Mr. Fix-It

Mr. Fix-It

A local orthodontist talks about getting braces, the “Do Not Eat” list, and how technology is changing his job

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Orthodontist Eduardo Avila and his wife, Amanda, a dental hygienist. Photo by Lisa Helfert

When Eduardo Avila was in dental school, his dad bought him the horror movie The Dentist as a joke. “He said, ‘This is what patients are thinking of you…so be compassionate,’ ” says Avila, who keeps that advice in mind and uses humor to help put patients at ease.

Avila, who owns Sublime Smiles, has known he wanted to be an orthodontist since he was 12 years old and had braces himself. His orthodontist took him under his wing, teaching him about X-ray machines and how to make models of teeth. Avila enjoyed having braces as a child and was fascinated by the process. He went on to have orthodontic treatment two more times as an adult, both to tweak his own teeth and to gain a firsthand understanding of the techniques and products being used.

“I love seeing how people transform from being shy and [not wanting] to smile to being happy and more positive,” he says. “As a kid, I liked to play with Erector [construction] Sets and Legos. Being an orthodontist is like being an engineer, but on a micro scale.”

At his offices in Gaithersburg and Rockville, Avila sees patients as young as 7 and some into their 80s. A graduate of the Tufts University School of Dental Medicine in Boston, where he later returned for two years of specialized training in orthodontics, he bought the practice in 2011 and has expanded it from 110 to 500 patients. About half are adults who often want treatment after seeing their children’s teeth straightened and realizing how the process has improved.

Technology has changed the way Avila treats patients and, he says, often leads to better, quicker results. Gone are the days of impressions made with a gooey material. Now machines scan patients’ teeth to make digital models. Avila, 44, uses computer software to simulate the movement of teeth and to show patients what their smiles could look like after treatment. The digitized records allow for virtual consultations, minimizing emergency trips to the office. About 60 percent of his patients opt for Invisalign, which involves transparent removable aligners; the rest get traditional metal braces.

Avila’s wife, Amanda, a dental hygienist, is the office manager at Sublime Smiles. The Bethesda couple has two children, ages 3 and 5. Settling in the D.C. area was a compromise: She’s from Maine; he was born in El Salvador and grew up in Miami, so they picked a place about halfway in between.

They try to create a fun atmosphere at work. “We play music, and it’s not uncommon to see people dancing around,” Amanda says. One Halloween, the staff dressed up as foods that patients shouldn’t eat if they have braces. For National Karaoke Week every April, they put a karaoke machine in the waiting room.

The most excitement, however, occurs on the days when patients get their braces removed. “When people at the end give me a high-five, or they feel so comfortable with me that they give me a big hug, that makes my heart melt,” Avila says. Once the braces are off, they leave with an exit gift: a bag full of items on the “Do Not Eat” list, including popcorn, a Snickers bar and chewing gum.

In His Own Words…

Bending The Rules

“Initially, it’s good for [patients] not to eat the things on the ‘Do Not Eat’ list. But after a while, I’m sure everybody eats everything on that list. It’s just a matter of how you adapt. Instead of eating a whole bagel toasted, you can slice it up and eat it in pieces. You can get by with eating things on the list, just making sure you do it the right way. It’s kind of like speeding—everybody does it. …We give them five broken brackets without being charged.”

The Price of Roughhousing

“I had one kid who was wrestling in the living room and the carpet got stuck in his braces. They had to cut around it, and he came into the office with a little tuft of it that I had to clean out. I came into the office on the weekend to meet him.”

Unexpected Reactions

“Sometimes, actually, when they get their braces off, people are sad the experience is over. They are actually in tears. They want them back in because they miss the feel and being able to come in. Maybe they think they can’t get out of school early anymore.”

On Social Media

“People are more conscious about their looks, and that drives people into our office. They are always shocked by the before-and-after photos. They are extremely grateful most of the time about how their bite has changed. Now they can take their Instagram photos from different angles. They used to say they could only do their right side, and now they can do both sides.”

The Future

“The next revolution will be the virtual consult. Basically, everything will be on [the] computer. There will be stations set up in CVS that take a scan [of your teeth]. A doctor will talk to you about it virtually. Or maybe there will be a van that goes to your house to take a scan, and a doctor goes over your case virtually on FaceTime. [This approach] is starting to slowly be integrated. It might be mainstream in three years. I hope to be part of that.”

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