What is the Purpose of an Orthodontic Observation or Recall Appointment?

Moms and dads have busy schedules. Picking their children up from school and taking them to the orthodontist is no small task. Sometimes the appointments are very short and seemingly meaningless. One of these appointments is the observation or recall visit. These appointments are usually less than 15 minutes long and many wonder if they are necessary at all. Recall or observation appointments are very important, and here’s why…

Observation or recall visits determine best time to begin treatment
Observation or recall visits are scheduled for orthodontic patients who are either not yet quite ready for braces or have had an interceptive phase of treatment and are waiting for their remaining permanent teeth to come in so they can finish. The orthodontist may take a progress x-ray at this appointment to help him evaluate your child’s dental development. There are three things that I look for when your son or daughter is in my chair.

We check retainers if they are present
First, if the patient has had an interceptive phase of treatment, the first order of business is checking the condition of the retainers. Our Phase 1 retainers are bonded directly to the teeth and sometimes the bonding material wears thin with normal eating. If a retainer comes loose or is lost, the teeth will move and the result of the initial treatment compromised. It only takes a couple of minutes to add cement to an intact retainer. It is not possible however to realign teeth formerly attached to a broken retainer without putting the braces back on. Another type of retainer we use in young patients is called a space maintainer. It is designed to preserve the space necessary for the eruption of a permanent tooth after the corresponding tooth is lost early. It is at a recall appointment that we determine when it is appropriate to remove a space maintainer.

We evaluate the loss of primary teeth
The second objective of this appointment is to evaluate the loss of primary teeth and the eruption of the permanent replacements. Losing primary teeth on time and in the right order can help the permanent teeth come in straighter. If I notice that a baby tooth is not falling out on time, or I identify in an x-ray that the permanent teeth are headed in the wrong direction, I usually recommend that a patient see their family dentist to get the offending baby tooth removed. Evaluating the loss of primary teeth and the eruption of permanent ones doesn’t take much time, but ignoring developing problems can add months or years to a patient’s orthodontic treatment.

We determine the timing of treatment
The third objective of an observation appointment is to counsel with the family about the timing of the next phase of treatment. My philosophy is that I will begin no treatment before a patient is ready. This might mean waiting a few months or even years. If we start too early, your son or daughter may have the braces on too long. If we wait too long, we might miss the opportunity to keep treatment as short as possible or end up extending it into the prom or graduation years of high school (not popular with patients or their families).

Having your orthodontist follow your child’s development will help them receive the care they need when they need it. Although they are short and sometimes seem like a wasted trip, your orthodontist knows exactly what to look for at an observation or recall appointment and will make sure that your child is progressing towards an excellent orthodontic result. Next time your son or daughter has an observation visit with your orthodontist, make sure and ask for an explanation of the things he was looking for and what he found. I think you’ll find that these short, to-the-point appointments are as important as any you’ll ever have.

NOTE: The author, Dr. Greg Jorgensen, is a board-certified orthodontist who is in the private practice of orthodontics in Rio Rancho, New Mexico (a suburb on the westside of Albuquerque). He was trained at BYU, Washington University in St. Louis, and the University of Iowa in the United States. Dr. Jorgensen’s 25 years of specialty practice and 10,000 finished cases qualify him an expert in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems (including conventional braces, Damon and other self-ligating brackets, Suresmile, and lingual braces). This blog for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. Jorgensen is licensed to diagnose and treat patients only in the state of New Mexico. He cannot diagnose cases described in comments nor can he select treatment plans for readers. Because he has over 25,000 readers each month, it is impossible for him respond to all questions. Please read all of the comments associated with each article as most of the questions he receives each week have been asked and answered previously. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.