Is your child's chin receded (weak) in appearance? This is a challenging orthodontic problem.

Suprisingly, when the lower jaw is receded (backward), the upper jaw and teeth are also usually retruded (backward).  A retruded upper jaw can sometimes be recognized by the angle between the upper lip and the uperside of the nose being greater than 90 degrees.  If the child's bite requires it, the lower jaw can be advanced with an orthodontic bite advance.  Before the lower jaw is advanced with a permanently-attached orthodontic device, it may be necessary to advance the upper teeth with braces to a normal position first, which makes the overjet worse temporarily.

If an overbite is corrected in a growing child, it can make an improvement of half an inch in the forward chin position of the adult.  Tools used to correct short chins include various combinations of braces, elastics, jaw expanders, and semi-permanent orthodontic bite advancers.  Sometimes jaw surgery is warranted, to advance the lower jaw.

Are your child’s lips protrusive (stick out too far)? Get help from an orthodontist.

A certain amount of fullness of the lips is desirable in a child, because their

nose and chin will become more prominent as they mature.  Excessive fullness

of the lips is usually caused by the  teeth being too protrusive, forcing both lips

forward.  If the angle between the under side of the nose and the upper lip is

less than 90 degrees, it may mean the teeth are too forward.  There are

measurements that can be made on head x-rays or photos for evaluating lip

fullness, but parents’ and patient’s opinions are more important.

If they want the lips flatter, it is achievable, and if they like them the way

they are, that is important to recognize too.

If the lips are to be flattened, a common approach is to remove 4 bicuspids

(one from each quarter of the mouth) and retract the front teeth with braces. 

 The child can be referred to an orthodontist at any time after age 8, but generally

 treatment would not begin until age 12, when the permanent teeth have grown in.

Is your child’s chin too forward, or does the lower lip protrude in front of the upper lip? This is an orthodontic problem.

Around five percent of the population has an underbite, where the lower teeth are too forward compared to the uppers. It is easy to spot, because of the distinctive face appearance. It does not usually provoke teasing from the schoolmates, but rather is usually spotted and referred by dentists.

It is routine for orthodontists to treat underbites early, sometimes as early as age four, but more often at age eight after the permanent incisors have grown in. The reasons treatment is done early are that the teeth and face bones are more easily moved at a younger age, and it is easier to get a child to wear the necessary devices (braces etc.) at an earlier age. It is assumed that they will still need orthodontic treatment again in a second stage at age 12 or so, but the early treatment is felt to give them a result that would not have been attainable if they had waited.

Treatment of underbites will often involve upper jaw expansion in order to loosen the bone sutures, and simultaneous facemask headgear to pull the upper jaw forward. In eight-year-old children who wear the facemask 12 hours per night, underbites can be corrected in less than a year. They are sometimes overcorrected in anticipation of relapse and partial return of the underbite.

Years ago it used to be taught that underbites should not be treated until growth was complete (age 18), and then jaw surgery would correct the underbite. It is now preferred to treat children early while the sutures are immature, but with the understanding that two stages will be needed.

Does your child’s chin deviate to one side? An orthodontist is trained to look for this.

The usual reason the chin is not directly under the center of the nose is that it has shifted to one side in order for the upper

and lower teeth to fit together better, due to a narrowness of the upper jaw.  The upper jaw, being just a little too narrow,

does not bite well against the lower, so a slight shift of the lower jaw to the right or left makes the bite normal on one side

and full crossbite on the other, providing more tooth contact and a sense of stability.

 

If allowed to remain, the chin may permanently grow into that unsymmetrical position.  Orthodontists are usually quite

alert to this occurrence and recommend widening the upper jaw immediately.  Once the upper jaw is widened sufficiently,

the lower jaw will usually seek equilibrium with it and the chin re-centers itself.  The widened upper jaw is best maintained

with a holding wire for an extended time, since the cause of the narrow arch may still exist.

An orthodontist invites you to look. Does your child’s chin pucker in order for the child to close their lips together?

It is common for the upper incisors to protrude. When a child swallows, the lips normally come together to form a seal,

but this seal is hard to achieve if the upper teeth protrude excessively.  The chin muscle then puckers in order to push the

lower lip up far enough to meet the upper lip, and the resulting facial expression is somewhat unattractive.

 

The  puckering of the chin muscle in order to extend the lower lip up to form a lip seal causes the lower lip muscle

to increase in size.  This increase in bulk of the lower lip will cause crowding of the lower incisors.  It can be avoided

by referral to an orthodontist experienced in treatment of young children. Treatment may include expansion of the jaws

to reduce the incisor protrusion. Or treatment may consist of correcting the incisor protrusion by advancing the lower jaw. 

 Sometimes removal of 2 or 4 teeth is desirable.  The faces created are better than if untreated and the stability of the

results is remarkable once correct jaw posture and tongue posture have been created.

See the full gallery on Posterous

Do the upper front teeth protrude beyond the lips, or is the lower lip behind the upper incisors, or does the lower lip curl downward? Time to see an Orthodontist.

Protruding incisors are at risk for being fractured or knocked out by any of the common activities and accidents of childhood.  Even if they somehow avoid damage, they can be the object of considerable teasing from other children.

A common cause for protruding upper incisors is thumb or finger sucking, which if done long enough will make the upper front teeth flare forward and will tip the lower front teeth backward. 

 

Most children stop thumb/finger sucking once they get into the social pressure environment of school, but if they have already created a deformity in tooth position with the thumb, the deformity will be maintained even after stopping the thumb habit by the tongue protruding into the anterior open bite, and worse, the lower lip parking behind the upper incisors will push them even further forward horizontally.

Most parents are aware of the chili pepper sauce on the thumb regimen, but it does not always work well.  Another treatment involves taking a sock, folding its top down and sewing it into a channel through which is passed a shoestring to be used as a drawstring, and the sock is tied onto the hand at bedtime (sometimes both hands have to be so covered, individually).  For younger kids, the sock can have a face drawn or sewn onto it and the sock can become a personality, such as “Mr. Wizard,” who helps the child.  The sock prevents the thumb or any finger from being extended to be sucked.  It takes considerable discipline from the parent to do this every night for several months (and possibly daytimes after school), but it can work, especially for the child who only sucks at bedtime.

Another fun therapy that can be piggybacked onto that one (or which can stand alone) is to play a game where any day and night that no thumbsucking happened, a happy face sticker is put onto a calendar, and 5 happy faces in a week earns a trip to 31 Flavors, and 25 happy faces in a month earns a trip to Chuck E. Cheese with a friend!

 

A tried-and-true orthodontic therapy, for those who need it, is to place a permanent wire screen device in the mouth, soldered to bands which are cemented to the upper molars, and which forms a physical barrier to keep the thumb and fingers out and to keep the tongue from protruding forward.  It must be left for several months, because if removed too soon the habit has been seen to return.  While the device is in place, the front teeth will usually erupt and the open bite will usually close.  If the upper incisors are flared severely forward, they may need a brief period of braces to upright them, but care must be used not to tip them back into the unerupted permanent canines.

Are Your Childs Lips Apart?

Lips are normally closed together when not speaking.  If the lips are seen to be constantly apart, chances are that the nasal airway is impaired and the child

is mouth-breathing.  If they are, it is possible that specific face changes will happen.  When the mouth is held open to breathe, the tongue drops down

because the tongue is attached to the inside of the lower jaw, so it no longer rests against the roof of the mouth.  The absence of tongue pressure on the

roof of the mouth causes the upper jaw not to widen from growth.  This is made worse by the tightness of the cheeks against the outside surfaces of the

teeth caused by holding the mouth open, pushing inward on the upper teeth and causing them to narrow.  Constant mouth-breathers tend to have narrow

upper jaws, which are easily recognized because one or both sides will be in crossbite, biting inside the lower teeth instead of outside.

 

Mouthbreathing may be because the nose if stuffy from allergies, or the nasal septum is deviated, or the adenoids are large, or the tonsils are large, or the

soft palate/uvula is oversized.  Dentists can recognize long soft palate/uvula and large tonsils by depressing the tongue with a mouth mirror and telling the

child to say “Ahh”. 

 

Large adenoids can be detected by the nasal sound of the speech, and can be viewed easily with an x-ray of the head.  Parents can notice if the child snores,

which often accompanies throat airway problems. 

 

It is not usually helpful to take a child’s airway problem to a pediatrician, because they are taught that tonsillectomy and adenoidectomy are to be avoided in

order to preserve a child’s ability for immunity in adulthood.  They are taught little about the growth of the face and the adverse effect of a blocked airway

on the shape of the jaws and appearance of the face.  It is often effective, however, to take a child to an ear-nose-throat specialist, because in general these

doctors will consider tonsil and adenoid surgery if medication does not suffice to keep the airway open.

 

 

If mouthbreathing has resulted in a narrow upper jaw, the jaw can be widened by an orthodontist using palatal expansion.  It has been shown that widening

the upper jaw also widens the base of the nose and reduces nasal resistance, improving nasal airflow, and the most common reason orthodontists widen the

upper jaw is to correct crossbite(s) caused  by a narrow upper jaw.

 

Mouthbreathing left undetected and untreated may result in a long thin face, with the chin more backward, and with the roof of the mouth apparently high

and narrow due to the failure of the jaw to widen because the tongue is too low.

 

                                                                     ©2011  James E. Eckhart, D.D.S.,  Inc.

                                                                                                   www.eckhartorthodontics.com

                                                                                               1101 N. Sepulveda Blvd,  Suite 202, 

                                                                                          Manhattan Beach,  Ca.  90266  (310) 546-4724

                                                                                21210 Anza Ave., Torrance, CA 90503 (310) 540-5911  

Are Braces Expensive?

It may save you money in the long run - less dental care, less time off work. Nothing is too expensive if you want it bad enough or if you have to have it. Straight teeth for the balance of one's life, assuming 60 years left, is only $50 a year, or $0.15 a day.   Many people regard this as a better use of their money than a trip to Mexico. Orthodontists don't like to see money get in the way of your health. They adapt the payment plan to your particular needs and come up with an affordable solution.  Of all medical services, orthodontic treatment has gone up the least.  Shorter treatment time and greater efficiency has reduced the cost.   Even people of limited means are getting their teeth straightened too, including secretaries, single parents, etc.  It may actually make you money; with the increased self confidence you may gain from knowing your teeth look their best.  The doctor doesn’t live in Beverly Hills, he lives and works locally and is in touch with what local people can afford.

 

 

Copyright 2004  James E. Eckhart, D.D.S.,  Inc.

1101 N. Sepulveda Blvd,  Suite 202, 

Manhattan Beach,  Ca.  90266  (310) 546-4724

21210 Anza Ave., Torrance, CA 90503 (310) 540-5911

 

Am I to old for Braces or aren't Braces for kids?

Around 50% of Orthodontic patients are adults.  A lot of adults are looking for long term solutions rather than settling for "quick fixes" or "patches".  For adults, the main dental disease is breakdown of the gums, not cavities.  By aligning your teeth, you not only improve your appearance, but also improve your hygiene because brushing and flossing is now easier and more effective, This can save the health of your gums.If you lose your teeth, you'll look even older. 

Many adults are realizing that now that their children have finished braces, and that they can afford braces for themselves understand its value, they are entering treatment too.  Some adults needed orthodontic treatment as a child but it was unavailable to them, so now that they have the means they pursue it.  Nobody is really too old.  If a person assumes that they are going to live the next 2-3 years anyway, they might as well harness the time, get their teeth straight, and enjoy the results the rest of their life.

©2011  James E. Eckhart, D.D.S.,  Inc.

www.eckhartorthodontics.com

1101 N. Sepulveda Blvd,  Suite 202, 

Manhattan Beach,  Ca.  90266  (310) 546-4724

21210 Anza Ave., Torrance, CA 90503 (310) 540-5911  

Straightening Teeth With Invisalign Part V

Future Advances In Invisalign

 

In the future, it is probable that impressions of the teeth will no longer be necessary for starting Invisalign treatment, but that instead the teeth will be scanned by an intra-oral device, and the data will be collected electronically instead of physically.

As technology improves, the plastic of the aligners will probably vary in stiffness depending on which tooth that section of the plastic is attaching to.The locations and shapes of bumps on the teeth (attachments) will continue to evolve, and the ability to correct certain types of overbites and underbites will improve as more use of elastics and bone screws are integrated in with Invisalign.

 

©2011  James E. Eckhart, D.D.S.,  Inc.

www.eckhartorthodontics.com

1101 N. Sepulveda Blvd,  Suite 202, 

Manhattan Beach,  Ca.  90266  (310) 546-4724

21210 Anza Ave., Torrance, CA 90503 (310) 540-5911  

 

 

Straightening Teeth With Invisalign Part IV

Differing Opinions Among Orthodontists Regarding Invisalign

 

Invisalign has evolved tremendously over the past 12 years.  One of the main tools Invisalign has developed to make the aligners more effective in moving teeth is the temporary addition of tooth-colored plastic bumps onto the tooth surface. These bumps are called “attachments”, and there are different sizes and shapes of them, but their purpose is to allow the aligners to grasp the tooth more effectively in order to produce the desired tooth movements.  These “attachments” have evolved in recent years into shapes that have proven to help produce otherwise difficult tooth movements.  They have been created by a team of nearly 200 engineers hired by Invisalign to find effective ways to move teeth with aligners.  Invisalign continues to study the most effective way to use attachments to control tooth movements, and averages 1-2 new software releases per year as knowledge accumulates.  Doctors who used Invisalign years ago and quit, or who have  only done a few cases (less than 100, say), probably have not stayed current with the advances made by Invisalign, and may not have developed the experience to see the wide range of applicability Invisalign now offers.  It is quite clear to this writer that the profession of orthodontics is evolving into much more of an Invisalign delivery system, and much less of a braces delivery system, over the next few years.

 

©2011  James E. Eckhart, D.D.S.,  Inc.

www.eckhartorthodontics.com

1101 N. Sepulveda Blvd,  Suite 202, 

Manhattan Beach,  Ca.  90266  (310) 546-4724

21210 Anza Ave., Torrance, CA 90503 (310) 540-5911  

 

Straightening Teeth With Invisalign Part III

Advantage of Invisalign Over Braces

 

 

Since aligners are removed for eating, you can eat whatever you want.  That is not true for braces, because braces can be broken off the teeth if you eat something too crunchy.

Since aligners are removable, it is easy to thoroughly clean your teeth after eating.  You can brush and floss without any brackets (braces) being in the way and trapping food.

Invisalign hugs the teeth closely and has a very low profile, so there is nothing protruding out from the tooth surfaces to irritate the inside of the lips or cheeks.  Invisalign moves

the teeth in tiny increments, so the pressure on the teeth is small and very controlled, whereas with braces the teeth are moved by wires and the forces are larger and harder to

control.  For this reason, Invisalign causes very little soreness of the teeth, and what soreness there is lasts only hours, not days.  Invisalign is clear and hard to see, and is therefore

cosmetically superior to even the “clear” braces.  Also aligners can be removed for close-up photos, but braces are not so easily removed.

 

 

©2011 James E. Eckhart, D.D.S., Inc.

www.eckhartorthodontics.com

1101 N. Sepulveda Blvd, Suite 202,

Manhattan Beach, Ca. 90266 (310) 546-4724

21210 Anza Ave., Torrance, CA 90503 (310) 540-5911

Straightening Teeth With Invisalign Part II

Competing Products vs Invisalign

Invisalign was introduced to the world in the late 1990’s.  Prior to its arrival dental labs had been making plastic overlays to move teeth small distances, for many decades, and they still do.  But those labs do the work by hand on physical models of the teeth, actually cutting the teeth off the models and re-positioning them, and making aligners to fit those newly re-positioned models, and the reliability of that method was and is limited to moving front teeth only, and only for up to 5 stages.  The primary patent that gives Invisalign its advantage is that the tooth movement is first done virtually in the computer using unique proprietary software, and then they can manufacture a large number of progressive stage models, moving both front and back teeth simultaneously, and the method has proven to be very reliable in producing the desired results. 

 

©2011  James E. Eckhart, D.D.S.,  Inc.

www.eckhartorthodontics.com

1101 N. Sepulveda Blvd,  Suite 202, 

Manhattan Beach,  Ca.  90266  (310) 546-4724

21210 Anza Ave., Torrance, CA 90503 (310) 540-5911  

 

 

 

 

Straightening Teeth With Invisalign Part I

How Invisalign Works

 

Invisalign is a system of clear plastic overlay sleeves custom-made to fit your teeth, which gradually move your teeth from the beginning crooked positions to the desired straight positions. 

An accurate impression is made of your teeth by a doctor, and it is sent to Invisalign.  They scan the impression into a computer.  Using proprietary software, a computer technician then moves all the teeth simultaneously in a computer simulation from the beginning positions to the desired final straight positions as requested by the doctor, but the tooth movements are controlled by the software to be in very small increments equal to how far teeth can biologically move in two weeks.  There may be anywhere from 10 to 30 stages, depending on how far the teeth need to be moved overall.  The software then guides a machine to carve a new model of the teeth out of plastic for each two-week stage, and a plastic overlay sleeve (called an “aligner”) is made to fit over that model.  Each “aligner” is imprinted with the stage number, and packaged into a ziplock bag.  The entire group of aligners is then shipped to the doctor, who then delivers them in stages to you.  How many stages you get at a time varies with different doctors.

You wear the aligners full time, taking them off only to eat and brush your teeth.  You change aligners each 2 weeks.  As you near the end of the series of aligners, your teeth will look much better.  If you are satisfied, you will switch to wearing part-time retainers to hold the teeth in the new positions.  If you would like them even nicer, you can have a refinement, which is another series of aligners to produce more movement of your teeth, and then have retainers after that.

 

©2011  James E. Eckhart, D.D.S.,  Inc.

www.eckhartorthodontics.com

1101 N. Sepulveda Blvd,  Suite 202, 

Manhattan Beach,  Ca.  90266  (310) 546-4724

21210 Anza Ave., Torrance, CA 90503 (310) 540-5911  

 

Overbite Studies

There are 3 overbite studies I am initiating.

 

1. How much can the forward growth of the chin be enhanced during overbite correction using the MARA overbite corrector?

It is expected that adolescent teenagers will experience considerable forward growth of the chin using the MARA overbite corrector carefully, trying not to lengthen the face but to direct the growth of the lower jaw horizontally.  I will study whether there is a difference between boys and girls.  I will also study whether adults can experience some forward growth of the chin, even though they are “done” growing.

This study will be compared to an untreated group of adolescent teenage boys and girls, in order to understand how much change in the horizontal chin position the MARA produces.  These untreated teenagers have head xrays stored at the University of Michigan from years ago, and are available for studies such as this.

 

1. How fast can overbite correction occur and still be stable?

By combining braces with the MARA overbite corrector, and starting elastics wear earlier too, we will study whether the treatment time for overbite correction can be reduced from 33 months average to 20 months average.  The groups to be studied are adolescent boys, adolescent girls, and adults.

 

1. How reliably can overbite correction be accomplished using Invisalign instead of braces, along with the MARA overbite corrector?

A group of adolescent boys and a group of adolescent girls and a group of adults will be treated with first the MARA overbite corrector, and then after the MARA is removed, with Invisalign, to see how nicely the bite can be corrected without braces.

 

©2011  James E. Eckhart, D.D.S.,  Inc.

www.eckhartorthodontics.com

1101 N. Sepulveda Blvd,  Suite 202, 

Manhattan Beach,  Ca.  90266  (310) 546-4724

21210 Anza Ave., Torrance, CA 90503 (310) 540-5911  

 

Can Braces Cause Cavities?

With Invisalign, the aligners can be removed for brushing.  Poor tooth brushing causes cavities.  Most orthodontists monitor tooth brushing carefully and reward good brushing.  The good brushing habits formed during braces last a lifetime.

 

A person seeing an observant orthodontist once every month or two is less likely to have new cavities undetected than a person who only sees the dentist once or twice a year.

 

Orthodontic patients get their brushing graded at every appointment, and they are provided brushes and other cleaning supplies.  They also get instruction on diet, fluoride rinses, etc.

 

In the old days with bands wrapped around the front teeth, sometimes loose bands were hard to detect and would decay underneath. Nowadays, with bonded brackets, it is easier to tell.

 

Today's orthodontic cements have fluoride in them and the teeth are sealed for protection before gluing the braces on.

 

If an orthodontist realized that a patient was not brushing adequately after  many lessons, he would just remove the braces and discontinue treatment, before any serious cavities developed.

 

 

©2011  James E. Eckhart, D.D.S.,  Inc.

www.eckhartorthodontics.com

1101 N. Sepulveda Blvd,  Suite 202, 

Manhattan Beach,  Ca.  90266  (310) 546-4724

21210 Anza Ave., Torrance, CA 90503 (310) 540-5911  

How Do You Find a Desirable Orthodontist?

There are 4 popular ways to find an orthodontist.  The most popular is still to ask your general dentist for a recommendation.  The general dentist gets feedback from earlier referrals and has an idea of how happy patients have been with an orthodontist, and sees the quality of treatment when the patients return for dental checkups, and is in a position to judge that quality. 

 

The second most popular way to find an orthodontist is to do an Internet search for “orthodontist” in your town or zipcode, and to look on Page One for directory listings that have lots of favorable reviews of  an orthodontist.

 

The third most frequently used method for finding an orthodontist is to ask your nearby personal contacts (friends, neighbors, workmates, relatives) who they have used and how happy are they with that choice.

 

A fourth way to find an orthodontist is to ask you dental PPO insurance company for a list of providers in your area, and then to compare that list to the reviews findable on the Internet in option 2.

 

©2011  James E. Eckhart, D.D.S.,  Inc.

www.eckhartorthodontics.com

1101 N. Sepulveda Blvd,  Suite 202, 

Manhattan Beach,  Ca.  90266  (310) 546-4724

21210 Anza Ave., Torrance, CA 90503 (310) 540-5911  

 

 

Selecting an Orthodontist Part 3- How Many Opinions Should You Get?

One school of thought says that you should get at least two opinions.   The theory is that you choose after considering different points of view, and you are better off because of being allowed to weigh options.  The weak part of this approach is that many times a person who is confronted with choices will not choose anything because they are confused.  Lacking in-depth knowledge of dentistry can make a person uncertain of their ability to choose wisely.  They do not have enough education or experience to know what to believe or how to choose, so they do nothing and they might as well not have gotten any opinions.

 

During consultations with patients who have had prior opinions, when the patients are invited to disclose what the differing opinions were, the immediate orthodontist can explain the thinking behind each point of view, and should state that each opinion has merit, and that the orthodontist responsible for each opinion could in all likelihood succeed with their approach, so that the patient is justified in selecting whichever plan appeals the most, and the important point is to start with some treatment.

 

©2011  James E. Eckhart, D.D.S.,  Inc.

www.eckhartorthodontics.com

1101 N. Sepulveda Blvd,  Suite 202, 

Manhattan Beach,  Ca.  90266  (310) 546-4724

21210 Anza Ave., Torrance, CA 90503 (310) 540-5911  

 

 

Selecting an Orthodontist Part 2: When Should An Adolescent Be Taken to an Orthodontist?

The last thing a teenager wants is to find out at age 16 that they need braces. Their self image is often shaky during this transition from child to adult, and the thought of Senior pictures with braces on has prompted many moans and questions regarding why they were not started earlier. Your general dentist  may overlook impacted upper cuspids which are frequent causes of these delayed referrals and the dentist should be suspicious whenever the upper cuspids are not present or palpable in the mouth by age 10-13.

 

In general, bring your child for orthodontic screening any time after age 7.  The orthodontist will not mind even if nothing is necessary to do now.  A typical age for beginning orthodontic treatment is 11 or 12. ©2011  James E. Eckhart, D.D.S.,  Inc. 1101 N. Sepulveda Blvd,  Suite 202,  Manhattan Beach,  Ca.  90266  (310) 546-4724 21210 Anza Ave., Torrance, CA 90503 (310) 540-5911   www.eckhartorthodontics.com

 

Selecting an Orthodontist Part 1: When Should A Child Be Taken to an Orthodontist?

You may have heard that it is not a kindness to the patient to wait to take them to an orthodontist when the permanent teeth are all erupted. Some orthodontic problems require earlier treatment. Severe crowding, crossbites, narrow jaws, severe over jets, underbites, thumb and tongue problems, all these sometimes benefit from early treatment. Postponing the initial examination may mean beginning treatment later in the child's all-too-little remaining growth, and condemns the patient to extractions, reduced jaw size, less harmonious facial profile, and increased risk of gum or jaw-joint problems later. Most children should be screened by an orthodontist at age seven. A few will need early treatment (while baby teeth are still present), and they will probably need a second stage of treatment at age 13, but the results are important enough that the option should be considered. Some children should be referred even earlier, as soon as the malocclusion is discovered in the baby teeth. The bad bites to watch for are open bites, crossbites, severe overjets, underbites, and small jaws. 2011 James E. Eckhart, D.D.S., Inc. 1101 N. Sepulveda Blvd, Suite 202, Manhattan Beach, Ca.90266 (310) 546-4724 21210 Anza Ave., Torrance, CA 90503 (310) 540-5911 www.eckhartorthodontics.com