Frequently Asked Questions

1) How do we get a referral to an orthodontist?
Anyone can call an orthodontist without a referral. In fact, many patients seen by orthodontists are self-referrals.

2) I’m not sure that anything needs to be done now – our child has a lot of time to grow – she may grow out of her problem that the dentist sees. Why do we need to see an orthodontist?
There are many problems with teeth and jaw bones that the layperson may not be aware of. Growth is a good thing, however, growth can be disproportionate like when one leg continues to grow a little longer than the other leg each year. Growth of the face also needs to be monitored – an orthodontist uses dental casts, films and computer studies to help reach a diagnosis. It is also important to realize that patients do not tend to grow out of dental and skeletal problems –the problems tend to worsen over time. An orthodontist can show you existing and developing problems in order to help make you better informed. The American Association of Orthodontists recommends that patients be evaluated by an orthodontist no later than age 7 years. See their website,, for more information.

3) Our dentist has not said anything about a need for braces yet—should we wait until something is said?
If one has any doubts, unanswered questions, or would just like more information, you can set up an evaluation appointment with an orthodontist. Braces typically are placed around the age of 12, however, new research has confirmed that many patients may benefit from preliminary orthopedic care which is best accomplished earlier. Your orthodontist should be able to measure your child’s jaw bones and show you if there is a need for dento-facial orthopedics.

4) What specifically does an orthodontist do?
An orthodontist has at least two academic years of full time additional training, after dental school, at an accredited orthodontic residency program in order to be called an “orthodontic specialist.” Space does permit a comprehensive answer here. Orthodontists straighten teeth and guide the development of the jaws.

Orthodontists also treat the bite for more ideal meshing of the teeth. Many orthodontists also attempt to improve a patient’s overall health by way of orthopedic palatal expansion which improves the upper jaw shape and improves the function of the nasal airway. There is more. Your orthodontist can explain your child’s specific needs.

5) What is the difference between “orthodontic” care and “orthopedic” care?
Our national journal is called the American Journal of Orthodontics and Dentofacial Orthopedics. The title emphasizes that an orthodontist is not only trained to help align the teeth (orthodontics) but also to help guide the development of the facial skeleton (dentofacial orthopedics). Orthopedics is typically started at an earlier age than orthodontics, as discussed above

6) I’m not sure our 8 year old can handle palatal expansion treatment if it is needed — will it hurt?
Most young children do very well – just ask some of our former patients. Our caring staff and doctors can help your child through the process.

Research Publications, peer reviewed:

  1. Hayes JL. One-phase versus 2-phase treatment. Am J Orthod Dentofacial Orthop. 2005; 128:557-558.
  2. Hayes JL. Rapid maxillary expansion. Am J Orthod Dentofacial Orthop. 2006; 130:432-433.
  3. Hayes JL. Consider the evidence. Am J Orthod Dentofacial Orthop. 2006; 130:563-564.
  4. Hayes JL. Letter to the Editor. Middle Atlantic Society of Orthodontists Journal. Autumn 2005;11.
  5. Hayes JL. Evidence–based orthodontics. Am J Orthod Dentofacial Orthop 2008;135:637-638
  6. Hayes JL. More Questions. J AM Dent Assoc. 2008;139: 888-889.
  7. Hayes JL. Economics and Ethics of Two-Phased Treatment. J Clin Orthod. 2008;42:393.
  8. Hayes JL. Long-term follow-up needed of RME treatment. Am J Orthod Dentofacial Orthop 2008;134:465-6.
  9. Hayes JL. Design flaws in some randomized controlled trials. Am J Orthod Dentofacial Orthop 2008; 134:466-7.
  10. Hayes, JL. Williamsport Orthodontic Study. Penn Ortho Alumni data base. 2009.
  11. Hayes JL. Problems with RCT design. Am J Orthod Dentofacial Orthop 2009; 136:143-4.
  12. Hayes JL. In search of improved skeletal transverse diagnosis. Part 1: traditional measurement techniques. Orthodontic Practice US 2009;1(3);34-39.
  13. Hayes JL. In search of improved skeletal transverse diagnosis. Part 2: A new measurement technique used on 114 consecutive untreated patients. Orthodontic Practice US 2010; 1(4);34-39.
  14. Hayes JL. Proposed clinical skeletal transverse measurement technique – palpation adjacent to the molars. Orthodontic Practice US; 2011; 2(2); 28-30.
  15. Hayes JL. A new regimen of phase I care applied to anterior open bite—10 case studies: an etiology proposed by the strategy of triangulation. Orthodontic Practice US; 2012; 3(3); 18-26.
  16. Hayes JL. A new regimen of Phase I care applied to potential canine impactions.. Orthodontic Practice US 2013; 4(3); 44-51.
  17. Hayes JL. Chapter 10, Orthodontics. Kennewick Man: The Scientific Investigation of an Ancient American Skeleton. Texas University Press; 2014; College Station, TX.