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Considering a D2C orthodontic company?

Many online orthodontic companies make their treatment sound so easy and convenient-you take some selfies, an impression or maybe a scan—and voila, in no time you have a great new smile.

Based on my decades of professional training and experience, straightening your teeth and improving your bite is rarely that simple.  If it were, licensed orthodontic specialists would not be required by the state to go to school for the mandated 11 to 12 years and another 2-4 years beyond dental school in order to render expert specialist care.

Easier Isn't Always Better

The main risk you should consider is that with direct to consumer orthodontic companies, the critical in person initial pretreatment evaluation, the diagnostic process, and ongoing supervision is usually removed from the process.   So a lot of important biological factors are skipped and that could potentially lead to irreversible and costly damage like gum loss, changed bites, and root and bone deterioration.

Really, the main question to ask yourself is what other medical procedure would you pursue without an in person evaluation and the continued direct supervision of a professional?

What You Need to Ask Yourself

The American Association of Orthodontists (AAO) lists 14 important questions you should ask when researching direct to consumer ortho aligner companies.  You can go to the AAO consumer alert to read them all. However, for the sake of brevity, I have condensed the AAO list into 6 key questions that should be answered before starting any treatment.

  • As part of your treatment, is a clinical examination of your jaw alignment, teeth, bite and supporting structures performed and are comprehensive diagnostic records like x-rays taken before your treatment?
  • Does your treatment fee include the cost of any in person visits to an orthodontist to make sure teeth are moving as planned?
  • Is only one type of treatment offered; how do you know that is the best option for your individual case?
  • If a general dentist or orthodontic specialist is involved with your treatment, do you know his/her name and can you communicate directly with the doctor in a timely manner?
  • Who can you speak with at the online orthodontic company about your treatment and if an issue arises how will it be handled and who will be responsible for handling it?
  • Does the treatment model comply with the dental laws in your state?

Remember that orthodontic treatment is not a product or device-it is a professional medical service-you want your treatment to be directly supervised by a highly trained specialist. Before making any decision about orthodontic treatment, consider doing some research and having an in person consultation with a post-doctorate residency trained orthodontist.

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Recent Advances in Orthodontic Care


All of our efforts as parents and grandparents are undertaken in order to raise healthy, happy and confident children who will excel and contribute to our community and nation in very positive ways.  Orthodontics has always been a key piece to this puzzle. A bright and attractive smile always facilitates a significant social edge and translates to more joy and success in life.

For children and adults who need braces or aligners, orthodontic treatment can make a huge difference in their outlook on life. When a person who does not feel good about his or her smile can become comfortable and confident, it is a life-changing experience!

Being able to give a person confidence and self-esteem is the most fulfilling part of our job. We love what we do! We want everyone to experience the satisfaction and fulfillment that comes from having a great smile and the confidence to show the world. Nothing warms a room, a relationship or changes attitudes like a great smile!

The days of having to see the orthodontist every month, painful bands and separators, headgear and high down payments are in the past! Modern technology, modern convenience and modern financing make braces more attractive and affordable now than ever before.

Orthodontics and the process of getting braces has changed tremendously over the last few years. Forget all the things you had to endure as a child, the lack of affordability and the painful process. Things are different now! Change is good.

Call and make an appointment to see an orthodontist today. It will change you or your child’s life!

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The Difference Between An Orthodontist and a Dentist

Have you ever found yourself wondering what the difference between a dentist and an orthodontist is? Though the lines may seem blurred at times, there are some important distinctions to consider when thinking of the two!

How Much Schooling Did They Do?

The first thing to consider is education. All orthodontists are dentists, but not all dentists are orthodontists! The journey to becoming an orthodontist begins with completing dental school and becoming a licensed dentist. Once completed, orthodontists continue in their education with three more years of residency in order to become a specialist.  

The next thing to consider is specialization. The hours of specialized training that orthodontists receive is invaluable and makes them the clear choice when deciding who to trust with your orthodontic issues. Orthodontists solely focus on enhancing facial beauty by aligning teeth and jaws, that’s it! 

If you had to have your knee replaced, you most likely wouldn’t go to your family doctor to have the procedure done. You would likely find a doctor who specializes in this type of procedure. You should do the same for your smile. When it comes to the alignment of your smile, it is best to trust an orthodontist.

Finally, one must consider experience. During an orthodontist’s education and training, they are exposed to many different orthodontic issues that they must learn how to address. When visiting an orthodontist, you can be sure that they have the necessary experience to understand and address your needs. 

You don’t want to trust just anyone with your smile.  At Kineret Orthodontics we are passionate about creating exceptional smiles and memorable experiences. We remain committed to caring for you with expertise, professionalism, all in the most heart centered-way. We would love to help you feel confident in your smile! To schedule your consult, please give our office a call at (916) 772-5832. 

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How Important are Straight Teeth?

Picture yourself flipping through a magazine. Page after page you see advertisements featuring people who most likely have something in common. That commonality is straight teeth with a beautiful smile. Let’s face it, smiles are one of the first things that people will notice when they meet you. Don’t you want to have a smile that will leave a lasting impression?

Study after study has shown that people with straight teeth are more likely to be successful, more likely to get a job and more likely to have higher self-esteem. The aesthetic benefits of straight teeth have been shown to improve your overall confidence.

Higher self-esteem and confidence are important for adults but even more so, they are important for children. Everyone wants their children to be happy and healthy. We want them to be confident and successful, too. And a beautiful smile can contribute to this.

While the aesthetic benefits of straight teeth are great, the health benefits are something that should also be considered when looking into orthodontic options.

First of all, crooked/crowded teeth are more difficult to clean. It is harder to reach all of the areas between your teeth to remove plaque and bacteria when your teeth are crooked. This problem could lead to an increase in the risk of cavities and gum disease.

A crooked smile can also lead to issues with your bite. This misalignment can lead to uncomfortable tooth grinding, pain, TMJ and sinus issues. These problems can be avoided or corrected with the proper care from your orthodontist.

People who have crooked teeth are more likely to suffer from tooth breakages, chips and fractures. If teeth are protruding, they are less protected than straight teeth and more susceptible to these types of issues.

Overall, straight teeth can increase your confidence, contribute to your overall health and well-being and save you money in the long run. Modern technology, modern convenience and patient-friendly financing make braces and aligners more attractive and affordable now than ever before.

Now there is nothing to hold you back, whether young or old (25% of our patients are adults!). Call and make your consultation appointment today. We look forward to meeting you!

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Are braces really worth it?

The Worth of a Smile

The thing that goes the farthest
Towards making life worth while,
Which costs the least and counts the most,
Is just a pleasant smile.
The smile that bubbles from a heart
That loves its fellow men,
Will drive away the clouds of gloom
And coax the sun again,
It is full of worth, and goodness too,
With many kindness blent;
It is worth a million dollars
And it doesn’t cost a cent.

There is no room for sadness
When we see a cheery smile,
It always has the same good looks,
It’s never out of style.
It nerves us on to try again
When failure makes us blue,
The dimples of encouragement
Are good for me and you.
It pays a higher interest
For it is sincerely lent;
It is worth a million dollars
And doesn’t cost a cent.

A smile comes very easy,
You can wrinkle up with cheer
A hundred times before you
Can squeeze out a soggy tear.
It ripples out moreover
To the heart-strings that will tug,
And always leaves an echo
That is very like a hug;
So smile away, folks understand
What by a smile is meant;
It is worth a million dollars
And doesn’t cost a cent.



Are Braces Worth It?

Here are some blog comments to consider…

“Good luck, and I recommend braces!!” (Samantha)

“Yes it’s worth it!!! Because the older you get the more your teeth start to shift. and it makes your teeth completely straight. I’ve had my braces for about 9 months and I still have 9 more to go, but my teeth are already pretty straight and they were really bad before. And about the retainer for the rest of your life… you really only wear it at night, as my friend does, so don’t worry about that and wouldn’t you want perfect straight teeth? So go for it!” (Anonymous)

“It’s deffs worth it! Your smile is the first thing people notice about you lol! There’s a lot of people that have done it and they don’t mind the retainer or anything. So if you can afford it do it. 😉 Take my word for it! You will be way more attractive so hurry and do them while you are still young!” (Meh:)

“I had braces for 2 years and was told I had to wear the retainer forever. It was worth it and I only wore the retainer for 1 year and then on occasion after that. I think you should because you’re still in high school and it’s still socially acceptable to have braces.” (Dave)

“Yeah they are worth it! 🙂 I have crooked teeth and regret not getting them.” (asban)

“Absolutely since your teeth might look fine but the overbite is a problem that should be fixed. You will love the band behind your teeth once you get your braces off compared to a plastic retainer since you do absolutely nothing with it. You don’t feel it, don’t notice, and most of all will not care about it. The band is simply a tiny metal retainer that goes behind your bottom 4 teeth to prevent it from moving.” (Anonymous)

“A smile costs nothing but gives much. It enriches those who receive without making poorer those who give. It takes but a moment, but the memory of it sometimes lasts forever. None is so rich or mighty that he cannot get along without it and none is so poor that he cannot be made rich by it. Yet a smile cannot be bought, begged, borrowed, or stolen, for it is something that is of no value to anyone until it is given away. Some people are too tired to give you a smile. Give them one of yours, as no one needs a smile so much as he who has no more to give.” (Anonymous)

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Single Phase vs Two-Phased Orthodontic Treatment?

Single phase orthodontics means we wait until nearly all of the permanent teeth are in place prior to starting treatment.  Phased orthodontic treatment means a first phase of treatment is started earlier — commonly at age 7 to 9, when all permanent incisors (front teeth) and permanent first molars are in place but permanent canines and premolars have not yet erupted.  There are indications for both approaches and the option selected should be individually based.

If you select the phased treatment option, it is important to realize that there is a greater than 50-50 chance that you will need to do both phases – i.e. even if you start early you will not finish early, and there may be additional cost and time involved.

In our practice,  we have a comprehensive approach to the first phase, a rigid retention program, and, in fact, 1 out of 3 patients will not need to go on to a second phase.   Furthermore, for the 2 out of 3 patients that still require phase II treatment, the second phase of treatment is often simpler and faster than if we had done single phase treatment.  That being said, we do not do phased treatment on everyone, preferring to wait when problems are mild to moderate.

On the other hand, the benefit of a phased approach to young patients may be worth much more than the extra time or cost.  For example, many female patients finish most or all of their jaw growth prior to the time their full permanent dentition is in place.  Teeth that erupt into the wrong place or are impacted (‘stuck’ or blocked out of place) often require extractions or surgical intervention and this is often circumvented with earlier treatment.


The literature lists the following as benefits of phased treatment:

1.       Takes advantage of growth

2.       Requires fewer extractions of permanent teeth

3.       Involves less orthognathic (jaw) surgery

4.       Addresses harmful habits

5.       Causes less tooth trauma and enamel wear

6.       Improves self-esteem and social comfort

7.       Assures greater compliance with the course of treatment than in the challenging teenage years

Most important is the improvement in self-esteem and confidence that occurs when a child is given a beautiful smile during the socially challenging middle school years.  With a list of clear long-term medical benefits, the ultimate decision is still based most often on the consideration of that more intangible factor:

How much is your child’s self-esteem worth?

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Extractions vs. Non-Extractions

A question that comes up often in orthodontic consultation, diagnosis, and treatment planning is: Will it be necessary to remove premolar teeth to straighten your teeth or to correct your malocclusion (bite)?

The answer is that it depends.   There are several factors to consider, including the degree of crowding; flaring; thick versus thin gum tissue; missing, fractured, diseased, or impacted teeth; and the severity of the overbite or jaw imbalance.

A general observation is that about 25 percent of the time extractions are clearly not indicated. These are situations where crowding is mild to moderate, the front teeth are not flared forward, and bite and jaw discrepancies are mild to moderate.

10-25 per cent of the time (percentage varies according to the local prevalent genetic make-up) extractions are definitely indicated.   These are situations where the orthodontic patient has either extreme crowding, flaring of teeth, or a significant overbite.

The 50 to 65 percent of patients in the middle of the spectrum are considered to be border line and usually started on a non extraction trial.    These days, most folks in this group complete their treatment without removing teeth.

The good news is that, looking at all patients combined, premolar extractions can be avoided about 70 to 90 percent of the time!

Here at Kineret Orthodontics, most extraction cases are started non-extraction.   The rationale being that once premolars are removed, you can’t put them back.  So if there is a small but reasonable chance of substantial response to wires and rubber bands, it is best to defer extraction decisions until mid-treatment.

Even when it is certain at the outset of treatment that extractions are indicated, I prefer to defer extractions until mid-course.  The reason being that by mid-treatment we are in large arch wires, have started rubber bands and can more strategically and efficiently close extraction sites.

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Four Keys to Making a Good Orthodontic Decision – By Dr. Stephen Kineret

First of all, choose the right doctor

In this state, it is legal for general dentists to offer and provide orthodontic treatment to their patients (irrespective of the intensity of their orthodontic education).  So, in my opinion, you should be clear on the differences between the levels of training, experience, and expertise that exist between a general dentist with a special interest in orthodontics and a university trained board eligible or certified orthodontic specialist.  Short answer:   the orthodontic specialist made the commitment of a full time 2 or 3 year postgraduate residency in our specialty, earned a clinical certificate (and a masters degree –credentials:  DDS, MS if they did a research project and thesis).

In comparison, the level of training for a general dentist with a special interest in orthodontics is based on the minimal dental school curriculum exposure to basic orthodontics and the weekend courses they have attended.

The orthodontic specialist has limited his practice to orthodontics alone, whereas the general dentist also provides other services.  In my mind, the compounding of limited specialty practice with a 2 or 3 year post graduate residency experience distills down to a substantial difference in levels of experience and expertise.

Here is another way to look at this.  If you needed a quadruple bypass, who would you choose to do it—an experienced, well-trained cardiac surgeon or the family doctor?


Secondly, follow these guidelines:  

Do not base your decision on price but on value. 

I believe the general erroneous assumption made by the public is that most doctors’ training, philosophy and results should be the same because our profession is regulated by the state.   Remember appearances sometimes can deceive.  And guess what?  In our community, fees don’t deviate all that much!  So the question is:  Do you want to be in a great practice and have a very positive experience for you or your child or do you want to save a few dollars a month?   May I suggest a checklist to help you choose?


If the conditions on the following checklist have been met, congratulations; odds are that you have made a great investment in your oral health.  You have found your new orthodontic home.


You have been referred by another patient(s) who had a very positive experience in that office

The doctor can show you similar cases with pleasing results (there are before and after examples on our blog and website)

You feel that there is very good communication and direct and frequent interaction with the doctor

The staff is very friendly and caring

The office is conveniently located and offers office hours throughout the week and runs on time

The office implements contemporary technologies and infection controls

The office helps you maximize your insurance benefits and offers flexible no interest and no down payment options, and cash discounts


Choose the right office based on the above checklist/criteria–do not get bogged down in terminology or types of appliances used.

There are fads in orthodontics, just like in other professions and industries.  Decisions should be based on good diagnosis and treatment planning not on marketing fads, or using the latest, greatest widget.  I frequently see this kind of thing happen when the general dentist gives the patient/parent several referral cards; the patient dutifully gathers multiple diverse opinions and then becomes very confused.  Instead, use my checklist.  It will help, I promise.


Make sure your child is on board and encourage them to cooperate and follow directions to maximize results

I always tell my patients that a great patient and an average orthodontist can often get better results than the reverse.  Meaning, this is all about team work folks!  If you really want to get a great return on your investment, keep your kids on task with doing their part in treatment—compliance is paramount!  Treatment always turns out better and usually moves along faster, if patients keep their appointments, keep the teeth, gums and braces clean, wear their rubber bands consistently, and are careful not to loosen the non-permanent adhesive that attaches the braces to the teeth.

In our office we have many incentives and rewards in place to encourage compliance and responsibility.  However, if you can maintain tandem reward systems at home, the gains are more than doubled!   The side benefit of this is the maturation and personal growth that occurs when patients take responsibility and become active participants in their treatment.


By Dr. Stephen Kineret

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