smileOrthodontics is a branch of dentistry specializing in the diagnosis, prevention, and treatment of jaw, face and bite irregularities (malocclusions).

Dentofacial orthopedics is the process of normalizing the growth of a patient’s bone structure and repairing any imbalances of the face and jaws. This process often involves a two-phase treatment and often begins when the patient is around 6 to 8 years old.

Because Dr. Tamara Shamlian is skilled in both areas, she is able to diagnose any misalignments in the teeth and jaws as well as the facial structure, and can devise a treatment plan that integrates both orthodontic and dentofacial orthopedic treatments.

Orthodontic treatment is provided by an oral health care provider known as an 0rthodontist, who has completed two to three years of additional training beyond dental school. The increasing awareness on the health and look of a patient’s smile has fueled the desire for many to seek out orthodontics not only as a medical necessity, but for cosmetic reasons as well.

The goal of orthodontics is to correct a malocclusion.  Teeth may be crowded or crooked or the upper and lower jaws may be out of alignment. Occasionally, even when teeth appear straight, the patient may have a bite which is not even and which may be causing further dental problems and permanent damage.  Malocclusions can be genetic in origin, they can develop over time or may be caused by poor habits such as thumb sucking, pen-biting or poor tongue posture.  Orthodontic treatment seeks to address any or all of these problems. The goal of orthodontic treatment is to not only create a beautiful smile, but to develop a stable bite that can promote sound oral health.

Orthodontics utilizes gentle forces (and the laws of physics) to slowly move teeth into the proper position. This is performed by using corrective appliances, including braces aligners and retainers. Brackets are bonded onto the teeth and arch wires are tied into these brackets. The tension and tightness of these wires determines the individual movement of each tooth. By making adjustment to your appliances at follow up visits, Dr. Shamlian controls the movement of your teeth until the malocclusion is corrected. Once the desired result is achieved and appliances are removed, retainers are worn to help maintain the final position of the teeth and bite.

You may not realize it, but having proper jaw alignment and straight teeth are important for your overall health. Misaligned teeth are difficult to clean and maintain which can lead to gum disease, tooth decay and even tooth loss. Other problems that can result from a malocclusion (bad bite) include difficulty eating, stress on the bone and tissue supporting the teeth, abnormal tooth wear, and temporomandibular joint disorders. Some of these problems can lead to face and neck pain and even chronic headaches. The cost of treating these problems far exceeds that of initially correcting the orthodontic problem. Finally, the most obvious benefit of orthodontic treatment is a beautiful smile; most people feel better about their appearance and are more self-confident after treatment is complete.

People of all ages can wear braces.


Today, many adults are choosing to fix orthodontic problems that were not corrected as children or have arisen later in life. Over 20% of all patients receiving orthodontic care are adults. Because their jaws are no longer growing, surgery may be recommended in some instances. Moreover, adult patients may require periodontal treatment in conjunction with orthodontics if there is evidence of breakdown of the bone and gums supporting the teeth. If there is bone loss, there may be limitations to the extent and direction that the teeth can be moved by the orthodontist.

Braces and Children

The American Association of Orthodontists recommends that children see an orthodontist by age 7 for an examination. If treatment is necessary, the orthodontist will determine the best time to begin. By age 7, incisors and the first permanent molars are typically present, and issues such as crowding, crossbites, and jaw alignment can be evaluated.

Treatment that is begun early can help to guide the jaws and teeth as they grow. Orthodontic treatment in childhood can also help coordinate the width of the dental arches, maintain necessary space for incoming permanent teeth, and reduce the chance of permanent tooth impactions and permanent tooth extractions. Early treatment can also correct protruding teeth caused by thumb sucking, as well as speech problems, and swallowing abnormalities and habits. In short, early orthodontic treatment can sidestep future potential problems.

There are many types of orthodontic appliances available today. Dr. Shamlian can help determine which kind is best for you. Some appliances are made of metal, while others are plastic or ceramic. Some types are completely removable and clear (such as Invisalign® aligners), and others have brackets bonded to the front (or back–INBRACE®) of your teeth for the duration of the treatment. All appliances do the same thing; they place a constant force on your teeth that moves them slowly towards the correct position. Wearing braces is less noticeable than it used to be. Brackets are now available that are clear or metal, and the ties that hold the wires come in a variety of colors or tooth-color coated. The wires themselves are less conspicuous and more efficient in moving the teeth and with less discomfort than in the past. Ask us about our esthetic brackets and wires!
Orthodontic treatment time varies depending on the severity of the problem and age of the patient. Phase I (early treatment) is typically 6 months to 1 year. Phase II is approximately 12 to 18 months. Full comprehensive treatment (when no Phase I is indicated) can range from 1 to 3 years. Because individuals respond differently to treatment and jaws and teeth grow at different rates, the estimated treatment time may change. If the patient uses their prescribed elastics or auxiliary appliances as directed and does not break or damage his or her braces, treatment time will be optimized, whereas poor cooperation can lead to an increase in treatment time.
Dental x-rays are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam. Dentists and orthodontists use this information to safely and accurately detect hidden dental abnormalities and complete an accurate treatment plan. Without x-rays, problem areas may go undetected. We are all exposed to natural radiation in our environment. Digital x-rays produce 80-90% lower levels of radiation compared to traditional dental x-rays. Not only are digital x-rays better for the health and safety of the patient, they are faster and more comfortable to take, which reduces your time in the dental office. Also, since the digital image is captured electronically, there is no need to develop the x-rays, thus eliminating the disposal of harmful waste and chemicals into the environment. Even though digital x-rays produce a low level of radiation and are considered very safe, dentists still take necessary precautions to limit the patient’s exposure to radiation. These precautions include only taking those x-rays that are necessary, and using lead apron shields to protect the body.