Gum, caramel, tootsie rolls, peanut butter, toffee, taffy, granola bars, frozen candy bars
To achieve the most beautiful and healthy smiles for our patients and to guide them along a path of optimal dental health and wellness. To promote Evidence Based Philosophies and treatment modalities. To non judgmentally deliver the highest possible care with empathy, respect, and commitment to excellence. To continuously and relentlessly pursue excellence through continuing education and personal and team growth. To master and deliver leading-edge Orthodontia care to our patients and to consistently perform better than would be reasonably expected.
To adopt World Class Practices and make SIERRA ORTHODONTICS the preferred destination for Orthodontic care in our community. To make ‘Excellence in Every Smile’ our motto. To link this vision statement to our underlying values of integrity, compassion, respect, teamwork, and pursuit of excellence.
Imagine earning points for being a great patient and having a great smile! With Sierra Orthodontics, you get to join a membership club of lucky users who earn points for doing all kinds of awesome things. And the best part is that you get to use your points to play games, order gift cards, and more!
Dr. Abhijit Gune received his B.D.S (Bachelors in Dental Surgery) from the Bombay University (now known as Mumbai University) in 1997. After earning top honors in Anatomy, Oral Surgery, and Orthodontics he decided to pursue his Masters in Orthodontics and Dentofacial Orthopedics at SDM College of Dental Sciences, one of the most prestigious educational institutions in India. Dr. Gune received his M.D.S (Masters in Dental Surgery) in 2001 and his D.N.B (Diplomate of National Board of Orthodontics) in 2003. He immigrated to the United States and received his D.D.S and California Dental License in 2004. He has made Tuolumne County his home since then and has served as the Dental Director for the Tuolumne Me Wuk Dental Clinic in Sonora and enjoyed his involvement in community dental health projects. Dr. Gune is currently on staff as Adjunct Assistant Professor in the Department of Orthodontics at the Arthur Dugoni School of Dentistry at Pacific University in San Francisco.
At Sierra Orthodontics, he offers the latest advances in Orthodontics utilizing the passive self ligating Damon System. Dr. Gune is also certified in the Invisalign system. Sierra Orthodontics is the only office in the community to also offer the Incognito System (tongue side braces) which offers a great alternative for adult patients who are esthetically conscious about having braces showing during treatment. Dr. Gune is certified in the Incognito System. He has enriched his knowledge and professional skills by participating in numerous conferences, workshops, and other academic activities.
Dr. Gune is an active members of the American Dental Association, the California Dental Association, and the San Joaquin Dental Society. Through continuing education above and beyond his license requirements, he is constantly working toward the goal of providing the best orthodontic care based on sound scientific evidence for his patients in a caring and gentle environment.
We Are Dedicated To Creating
Excellence In Every Smile
Click on individual images to see orthodontic results
It’s not going to be easy at first and, in the beginning, foods you can eat will be limited. You’ll want to stick to foods that are soft, fluffy, and easily mashed up. Pancakes, oatmeal, bananas, soups, cooked vegetables, applesauce, mashed potatoes, mac & cheese, and soft ice cream – just to suggest a few. Stay away from foods that are hard, crunchy, sticky, or tough.
Please avoid these foods while wearing braces.
Gum, caramel, tootsie rolls, peanut butter, toffee, taffy, granola bars, frozen candy bars
Apples, carrots and other raw vegetables, chewing ice, nuts
Popcorn, chips, hard tacos, celery
Bagels, corn on the cob, sandwiches, steak, ribs, beef jerky
Your mouth is going to feel sensitive and a bit sore when you first get your braces put on. To help alleviate the soreness, you can rinse your mouth with a salt-water solution or take an over-the-counter analgesic. If your braces are rubbing or poking your mouth, you can use dental wax (available at the office or your local drugstore) to cover problem areas and prevent blisters.
Part of the process of creating your new, beautiful smile is moving your teeth; to move them, they need to loosen up first. “Loose teeth” are a natural part of the process. Once your teeth are in the right place, they will settle into their new position.
Inevitably, something is going to come loose. A bracket will loosen or a wire may pop out of place. If it’s a flexible wire, you might be able to push it back into place using tweezers. If you can’t move it with tweezers, you can use a pencil eraser or the back of a pen to push the offending wire down. Dental wax will also be your friend; place a small amount on the spot to cover the problem area. Next, schedule an appointment to have the wire, bracket, or band repaired.
It is always important to brush and floss your teeth to keep them clean and healthy – with braces, it’s more important than ever. Consistent brushing and flossing will ensure that your gums and teeth remain healthy throughout your treatment.
When is the best time to begin orthodontics?
Though a smile can be enhanced at any age, there is usually an optimal time period to begin treatment. Beginning treatment at this time can ensure the best result and the least amount of time and expense. We at Sierra Orthodontics recommend that the initial orthodontic evaluation should occur when the 6 year molars are coming in and the four upper adult front teeth and the four lower adult teeth are coming into the mouth; this is usually around 6-7 years of age. At this early age, orthodontic treatment may not be necessary, but an orthodontic examination and an evaluation of the patient’s airway and swallow pattern can anticipate the most advantageous time to begin treatment.
What are the benefits of early orthodontic evaluation?
Early evaluation provides both timely detection of problems and greater opportunity for more effective treatment. Prudent intervention guides growth and development, preventing serious problems later. When orthodontic intervention is not necessary, Sierra Orthodontics can monitor growth and development and begin treatment when it is ideal.
Why is ages 6 or 7 considered the optimal time for screening?
By the age of 6 or 7, the first adult molars erupt, establishing the back bite. During this time, we can evaluate front-to-back and side-to-side tooth relationships. For example, the presence of erupting incisors can indicate possible overbite, open bite, crowding, improper swallow patterns, and possible airway constrictions leading to snoring or sleep apnea. Timely screening increases the chances proper facial growth and development as well as an incredible smile.
What are the advantages of interceptive treatment?
Some of the most direct results of interceptive treatment are:
Are you a candidate for orthodontic treatment?
Orthodontics is not merely for improving the aesthetics of the smile; orthodontic treatment improves bad bites (malocclusions), muscle function, and airway constriction. Malocclusions occur as a result of tooth or jaw misalignment, improper swallow patterns, and limited or compromised airway. Malocclusions can affect the way you smile, chew, clean your teeth, or feel about your smile.
Why should malocclusions be treated?
According to numerous studies, untreated malocclusions can result in a variety of problems. Crowded teeth are more difficult to properly brush and floss, which may contribute to tooth decay and/or gum disease. Protruding teeth are more susceptible to accidental chipping. Crossbites can result in unfavorable growth and uneven tooth wear. Openbites can be caused tongue-thrusting habits and result in speech impediments. Improper swallow patterns can lead to dental crowding and malalignment. Finally, airway constriction and sleep apnea can ultimately lead to serious adult health issues. In the end, orthodontics does more than make a pretty smile-it creates a healthier you.
Orthodontics isn’t just for kids anymore. Tooth alignment can be changed at any age if your gums and bone structure are healthy. We offer a variety of treatments for adults. Traditional braces, “invisible” braces, and aligners like “Invisalign. A new smile can begin today.
Orthodontic treatment at later stages of life can dramatically improve your personal appearance and self-esteem. Improving the health of your teeth and gums is equally important. Crooked teeth and a bad bite can contribute to gum and bone loss, tooth decay, abnormal wear of the tooth enamel and surfaces, headaches, and jaw joint (TMJ/TMD) pain.
Good news! The new techniques and appliances we use greatly reduce discomfort levels, decrease the frequency of visits, shorten treatment time, and may allow you to choose from several options. Your options may include metal braces, translucent or clear ceramic braces, braces on the “tongue side” of your teeth, or transparent aligners that can be worn.
During the initial examination, we will be able to determine the different options tailored for your individual needs. We can outline the treatment plan, time required for proposed treatment, and the approximate cost.
A large percentage of our patients at Sierra Orthodontics are adults, and they agree that it’s never too late to improve their greatest asset – their smile.
Using a soft-bristled toothbrush, begin by brushing the outside of your teeth and braces holding the brush tilted at a 45 degree angle. Brush along the top and bottom of the braces using light to moderate pressure, making sure you cover every surface very carefully.
Don’t forget to brush the teeth all the way in the back and behind your back molars. It’s a good practice to brush for three minutes at least twice a day. Using a timer or singing along to a song will help you keep track of your time.
Flossing at least once a day is very important for good dental hygiene and to keep your teeth healthy. Flossing with braces may seem difficult at first. To floss properly, you will need to thread the floss under the archwire. This can be done in two ways – either by threading the floss through on your own or using a floss threader to thread the floss under the wire.
When threading the floss, it is a good practice to start by pushing the floss vertically from the top to the bottom on your upper teeth and from the bottom to the top on your bottom teeth, always threading away from your gums. Once threaded, carefully floss around each tooth and gum, moving the floss up and down, just like you did without braces.
Worried about having metal braces for Prom, yearbook photos, or playing sports? Invisalign clear aligners are virtually invisible and most people do not even notice them. Since they are removable, you can eat what you want without any worry of breaking a bracket or rubber band. Not only are the aligners removable, they are very durable.
Invisalign is the ultimate in terms of aesthetic treatment options. We use custom molded clear trays to move your teeth to the ideal position. Because they are removable, patient compliance is extremely important with aligners. Invisalign is a terrific option for working professionals or patients seeking a discreet solution to improve their smile.
The Damon System bracket is self-ligating, so it eliminates the need for elastic ties to keep the wire in. Without a tie, the braces stay clean and friction is reduced, allowing your treatment to progress more efficiently and with less discomfort along the way. Damon System braces are available with both a metal and a clear option.
Insignia Custom Smile Design, a computerized system that combines digital treatment planning with custom brackets and wires tailored to your specific dental anatomy. A treatment plan developed with Insignia creates a layer of meticulous detail that provides fast, accurate, and predictable results.
We Are Dedicated To Creating
Excellence In Every Smile
True orthodontic emergencies are very rare, but, when they do occur, we are available to you. As a general rule, you should call the office when you experience severe pain or when you have a painful appliance problem that you can’t take care of yourself. We’ll be able to schedule an appointment to resolve the problem.
You might be surprised to learn that you may be able to temporarily solve many problems yourself until you schedule an appointment with our office. When working with your appliances, you need to know the names of the parts so you are able to identify what part is broken or out of place. After alleviating your discomfort, it is very important that you still call our office as soon as possible to schedule a time to resolve the problem. Allowing your appliance to remain damaged for an extended period of time may result in disruptions to your treatment plan.
The following solutions may help you relieve your discomfort
Using a pencil eraser, push the poking wire down or place wax on it to alleviate the discomfort.
If your bracket or band is still attached to the wire, you should leave it in place and put wax on it. If the wire comes out entirely, wrap the bracket with a tissue.
Using tweezers, try to put your wire back into place. If doing this does not help you may, as a last resort, use a small fingernail clipper to clip the wire behind the last tooth to which it is securely fastened. If your discomfort continues, place wax on it.
If your appliance is poking you, place wax on the offending part of your appliance.
When you get your braces on, you may feel general soreness in your mouth and teeth may be tender to biting pressures for three to five days. This can be relieved by rinsing your mouth with a warm salt water mouthwash. Dissolve one teaspoonful of salt in 8 ounces of warm water, and rinse your mouth vigorously. Placing Orabase on the affected area may help; this product can be found in your local pharmacy. If the tenderness is severe, take Tylenol, Ibuprofen, or whatever you would normally take for headache or similar pain.
The lips, cheeks and tongue may also become irritated for one to two weeks as they toughen and become accustomed to the surface of the braces. You can put wax on the braces to lessen this. We’ll show you how!
Orthodontic emergency appointments are rare and usually involve a loose bracket or poky wire. If you are in pain or have had an accident, call our office at (209)532-2288 immediately so we can make you comfortable as quickly as possible
Wear your retainers! Your new smile can last a lifetime!
Sierra Orthodontics was one of the first offices in California to fully embrace a whole new paradigm in orthodontics – Damon System braces and treatment techniques. The Damon System incorporates passive self-ligating brackets and high technology archwires, allowing your teeth to move more comfortably and easily than with traditional braces. Thanks to these innovative new braces, achieving your perfect smile will be faster and easier than you ever thought possible.
The Damon System allows us to eliminate many of the complicated and time consuming procedures that were required with traditional braces. We have been able to significantly reduce the number of appliances we use, including palatal expanders and headgears. We have also significantly reduced the number of extractions needed for our patients.
Less Time Out of Your Schedule
Damon braces are self-ligating – they have a small door that opens/closes. This means that they do not require a ligature (either elastic or metal) to keep the wire tied into the brackets. Self-ligating brackets work more efficiently, allowing shorter and less frequent appointments.
In addition to greater comfort, the Damon System makes it easier to maintain good hygiene because it’s easier to keep clean. This contributes to greater health, happiness, and physical attractiveness for the duration of patient treatment.
What is it?
Invisalign offers a cutting-edge approach to orthodontics by using a series of custom-made, invisible aligners. Using 3-D computer imaging, each aligner is specific to your teeth, gradually and gently shifting your teeth into place. The best part about the whole process is that most people won’t even know you are wearing the aligners, so you can smile with confidence–both during and after your treatment.
Why would I want it?
There are no metal brackets or wires to tighten. The clear aligners are virtually invisible to other people, so no one will notice you are wearing the aligners. The aligners are also removable, which means you can eat what you want, brush your teeth with ease, and floss with no problems. With the complete, virtual treatment plan, you can see the anticipated results before even starting your treatment. Since you have a series of aligners instead of metal wires and brackets, you actually need to go to our office less often to get adjustments.
How does it work?
Using modern 3-D imaging technology, a custom set of aligners is made for you. Every two weeks, you switch to a new aligner. As you switch aligners, your teeth gradually and comfortably shift, resulting in a beautiful smile. Dr. Gune will have you come by the office every six weeks to confirm the progress of your treatment. On average, you will be in treatment for 9 – 15 months and wear 18 – 30 different aligners. However, actual treatment times will depend on your particular case.
Like a fingerprint, your smile is unique—and so is Insignia Custom Smile Design, a computerized system that combines digital treatment planning with custom brackets and wires tailored to your specific dental anatomy.
The process is simple. Following your initial exam, Dr. Gune will take an impression of your teeth for the Insignia smile design lab. Sophisticated imaging software then creates a digital representation of your bite, while braces and wires are custom-fabricated for you.
Insignia treatment is tailored to the individual with each aspect precisely calculated to affect tooth movement in the most optimal way. This means fewer office visits and exceptional comfort throughout treatment. And because treatment is personalized, Dr. Gune often sees a reduction in the amount of time his Insignia patients would ordinarily be in braces. This treatment option is ideal for most cases and patients, whether it’s an adult with a hectic schedule, or a teen who wants to be in and out of braces as quickly as possible.
Utilizing Insignia’s proprietary 3-D software, Dr. Gune can show you your end result before you even start treatment! You’re able to view, with precision accuracy, the curvature and width of the best smile specifically proportioned to your facial features. Unlike off-the-shelf braces and wires, a treatment plan developed with Insignia creates a layer of meticulous detail that provides fast, accurate, and predictable results.
Surgical orthodontics is a combined treatment by our doctors and an oral surgeon to correct jaw abnormalities. These issues are determined after reviewing the patient’s X-rays and models.
The orthodontist initially levels and aligns the teeth in the jawbone, then the oral surgeon positions the jaws into a more normal position to allow the bite to come together in an ideal manner. This procedure results in the improved ability to chew, speak, and breathe, while also delivering tremendous facial aesthetics.
Dr. Gune embraces the latest in orthodontic technologies to reduce the overall need for this method. However it can still be required in those with improper bites, as well as those with facial aesthetic concerns. All growth must be complete before jaw surgery can be performed (jaw growth is usually complete by 16 years with girls and 18 with boys); however, it is very common to begin correcting tooth position while a patient is still growing.
The temporomandibular joint connects the jaw to the skull. Pain in this area is characterized as Temporomandibular Disorder. This joint is similar to many others in the body, and, as such, is susceptible to conditions like ankylosis, arthritis, and dislocations.
TMD Symptoms Include:
Biting/chewing difficulty or discomfort
Neck and shoulder pain
Headaches/earaches in the morning
Jaw pain or tenderness
Reduced ability to open/close the mouth
Accelerated Orthodontics is a treatment with quicker results with less time in braces. The technique can be applied to just about every case of orthodontics. The treatment requires a safe, minor surgical procedure that assists the teeth moving quicker and without as much loss of either root or bone support.
Temporary Anchorage Devices (TAD’s) are titanium bone anchors that look like a miniature version of a wood screw. The screw’s length is about half the length of your thumbnail, and no wider than the width of the head of a pin. TADs are made of titanium and are painlessly placed while in our office.
How are TADs placed?
The area in which a TAD is placed is first numbed with a powerful, topical anesthetic gel and then with a device that places a puff of anesthetic through the gum tissue into the bone–no needles are used. With the patient numb, our doctors place the small TAD directly through the gum tissue into the bone. Most patients feel a little pressure when the TAD is placed and some feel this during the day of placement. Tylenol or Ibuprofen are recommended for the day of placement, and patients report no pain or pressure the day after placement. The TAD is gently brushed twice a day with antimicrobial rinse that we provide during its use. The TAD is removed when orthodontic treatment is completed or the TAD is no longer needed. It takes less than a minute to remove and is painless.
Why do we use TADs and why are they revolutionary?
A common example of orthodontic anchorage is the situation when the orthodontist wants to pull in your front teeth that are sticking out. He uses the back molar teeth to help him because they are large, multirooted, and generally move very little when they are used to pull back the front teeth. The molar teeth are fairly well anchored in your jaw; however, any tooth still moves in response to the “equal and opposite force.” A simple way to think about TAD anchorage:
A fisherman is sitting in a row boat and has caught a very large fish. If he has thrown an anchor overboard (TAD), and is strapped into the boat, he can, in time, reel the fish (tooth) in toward the boat without being pulled out to sea, or the boat moving from its original position.
Sierra Orthodontics is proud to offer 3D imaging to enhance the diagnostic ability of our doctor. Our Imaging Center provides low radiation, three-dimensional Computerized Tomography (3-D CT images) for our orthodontic patients utilizing the i-CAT Cone Beam CT scanner by Imaging Sciences International. There are less than 5000 Orthodontic Offices in the United States that utilize this technology and Sierra Orthodontics is proud to be one of them.
This new and exciting technology enables our doctor to obtain high definition, 3-D CT scans of our patients’ maxilla and mandible. With one scan, lasting under 5 seconds, Dr. Gune is able to obtain all the necessary information required for orthodontic evaluation and treatment planning.
The i-CAT cone beam scanner is used to produce 3-D diagnostic records which are invaluable to developing a complete, accurate diagnosis and the most effective treatment result for our patients. This state-of-the-art technology affords Cone-beam CT 3-D scan views of the face, head, and teeth at one one-hundredth of the radiation of a medical “cat scan”. This means that the i-CAT scan uses a low (safe) radiation while being exceedingly accurate. Additionally, this digital system does not use processing chemicals so it is also very environmentally friendly.
The i-CAT scan provides the doctors with high quality, 3-D images of the teeth, supporting bone, jaws, jaw joints, the airway and other bony and soft tissue structures important to the diagnosis and treatment of a wide variety of common dental problems.
Our primary role is to make the teeth fit together properly and to produce the fullest, healthiest, and most natural smile (i.e., facial and dental beauty). To us, this also means ensuring the best possible harmony between the teeth and jaw joints. Recognizing the importance of proper diagnosis and creating the best possible coordination of the teeth and jaw joints, the i-CAT scans help us accomplish the best total treatment results.
In addition to 3-D orthodontic evaluations, our Imaging Center also provides cone-beam scans for the entire foothill professional community.
Lythos is the world’s most sophisticated intraoral digital camera. The introduction of Lythos scanning technology into our practice is the first step of the process that will eliminate uncomfortable and messy impressions from our practice forever. Lythos is designed to integrate easily into our practice’s workflow, allowing the team to transition quickly into digital impressions, which saves time for our patients. Using the Lythos scanner, we can get a single, high resolution scan in less than 7 minutes. The lightweight, compact Lythos wand is comfortable and ergonomic for the operator. This, combined with the the small wand handle and tip, allows operators to access the posterior easily, maximizing your comfort.
iTero Impressionless Scanners have several benefits over traditional impressions. First, a patient’s movement does not distort the scan while eliminating the invasiveness and discomfort caused by impressions. Second, the real-time digital display of scans allows for immediate adjustment, assuring accurate scans the first time. Finally, the image quality of impressionless scans is superior to conventional impressions.
AcceleDent is a simple-to-use, hands-free device designed for faster orthodontic treatment with only 20 minutes daily use. This accelerated orthodontic treatment is clinically proven to move teeth up to 50% faster, and is available only by prescription from your orthodontist.
AcceleDent works by inserting the mouthpiece fitted around your existing orthodontics and wearing the activator for 20 minutes every day. Your orthodontics work on their own by moving your teeth in specific directions. AcceleDent uses SoftPulse Technology® to generate small vibrations, or micropulses, enhancing the movements directed by your orthodontics, allowing for faster tooth movement.
PROPEL® Orthodontics is an innovator and manufacturer of advanced orthodontic medical devices which revolutionized how teeth are moved. It is a pioneering treatment that can be performed in minutes and is relatively painless for the patient.
University researchers developed this procedure called Alveocentesis™ that stimulates alveolar bone when orthodontic force is applied to teeth. As a result, bone is remodeled more efficiently, subsequently reducing treatment time by 60% or more.
Our process is patient-focused, creating ways for Orthodontists to give the most efficient and effective care. The PROPEL System can be used in conjunction with any of Sierra Orthodontics’ types of treatment plans.
We can’t wait to meet you and welcome you to our office! Our team is committed to making your treatment as easy and enjoyable as possible, in a friendly and welcoming environment.
During your first visit, you’ll get acquainted with the process and procedures for braces; we’ll discuss your customized treatment options in detail, estimated treatment length, and the associated costs. The initial consultation is free.
If treatment is indicated, we’ll begin by taking diagnostic pictures, x-rays of your teeth, bite registrations, and impressions. These diagnostics will be referenced throughout your treatment and used to monitor progress. There is a charge for collecting the diagnostics.
Want to get a head start on your new patient forms? Before your first appointment please fill out our online patient forms
All treatment plans are customized for each individual and associated costs depend on the severity of necessary treatment. We accept these financing solutions to assist your orthodontic care.OrthoBanc Care Credit
In-office financing is also available at 0% for certain types of treatment. Please inquire for more information.
Orthodontics is a specialty within dentistry that focuses on the diagnosis, prevention, and treatment of dental and facial irregularities.
An orthodontist is a specialist within field of dentistry. They attend 2-3 years of advanced training after dental school, focusing on tooth movement and facial development.
A beautiful smile
Better functionality of your bite
Improved self confidence
Reduced wearing on your teeth
Guidance of permanent teeth into ideal position
Improved health of teeth and gums
Easier to clean your teeth by flossing & brushing
Excessive spaces in between teeth, particularly in the front
Excessive crowding of teeth, causing teeth to rotate
Upper teeth protruding excessively over lower teeth
Lower teeth protruding past the upper teeth
Upper teeth covering the majority of lower teeth when biting
Center of upper teeth do not align with center of lower teeth
Difficulty chewing foods
Excessive or uneven tooth wear
The American Association of Orthodontists recommends that every child first visit an orthodontist by age seven. Many orthodontic problems can be solved more easily at a younger age, before jaw growth slows, to avoid the need for more complicated procedures. That being said, treatment can be sought out at any age, and there are many attractive treatment options available to adults today that ensure an efficient, aesthetic, and comfortable orthodontic experience.
Treatment duration is dependent on the severity of the case and the compliance of the patient. A patient who maintains good oral hygiene, keeps appointments, and follows instructions throughout treatment will complete their treatment on or ahead of schedule. The average treatment time is typically one to two years.
Most of our patients tell us that their teeth are sore for the first few days. Simple, over-the-counter pain medication usually alleviates this. In addition, we provide soft wax and silicone to place on any rough areas of your braces to minimize mouth irritations. Warm, salty water is also a good home remedy for oral discomfort.
We average 6-8 weeks between visits, though it depends on the case and treatment plan. In the beginning of treatment, some patients need to be seen more frequently, while others have long (10-12 weeks) intervals between appointments. As we get closer to finishing your treatment, appointments become more frequent. When we factor all visits together, we average about 6 weeks between appointments.