Missing Permanent Teeth?

June 20th, 2018


One of the questions I often answer during new patient appointments is, “Do you see many patients with missing permanent teeth?” The answer is, “Yes, I do.”

Approximately sixteen percent of the population is congenitally missing a permanent tooth, meaning the tooth never forms. This figure does not take into consideration third molars or patients who have lost a tooth during their life.

Another common question I receive is, “Why do you see so many patients with missing teeth when it is a relatively small group in our population?” Because, orthodontics provides the best treatment plans to help patients solve this problem. Solving this problem orthodontically tends to be less invasive and less financially costly to the patient.

The three main orthodontic treatment plans I recommend for correcting the tooth missing issue: are: 1. preserve the primary (baby) tooth; 2. replace the missing tooth; or 3. orthodontically close the space where the permanent tooth is missing. The condition of the teeth, the fit of the teeth (occlusion), and the amount of crowding/spacing in the mouth are all factors that influence which treatment plan is ideal for a patient.

Preserving the baby tooth is my preferred plan of treatment as long as the fit of the teeth is good and there is not significant crowding. If the primary tooth fuses with the bone (ankylosis) at any stage, the primary tooth will need to be removed and a restorative treatment plan put into action. Replacing the missing tooth is usually accomplished with an implant and a crown.

An implant is a permanent structure placed into the bone, usually by an oral surgeon or periodontist. The implant will remain in the bone for the rest of the patient’s life. The crown on top of the implant is placed by the primary care dentist and usually needs to be replaced every ten to fifteen years.

If the patient has crowding, the primary tooth can be removed and the teeth can be orthodontically moved to close the space and fit the teeth together properly.

If you or your child is missing permanent teeth, please visit an orthodontist to learn more about your treatment options. An orthodontist will work with your primary care dentist to develop the best treatment plan for you, while orthodontically moving your teeth to give you the smile you have always wanted and a bite that is properly aligned. Every smile deserves the best treatment options and, when needed,  a board certified orthodontist.

Choosing an Orthodontist MATTERS

August 8th, 2017

(click image above to view a short video from Dr. Kelley)

Alison and I often get asked by friends living outside of Fort Worth, “How should I pick my orthodontist?” With as many dental specialties as there are and with insurance changing regularly, I am not at all surprised by this request. Please understand, I am not posting this blog in order to persuade anyone to choose me to meet their orthodontic needs, but to educate friends in their search.

First, make sure that every professional you consider is actually an orthodontist and not just a dentist that does braces. An orthodontist is a dentist who has not only completed a graduate program in dentistry to receive their DDS or DMD (Doctor of Dental Surgery or Doctor of Dental Medicine degree), but has also gone through a competitive residency at an accredited orthodontic program for an additional 2-3 years to be trained specifically in orthodontics. One way you can be sure that he or she is a specialist is to look him or her up on the the American Association of Orthodontists website. This site lists only specialists who have graduated from an accredited orthodontic program and belong to the AAO.

A board certified orthodontist is an orthodontist who has voluntarily taken their specialty a step further. They have gone through hundreds of additional hours of preparation to demonstrate their judgment, skills, and knowledge required for providing the highest level of patient care. They have achieved board certification through the American Board of Orthodontics, the only orthodontic specialty board recognized by the American Dental Association and in affiliation with the American Association of Orthodontists. Achieving board certification is the last step in a long and intensive educational experience to ultimately provide excellent patient care. The American Board of Orthodontics website lists orthodontists who have taken this extra step and become board certified.

The next place I would seek a referral would be from other SPECIALISTS in the area, especially oral surgeons. Although there are a lot of primary care dentists who might be helpful in your search, many of them are attempting orthodontics themselves. Some general dentists also form personal relationships with specific orthodontists and may refer you to their “buddy” whether or not he or she does the best work. Oral surgeons and other specialists work with all of the orthodontists in the area. Thus they are able to see and compare their work. A primary care dentist may only work with a couple of orthodontists, but an oral surgeon typically works with dozens.

Another good source of information today is the Internet. However, you need to take the information you find there with a grain of salt. First, practice websites and social media sites do not always accurately portray the quality of work the orthodontist provides. A bad orthodontist might have found an excellent website designer. On the other hand, an excellent orthodontist just might not be up with the times. You should search for reviews on the orthodontists you are considering, but again realize that not all reviews are accurate. Happy patients usually don’t go out of their way to write reviews, but unhappy ones can’t wait to get their fingers to a computer. No doctor can make every patient happy all the time. (I would actually warn you to stay away from those who contort themselves trying.) One or two poor reviews should not scare you off, assuming they are accompanied by several positive ones.

Last but not least, pay a personal visit to the office you are considering. What is your initial impression as you park, approach the building, and are greeted at the front desk? Is the office up to date and clean? Is the staff helpful and in a good mood? Remember that you are going to be visiting this office about once a month until your treatment is complete. Upon visiting, ask yourself if the office feels like home and if the staff feels like an extension of your family. Finding an orthodontist is not always easy, but it is definitely worth your time, your mental peace, and your smile to do some homework.

Just for the record, I am a board certified orthodontist. Most dentists are not orthodontists. And not every orthodontist is board certified. I feel extremely blessed to be part of this elite group of specialists practicing orthodontics today. I encourage you to always ask your doctor if they are specialists. After all, doesn’t your smile deserve the BEST?

The Joys of Summer

June 12th, 2017

Most of our students are free from school for a few short months. Our entire Kelley Orthodontic office loves summer and the change of pace. I love seeing patients coming to our office with a smile on their face, a tan from being away from the classroom, and stories of their adventures. Our adult patients seem more relaxed and less stressed.

My best memories of summer centered around days with friends and family without an agenda. The fun was focused on the people we were with more than the activity of the day. Oftentimes, we did not know the day of the week. Each summer day felt like a Saturday.

I was blessed to get to spend significant time each summer with my grandparents. I attribute my close relationship with my grandparents to the extended visits over the summer. I encourage all of my patients to take the time to invest in the relationships of family. You will learn so much about yourself and how your story was put together.

Summer is also the time in our lives when we try new experiences. Learning to swim, sports and academic camps, road trips, new sites, great books, overnight camps, and mission trips. Each of these opportunities provides incredible influence on our character development. Two of my favorite activities, water skiing and sailing, were initiated during my summers. I encourage you to try something new...pick up a new hobby, read a different style of genre, try a new recipe, make a new friend, go on an adventure. You are never too old to develope a new skill or passion.

I wish each of you a joyful summer, full of experiences which stretch you a little and provide loads of fun and relaxation. I look forward to hearing your stories at your next appointment.


November 16th, 2016

It is hard to believe that we are actually celebrating our 5th year with Live Thankfully. What started with just a few Thanksgiving turkeys has grown into a movement across our city.  I am constantly asked how Live Thankfully came to be and what our vision is when it comes to LT in the future.  Honestly, when I reflect over the past 5 years, I don’t know how we got here or how in the world LT continues to keep growing with such momentum.  I just know that God continues to bless our efforts, cover our many mistakes, and graciously bring us folks to guide us and serve alongside us.

John often refers to Live Thankfully as our "accidental nonprofit" (or my very expensive hobby). Never in a million years did I think we would have started and been running a  charitable organization.  Don’t let this blog or social media posts fool you. The nonprofit world falls way short of glamorous. Startup nonprofits require a ton of work, cause a significant amount of stress, cost a lot of money, and are never ending. Yet our reasons for continuing to press on are anything but accidental – they are completely intentional.

You see, Live Thankfully is not just about serving meals, we are about preparing young hearts for service.  (Turkeys and cans are simply the conduits!)

What began as a way of marketing Kelley Orthodontics has turned into a four-part service project involving the entire community.  In the past, before LT, Kelley Orthodontics gave turkeys to John’s referring dentists around the holidays. In 2012, we decided to redirect our efforts and reach out to families in our neighboring schools who were struggling to put a Thanksgiving meal on the table.   That year, with the support of our dental community, we gave 60 meals to families in need.  Five years later, we are giving approximately 600 meals to families adopted through 20+ Fort Worth schools, Gill Children Services (an organization John faithfully serves with professionally), and 2 local churches.

Leadership training takes place in all of our Live Thankfully schools throughout the academic year. The process begins with education and changing the way kids think about service and giving.  LT volunteers spend numerous hours in our partnering schools, mentoring student leaders, and teaching them how to conduct successful food drives.  We teach kids that they have the power to create positive change in their communities.

Not every child can be a superstar academically, but every child can serve.  The evidence of a good leader is service.

Food drives are conducted the month of November in our partnering schools and business offices. LT volunteers pick up these heavy boxes of food weekly, transfer them to our storage unit where students of that campus organize them for our packaging party.  Our food drives collect enough food to fill 2500 bags of groceries and donate another 5000 plus food items to local area food banks.

Packaging Party: Live Thankfully hosts a party in which volunteers from the community come together to package the groceries collected from our LT local food drives. This party takes place on the Sunday evening prior to Thanksgiving.

I am constantly blown away by who shows up to sort and bag the food.  There is no discrimination of age, religion, socioeconomics, physical abilities, or race.  This, to me, is the most beautiful part of Live Thankfully. A person simply volunteering their time may be serving next to another who is actually receiving a meal. Since those receiving meals serve alongside those who give, students recognize the needs around them, compassion increases, relationships strengthen, and our community solidifies.

Thanksgiving Dinner Distribution: Thanksgiving dinners, purchased through Live Thankfully, are given to families selected by our partnering schools’ counselors. Each family receives a full meal along with 2 bags of groceries from our packaging party.  These families are chosen based on financial, emotional, and physical needs.  Our counselors are diligent to follow up with these families throughout the school year.  We offer resources and collaborate with other nonprofits to help these families get back on their feet.

Every participating school has teachers and administrators present to give the meals to their adopted families.  We desire to tears down walls of distrust and builds bridges of trust between those in need and those who are able to help.  This starts in the micro-communities of the schools with the teachers, administrators, and fellow students meeting the needs of their own school families.

So what do I envision for the future? I truly am open to anything.  We simply pray that the Lord will organically grow Live Thankfully as He desires: that He would bring the financial support, the manpower, the resources we need to continue being the hands and feet of service in our local schools and community.

We are considering saying “yes” to more schools next year. And saying, “yes” to having more than one site for our packaging party and meal pick-up.  This would allow others in the community to realistically join us in service, thus maintaining dignity and pride in those we bless with meals.

I have a vision of providing some type of paid stipend or job for the single moms who receive our meals (a sort of income generating activity).

We provide a smaller scale leadership opportunity on our school campuses during the spring called Created for Compassion. But I would love to see LT offer another large community involved service project in late May or early summer.

I envision a Live Thankfully summer day camp. Young leaders, both kids “of plenty” and kids at risk for failing or dropping out of school, would come together for a week or two. We would pour into them and challenge them in areas of service. They would problem solve and work together for the betterment of their schools and community.

So, I am a visionary. (It’s amazing what you learn about yourself when you take on something new.) I have been so blessed to find and hire an incredible Executive Director who comes alongside me, keeps me on track, makes sure we are staying within our mission, and doing what we were called to do WELL, before moving forward.

I have no idea where Live Thankfully will be tomorrow. I just know that I have fallen completely in love with the teachers, administrators, and kids of our public schools. I see the chains they wear because of governmental red tape and ridiculous testing requirements. I see children who have so much potential, so much character, so much to offer our society, being crushed in spirit because they don't fit into a box.  Live Thankfully gives our schools a diffent kind of box - one that is moldable and pliable. The schools can change and manipulate it based on the needs of their students and the conditions of their individual schools.

I have been told numerous times by our teachers that they have witnessed transformation in the students that are actively involved with LT.  For some, Live Thankfully is the only place they feel successful in school. Through Live Thankfully, they experience the joy of hands on learning and the excitement of discovery. They  come to believe that they are so much more than a test score, and that academics don't always get in the way of a good education. These kids are coming alive and so are their campuses during Live Thankfully season!

So this is what keeps me going. This is why we can’t stop, why we can’t throw in the towel when I desperately (at times) want to go back to simply giving turkeys to dentists. Running a fulltime nonprofit is HARD.  It is HARD HARD HARD.  But  nothing worth fighting for doesn’t come with difficulties, with trials, with sweat and tears. Right? These kids are worth fighting for, our schools are worth fighting for, and our community is indeed worth fighting for. Spend just a few hours in our Fort Worth schools, look past the system and see the faces.  You too will be hooked!

In one sentence: Live Thankfully is a life style. Won’t you live thankfully too? livethankfully.org

(click image below for 5 year annivesary video)

Guest blogger: Alison Kelley (aka: Dr. Kelley's bride) pictured below with Executive Director, Sarah Nader

Words Do Matter

April 26th, 2016

I have the great privilege of developing friendships with a great majority of our patients.  I have learned a tremendous amount about our world and the hearts of people.  One resounding lesson is the words we choose to express to others matter.  I was profoundly reminded of this lesson a few days ago.  A very special adult patient named Debra sent an e-mail to me about her experience as an orthodontic patient and the reason she chose to pursue orthodontics  with us as an adult.  With her permission, I will reprint her words.

“Dr. Kelley, for 40 plus years I was ashamed of my teeth.  In front of the entire class, I was told by my 8th grade music teacher that I should not smile.  It was many years ago, but I never forgot how it made me feel.  I can now at 60 years of age scratch braces off my bucket list. After my braces were removed, I was finally able to share with my husband why it was so important for me to see an orthodontist. Thanks to you and your staff I couldn’t be more proud of my brand new smile.”

I am thankful Debra was able to attain the smile she has longed for since 8th grade.   I am touched by her willingness to let our office know her story.  Her story is a great reminder to me to choose my words wisely each day with my wife, children, and patients.  Each of us can build others up or tear them down simply by the words we express to others.

I tell my kids all the time that our words have meaning. Most of the things we say will be forgotten. (Thank God!) But other things we say will forever be engrained in the minds and hearts to whom we speak. These words can either bring life or they can bring pain and suffering.  I want my words to always bring life, to bring transformation, to bring positive change and hope. One thing is for sure, our words have meaning.  They are either building up or tearing down. I encourage you to choose today who you will be... and then proclaim it through your words!

On the Verge of Technology Break Through

March 14th, 2016

We live in a virtual/digital world so I am not surprised when asked, “Dr. Kelley do you use digital scanning when making impressions?” My answer is usually, “not yet, but for a very good reason.” I then proceed to explain why.  Well my “why” is the very reason I blog today. And I am excited to share some new developments on this topic.

My team would love to be able to utilize a digital scanner instead of alginate impressions.  There actually are several digital scanners on the market today. We have always been committed to bringing the most innovative approaches and technology to our practice.  So why haven’t we introduced digital scanning? Unlike most orthodontic offices, our team specializes in the care of a diverse group of patients, patients ranging from birth to senior adults.  We gladly embrace and consider it a privilege to treat the most complex and challenging of orthodontic cases. Thus, Kelley Orthodontics is waiting to invest in a digital scanner that can meet the needs of all our patients (babies born with cleft lip/palate, traditional orthodontic patients, and patients wearing Incognito or behind the teeth brackets.) Unfortunately, as of today, accurate digital scanning is only available to traditional orthodontic patients. However, we believe we are on the verge of a technology break through and Kelley Orthodontics is at the forefront of this discovery! I could not be more excited about this development.

Currently, we take traditional impressions of our cleft babies at Cook Children’s Hospital in an operating room.  The cost incurred by these families is astronomical, not to mention the discomfort and emotional strain caused to both baby and parents. Thus, the ability to take a digital scan in our office would be a gigantic step in the right direction.  Because there is no scanner on the market able to accomplish this task, we are partnering with Sirona, an amazing company that has a reputable presence in medical and digital imaging, in hopes of making this happen.

A couple of weeks ago, our representatives from Henry Schein dental company brought the Sirona scanner to our office to try on one of our cleft patients.  We attempted to take the scan utilizing the current scanner and software.  We were extremely pleased that we were able to get a significant portion of the scan. However not all of the critical areas were accurately recorded.  Thus, we are requesting the software engineers at Sirona Germany to rewrite a portion of the software to allow us to retrieve the data we need from the scan.  Since we are the first orthodontic office in the country to attempt this, we are breaking new ground.  I believe the wait and effort is worth it.  Cleft lip and palate families around the globe will greatly benefit with this new technology along with the specialties of Oral and Maxillofacial Surgery, Plastics, and Otolaryngology.

The potential ripple effects of this type of development are indescribable. Babies failing to thrive because they are unable to eat could be orally scanned and fit for an orthodontic feeding appliance days, instead of weeks, after they are born. These little ones, with lengthy roads of surgeries and therapies, could begin eating sooner, leave the hospital earlier and begin their long term treatment and healing process; all while deterring major medical costs and emotional and physical discomforts.

So how does this affect you, our general population, our mainstream and most encouraging orthodontic patient-group?  Once a scanner and software are developed that will meet the needs of our entire patient population, we will invest in it. We will be able to scan all patients here in our office!  Thank you for waiting this out with us.  Thank you for having hearts for those born with special differences. Thank you for sacrificing the good today in order to possess the best tomorrow. I have no doubt this will happen in the near future and we as an orthodontic community are all a part of making it happen.  That is exciting! Kelley Orthodontics will indeed throw a party when this day arrives.

I am very thankful for families like yours who are willing to partner with us.  I have included a couple photos from our first attempt of getting a scan of a baby born with a cleft lip/palate.  The success of this appointment will be the springboard to success for our office and offices around the world.  We are making history. You are making history. #inthistogether!

Stay tuned.  The best of orthodontics is in our future.

Live Thankfully

October 31st, 2015

People often ask me what is Live Thankfully? How did you come up with this nonprofit and what are your plans for it? Honestly, all I can say is, "I really don't know how we got here.  Alison and I had a dream, we prayed about it, and it exploded in a way that we could never have imagined."  I wanted to see the smiles of Kelley Orthodontics reach deep into the hearts of our Fort Worth community.  I wanted to give my patients something of substance to smile about.  We never set out to start a nonprofit. Trust me there are many times I feel overwhelmed by all it entails. Nonprofits take a lot of work, a lot of money, and a lot of emotional sweat and tears. But in the end, our hearts beat hard for the mission of Live Thankfully, the Lord re-energizes us, and we just keep going.

We love kids, we love our community, we love people (all people), and we love seeing a diversity of folks come together for a greater cause.

Live Thankfully: Extending our Smiles to the Hearts and Stomachs of our Community! LT is not another turkey handout nor another can food drive. We are about empowering the next generation to be life long givers of their communities.  It is our goal to tear down walls and build bridges of trust between families in need and those in our community who can help them. Live Thankfully is a life style, it is a way of living that brings dignity and pride to our families in need and establishes a lifestyle of service in our future leaders.

What started four years ago as 60 turkeys to give to families in need, has turned into a three week long service project.  This year, we will give approximately 600 turkey dinners and groceries away to families in need. These families are adopted and selected by school administrators of the 22 schools that are partnering with us. We also come alongside Welcome Back Tarrant County and Christ Chapel Bible Church and supply groceries to the families they purchase turkey dinners for.

In order for a school to have families adopted through Live Thankfully, they must participate in the entire LT process. We go into these schools and encourage, educate and commission these students to be life long givers of their community. We explain that through Live Thankfully, families receiving meals actually have the opportunity to work alongside and give back to their community. We give the schools all the tools they need to have a successful food drive and allow them the creativity to run it themselves. I am blown away by how well these students plan, trouble shoot, encourage their student body, and orchestrate the drives in their schools. The teachers and staff fully support it as well. One teacher commented just last week that the families who receive meals, tend to really give and get behind the can food drive.

Our LT schools also invite and encourage their students to attend LT's Party with a Purpose.  Some schools even bus their students in to serve.  After can goods are collected for three weeks, we throw a HUGE party where volunteers sort and bag all these groceries. Last year we filled over 2000 bags in less than 30 minutes! There is nothing more beautiful than seeing families chosen to receive a meal, working so hard alongside volunteers. Service and love are universal languages that need no translation. Dignity and pride are maintained when those in need have the opportunity to buy into what they are being given.

Our LT schools also commit to have school representation pass out the turkey dinners and groceries to their adopted families. Every one of our LT partnering schools will have teachers, counselors, or principals present to pass out meals. This strengthens the bond of trust between those who are in need and their school leaders. Our schools use the rest of the academic year to point these families in the direction they need to receive permanent help.

One thing I tell students when speaking to them is, "change happens when we invest in people." Live Thankfully is about relationships. Turkeys are simply the conduit into the schools. Educating, encouraging, commissioning, investing and following up with people takes a lot of time, money and emotional energy. But it is so worth it! Alison and I have fallen completely in love with our Fort Worth schools, public and private. We have been humbled by the outpour of support from our business and dental community.  These businesses have not only given of their finances but have volunteered their time and expertise to make LT happen.

Live Thankfully is not just a Kelley Orthodontic thing. It is much bigger than anything we could ever make happen. We utilize hundreds of volunteers and ask for financial donations and sponsorships. We NEED volunteers and financial gifts. We invite you to join us.

Live Thankfully is changing our community one student, one family, one school at a time! Won't you consider LIVING THANKFULLY with us?

(to volunteer, make a financial donation, buy a t-shirt & to learn more visit livethankfully.org)

Welcome to Our Blog!

February 20th, 2013

Thank you for taking the time to visit our blog. Please check back often for weekly updates on fun and exciting events happening at our office, important and interesting information about orthodontics and the dental industry, and the latest news about our practice.

Feel free to leave a comment or question for our doctor and staff – we hope this will be a valuable resource for our patients, their families, and friends!

A Few of Our Smiles

What our Patients are Saying

"John Kelley has partnered with us in transforming the H.O.P.E. Farm Boys into men. Kelley Orthodontics has the ability to help our boys develop confidence in their appearances and more importantly their characters. The Kelley Orthodontics team has been an irreplaceable instrument in the success of our program. John Kelley and the Crew… you are the best! "

"Professionalism and efficiency usually don't mix well with warm hospitality, but somehow at Dr. Kelley's office you find it blended comfortably together at every visit. Dr. Kelley not only takes his work seriously but also his relationship with you, the patient. You will not find a more friendly, helpful staff anywhere. "

"When I first found out I was getting braces, I got kind of worried, but Dr. Kelley explained everything to me step by step and made sure I knew how to treat minor pokes or pains in my teeth. They also provided me with toothbrushes and floss just for braces and taught me how to use them. The staff is really friendly and they're really good at accommodating me to where I don't miss anything big at school. Kelley Orthodontist has done a great job helping me with my braces! "

"I personally like it when I go to the orthodontist. When all the other kids at school say, 'I have to go to the orthodontist today,' the usual responses are, 'Hope you come back alive!' or 'That stinks!' But my response is, 'Who do you have?' The reason all the kids hate orthodontics is because they don't have Dr.Kelley! The staff is amazing, they don't put pointy things into your mouth, and they make the appointments quick and fast. Thank you Dr. Kelley for making a place that makes my mouth good as new!"

"We have been so grateful for Dr. Kelley's orthodontic care of our children. His kindness in dealing with our family, thorough medical expertise, and friendly office staff have made this office feel like a second family. Three of our children have been through orthodontics with Dr. Kelley, and not only are their smiles fabulous, but they even enjoy going to the office for visits. We have full confidence in Dr. Kelley's treatment of our children's individual orthodontic needs, and for one of our children in particular have seen significant progress that will likely keep him from surgery down the road. Because orthodontics requires frequent visits and check ups, we are all the more thankful for such a fantastic orthodontist and office staff to spend time with."

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