All posts by Gernot Kalcher

Dental Implants and Orthodontics: Which Comes First?

It is widely known that very few people have perfectly aligned teeth and that millions of Americans are missing at least one tooth. Therefore, it is not surprising that some people have both problems. Misaligned teeth and missing teeth can both be corrected with orthodontic treatment and dental implants. But which should come first, braces or dental implants?


Braces First, Implants Second


In most cases, it is best to undergo orthodontic treatment before getting dental implants. This is because dental implants are permanently implanted into the jawbone, which means they cannot be moved once placed. Therefore, the teeth should be re-positioned first so that enough space is made available for placement of the dental implant(s) once orthodontic treatment is complete. If you are in this situation, you should speak to your orthodontist before being treated with braces so he or she can develop a treatment plan that accounts for your desire to get dental implants and make sure there is ample room available in the empty spaces to fit them.



In some cases, it may be necessary to place a dental implant before orthodontic treatment begins. For example, if the dental implant needs to serve as a stable anchor point so the appropriate forces can be applied to move the teeth as needed, the patient would likely get the implant before the orthodontic appliances are put on. Also, if the teeth in the vicinity of the implant are not targeted for the orthodontic treatment, the patient may get the implant in that situation as well.


Ultimately, your oral surgeon and orthodontist will work together on a treatment plan that requires both braces and dental implants to determine the optimal timing for both treatments.


Questions? Contact Our Orthodontist in West Seattle & Burien


If you have any questions about orthodontic treatment and dental implants, please don’t hesitate to contact the team at Peralta Orthodontics as we’re always happy to speak with you. If you would like to speak with Dr. Peralta about your options for improving your smile, please schedule a complimentary consultation appointment. During your first visit with us, Dr. Peralta will examine your teeth and bite and speak with you about your treatment goals. He will help then help you decide on what course of action to take in order to help you achieve those goals.

How Direct Bonding of Braces Brackets Differs From Indirect Bonding

For patients just starting orthodontic treatment, there are two techniques used to attach the brackets to the teeth: direct or indirect bonding. There are many variations of orthodontic brackets with each type claiming superiority in achieving the optimal final tooth position and interarch occlusion. However, if the brackets are not positioned ideally on each individual tooth, all the innovations in bracket design become irrelevant. The ideal positioning of each bracket must align the individual tooth in relation to each of the neighboring teeth and also in relation to the entire arch.


The Indirect Bonding Technique


When the indirect bonding technique is used, instead of positioning the brackets directly on the teeth, they are first positioned on a plaster model of the teeth. The braces are then transferred to the patient’s teeth. While this method typically makes the patient’s initial bonding appointment shorter, successive appointments, and even treatment length, can be longer due to the increased likelihood for repositioning brackets because they can slightly shift during the bracket transfer process. Dr. Peralta believes the most predictable and precise way to bond brackets is with direct bonding.


The Direct Bonding Technique


When the direct bonding technique is used, the brackets are placed directly on the teeth, one tooth at a time, and not on a plaster model. This method takes more time than the indirect bonding method because each individual bracket is meticulously placed correctly from the start, taking into consideration the teeth’s crown and root position. Our Seattle orthodontist, Dr. Peralta, takes the extra time to perform direct bonding because it results in a higher degree of precision and more detail-focused results. You can see the results that direct bonding produces here.


Our Focus is on Helping You Achieve Your Best Possible Smile!


At Peralta Orthodontics, we work hard to ensure that each patient we treat achieves their best possible smile! Because Dr. Peralta is our only orthodontist, the pace of treatment is more consistent and efficient, resulting in treatment taking as little as 12 months. He personally meets with each patient at every visit and oversees all details of treatment, providing each patient with the personal attention and meticulous care they deserve. Patient satisfaction is what’s most important to us!


If you would like to schedule a complimentary consultation with Dr. Peralta to find out how you or your child can benefit from orthodontic treatment, please schedule an appointment with us today. We look forward to welcoming you to our practice where we give our patients many good reasons to smile!