May 28, 2020 administrator

Dear Parents/Patients

We hope this letter finds you and your family in good health. Our community has been through a lot over  the past few months. We can’t tell you enough how much we appreciate your patience and understanding. Good news, under the Governors guidance we can start seeing our wonderful patients again on Monday, June 1st.

We have been preparing for the day getting our office in order. While many things have changed, one thing has remained the same, our commitment to safety. Our office follows the infection control recommendations of the ADA, CDC, OSHA, and AAO. These agencies keep us up to date on new rulings and guidance that may be issued.

As staff will look different  with additional PPE (Personal Protection Equipment) so will the office. We have added acrylic panels around the front desk and between our operatory chairs. The office is deep cleaned and sanitized routinely.

New changes for your first appointments:

Please have your children brush their teeth at home ( our tooth brushing station is closed).

When you arrive, stay in your car. You may call or text us that you have arrived. Text our regular phone numbers : 248-528-3300 & 586-795-0300.

Staff will approach you at your car with a question survey. If you have your own pen, perfect, if you need a pen we will give you one to keep. We will flag you or your child in when the paperwork is completed. Your child  can bring the clipboard in with them. Please, no parents or siblings with your child. ( We understand very young patients may need to be accompanied in.)

 Your child’s temperature will be taken and recorded as well as their hands sanitized before entering the operatory and seated.

It is very important we have very few people in the lobby area. If you need to talk to the Dr. we will arrange this after he has seen your child.

If you are making a payment, please advise the staff member. If your child can make the next appointment before leaving, please let them, if not, please call us or text us to make that next appointment.

Talking about appointments

After reading this letter we understand that you may want to call us immediately to get in the schedule . It is fine to call the office, we will also be reaching out to you as well. Appointments need to be handled a little differently allowing more time between them. We appreciate your patience regarding scheduling as we need to prioritize your appointments while at the same time implementing new protocols to protect everyone. Please be assured we’ll make time for all of you.

We are getting a lot of questions about treatment and not being seen during shut down. Dr. Palmer wants to emphasize that the new wire and appliance are made to perform much longer than your regular interval of appointment. At times wires may not be advancing but treatment is minimally delayed.

We understand all this information seems overwhelming, but together we will continue to get through this and make beautiful smiles.

Thank you for being our patients,

Dr. Nick Palmer and staff.


March 4, 2020 administrator

Parents no longer take the back seat while their kids reap the benefits of orthodontic treatment. With one-in-three orthodontic patients over the age of 18, the number of adults seeing an orthodontist is at an all-time high.

Experts believe this upward trend is likely here to stay – why?  

It works.

Orthodontic treatment is just as effective for adults as children. Healthy teeth can be moved at any age because it’s the same physiological process.

Depending on the complexity of the case, as well as what the patient wants to achieve, a short-term touch up can take as little as several months while comprehensive treatment can take much longer. Orthodontic specialists will customize your smile according to your preferences, and they don’t require a referral from a dentist.

Treatment doesn’t have to be noticeable to others.

Advances in orthodontics have made treatment more comfortable and less noticeable than ever. Many of today’s treatment options are designed to minimize the appearance of the appliance to better fit any lifestyle.

Options include clear aligners, tooth-colored braces, tiny but more traditional metal braces, and braces that go behind the teeth.

Because not every appliance is suitable for every kind of orthodontic problem, an orthodontic specialist will be able to determine which type is right for the best result.

It’s more than a beautiful smile.

Yes, straight teeth are attractive and create confidence, but there’s more to it.

Leaving misaligned teeth untreated may lead to other dental problems such as tooth decay, gum disease, abnormal wearing of tooth enamel and difficulty chewing. We are living longer than ever before, and healthy teeth are therefore more important than ever.

Adults are taking note and prioritizing their dental health.



February 14, 2020 administrator

Questions to Consider When Researching Direct-To-Consumer Orthodontic Companies (like SmileDirectClub, Candid Co., Smilelove, SnapCorrect, Orthly, Etc.)

Download Questions to Consider Flier

Some online orthodontic companies make their treatment sound so easy. Perhaps you take a selfie and/or an impression of your teeth or get your teeth scanned. Next, you receive aligners in the mail and after so many months – straight teeth! Right? What else is there to think about?

Before you decide to proceed with a direct-to-consumer orthodontic company, the American Association of Orthodontists (AAO) believes there are a number of factors and questions you may want to consider. For example, in some instances direct-to-consumer orthodontic companies do not involve the in-person evaluation and/or in-person supervision of your orthodontic treatment by an orthodontist. An in-person evaluation and in-person supervision throughout treatment can be very important, because there is more to creating a healthy, beautiful smile than moving the visible portions of your teeth.

Orthodontic treatment involves the movement of biological material, which if not done correctly could lead to potentially irreversible and expensive damage such as tooth and gum loss, changed bites, and other issues. For an example of a consumer who claims to have had an issue with his orthodontic treatment, click here to view a news story. 

Consider this question: What other transforming medical treatment would you undergo without an in-person, pre-treatment evaluation or ongoing in-person supervision from a medical professional.

Ask Questions, Get Answers

If you are researching orthodontic treatment (including treatment models from direct-to-consumer companies like SmileDirectClub, Candid Co., Smilelove, SnapCorrect, Orthly), here are a few questions you may want to consider:

  1. As part of your treatment, are comprehensive diagnostic records like x-rays taken before your treatment?
    • YES
      • Does the treatment and fee inclue x-rays of your teeth and jaws?
      • Does the treatment and fee include a clinical examination of your jaw alignment, teeth, bite, and the relationship of your teeth to the skeletal structures?
      • Does the treatment and fee include taking photographs of your face, facial profile, mouth, and teeth?
      • Does the treatment and fee include taking digital scans or other impressions of your teeth?
    • NO – are you comfortable starting orthodontic treatment without comprehensive diagnostic records? If you still want comprehensive diagnostic records taken, are you all right going to another dental professional to take them? If yes, what will that cost?


  2. As part of your treatment fee, do you receive any in-person visits to a dentist’s or orthodontist’s office during your treatment?
    • YES
      • How many?
      • What occurs during these in-person visits?
      • Is there a licensed dentist or orthodontist in the office to supervise the visits?
    • NO – are you comfortable with orthodontic treatment that does not involve any in-person visits with a dentist or orthodontist?


  3. If a dentist or orthodontist is involved with your treatment, do you know the name of the dentist or orthodontist who will be specifically involved with your case (for example, is it available on the company’s website or elsewhere)?
    • YES
      • What are his or her education and credentials?
      • In what state is he or she licensed?
      • In what state does he or she practice?
      • What do other patients being treated by him or her have to say?
    • NO – are you comfortable not being able to research your dentist’s or orthodontist’s background, credentials, patient reviews, etc. before you begin treatment?


  4. Is only one treatment type offered (such as invisible aligners or a certain appliance)?
    • YES – how do you know that is the best treatment option for you, given your unique situation and oral condition, compared to other treatment models (such as braces)?
    • NO – how is the decision being made for the best treatment model for you, and who is making that decision?


  5. How do you know if your teeth and gums are healthy enough for orthodontic treatment?
    • Who is making that decision and how is it being determined?
    • If the decision maker is a dentist or orthodontist not associated with your treatment, who pays for that assessment?


  6. What are the possible risks (financial, health, etc.) associated with your orthodontic treatment?
  7. Who can you speak with at the online orthodontic company about your orthodontic treatment?
    • What is his or her education, background, qualifications and/or experience with orthodontics?


  8. Who is responsible for detecting any issues that may occur during your orthodontic treatment?
    • Is it you?
    • If it is a doctor not associated with your treatment, who pays for those check-ups?


  9. If an issue arises during your treatment, how will it be handled and who will be responsible for handling it?
  10. If a doctor is involved with your orthodontic treatment, how can you contact him or her over the course of your treatment? How can you contact him or her if an emergency arises?
  11. If an emergency arises, does the company have a dentist or orthodontist in your area that you can see in-person? If not, who would cover the costs associated with seeing a dentist or orthodontist in your area?
  12. If you are injured or have another dispute involving your orthodontic treatment, how is it handled (litigation, arbitration, etc.)? State dental boards have their own complaint processes for patients who have had issues with orthodontic treatment. Contact information for your state dental board can be found at https://www.aaoinfo.org/aao/state-dental-board-info.
  13. If you are injured or have a dispute involving your orthodontic treatment, what rights do you have against the person or company involved with your orthodontic treatment?
    • Are you asked to sign any forms that seek to release them from liability?


  14. Does the treatment model comply with the dental laws in your state?


Your Health Care Decisions Are Very Important Personal Decisions.

The AAO is a professional association of orthodontists dedicated to, among other things, “improving the health of the public by promoting quality orthodontic care, the importance of overall oral healthcare, and advocating for the public interest.” Your health and well-being are extremely important.

Remember that orthodontic treatment is not a product or device – orthodontic treatment is a professional, medical service. When your care is personally supervised by an orthodontist who is a member of the American Association of Orthodontists, you are assured that your orthodontist spent years in a post-doctoral residency program focused on providing orthodontic treatment to patients.

Before making any decision about orthodontic treatment, consider doing some research and having an in-person consultation with a member of the American Association of Orthodontists.


January 25, 2019 administrator

We’ve long understood the negative correlation between smoking and oral health, but it turns out vaping can cause similar, irreversible, damage. Damage that may lead to the death of gum tissue, gum disease and, in some cases, loss of teeth – making vaping a significant risk to your oral health.

Does vaping ruin your chances of successful orthodontic treatment?

It’s possible. E-cigarettes don’t contain tobacco like traditional cigarettes, but they do contain nicotine, which is a risk to your mouth.

Literature indicates nicotine reduces blood flow, which can lead to the death of gum tissues and gum recession. It also may cause gum inflammation and swelling, tooth sensitivity, increased risk of cavities and, in some cases, loss of teeth.

In addition to the damages noted above, the combination of the dry mouth, bacteria and tooth decay resulting from nicotine is a formula for gum disease.

So, why does this matter for successful orthodontic treatment?

The key factor in determining a good candidate for orthodontic treatment is the health of teeth and gums. It is imperative to have a periodontal (gum) check-up with either a periodontist or your general dentist to make sure that your mouth is a good candidate prior to beginning treatment.

The acceleration of gum damage caused by vaping reduces the ability of teeth and gums to respond to orthodontic treatment. In other words, your teeth do not move as fast if you are vaping.

There is also an added tendency for teeth to relapse into previous positions post-treatment, due to increased risk of gum disease.

The takeaway:

The harm vaping may cause is completely preventable. If you’re considering orthodontic treatment, you’re considering investing a lot of time and effort in creating a healthy smile. Don’t chance damaging it.

Trust an AAO orthodontist.

You can work with an American Association of Orthodontists (AAO) Orthodontist to achieve a healthy, beautiful smile at any age. Orthodontists are experts in orthodontics and dentofacial orthopedics – properly aligned teeth and jaws – and possess the skills and experience to give you your best smile.

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