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Why See an Orthodontist?

Whenever you want something complex done very well, you go to the person who does that one thing all day every day for a living. When you have a serious problem with your knee, you see an orthopedist or physiatrist, rather than your family doctor. If your company is going through a merger, you would seek the help of a corporate attorney, not an attorney who focuses on estate planning or family law. If you want your teeth straightened and your bite idealized, or your teeth straightened so that your smile (how teeth are arranged in the lip drape and facial profile) looks awesome, you see an orthodontist.

The world’s first dental specialty board, the American Board of Orthodontics, was founded in 1929. Today, orthodontists are professionals who have completed four years undergraduate studies, four years of dental school, and two to three years of residency training at an accredited program in orthodontics and dentofacial orthopedics. Orthodontists are not only experts in the biomechanics of tooth movements and occlusion, they also understand the growth and development of the facial bones and how this can be anticipated or manipulated for the most favorable esthetic and functional outcome.

Your First Visit

At your consultation, the lovely High Line Smile Design team will first take a series photographs, radiographs, and detailed measurements. Dr. Pompei will then review all of these with you carefully, so that you can clearly see any concerns she sees about your jaw relationship, tooth development, tooth alignment, bite, and smile. You will be given treatment options and an explanation of the potential benefits and drawbacks of each.

Our helpful treatment coordinator will then detail next steps to getting started and explain insurance benefits. If you are the kind of person who knows what you want when you see it, great! We will do our best to save you time and get your started on your way to a new smile that same day. If you are the kind of person who likes to mull big decisions over and sleep on it, we will send you the summary of the consultation in writing and we’re here for you when the time is right.

Flexible Financing and Insurance

Our aim is to eliminate any obstacles that may be in your way to securing your ideal orthodontic treatment experience and outcome. We work with most insurances and are skilled in helping you understand how to maximize your orthodontic insurance benefits or health care flexible spending account benefits. We offer low down payments to those who are qualified. When requested, we extend balance payments beyond the estimated treatment completion timeframe, without interest, so that orthodontic treatment can easily fit within your monthly budget.

We accept major credit cards, cash, and check for payments.


You have questions, we have answers! If your question isn’t below, use the form below to send it to us and have it answered.

How is an orthodontist different from a general dentist?

Like a general or family dentist, an orthodontist attended four years of dental school after earning an undergraduate bachelor’s degree. In dental school, all students learn anatomy, physiology, pharmacology, pathology and many other areas of the medical sciences. Dentists then learn how to diagnose oral diseases and restore/replace teeth that are diseased, missing, or need cosmetic improvement. They are taught how to remove teeth, clean and fill root canals of teeth that are diseased, provide basic care for the gums and bones around the teeth. Dental schools will also expose students to orthodontics, oral maxillofacial surgery, and periodontal therapies/surgery.

In New York State, to become a licensed dentist, young dentists must complete a one year general practice residency. During that time, they will hone clinical skills, often in a hospital setting. Alternatively, a dentist may complete a 2-3 year residency in a dental specialty. Orthodontists are dentists who have completed one of these specialty residencies, spending additional years focusing solely on the science of facial growth and development and the proper way to safely and efficiently move teeth and bites into alignment. When they enter practice, orthodontics is the only focus of their practice.

What is dentofacial orthopedics?

It is the guidance of dental, jaw, and facial development via various fixed and removable appliances.

Will I need to have teeth taken out if my teeth are very crowded?

The decision to extract teeth is never taken lightly by any orthodontist. As dentists who are entrusted with protecting our patient’s health and well-being, our usual objective is to save healthy teeth.

When an orthodontist considers a crowded case, several detailed measurements are taken to determine how the teeth can be made to fit together in the mouth so that the end result is a beautiful smile with no crowding, no spacing, good overjet and overbite, and healthy biting contacts on each side of the mouth.

There is a limit to how much teeth can be moved and still keep them upright in supporting bone, surrounded by healthy gums, for many years into the future. If teeth are pushed too far out of their bony housing in an effort to get them straight, problems may occur. Orthodontists will consider your profile, the thickness and harmony of your facial soft tissue (lips, cheeks) and evaluate how removing teeth may affect these aspects of facial balance either positively or negatively.

Only after all of these factors are taken into account would an orthodontist make a recommendation to straighten with or without extracting (perhaps in conjunction with interproximal reduction, see below). An orthodontist will explain why a certain treatment plan is recommended for your unique situation.

What is Interproximal Reduction (IPR)?

Interproximal reduction (IPR) is the conservative removal of some of the outer tooth surface, called enamel. Usually only about .1-.25mm of enamel, a miniscule amount, is removed on each surface. This technique has been used in orthodontics since the 1940s. It is also known as slenderizing, contouring, stripping, enamel reduction, reproximation and selective reduction.

Whatever the name, the intentions are the same—to acquire more space for your teeth, to reduce friction in between your teeth facilitating movement, to improve your bite, or to make the teeth more attractive. Sometimes it is done following orthodontic treatment to improve stability.

Tooth enamel is a bit like your fingernails—it has no innervation. The tenths of millimeters removed with IPR does not hurt, does not require anesthesia, and can be done a matter of a few minutes. Studies have shown when done properly it does not increase your risk for cavities or sensitivity.

My wisdom teeth are growing in and I’m worried they’ll cause my teeth to get crowded! Do I need to have my wisdom teeth taken out?

Many years ago it was thought that developing wisdom teeth caused front teeth to be pushed forward and get crowded. However, several well-designed recent studies have shown that the growth of wisdom teeth in the back of the jaw are too far away to impact tooth position in the front. People who never had wisdom teeth or had them extracted STILL get crowding, while some people with impacted wisdom teeth keep their straight teeth. However, there are other legitimate reasons to have wisdom teeth extracted, your oral surgeon can review considerations with you.

How can I speed up my time in treatment?

When teeth move from a position where they are crooked to a position where they are straight, bone is removed from one area surrounding the tooth and deposited in the area where the tooth vacated. This is a process that takes weeks to months, limited by the biology and biochemistry of bone cells. There are appliances, such as the V-Pro5® or OrthoPulse® that help keep your orthdontic treatment on track, but there is no good independent evidence yet that it speeds it up. Other techniques such as Micro Osteo Perforation or Wilkodontics have better scientific evidence behind them, although some of it is inconclusive. Dr. Pompei can discuss pros and cons of your options for getting in and out of treatment as fast as you can.

What will happen if I don’t fix my child’s bite or leave my teeth spaced or crooked? What if my child waits until adulthood to get braces?

Orthodontics is largely an elective health care service. As the saying goes, “Nobody ever died of crooked teeth.” However, orthodontics has the potential to tremendously improve quality of life. Straight teeth are easier to keep clean and a healthy bite helps prevent enamel wear over a lifetime. Additionally, studies have shown that a person’s teeth may impact whether he or she will be hired for a job. Lastly, orthodontic treatment that is completed while a child is still growing has many advantages, it is often faster and better tolerated than treatment in an adult who is done with growth.

I just want to fix one tooth, do I really need treatment on all my teeth?

In short, usually it is advisable to undergo comprehensive treatment, even if there is “just one crooked tooth.” Here’s why: your upper teeth and your lower teeth have to fit together when you bite down. Although there may be one tooth that is rotated, the adjacent teeth will have to be moved to make space to move the problem tooth or teeth. When you change teeth in one arch, you change that arch shape, and thus the relationship to the opposing arch when you bite down. Comprehensive treatment allows correction of alignment and assurance that your bite at the end will be proper.

Do I still need to go to the dentist while I’m receiving orthodontic treatment?

Yes! Please keep going to your dentist for regular check-ups and cleanings. Although you see us more frequently than your general dentist, we will not be doing explicit exams for cavities or cleanings every time you come in for an orthodontic adjustment.

I have TMJ pain, what should I do?

TMJ pain is usually multifactorial in nature and it is extremely rare that a bad bite alone is the only cause of jaw joint pain. If you are experiencing chronic, radiating TMJ pain, that interferes with your daily activities, it is advisable that you see an orofacial pain specialist first to address the many possible causes of this pain before undergoing orthodontic treatment.

How long do I have to wear my retainer?

You should wear your retainer regularly for as long as you want your teeth to stay straight. For most people who are years out of orthodontic treatment, “regularly” means several nights per week during sleep time. Nothing in your body stays the same with time and age. Just like you can’t go to the gym, acquire peak fitness, and then stop exercising and expect to keep the same level of fitness, you can’t straighten your teeth and expect them to stay in the same place at age 80 as they were at age 14. Maintenance, via retainer wear, is required or there is a risk your teeth will shift. Even people who have never had orthodontic treatment may notice their teeth shifting with age. Some lucky people will stop wearing their retainers and notice no changes over the years, but we cannot predict who will and will not fall victim to relapse.

I've seen several different orthodontists for a consultations and they've all offered me different treatment plans, how do I know which one is best?

There are numerous ways to achieve an excellent orthodontic result for every case, but every treatment approach, appliance, and technique has several pros and cons. Each orthodontist will weigh these factors as a whole differently and advise accordingly. It is not uncommon to receive slightly different recommendations if you consult with various specialists. The important thing when making a decision is that you feel comfortable that you understand the risks and benefits of your choices. You should feel you have a selected an orthodontist who has listened to and understood your concerns so that you are on the same page from the beginning, and know what to expect along the way.

Send Dr. Pompei a Question!

If you have a general question that you’d like to have answered before scheduling a consultation, send it to Dr. Pompei using the form below and she will email you back. Keep in mind, if your question is very detailed in nature and unique to you, an exam may be required before a complete answer can be given.