Your first visit is important for both Dr. Shapiro and patient/parents to become better acquainted. He will assess your teeth and bite, and determine if there are any immediate concerns.

In order for Dr. Shapiro to provide an accurate diagnosis and to provide treatment recommendations, we will typically take some clinical photographs and one or two digital xrays (note: our digital xrays offer extremely less exposure than conventional ones). These are necessary to assess the position and health of the developing teeth and surrounding bone. Dr. Shapiro wants to be sure your teeth are developing properly in the correct position and at the appropriate time.

Click the following links to view videos of normal tooth development:

• Normal Development (view 1)
• Normal Development (view 2)

With these xrays, we are often the first to diagnose many problems such as teeth that are congenitally missing or impacted. Some patients have extra teeth, benign developmental cysts, jaw asymmetries, and other common problems.

While we will always prefer to defer treatment as long as possible and provide it in one comprehensive phase, some patients would substantially benefit from an interceptive phase of treatment at a younger age. Typically referred to as Interceptive of Phase I treatment, these limited scope treatment plans are designed to minimize the invasiveness of future treatment along with increasing the success of our final result. As such, it is important for all children to have an orthodontic assessment by age 7 as recommended by both the American and Canadian Association of Orthodontists. (Click here for Problems To Watch For in Growing Children).

If no immediate treatment is required, we will usually recommend your child be seen every year to monitor their dental and jaw development. We will continue to monitor your child until such time as treatment may be indicated. Note that there will not be any fees for these follow up appointments.

If orthodontic treatment is required and you decide to proceed, further diagnostic tests may be necessary including:

• Additional imaging of the teeth and face
• Cephalometric (skull) radiographs to determine positioning of the teeth, jaws, and cranial structures, analyze the soft tissue profile and other skeletal features (ie. Airways)
• An accurate model of the teeth and surrounding structures to determine tooth size discrepancies and evaluate the relationship between the teeth
• Computerized tomography of the jaws and jaw joints (if indicated) to analyze skeletal asymmetries and/or tempero-mandibular dysfunction
• Consult discussions with your family dentist, physician, and other medical/dental specialists

If treatment is recommended, you will receive a financial estimate along with a treatment plan. Your family dentist will also receive a copy of our recommendations by mail.