Smile Studio Orthodontics Blog

Dr. Marie Farrar and Smile Studio do not endorse any products for financial gain.  Dr. Farrar speaks candidly about products and services she uses and likes.  Any recommendations made on this blog are her own personal--though well-reasoned--opinions.

Entries by Marie Farrar (24)


Introducing our Summer Office Game! 

Enter on any of our social media accounts and you could win $100 gift card to Sunglass Hut at the end of the summer!! Good Luck!!


Mother's Day Contest

We love our Mothers here at SmileStudio and we know you do to! Let us know what you love to call her, (i.e. mom, momma, ma, mommy) and you could win a Spa Pedicure from our friends down the road at Nail Works! You can comment of Facebook, Instagram, or come by and see us! 


January Brace Friendly Recipe 


Since we think cheesecake is a pie, why not make one today on National Pie Day!

Crust Ingredients:

• 1 . cups graham cracker crumbs (about 28 squares)

• 1/4 cup packed brown sugar

• 1/2 cup butter, melted

Filling Ingredients:

• 3 packages (8 oz each) cream cheese, softened

• 1 cup packed brown sugar

• 3 eggs

• 3/4 cup whipping cream

• 1/4 cup caramel-flavored coffee syrup

Caramel Sauce Ingredients:

• 1/2 cup butter

• 1 . cups packed brown sugar

• 2 tablespoons caramel-flavored coffee syrup

• 1/2 cup whipping cream

• 1 . teaspoons flaked sea salt


1. Heat oven to 350°F. Wrap outside bottom and side of 9-inch springform pan with heavy-duty foil to prevent

1. Heat oven to 350°F. Wrap outside bottom and side of 9-inch springform pan with heavy-duty foil to prevent

leaking. Grease inside bottom and side of pan with shortening. In small bowl, mix crust ingredients. Press in

bottom of pan. Bake 8 to 10 minutes or until set. Reduce oven temperature to 300°F. Cool crust 10 minutes.

2. Meanwhile, in large bowl, beat cream cheese and 1 cup brown sugar with electric mixer on medium speed until

smooth. Beat in eggs, one at a time, just until blended. Add 3/4 cup whipping cream and 1/4 cup coffee syrup;

beat until blended. Pour filling over crust.

3. Bake at 300°F 1 hour 10 minutes to 1 hour 20 minutes or until edge of cheesecake is set at least 2 inches from edge

of pan but center of cheesecake still jiggles slightly. Turn oven off; open door 4 inches. Let cheesecake remain in

oven 30 minutes. Run small metal spatula around edge of pan to loosen cheesecake. Cool in pan on cooling rack

30 minutes. Refrigerate at least 6 hours or overnight.

4. In 2-quart saucepan, melt 1/2 cup butter over medium heat. Add 1 1/4 cups brown sugar and 2 tablespoons coffee

syrup. Heat to boiling; cook and stir 1 minute until sugar dissolves. Stir in 1/2 cup whipping cream; return to

boiling. Remove from heat. Cool 10 minutes.

5. To serve, run small metal spatula around edge of springform pan; carefully remove foil and side of pan. Cut

cheesecake into slices. Drizzle caramel sauce over slices; sprinkle with salt. Cover; refrigerate any remaining



Main X 24

We love our patients a "Waffle Lot" and we had a blast handing out waffles for Main x24!! We survived the rain! The show must go on! 



Christmas Contest is here!!!

Go to Facebook or Instagram to comment your answers to be entered to win!! Links are on our home page!


Brace Friendly Recipes

 How yummy would it be to have some Pumpkin Spice Pull-Apart Bread for breakfast on Halloween

tomorrow? Check out this delicious and easy recipe:

Ingredients for The Pull-Apart Bread

 Butter, for pan

1 c. sugar

1 1/2 tsp. pumpkin pie spice, divided

1 (16-oz.) can refrigerated biscuits, halved lengthwise

1 c. pumpkin puree

1/2 tsp. pure vanilla extract

Ingredients for The Glaze

 1/4 (8-oz.) block cream cheese, softened

1/2 c. powdered sugar

1/2 tsp. pure vanilla extract

1/4 tsp. pumpkin pie spice

1/4 c. milk

Directions for Pull-Apart Bread

 1. Preheat oven to 350° and butter a 9x5-inch loaf pan. Pour sugar and 1 teaspoon of pumpkin pie spice into a large

resealable plastic bag and shake to combine. Add biscuit pieces to bag 2 or 3 at a time, seal, and shake until coated. Set

coated biscuit pieces aside on a plate and repeat with remaining pieces.

2. In a medium bowl, combine pumpkin puree, vanilla, and remaining teaspoon pumpkin pie spice. Slather pumpkin

filling on a biscuit, then top with another biscuit and slather with more filling. Repeat until you’ve created a stack of

biscuits (or two stacks of biscuits).

3. Place biscuit stack on its side in prepared pan, so you see layers of pumpkin filling.

4. Bake until biscuits are golden and puffed, 38 to 40 minutes. Let cool slightly, then turn out onto a plate.

Directions for Making Glaze

 1. In a large bowl using a hand mixer on low speed, beat cream cheese until light and fluffy. Add powdered sugar, vanilla,

and pumpkin pie spice and mix until combined, then gradually add milk and beat until it’s a pourable consistency.

2. Drizzle glaze over pull-apart bread before serving.



Fall Festival Fun at CCS

We loved seeing all the smiling faces at Chattanooga Christian School's Fall Festival this weekend! We had fun playing Poke-A-Pumpkin and giving away lots of prizes! We love supporting our community and neighbors!!


Mary's Office Anniversary

Congratulations Mary on celebrating your 3 year anniversary at Smile Studio! Mary is our clinical coordinator and the one that you see when you come in for your treatment! Mary has two young boys so she is a busy woman at work and at home! Thank you Mary for all you do here at Smile Studio!!


Announcing our 6th Annual Candy Buy Back Event!

Every year Dr Farrar takes all the candy that may not be so good for your braces and sends them to our military troops that are overseas! You can make a little cash and send our troops lots of sweet treats!! Just bring it to us and Krista will weigh it for you!!


Pacifiers and Thumbs Suck

Note:  This is a reprint of an article published in February 2017 Natural Awakenings.

Finally, science is confirming what orthodontists have long understood.  Pacifiers cause children to need braces later on.  And not just pacifiers, but thumbs, fingers, blankies, and any other comfort device an infant may habitually suck on to soothe himself.

A systematic review and meta analysis published in the December 2016 Journal of the American Dental Association concluded that non-nutritive sucking behaviors are strongly associated with malocclusion as late as the mixed dentition.  By pooling 15 different studies, Australian researchers Drs. Esma Dogramici and Giampiero Rosse-Fedele were able to provide the strongest evidence yet that sucking habits are definitively associated with anterior open bite (front teeth that don’t overlap or touch), posterior crossbite (top teeth that don’t overlap the bottom ones), and class II (top teeth that protrude and/or bottom teeth that retrude).

Local orthodontist, Dr. Marie Farrar, says she struggled when her children were infants with how to proceed regarding sucking habits.   Having seen the after-effects of sucking behaviors, she was anxious to prevent as much orthodontic treatment as possible for her own children.  But she totally gets why it’s such a hot-button issue for stressed out parents.

“It’s easy to say no ‘paci’, no thumb.  But when it’s your child suffering -- or your own self, suffering from lack of sleep and sanity – I know from experience that you’ll do whatever it takes to keep your child comfortable and happy,” Dr. Farrar relates. 

The thumb vs. pacifier debate has raged for years.  Dr. William Sears promoted the thumb over the pacifier because baby can always find it in the night and self-comfort herself for years. 

“But I’d read,” Dr. Farrar continues, “that babies’ suckling instinct starts to decline from about six months and that six to nine months is the magic age for weaning them from the paci, before they get too emotionally attached to it.  We were successful in getting our oldest off his pacifier that early, but our daughter was a different story.  She had started day care earlier and got in that cycle of recurrent ear infections, so for our sanity and hers, we weren’t able to get her off her pacifier until she was almost three.”

Dr. Farrar suggests offering a cozy “lovey” at the time of weaning off the pacifier to transfer the child’s emotional attachment to something more tactile.

“I’m actually less concerned with the dental after-effects of sucking habits—those can be fixed with orthodontic interventions and treatments, Dr. Farrar states.  “But I’m a lot more concerned about the successful transition from tongue thrusting.  Non-nutritive sucking just seems to delay that transition, and some adults never develop proper tongue function.  Normal tongue posture happens naturally at the right time if a baby doesn’t have a thumb or pacifier in the way.  But the longer it goes on, the harder it is to correct.  And improper tongue posture and function WILL create lifelong dental problems; that’s what I treat all day long every day.”

Dr. Farrar asserts that dental arch and even airway development would be improved if babies were swaddled, carried, and nursed on demand for at least the first nine months of life, and never offered a pacifier, bottle, or sippy cup.  But with a laugh, she says, “that’s highly unlikely and unreasonable in our 21st century society, so we orthodontists are here to help pick up the pieces.” 


Sugar Substitutes for your Sweet Tooth

So last week my daughter shopped for and took in snacks for her home room: a bag of Cheetohs, a 2L Coca-Cola, cupcakes made from a mix, and 2 containers of store-bought frosting.  Where, oh, where did I go wrong?!?  My only consolation is that she said she was just thinking about what her friends like.  Hmmmm.

If you follow our Smile Studio facebook page, you know I’m on a huge tirade against refined sugar. You see, I run across SOOO many patients (and it’s not just kids), who have tons of plaque and get white spots and cavities because they have a bad sugar habit (combined with less than stellar oral hygiene!).  And this isn’t just associated with braces.  I’ve seen it before braces are even applied, with clear aligners, and in retention. 

I’m not a whole lot happier at the thought of using artificial sweeteners, especially chemicals such as saccharin (Sweet’N Low), aspartame (Equal) and sucralose (Splenda).  Besides the long-standing concerns about the toxicity of these substances, lately I’ve been reading how artificial sweeteners trick the brain and end up contributing to weight gain and not improving diabetes

Other sweetener substitutes are the sugar alcohols such as mannitol, sorbitol and xylitol.  These are frequently used in sugar-free candies and gum but are rarely used for baking because they’re not as sweet as sugar, still have calories, and can cause bloating and diarrhea.  These are the sugars that “don’t promote tooth decay”, because they don’t feed the bacteria that cause cavities. 

The one I want you to pay attention to, though, is xylitol, because there have been numerous studies demonstrating that it is actually antibacterial to the pesky bugs in the mouth that cause tooth decay, and even to the pesky bugs in the nasopharynx that contribute to ear infections, sinus infections, allergies, and even asthma.  Some people use it as a nasal spray, and some even take it as a supplement.   What I recommend is that you find a xylitol chewing gum that you like, and use it instead of any other gum you are accustomed to using.  Now these can be expensive and hard to find (think Whole Foods).  I have found that Mentos PURE has xylitol as its number one ingredient, though it also has sorbitol and mannitol.  It’s readily available on most candy aisles.  Just be aware that xylitol is toxic to dogs.

I must caution you that I can’t wholesale recommend all products with xylitol or sugar alcohols as 100% good-for-you, because I can’t vouch for their pH.  We know that acidity in our foods and drinks are causing as much trouble for some folks as sugar due to acid erosion.  At least one report questions the widespread use of sugar alcohols without further study of the acidity of other additives.  

Other sweeteners you might consider (though you should know that they aren’t calorie-free or necessarily useful in preventing tooth decay) are whole, natural sweeteners such as medjool dates, molasses, honey, and maple syrup.  I prefer to use these at home in place of sugar when possible, because they are natural sugars that haven’t been refined.  They’re far easier for our bodies to process and less addictive.  You can find lots of recipes online but here’s my favorite “raw” brownie made with dates.  A side benefit to honey is that it is naturally antimicrobial and local honey supposedly helps to reduce allergies to local pollens.  I buy unsweetened yogurt and mix in a dollop of honey to sweeten it to my taste.

Stevia is another good sugar substitute that’s also naturally occurring, but it’s generally sold as a refined product extracted from the stevia plant.  You can buy it in many grocery stores, though it’s a lot more expensive than sugar and artificial sweeteners.  It’s got zero calories, and appears to have multiple health benefits in addition to not promoting tooth decay.  I’ve never tried baking with it, but I do buy it in packets for sweetening tea and coffee.

So the long and short of it is that we Americans have insatiable sweet teeth, and sugar substitutes don’t seem to take away our desire for more.  My personal rule of thumb is that if Mother Nature made it, it’s probably OK in moderation.  If it’s been manufactured by humans, I try to avoid it.  Of the refined or processed naturally occuring sweeteners I prefer Stevia and Xylitol, because of their proven health benefits.   

Dr. Farrar’s tips for managing your sweet tooth:

  • eat fresh, whole fruits, or drink juices or smoothies made from them
  • nibble on a small piece of dark chocolate, savoring the flavor with a warm beverage
  • chew xylitol gum (Mentos PURE will do just fine), especially after a meal for up to 20 minutes
  • sweeten hot beverages, oatmeal, and plain yogurt with local honey
  • if you bake, try some recipes using whole, natural sweets such as medjool dates or maple syrup or honey
  • if you must sweeten your beverage, use xylitol or stevia packets instead of Equal, Splenda or Sweet’NLow

Resolved to make your smile a priority this year?

Of course, an orthodontist can check out your bite and give you advice.  But your very first step should be calling your dentist’s office.  He or she can take care of any active tooth decay and/or gum disease, get you on a maintenance program of dental cleanings, and give you treatment options to improve the esthetics of your smile and the function of your bite. 

You don’t necessarily have to go to a dentist who promotes him- or herself as a cosmetic dentist.  There is no formally approved specialty in cosmetic dentistry, as all dentists are trained to replace and repair teeth cosmetically.  Wikipedia states that the only two dental specialties with formal advanced training in dental esthetics are Prosthodontics and Orthodontics.  (So, if you're looking for esthetic options in the Chattanooga area, I think Dr. Baldree and I could be a "one stop shop" for you!)

Often, esthetic concerns have an underlying bite issue that can be treated orthodontically for far less money and with greater stability and longevity than by treating them with facings or caps.  So before having any healthy teeth cut down for crowns or veneers, you should also consult with an orthodontist. 

Please know that many of the highly advertised aligner and “six month” treatments are often limited to correcting just mild to moderate alignment issues without correcting underlying problems with the fit and function of the back teeth.  Be aware that many dentists who provide these orthodontic services are not specialty-trained orthodontists.  An actual orthodontist can offer both limited and comprehensive plans, and advise you regarding the risks and benefits of each approach.

Be sure to ask about how long you can expect your results to last, as well as how much you will need to commit in terms of money and time.  And before expending your life energy on this process, be sure to do your homework and research both your provider and the procedures he or she recommends.  The Tennessee Board of Health has a practitioner lookup here that gives you licensure and educational background as well as disciplinary actions.


Sugar, Sugar Everywhere!

‘Tis the season for holiday gatherings and gift giving, and all the sugar and heavy foods are making me feel just plain yucky.  Do you feel it, too?

I KNOW the dental and physical harms of too much sugar in our diets, and yet here I am again this year, in the kitchen baking.  I baked 5 dozen cookies to take to my daughter’s school last week, baked a few more this weekend for teacher gifts, and still have 2 cakes to bake for family gatherings.  Ah, what’s a good dentist to do?!? 

I don’t have to tell you that the evidence is piling in that we Americans eat far too much sugar, and consequently we are growing heavier and more unhealthy.   We are also hearing more about the dangers of the sugar we consume not only in sweet drinks, desserts and treats, but also from hidden sources such as spaghetti sauce, crackers, and salad dressings. 

From the dental perspective, we know that the bacteria responsible for tooth decay thrive on the sugars that pass through our mouths and stick to our teeth in the form of dental plaque.

So how do we handle the onslaught of sweets during the holiday season?  Here are just a few tips I’ve learned through the years.

A little bit goes a long way.  Unless you’re a diabetic or on a special diet, you don’t have to feel guilty for an occasional indulgence.  They’re best enjoyed at the end of a meal and in small bites.  When my husband and I are eating together and there are multiple desserts on a buffet, we will make up a small plate of tiny servings and each sample a bite of all the offerings. 

Avoid sweet drinks, especially between meals.  I’m a big fan of water; it’s inexpensive, readily available, and hard to get too much of.  Herbal teas are my second favorite.  (I found Candy Cane Lane tea at Target this week, OMG it’s my all time favorite, and harder to find than hen’s teeth!  Sorry Chattanogans, but I bought the last two boxes.)   If you must sweeten your tea or coffee, use xylitol packets (they’re expensive and hard to find, but worth it).   Stevia, honey, and maple syrup are all more natural options than refined sugar or sugar substitutes that may be somewhat better for your health if you must drink sweet drinks.  The whole issue of sugar substitutes is a “whole ‘nother topic” for a separate blog post. 

Pick your poison.  When eating sweets, I choose dark chocolate with nuts, and fruit-based over ones made from milk chocolate or nougat.  I also choose homemade sweets over ones that look like they’ve come in a package from a store. 

Clean your mouth after meals and snacks.  If you can’t get to a toothbrush, then swish your mouth with water and/or chew some sugar-free gum (preferably xylitol-sweetened like Mentos PURE).

Out of sight, out of mind.  Graciously accept the wonderful sweet treats given to you by well-intentioned friends and family, but put them on a shelf in the cupboard rather than out on the counter top.  That way you won’t be tempted to sneak a snack. 

It’s better to waste the food than to waste your body.  Don’t hesitate to throw out sweets you won’t eat or don’t like, or in excess of what you and your family should consume.  Or drop them by your community’s homeless shelter to supplement their meals.

Add in AT LEAST one dark, leafy green per day.  This one comes from my friend Jenni Lee at Greenlight Health Coaching.  Collards, kale, and spinach can be eaten raw as in a salad or can be easily added into soups and stews.  Enzo’s, just down the street from my office, makes a fabulous kale salad that I often crave.  And here’s a simple recipe for a great looking collard green salad. 

Grab a piece of fruit or a handful of nuts to satisfy your craving.  A sugar craving indicates you have been eating too many refined sugars and carbs.  Clementines, apples, and bananas are easy to grab and go and are surprisingly satisfying.  Nuts and nut butters are also healthy options for between meal snacks.  Almond butter spread on apple slices satisfies my sweet tooth far better than most syrupy sweet dessert offerings. 

Consider recipes using natural products for sweetening.   There are so many whole and nutritious food bloggers out there on the internet.  Check out this great recipe a friend shared with me for delicious and healthy “raw” brownies using medjool dates instead of refined sugar.

Bake only what you need as you need it.  At home, I refrigerate my cookie dough and pop a few in the oven to bake as we are eating dinner.  You can even bake cakes in small loaves.  This helps you serve small slices of cake and freeze the extra loaves that you don’t need immediately. 

Bake with love from scratch using fresh ingredients.  Store-bought packaged sweets and boxed mixes are full of all kinds of preservatives and ingredients I can’t pronounce.  When you bake, bake from scratch using fresh ingredients.  

Experiment with your recipes.  While I've never tried baking with Stevia, I have learned through the years that I can reduce the sugar content by as much as half in several of my family's favorite recipes with little effect on our enjoyment of them.

Get fresh air, sunshine, and exercise.  All of these help clear your head and lighten your mood.  Physical exercise strengthens your muscles and your heart as well as improves your metabolism and helps you burn off excess calories.  Try to get in a workout before a holiday feast, or talk a walk with a friend afterwards - rather than a nap!   

Learn from your mistakes.  When you do give in to temptation and overindulge, pay attention to the way it makes you feel afterward.  Do you feel sluggish and heavy, and are you left with a bad taste in your mouth? Was the transient sugar high worth the longer-lasting side effects?  The next time you are tempted, you will be less likely to fall victim to sugar’s allure.

Here's my family's favorite cookie recipe.  They are so indulgent that I only bake them at Christmas.  I have a bowl of dough sitting in my fridge right now, but I'm not sure when I will bake them because we have so many sweets coming into the house at the moment!

Holiday blessings to you and your family this holiday season.




No Pain, No Gain?

One of the things new patients always ask about is pain.  They’ve heard that braces hurt.  Let me reassure you that the vast majority of patients are pleasantly surprised that braces hurt far less than thought it would.

Here’s what I can tell you about the discomfort of tooth movement:  

There is some inevitable discomfort associated with the start of the tooth movement process, whether the tooth movement is associated with braces, aligners, or tooth-moving retainers.  This is typically described as a dull ache that can be intermittently sharper when chewing or biting or even brushing your teeth.  Most patients report that this soreness gradually increases over several hours, peaks about a day after the tooth-moving force is applied, then lasts for 2-5 days after braces are placed, and for 1-3 days after adjustments.

For teeth to move orthodontically, we rely on the periodontal ligaments that hold the teeth in the bone, to relay the pressure from the archwires (or aligners or retainer springs) to the bone, causing bone to resorb on one side of the tooth and fresh bone to be deposited on the other side.   The pressure should be constant for this process to get under way.  Intermittent pressure from rubber bands, retainers, or aligners will just cause the bone around the teeth to get dense, and the fibers between the teeth and the bone will get tighter as the body “bucks up” to the new challenge. 

This is why it takes so much more discipline to move teeth with retainers or aligners.  But if you do try it, just remember that your teeth won’t always be as sore as they are in the first few days.  The teeth don’t stay sore the whole time they are moving.  They will keep moving throughout the entire time between adjustments even though the soreness happens in the first few days.

The tooth movement process happens most efficiently (with less overall discomfort AND faster movement) when the periodontal fibers get “stimulated” through chewing, vibration, or light pressure.  This stimulation basically pumps fresh tissue enzymes and oxygenated blood into the site while moving out the inflammation and pain mediators.  It also helps to release minor frictional binds that can occur between the wire and the brackets.  

There is a device currently being marketed, specifically to accelerate tooth movement through a light vibration, but it requires patients to sit with this device in their mouths, biting on it for 20 minutes daily.  This seems impractical to me, as well as costly.  You can get virtually the same effect with sonic toothbrush, but I don’t know who would actually brush for 20 minutes a day!

You should know that in my practice, I start braces treatment with light, flexible, archwires in an effort to minimize the discomfort and other adverse effects of tooth movement.  The gentler the tooth-moving force, the fewer pain mediators are found in the tissues.

I also give patients a rubbery “therabite” wafer to chew on periodically after braces are placed, and aligner “chewies” after delivering aligners.  However simply chewing normal foods and biting your teeth together periodically will also help.  If you notice a specific tooth that is getting particularly sore, it’s probably because it does not hit when you bite your teeth together.  So you can just take your finger and lightly press on that tooth periodically until the soreness passes. 

The key to the ligament stimulation method of managing discomfort and speeding up tooth movement is to start the stimulation before the teeth actually get sore.  If you wait until the soreness has set in, you will find it more uncomfortable to stimulate the tissues—but even then it will be more effective than no stimulation at all.

If you are still uncomfortably sore, I suggest taking the recommended dose of over-the-counter Tylenol (or generic acetomenophen).  Never take more than the recommended dose because there is not a lot of margin before Tylenol becomes dangerously toxic!

If the Tylenol hasn’t had the disired effect after an hour, try adding a dose of a NSAID such as ibuprofen (Motrin or Advil) or Alleve.  Tylenol and Motrin act in different ways, and some studies indicate that, when taken together or alternatingly, they can be just as effective as a narcotic.

An adult can actually take a prescription strength of ibuprofen using OTC pills: up to 1000 mg as a loading dose, followed by 600 mg every 6 hours or 800 mg every 8 hours.   The maximum daily dose is 3200 mg.

If you are still in a lot of pain after taking the maximum dose of Tylenol and the maximum dose of ibuprofen, especially if the discomfort does not improve over the course of a day or two, it may be a sign that a tooth has abcessed and will need a root canal treatment.

I no longer recommend starting out with a NSAID (even though they are more effective against tooth movement pain) because they have been shown to actually slow tooth movement by blocking both bone resorption and ligament and cartilage repair.  Management of tooth-movement discomfort should be managed without ibuprofen if all all possible.

In summary, follow these steps to manage your tooth movement discomfort and provide for the fastest movement:

  • Stimulate your periodontal fibers periodically before the discomfort peaks, and continue stimulating until it subsides.
    • chew normal foods (no “babying”)
    • chew gum (if you are in stiff wires)
    • bite on a therabite or aligner chewy
    • press on your tooth/teeth with your finger
    • brush with a sonic toothbrush
  • If you become too uncomfortable, take over-the-counter acetaminophen (Tylenol) at the recommended dosing—never more than the dosing recommended on the label!
  • Add in an OTC NSAID (Motrin, Advil, or Alleve) only as needed to get you through the peak discomfort.
  • If you are trying to move teeth with rubber bands or a removable aligner or retainer, it is vital that you minimize the time they are out of your mouth, at least until this initial soreness is resolved.  

Don't focus on the potholes

I had a revelation the other day when out with my 15 year-old practicing her driving.  I found myself describing to her how to avoid potholes: focus on where you want to be, rather than on what you don’t want to hit. 

I first heard this years ago from a trail bike guide at a resort in the Sonora desert.  This guide would huddle us novice cyclists up periodically to prepare us for the desert trail’s upcoming twists, turns and obstacles.  He would remind us that if we focused on the cactus at the side of the trail, we’d be sure to brush against it.  He encouraged us to instead note and acknowledge its presence, but focus our attention on the clear part of the trail.

My mind took me to my conference room table, explaining the informed consent for braces treatment—the litany of all the pitfalls that I legally have to explain to patients before they start treatment.  Like the surgeon explaining that you can die on operating table.

I’ve always hated telling patients all the terrible things that can befall them, because I’d rather set the expectation for the beautiful results at the end.

Do you know anyone who likes to expect the worst, so they can be pleasantly surprised when things actually go smoothly?  Watching these pessimists go through life, I sure wonder if they don’t bring more bad things upon themselves with their fear and worrying. 

On the other side of the fence are the Pollyannas who refuse to acknowledge potential pitfalls.  They can easily be blindsided when things go wrong. 

I prefer to be aware of the problems that can arise—whether in the road ahead, in medical treatments, or just in life in general.  With that awareness, I can acknowledge the potholes, yet focus my attention on the clear spots and aim for a clear passage.  In orthodontic treatment planning, I set the intention for a desired outcome that can be realistically achieved, and chart the course to get us there.  While I legally have to tell patients all the things that could go wrong, I try to shift the focus back to the expectation of smooth sailing to a successful outcome.

What about you?  Do you consider yourself a pessimist or an optimist?

How do YOU avoid the potholes in life?


Why visit an orthodontist by age 7?

Don’t kids need all their permanent teeth for braces?

Yes, the American Association of Orthodontists recommends that all children be screened by an orthodontist by age 7.  And yes, comprehensive orthodontic treatment should align all the permanent teeth through the 12-year molars.  But you should know that actual braces are rarely recommended for a child at age 7.

By age 7, your child should have lost several baby teeth and grown in their permanent replacements as well as the permanent 6-year molars.  A panoramic x-ray taken at this time will identify any missing permanent teeth or problems with wayward teeth that are not erupting properly.  

An orthodontist will be able to identify issues with crowding, crossbites, or jaw size imbalances, which are often best addressed during the transition from baby teeth to permanent teeth before jaw growth is complete.  Since lip, cheek, and tongue forces help guide the teeth as they erupt, an orthodontist will also help manage any oral habits such as thumb or finger sucking, lip trapping, tongue thrusting, or mouth breathing.

Most treatments I recommend at this age are passive guidance of tooth eruption and arch development aimed at intercepting bigger problems, minimizing the need for permanent teeth to be pulled and reducing the time spent in full braces.

Can all of this be handled after all the permanent teeth are in and jaw growth is complete?  Perhaps.  But know that your child’s treatment may involve more time, money, and effort if he or she doesn’t see an orthodontist until after the dental development is complete. 


We are certifiably green--AGAIN!


Dr. Marie Farrar at the first ever Green Dentistry Conference with Ina and Dr. Fred Pickross, founders of the EcoDentistry AssociationI am pleased to announce that Smile Studio Orthodontics has achieved the Gold level of GreenDOC Dental Office Certification by the EcoDentistry Association!

Being LEED certified was a big part of our reaching Gold.  You can read here about all the measures we took to become certified as LEED Silver for Commercial Interiors.  Listed below are some of our additional initiatives that make us EcoDentistry Certified Gold.

Waste Reduction & Pollution Prevention

  • we use a steam autoclave with reusable instrument cassettes instead of paper-plastic pouches, and we distill our own water
  • we have reduced the use of plastic barriers and disposable supplies
  • we use eco-friendly disinfectants for surfaces and equipment lines
  • we have eliminated the use of toxic cold sterilants by selecting instruments that can be heat sterilized
  • we have a digital x-ray system, which eliminates chemical waste
  • we subscribe to a recycling service and even our sharps waste is recycled
  • we collect and recycle ink and toner cartridges, batteries, fluorescent bulbs, propane and oxygen bottles, and small appliances
  • we recycle the disposable toothbrushes used by patients in our office, and collect their toothbrushes and empty toothpaste tubes and floss dispensers
  • we compost our kitchen waste
  • we provide filtered drinking water in our break room and reception room to eliminate the need for bottled water
  • we save transportation and shipping waste by having an in-house lab for our models and retainers
  • we use rechargeable batteries where possible
  • we purchase in bulk and choose recycled content, recyclable, and/or compostable supplies when available
  • we purchase supplies from eco-friendly vendors when possible
  • our cleaning service uses green cleaning products and processes
  • we utilize a green landscape management company
  • our stationery and prnted communications are printed on FSC-certified paper
  • we send appointment reminders and many other communications electronically
  • we print and copy double sided when possible
  • we send patients’ take-home supplies in a reusable shopping bag


Water Conservation

  • we use hand sanitizer instead of soap and water when possible
  • our landscape plantings are drought tolerant and we do not irrigate automatically


Patient Care, Workplace Policies, & Community Contribution

  • we participate in charity dentistry projects such as Smiles Change Lives
  • we participate in community service such as the Oral Cancer Foundation’s Walk for Awareness
  • my staff and I take continuing education about green dentistry
  • we use only BPA-free adhesives
  • I provide patient education regarding whole-body health
  • we provide honey, Stevia, and xylitol as sweeteners at our hot beverage station for patients
  • we give patients a BPA-free reusable water bottle with Xylitol-sweetened candies and gum when patients get their braces off
  • we send healthy gifts to referring offices, such as oranges, chocolate covered strawberries, and trail mix


Oh, and did I mention I drive a Prius?  And since my husband works next door, we frequently carpool to and from work!

As a healthcare provider, I seek to practice sustainably and in a way that "does no harm" - either to patients or to the environment.  As eloquently put by Christopher Gavigan, co-founder with Jessica Alba of the Honest Co.: "Most people think living greener is about safeguarding the Earth, but my approach is about living for your health, which ultimately has positive impacts for the planet."


Got Gardasil?

Our Smile Studio team at the 2013 Oral Cancer Walk

April was Oral Cancer Awareness month, and our Smile Studio team was proud to walk in support of oral cancer awareness at the Oral Cancer Foundation's 4th annual Walk for Awareness in Chattanooga.   I was happy to participate again in the free oral cancer screenings and enjoyed getting to use the Identifi screening light generously loaned by Patterson Dental.  When I got back to my office, I was pleased to verify that my new UV curing can also double as a screening light.  

Thankfully, I personally have never diagnosed oral cancer in one of my orthodontic patients (knock on wood…), but now I have a tool for screening suspicious lesions before having to send patients to have a biopsy.  

I have, unfortunately, seen oral cancer's devastating results far too many times.  Imagine not being able to chew, swallow, or talk because a big part of your jaw or tongue or throat has been cut away.  This is truly a destructive disease that has devastating effects on quality of life.

Back when I started practicing, the main candidates for oral cancer were tobacco chewers and older adults who smoked and drank alcohol heavily.  Not the type of patients typically treated in the orthodontic chair—though I’ve seen my share of teenage and young adults with suspicious lesions due to smokeless tobacco through the years.

For a while, oral cancer rates dropped, thanks to the remarkably successful national campaign against tobacco use.   I’m around smoking so little now <thank heavens!> that I can smell a smoker 20 feet away!

But now the oral cancer news is all about the rise of oral cancer in a younger, more health-conscious demographic.  And it’s specifically related to the human papilloma virus (HPV), specifically HPV-16.  HPV-16 is one of the versions known to be sexually transmitted—yep, from oral sex, but also apparently from “French” kissing.  Pretty scary, huh?

Parents, and maybe some teens, are aware of the new Gardasil vaccine, which is effective against HPV 6, 11, 16 & 18.   We’ve been hearing about how Gardasil can prevent sexually transmitted cervical cancer in girls, but there’s now a push to have boys immunized as well.  Preferably, this vaccine should be given before sexual exposure, but it’s specifically recommended for males and females between the ages of 12 & 26.  Now THAT demographic is about 80% of my practice! 

Soooo... I’m on the bandwagon!  

Parents:  Get the Gardasil vaccine for your teens!  Do it now!   Summer physicals are coming up, so make a note to ask your pediatrician and get the series started.   And since it’s a 3 shot series over 6 months, don’t wait until your teen is headed to college.   (I learned that one the hard way.) 

Young adults:  It’s not too late!  Even if you’ve possibly been exposed to HPV, you may not have contracted one of the forms Gardasil prevents.  Getting the vaccine now will protect you from contracting it from in the future!  Ask your doctor to start the series right away.

Here's a great video to watch and share with your loved ones.  Perhaps one day we’ll be able to say that HPV & HPV associated cancers are totally eradicated, like smallpox. 


Yes, braces are truly worth all the time, money, and trouble!

My favorite part of what I do is sitting down with patients at the end of treatment to review their before and after pictures.  And I've never had a patient regret their investment of time, money, and life energy in achieving a great smile and balanced bite.

Like it or not, numerous studies show that people with straight teeth are judged to be more attractive, intelligent, happy, and successful than those with unsightly smiles.  Studies also show that not only do we smile because we are happy, but we can also become happier because we smile!  So if you cannot smile confidently, perhaps you are not as happy or successful as you could be.  Check out this great TED talk for more info.

Scientists suggest that we are hardwired to judge each others’ smiles because our teeth are indicators of overall health, and are therefore an important factor in choosing a future mate.  As an orthodontist, I can tell you that 99% of the time, a healthy and functional bite is also esthetically pleasing.

There are numerous benefits when your teeth are aligned relative to each other and relative to the jaws, and when they fit and function properly:

  • They are easier to keep clean (and therefore, free from cavities and gum disease).
  • They help improve your overall health, because gum disease is linked to diabetes and cardiovascular disease.
  • They help you chew your food better.
  • They help you speak more clearly.
  • They help prevent abnormal stresses on your jaws.
  • They help to prevent excessive or uneven tooth wear.
  • They help you keep your teeth for a lifetime!


I see many adults who seek orthodontic treatment because they have begun to experience some of the long-term side effects of a bad bite.  Malocclusion (improperly fitting teeth) is a “disease of civilization” that is increasingly causing problems for adults.  Thankfully, we are living longer and keeping our teeth longer than ever before.  But eventually an uneven bite will lead to one or more of these problems (depending on the patient’s weakest system):

  • worn down, chipped or broken teeth
  • broken down bone and/or gum tissue supporting the teeth
  • painful jaw joints and/or facial muscles


These issues may take decades to appear, but eventually they will become a problem that will affect your quality of life and require extensive dental care to treat.

So invest in yourself to enjoy the benefits now and head off bigger problems in the future!


Smile Studio is Certifiably GREEN

We are pleased to announce that we were recently awarded LEED Silver certification for Commercial Interiors by the US Green Building Council.  We are grateful for the grant from green | spaces that covered the expenses associated with documenting and commissioning the project.  And we couldn't have done it without Berry Construction and Hefferlin + Kronenberg architects.

These are the measures we took to achieve the silver certification level:

Water Conservation- To conserve water, we installed all water conserving fixtures, including low flow sinks, a bubbler for brushing teeth, and new low flow toilets.

Natural Lighting- Because our space has only one wall with exterior windows, we capitalized on the available natural light by using translucent panels at partitions and for many of the doors.

Location- Our office is located on Main Street, within a quarter mile of over ten other shops offering basic services. This allows people to park in one place and take care of various needs without the use of a vehicle. Additionally, we are located within a half mile of three public bus stops.

High Recycled Content- In selecting materials for our office construction and furnishings, we opted for materials that contain a high level of recycled materials. Twenty percent of all materials in our project are recycled.

Biking- To encourage biking to work, we have provided a shower for the use of all employees. We have also provided a bike rack adjacent to the parking lot to allow both employees and guests to secure their bikes if they choose to use alternate transportation to the office.

Energy Star- Over ninety percent of the power from office equipment we use is Energy Star qualified.

Recycling- We recycle paper, cardboard, plastics, and metals. We also participate in a sharps recycling program, along with Dr. Baldree’s office. During construction of our space, we recycled over 75% of construction and demolition waste.

Good Air Quality- We do not allow smoking anywhere within 25 feet of the entrance to our space and we exceed the requirement of national standards for fresh, outdoor air intake. Additionally, all paints, adhesives, sealants, flooring materials and composite wood products used in the building have minimal to no VOCs (volatile organic compounds). Even our furniture is low-emitting.

Efficiency- Our connected lighting density is over thirty percent less than what is required by national standards and every employee has the ability to adjust the lighting in their area to suite their tasks. To ensure that our HVAC, lighting, and hot water systems were operating at the efficiency we expected, a commissioning authority was employed and verified the installation and performance of all the building systems.