potentially being uncomfortable every other day, the discomfort would be every 6-8 weeks for 3 to 4 visits. The 3D expander stays in for 6 months followed by 6 months of retention to ensure stability.

What are the downsides of expansion?

Really none, the predictability, the reduced need for extractions, the stability, less time in braces as a teen and better results! Plus as we mentioned it can help with sleep and optimum facial development.


If your child is in the 6-10 year old range, call us for a complimentary consultation.

Do vibrating or light emitting devices move teeth faster?

November 26th, 2019

Do vibrating or light emitting devices move teeth faster?

I am often asked this question on new devices that promise faster movement of the teeth which should result in shorter treatment times.

The current unbiased research (in other words, research that is not paid for by the manufacturer of these devices!) doesn’t support any claims of shorter treatment times. So if you have a friend who claims their teeth are moving faster because of using one of these devices or a dentist or orthodontist claims they will accelerate treatment, the research does not back up any of these claims. If it did you can be sure we would use them at Elite Smiles plus are there any long term (haven’t studied) negative consequences of using them, we don’t know.

Call or email if you’re ready to “build a better smile”

Smile Direct Club

November 13th, 2019

Smile Direct Club

If you watch tv or are on social media then you have to be aware of Smile Direct Club. It is a method of moving teeth without direct supervision of an Orthodontist. I can tell you as someone who has done thousands of patients using doctor monitored Invisalign that direct supervision is critical to the success of treatment.

As has been anticipated by Orthodontists, Smile Direct Club has passed 1,000 complaints on the Better Business Bureau’s website in a short time. I personally, have 2 patients whose bites (the fit of their teeth) were significantly altered for the worse by using Smile Direct Club. They came to us after using Smile Direct Club when they realized their bites were “way off” and could no longer chew properly. Both now have to undergo comprehensive orthodontic treatment with braces for up to 2 years!

If you or anyone you know is going to consider this route to straighten their teeth, at least visit an Orthodontist prior to treatment to discuss what your options are.

Why should I choose Dr. Sebastian as my Family's Orthodontist?

October 17th, 2019

Orthodontics and your Family


Why should I choose Dr. Sebastian as my Family’s Orthodontist?

A pioneer in early orthodontic evaluation and treatment of the developing child, Dr. Michael Sebastian has the experience and expertise to critically assess the growing child’s mouth, upper airway and surrounding facial structures. His timely holistic approach is designed to encourage optimum facial esthetics supported by a healthy, stable and beautiful smile.

The first visit with Dr. Sebastian is recommended at 7 years old. This appointment includes a health, dental and airway questionnaire review, a comprehensive photographic examination, a 3 dimensional radiographic analysis along with a thorough orthodontic exam, upper airway and facial assessment all accomplished in a welcoming comfortable child friendly environment.

Dr. Sebastian will summarize all the findings in a priority format so you will know what and when, if anything, needs to be done for your child.

There are two basic directions which can be recommended:

  • Treatment now- this route is suggested if there are growth or tooth/teeth coming in concerns which if left to address later, could result in a compromised result for your child.
  • There are no current developmental conditions which require intervention- In this case, your child is placed on a 12 month growth and development assessment to identify if any changes occur. This could include changes in growth of the face, upper airway and/or the way the teeth are coming in. If such, treatment may be suggested or your child continues on a 12 month recall.

12 years old

All the permanent teeth are usually in at 12 years old. At this time, your child is evaluated for braces or Invisalign to finalize the alignment, fit and esthetics of their teeth. Now, not all children are seen on this schedule as their dentist may not have referred them at 7 years old. They may follow your child until all the permanent teeth are in then make the referral around 12 years old.

If my child doesn’t see Dr. Sebastian at 7 years old can they still be helped?             Yes, Dr. Sebastian will provide a complete assessment with recommendations at any age.

My child is almost a teen, what can be done? Treating teens is the original reason Dr. Sebastian became an Orthodontist, he enjoys interacting with and understands how to work with teens.

There are 2 keys to successful orthodontic treatment of a teen:

  • Choose an orthodontic treatment which best resolves the teens bite, tooth alignment and skeletal issues in the fastest amount of time. The longer teens are in braces, the more likely they will develop cavities and gum disease.
  • Involve the least patient cooperation as possible- teens have a million things on their minds, asking them to overly cooperate is generally not the best choice and results in long treatment times. Dr. Sebastian has developed treatment protocols to help teens be successful while minimizing cooperation! He often recommends Invisalign for teens, because for the right person, this treatment can offer great results with esthetics, comfort and reduced inflammation of the gums (gingivitis).

Experience, communication, comfort, choice and excellence are the principals by which Dr. Sebastian connects with every one of his young patients. You can feel secure in your decision to entrust us with your child.