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Marie B Farrar DDS MS, orthodontist in Chattanooga, TNAbout Dr. Farrar:

A third generation dentist specializing in orthodontics, Dr. Marie Farrar (pronounced “fairer”) is an LA girl—born and raised in "lower" Alabama.  Following ten years of higher education in Memphis at Rhodes College (BS in psychobiology cum laude) and the University of Tennessee College of Dentistry (DDS with high honors & MS in orthodontics), Dr. Marie officially adopted the volunteer state as her home.  She and her husband, Dr. Mitch Baldree, settled in Chattanooga in 1991.  

Dr. Farrar participates in the Chattanooga Area Dental Study Group, and maintains membership in the Chattanooga Area Dental Society, the Tennessee Dental Association, the American Dental Association, the Tennessee Association of Orthodontists, the Southern Association of Orthodontists, and the American Association of Orthodontists.  She has attained diplomate status in the American Board of Orthodontics, and has been honored by membership in the Pierre Fauchard Society.

The mother of two young adults, Dr. Marie has spent time as a class mom/PTA representative, as a cubmaster for her son’s cub scout troop, and as a Sunday school and confirmation class teacher.  She is quite active in her church, First-Centenary UMC, having served in various ministries and leadership roles, including chair of Church Council.  When she has some time for herself, she enjoys practicing yoga, reading, and digging in the dirt at her family’s in-town hobby farm.

Dr. Marie feels blessed to have spent the first 20 years of her career honing her clinical skills in a large, high volume - yet high quality - practice.  This position gave her the wonderful opportunity to work in her profession part time while her children were young.  She is excited and pleased to now have the opportunity to establish her own intentionally small, low volume practice devoted to individualized patient care.

With her compassion, intellect, quality education, and years of clinical experience, Dr. Marie Farrar brings a woman’s eye and a mother’s touch to the practice of orthodontics.

 

An interview with Dr. Marie Farrar: 

 

How did you decide to become an orthodontist?

Well, you know, my father and my grandfather were dentists, so of course, being a dentist was the last thing in the world I ever considered!  I started college thinking I would be a math major, then go into architecture or perhaps engineering.  But having skipped my senior year of high school (and trig), calculus got the best of me and I ended up with a bridge major in biology & psychology.  I considered medicine, but after working in my dad’s office during the summers I realized that dentistry really was a better fit for me.  As I tell prospective dental students, dentistry is a wonderful mix of art and science.  We dentists get to work with our hands to create esthetic smiles, and we get to establish long term relationships with patients.  But one of the best things dentistry has offered me is the ability to work part time while my children were young.

After I had been in dental school for a couple of years, it became clear to me that I was personally driven – more than most of my classmates - to provide the best possible care for my patients.  I realized that my trait for perfectionism would drive me crazy in a field as broad as dentistry and that I should specialize for my sanity!  I chose orthodontics because I remembered those awkward days of junior high school and how much my braces treatment had improved my confidence and self-esteem. 

As a parent, I have tried to help my children recognize their aptitudes and gifts so that they can use and develop them in service to the world.  Now that I’ve been in practice for all these years, I realize that my own gifts and graces are particularly suited to orthodontics: my aptitude for spatial relationships, my manual dexterity, my artistic eye, my mental acuity, and even my psychology background.  So it was fortuitous that that I found my way from designing buildings and structural spaces to designing smiles and faces!

 

How long have you been in practice?

I’m in my third decade of practice, can you believe it?  I finished my residency in 1991 and started practice with Dr. DeWayne McCamish here in Chattanooga a month later.  That was a wonderful place to see a whole bunch of interesting cases and gain a ton of experience.  I also learned a whole lot about the business of orthodontics.  When my first child was born, I was able to drop my hours from full time to ¾ time, and then down to half-time when my second was born.  Dr. McCamish was a great boss, and made it so easy for me to have the best of both worlds—a rewarding profession and a great home life with my husband and children.  That’s why I stayed there so long—20 years!

But in 2011, I was growing restless with the pace of the large practice, which had grown to 3 locations and 4 doctors.  And with my children in their teens, I felt the time was right for me to return to full time practice.  I had, over my 20 years of practice, developed specific ideas about how I wanted to treat my patients, and that was increasingly difficult with such a large staff and busy schedule. 

My husband and I already owned a building in downtown Chattanooga for his dental office, and it had some additional space available.  The Lyndhurst Foundation was offering some business development grants to entice business to the Southside, and I was able to secure a grant from green|spaces to pursue LEED certification, so I decided the time was right to take the leap into solo practice.  I moved into my new space at 204 W Main Street in September 2011.

 

How are you different from other orthodontists?

Well, it’s not so different any more to be a woman orthodontist.  But some things that really make me stand out are my years spent as a part-time stay-at-home mom, having (as a mom) supported my own two children in braces, and even being married to a prosthodontist.  These perspectives, as well as my particular aptitudes and graces, give me a drive to simplify and streamline the process of orthodontics to provide the most esthetic and stable results with a minimum of effort on the part of the patient and parent as well as myself and my staff.

Also, I’ve reached the stage in my life where I don’t really HAVE to work – or at least I don’t need a great deal of income.  So I can be satisfied with a much smaller, low volume practice where I can give lots of individual attention to my patients and their parents.

So, yes, I believe I do bring a woman’s eye and a mother’s touch to not just the clinical aspects of braces treatment, but to the whole experience, for my patients to achieve a lifetime of health and wellbeing.

 

You say that you promote overall health and wellbeing through orthodontic care.  I thought braces were just about esthetics.

Ahh… if it was all just about a pretty smile, you can bet I wouldn’t still be in the practice of orthodontics!  I’m not a big fan of cosmetic procedures done for appearances only.  

I firmly believe that an effective, balanced, functional bite, is also esthetic; but not all pretty smiles have a healthy foundation.  I maintain that a healthy bite is important for the long-term stability of your teeth and gums and jaws.  Most of the patients in my husband’s prosthodontics practice requiring tens of thousands of dollars of bite reconstruction also have malocclusions that should have been corrected when they were younger.  So I know that years of living with a bad bite will eventually cause dental problems that definitely have a negative impact on a patient’s overall health and wellbeing – and on their pocketbook! 

Also, more and more studies are showing the links between dental health and overall health.  Poor oral health has been shown to increase a patient’s risk of diabetes, respiratory disease, cardiovascular disease, and delivery of pre-term low birth weight babies.  It’s easier to keep straight teeth clean, and your gums are jaws are healthier if your bite is good. 

Now, I don’t mean to discount the value of a pretty smile.  Certainly braces will dramatically improve the appearance of a patient’s smile, and there is definitely value in that.  If you are self-conscious about your teeth, you just won’t smile as much.  I firmly believe that smiling is vital to your overall wellbeing.  Psychologists have shown that your facial expressions affect your mood, and Zig Ziglar and Dr. Norman Vincent Peale and others have all taught us the importance of a positive outlook to our success in life. 

There have also been some interesting psychological studies that show that people with nicer smiles are treated better by others, are seen as more competent, and achieve greater success in life.  Nobody wants to admit that they favor pretty people, but the harsh reality is that we all do.

 

I see a lot of Invisalign and Six Month Smiles treatments being advertised by general dentists, and my child’s pedodontist does braces.  Why should I want treatment by an orthodontist?

Oh, that’s a hot-button topic!  The short answer is that orthodontists get the 4 years of dental school training PLUS 2-3 years of training specifically for braces treatments.  Your general dentist has just taken an expensive weekend course (or series of courses), and your child’s pedodontist probably got a module of instruction during their pediatric residency, but this was only a small portion of their training.  You tell me: if you have a brain tumor, do you want your family doctor, a general surgeon, or a neurosurgeon to remove it? 

The longer answer involves a discussion of the orthodontic “standard of care”, which any non-orthodontist must be able to meet if he or she is offering orthodontic treatment.  It also involves a discussion of the treatments offered and the claims made about them.  I am personally concerned that many of the dentists offering orthodontic treatments really can’t know how to finish a case for best esthetics, function, and stability, and they sure don’t know how to manage all of the things that can go wrong. 

I like to use a travel analogy.  If I want to go to Chicago, there are lots of ways to get there depending on my available time and money, how I want to travel, and what I plan to see and do while I’m there or along the way.  An orthodontist is kind of like a travel agent who knows all the routes to get there and can advise you on the best routes and modes of transportation to meet your needs and your budget, will book your travel, and provide itineraries and route maps.  A dentist doing braces is kind of like a limo driver saying, “Hey, I can get you to Chicago.”  They can probably get you there, but it may not be the most efficient or cost-effective way.   And they may not know the detours to take when the road is blocked, or feel comfortable driving in the traffic of an unknown big city.

 

Do you mainly treat middle-schoolers?

It just so happens that middle school is, for most patients, the perfect time for orthodontic treatment in terms of dental, skeletal, and emotional and cognitive development.  I like to start monitoring kids when they are transitioning from baby teeth to permanent teeth (about age 7), because we can head off some bigger problems with minor interventions.  And of course, some kids’ dental development is early so we can start (and sometimes finish) full treatment in elementary school.  

Since I don’t like to finish treatment until the 12-year molars are aligned, I generally postpone treatment until those teeth have started to erupt.  Unfortunately for some teens, their dental development is slow and they can’t get their braces until high school. Also, some teens have an abnormal jaw growth pattern, so we need their skeletal growth to be completed before we start treatment.  But it’s generally beneficial for treatment to happen during the adolescent growth spurt. 

That said, I can and do treat patients all the way up to mature adulthood.  My oldest patients in braces or invisible trays have been in their 70s, and I have a night guard/retainer patient who is over 90 years young!

 

Since braces are most common in middle school, won’t they make an adult just look like an immature adolescent?

Well, my personal opinion is that braces are beautiful!  They really just reflect that the person who has them is committed to improving his or her own health and wellbeing. 

Of course, we have esthetic options that far improve the appearance of a smile under construction.  Ceramic brackets are tooth-colored, so they do not draw attention to a patient’s teeth.  Invisible aligner trays are virtually unnoticeable, though they are not an option for some patients.  A final option is lingual braces which are attached to the inside (tongue) side of the teeth.  This treatment modality is not commonly used because of its expense as well as the additional chair time involved.

 

Are there any people who should NOT get orthodontic treatment?

Yes, indeed.  Folks with active periodontal disease should not get braces until it is well-controlled.  And patients who have taken bone-strengthening drugs for osteoporosis or bone cancer may not be candidates due to the excessive density of the bone around their teeth.  Some previously injured teeth may not be moveable with braces due to scar tissue that has fused the tooth to the bone, though there may be surgical options for those teeth.  Patients with poor oral hygiene and active dental decay are also not good candidates until they get their plaque and decay under control.  Patients with painful jaw joints should get to a comfortable jaw position using a mouth guard before embarking on active orthodontic treatment.

Some patients and/or parents are just too busy with other priorities to make time for their orthodontic appointments and for the extra care braces will require.  Patients (and parents) have got to be “all in” or we will never achieve their desired outcome. 

And there are some folks out there who have unrealistic expectations about what orthodontics can do or the results that can be achieved.  They may have developed a heightened sensitivity about the fit of their bite or the appearance of their smile such that they can never be satisfied with even the most perfect outcome. 

 

I’ve heard that braces are terribly uncomfortable.

Well, I remember the most painful part of braces when I had them (back in the dark ages) was putting bands on my lower incisors teeth.  I had to put those old white plastic “dumbbell” shaped spacers between my teeth the night before to get them just so exquisitely tender to touch, then my orthodontist used this awful torture instrument that he affectionately called “Mr. Thumpy” to push the metal bands onto my teeth.  I get tears in my eyes just thinking about it now.  :’(

OK, I know as an orthodontist I should never admit that any orthodontist has hurt any patient EVER.   We orthodontists all cringe at those awful scenes in Willy Wonka and Finding Nemo!  At least I can say that I don’t use those headgear torture devices anymore! 

But I won’t sit here and tell you that a patient has never shed a tear sitting in my chair.  I will tell you that when it happens I shed a tear, too, and relive my experience with “Mr. Thumpy”.  I truly wouldn’t do what I do every day if it always made people hurt that way.  I can tell you that getting a shot for numbing your mouth would be more uncomfortable than anything I do when braces are being fitted or removed or adjusted.  So I don’t have to give shots, and patients don’t have to worry about getting them in my office! (Hooray!) 

I will tell you that there is a bone and joint type of achiness that patients will get as the tooth movement process starts, but it usually takes several hours for that tenderness to set in.  Hooray for me, then, because I rarely have to work on patients when their teeth are in that “exquisitely tender” stage like MY orthodontist obviously did routinely.  Tylenol helps with this soreness, and it will go away faster if you don’t “baby” your teeth throughout this process. (Motrin or Aleve will also help with the soreness, but alas, NSAIDs can also slow tooth movement so I generally recommend avoiding them.)

The final type of discomfort braces can cause is from the lips and cheeks and tongue rubbing on the hardware in your mouth and causing irritations.  This is usually limited to the first couple of weeks after the braces are put on.

All of these issues are far and away better than they were when I had braces back in the dark ages!  We are bracketing more teeth instead of using bands, we have high-tech memory wires and self-ligating brackets that reduce the forces used to get the tooth movement process started, and the brackets themselves are smaller and smoother.  So, periods of discomfort AFTER adjustments – yes.  Sharp or constant pain – no.  And definitely not while you are in the chair.

Probably once a week, I have a new little patient whose tummy is tied up in knots with worry about how much it is going to hurt.  I love to see their relieved little smiles when they have the realization that “oh, that’s all there was to it?”  We try to tell them not to worry….

 

Aren’t braces expensive?  How can people afford them in today’s economy?

I think braces are an excellent value when compared to their lifetime benefit of improved confidence, outlook, success, oral health, and even overall health.  When you compare the cost of braces to the cost of NOT having braces when you need them, I have no hesitation suggesting that they are worth every penny spent on them.  My office offers an interest-free payment plan if it is set up on an automatic monthly draft from a bank account or credit card.  I can assure you that most offices offer some type of payment plan that makes it reasonable to most every budget. 

I would go so far as to say that even for families on a tight budget, there are plenty of ways to scrape together enough to make the monthly payments.  Maybe postpone trading in your car for a year, and make your typical car payment toward your braces.  Or take a “stay-cation” instead of a family vacation for a year or two.  Or brew your own coffee rather than stopping at Starbucks every morning. 

For families that can’t afford car payments or family vacations or Starbucks, I participate in a program called Smiles Change Lives, which funds braces for low-income families that otherwise couldn’t afford it.

 

What about the time commitment for braces?  Some bosses don’t let employees miss work and schools don’t like kids missing school.

I find that with our clinical efficiencies we are able to treat most patients with short 15 to 30 minute adjustments every six weeks, which we can usually fit in toward the beginning or end of the day or over a lunch hour.  We like to allow a couple of hours, preferably in the morning, for the appointments to put the braces on and to take them off.  Most patients and parents can find a way to work those key appointments into their schedules if they plan in advance and maybe use a little creativity.   Sometimes patients take a day off work or schedule to get their braces put on when school will be out.  Most schools and employers will excuse an absence if you plan it in advance, and we can print out an excuse if needed.  

Patients do need to be willing to take the extra few minutes each day for the extra care their braces will require.  Brushing and flossing will take longer, and will be needed more frequently when you have braces.  

 

What’s involved in getting started with braces?

Well, of course the first step is scheduling an appointment with an orthodontist to see if you are a good candidate for braces and to get an estimate for how involved your treatment might be.  Every orthodontist will want diagnostic records made before starting treatment (x-rays, photographs, and sometimes impressions or scans of your teeth).   Each orthodontic office is slightly different in their process, but in my office, we can start uncomplicated cases on the second visit if a patient is ready for treatment and they are really motivated to get started.  Complex cases may take up to four appointments.  We never push patients to start, and pre-treatment records are good for a year.

 

Do you have anything else you’d like to share?

Well, yes, let me just say how truly blessed I am to be able to work in a job I’m so suited for, and that makes such a big difference in people’s lives.  I love taking braces off and seeing the beautiful result, and I love seeing patient’s broad smiles on their first adjustment visit after getting braces, because they can already see the difference in their smiles, and because braces are far easier than they thought they would be.  

I am profoundly grateful every day that I get to work in such a beautiful office space with a wonderful staff and the best patients in the world!  It is an honor that my patients (and their parents) entrust me with care of their most valuable possessions—their smiles.