For All Ages


Orthodontics For Children

The American Association of Orthodontics recommends visiting the orthodontist around the age of seven or at the first sign of an orthodontic problem. The exact age for children to begin treatment will vary by individual.

Orthodontics For Teens

There is no need to worry, braces are not as terrifying as you may be imagining. Braces today come in more variety than ever. You will be able to choose the style, material, and color that best fit your needs. Braces are much more comfortable and stylish than ever before.

Orthodontics For Adults

Orthodontic treatment is no longer just for teens. In fact, the American Association of Orthodontists states that one in five orthodontic patients is over the age of 21. Many adults are choosing to receive treatment because they understand the importance of maintaining their health, and they want to feel better about their appearance. Adults everywhere are taking advantage of the opportunity to receive orthodontic care, and now you can too.

For All Ages

Orthodontics For Children

The American Association of Orthodontics recommends visiting the orthodontist around the age of seven or at the first sign of an orthodontic problem. The exact age for children to begin treatment will vary by individual.

By age seven, most children will have mixed dentition, meaning they still have some baby teeth while the adult teeth have also begun erupting. The mixed dentition will make it possible for Dr. Garfinkle to diagnose and correct tooth and jaw problems more quickly and with less invasive treatments, most likely avoiding surgery. This is referred to as early treatment.

Early treatment will allow Dr. Garfinkle to:
  • Correct and guide the growth of your child’s jaw to help the permanent teeth come in straight
  • Regulate the width of the upper and lower arches
  • Create more space for crowded teeth
  • Avoid the need for permanent tooth extractions later in life
  • Correct thumb sucking and help improve minor speech problems

For parents, it may not be an easy task to determine if their child needs orthodontic treatment which is why an orthodontic screening is recommended around the age of seven.

Below are some of the signs that your child may need orthodontic treatment:
  • Early or late loss of baby teeth
  • A hard time chewing or biting food
  • Mouth breathing
  • Finger or thumb sucking
  • Crowded, misplaced, or blocked teeth
  • Jaws that pop or make sounds when opening and closing
  • Teeth that come together abnormally, or do not come together at all
  • Jaws and teeth that are not proportionate to the rest of the face
  • Crowded front teeth around age seven or eight
If your child is seven or older and has not had an orthodontic screening or is showing some of the warning signs, call our Portland office today. Beginning treatment when needed will give your child a healthy and beautiful smile that will last a lifetime.

Orthodontics For Teens

Here is everything you want to know about orthodontics, braces, retainers, aligners, and more!

So you found out you will need braces, what now?

There is no need to worry, braces are not as terrifying as you may be imagining. Braces today come in more variety than ever. You will be able to choose the style, material, and color that best fit your needs. Braces are much more comfortable and stylish than ever before.

How long will I have to wear braces?

There is no set answer for this because the time your treatment will take will depend on three factors:

  • If you had early treatment — Early treatment typically shortens the second phase of treatment because it allows the orthodontist to monitor the growth of the jaw and to implement orthodontic treatment when it becomes needed. Not everyone is treated as a child and in some cases, it can even be recommended for a patient to delay treatment until the mouth is more developed.
  • What needs correction — Your diagnosis and cosmetic goals will determine what needs to be corrected and how long it will take to make those corrections. Every patient also reacts differently to treatments, the same treatment may take one patient 12 months while it may take another patient 18 months.
  • YOU! — Your commitment to your treatment and using the appliances as prescribed will play an important role in how long it takes you to complete your treatment. Take care of your braces and appliances as directed by Dr. Garfinkle and your treatment will be done sooner.

Our practice offers a variety of braces, types, and styles, to choose from. Some common options include:
  • Ceramic braces
  • Invisible braces
  • Lingual braces
  • Traditional metal braces
For many teenagers, braces are a big part of life. In the past, braces earned a bad reputation but the truth is that today’s braces will make you look and feel great! Contact our Portland, Oregon office today to schedule your next appointment.

Orthodontics For Adults

Orthodontic treatment is no longer just for teens. In fact, the American Association of Orthodontists states that one in five orthodontic patients is over the age of 21. Many adults are choosing to receive treatment because they understand the importance of maintaining their health, and they want to feel better about their appearance.

Adults everywhere are taking advantage of the opportunity to receive orthodontic care, and now you can too. Orthodontic treatment is not limited to teenagers and children. According to the American Association of Orthodontists, 20% of all orthodontic patients are older than 21. Most adults who choose to receive orthodontic treatment, do so to maintain their health and to improve their appearance. Adults everywhere are taking the opportunity to undergo orthodontic care, and if you are in the Portland, Oregon area, you can take advantage of doing so at our office!

Common reasons why adults consider orthodontic treatment:

  • A bad bite or malocclusion, causing teeth to fit together incorrectly
  • Teeth are crowded or spaced apart, possibly causing tooth decay or gum disease
  • Abnormal jaw pain, or pressure that is caused by crooked teeth
  • Desire for a healthier mouth and a more confident smile
  • Treatment options for adults

Many adults cringe at the idea of having metal braces enough to avoid treatment. However, there’s no need to worry, today’s orthodontic treatment options include a wider variety of braces and other appliances that are comfortable, visually pleasing, and can be customized to ensure your needs are met.

Types of braces include:

  • Clear braces
  • Ceramic braces
  • Self-ligating braces
  • Lingual (behind the tooth) braces
  • Invisible braces
  • Traditional metal braces

Main differences between treating adults versus children and teens:

The main difference that Dr. Garfinkle considers when treating adults is that younger patients still have developing jawbones. In adults, these bones have finished growing which likely means that orthognathic surgery may be required if the jawbones need to be aligned.

Other differences to consider include:

  • Periodontal disease (gum or bone loss) — It is more probable that adults suffer from gum recession or bone loss caused by gingivitis or advanced periodontal disease than children. Patients with straight teeth are much less probable to develop gum disease because straighter teeth are easier to keep clean.
  • Worn or missing teeth — Adults have had their teeth longer than children and teens and with time teeth are worn down and may shift into different positions, these conditions can only be corrected with orthodontic care. Adults are also more likely to be missing teeth which can then cause the remaining teeth to shift or tilt therefore creating a bad bite as well as raising the possibility of gum disease.
  • Incomplete orthodontic treatment as a teen — Some adults may have begun orthodontic treatment as a child or teen but failed to complete their treatment. As adults, they decide to finish their orthodontic treatment as a means to realize the healthy, show-stopping, and functional smile they have always wanted.

  • At Orthodontists Portland in Portland, Oregon, we understand that adults and children have different needs and therefore require different strategies in their care. We will be sure to discuss your needs and wants and make sure that we provide the most fitting treatments in a respectful and understanding manner from us.

    Why should you consider orthodontic treatment?

    • Straight teeth are happy and healthy teeth — It simple, straight teeth can be kept clean with little effort if they are brushed and flossed. Keeping your teeth clean will help prevent other health problems.
    • A pearly beautiful smile builds confidence — Achieving the smile that you have always wanted through orthodontic treatment will help improve your self-confidence and allow you to live your best life!
    • Untreated problems can worsen — Failing to seek orthodontic treatment when it becomes necessary can lead to more serious costly long-term health issues.

    To get more information regarding the benefits of receiving orthodontic treatment as an adult, please call Garfinkle Orthodontics in Portland, Oregon to schedule an appointment. We will be sure to look for the most convenient time to schedule your appointment.

Life With Braces

Now that your braces are placed, you are ready to continue living your best life with a few minor adjustments. Below you will find out more about the changes that are needed in your routine to make the best of your orthodontic treatment.

Life With Braces

Eating With Braces

To get the best results from your orthodontic treatment, you will have to safeguard your brand new braces. One of the most challenging adjustments will be modifying your diet to accommodate your braces. If you eat foods that you shouldn’t, you can damage your appliance and likely delay your treatment.

Below you will find a list to of foods that should be avoided to guarantee the best results:

  • Chewy foods — bagels, licorice
  • Crunchy foods — popcorn, chips, ice
  • Sticky foods — caramel candies, chewing gum
  • Hard foods — nuts, hard candies
  • Foods that require biting into — corn on the cob, apples, carrots (consider cutting into smaller pieces)

Okay, so now that you know what foods to avoid, let’s look at the foods you CAN eat while wearing braces:

  • Dairy — soft cheese, pudding, milk-based drinks
  • Breads — soft tortillas, pancakes, muffins without nuts
  • Grains — well-cooked pasta, soft cooked rice
  • Meats/poultry — soft cooked chicken, meatballs, lunch meats
  • Seafood — tuna, salmon, crab cakes
  • Vegetables — mashed potatoes, steamed spinach, beans, well-cooked vegetables
  • Fruits — applesauce, bananas, fruit juice
  • Treats — ice cream without nuts, milkshakes, Jell-O, soft cake

Soreness Caused By Braces

‘Are my braces going to hurt?’

Almost every patient asks us if their braces will hurt before beginning treatment. To be honest, most patients do experience some level of soreness but do not hurt per se. Most of our patients can return to work or school immediately after their braces are placed.

The first few days with your braces will the most difficult. Your teeth will likely feel sensitive when biting and your lips and cheeks may be getting used to the presence of your braces. We recommend eating soft foods and possibly taking an over-the-counter pain reliever to deal with sensitive teeth. You can also use a simple saltwater rinse to alleviate the soreness and irritation. If there is a particular offending part of your appliance, you can place dental wax over it.

Loosening Teeth

It may seem troubling to our Portland patients to have their teeth loosen during treatment. Be assured that this is completely normal and it is actually a necessary part of treatment. It may feel like your teeth are going to fall out, but don’t worry, they won’t, your teeth will only slowly shift to their ideal position. Once your treatment is completed, you will be prescribed a retainer to keep your teeth in their final spots while the surrounding bone settles.

Loose Wires And Bands

For most patients, a loose appliance will be a part of their treatment. Don’t worry, just contact our Portland office as soon as possible and we will advise you on what to do to stay as comfortable as possible until your next appointment is scheduled.

If you feel a loose wire begins to poke, gently push it back into place by using the eraser end of a pencil. If this does not work, cover it with dental wax to keep it from irritating you. If neither of these two things works, sterilize a pair of small nail clippers and try clipping it.

Always Following The Treatment Plan

To achieve the most accurate and efficient results, follow Dr. Garfinkle’s prescription to detail. If you fail to follow your treatment plan, your results and treatment time will suffer. Be sure to mention to Dr. Garfinkle if you play any sports so that Dr. Garfinkle can include the necessary steps in your treatment plan.

Our goal is to provide the best braces experience in Portland, reach out to our office if you have any questions.

Brushing and Flossing


Brushing Your Teeth With Braces

While you are undergoing orthodontic treatment with braces, you must keep your teeth and gums beaming with health by brushing after every meal and flossing at least once a day. If you need any assistance selecting the correct toothbrush, toothpaste, or dental floss, ask Dr. Garfinkle or any of our staff members and we will assist you to select the best products for you.

Brushing Your Teeth With Braces


Brushing: Step 1

Place your toothbrush at a 45-degree angle to your gum.

brushing 1

Brushing: Step 2

Brush gently in a circular motion.

brushing 2

Brushing: Step 3

Brush the outer, inner, and chewing surfaces of each tooth.

brushing 3

Brushing: Step 4

Use the tip of your brush for the inner surface of your front teeth.

brushing 4


Flossing: Step 1

Using a piece of floss about 18 inches long, carefully thread the end between braces and wire. You may find a floss threader helpful.

flossing 1

Flossing: Step 2

Carefully floss around the braces.

flossing 2

Flossing: Step 3

Carefully floss around the gum areas.

flossing 3

Flossing: Step 4

Carefully floss around each tooth.

flossing 4

Palatal Expander

The palatal expander serves to expand or widen your upper jaw by placing gentle yet effective pressure on your upper molars each time an adjustment is made. The animation below will show you what the best time is to adjust your expander and how to do it. Once the desired expansion is reached, you will continue to wear the appliance for a few months to set the expansion and prevent your jaw from reverting.

Palatal Expander

Adjusting The Palatal Expander

You can also download these instructions in a printable PDF document and remember that you can download Acrobat Reader for free to open PDF documents.
Palatal Expander Instructions

Carriere® Distalizer™ Appliance


Creating A Corrected Bite Without Headgear

The Carriere Distalizer is an orthodontic device developed to correct a bite without removing permanent teeth when teeth have erupted incorrectly. With an effect similar to headgear, but without the use of a bulky appliance, the Carriere Distalizer pushes upper teeth back to create a corrected bite prior to the addition of braces. How does the Carriere Distalizer work?

Carriere® Distalizer™ Appliance

  • First, your orthodontist will create an anchor point, most commonly with a lower Essex Appliance, a passive lingual arch, full mandibular fixed appliance, or mini-screws. A Carriere Distalizer arm is then attached to the upper teeth on both sides of your mouth.
  • An elastic band is attached from the upper bar to the lower back molars and should be worn at all times except when eating.
  • With good elastic wear, your bite can be corrected in a matter of months, depending on the severity of your case.
  • When the Carriere Distalizer arms are removed, we will place upper braces to finish correcting your bite and aligning your teeth to the perfectly straight, ideal smile you’ve always wanted.



Perfect Your Smile Faster!

So you want to improve your smile but you can’t fathom the thought of spending years in braces? OrthoPulse is perfect for you because it speeds up your tooth movement. Actual results will vary but some patients have reported their treatment time reduced by up to 80%! This appliance is fast, safe, and very easy to use.

It’s lightning fast!

OrthoPulse is an appliance that very light, pleasant, and can be used hands-free. We recommend using the appliance for 10 minutes per day as an addition to your orthodontic treatment. This appliance uses low-intensity light that is near infra-red level to accelerate tooth movement and reduce treatment times.

It’s Gentle.

The light emitted by the OrthoPulse is a wavelength that is naturally found in sunlight and encourages the cells in your mouth to heal and regenerate. This process helps to reduce swelling and discomfort while reducing treatment time.

It’s Safe and Effective.

OrthoPulse is proud to be the only device of its kind cleared by the FDA for use with both braces and aligners. This device has been proven to be completely safe with no adverse side effects.

OrthoPulse® FAQs

The innovative OrthoPulse technology cuts down your treatment time while increasing the comfort level of your treatment. To learn more about this device and what it can do for you, contact our Portland office!

OrthoPulse® FAQs

How does OrthoPulse work?

You simply have to fit the mouthpiece around your orthodontic appliance and use the device for ten minutes each day. OrthoPulse uses near-infrared light to accelerate your tooth movement. The light serves to stimulate tooth movement and cell regeneration which serves to shorten your orthodontic treatment while making your entire orthodontic experience more enjoyable.

Is OrthoPulse safe to use?

Absolutely! The FDA has cleared the OrthoPulse to use with braces and aligners and deemed it safe with no side effects.

How much time will OrthoPulse reduce my treatment?

The results will vary depending on the individual case but patients have reported up to 80% reduction in total treatment time.

How do I know if I am biting into the mouthpiece correctly and applying the required amount of force?

You should be able to hold the OrthoPulse device without the use of your hands, the amount of force you apply should be just enough to achieve this. If you use too much force, your device may show excessive wear prematurely.

What is the best way to clean the OrthoPulse device?

To clean your device, rinse the mouthpiece with lukewarm water and allow it to air dry. You can also wipe the mouthpiece with a cleansing wipe after each use.

Is there some way that OrthoPulse can “track” my usage?

Of course! OrthoPulse comes with a mobile app that enables you to keep track of your device use.

Can I sanitize my OrthoPulse and share it with a friend or family member who also has braces?

We do not recommend sharing the device. OrthoPulse is designed to be used only by the patient it is prescribed to, failing to follow this recommendation may negatively impact the appliance’s warranty, progress tracking, and battery life.

What do the different status light colors mean?

Green indicates that the device is charged and ready for use. Yellow indicates the device needs additional battery charging to complete a full treatment session. A solid blue light means treatment is currently in process, and a blinking blue light means that the treatment session is done and the time has come to flip the device.

How long does the battery last?

A full battery will last through an entire 10-minute treatment session. When you are not using the device, we recommend keeping it in its charging case.



Craniofacial Orthodontics – Cleft Lip And Palate

What is Craniofacial Orthodontics?

Craniofacial orthodontics is a sub-specialty of orthodontics and focuses on treating patients who were born with a congenital condition like a cleft lip or palate. When treating this type of condition, the orthodontist will work with a team that usually includes speed pathologists, oral surgeons, and craniofacial plastic surgeons. The craniofacial orthodontist’s role within the team consists of evaluating tooth and jaw development and growth. He will then address the non-surgical portion of treating the position of the jaw and perform the pre- and post-operative treatment of jaw surgery by observing the growth via X-rays and models.


What is a Cleft Lip and Palate?

A cleft lip and cleft palate are facial defects where the parts of the face that form the upper lip and mouth fail to seal before birth and remain split apart. These splits can occur in the roof of the mouth or on the palate. Clefting happens when there is a deficient amount of tissue either in the mouth or lip area and the available tissues fail to join together properly. The cause of this condition is unknown in most cases but it always occurs during early fetal development. The condition has been linked to certain genetic characteristics and maternal environmental exposures during pregnancy.

This birth defect can affect people in ways that go beyond looks.

  • Difficulty Eating – The separation or opening in the palate can allow food and liquids to pass from the mouth to the nose where they are expulsed. Patients can use expertly designed prosthetics as a temporary solution for keeping fluids flowing towards the stomach and allowing the patient to receive adequate nutrition. Surgery is usually a permanent solution.
  • Speech Difficulties – Due to the improper formation of the upper lip and palate, children may find it difficult to speak clearly and may produce a nasal sound. A speech pathologist can help to make the speech more understandable.
  • Ear Infections – A cleft lip and palate promote the buildup of fluid in the middle ear which increases the risk of ear infections. If the buildup of fluid is not treated properly, the patient may even become deaf. Small tubes can be placed in the eardrums to promote fluid drainage.
  • Dental Problems – Cleft lip and palate are associated with missing, malformed, and displaced teeth which contribute to an elevated amount of cavities and other dental and orthodontic problems in the children who suffer from these conditions.


Most cleft lip and palate cases are treated with surgery which is the part where the craniofacial orthodontist and the rest of the specialists make their entrance. In more severe cases, more than one surgery may be required. Surgery is typically recommended in children between the ages of three and six months of age to achieve the best results.

Surgical Orthodontics

Orthognathic surgery or surgical orthodontics is an orthodontic treatment that corrects a variety of severe cases ranging from bad bites to jaw bone abnormalities to malocclusion. Oral and maxillofacial surgery is recognized as one of the nine recognized dental specialties. This specialty treats complex craniofacial cases that have to do with either the mouth, jaw, face and/or skull. If your treatment plan includes surgical orthodontics, Dr. Garfinkle will coordinate with a maxillofacial surgeon to guarantee that you receive the highest quality of care possible.

Surgical Orthodontics

When are you most likely to need surgical orthodontics?

Jaw surgery is used to treat adults who suffer from improper bites and other aesthetic concerns involving the jaw. To be a candidate for orthognathic surgery, your jaw must be done growing, this process is usually completed by age 16 in female patients and 18 in male patients. Surgical orthodontics is typically required when the jaws do not line up correctly and orthodontic treatment alone will not correct the problem. Orthognathic surgery will achieve the proper alignment of the jaw and braces will then complete the process of a gorgeous smile by aligning the teeth.

How Do I Know If I Need Orthognathic Surgery?

Your orthodontist can tell you if orthognathic surgery is needed as part of your treatment. Depending on the severity of your case and the alignment of your jaw, you may or may not need surgery.

How Does Orthognathic Surgery Work?

An oral and maxillofacial surgeon will perform your orthognathic surgery, and the surgery will take place in a hospital. Orthognathic surgery can take several hours depending on each individual case. Once the surgery is complete, you will have about a two-week rest period. Since orthognathic surgery is a major treatment, we recommend that you schedule sometime away from work and school during the healing process. After your jaw has healed, your orthodontist will once again “fine-tune” your bite. After surgery, you will have to wear braces, and most braces are removed within six to 12 months following surgery. After your braces are removed, you will wear a retainer to help maintain your new smile.

What Are The Risks Associated With Orthognathic Surgery?

Orthognathic surgery is considered a tried and proven procedure since it has been performed over and over again for many years in practices and hospitals all over the world. However, as with any major medical surgical procedure, there are risks involved. If you are nervous about an upcoming procedure, please contact our Oregon practice and allow us to answer any questions you may have. Your comfort and confidence are important to us.

What Rewards Can I Expect From Having Orthognathic Surgery?

Typically, patients find that the biggest reward to be obtained is finally obtaining the smile they’ve always dreamed of. However, orthognathic surgery will also correct the function of your smile to allow you to chew and speak correctly as well as restore your confidence for the rest of your life.

Corrective Jaw Surgery

Corrective jaw surgery has the goal of achieving a more balanced, functional, and healthy teeth and jaw position. This surgery can improve your bite and function, appearance, and even speech dramatically. We want to improve your quality of like as a whole and will work with you to help you achieve a life where you have lots to smile about.

Corrective Jaw Surgery

Who Needs Corrective Jaw Surgery?

Ideal candidates for corrective jaw surgery include patients who have upper and lower jaws that grew at different rates and patients who suffer from injuries or birth defects that negatively affect jaw alignment. Orthodontics can be enough to correct problems of misaligned teeth but corrective surgery may be necessary when the jaws are misaligned. If you suffer from the conditions below, schedule an appoint to discuss corrective jaw surgery:
  • Difficulty chewing, biting food, or swallowing
  • Chronic jaw or jaw joint (TMJ) pain and headache
  • Excessive wear of the teeth
  • Open bite (space between the upper and lower teeth when the mouth is closed)
  • Unbalanced facial appearance from the front or side
  • Facial injury or birth defects
  • Receding chin
  • Protruding jaw
  • Inability to make the lips meet without straining
  • Chronic mouth breathing and dry mouth
  • Sleep apnea (breathing problems when sleeping, including snoring)

Choosing to receive treatment to correct the conditions above is a step toward a healthier and happier life. Treatment plans that involve surgery in addition to orthodontic treatment often take years to complete but the results will be with you for the rest of your life. We do not believe that anyone should have to live with painful or uncomfortable conditions. Contact our Portland office as soon as possible to learn about the treatment options we have available for you.

Dentofacial Orthopedics

Dr. Garfinkle specializes in Orthodontics and Dentofacial Orthopedics. Most people are familiar with the orthodontics part but not the dentofacial orthopedics part of the title.

Every orthodontist begins their journey in dental school. Once dental school is completed, some doctors start practicing right away as family dentists. Other doctors choose to become specialized dentists by enrolling in a residency program that will last between two and three years. The American Dental Association sanctions nine specialties. Some of the specialties are relatively well-known including Pediatric Dentistry (dentistry for children), Periodontics (dentistry specializing in gums), and Oral Surgery.

Dentofacial Orthopedics

“Orthodontics and Dentofacial Orthopedics” is one of the nine specialties. Orthodontics involves the management of tooth movement while dentofacial orthopedics deals with the guidance of facial growth and development, this phase occur largely during childhood. Specialists of orthodontics and dentofacial orthopedics use appliances to treat patients including the commonly known braces in addition to other specialized appliances like headgear and expanders depending on what facial abnormalities are present. For some patients, orthopedic treatment is implemented before conventional braces. However, orthopedic and orthodontic appliances can be used at the same time. So if your child is prescribed braces and headgear, he’s undergoing orthodontics and dentofacial orthopedics simultaneously.

Dr. Garfinkle is skilled in both areas and can diagnose teeth misalignment, jaw misalignment, and unbalances in the facial structure. He can also design and implement a treatment plan that integrates orthodontic and dentofacial orthopedic treatments.

Sleep Apnea

Do you experience unexplained drowsiness during the day? Do you snore loudly and sometimes even wake up gasping for air at night? If so, you may be among the twelve million Americans who suffer from sleep apnea.

What Is Sleep Apnea?

Sleep apnea is a condition where your breathing stops periodically while you sleep, it may happen up to twenty or even thirty times per hour. Every time you fail to breathe while you sleep, your brain is alerted by the lack of oxygen and you temporarily wake up to restart your breathing. The time you spend awake to restart your. breathing is so short that most people don’t remember it and believe they are getting a good night’s sleep despite that not being the case. The constant loops of wake-sleep, wake-sleep keep individuals suffering from sleep apnea from being able to reach a deep sleep status and causes them to constantly feel drowsy during the day.

Sleep Apnea

What Are The Signs Of Sleep Apnea?

The following symptoms may be caused by the presence of sleep apnea. If you notice one or more of these, contact our Portland practice to schedule an appointment today.

  • Insomnia or difficulty sleeping
  • Loud snoring at night
  • Waking up at night short of breath
  • Snorting or choking sounds during the night (indicating a restart of breathing)
  • Headaches upon waking in the morning
  • Falling asleep unintentionally during the day
  • Extreme drowsiness throughout the day

Are There Different Types Of Sleep Apnea?

There are three different types of sleep apnea. The most common type of sleep apnea is OSA (Obstructive Sleep Apnea), this condition is caused by a physical blockage. The physical blockage is usually explained by a collapse of the soft tissue in the back of the throat. CSA (Central Sleep Apnea) is a lesser-known form of sleep apnea which involves a lack of proper signal transmission from the brain to the muscles responsible for breathing. Some people also suffer from “mixed” or “complex” sleep apnea which is a condition that presents itself when CSA and OSA are combined in a single patient.

What Are Risk Factors For Sleep Apnea?

Men and adults over the age of 40 are more likely to suffer from OSA. However, anyone can suffer from sleep apnea regardless of their age or gender. Other factors that make OSA more likely include obesity, smoking, drinking, use of sedatives or tranquilizers, and family history. Central sleep apnea strikes most often in people with heart disorders, neuromuscular disorders, strokes, or brain tumors.

Is Sleep Apnea Dangerous?

Yes, sleep apnea is a serious medical condition and if is left untreated it can cause the development of other health problems including high blood pressure as well as heart failure and stroke. The constant fatigue caused by sleep apnea can also lead to a subpar performance at work or school and even put the patient in danger while operating a car or other heavy machinery. Sleep apnea can also cause adverse reactions to medication or during surgery because sedation by anesthesia becomes riskier and lying flat in bed after an operation can also be dangerous. If you think you or someone you know shows the symptoms of sleep apnea, let your doctor know before taking prescribed medication or undergoing surgery and contact our practice as soon as possible to learn more about sleep apnea and your treatment options.

How Is Sleep Apnea Treated?

There are many ways to treat sleep apnea and the appropriate treatment option will depend on each case and its characteristics including severity. For example, treatment can be behavioral such as instructing the patient to maintain a healthy diet to lose weight, stop smoking, or sleep on their sides as opposed to their backs. For more medium severity cases, oral devices are a good option to maintain the airway open and prevent throat blockage. In more severe cases, surgery may be recommended.

What Should I Do If I Suspect That Someone In My Family Suffers From Sleep Apnea?

Contact our Portland, Oregon office and we will refer you to a sleep apnea specialist. The specialist will likely ask you to undergo a sleep study to diagnose the problem and determine the extent of it. The sleep apnea specialist will then recommend a treatment plan which may include a custom oral device which is where our office comes in.

Emergency Care

Fortunately, true orthodontic emergencies are a rare occurrence. However, if they do happen, we are here for you. We recommend that you call our office immediately if you feel severe pain or have a painful appliance problem that you are unable to handle yourself. We will evaluate the situation and schedule an appointment to see you as soon as possible and resolve the situation.

Emergency Care

You can temporarily solve most orthodontic appliance issues on your own until you can get seen by Dr. Garfinkle. If there is a loose piece of appliance that can be removed, remove it and save it in a plastic bag or envelope to bring to your next appointment. If your braces are poking the inside of your mouth, place some orthodontic wax on the offending piece. If the wire has moved to one side, take a pair of small needle-nosed pliers and pull it back to the other side.

Once you have resolved the emergency by addressing the discomfort, we still urge you to call our office as soon as possible to have your appliance repaired. If you allow your appliance to remain broken or damaged for a long period, this will lead to delays in your treatment plan.

General Soreness

When you get your braces placed, you will likely experience general soreness in your mouth and your teeth may be sensitive to biting pressures for a few days. We recommend sticking to a soft diet while your teeth feel tender to chewing. Soreness and irritation can also be alleviated by using a salt-water rinse. Dissolve one teaspoon of salt in eight ounces of warm water and use the solution to rinse your mouth. Alternatively, you can also use the Healthy Gums Rinse by The Natural Dentist to achieve the same results. You can also place Orabase on the affected area. Orabase can be found over the counter at any pharmacy. If the discomfort is severe, take Acetaminophen (Tylenol) or a similar pain reliever. Make sure to avoid Aspirin, Aspirin, Ibuprofen (Motrin, Advil), and Naproxen Sodium (Naprosyn, Anaprox) because these medications slow tooth movement and should not be used while undergoing orthodontic treatment.

As your lips, cheeks, and tongue learn to live with the new surface of the braces, they may feel irritated for the first week or two. We recommend using wax on the surface of your braces to alleviate the irritation. Ask us to show you how to use the orthodontic wax.

Damon® Clear™


The Clearest Way To See Astonishing Results!

Damon Clear is part of the Damon Smile family which is an innovative tie-less bracket system that uses technologically advanced archwires to move your teeth faster and with increased comfort without compromising results. Damon Clear can combine the best of two worlds: traditional clear braces and technological advancement to achieve a discreet treatment experience with unbelievable results.

Damon® Clear™

Braces Do Not Have To Be Inconvenient, Uncomfortable, Or Involve a Mouth full of Metal.


By going with Damon Clear, most people won’t even be able to tell you’re wearing braces. Damon Clear braces are subtle and resistant to stains and discoloration.

Treatment time

With Damon Clear, you will see results faster than you ever thought possible. Treatment times will vary from case to case but the Damon Smile treatment has been proven to be up to six months faster than traditional braces. Damon Smile also requires fewer office visits to our Portland office than traditional braces. That means more time to spend on the activities that you love.


Damon Clear brackets are tie-less which means that they won’t require tightening and will be gentle to your teeth and gums. Other braces use elastics that keep the archwires in place and place unnecessary pressure and discomfort on the mouth and teeth.

The Difference Is Clear!

Damon Clear uses an innovative slide mechanism that keeps the archwires within the bracket. This allows the archwires to move freely while reducing friction and binding and allowing your teeth to move faster and with increased comfort.

Damon® Smile

Our office is excited to offer our patients the latest in passive self-ligating braces. Damon Smile braces use a slide mechanism to ensure that the archwire stays in place. With this system, the amount of pressure exerted on the teeth is minimized and the teeth can move with increased freedom, speed, and comfort. Reaching your goal of a beautiful and perfectly straight smile can be done quicker and easier than you ever considered plausible!

Damon® Smile

Braces Are The Beginning, But The System Makes The Smile!

Damon Smile is a whole new way to treat patients that goes beyond revolutionary orthodontic appliances!


Damon braces do not require any metal or elastic ties which means that there are fewer adjustments and you will be able to avoid the tightening sensation.


Damon Smile works quickly but the force it uses is gentle and uses little friction which means the whole experience will be a comfortable one.


Damon braces have been designed to be convenient in every aspect. They are discreet, comfortable, and very easy to keep clean. Since there are no elastic ties, there will be less plaque collected and dental hygiene will be a breeze during treatment. Damon Smile is available in a clear bracket version to meet the needs of patients who may not want the look of metal braces.

Treatment Time

The final treatment time will vary from case to case but Damon Smile typically offers a reduced timeline when compared to conventional braces. Also, fewer adjustment appointments will be necessary during treatment which will also contribute to a hassle-free experience.

Orthodontic FAQs


What Is Orthodontics?

Orthodontics or dentofacial orthopedics is a specialty within dentistry that focuses on the diagnosis, prevention, and treatment of dental and facial irregularities.

What Is An Orthodontist?

An orthodontist is a specialized dentist who has gone through an additional 2-3 years of education and practice to be able to practice orthodontics. An orthodontist has specialized knowledge and experience that allows him to straighten teeth, correct a misaligned jaw structure, and improve the overall function of your bite.

What’s The Best Age To Visit The Orthodontist?

There is no better time to visit an orthodontist than now. At Garfinkle Orthodontics in Portland, Oregon, we address the unique needs of our patients of any age. The American Association of Orthodontists recommends that children visit an orthodontist for the first time around the age of 7 or at the first sign of an orthodontic problem. There is a misconception that orthodontic treatment is limited to children and teens, but this is not true, adults are also eligible for treatment. In fact, 20% of all orthodontic patients are over the age of 21. Regardless of age, if you or your child needs to improve and look, feel, and function of their smile, schedule an appointment with our office today.

Frequently Asked Questions About Orthodontics

What Is Orthodontics?

Orthodontics or dentofacial orthopedics is a specialty within dentistry that focuses on the diagnosis, prevention, and treatment of dental and facial irregularities.

What Is An Orthodontist?

An orthodontist is a specialized dentist who has gone through an additional 2-3 years of education and practice to be able to practice orthodontics. An orthodontist has specialized knowledge and experience that allows him to straighten teeth, correct a misaligned jaw structure, and improve the overall function of your bite.

What’s The Best Age To Visit The Orthodontist?

There is no better time to visit an orthodontist than now. At Garfinkle Orthodontics in Portland, Oregon, we address the unique needs of our patients of any age. The American Association of Orthodontists recommends that children visit an orthodontist for the first time around the age of 7 or at the first sign of an orthodontic problem. There is a misconception that orthodontic treatment is limited to children and teens, but this is not true, adults are also eligible for treatment. In fact, 20% of all orthodontic patients are over the age of 21. Regardless of age, if you or your child needs to improve and look, feel, and function of their smile, schedule an appointment with our office today.

How Can I Take Care Of My Teeth If I’m Wearing Braces Or A Retainer?

  • First, let’s start with the basics, you must brush your teeth after every meal and remember to floss at least once a day.
  • Be sure to select a toothpaste enriched with fluoride, and as Dr. Garfinkle if he recommends using a fluoride rinse. Brushing and rinsing regularly with fluoride products will help prevent cavities.
  • If you have a retainer, make sure you take it out when you eat or brush and floss your teeth. To avoid your retainer getting lost or broken, be sure to keep it safe in its container. In addition to keeping your teeth clean, you also have to keep your retainer clean.
  • Keeping your retainer clean is easy, just brush it softly with a toothbrush and toothpaste. Alternatively, you can also soak your retainer in denture cleaner, ask Dr. Garfinkle for instructions.
  • Be aware that you cannot put your retainer in boiling water or in the dishwasher as heat will deform it.
  • Sugar increases the number of bacteria that grows in your mouth, bacteria can then lead to more plaque and possibly cavities. We recommend avoiding sugar-heavy foods during your treatment. It is also important to protect your appliance and avoid sticky and chewy foods such as caramel, chewing gum, and gummy bears, hard foods such as hard candy, nuts, and ice cubes, and any foods that are likely to get stuck in your braces like corn on the cob, soft bagels, ribs, and taffy to name a few.
  • Remember that an important part of taking care of your teeth while undergoing treatment is to continue with your check-ups and cleanings with your regular dentist every six months.

What Are Braces?

Braces are an appliance that is used by Dr. Garfinkle to improve the look, feel, and function of your smile.
Today, there is a wide variety of braces to choose from, including:

  • Clear braces
  • Ceramic braces
  • Lingual braces
  • Self-ligating braces
  • Invisible braces
  • Traditional metal braces

If I Get Braces, How Long Do I Have To Wear Them?

The total time you spend in braces will depend on a variety of factors that are unique to you including how your body responds, your treatment plan, and the amount of correction that is needed. Treatment times typically range from six to thirty months, with most treatments averaging twenty-two months.

Do Braces Hurt?

Braces do not hurt per se but you may experience a certain level of discomfort for a few days following the placement or adjustment of your braces. This is normal and will only last while your teeth, gums, cheeks, and mouth grow accustomed to your new appliances. You can alleviate the discomfort with salt-water rinses and an over the counter pain reliever.

Do I Need To Brush My Teeth More Often If I Have Braces?

You must keep your teeth, gums, and mouth as healthy and clean as possible while you are undergoing orthodontic treatment. To achieve this, you should brush your teeth, gums, and mouth after every meal or at least three times a day. By brushing your teeth regularly, you will be able to remove any food that may become trapped between your braces. It is also important that you floss daily to get to any food that is caught between your braces where the brush doesn’t reach. Ask Dr. Garfinkle to show you how to properly brush and floss once your braces are placed.

If I Have Braces, Do I Still Need Dental Checkups Every Six Months?

Affirmative! Visiting the dentist regularly becomes even more important while receiving orthodontic treatment because, with braces, food is more likely to get caught in places where your toothbrush does not reach. The caught food causes bacteria to accumulate and can eventually cause cavities, gingivitis, and gum disease to develop. Your dentist and Dr. Garfinkle will coordinate to ensure that you get the best care possible.

Will My Braces Get In The Way Of Activities Like Sports, Playing An Instrument, Or Singing?

Having braces will not prevent you from taking part in any of your school or social activities. However, you may need to make some adjustments to play an instrument or play a contact sport when you first get your braces placed. We recommend wearing a mouthguard when playing contact sports to protect your mouth and appliance, ask Dr. Garfinkle to recommend one to you.

How Do I Schedule My Next Appointment?

It’s very easy, just call our Portland office! You can also request an appointment through our website. We will do our best to find an appointment that fits seamlessly into your schedule. If it will be your first time visiting us, let us know and we will be sure to give you all of the information that you need.