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Emily has been in dentistry and specialist orthodontic private practice for 12 years. She completed her undergraduate dental training at the University of Otago in 2004. Emily spent 3 years in private practice and teaching oral surgery in Melbourne. She completed her postgraduate specialist training at the University of Otago in 2010 with a Doctorate in Clinical Dentistry specialising in Orthodontics. Emily joined Peter Gilbert and Peter Dysart in 2010 in Lower Stuart Street. Emily has treated over 2000 patients in Dunedin and the Otago region. Emily’s interests outside of orthodontics include cooking, gardening and holidays with her husband Yash and two Children. She is a member of the New Zealand Association of Orthodontists, New Zealand Dental Association and Dunedin Dental Association. Emily is proud to be a participating orthodontist for the Wish for a Smile Trust , the charitable arm of the New Zealand Association of Orthodontists.
Ali has been our Clinical Manager since 2000 and works closely with our orthodontists in the clinic, lab and at reception. She has exceptional organisation skills and does all our ordering and keeps us all on time and working efficiently as a team. Ali is a registered Orthodontic Auxillary and loves all aspects of her job. Ali enjoys gardening, walking and the outdoors.
Mel works chair side with our Orthodontist. She is currently finalizing her registration as Orthodontic Auxillary with the NZ Dental council. She has been part of the team since May 2016 and greatly enjoys working with all ages and interacting with the patients. Mel grew up in Central Otago and enjoys socialising with friends and family, the outdoors and has two fur babies.
Brittany works along side the Orthodontist. She is bubbly and very kind. Brittany joined our team in 2017 and is a great asset to the team. Her interest outside of work include exercise, catching up with her friends and "The Block"
Tracy joined Otago Orthodontics in March 2014. She manages the administration and finances for the practice. Tracy has a wealth of experience in the accounting industry and enjoys providing work of a high standard of and all aspects of patient contact. She is the mother of two children and loves spending time with her family, camping and the great outdoors.
Michelle is our receptionist. She has a vast experience in working with people and will always greet you with a smile. Michelle's interest include food, her family and holidays with her husband. She has two beautiful daughters who are equally successful.
Otago Orthodontics is a place where the genuine care and comfort of our patients is our ultimate mission. Our highly skilled team of professionals are committed to providing the finest personal service and highest possible standard of orthodontic care for our patients. Our practice employs only the most advanced orthodontic techniques that are designed to achieve the best possible outcome in the minimum treatment time necessary.
From the time you first contact our practice, you will find that we are committed to excellent communication and dialogue with our patients and their parents. We strive to provide you with as much information as possible before, during and after the orthodontic treatment process. We will provide you with verbal and written summaries of proposed treatment plans before commencing treatment as well as written information about the various aspects of the different treatments we provide. We appreciate the opportunity to provide orthodontic care for you and your family.
Otago Orthodontics was established originally by Peter Gilbert more than 35 years ago, later joined by Peter Dysart and more recently Emily Lam. The practice has been steadily expanding and upgrading ever since.
Otago orthodontics is located within walking distance from the Octagon on Lower Stuart Street, upstairs from R&R sport. There is usually carparking right in front on the street or there is a paid carparking building just around the corner on Moray place opposite Redcurrent gift shop.
We are pleased to provide a comfortable and relaxing reception area for parents/siblings and a large and welcoming open-plan clinical area for patients in treatment. The practice utilises strict infection control and sterilisation procedures with regular equipment and technology upgrades to keep abreast of current best practice.
Our clinic is staffed by an experienced team of orthodontists, dental auxillary assistants and reception staff.
Common Orthodontic Problems
An orthodontic opinion might also be sought when you have:
Diagnosis and treatment planning
The most important aspect of successful orthodontic management occurs before any actual treatment commences.
If at your initial consultation appointment it is determined that orthodontic treatment can be commenced straight away, a comprehensive diagnosis is established via analysis of clinical measurements, dental casts, radiographs (X-rays) and photographs of the teeth and face. Some of these records may also be collected to use as a baseline reference point in younger growing patients, even if they are not ready to commence active treatment immediately.
The primary problems and concerns are then identified from the diagnostic information and a detailed, customised treatment proposal is formulated and provided to you. In some cases there may be more than one treatment option each with specific pros and cons. More complex treatment proposals may require a face-to-face treatment discussion visit with the orthodontist to outline the findings and recommendations.
We will always recommend the most ideal treatment option that provides the best possible treatment outcome in the shortest period of time.
Active treatment can usually commence directly after this important diagnostic/planning stage is completed.
Early orthodontic treatment
Early examination of the teeth and jaws in younger children (ages 7-12 yrs) allows us to detect and evaluate problems and plan the best timing for treatment. In some young patients with specific problems, early treatment may prevent orthodontic problems from worsening.
It may also result in shorter and less complicated management if braces are required at a later age. Early orthodontic treatment may involve the use of removable plates, arch expansion devices, functional appliances, anti-habit appliances, headgears or partial braces.
Fixed appliance treatment (braces)
Braces are still the most efficient and accurate way of moving teeth. For most patients the optimal time to start orthodontic treatment with braces is after the last baby tooth has exfoliated. This usually occurs by 12 years of age but there is great variation between individuals. The most commonly used fixed braces are made from stainless steel and selected highly elastic metal alloys. Ceramic tooth coloured braces are the most popular choice amongst adult orthodontic patients and are growing in popularity with our teenage patients. They are very discreet and minimize the appearance of the braces. As a general rule ceramic braces are only used on the top teeth. Orthodontic treatment with fixed braces usually takes 18-24 months to complete for teenagers and a little longer for adult patients.
The basic biological and mechanical process of tooth movement is the same at any age. Therefore orthodontic treatment can be successfully completed in healthy adult patients, although over a slightly longer time frame than in children. Adults attend this practice for management of a variety of orthodontic problems. Most have had orthodontic concerns since childhood and are only now seeking
treatment for cosmetic or functional reasons.
These are a few of the most common presenting orthodontic problems in children and adults. Some adults present for treatment because they have new problems that have developed since childhood that now require specialist orthodontic care. Such problems include excessive tooth wear, gum damage or drifting of teeth due to gum disease or previous extractions.
Today’s orthodontic appliances are very different to those even used a decade ago. Recent advances in scientific knowledge and orthodontic technology have greatly enhanced the aesthetics, precision and comfort of orthodontic appliances. Old style chunky metal braces and bands are no longer a necessity. Ceramic “Tooth Coloured” Braces, lingual braces and Invisalign removable tooth aligners are the cosmetic orthodontic appliance options for adults. All of these appliances are very discrete and well accepted by adults.
Patients who present with significant discrepancies in the size, shape or position of their jaws may require fixed braces treatment in conjunction with a corrective jaw surgery procedure (Orthognathic Surgery). This type of treatment is usually recommended in adults when there has been a significant jaw developmental problem and orthodontic treatment alone cannot produce a satisfactory outcome.
Orthognathic Surgery is generally restricted to healthy adults where all major skeletal growth has ceased. Patients from ages 18 to 45 years of age are the best candidates. Orthognathic Surgery is usually recommended when there has been a significant jaw growth imbalance resulting in a considerable malocclusion or “bad bite”. In these situations, simple alignment of dental arches with orthodontic appliances alone cannot produce a satisfactory aesthetic or functional outcome. This is primarily because the orthodontic appliances such as braces will only move the teeth and have very little effect on irregular jaw positions.
Who Performs the Surgery?
The surgery is performed by an Oral and Maxillofacial Surgeon. These specialist practitioners have training in dentistry, medicine, general surgery and head and neck surgery. You will be referred to an experienced surgeon who works in close collaboration with your orthodontist.
What Happens First?
The Orthodontist is usually the first person in the dental team to recognise the need for Orthognathic Surgery. After collecting facial and dental x-rays, dental casts and photographs, your orthodontist will evaluate the type of jaw repositioning required. After liaising with an Oral and Maxillofacial Surgeon, a definitive treatment plan is agreed upon.
Wish for a smile
The Wish For A Smile Trust is a public health initiative of the New Zealand Association of Orthodontists (NZAO). The Trust aims to make specialist orthodontic treatment available to young New Zealanders who would otherwise be unable to access orthodontic care. Wish For A Smile orthodontists are full NZAO members and registered orthodontic specialists. Participating orthodontists have undertaken to treat selected children within their community who are unable to access orthodontic care because of financial hardship.
The Wish For A Smile programme is only available in those areas serviced by participating members of the NZAO. Otago Orthodontics provide treatment for the Wish For A Smile programme.
Orthodontic treatment can make a huge difference to a child through increased self esteem and an optimistic future outlook. Unlike standard dental care, orthodontics is not free for young people in New Zealand.
Applications to the Wish For A Smile Trust are based on:
The Wish For A Smile Trust board meets immediately post February and August to consider applications assessed at the the end of those months.
If you have any questions, please check their Frequently Asked Questions page or contact them directly:
Wish For A Smile Trust Administrator
3 Clyde Road
Fax: 03 962 0283
The Wish For A Smile Trust is a non-profit charitable trust that is dependent on donations.
Orthodontics is that branch of dentistry that specialises in the diagnosis, prevention and treatment of problems in the alignment of teeth and jaws. Common problems encountered include crooked or crowded teeth, protruding or “buck” teeth and incorrect jaw development. Orthodontic treatment involves the design and use of appliances (such as braces and plates) to bring the teeth and jaws into proper alignment.
An orthodontist is a dentist who has completed a 3-year full time university doctorate training program that enables them to specialise in the area of orthodontics. Orthodontists do not generally perform general dental treatments such as fillings, extractions or crowns.
The timing of orthodontic treatment is extremely important and greatly affects the treatment result. Since no two patients are alike, there is no specific age that is best to begin treatment. We recommend a specialist orthodontic examination by age 9 – 10 years if a parent or the family dentist discovers a potential problem. Fortunately not all of the children examined at that age will require immediate or urgent treatment. For those that don’t, an appropriate review protocol can be created so that their dental and facial development is closely monitored during the important growth years.
Treating children during their growth spurts allows orthodontists to achieve results that may not be possible when the face and jaw bones have fully developed. When indicated, this early treatment can prevent more serious problems from developing and simplify future care.
Typically, comprehensive treatment with braces is started when all the permanent teeth have erupted usually between the ages of 10 and 13. In some cases, it is an advantage to start just before the last baby teeth are shed.
The process involved in moving teeth is the same at any age and orthodontic treatment is also successful for adults.
Aside from the obvious improvements in smile aesthetics and self-esteem, orthodontic treatment can also lead to improvements in oral health and function. Orthodontic treatment will:
No, but it is recommended you see your general dentist for a general check-up beforehand.
Each individual’s orthodontic needs are different and deserve personalised attention. Your initial visit is an opportunity for us to get to know you and to help determine your orthodontic goals.
At your first visit, your orthodontist will give you (or your child) a comprehensive orthodontic examination. This entails looking at your teeth and jaws, and how they fit together. An assessment will also be made of gum health, oral hygiene and facial symmetry. We will then review these findings with you and give advice on the treatment options available, when treatment should commence, the expected duration of treatment, and the approximate cost.
If it is determined that orthodontic treatment is necessary, arrangements will then be made for the taking of pre-treatment diagnostic records (Dental Casts, Photographs and X-rays). These records provide essential information for diagnosis and treatment planning. A subsequent consultation appointment can then be arranged to discuss the findings of these records, present a detailed treatment proposal and outline the financial aspects of the proposed treatment.
Each individual case presents unique challenges, with unique opportunities to achieve a beautiful and functional smile. That is why we take the time to fully diagnose and explain the details of our findings before starting any recommended treatment.
Once you are comfortable with the proposed treatment plan and treatment objectives then you are ready to proceed into orthodontic treatment. If you require extractions or any other general dental treatment, this will need to be arranged with your general dentist before the orthodontic appliances are fitted. A general dental check-up and scale and clean is strongly advisable prior to the fitting of braces.
Treatment times vary significantly depending on age, the severity of the initial problem, type of orthodontic appliances used and patient compliance. Comprehensive orthodontic treatment typically lasts between 18 and 24 months with appointments scheduled every 4-8 weeks. Complex treatments and adult orthodontic treatment may take in excess of 2 years to complete
Our fees for comprehensive treatment vary greatly depending on the nature and severity of the presenting problems, the age of the patient, the treatment method, the type of appliances used and the anticipated treatment duration. The total cost of treatment will be discussed with you at your consultation once all your records have been analysed.
We believe in non-extraction treatment whenever possible. With this goal in mind, we stress the importance of early screenings and intervention when necessary for children. Even with early screening, about 30% of patients with crowding problems will probably need 2 or more teeth removed to create space to align the remaining teeth.
No. We offer the latest innovative and cosmetic options in orthodontic treatment, particularly for our adult patients. These include tooth-coloured braces lingual braces (braces on the inside of your teeth) and Invisalign® tooth aligners. Colourful rubber bands used in conjunction with metal braces make braces fun for many of our younger patients.
Having separators and braces put on is a relatively easy and painless procedure. Putting in separators is as easy as flossing a tiny rubber ring between two teeth and leaving it there. Many patients describe separators as like having a piece of food stuck between your teeth.
No needles or “drilling” are involved in the fitting of braces, as they are simply glued to the teeth. The majority of patients will experience slight pressure or discomfort for about two or three days after their braces are first fitted and then again for a day or two after each adjustment. Even though braces only protrude out about 2-3 millimetres from your teeth, it may take your lips, cheeks and tongue a few days to a few weeks to become accustomed to rubbing against the braces. If part of the braces is irritating your mouth, you can place orthodontic wax to help smooth the rough area. Any small ulcers that develop usually resolve with a few weeks.
That depends. We are not only concerned with straightening your teeth for cosmetic purposes, but we also need to make sure your bite is comfortable and stable at the end of treatment. Generally, if only one arch is treated, your bite will remain uncorrected or maybe even made worse. Over time, a malocclusion (bad bite) could cause damage to your teeth, gum tissues, and jaw joints. Therefore, with many problems, correcting just one arch would not be offered as a viable orthodontic treatment option.
At the completion of the active part of orthodontic treatment, the braces are removed and retaining appliances (retainers) are fitted to hold the teeth steady in their new position while the surrounding bone and gums adjust around them. These appliances may be plastic removable plates or fixed wires fitted behind the teeth.
Retainers play an important role in long-term orthodontic treatment success. If they are not worn according to instructions, the teeth will move back towards their original position. The removable retaining appliances are usually worn:
Fixed or “bonded” retainers are usually secured to the inside surfaces of the front six teeth and are designed to be kept in place indefinitely. The longer a fixed retainer is worn, the better, as it maximises the chance of the teeth staying perfectly straight as you age.
Yes. It is very important you or your child continue regular annual checks and cleans with your general dentist to ensure oral health is maintained. Orthodontic treatment may need to be put on hold or stopped altogether if there is a significant deterioration in oral health during the active treatment period.
Vector Tas Miniscrews
VectorTAS provides clinicians with a fast, effective means to treat a full range of orthodontic cases without compensating for the inadvertent reciprocal movement of adjacent teeth.
Designed by orthodontists specifically for orthodontic use, VectorTAS is a coordinated system of miniscrews, attachments and instruments that provide clinicians with all the benefits of temporary anchorage:
The Forsus appliance consists of spring coil springs that are permanently affixed to the patient’s braces. It works similarly to traditional orthodontic rubber bands, however, it does not need to be replaced by the patient.
The Forsus appliance is used to reposition the jaws in growing patients whose upper jaws and teeth protrude over the lower jaws and teeth. The appliance improves the alignment of the teeth, reduces overbites, and promotes proper jaw growth in adolescents. The Forsus bite springs stay in place for six to nine months. The treatment time depends on the severity of the problem and the size of the patient’s jaw. The appliance needs occasional adjusting during the course of the treatment period. For most patients, the springs do not affect eating or speaking after the initial adjustment following placement.
There are numerous advantages to using a Forsus appliance over conventional class II bite correction methods. Forsus appliances can correct the bite problem faster than rubberbands for many patients and are more comfortable to wear than bulky headgear. Additionally, patients don’t need to remember to wear their headgear or rubberbands as the Forsus appliance is working all the time. The appliance may also help to prevent the need for expensive jaw surgery in the future.
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