Camouflage or “Masked” Orthodontic Treatment

By Eliyahu Gherman, DDS

It’s Adar and Purim is in the air! The stores are stocked with costumes of all types and many are happily engaged in choosing a family costume theme. Picking costumes for your family can be tricky; each family member insists on something perfect for them and in the end it’s all a question of compromise.

If your 5-year-old is stuck on being a giant, maybe Og Melech Habashan will fit the bill, or perhaps Hagrid? Then you’re faced with the creative challenge of granting him an extra ten feet in height.
Perhaps you suggested the classic gumball machine concept for your heavily pregnant daughter.
Instead, she prefers to be a piece of matzah and her bearded husband wants to be a pregnant
woman. We can agree on this: you have some serious, if not impossible, costume challenges.
At this point you may be asking yourself what choosing a Purim costume has to do with braces.
The answer lies in camouflage or “masked” orthodontic treatment. This type of treatment might be used when the orthodontist determines that the patient’s teeth can be moved just enough to mask the underlying skeletal discrepancy; in other words, the jaw disharmony is not so severe and there’s enough of a base to mask it and create an acceptable bite. In the Purim costume paradigm, your five-year-old is tall for his age and if fitted with elevator shoes, you may have enough material to work with to make him into one fine giant.
When would we consider using camouflage treatment?
Most of the time, when a patient has a malocclusion (bad bite), it is due to both teeth position and jaw position. A well-trained orthodontist knows how to move both teeth and jaws.
While a child is growing we are able to rebalance the growth of the upper and lower jaws through the use of orthodontic appliances, such as a night brace or an expander; however, once growth is complete, this is no longer possible.
If the skeletal discrepancy remains severe, then orthognathic surgery (a combination of braces and surgery) may be needed to move the jaws. The fact that the growth of the jaws can be balanced during a child’s development, is one of the reasons why the American Association of Orthodontics recommends children be seen by the orthodontist by the age of seven. Don’t panic if your child is past that threshold, as most often at that early age, we will just get a baseline of how your child is growing, but do remember that earlier is always better.
Let’s say you didn’t get the memo, and you present to your orthodontist with a significant jaw discrepancy after growth is complete.

What are your options?
1. Orthognathic Surgery
2. Camouflage Treatment

1. Orthognathic Surgery: If your jaw discrepancy is severe we may recommend orthognathic
surgery, which is done with an oral surgeon. This treatment is often ideal and Israel has several good options for this type of surgery. A large part of my three-year orthodontic training at Montefiore Medical Center was devoted to surgical orthodontics, and if needed, the results are

2. Camouflage Treatment: As discussed above, if surgery is declined but the discrepancy
is workable, we can move the teeth into a healthier and aesthetically more pleasing position. In addition we can mask the jaw discrepancy so that it is not visible.
For patient M.B., (photos below), we utilized camouflage treatment. We did not use surgery or remove any teeth. The treatment took approximately 16 months. The patient’s phone number can be provided upon request, to answer any questions regarding the treatment experience.

“Throughout my whole life I was led to believe that without surgery my bite was hopeless. I did not want surgery and had nearly given up on ever correcting my smile. Thank you Dr. Gherman for analyzing my bite and using this unique method. My bite now feels more comfortable and I can also chew better. Most importantly, instead of hiding my smile, I now smile more than ever before!” M.B.

Whether you think you’re too old to dress up or you’re young at heart, we would love to see
whether we can add some smile to your Adar. Check out our other smile-improving articles on the Bizness website archives.

Dr. Gherman has been creating beautiful smiles for the past 16 years. He received his dental training at New York University College of Dentistry and did a three-year orthodontic training residency at Montefiore Medical Center. Dr. Gherman was granted a special award by the American Association of Orthodontics for his achievements in helping to further the science of orthodontics. As an active
member of the American Association of Orthodontics and numerous study clubs, he continuously stays
up to date with all the latest technology. Rechavia Dental Center is a full service American dental and
orthodontic clinic in Jerusalem.

Rechavia Dental can be reached at 02-561-9770 or through their website and email

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