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Top Dentists in Delaware: The Latest in Orthodontics


When it comes to correcting the alignment and level of teeth, “there’s always new stuff,” says orthodontist M. Constance Greeley. “This is a great technological age. Every year there’s something else.”

At the top of her list is passive self-ligation, a fancy term for the bracket-and-wire system that pulls teeth into position. Old systems employed steel bands around the tooth, with the tension of the attached wires adjusted by hand. That could place too much force on the teeth and gums, which inhibited the supply of healing blood. The brackets of new systems—usually tooth-colored porcelain—are glued to teeth, then tied with light memory wire that gently pressures teeth into position for a more efficient correction. “It’s better for the dentist and the patient,” Greeley says.

Greeley also praises advances in proprietary systems such as Clear-Align and Invisalign. Orthodontists have used the systems for several years now, but their knowledge about how to use them has increased, which has led to improvements in the product itself and to more efficient corrections. “I’m constantly online tutoring and coaching,” she says.

The fix has been popular among adults because of its inconspicuousness—the user wears a clear plastic retainer over the teeth instead of obvious brackets and wires—but Greeley and orthodontist Robert A. Penna also employ them on teens who have the discipline to use the system correctly. “Invisalign is a wonderful adjunct to orthodontics in some cases,” Penna says.

The technology he’s most jazzed about isn’t the system, however, but a diagnostic tool: 3-dimensional cone-beam imaging. The low-level X-ray gives a complete view of the mouth and teeth below the gum.

“In some cases, teeth are erupting in the wrong places or encroaching on the root of another. We can see exactly what’s going on,” Penna says. “It’s easier to know what to do. It’s not necessary to use in every case, but in the more complex ones, it’s a neat and powerful tool.”

Both orthodontists are treating more adults than ever. Many are experiencing some tooth shifting—a common result of aging, though sometimes caused by former wearers of bracers who didn’t use their retainers. (Penna cops to being one of them.) But in general, more adults are beginning to understand the importance of well-aligned teeth.

“People are living longer,” Greeley says. “Sometimes it’s necessary to restore biting ability. If you can’t chew healthy food, you can’t keep your body healthy.”