Rene S. Johe, D.M.D.

Orthodontics for Children and Adults

Specialty License #5206

 

About Dr. Johe:

 

Dr. Johe has completed an extensive three year  program in clinical orthodontics while simultaneously participating in the prestigious Dental Scientist Award research program.  Dr. Johe is a licensed specialist in orthodontics.  He has also completed a 2 year program in the study of temporomandibular joint disorders (TMD's) and currently teaches orthodontics at the New Jersey Dental School.  Dr. Johe practices the most modern orthodontic techniques currently available with the goal of achieving the best esthetics possible for his patients.

 

Who Needs Treatment?

 

Crooked teeth can result from genetic predisposition, poor oral habits, or just plain bad luck.  The American Association of Orthodontists recommends that every child first visit an orthodontist by age seven or earlier if a problem is detected by parents, the family dentist, or physician.  Treatment usually involves wearing fixed (glued on) clear or metal appliances (braces) or removable acrylic appliances.  Dr. Johe will inform you of how he intends to treat you or your child following the initial screening visit.  This screening visit will take approximately 15 to 20 minutes.

 

The following information will explain the typical age groups for orthodontic treatment and what our fees include.

 

Phases of Treatment:

 

There are three age groups that are typically treated with orthodontics:

 

Age 6 - 10

 

Children at this age may exhibit any of the following typical malocclusion problems:

 

    A.)  Crowding- overlap and rotation of the front teeth.

    B.)  Underbite- some of the upper teeth being "behind" the bottom teeth.

    C.)  Overbite- lower teeth being behind the upper teeth or the upper teeth "sticking out".

    D.)  Crossbite- upper jaw being narrow compared to the lower jaw.

    E.)  Extra / Missing teeth- eruption / exfoliation anomalies.

 

All of these conditions may be accompanied by poor oral heath habits, including thumb sucking, tongue thrusting, lip wedging / biting, and others.  Treatment at this age typically involves removable appliances including expanders, habit appliances, retainers, and extra oral appliances, and is termed Interceptive treatment.  Treatment may also involve wearing braces for up to one year duration.  Retainers are typically required following treatment.  Although patients typically require further orthodontic treatment at a later time, the final result can be greatly enhanced and treatment simplified by treating children at this age.

 

Ages 11 - 17

 

Children at this age may exhibit any of the malocclusion problems listed previously and in addition may exhibit:

 

    A.)  Tooth impaction - improper tooth eruption of canines / premolars.

    B.)  Posterior crowding - overlap and rotation of the back and front teeth.

    C.)  Spacing - some spacing in the front teeth is normal up to age 12.  Spacing beyond

           this time period may indicate a need for orthodontic treatment.

 

Treatment at this age typically involves wearing braces anywhere from 18 months to 30 months and is termed Comprehensive treatment.  In some cases, treatment may also involve wearing removable appliances.  In rare cases, surgical intervention may be necessary.  Retainers are always required following treatment.

 

Ages 18 - 100

 

Adults can exhibit a wide variety of malocclusion problems, including any of the previously mentioned conditions.  Some other typical examples:

 

    A.)  Lower incisor crowding - This typically occurs in 20-30 year old patients who did or

          did not have prior orthodontic treatment.

    B.)  Rotation / Crowding of anterior teeth - This typically occurs in 20 - 50 year old

          patients exhibiting slow methodical crowding of front teeth over long periods of time.

 

Treatment at this age typically involves wearing braces or retainers anywhere from 6 months to 30 months.  In some cases, surgical intervention may be necessary.  Retainers are always required following treatment.

 

Explaining Orthodontic Materials

 

Dr. Johe believes it is important to use quality materials in order to achieve a quality orthodontic result.  Dr. Johe does not recycle appliances, assuring consistent quality for his patients.  The braces and retainers utilized by Dr. Johe provide the highest quality and performance available.

 

The Truth about Invisalign

 

Although many television commercials have popularized clear removable retainers, their actual utility in orthodontics remains extremely limited.  Although Dr. Johe does treat patients with clear retainers, their use is limited to fairly straight forward and non-extraction cases.  In addition, long term retention, the tendency for teeth to stay straight following cessation of orthodontic treatment, may be greatly reduced with this type of treatment.

 

The Truth about Retention

 

Retention, or the tendency for teeth to stay straight following cessation of orthodontic treatment, is greatly affected by how litigiously retainers are worn after you or your child leaves Dr. Johe's office.  Dr. Johe recommends long term wear of retainers typically extending years after treatment is complete.  Should retainers be lost or broken, new retainers will need to be fabricated at an additional cost.

 

The Truth about Fees

 

Dr. Johe believes in stating COMPLETE and HONEST fees BEFORE any treatment begins.  Any fee quoted will include ALL necessary orthodontic appliances required, including expanders and retainers to be worn during and after treatment is complete.  Interceptive orthodontic treatment involves a separate fee from comprehensive orthodontic treatment.  The office charges a reduced comprehensive fee if interceptive treatment was previously completed.

 

Typically the fee quoted will include a records fee, due at the time Dr. Johe takes records (pictures, impressions, X-rays), an initial starting fee, and a monthly fee to be paid for a stated period ranging from 9 to 36 months.  At the time the braces are removed, any balance remaining is due in full.  Any insurance payments are applied toward this fee.  Please be aware the you are responsible for the complete fee should your insurance company decline coverage or your coverage change.

 

If you have any questions about our fees, please fee free to consult with our front desk staff.  We are always willing to work with you on a payment schedule that suits your needs.

 

Examples of items NOT included in Orthodontic Fees

 

    - Extraction of teeth

    - Restorative dental treatment (fillings, veneers, crowns)

    - Regular dental cleanings

    - Remake fees for broken / lost appliances

 

Many of these items are not performed by Dr. Johe and will therefore incur a fee with another dentist or laboratory.

 

Timing of Visits

 

Following your screening visit, if treatment is indicated, a 45 minute records visit will be scheduled.  These records will need to be processed and evaluated so a definitive treatment plan can be generated.  This process takes approximately 4 weeks.  A 30 minute consultation visit will be scheduled following your records visit to discuss specific details of your or your child's treatment plan.  In some cases, this treatment plan may differ significantly from the preliminary plan suggested during the screening visit.  Should you have questions regarding scheduling or treatment, please do not hesitate to ask us at any time!