Click below to learn more about:
New Patient Appointment
Recall Appointment
Records Appointment
Early Treatment
Full Treatment
Appointments
Loose or Broken Appliances
Rescheduling of Appointments

The purpose of your first visit is to meet with Dr. Spence to evaluate and discuss treatment needs. The Doctor will review your medical and dental history and perform a clinical examination. In order to save time during your visit, please feel free to fill out the new patient form and bring it with you to your appointment. This form will be mailed to you when you call for an appointment or you may download one from the web site. This important visit will address your orthodontic needs or those of your child and is free of charge. If treatment is indicated Dr. Spence will discuss the treatment plan and answer any questions you might have as well as quoting a fee for treatment.

Click here to download our Adult New Patient Form
Click here to download our Child New Patient Form

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If the patient is not yet ready for treatment, we will recommend periodic recall to monitor growth and eruption of teeth. There is no charge for the recall visits. The American Association of Orthodontists recommends all children receive an orthodontic evaluation by the age of 7. Although we do identify any problems that need to be addressed, the majority of children will not require active treatment at this age.

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If treatment is indicated, a set of diagnostic records will be taken. Records include radiographs, pictures, and models of the teeth fabricated from impressions. These records are used to develop a custom treatment plan for each patient. These records are also helpful in tracking the progress of treatment as the teeth move into their corrected positions.

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Early treatment is sometimes referred to as Phase I treatment. Not all patients need an early phase of treatment. This is generally indicated for correction of crossbite, getting teeth out of traumatic occlusion, as well as some other problems. This treatment typically is of relatively short duration (usually lasting 4 to 12 months or less) and is usually directed at only one problem. Comprehensive treatment is usually needed later when more permanent teeth are present to correct other problems that respond best to correction at full treatment.

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Full treatment is sometimes referred to as comprehensive treatment or Phase II. This phase is undertaken to address problems best corrected when most or all of the permanent teeth have erupted. This stage consists of full braces on both upper and lower teeth. Overbites and correction of crooked teeth are examples of problems best corrected in comprehensive treatment. The start of this stage is based on the dental development of the patient. Some patients may be ready at 10 or 11 while some may not be ready until 12 or 13. Timing in orthodontics is everything. We will time the treatment so we can get the most done in the shortest amount of time consistent with providing top quality results.

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Cooperation is requested in making and keeping all appointments. Patients are seen by appointment only. Please be aware that many of our appointments are preset at certain times of the day. This is done in an effort to better stay on schedule and see you at your appointed time. As most of our patients are school age, it is impossible to see everyone after school. We will make every effort to give each patient their share of after-school appointments, however please be aware that many appointments, especially those of longer duration, will be during school hours. We are happy to provide a school excuse, if needed.

The appointment to place your braces usually takes from one and one- half hours to two hours. Subsequent appointments are usually scheduled at 4-8 week intervals and normally take about 30 minutes. We make every attempt to be on time for our patients and ask that you offer us the same courtesy. In fairness to others, we may not be able to “squeeze” you in when you are late for your appointment and we will probably need to reschedule your appointment. In addition, a patient arriving with broken appliances without having called in advance, may also need to be rescheduled.

If you prefer to come to the office during a quieter time please schedule during school hours. E-mail reminders can be sent in advance when you sign up with our online account access.

If you have a problem requiring emergency treatment please call us as early in the day as possible so we can schedule you when adequate time is available to fix your braces. Should you have an emergency after hours, please call our office at (573)33BRACE and follow the instructions to reach the doctor on call.

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Any breakage of the appliances (loose bands or brackets, broken wires, etc.) should be reported immediately to the office and an emergency appointment made to repair the appliance. Do not wait until your next scheduled adjustment as there is insufficient time during this appointment to repair appliances and make an adjustment. Arriving with a broken appliance without first calling may necessitate rescheduling in order to have time available to repair the damage.

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If an appointment must be broken due to illness, accident, or unforseen circumstances, our office should be informed immediately and another appointment reserved. Whenever possible, advance notice of 24 hours is appreciated if an appointment must be changed. It is difficult to reschedule, since most appointments are made 4 to 8 weeks in advance. (There are no additional charges for missed appointments or same day cancellations unless they become excessive). If an appointment is missed, it is important not to delay rescheduling for a month just so you can have an after school appointment. This will unnecessarily lengthen treatment time and may have an adverse affect on treatment results.

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