Having gone through a myriad of orthodontic treatments, from palate expanders to braces to Invisalign, I’ve realized the importance of having straight teeth and a healthy bite. Although I often resented having braces or Invisalign due to the pain and inconvenience they caused, I’ve come to greatly appreciate that I had access to these orthodontic treatments and that they improved the alignment of my teeth.
This summer, I had the amazing opportunity to intern with Dr. Noxon and Dr. Bruno at Noxon Orthodontics in Wellesley, MA. Orthodontics is a branch within the field of dentistry that focuses on aligning bites and straightening teeth. Orthodontic treatments help to provide cosmetic corrections, create a healthy bite, and prevent diseases of the teeth and gums.
During my three-week internship, my job was to help create a smooth and efficient workflow for the doctors and assistants. After patients were done being treated, I would wipe down their chairs and clean their trays, which consisted of sorting different instruments and putting away other tools in designated drawers. Before seating the next patients, I set out different trays next to each chair based on their specific treatments. For example, there are “observation” trays, which consist of just a mirror, “adjust” trays for adjusting braces, and “bond” trays for putting on braces.
I also had several smaller tasks, one of them being refilling braces trays. Each upper and lower tooth has a designated type of brace, which is labeled with a number. After a braces tray is used and has missing packets, I would meticulously reload the missing spaces of the tray with their correlating brace packets. I then carefully checked my work and made sure each brace packet was in the correct place.
Restocking braces packets Full braces trays
During my stay at Noxon Orthodontics, countless patients finished their braces treatment, which meant that the doctors had to make a large number of retainers in the lab. To make these retainers, 3D printed resin molds of a patient’s teeth were created, then the doctors would take the resin molds to the lab and melt a piece of plastic over them to shape the retainers. After this process was completed, the doctors would sand off any edges and imperfections. I then would wash the retainers and put them in labeled cases. Lastly, I updated each of the patients’ files on the computer, writing a note that their retainers were made and ready. This way, every doctor could easily follow patients’ treatment plans through an effective communication system.
Washing retainers A set of resin molds and retainers
Along with assisting with braces treatment, I had the chance to learn more about Invisalign, which has become much more common in recent years. Invisalign treatment is the process of wearing clear, removable aligners that gradually straighten the teeth over time. Dr. Noxon showed me how the computer can generate molds that will realign and correct the teeth of a patient. In the computer software, each tooth can be highlighted and moved in a specific direction in increments of 0.1 millimeters and fractions of degrees. After adjusting each tooth and moving it to the desired place, the animated aligners can be created for patients to wear.
I also had the opportunity to gain more insight into the process of creating treatment plans for patients. When establishing a path of treatment for an individual, there are several factors to take into account, such as the timeline, the bite, risk factors, and more. Sometimes, there are tough decisions to make within a patient's treatment plan, and therefore, doctors will sit down to discuss and further evaluate the situation. Dr. Noxon and Dr. Bruno graciously allowed me to sit in on a few of their conversations, where I learned more about the process by which they assess and finalize different patients’ courses of treatment. For instance, in one specific case I sat in on, the young patient seemed to be noncompliant, and did not want to have orthodontic treatment. Dr. Noxon and Dr. Bruno therefore had to factor the patient’s noncompliance and lack of discipline into their evaluation. For example, certain treatments such as Invisalign and other smaller appliances attached to the teeth would not be a good fit for this patient, as these treatments require a lot of self-discipline. After weighing in several other factors, the doctors ultimately decided to choose braces over other appliances to fix the patient’s bite.
Most intriguing during my time at Noxon Orthodontics was getting to analyze and learn about unique patient cases. In one case I looked at, while the patient seemed to have a perfect set of teeth, they actually had many orthodontic irregularities and flaws. They had a severe overbite, a total of eight missing teeth, and multiple retained baby teeth that were in the wrong spots. After carefully assessing the patient’s situation, the doctors finalized a treatment plan. The course of treatment included using braces to reposition the patient’s teeth to replace three out of the eight missing teeth, all without any extractions or surgery. Since the treatment plan left a gap for the baby teeth, when they eventually fall out, implants will be used to replace the fallen teeth.
Animation of the patient's bite X-ray of patient's teeth
Interning at Noxon Orthodontics has not only provided me with more in-depth knowledge on the specialty of orthodontics, but it has also taught me the importance of teamwork, reliability, and communication in a work environment. I would like to thank Dr. Noxon and Dr. Bruno for sharing their time and knowledge with me, and I would like to thank the rest of the staff for creating such a supportive and kind environment for me to learn in. And lastly, I would like to thank Mr. Schlenker for making this amazing internship possible.
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