Surgical
Surgically Facilitated Orthodontic Therapy (SFOT)
Surgically Facilitated Orthodontic Therapy (SFOT) is an advanced dental procedure that enhances orthodontic treatment (braces or clear aligners) by modifying the bone and soft tissue surrounding the teeth. This technique enhances tooth movement, reduces treatment time, and helps achieve more stable and predictable, long-lasting results.
What is SFOT?
Think of your teeth and jawbone like a house and its foundation. If you want to move walls or expand rooms, you need to ensure the foundation is strong enough to support those changes. SFOT works the same way— it prepares and strengthens the foundation (your bone and gums) so your teeth can move more efficiently and safely during your orthodontic treatment (braces or clear aligners).
By creating a stronger foundation, SFOT ensures smoother, faster, and more effective tooth movement. We work closely with your orthodontist or dentist to create a customized plan for your unique needs. Your orthodontic treatment focuses on straightening your teeth, while we ensure your bone and gum tissue are strong enough to support those changes safely. By combining our periodontal expertise with your orthodontic treatment, we help you achieve a beautiful, long-lasting smile in less time.
How Does SFOT Work?
During the SFOT procedure, the alveolar bone is carefully cut and augmented with bone and soft tissue grafts as needed. This stimulates the natural healing process, creating a healthier environment that accelerates tooth repositioning. By enhancing the effectiveness and efficiency of orthodontic treatment, SFOT can significantly reduce treatment time—potentially cutting it in half! Importantly, SFOT does not require special orthodontic appliances; it works seamlessly with traditional braces or clear aligners.
How Does SFOT Work with Invisalign?
SFOT and Invisalign work hand-in-hand to help patients achieve faster, safer, and more stable orthodontic results. You’ll still wear your aligners as directed by your orthodontist or dentist. SFOT supports and enhances your Invisalign treatment; it doesn’t replace it. Your orthodontist creates the Invisalign plan, while your periodontist (that’s us!) performs SFOT and manages the health of the bone and gum tissue. We collaborate to ensure every phase of treatment is coordinated for the best functional and aesthetic results. After the SFOT procedure, you will continue your clear aligner treatment as planned. Your orthodontist or dentist will adjust your aligner schedule to account for the accelerated movement made possible by SFOT, so you will change aligners more frequently.
Who is a Good Candidate for SFOT?
You may be a great candidate if you face one or more of the following challenges:
Patients with narrow dental arches often experience crowding, misalignment, and a lack of space for teeth to move. Traditional orthodontics may require extractions to create space, but SFOT stimulates bone remodeling, allowing for more efficient and stable arch expansion while minimizing the risk of soft tissue damage. By modifying the bone structure, SFOT ensures that teeth can move into a broader, more balanced position safely.
Moving teeth in patients with thin gum tissue can increase the risk of further gum recession, root exposure, tooth decay, and sensitivity. SFOT thickens and strengthens the gums before tooth movement. This reduces the risk of further gum recession, protects the roots, and enhances the long-term health and aesthetics of the smile.
When major tooth realignment is needed, traditional orthodontics can take several years to achieve the desired result, and without proper bone support, teeth may shift back over time. SFOT accelerates tooth movement while maintaining a strong periodontal foundation, reducing treatment time and ensuring long-lasting, stable alignment.
Orthodontic treatment requires strong bone support for safe and effective tooth movement. However, patients with bone loss—often due to past gum disease or aging—are at a higher risk of complications. SFOT adds bone where needed, reinforcing the foundation before orthodontic treatment begins. This prevents further bone loss, ensures proper tooth support, and allows for more predictable, stable results.
Some patients have a heavy buttressing alveolar bone that resists orthodontic movement, making treatment slower and less predictable. By reshaping and optimizing the bone, SFOT eliminates unnecessary resistance, making tooth movement smoother, faster, and more controlled.
Many patients want to straighten their teeth but don’t want to spend years in braces or clear aligners. SFOT increases the speed of tooth movement, allowing patients to complete orthodontic treatment in a fraction of the time compared to traditional methods.
Do I Need SFOT?
While traditional braces or clear aligners are designed to straighten teeth, they don’t always consider the condition of the surrounding bone and gum tissue. For some patients, moving teeth without first preparing the bone and gum foundation can lead to:
1
Gum Recession
When teeth are pushed through thin gum tissue, the gums can recede, exposing the roots and leading to sensitivity and potential tooth loss.
2
Bone Loss
Insufficient bone support can lead to further jawbone deterioration, making it harder to maintain tooth stability.
3
Relapse After Treatment
Without proper bone support, teeth may shift back into misalignment after braces or aligners are removed.
4
Prolonged Treatment Times
Dense or misshapen bone structures can slow tooth movement, leading to longer treatment plans.
Gum Recession After Invisalign? SFOT Can Prevent That!
If your gums are already thin or your bone is weak, moving teeth with Invisalign can sometimes make things worse, leading to gum recession. That’s where SFOT comes in. It strengthens the gum and bone before moving the teeth, which helps minimize the risk of recession down the road and sets your smile up for long-term health.
If you’re considering Invisalign, make sure a periodontist is part of your team. We can evaluate your bone and tissue first and help set you up for a healthier, more stable result.
Frequently Asked Questions: SFOT
- Consultation & Planning– A comprehensive evaluation, including digital imaging, is performed to determine candidacy for SFOT.
- Surgical Procedure– A minimally invasive surgical technique is used to reshape or graft bone tissue to optimize orthodontic movement.
- Orthodontic Treatment Begins– Braces or clear aligners are placed soon after surgery to take advantage of the enhanced bone remodeling.
- Healing & Monitoring– Regular follow-up visits ensure proper healing and monitor orthodontic progress.
One of the biggest advantages of SFOT is that it’s a one-time procedure with lifelong benefits. You’re less likely to experience relapse, bone loss, or gum problems down the road. SFOT minimizes future complications and ensures your orthodontic results last as long as possible.
After the procedure, you may experience swelling and tenderness. There will be minor oozing and/or bleeding up to 72hrs which is normal. You will be given a detailed instruction sheet. A soft food diet is recommended- no hard or crunchy foods. The days immediately after surgery, avoid eating or drinking hot foods or liquids. Cold or room temperature is better. Avoid strenuous physical activity during the immediate recovery period. You should plan to rest at home for the remainder of the day and up to a week. You can read, watch TV, or work at a desk from home.
No, it works with the same orthodontic appliances, such as braces or clear aligners. SFOT simply enhances the effectiveness and efficiency of orthodontic treatment.
The procedure is typically well-tolerated, with most patients experiencing minimal discomfort managed with pain medications.
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District Dental Surgery Locations
Washington, DC
(Formerly Known as District Perio)
1828 L St NW Suite 860 Washington, DC 20036
