Cary & Clayton Family Orthodontics
Southern Smiles for All Ages
At McNutt Orthodontics, we believe a beautiful smile can change the way you see yourself — and change the way the world sees you.
That’s why we offer compassionate, high-quality care to patients of all ages in Cary, Clayton, and the surrounding North Carolina communities.
Orthodontics for Children
We are often asked questions like, “At what age should a child get braces?”, or “At what age should I first bring my child to be looked at?”
Generally speaking, children should be evaluated by the orthodontist no later than age seven to nine. Most of our early childhood consultations are with children ages seven to ten.
Occasionally, significant problems with the teeth or the bite may develop in children younger than age seven. In these cases, your family dentist has been trained to spot those problems and refer them to the orthodontist.
When it comes to what age is best to start orthodontic treatment, it really varies depending upon the problem to be corrected. Every child is an individual. Some children lose their baby teeth early and their permanent teeth come in early compared to their classmates. Other children lose their baby teeth very late and may not be ready for orthodontic treatment until after many of their classmates have already started treatment.
In general, if your child requires early orthodontic intervention before age 10, we typically refer to this as Phase I Treatment.
Early Childhood Phase I Treatment
Early orthodontic treatment usually refers to treatment that occurs when the child has a mixture of baby teeth and some permanent teeth, typically between ages 8-10. Early childhood treatment is often referred to as Phase I Interceptive Orthodontic Treatment.
Earlier in his career, Dr. McNutt described himself as being very conservative with early treatment and this sometimes led people to believe that we are against early childhood treatment. The vast majority of our patients have treatment one time during their teen years.
However, there are plenty of children who need and should have early childhood treatment. The best way to describe our philosophy is to state that we will not recommend early childhood treatment without principled and well-founded reasons.
For example, we occasionally treat children as early as age four, however, the circumstances that would require such early treatment are rare.
Some problems should be treated between ages 8 and 10 because there is a narrow window of growth and development during which the orthodontist can effectively correct certain problems that would be very difficult to improve later or would require surgery to correct.
When a first phase of treatment for children aged 8-10 is called for, 90% of those children will go on to have a second phase of treatment, called Phase II Orthodontic Treatment, after all the baby teeth are gone and the majority of the permanent teeth have come in.
The reason for this is that when a problem develops that is severe enough to warrant early childhood treatment (Phase I), there is a high likelihood that more problems will develop later that will also need to be addressed.
Smile & Bite Issues Requiring Phase I Treatment
- Cross-bites of the front or back teeth
- Open bites due to a thumb or finger-sucking habit
- Severe crowding and eruption problems
- Severely protruding front teeth that are at risk for trauma
- Problems with how the upper or lower jaws are growing
- A narrow upper dental arch due to deficient jaw growth
- Impacted teeth that are stuck in the jaw bone or are moving in the wrong direction
When Phase I Orthodontic Treatment is needed, our orthodontic team creates a uniquely tailored plan for each child with specific goals in mind.
Early interceptive orthodontic treatment is focused only on specific goals that need to be achieved in order to greatly reduce the severity of developing problems and to reduce the impact of future problems.
Early orthodontic treatment can be difficult for some children and we always look at the situation as though we were making a decision for our own family.
Orthodontics for Teens
Orthodontic treatment during the teen years is a rite of passage for many. Most of our patients are in their teen years, and it is a privilege to watch so many talented young people grow up and find their smile and their purpose.
For many patients, the early teen years are ideal for treatment because typically all the baby teeth (primary teeth) are gone and most of the adult permanent teeth have come in.
This time period also coincides with the adolescent growth spurt. Orthodontists have a greater ability to move teeth efficiently during this growth spurt and teeth can be placed in their final positions at this age.
Being a teen is not easy, and they feel pressure from lots of different directions in life as they navigate growing up. Our goal is to treat teens with respect, educate them, and involve them in the process of their treatment as we journey toward their best smile.
Teen Treatment Options
When it comes to the best treatment options for teens, just like adult treatment, we have lots of great options to consider. We have options for braces and clear aligners (for more detail on options read our adult treatment options above).
However, we will also be candid and realistic about the pros and cons of different options. Unfortunately, there is a lot of marketing online and on television about orthodontic treatment that is unrealistic and downright just not true.
Teens who have braces or clear aligners like Invisalign or Spark, really want the same things that we want in our orthodontic practice. Teens want treatment to be comfortable, as short as possible, to have healthy teeth and a fantastic smile. We work hard to provide those things for our patients and we go out of our way to create an atmosphere of teamwork and to be positive mentors. We know that orthodontic treatment is just one small piece of a very busy teen life.
We have a deep commitment to helping our patients understand what is realistic and to understand the true responsibility that comes with treatment. We are committed to putting your children ahead of our own interests.
When we sense that a teen wants a particular type of treatment that is unlikely to give them the best results or we sense they are not ready for the responsibility, we will not ‘sell’ you on what your teen wants.
We will recommend what we believe to be best, just as if your child were our own. Doing what is right is not always the same as doing what is popular.
Our Commitment to Extra Retainers for Teens
We are also firmly committed to setting teens up for success following orthodontic treatment. We put an uncommon amount of time and energy into helping our patients maintain the results of orthodontic treatment.
The standard of care in our profession is to provide a single upper and a single lower retainer for your teen at the end of treatment. Dr. McNutt’s philosophy is that this standard is not high enough because it creates an expectation for patients to be perfect and not to misplace or break a retainer.
We believe that when you factor in the time, money, and commitment that goes into orthodontic treatment, your teen deserves more support. That is why our standard is to provide two upper and two lower retainers.
Most teens get what we call “the McNutt Special…” which consists of an upper clear retainer, an upper Hawley retainer (the old school kind that lasts a decade or more made of wire framework and acrylic), a lower permanent bonded retainer for the front teeth, and a lower removable clear retainer. Each style of retainer has strengths and weaknesses.
Our strategy protects your investment in your teen’s smile and healthy bite. In the event that a teen loses or breaks a retainer, they already have a backup.
Most teens also are given a 3D-printed model of their teeth after treatment and these can be used to quickly replace lost or broken retainers. If you go through adult treatment with us, don’t worry, we make the same commitment with retainers for our adults.
Orthodontics for Adults
Adult orthodontic treatment is an exciting part of our practice and we have treated patients well into their 80’s. About 20% of our entire practice is made up of adults, and we are fond of saying that “braces are beautiful at any age.”
We cherish our patient relationships with adults. Often they have waited many years to take care of themselves, prioritizing their children first. It gives us such great joy to see how happy our adult patients are when treatment is finished and they finally have the smile they have dreamed of.
Adult Treatment Options
Adult treatment options and treatment needs are often different from that of children and teens. We work hard to learn what goals are important to you as an adult and to tailor a unique treatment plan and options to your needs.
Often we work in tandem with your family dentist to align teeth in advance of planned dental work, such as veneers, implants, crowns, and cosmetic bonding procedures to enhance the smile.
Adults often desire more cosmetic-appealing options to align their teeth. Many people are familiar with the fact that there are cosmetic options for braces (like clear and gold) and many are familiar with clear aligner therapy (also known as ‘CAT’) such as Invisalign, Spark, or ULAB.
We offer cosmetic options for braces, as well as clear aligner treatment. We use Spark Aligners and ULAB Aligners in our practice, as these have proven to be the best option for our patients. Most of our aligners are actually designed and manufactured in-house using the ULAB system. Instead of relying on a non-doctor technician at a large corporation to design your digital treatment plan, our orthodontist creates the entire plan, we 3D print the dental models that are necessary to create the aligners, and then we fabricate the aligners ourselves.
For the first time in the history of clear aligners, this allows us to control the entire process, assuring accuracy, and direct quality control, and significantly reducing the lab fee costs associated with creating clear aligners. These savings are passed on to our patients and make treatment truly more affordable.