If you are considering braces or clear aligners, you probably expect your first orthodontic consultation to involve someone looking at your teeth. But an orthodontist is evaluating much more than whether your smile is straight.
At Hughes Orthodontics in Alexandria, VA, your first consultation is an opportunity for Dr. Justin Hughes to look at how your teeth, bite, jaws, and facial structures work together. The goal is not simply to identify crooked teeth. It is to understand the complete picture and determine whether treatment is needed, when it should begin, and which approach makes the most sense for you.
As a board-certified orthodontist, third-generation orthodontist, and fourth-generation dentist, Dr. Justin brings extensive training and a family tradition of orthodontic care in Alexandria that dates back to 1958.
So, what exactly is he looking for during that first visit?
1. How Your Teeth Are Aligned
One of the most obvious things an orthodontist evaluates is the position of your teeth.
Dr. Hughes will look for concerns such as:
- Crowded or overlapping teeth
- Gaps and excessive spacing
- Teeth that are rotated or tilted
- Teeth that have erupted in unusual positions
- Permanent teeth that have not erupted as expected
But identifying these issues is only the beginning. The next question is why they are happening.
Crowding, for example, can be influenced by the relationship between tooth size and available space in the jaws. A tooth that has not erupted may simply need more time, or there could be something preventing it from coming into the correct position.
Understanding the cause helps Dr. Hughes determine the right approach rather than treating what is visible at the surface.
2. Your Bite
Straight teeth are only one part of a healthy, functional smile.
An orthodontist also evaluates your bite, or the way your upper and lower teeth come together. This is an important distinction between simply wanting straighter teeth and receiving a comprehensive orthodontic evaluation.
Dr. Hughes may look for:
- Overbite: How much the upper front teeth vertically overlap the lower teeth
- Overjet: How far the upper front teeth project in front of the lower teeth
- Underbite: When the lower teeth or jaw sit in front of the upper teeth
- Crossbite: When certain upper teeth bite inside the lower teeth
- Open bite: When upper and lower teeth do not meet properly when biting down
- Midline discrepancies: When the centers of the upper and lower teeth do not properly align
These relationships can influence not only how a smile looks but also the treatment plan required to create a stable result.
3. How Your Upper and Lower Jaws Relate to Each Other
Sometimes what appears to be a problem with the teeth actually involves the jaws.
During an orthodontic consultation, Dr. Hughes considers the size, position, and relationship of the upper and lower jaws. This is especially important when evaluating children and teenagers who are still growing.
For a younger patient, growth can sometimes work in our favor. In other situations, the best recommendation may simply be to monitor development and wait.
That is one reason an orthodontic consultation does not automatically mean treatment needs to begin immediately.
The right timing can be just as important as the treatment itself.
4. Whether There Is Enough Space for Developing Teeth
For children, an orthodontic evaluation involves looking beyond the teeth you can currently see.
As permanent teeth develop and erupt, Dr. Hughes evaluates whether there appears to be adequate room for them and whether they are following an appropriate eruption path.
This can help identify issues such as significant crowding, teeth erupting in unexpected locations, or permanent teeth that may become impacted.
In some cases, early orthodontic treatment can help address a specific developmental concern. In others, observation is the better choice.
The purpose of an early consultation is not to put every child in braces. It is to make sure development is progressing appropriately and identify the right time to intervene if treatment becomes necessary.
5. Your Facial Balance and Profile
Orthodontic treatment happens within the context of the entire face.
Dr. Hughes looks at factors such as facial symmetry, the relationship of the jaws, lip position, and overall profile when developing a treatment plan.
Why does this matter?
Moving teeth can influence more than the appearance of the smile itself. Treatment decisions should work harmoniously with a patient’s natural facial features rather than focusing on perfectly straight teeth in isolation.
This is one of the reasons orthodontic treatment is highly individualized. Two people with similar-looking crowding can require very different treatment approaches based on their bite, jaw relationships, facial structure, age, and goals.
6. Your Gum and Dental Health
Before moving teeth, an orthodontist also wants to know that the surrounding teeth and gums are healthy enough for treatment.
Existing dental work, cavities, gum health, missing teeth, crowns, implants, or other dental concerns can all affect orthodontic planning.
When appropriate, orthodontists coordinate with a patient’s general dentist and other dental specialists so treatment can be planned in the proper sequence.
For adults in particular, this interdisciplinary approach can become important when orthodontics is part of a larger restorative or cosmetic dental plan.
7. Habits That Could Affect Your Teeth or Bite
Some orthodontic concerns are influenced by forces and habits outside the teeth themselves.
Depending on the patient, Dr. Hughes may consider factors such as tongue position, prolonged thumb or finger habits, mouth breathing, clenching, grinding, or other behaviors that could influence dental development or treatment stability.
Identifying these factors helps an orthodontist see the bigger picture and consider what may be contributing to a bite or alignment concern.
8. Your Age and Stage of Development
There is no single “right age” for orthodontic treatment.
Children, teenagers, and adults can all benefit from orthodontic care, but treatment planning looks different at different stages of life.
With children, Dr. Hughes considers dental development and future growth. With teenagers, he may evaluate how much growth remains as permanent teeth finish erupting. With adults, considerations may include gum health, existing dental restorations, missing teeth, or previous orthodontic treatment.
Your age does not determine whether orthodontics can work. It helps determine how treatment should be planned.
9. Your Goals
An orthodontic consultation is not only an examination. It is also a conversation.
Some patients are primarily concerned about one crooked tooth. Others have been told by their dentist that their bite should be evaluated. A teenager may want an inconspicuous treatment option, while an adult may be seeking a small improvement to a smile that has shifted since previous orthodontic treatment.
At Hughes Orthodontics, treatment is customized around each patient’s needs and goals rather than taking a one-size-fits-all approach.
Understanding what you want to accomplish is an important part of determining the right treatment plan.
What Happens After the Orthodontic Evaluation?
Once Dr. Hughes has evaluated your smile, bite, and individual needs, the next step is discussing what he found.
That may include:
- Whether orthodontic treatment is recommended
- Whether treatment should begin now or be monitored
- Which treatment options may be appropriate
- The goals of treatment
- An estimated treatment timeline
- Financial and payment information
- Your questions or concerns about treatment
Hughes Orthodontics offers complimentary new-patient consultations in Alexandria, including in-office consultations and virtual smile assessments.
And sometimes the best recommendation is simply to wait and continue monitoring. A good orthodontic consultation is about finding the right treatment at the right time, not rushing someone into treatment.
Why See an Orthodontist for an Orthodontic Evaluation?
Orthodontists complete additional specialty training specifically focused on the diagnosis, prevention, and treatment of tooth and jaw alignment problems.
That specialized perspective becomes especially important when determining not only how to straighten teeth, but how to create a bite and smile that work together.
Dr. Justin Hughes earned his dental degree from Virginia Commonwealth University, completed a one-year dental residency at St. Barnabas Hospital in New York City, and earned his master’s degree in orthodontics from the University of Iowa. He is also a Diplomate of the American Board of Orthodontics.
For Dr. Hughes, the first consultation is therefore much more than deciding whether someone “needs braces.” It is the beginning of understanding that patient’s unique anatomy, development, concerns, and goals.
Looking for an Orthodontist in Alexandria, VA?
If you have questions about your child’s developing smile, are considering braces or clear aligners for yourself, or simply want an expert opinion about your bite, a consultation can give you clarity about your options.
At Hughes Orthodontics, families in Alexandria have turned to the Hughes family for orthodontic care since 1958. Today, Dr. Justin Hughes continues that tradition with personalized treatment planning designed around the individual patient.
Schedule a complimentary consultation with Hughes Orthodontics in Alexandria, VA, and find out what Dr. Hughes sees when he looks at your smile.
Frequently Asked Questions About Your First Orthodontic Consultation
What does an orthodontist check during a consultation?
An orthodontist evaluates much more than whether your teeth are straight. The examination can include tooth alignment, bite relationships, jaw position, spacing, crowding, dental development, facial balance, oral health, and other factors that may influence treatment.
Does an orthodontic consultation mean I will need braces?
Not always. The purpose of a consultation is to determine whether orthodontic treatment is appropriate and, if so, when it should begin. Some patients may benefit from braces or clear aligners now, while younger patients may simply need periodic monitoring as they grow.
What should I ask an orthodontist at my first consultation?
Consider asking what the orthodontist sees, whether treatment is necessary, what the goals of treatment would be, which treatment options are appropriate, how long treatment may take, and what could happen if you choose to wait. If you feel like treatment may be out of your budget, you can ask what the minimum downpayment and monthly payments are. You never know – often treatment can be more affordable than you think!
How long is a first orthodontic consultation?
The exact length can vary depending on the patient and the records needed. Hughes Orthodontics initial consultation for traditional braces is a complimentary 30-minute visit that includes discussing goals and evaluating the bite.
At what age should my child see an orthodontist?
Children can benefit from an orthodontic evaluation before all of their permanent teeth have erupted because it allows an orthodontist to evaluate developing teeth, jaw growth, bite relationships, and eruption patterns. An early evaluation does not necessarily mean early treatment. The American Association of Orthodontists recommends all children be evaluated around age 7.
Can adults have an orthodontic consultation?
Absolutely. Orthodontic treatment is available for adults as well as children and teenagers. An adult consultation may also consider existing dental work, gum health, missing teeth, previous orthodontic treatment, and the patient’s cosmetic and functional goals.