Moving teeth into optimal alignment is sometimes beyond the scope of traditional orthodontics. If there is insufficient bone and surrounding tissue to support tooth movement, your Dr. May recommend a treatment option called surgically facilitated orthodontic therapy, or SFOT. SFOT can safely move teeth a greater distance and into ideal position while improving the bone volume around the often deficient root structures. This advanced procedure requires an interdisciplinary team often consisting of an orthodontist and an oral surgeon, or a periodontist who work together to develop a personalized treatment plan. On the day of surgery, orthodontic brackets are typically left in place, but the wire may be removed for better access. The procedure typically involves gently pushing tissue away from the teeth. To access the surrounding bone, the surgeon gently perforates the outer shell of the bone following the contours of the roots. The body's reaction to this will reduce the density of the existing bone around the teeth to allow for more expansion and to stimulate the body's natural healing process. If there is a limited amount of bone or tissue, your Dr. May choose to add bone augmentation material to strengthen the area and protect the roots of the teeth during the three to four months it takes to heal. Your orthodontist may see you at regular intervals to change out orthodontic wires. This will help move the teeth as quickly as possible because bone naturally heals rapidly from injury. SFOT allows orthodontists to move teeth two to three times faster and two to three times farther than without SFOT, thus shortening orthodontic treatment times and maximizing the aesthetics and functional benefits. Other possible benefits of SFOT include eliminating tooth extractions for orthodontic treatment, acting as an alternative to jaw surgery, in some cases, creating healthier bone and tissue surrounding the teeth, and improving retention of the teeth after orthodontics. Ask your doctor if SFOT is an option for you and your unique needs.