from By Dr. Jeff Beyer

It may come as a surprise to you that adults make up close to 35% of my patient pool (that’s one out of every three patients!) so I thought I would devote a blog to adult treatment.

“I am too old for orthodontic treatment” is a statement I hear at least once a week. Truth is, your body and teeth are going to react to tooth movement in the same way whether you are 20 or 80. There are certainly some additional challenges when treating adults due to the fact they may have more dental restorations, missing teeth, or periodontal issues, but with the advancement in technology with both fixed and removable braces, treating adults has become MUCH easier (and less invasive) than it ever used to be.

Since 2010, the number of adults seeking orthodontic care has been on the rise each year. This can be attributed to increased awareness due to greater marketing efforts from clear aligner makes such as 3M, and increased awareness on the part of the dentist and hygienist of the importance of straight teeth and a proper bite. In addition, having a nice smile is something that can build self-esteem and research has been shown that a person’s smile is one of the first things we notice when we first look at them.

About half of my adult patients seeking treatment come because they are looking for an improvement in their smile/appearance. We have seen the most dramatic increase in new patient visits from 45-70-year-olds. These are folks who have noticed that their probing depths (the “two, three, two, four,” etc. numbers you hear the hygienist call out at your visits when they are measuring the pocket depth in between the teeth and gums) are increasing due to the beginning bone loss around teeth that are crowded. Typically, this is seen most in the lower front teeth, and having treatment can be very beneficial for providing ease of cleaning, centering the teeth properly in the bone, reducing the risk of further bone loss/periodontal issues, and helping to promote the longevity of those teeth.

In our practice, adult treatments range from simple single tooth alignments, to complex full orthodontic treatments where we take a multi-disciplinary approach with your dentist and other dental specialists. Simple cases are most effectively treated with removable appliances such Invisalign, and more complex cases are usually treated with conventional braces. The good news is conventional braces are not what they used to be. We no longer use spacers, bands that go around each tooth, headgears, etc., and we even have ceramic (invisible) braces. We also now use Invisalign retainers that are just worn at night when treatment is complete. We even have some adults who wear silver braces and get colors to be just like the kids!

If you have ever considered orthodontic treatment as an adult, there has never been a better time to have an evaluation and see what options are possible. Some insurance companies are even offering benefits for adult treatment. Also keep in mind that you can use Health Savings Accounts and/or Medical Savings accounts through your employer (pre-tax dollars) to pay for your treatment.

Unlike most medical procedures, you do NOT need a referral from your dentist to have an orthodontic screening/evaluation, and at Commonwealth Orthodontics all of our initial consultations are complimentary, so there is no cost to you or your insurance.

If you would like to meet one on one with Dr. Beyer to talk about options for adult orthodontic treatment, simply give us a call and we will be happy to schedule a consultation for you.

When we say we serve the entire family at Commonwealth Orthodontics, it means a couple of things.
 
First, it speaks to the fact that we treat everyone from children through adults.
 
It also means that through the years, we may see everyone under your roof.
 
One of the most fulfilling aspects of our jobs is being part of your family’s journey. For example, we love it when a younger brother begins treatment, and tells us all the amazing things his older sister has been doing since completing her own orthodontic treatment years ago.
 
The Carduck family exemplifies this phenomenon. Jake, the youngest, just finished up treatment and had his braces removed. His mother was kind enough to leave us this note…

This made our day. And it’s a reminder that when you’re looking for an orthodontist, it’s not just about booking one appointment. It’s about finding someone you’re comfortable bringing your family to see through the years. We hope we can be that practice for your family.
 
So, happy holidays from our family to yours! We hope to see you soon — or simply hear how the family’s been doing.
 
--The Commonwealth Orthodontics Team
 
(And if you’d like to leave a review of your own, we have the easy steps to follow right here. Thanks!)

By Dr. Jeff Beyer

If you are like me, lately you have been getting bombarded with ads on TV, social media, and Google for “do-it-yourself orthodontics.” These are mostly coming in the form of clear aligners such as the Smile Direct Club, Candid, etc., and there are new companies popping up almost daily.

A quick search of the internet reviews and you will find everything from a wide range of testimonials of “life changing smiles,” to the multiple lawsuits against these companies being filed from patients themselves due to failed treatments or other dental/facial ailments caused by the treatment, to state dental boards that are claiming that these companies are practicing dentistry without a valid license.

So what’s a consumer to do? Certainly, if a patient’s case can be treated with one of these systems there can be a significant cost savings to the consumer, and that appears to be the number one reason that these companies were created. Now they are making claims that there are shorter treatment times, appliances can just be worn at night, etc. Honestly, most of these treatment claims are without scientific merit, but the cost differential can be significant over having treatment with a qualified orthodontist.

Listen, I get it. I am the 1st guy to go to Lowe’s, Home Depot and Costco to compare every aspect of a new refrigerator I am going to buy to make sure I am getting the best deal. I scan my valued customer card at every conceivable store to get my rewards points. Heck, I just got 6 pairs of socks for FREE this week with my Kohl’s cash!

Orthodontic treatment IS a significant investment, but think about this – there must be a reason we go to college, dental school, and then do a 2-3 year residency for 10-11 years before we are allowed to practice orthodontics, right? Our degrees are in Orthodontics and Dentofacial Orthopedics (which is a fancy way of saying that the teeth are connected to the jawbones, which are connected to the face bones, which are connected to the head bones, etc.)

To me, this is what it boils down to – if you see orthodontic treatment as a PRODUCT, like you would purchase a car, vacuum cleaner or lawnmower, then do-it-yourself may be the right thing for you. But beware, if that product doesn’t meet your expectations or you are dissatisfied with what it does to your teeth (or in most cases want it doesn’t do), are you going to return the product for a refund? What are you going to do if your bite is now worse than when you simply tried to “straighten your teeth?” What if you develop TMJ problems or issues with the surrounding teeth and gums?

You see, I still see orthodontics as a SERVICE, not a product. Patients come to me for my expertise, just like a doctor, lawyer, accountant, plumber, electrician, auto mechanic, etc. When something doesn’t go as planned, I have the expertise and experience to know what options are available to correct the problem. Will the 800 number you call, the email you send, or the website chat box you open be able to do that? I’m not 100% sure, but I would most likely bet against it.

In the end, it is a good thing for patients to have choices when it comes to their treatment. But keep in mind when you do anything to alter your body, there are inherent risks and potential complications. You probably wouldn’t attempt to fill your own tooth, make your own denture, or perform a root canal on yourself. So, why would you consider your own tooth movement and bite coordination?

Certainly something to think about...

By Dr. Jeff Beyer

A large number of my patients have something in common: they chose to be my patients after reading a review.

Because practice reviews play such a large role in building and maintaining my practice, and are something that prospective patients place so much stock in, I wanted to take a few moments to share some thoughts about them, as well as show you where to find them and how to add yours.

 
Where to find and write reviews for Commonwealth Orthodontics
I’ve included links below to the most popular platforms for my practice: Google and Facebook. Please feel free to consult them if you’re a prospective patient or add to them if you’re an existing patient. Thanks in advance!


Facebook - Mobile App

• Search for Commonwealth Orthodontics or click here
• Tap on the “Reviews” tab
• Find the text box stating, “Do you recommend Commonwealth Orthodontics?”
• Select “yes” and you’ll be asked to share what you recommend about our practice

Facebook - Web Version (Desktop & Mobile)

• Simply click here

Google reviews: Simply make sure you're logged into your Google account and click the appropriate link below:

• Midlothian / Chesterfield location
• Colonial Heights location

Reviews help – more than you may know it
You might imagine that positive patient reviews impact my practice in a pretty obvious way. When people have a terrific experience with me and my staff, and they share this with others, there is a very good chance that these prospective patients and families will consider their opinions in choosing Commonwealth Orthodontics to help with whatever challenges they’re facing.

Reviews with constructive criticism can also be helpful. They provide valuable insights that my team and I can look at, and see if we need to make any changes. Fortunately, I’ve only received a few of these through the years, but they’ve often been an important learning experience that allowed my practice to further grow and improve.

I’ll make one more quick comment about the value of reviews. I got into orthodontics to help boost people’s health and self-confidence – and not to be a marketer. The more and more people I have join my practice organically through reviews, the less time and money I have to spend focusing on marketing my practice. You benefit because I pass these savings on to you, and because I’m able to focus 100 percent on my patients.


I’d like wrap up by once again thanking my patients for any reviews they’ve submitted. This extends to all who have voted for me as a Best Orthodontist in Richmond through the Richmond Times-Dispatch. We really appreciate it!

By Dr. Jeff Beyer

I have always been a big fan of the outdoors. I grew up in Buffalo where we definitely had four distinct seasons, so in August I would be water skiing in Lake Erie, and just six months later I found myself skiing compliments of the lake effect snow that came from Lake Erie as well.  I also love to travel, particularly in the United States. In fact, the only state I have not been to is North Dakota (now a bucket list item).

In light of this, a couple of years ago we decided we would “try” an RV. No sooner did we visit the showroom than we made our first purchase, and we drove off in our 30-foot Class A motorhome completely clueless about all things RV’ing. We joined forums, researched stuff on the Internet, and did our due diligence so that we would not stick out like the Griswolds on our first outing.

We found a cute little RV park in Southwest Virginia and decided to make our first journey. A great part about RV’ing is that you can take your pets with you, so we loaded everybody in and off we went. To say that we liked it would be the understatement of the year – WE LOVED IT! A few more trips and we were completely hooked. We realized that this was going to be our new hobby and that we were going to spend the years ahead of us exploring this great country.

What’s great about the lifestyle is that there is something for everyone – whether you have a pull-behind “pop up,” or a luxury 45’ diesel bus motorhome, manufacturers have something for everyone. Campgrounds can be very rustic or extremely modern. I will also say we have met some of the nicest people while RV’ing. A lot of the fun for us is the journey itself. Stopping in little towns, enjoying the local fare or just attending a festival or visiting a park; there are so many cool places to explore and visit in this great country we live in. We are even planning our first retirement trip – a journey across the Trans-Canada highway all the way to Vancouver.
There is something very special about being able to essentially take your house with you – no waiting in airports or bus/train stations. You can prepare and eat your own meals without having to go to restaurants, and you get to sleep in your own bed every night! We love to be able to take the dogs along to share our experiences as well.

Last fall, we took the kids for just a short weekend close to home. I expected it to be like most weekends where they spent most of the time on their phones, just as kids do. But guess what? We hiked trails, we cooked and ate meals together, we played board games, made campfires and s’mores, and actually TALKED to one another. I will never forget that weekend as long as I live.

If you have ever thought about trying RV’ing – I would highly encourage it. You can always rent first to see if you and your family likes it. Our kids call us the Griswolds now, because we are always learning new things about our RV and exploring and planning our next adventure!

By Dr. Jeff Beyer

This is a question I get asked almost daily in my practice, and quite honestly, it is a perfectly valid question to ask from a generation of parents who were never told to see the orthodontist (when they were kids) until middle school or even high school.

A little history here… during the ‘70s, ‘80s and early ‘90s, both pediatric and general dentists recognized orthodontic problems in their younger patients (age 6-10), but there was nothing they could do about it. So in the ‘90s, the orthodontic community decided it would be good to evaluate these young folks and offer them some options. Hence, the era of interceptive, Phase I orthodontics or Early Orthodontics (there are more labels than I can write here) treatment was born.

As you can imagine, this created some confusion on the part of the parents who did not understand why they were taking their child in to see the orthodontist before they had all of their permanent teeth. Quite frankly, we as orthodontists did a very poor job of explaining this, and some parents saw this as nothing more than a ploy to fund the orthodontist’s 401K account by charging parents “twice” for braces.

The reality is that there are some children who can benefit greatly from having early treatment. The truth is, however, that there is no UNIVERSALLY accepted standard for who should get treatment and who should not. A more aggressive orthodontist may treat 80-90% of patients with Phase I, while a more conservative orthodontist may only treat 20-30%.

Over my 20 years of practice, I have settled in on three major reasons for recommending Phase I treatment. It’s when I observe at least one of the following…

1. A severe crowding problem in one or both jaws, that if not corrected, would result in the need for multiple oral surgical procedures to have multiple baby and permanent teeth extracted
2. A severe growth problem (overbite, underbite, crossbite) that could greatly benefit from orthopedic (skeletal or bone) correction that may prevent the need for future jaw surgery
3. A traumatic bite of the permanent teeth that are present, that if left uncorrected while waiting for the remaining permanent teeth to erupt, may cause irreversible damage to the existing permanent teeth
   
   

A more gray area is for cosmetics applications, which is open to a high degree of subjectivity. In cases like this, I will typically point out what can be done, but does not necessarily NEED to be done to improve the overall short-term (and possibly long-term) orthodontic situation.

The bottom line is this: If your orthodontist proposes Phase I treatment for your child, be sure to ask why, and what benefits it will have on your child’s orthodontic and dental health now. Ask what the potential ramifications are if you do not elect to proceed with treatment, as well as the financial implications (insurances have a lifetime maximum). In other words, be sure are comfortable with the treatment that is presented. If you are not, it is probably best to seek a second opinion. After all, if you proceed with Phase I treatment you are establishing what will become a long-term relationship with that particular orthodontist.

There are two final points I would like to make. First, over 95% of patients who undergo Phase I treatment will need full orthodontic care when they are teenagers.  I cannot emphasize this enough. We tell patients’ parents this and have it in or consent forms and literature, but I am still surprised at the number of parents who seem surprised when we tell them their child is ready for full braces 2-4 years after we have completed Phase I.
Finally, the American Association of Orthodontists recommends ALL children have an orthodontic screening at age 7 to 8. We wholeheartedly support and agree with this. Your initial exam is always complimentary at Commonwealth Orthodontics, and you do NOT need a referral from your general or pediatric dentist to schedule with us. Many times your child will not need anything but an annual checkup until they are ready for full treatment as a teenager. However, if your child can benefit from Phase I Orthodontics (or Early Orthodontics) and avoid potential future orthodontic complications, having the screening and your options presented to you is one of the best things you can do for your children.

By Dr. Jeff Beyer

Last month I had the opportunity to attend an American Association of Orthodontists symposium on Sleep Disorder Breathing and Sleep Apnea. It was a collaboration of medical and dental professionals sharing their expertise on a rapidly growing problem (dare I say epidemic?) that is becoming ever more prevalent in both adults and children across the U.S. and beyond. If you or a loved one are snoring at night, it could be part of a much more serious problem.

I received absolutely no training on sleep disorders in either my dental or orthodontic education, and wanted to have a better understanding of these disorders. That’s because many of my patients have indicated they suffer from sleep breathing disorders and the multitude of negative effects they can have on the body, up to and including death (yes, death). You were probably not aware that many celebrities — including Carrie Fisher (“Star Wars”), James Gandolfini (“The Sopranos”), Supreme Court Justice Antonin Scalia, Jerry Garcia (Grateful Dead) and NFL player Reggie White all died from complications from Sleep Apnea.

I was amazed to hear the following statistics:

• 42 million adults have sleep disorders
• 1 in 5 adults have mild Sleep Apnea
• 75% of severe sleep disorder cases remain undiagnosed
  
  

The data is not as clear for children, but we do know that sleep disorders in children and adolescents are on the rise, with disorders able to manifest during the first six months of life. This is of particular interest to me as these younger groups makes up over 50% of the patients I see every day.

There are some significant risk factors for adults, which include being male, over age 50, a BMI of over 30 (obese), and a neck circumference over 17”.  Symptoms include nightly snoring, chronic tiredness during the day, a bed partner observing stopped or interrupted breathing, and elevated blood pressure. In children, snoring is the No. 1 indicator of a sleep disorder, along with enlarged tonsils, and some things you may not think about – chronic bed wetting, attention deficit disorder (ADD or ADHD), and trouble with comprehension at school.

Fortunately, there are many professionals who have dedicated their careers to specializing in diagnosing and treating patients with sleep disorders. If you feel as though you or someone you know may be experiencing these symptoms, it would be wise to alert your PCP or dentist, and they can help guide you to these professionals. A sleep study at an accredited sleep center is the single best way to make a proper diagnosis, after which treatment can be prescribed based on the findings. The single most effective therapy is a CPAP machine, but for those for whom that is not the answer, both dentists and orthodontists are making oral appliances to help these patients.

I can honestly say this symposium is probably the most informative and educational meeting I have ever attended. While I am by no means a sleep disorder expert now, I do have a more thorough understanding of the signs and symptoms. I will also begin to incorporate this into my clinical examinations and practice, now knowing when to make appropriate referrals to sleep disorder professionals for proper diagnosis and treatment.

If you would like to schedule an initial consultation with Dr. Beyer or have another question, contact us today.

By Dr. Jeff Beyer

Braces are timeless. Not only do they continue to make up about 85% of all the patients that we treat, but — believe it or not — they have found evidence of braces all the way back to Egyptian mummies! Braces became a part of mainstream teenage life in the ‘70s, and the truth is, they were very uncomfortable, and not very pretty :). Large metal bands surrounded every tooth in the mouth, and most everyone had to wear a headgear (even to school!).

Significant advances with braces have been made in a relatively short period of time. Braces are now smaller, smoother, and most importantly, can be bonded directly to the tooth surface with the same material dentists use to place white fillings. In other words, no more bands around the teeth, which means no more spacers between the teeth, either. In addition, new wire types make moving teeth much less painful, and patients can often go 8-10 weeks before needing to return to the orthodontist for adjustments or wire changes.

We sometimes get requests for “inside” or lingual braces, and to be quite honest, they are just not that popular. The trade-off for not being able to see them — they’re attached behind the teeth — is usually much more discomfort having all of the braces on the tongue side, so it is rare that we ever use them anymore.

Improvements continue to be made with the “look” of braces as well. We now have gold braces, clear braces, and even braces with different shapes. The most popular is still the silver (stainless steel) type, where people can choose an almost unlimited number of colors and change them each time they come in to update their look. For those patients who do not want colored braces, there is a type called “self-ligating,” which do not require any kind of color to be placed around the brace to hold the wire in.

Braces work by applying a specific force to a tooth, and in turn that force causes the tooth to move in the desired direction. Fully trained orthodontists spend the first part of their residency training programs undergoing intense training in physics and biomechanics. Once the tooth is moving, a lot of physiologic and biochemical reactions are taking place around the bones and gums to allow for the tooth to move and the body to adapt to it.

There is no denying that orthodontics (and dentistry in general) is moving toward a digital world. The invention of digital scanning, and 3-D printing have allowed for clear aligner systems (Invisalign) to become a part of how we deliver orthodontic care. But traditional braces are not going away anytime soon. Both systems have their pros and cons, and having both clear aligners and fixed braces give patients more choices than ever.

Would you like to schedule a consultation to discuss braces or other orthodontic treatment? Contact us today.

By Dr. Jeff Beyer

The initial consultation is a very important part of the overall treatment process. Scheduling this appointment is simple. Either give us a call at either of our locations, send us an email, or fill out the form and one of our staff will contact you during our regular office hours. Many of our patients are referred from their general dentist, but keep in mind that no referral is necessary (even from insurance) in order to have a consultation.

We view the initial consultation as possibly the most important visit of the whole treatment. It is here where we gather the information needed to start the entire patient care process. We allow almost an hour for this visit, and do not charge the patient or insurance. Why?  Orthodontic treatment is a significant investment with results that last a lifetime, and we want our prospective patients to have plenty of time to get to know us, express their desires and concerns about treatment, and have plenty of time to have all of their questions answered.

Here is a behind-­the-­scenes look at a one of our typical initial consultations. Keep in mind that we schedule these appointments during our “off-peak” hours (typically between 9:30 a.m. and 2 p.m.), so that the doctor and staff have ample one-on-one time with the patient and family.

1. We ask for some personal information. By obtaining your demographic and medical/dental history, the doctor is able to begin to understand your concerns and assess any treatment needs. We will also ask for your insurance information so that we can contact your insurance company and verify any orthodontic benefits you may have. If we’re able to get this info ahead of the consultation (via our online forms or fax/e­mail), it can save some time at the appointment and allow us to get a head start on your evaluation.
   
   
2. Exam, X-­Rays and photographs. Before meeting with Dr. Beyer, we will take a digital panoramic x-ray, digital photos of the inside of the mouth and face, and some measurements of crowding, spacing, and bite. These will help Dr. Beyer to make an accurate assessment of the overall orthodontic condition. Keep in mind ALL of our records are digital which means far less radiation than traditional x-rays, and all of this information and can be e­mailed directly to you and your dentist at the push of a button.
   
   
3. Meeting with Dr. Beyer. ­After reviewing the records, Dr. Beyer will meet with you in a private consultation area where the records will be visible on a large computer screen for everyone present to view. He will offer a thorough diagnosis and present treatment options. In rare or particularly difficult cases, additional records or referrals to other specialists may be necessary before settling on a final treatment plan. Part of this process is also addressing concerns you or your dentist have, and incorporating those into the treatment plan.
   
   
4. Treatment Coordinator meeting. This is an opportunity to meet our Treatment Coordinator, who will spend some time going over the overall process of how treatment/appointments work in our office, the different types of braces, colors, Invisalign, etc. She will also present fees for treatment, insurance benefits, our multiple payment plan options, and address any other questions/concerns you may have.
   
   
5. Put the plan into action. We are typically able to go from the initial consultation to starting treatment in one week or less, which puts you on the road your new smile faster than most offices. By not using spacers, bands, and other out­-of-­date bulky and uncomfortable appliances, one 60-minute visit to start your treatment is all you need!
   
   

For those patients who are not quite ready for treatment, we will place you on a recall schedule at specific intervals to monitor growth and development and/or dental work as you progress to the ideal time to begin orthodontic treatment.

Schedule a new patient consultation today. There is no referral is necessary.

Commonwealth Orthodontics Chesterfield: 1 (804) 739-6600
Commonwealth Orthodontics Colonial Heights: 1 (804) 520-7292
If it’s after normal business hours, or you simply prefer to reach out via email, please send us a note at: Office@commonwealthortho.com

By Dr. Jeff Beyer

As much as I’ve worked hard to innovate my orthodontic practice to maximize patients’ health and comfort, there is one area that’s always been a somewhat unpleasant experience for patients — and that’s making impressions of the teeth and bite. You know this as the “goop”, that icky substance we place in your mouth to create impressions of your teeth that act as the mold for braces, retainers, Invisalign and mouth guards. Even though we have more than 10 flavors available, it can still test your gag reflex and research has shown it’s one of the top reasons folks dread going to the orthodontist.

New innovations in software technology and 3D printing are rapidly being integrated into all aspects of dentistry, and I am proud to say that we have taken a huge step in eliminating the “goop” here at Commonwealth Orthodontics.We now an iTero Intraoral 3D Scanner in our offices. This is the third generation of this model and it incorporates the latest and greatest technology that is available today.

Here is how it works: Patients sit comfortably in a chair while one of my technicians or I simply wave a wand over and around their teeth and gums, capturing images at 6,000 frames per second. On the adjacent screen, detailed 3D renderings of your mouth are displayed, giving me everything I need to to perfectly fit orthodontic appliances to your unique bite.

This third generation iTero Scanner isn’t just more cutting edge and comfortable – it’s much faster, too. We are able to do a complete scan in less than seven minutes. Plus, we have a digital image that is stored forever (no more plaster!!), so we can send that to any orthodontic or dental lab in the world in a matter of seconds, and have appliances made with much shorter turnaround times. And here is one more REALLY cool benefit: the scanner looks into the future, with the ability to virtually “show” the proposed treatment outcome!

Needless to say, we are beyond excited to have this technology in our office and available to our patients. If you have been considering having treatment and been putting it off, ask to see the iTero Scanner during your next appointment, or set up an appointment to be scanned to see how your smile can be improved. The next generation of orthodontics is upon us, and we are proud to be one of the first practices in the area that is going “GOOP-FREE”!!!