Frequently Asked Questions

1. What is Orthodontics?
Orthodontics is a specialized branch of denistry, that diagnoses, prevents and treats dental and facial irregularites. There are many orthodontic benefits to properly-aligned teeth that are related to overall functionality of the teeth, good oral hygiene, and a confident radiant smile to enchance social and work relationships.
2. Why should you choose an orthodontist?
Dr. Garrett has over 30 years experience in treating orthodontic problems and is an “Elite Provider” of Invisalign. Orthodontists are specialists, continuing their education beyond dental school for 2 – 3 additional years. Dr. Garrett is also Board Certified by the American Board of Orthodontics.
3. Is it required to be referred by a family dentist to schedule an appointment?

We welcome all patients who choose our office for their orthodontic care and work closely with their family dentist to achieve optimal results. A good number of patients have contacted our office directly for an intial exam expressing their own concerns for their health and appearance. Many of our patients are referred by family, friends, and other patients.

4. At what age should an orthodontic screening be scheduled?
The American Association of Orthodontists recommends an orthodontic screening at age seven. By this age, the six-year molars and several permanent teeth in most children have erupted allowing the doctors to effectively evaluate most developing orthodontic conditions.
5. Will my child’s teeth straighten out on their own as they grow?
No, they will not. The space available for the front teeth does not increase as a child grows. In most people, after the permanent 6-year molars erupt, the space available for the front teeth actually decreases with age. Later, if problems develop without early treatment, this may lead to necessary surgery or extraction of teeth.
6. How old is too old for adult braces treatment?
Any age is a great age to make your smile as spectacular as it can be. A surprising number of our patients are adults desiring better health, more self confidence, and the highest quality of life in work and social interactions. Whether you are young in years or young at heart, orthodontics can improve your smile.
7. Can orthodontic correction occur while a child still has some baby teeth?
Yes. Some orthodontic concerns are significant enough to require early intervention. However, if a patient is not yet ready for treatment, we will follow that patient’s growth and development until the time is right for treatment to begin.
8. What is Phase One (early) Treatment?
Phase One treatment, when needed, is usually initiated on children between the ages of seven and ten. This usually takes about 12-21 months. Several primary objectives for Phase One treatment are: to initiate early intervention which may prevent significant corrections later; to modify crowding and jaw growth for an improved jaw relationship; and to improve self-respect and overall well being which is very important during the formative years.
9. Will my child need full braces if he/she has Phase One treatment?
It is best to assume that your child will need full braces even after Phase One treatment. The period of time following Phase One treatment is called the “resting period,” during which growth and tooth eruption are closely monitored. Throughout this period, parents and patients will be kept informed as to any future treatment recommendations.
10. Are any teeth removed for braces?
Removing teeth is sometimes needed to get the best orthodontic result. Straight teeth and a balanced facial profile are always the goal. However, because today’s technology has resulted in advanced orthodontic procedures, the need for removing teeth has been greatly reduced.
11. How long will it take to complete treatment?
This obviously depends on each patient’s specific orthodontic needs. In general, treatment times range from 12 to 30 months. Approximately 22 months is the “average” time a person is in braces.
12. How often will I have appointments?
Appointments are scheduled according to each patient’s individual need and treatment plan. Patients in braces will most often be seen every 8 to 12 weeks. Invisalign aligners are monitored by Dr. Garrett every 6 to 8 weeks. If more frequent monitoring is needed, appointments will be scheduled accordingly.
13. May all appointments be scheduled after school?
Unfortunately, we cannot schedule all appointments for student patients during after school hours. Most patients miss very little school due to their orthodontic treatments because most appointments are scheduled 8 to 12 weeks apart. We reference all area school calendars, and try very hard to meet the scheduling needs of our patients.
14. May a child be dropped off at the office for an appointment?
We are very understanding of busy schedules and working parents’ desires to run errands while their child is at our office. It is important however that parents or guardians be available at each appointment because Dr. Garrett and his staff want to communicate fully regarding the treatment progress. So, we request that parents check in with the orthodontic team member before and after dropping off their child.
15. After braces for kids are first applied, is it OK to return to school?
Yes. There is no reason to miss school because of orthodontic treatment.
16. Do braces hurt?
Generally, braces do not “hurt.” After some visits, teeth may be sore for a few days. In these situations, pain medications such as Advil or Tylenol can be used to ease the discomfort. For most visits, patients do not feel any soreness at all! We often remind our patients, it does not have to hurt to work!
17. Are shots given?
No. Shots are not necessary in orthodontic treatment.
18. Is there any medication taken for the placement of braces?
If indicated, one hour prior to the placement of braces, two pro-banthine tablets are taken to reduce the flow of saliva. Also, protein is restricted in the meal prior to this appointment as it may counteract the “drying” effect.
19. Do you use recycled braces?
Absolutely not! Each patient is provided with their own braces to achieve the very best orthodontic result possible. We have never and will never use worn, used or recycled braces.
20. Has anyone ever locked braces by kissing someone else with braces?
No, fortunately not.
21. Will braces interfere with playing sports?
No, they will not. Braces actually help with sports-related injury to the mouth and teeth. The braces will keep your teeth in place, before they will let them fall out as a result of an injury. We always advise our patients to wear a mouthpiece or a mouth guard while engaging in sports.
22.Will braces interfere with playing musical instruments?
There have been a number of research studies related to orthodontics and musical instruments. Woodwind instrument players may have slightly more difficulty than brass instrument players. Every musician seems to adapt very well to playing with braces after a week or two of practice. Some of them find that placing wax on the brackets is helpful during the initial adjustment period.
23. Is it necessary to see our family dentist while in braces?
Yes! Regular checkups with your family dentist are very important while in braces. Your family dentist will determine how often you should be seen for cleaning appointments while you are in braces.
24. How often should teeth be brushed while in braces?
Patients should brush their teeth at least four times each day: 1)after breakfast, 2)after lunch (or as soon as they get home from school), 3) after supper, and 4)before going to bed. We will show each patient how to floss their teeth with braces on, and may also provide a prescription for a special fluoride gel to help protect teeth.
25. Are there foods to avoid while in braces?
Yes. Once treatment begins, complete instructions and a comprehensive list will be provided regarding foods to avoid. Some of those foods include: ice, hard candy, raw vegetables and all sticky foods (i.e. caramel and taffy). Many emergency appointments to repair broken or damaged braces can be prevented by carefully following instructions regarding what foods to avoid. (Please visit our instructional media page for specific information).
26. How are emergencies handled?
If braces are causing pain or if something is broken, call our office. (540) 667-5446 In most cases, we can address an issue over the telephone. Then, if an emergency appointment is needed, a portion of our daily time is reserved to handle urgent care needs and an appointment will be made for you. (More information is given on our instructional media page).
27. Will an expander be needed?
At the completion of the initial examination, Dr. Garrett will determine whether a patient will need an expander or not.
28. Can braces be worn with missing teeth or teeth with crowns?
Yes. A tooth with a crown will move just like a tooth with a simple filling. When teeth are missing, orthodontic treatment will aid in the alignment of the remaining teeth so that the space where the teeth are missing can be properly restored.
29. What is the process for finally taking the braces off?
Braces are removed very quickly. We gently squeeze the braces and they pop off the teeth. Usually, there is little discomfort. Prior glue is removed and the enamel is polished to a brillant shine. Impressions then are made to construct an upper and lower retainer. You now have a radiant smile to dazzle your friends, family, and co-workers!
30. What is there to know about retainers?
Retainers are necessary to maintain the incredible results of your new smile. Fixed wire retainers may be glued behind the front teeth to keep them straight. A removable retainer is necessary to keep the back teeth and bite in optimal and stable condition. As time goes on, there is less need in the frequency of wearing the retainer.

Visit Our Office

Office Hours

Monday: 7:30 am – 4:30 pm
Tuesday: 7:30 am – 4:30 pm
Wednesday: 7:30 am – 4:30 pm
Thursday: 7:30 am – 4:30 pm

Winchester Office

1841 West Plaza Drive
Winchester, VA 22601

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Invisalign braces are a type of custom made clear, plastic, removable teeth aligners that are nearly invisible on the teeth. Invisalign appeals to adults and teens who want something different than the traditional metal braces. It is a great option for adults and teens who are compliant and motivated. Dr. Garrett will answer any question for you individually and make the most appropriate recommendations.

Advantages of Invisalign for Adults and Teens

Invisalign braces are nearly invisible and are not obvious to anyone that you are wearing them, which heightens the esthetic appeal.

Garrett Orthodontics uses a scanner to determine the most advanced diagnostic information as well as eliminating the need for messy impressions.

Invisalign Teen

Like Invisalign for adults, Invisalign Teen is a series of custom-made, clear plastic aligners that provide a teeth-straightening alternative to more traditional metal braces. Invisalign Teen is designed to help teenagers maintain their self-confidence and accommodate their active lifestyles during orthodontic treatment, giving them a reason to smile!

Invisalign Teen combines the benefits of the Invisalign system with new features, such as the Blue Dot Wear Indicator that fades when the aligner becomes worn and is ready to be changed; Eruption Tabs to accommodate the growth of second molars; and other features to address clinical needs common to teens.

Invisalign Teen Treatment: What’s Involved?

Invisalign Teen can be used to correct some overly crowded teeth, widely spaced teeth and overbite. Only an experienced orthodontic specialist, like Dr. Garrett, can determine if Invisalign Teen is the right orthodontic treatment for you.

During your consultation, pictures and of the teeth are taken and a panoramic x-ray is made to discuss treatment with Invisalign. Then the computer scanner is made and 3D technology maps tooth movements from the beginning to end of treatment, creating your customized aligners. Treatment time varies with every patient but an estimate may be advised as a reference since every patient’s needs are different.

The clear aligners must be worn every day for 22 hours which means all the time except for when eating, brushing or attending special occasions. A new set of aligners are provided every one or two weeks to strategically straighten teeth.

Advantages of Orthodontic Treatment for Teenagers

During Invisalign Teen treatment, teenagers can play sports, play musical instruments and keep up their active social lifestyle with a spontaneous smile. Removable aligners promote better oral hygiene, as well as less irritation to the gums and mouth. Extra office visits for broken braces or wires are eliminated.

Traditional Braces

We welcome our traditional braces patients from Stephens City, Strasburg, Berryville, Winchester, Front Royal and surrounding areas of Jefferson County, Warren County, Frederick County and Clarke County in VA and WV.

Metal Braces

Metal brackets can be silver or golden. The are very strong and can withstand most types of treatment. At first, gums and cheek tissue may become irritated, but there are several first aid tricks to deal with the discomfort such as saltwater rinses and applying wax to the metal brackets.

Most traditional metal braces require an elastic O-shaped rubber band, called a ligature, to hold the arch wire onto the bracket. Sometimes metal tie wires (wires that twist around the bracket) are used in place of elastic ligatures.

Years ago, metal braces were not just brackets, but a band that wrapped around each individual tooth. Today, small metal brackets are glued to the front of each tooth (much less fuss). The old type of bands are usually reserved for molars or teeth with fillings that overlap to the outside surface of a tooth. Metal brackets tend to be less expensive than other types of brackets. And now, choices of colorful ligatures are available in a rainbow of colors to individualize personal style.

Advantages of Metal Braces

Advantages of Metal Braces

Ceramic Braces

Ceramic brackets are made of composite materials. They are very strong and usually do not stain. Adults like to choose ceramic because they are more in color harmony with the teeth and are less noticeable than metal.

Advantages of Ceramic Braces

Disadvantages of Ceramic Braces

E-Arch (Expansion Arch)

e-archThe E-arch is used to widen the upper and or lower jaws to make room for permanent teeth. The appliance has two crowns or bands usually positioned on the baby molars or permanent 6-year molars. From the crown on one side is an L-shaped sleeve, and on the opposite side is an L-shaped arm which is attached to the opposing crown.

Between the two “arms” is a spring, which widens the arch by “gently” adding force.

The patient is seen about every 8 to 10 weeks. The arch width is measured and the spring is usually re-activated by adding “crimp stops” to hold the compressed spring in place. This appliance is very effective and requires little attention other than keeping it and the surrounding gums and teeth very clean.

Dr. Garrett recommends a fluoride rinse every night. Sometimes the teeth on which the E-arch is attached may loosen, allowing the arms of the appliance to position themselves over the biting surface of the teeth.

If this should happen, please call our office for an adjustment. Occasionally, the teeth to which the appliance is attached may come out. If this should happen, remove any parts possible and call us. Fortunately, in most cases, the E-arch has usually served its purpose by the time this could happen.

It is recommended that wax or EZO denture cushions be placed around any parts that may be irritated.

The Distal Jet

This appliance is a fixed appliance used to distalize (move back) molars to alleviate crowding. By making room, it allows Dr. Garrett to straighten the teeth without having to extract them. A TAD (Temporary Anchorage Device) is placed in the roof of the mouth The appliance has four “bands”, which are rings of metal that fit over 2 bicuspids and 2 molars. The front bicuspids are attached to the TAD  as an “anchor.” From the anchor there are two more “arms” which have springs that push against the button to move the molars back.

The patient is seen about every 8 to10 weeks and the springs are activated by adding, “crimp stop” to hold back the compressed springs.

Once the molars are in position, the bicuspids will be pulled back and then front braces are applied for overall alignment.

As with all fixed appliances, the important issue is good oral hygiene. It is extremely important to keep the appliance, teeth and surrounding gum tissue very clean to prevent infection. It is also important to keep the tissue under the acrylic button clean.

Once the appliance is placed; the technician will give instructions on how to clean under the button and around all the parts.

As always, Dr. Garrett recommends the use of a fluoride rinse every night

Rapid Palatal Expander (R.P.E.)

palatal-expanderThe R.P.E. is an all-metal expansion appliance able to deliver expansion up to 12 mm in the upper arch in a short period of time.

The appliance is turned, or activated daily with the use of a small wrench and is usually attached to either 2 or 4 teeth.

After the insertion of the appliance, the patient is instructed on the care and cleaning of it. Soft foods are recommended for the first couple of days and should be cut into small pieces, so that food will not get “caught” in the appliance and cause gagging, such as spaghetti dangling down the throat.

It is recommended that wax or EZO Denture cushions be placed over any irritating parts and warm salt water be used to smooth the gums, should they become irritated. It is quite common for a large gap to develop between the upper front teeth. This is normal. The appliance will be checked every 3 to 4 weeks until desired expansion is achieved.

Herbst Appliance

herbstThe Herbst Appliance is used in the treatment of jaw discrepancy (i.e., overjet, when the upper front jaw protrudes over the lower front jaw). In growing patients, it allows lower jaw growth. In older patients, it retrains the action of certain muscles. The average treatment time is approximately 9 months to 1 year, during which time the lower jaw is advanced initially about 3-4mm, and then incrementally, until the desired resting position is achieved.

The Herbst has telescopic arms which are attached to 4 crowns and by 4 hex screws. When the appliance is initially cemented into the mouth, it will have the lower jaw in an advanced position. Dr. Garrett will measure the progress approximately every 8 to 16 weeks and most likely continue to advance the appliance by adding “shims” to the arms to keep the jaw forward for continued correction.

Shims are small sleeves (or rings) of metal between 1 and 3 mm in length. The appliance is unhooked and the shims will slide on the arms for advancement and then the appliance is put back together.

There are times when a patient may open too wide and cause the arms to come out of the sleeves, if this should happen, the patient need only to open wide again and put the arms back. This may be a little tricky the first time or two, but most patients become proficient at this.

It is also recommended that the screws on the upper and lower portion of the Herbst be checked once a day to make sure they remain in place. This can be done with the small allen wrench provided.

When the Herbst is initially cemented, there is an adjustment period of about one-week. The limited range of motion for the jaw becomes “annoying” at first until the patient learns how to eat and talk with the Herbst.

Sometimes, there is extra saliva for a couple of days until the brain figures out that this is not food and then the extra saliva will subside.

The Herbst has some protrusive parts that may cause irritation, with the help of wax, cheek pads (which we provide) or EZO Denture Cushions. The initial discomfort can be managed with some helpful hints.

The most important item to remember with the Herbst appliance is cleanliness. It is extremely important for patients to brush the appliance, their teeth, and gums. Leaving any plaque on the teeth will result in irritation and infection.The appliance should look very shiny and not milky white (this is plaque). A nightly fluoride rinse is recommended.

Lingual Arch or Palatal Bar

lower-lingual-archThis wire is usually attached to the permanent 6-year molars. It can be removable, but it is sometimes soldered to the molar bands. It is used primarily to “anchor” the molars while continuing the change and correcting the teeth bite.

Did you know flicking the lingual wire up and down with your tongue could break the wire and possibly loosen bands?

Tongue Crib

tongue-cribThe Tongue Crib is used to inhibit the tongue from “pushing” the (front) anterior teeth when speaking. It is used to “retrain” the tongue posture in conjunction with speech therapy to aid in correction of the open bite. It also helps to break a thumb sucking habit.

Did you know playing with the tongue crib can cause the solder joints to break? OUCH!

The Bonded Bite Plane

bonded-bite-planeThe bonded bite plane is used to prevent the lower front teeth from “biting” into the tissue behind the upper front teeth thus causing damage to the tissue and teeth. By “opening” the bite in the front of the mouth, it allows the back teeth to erupt more in order to correct this problem.

The bonded bite plane is also used to correct a severe over-bite (the upper front teeth closing too far over the lower front teeth) in the same way.

The bonded bite plane is made by placing a small amount of bonding material to the backside of the upper teeth to create a triangular plane. They can also be placed on the molars. After correction, the doctor removes the plane by “polishing” it away with a special high-speed instrument.

It is important for patients to keep the tissue area surrounding the bite planes very clean. Watching out for hard foods that could break off these planes is also important. There are times when one of the planes may come off. This is okay, because as long as there is one remaining, the job can be accomplished.


elasticsRubber bands or elastics contribute a lot to straighter teeth. They are marvels of physics. Attached to your braces or Invisalign aligners , elastics exert the force that creates the right amount of pressure to move teeth in directions that the braces alone can’t. They don’t work without you. It’s important to wear your elastics as prescribed.

Shannon Lockhart, Treatment Coordinator

Shannon has been with Garrett Orthodontics since Oct 1989. She assists Dr. Garrett during the initial consultation appointment as well as the coordination of all aspects of enrolling our new patients. She enjoys spending time with her husband, two grown daughters and grandchildren. Her hobbies include gardening and vacationing at the beach.

Amanda Tapscott, Clinical Technician

Amanda started her career in orthodontics with Dr. Garrett in May 2008. She enjoys interacting with the patients and assisting in treatment to create a beautiful smile. Amanda is highly skilled as an orthodontic clinical technician and also proficient in making the retainers for our patients. In her spare time she enjoys spending time with her family.

Paola Phillips, Clinical Technician

Paola joined Garrett Orthodontics in February 2012 with ten years of experience in orthodontics. She is married and has two young sons She enjoys spending time with her family and riding their motorcycle. Paola likes to get to know her patients personally and see their smiles before and after orthodontic treatment.

Pam Frye, Financial Coordinator

Pam is our experienced financial coordinator and has been with Garrett Orthodontics since Sept 2005. Patients and parents meet with Pam at the beginning of treatment and at that time she assists them in setting up individual financial arrangements. Pam also monitors all patient accounts and assists with Treatment Coordination. Pam is a Winchester native and Handley graduate. She enjoys spending time with Lance her son and reading, cooking and going to the beach.

Michele Sherer

Michele is originally from Michigan and has six years of clinical orthodontic experience. Michele spends her free time on the weekends racing her road bike in the Mid Atlantic region. She is currently the Women’s Cat ½ Virginia State Time Trial Champion and holds various other titles within the Mid Atlantic Region.

Susie Garrett, Accounts Payable Supervisor

Susie has been the accounts payable and payroll supervisor since 1979. She was a graduate of the Medical College of Virginia School of Pharmacy in 1976 and practiced as a licensed pharmacist until 1990. Susie enjoys tennis, reading, traveling and especially spending time with her family. Susie and Dr. Garrett now have a new granddaughter Autumn Jane to spoil therefore grand parenting is her primary job.