Some smiles need more than routine care - severe bites, impacted teeth, missing teeth, or treatment that didn’t hold the first time. These complex cases reward a board-certified specialist. At Valley Orthodontics, Dr. Lew Sample - a Diplomate of the American Board of Orthodontics with decades of experience - plans and manages difficult cases at our Decatur and Hartselle offices, using advanced 3D imaging for precision.
Not every orthodontic case is straightforward, and the harder ones are exactly where experience and credentials matter most. If you’ve been told your case is complicated, if a previous treatment didn’t give you the result you hoped for, or if another provider wasn’t sure how to proceed, you’re in the right place. Dr. Sample has spent his career solving the cases other offices find challenging - and he’ll give you a clear, honest assessment of what’s possible.
What Makes a Case “Complex”?
Several situations call for advanced planning and specialist expertise:
- Severe bite or skeletal problems - significant overbites, underbites, or jaw discrepancies that go beyond simple tooth movement, sometimes requiring coordination with orthognathic (jaw) surgery.
- Impacted teeth - teeth stuck below the gumline (commonly canines) that must be carefully guided into place.
- Missing teeth - spacing and alignment planned around gaps, often in coordination with restorative dentistry or implants.
- Relapse and retreatment - smiles that shifted after previous braces, or earlier treatment that fell short of the goal.
- Multidisciplinary cases - treatment coordinated with oral surgeons, periodontists, or general dentists as part of a larger plan.
Why Board Certification Matters Here
For complex cases, the orthodontist’s training is the single biggest factor in the outcome. Dr. Sample is a Diplomate of the American Board of Orthodontics - a voluntary certification that not every orthodontist pursues - and he earned the Shepard Award for the highest score in the nation on the ABO Phase 2 examination. With decades of experience and thousands of smiles treated, he brings exactly the depth of expertise difficult cases demand. Meet Dr. Sample to learn more.
Advanced Diagnostics for Difficult Cases
Precise planning starts with precise information. Our offices use CBCT / 3D imaging to see roots, bone, and impacted teeth in three dimensions, and the iTero® digital scanner to map your bite without messy impressions. That detailed picture lets Dr. Sample plan complex tooth movement, surgical coordination, and impacted-tooth exposure with confidence - and lets you see the plan for yourself.
Retreatment & Second Opinions
If your teeth relapsed after old braces, or a previous course of treatment didn’t finish the job, retreatment can often get you where you wanted to be - sometimes with a discreet clear aligner plan, sometimes with braces, depending on the case. And if you simply want an experienced specialist’s take before committing to a plan you’ve been offered, we’re glad to provide a thorough second opinion. You’ll get a straight answer about what your smile really needs.
Coordinated Surgical Cases
When a bite problem is rooted in jaw position rather than tooth position, the best result may combine orthodontics with jaw surgery. Dr. Sample coordinates these cases from start to finish - aligning the teeth before and after surgery - in partnership with trusted oral surgeons. Our jaw surgery page explains how surgical orthodontics works.
Frequently Asked Questions
What makes an orthodontic case “complex”?
Generally, anything beyond straightforward tooth movement - severe or skeletal bite problems, impacted or missing teeth, multidisciplinary coordination, or a previous treatment that relapsed or fell short. These cases benefit most from a board-certified specialist’s planning.
Can orthodontic treatment be redone if my previous results relapsed or didn’t finish the job?
In most cases, yes. Retreatment is common, and modern tools make it more comfortable than you might expect. Dr. Sample will assess what happened and recommend the most efficient path to the result you originally wanted.
Do I need jaw surgery, or can braces alone fix a severe bite?
It depends on whether the problem is in the teeth or the jaw. Many bites can be corrected with orthodontics alone; some skeletal cases need surgical coordination. Our 3D imaging lets Dr. Sample tell you clearly which applies to you.
Can I still get braces or Invisalign if I have missing or impacted teeth?
Usually, yes - these situations just require careful planning. We map treatment around gaps and guide impacted teeth into place, coordinating with your dentist or a specialist when needed.
How do CBCT and iTero scans help with a complicated case?
CBCT 3D imaging shows roots, bone, and impacted teeth that a flat X-ray can’t, and the iTero scanner precisely maps your bite. Together they let Dr. Sample plan difficult movement accurately and predictably.
Schedule a Complex-Case Consultation or Second Opinion
If your case is complicated - or you just want an expert’s honest read - start with a free consultation.
Decatur Office - 2014 Danville Park Dr SW, Decatur, AL 35603 · (256) 355-5255 Hartselle Office - 220 Karl Prince Dr SW, Hartselle, AL 35640 · (256) 773-8613
Proudly serving Decatur, Hartselle, and the surrounding Morgan County communities.