Teeth Gap and Spacing Treatment in Shelby Township
Spacing means gaps between teeth that sit side by side. A gap can be between any two teeth, upper or lower.
Orthodontic specialist Dr. Thomas Fredal Jr. treats excess spacing at Fredal Orthodontics in Shelby Township.
*For new patients only. Patients transferring from another orthodontist: $250 consultation fee, credited toward treatment if they start here.
How Dr. Fredal Looks at Gaps Between Teeth
Every case at Fredal Orthodontics is diagnosed in 3D, with an i-CAT CBCT scan (a 3D X-ray scan) and an iTero digital scan of your teeth.
Dr. Fredal uses them to check the roots, the bone around them, how the jaws relate and the airway. He looks at more than the crowns (the visible parts) of the teeth.
What he finds can change his plan. Examples are whether to use braces, Invisalign or both, or whether to bring in other specialists.
Diastema vs. Generalized Spacing
Diastema can mean any gap between two teeth. In everyday use, it means a gap between the two upper front teeth.
Midline Diastema
A midline diastema is one gap between the two upper front teeth, the upper central incisors.
Generalized Spacing
Generalized spacing means gaps between several teeth, in one or both arches (the upper and lower rows of teeth).
Spacing Terms in Plain Words
You may hear these words when gaps between teeth come up.
Jaw-Tooth Size Mismatch
A jaw-tooth size mismatch means the jaw has more room than the teeth need.
Microdontia means teeth that are smaller than average.
Labial Frenum
The labial frenum is the fold of tissue that joins the inside of the upper lip to the gum above the upper front teeth.
Peg Laterals and Missing Teeth
A peg lateral is an upper lateral incisor (the tooth beside each upper front tooth) that is smaller and narrower than usual.
A congenitally missing tooth is an adult tooth that never formed.
Tongue Thrust or Thumb Sucking
A tongue thrust is when the tongue pushes forward against or between the front teeth, such as when you swallow or speak.
Fredal Orthodontics fits habit appliances. When tongue posture, oral habits or functional concerns are present, Dr. Fredal may refer you to a local myofunctional therapist. Myofunctional therapy (exercises for the tongue, lip and face muscles) is not offered in-house.
Periodontal Disease
Periodontal disease, or gum disease, affects the gums and the bone that hold the teeth in place. Dr. Fredal evaluates periodontal support (the gums and bone around the teeth) when he plans treatment. Fredal Orthodontics coordinates care with general dentists, periodontists (gum specialists) and other specialists when it is needed.
Whether and When to Treat
He decides not only how to treat but when treatment should begin. He weighs:
- Growth and dental development (how the teeth develop and come in).
- Skeletal relationships (how the jaws relate) and the goals of treatment.
Spacing Treatment Options at Fredal Orthodontics
Dr. Fredal typically recommends braces rather than Invisalign for significant spacing (large gaps between the teeth). Excessive spacing is one of the cases he does not treat with aligners.
| Option | What It Is | At Fredal Orthodontics |
|---|---|---|
| Damon Ultima Braces | Passive self-ligating metal brackets that hold the wire without elastic ties | They use lightweight shape-memory wires. For comprehensive (full) braces, Dr. Fredal plans bracket positions in 3D with DIBS AI software. |
| Invisalign | Removable clear aligners | Invisalign and Invisalign Teen are offered. If you start in clear aligners and need to switch to braces, the switch is covered at no extra charge. |
| Braces, Then Invisalign | Braces first for the hardest tooth movements, then Invisalign to finish | Not needed for every patient. Dr. Fredal decides case by case, and it is included in the treatment fee. |
Overall, Dr. Fredal’s patients are split 50/50 between braces and aligners.
Retainers After Treatment
At the end of comprehensive treatment, one set of Essix retainers (clear plastic retainers) is included. With braces, your retainer scan is taken the day the braces come off.
With Invisalign, your teeth are scanned the day the attachments are removed, and Vivera retainers (a brand of clear retainer) are ordered.
Dr. Fredal asks patients to wear their retainers full time for the first 1 to 3 months, then at night for life.
Fredal Orthodontics also offers Retainer Insurance, a paid program for replacement retainers. It costs $790 and runs for 7 years. With the program, each new retainer is a $40 copay, and you can receive one new set per quarter.
Dr. Fredal prefers removable retainers. Bonded retainers (a thin wire bonded behind the front teeth) are offered too. He may recommend one for teeth more prone to relapse (shifting back), particularly when treatment began with gaps between many teeth.
When one is used, he also recommends a removable Essix or Vivera retainer over it. If one is not clinically necessary but you choose to have it, it is made by a lab and costs $750 per arch.
If a Retainer Is Lost
A lost retainer is the most common retainer problem at Fredal Orthodontics. A replacement retainer is $225 per arch, or $450 for an upper and lower pair.
If you can’t wait for the lab, the office can make a retainer in-house. Only Essix retainers can be delivered at the same visit.
Gaps in Children’s Teeth
Dr. Fredal recommends that every child have an orthodontic evaluation by age 7. Each evaluation includes a 3D i-CAT CBCT scan. He uses the scan to assess jaw growth, erupting teeth (teeth that are coming in) and the airway.
He is an advocate of early treatment, also called Phase 1, when a child needs it. Fredal Orthodontics treats children from age 7. For Phase 1, it offers braces and Invisalign First (clear aligners for children).
Typical Treatment Timeline
| Stage | Duration | What Happens |
|---|---|---|
| Consultation | 50 minutes | You spend 20 of them with Dr. Fredal, who personally conducts every consultation. |
| Braces or Invisalign | About 12 to 18 months for many comprehensive cases | Dr. Fredal gives you an estimate for your own case after your diagnostic evaluation. Braces visits are every 6 to 8 weeks. With Invisalign, you switch to a new aligner every week, and visits are every 10 to 12 weeks. |
| Between visits | During treatment | You can text photos and questions to the team through Weave. The clinical team reviews them during business hours and replies with next steps. |
What to Expect at a Spacing Consultation
-
Records.
A free CBCT scan on the i-CAT FLX V17, an iTero Lumina digital scan of your teeth and clinical photographs. -
Airway screening.
Every comprehensive orthodontic consultation includes one. The screening looks at tongue posture and mouth-breathing patterns, among other things. Your history is also reviewed for signs such as habitual mouth breathing or snoring. This screening is not meant to diagnose sleep apnea. -
Your review with Dr. Fredal.
He reviews your complete records with you and gives his treatment recommendation. You can also talk about treatment options, timelines and financial options. -
The exact cost in writing.
You get the exact treatment cost in writing. -
Photo ID.
The practice asks for a photo ID at the new-patient consultation. -
What the consultation costs.
It is free for new patients. If you are in treatment with another orthodontist, a transfer consultation costs $250, credited toward treatment if you start here. A second opinion on treatment you are having elsewhere is free. A return consultation before you start treatment is also free, unless you missed a consultation as a no-show; then it costs $100.
Before & After
How Much Does It Cost to Close Gaps in Shelby Township?
Metal braces: from $5,280 (comprehensive)
Invisalign: from $5,280 (comprehensive)
Phase 1 for children: braces from $2,980, Invisalign First from $3,480.
Comprehensive fees have three levels, by case complexity: $5,280, $6,880 and $7,175. Your fee does not change with how long treatment takes. It includes elastics and every appliance your case needs.
There is no monthly fee for remote monitoring through Weave.
Insurance & Financing
Fredal Orthodontics is in network with Delta Dental PPO. For its other accepted PPO plans, the team files your claims on your behalf as a courtesy. The team takes your insurance card when you book, and you get your benefits verification in writing. You can also use HSA or FSA funds.
In-house financing has 0% interest and no credit check, with plans of up to 30 months. The lowest monthly payment the practice advertises is $179. The down payment is $750 for comprehensive braces or Invisalign, or $500 for Phase 1.
Cherry and CareCredit financing are offered too. The lowest Cherry down payment the practice advertises is $189.99.
Paying in full takes 5% off by cash, check or ACH (a bank transfer), or 3% by credit card, on your out-of-pocket portion. It can be combined with an eligible community discount.
Frequently Asked Questions About Teeth Gaps
Which does Dr. Fredal recommend for a gap, braces or Invisalign?
Both are offered, and the evaluation decides. Invisalign is the treatment of choice for many patients at Fredal Orthodontics. When the gaps are large, Dr. Fredal usually plans braces instead, and he does not use aligners for excessive spacing. The choice follows the bite, the tooth movements needed and the long-term goal. A plan can also start in braces and finish in Invisalign.
What does Dr. Fredal look at when you have a gap?
Dr. Fredal evaluates the tissue, the gap history, and the bone position on CBCT. The CBCT is a 3D X-ray scan, and every new patient gets one free at the consultation. He then reviews your complete records with you and gives you his treatment recommendation.
What retainers come after treatment?
Comprehensive treatment includes one set of clear Essix retainers. Dr. Fredal’s protocol is full-time wear for 1 to 3 months, then nightly for life. Removable retainers are his preference. He may add a bonded wire for teeth more likely to shift back, particularly after treatment that began with gaps between many teeth, with a removable retainer over it.
Can adults have gaps between their teeth treated?
Yes. Fredal Orthodontics treats children, teens and adults. In adults, Dr. Fredal looks at more than how the teeth line up. He checks how the jaws relate, the gum and bone support, root position and the airway. Orthodontic retreatment, a new round of treatment after earlier braces or aligners, is one of the adult cases he routinely treats.
What if I also need an implant, veneers or crowns?
When you are getting ready for implants, veneers or crowns, Dr. Fredal works closely with your general dentist and other specialists when needed to coordinate treatment. Orthodontic preparation for restorative dentistry is one of the complex adult cases Fredal Orthodontics routinely treats. Restorative dentistry is care that repairs or replaces teeth.
Is Fredal Orthodontics near me in Shelby Township?
Fredal Orthodontics is located in Shelby Township and serves families in Washington Township, Romeo, Rochester, Rochester Hills, Troy and the surrounding communities. The office is at 7827 25 Mile Road, at the northwest corner of 25 Mile Road and Van Dyke Avenue. Park in any available space in the lot next to the building. The entrance is on the southwest side.
Related Conditions
Ready to Close the Gap?
Book a free new-patient consultation with Dr. Fredal in Shelby Township. If you qualify, you can get one community discount of $250 off your share after insurance. Military, teachers and first responders qualify. So do healthcare workers, students and additional family members in treatment. You need ID proof to claim it.
*For new patients only. Patients transferring from another orthodontist: $250 consultation fee, credited toward treatment if they start here.