Orthodontist in Houston: braces and Invisalign

Do You Need an Orthodontist or Will a Dentist Do?

This is one of the most common questions on the subject and it deserves a straight answer.

An orthodontist is a dentist who completed two to three additional years of full time residency in tooth movement and facial growth after dental school. Any licensed dentist may legally provide braces or clear aligners; only an orthodontist has that specialist training.

For a straightforward case, plenty of general dentists produce good results. Where the training shows is at the edges: severe crowding, a bite that needs real correction, teeth that must move a long way, a growing child where timing matters, and any case that stops behaving the way the plan predicted.

The practical test is not the credential on the wall. It is who designs your treatment. Aligner software will propose a sequence for anybody. Ask whether an orthodontist decided that sequence or whether it was accepted as returned.

At Omega Dental Specialists, Dr. Boback plans every orthodontic case himself.

If your problem is jaw pain or clicking rather than crooked teeth, start with our guide to TMJ treatment in Houston.

How Braces and Aligners Actually Move Teeth

A tooth is not fixed in your jaw. It sits in a socket suspended by a periodontal ligament, and it can move.

When steady pressure is applied to one side of a tooth, bone on that side is resorbed by cells called osteoclasts while new bone is laid down on the opposite side by osteoblasts. The tooth migrates into the space created. Braces and aligners both work this way. What differs is the delivery.

Braces apply that force through brackets bonded to each tooth and a wire changed at intervals. The force is continuous, 24 hours a day, whether or not you think about it.

Aligners apply it through a series of trays, each shaped slightly differently, producing roughly a quarter of a millimetre of movement per tray. They work only while they are in your mouth.

This is also why treatment cannot be rushed. Bone remodelling takes the time it takes, and forcing teeth faster than the biology allows damages roots.

Your Options, and What Each Is Best At

• Metal braces. The broadest range of any option: severe crowding, significant rotations, large vertical movement, real bite correction, extraction cases, and growing patients. Visible, and they work whether or not you remember them. Also the least expensive option here, which makes them the value option.

• Ceramic or clear braces. The same mechanics with tooth coloured brackets, far less obvious at conversational distance. More brittle than steel, so more repair visits, and the elastic ties stain between appointments.

• Invisalign. Removable, essentially invisible, and much easier to keep clean. Handles crowding, spacing, relapse and mild to moderate bite correction. Requires 20 to 22 hours of wear a day, every day.

• Retainers. Not optional, and covered below.

Invisalign and ceramic braces carry the same fee because both are the discreet option, so between those two the recommendation is about your bite and your habits rather than the margin. Metal braces cost less; if visibility does not bother you, they are the value option, and we will say so.

Who Is a Good Candidate, and When to Start

Crowding, spacing and gaps. Overbite, underbite, crossbite and open bite. Teeth that have drifted back years after childhood braces. Teeth that are hard to clean because of how they sit, which matters more than appearance.

Adults are treated routinely. Teeth move at any age. The one genuine limit is that a true skeletal discrepancy, where the jaws rather than the teeth are misaligned, cannot be grown out of once you have stopped growing, so full correction in an adult may need surgery alongside orthodontics.

For children, the American Association of Orthodontists recommends a first orthodontic check at around age seven. Treatment usually does not start then. The point is that a growing jaw can still be guided, and a crossbite, a narrow upper arch or space lost to an early extraction is far simpler and less expensive to address while growth is happening. Teenagers who would rather not wear brackets can read our guide to Invisalign for teens.

Anything active gets treated first. Decay and gum inflammation are dealt with before teeth are moved, because orthodontics only moves teeth that have a solid foundation under them.

When should a child first see an orthodontist?

By age seven, and that number is not ours. The American Association of Orthodontists recommends every child have a first orthodontic check-up no later than age 7, because at that age the mix of baby and permanent teeth lets an orthodontist spot a developing bite problem in its earliest, easiest stage.

A check-up is not a commitment to braces. Most seven-year-olds need nothing but monitoring, and we say so. What the visit buys is timing: the small number of problems that genuinely benefit from early treatment, like crossbites and severe crowding, are far simpler to guide while the jaw is still growing than to correct after it has finished.

Orthodontics for adults: it is never too late

One in three orthodontic patients today is an adult, and the AAO's position is blunt: there is no such thing as too old for treatment. Teeth move at any age; what matters is that the gums and bone around them are healthy, which we confirm before starting.

For adults this is rarely vanity. Misaligned teeth wear unevenly, trap plaque that feeds gum trouble, and can make chewing genuinely harder. The discreet options, ceramic brackets and Invisalign, exist precisely because adult patients wanted treatment that fits a working life, and both are planned here by the same specialist who treats our youngest patients.

When braces or aligners aren't the answer

Full orthodontic treatment is not always the right call. If crowding is mild and only bothers you cosmetically, front teeth that overlap slightly but function fine, bonding or a veneer can close the visual gap in one or two visits instead of a year or more in an appliance; our cosmetic dentistry team handles that consult.

Someone who finished treatment years ago and has only drifted a little may need nothing more than a new retainer worn consistently, not a second round of braces. In children, the first orthodontic check the AAO recommends around age seven often ends with watching and waiting for more growth before any appliance goes on, because the jaw is not done developing.

And when the problem is truly skeletal, the jaws themselves misaligned rather than just the teeth, braces alone will not finish the job; that is a case for jaw surgery with Dr. Rosenstein or Dr. Watkins, planned alongside orthodontics rather than instead of it.

What the Process Looks Like

At the consultation we take photographs, X rays including a panoramic view, and a digital scan. If the case is skeletal we add a lateral cephalometric X ray, the side view that shows whether the problem is the teeth or the jaws.

You see the plan and, for aligner cases, the projected outcome on screen. You leave with the timeline and the fee in writing.

Fixed braces are adjusted every six to eight weeks. Expect two or three days of soreness after each visit, and expect at least one bracket to come off during treatment.

Aligner check-ins are every six to ten weeks and are short. You change trays at home.

Typical treatment runs 12 to 24 months for aligners and 18 to 30 months for complex fixed cases. The number of aligners, or the complexity of the movement, tells you more than the number of months.

Then retention, which is where results are kept or lost.

The risks, and what we watch for

Moving teeth carries real, well-documented risks, and we tell patients about them before the brackets or aligners go on, not after. Plaque collects around brackets faster than it does on bare teeth, and if it sits there too long it can leave a permanent white spot on the enamel underneath. Careful brushing and flossing around each bracket, which we show you at the bonding appointment, is what keeps that from happening.

Root resorption, a slight shortening of the root tip, is uncommon and usually minor; the X-rays we already take through treatment are how we would catch it. Gums often look puffy for the first couple of weeks with any new appliance, and it settles as brushing gets easier. Adjustments bring two or three sore days, then nothing.

None of this undoes a finished case; skipping the retainer does, and the retention section below covers that. The American Association of Orthodontists and the ADA both describe these as manageable, and well below the cost of leaving a real bite problem alone.

Retainers, and Why Results Relapse

Teeth drift for your whole life, and the pull back toward the original position is strongest during the first year after treatment.

Retainers hold the result. Expect full time wear at first, then nights indefinitely. A thin wire bonded behind the front teeth is an option that removes the need to remember anything, and for someone who has already relapsed once it is usually the better answer.

Retainers wear out and they get lost. Tell us early if one cracks or the fit has gone loose, so it can be replaced before the teeth have a chance to move. Replacements carry the same fee as the original.

We routinely see adults with shifting teeth who had braces as teenagers and stopped wearing their retainer in their twenties. It is the single most common way a good orthodontic result gets undone, and it is entirely preventable.

Seeing an Orthodontist in Midtown Houston

Dr. Bernard Boback trained at Harvard and handles orthodontics here. He plans every case himself rather than handing it to a technician or accepting whatever the software proposes.

Being multispecialty matters more in orthodontics than people expect. If gums need treating before teeth are moved, our periodontist Dr. Shirin Farhadian is in the same building. If a case needs a surgical component, our oral and maxillofacial surgeons are too, including Dr. Jonathan Rosenstein, who is board certified and a Diplomate of the American Board of Oral and Maxillofacial Surgery. Coordinating a combined case across two practices usually costs months; here it costs a corridor.

We are at 106 W Gray Street in Midtown, between Downtown and the Texas Medical Center, with parking on site. We treat patients from Montrose, River Oaks, the Heights, EaDo and the Museum District. Orthodontic visits are available on some Saturdays; ask when you book. That matters when the patient is in school and visits run every six to eight weeks for a year or more.

We take the records at the consultation. Call (713) 322-7474 or book online. Spanish-speaking staff are available every day we are open.

Treatments

We give you the exact fee in writing after your exam, before any treatment. What your own plan contributes depends on the policy, and we verify it with your insurer before treatment. Financing through Cherry, Affirm and Sunbit for qualifying applicants, subject to the lender's approval.

Frequently asked

Orthodontic guides

Braces or Invisalign

• Invisalign vs Braces in Houston: How to Choose
• How Invisalign Works, Start to Finish
• Invisalign Teen in Houston: What Parents Ask

Cost and financing

• How Much Do Braces Cost in Houston? What You Actually Pay
• Invisalign Cost in Houston
• How Much Do Retainers Cost in Houston?

After treatment

• Why Are My Teeth Shifting?