Lilly Cooke

My mother grew up in County Kerry, Ireland.  As a teenager, she moved to London to do her nursing training and by the time she was 20 years old, she moved to California.  She worked as an RN until she had four children (of which I’m the oldest, followed by Andrew, John & Martina).  It is hard for parents to manage two full time careers outside the home when you have four children, so that is why my mom decided to open a day care center in our home when I was in kindergarten.

From 1978 through 1994, when she passed away suddenly from a heart attack, my mom cared not only for her four children, but for many children in the community.  I was touched by how many people loved her and still remember her to this day.  Of course, everyone that she watched is now an adult themselves, but when they see me or my siblings, they always mention our mom.

April and May are always hard for us because of her birthday, mother’s day and the anniversary of her passing happen within 4 weeks.  While bittersweet, it reminds me that my desire to work with children started at home!

Did you know that all orthodontists are dentists?  I went to dental school for four years at UCLA, passed two national exams and the California Board Exam to become a licensed dentist in the state of California.  After that I went to UCSF for three more years to train to become an orthodontist.

These were my co-residents at UCSF 2004-2005. I'm in the back row and Dr. Sears is in the front row!

During those three years I studied and treated all types of malocclusions (improper bites).  We learned in depth the mechanics of tooth movement and the biological and physiological components of treatment.  Braces is the most conventional and well known tool used by orthodontists.  Invisalign is another.

I enjoy using both braces and Invisalign to correct teeth alignment and bites.  It is very important to me that if I choose to use Invisalign as my treatment method for you or you child that I am not only able to get the same results, but that I am addressing all the bite issues too.  This is because straightening teeth without addressing the bite issues can actually worsen your dental condition in certain situations.  As an orthodontist, I feel I have the education, knowledge and experience to get the results you deserve!

I augment my education by attending at least 5-6 continuing education courses every year.  I like to attend both orthodontic and dental courses so I can communicate better with your dentist and provide them with the foundation to do the rest of your dental work, if needed.

Last year I was asked to be the Invisalign Lecturer at UCSF Division of Orthodontics.  I am very honored to be giving them instruction in this area!

If you want to know how to choose between Invisalign and braces, see my blog How to choose between braces and Invisalign.

Well, you are not alone!  Someone even created an app to keep track of the subtle movement your teeth experience during orthodontic treatment!  To check it out, click on the picture.  Let me know what you think.

Attending this course was more special to me.  I didn’t have to travel to this course alone… I was joined by 6 other local dentists!

Dr. Varlakova, Dr. Yousefzadeh & Dr. Claus (Dr. Riley was taking the photos)

We had the opportunity to learn from an internationally respected prosthodontist, bond over dinner and enjoy 90 degree weather in April (at least during lunch).

Dr. Cooke, Dr. Varlakova & Dr. Poh-Matacio

Learning and expanding my understanding of comprehensive dentistry makes what I do as an orthodontist more fun!

Dr. Pratt & Dr. Claus

I always felt my dad, Paul Cooke, had an influence on my future career.

He had lots of expensive tools that he used to build things and to make homes beautiful and functional. He always made people smile and could create amazing things.  He was a contractor.

Almost forty years later, I have some pretty expensive tools and I build beautiful smiles and functional bites. Maybe the apple didn’t fall far from the tree.

My dad, Paul Cooke, walking me down the aisle!

At the age of 68, my father is now building my new office. He spends 6 to 7 days a week on site, reviews plans every night and lives, breathes and eats the details of our new home. I visit the new site a few times every week.  The subcontractors who work with my dad love working with him.  I hear this from people he met last month to people he has known for 4 decades.  My son Wayne calls the new office “Papa’s work”, not “Momma’s work”.  I wonder if he will remember that when he gets older.

My dad (Paul Cooke) and my son (Wayne)

Side by side with my brother John Cooke, my father is making my new office a labor of love.  When I get wrapped up on the stressful details of a remodel and move, I just have to remember that and know I’m in good hands.

Thank you Dad!  I love you!

My Dad showing me around the new office.

At the age of 7 years, most children have lost 4 to 8 baby teeth and 8 to12 adult teeth have come into the mouth. The first teeth that erupt into the mouth are the six-year molars that come in behind the baby teeth. Then we usually see the two lower front teeth get loose and fall out, followed by the rest of the incisors, both top and bottom.

Crossbite - upper jaw is relatively too narrow

I am able to evaluate the jaws and determine if they are developing harmoniously at this first meeting. I take two orthodontic x-rays to check the maturity of the adult teeth and both jaws. From this x-ray we are able to identify missing teeth, extra teeth and any teeth that are moving in the wrong direction and abnormal jaw growth.

Underbite - Lower jaw is relatively too large

Most of the time we will tell you that your son or daughter does not need any treatment at this time and that we want to evaluate the eruption of the teeth and growth of the jaws on an annual basis. This yearly exam gives us the benefit of identifying any anomalies or problems early. A normal pattern of skeletal and dental growth can change dramatically over the course of a year.

90% of the population will need orthodontic treatment some time during their life. More than likely your son or daughter will need full braces around the age of 12 to 13 years old. With close supervision, I am able to let you know when the exact right time is to get started. I want you to be prepared for the treatment recommendations and the financial investment when that time comes. With planning and care we can create a beautiful smile and excellent bite for your child!

You are likely most familiar with braces and so I’ll talk a bit more about Invisalign. Here are some photos of patients whom I have treated with Invsialign (the results would largely be the same had they worn braces):

One of the primary reasons people choose Invisalign is that they are nearly undetectable when worn. (My financial coordinator, Sarah B., wears Invisalign right now. Very few, if any, parents or patients have noticed that she has them on. And, contrary to what one might have heard, she doesn’t speak weird and she is able talk on the phone all day.)

Most patients have the option of braces or Invisalign. However, Invisalign doesn’t work for everyone and so I prefer to start off by meeting my patients and figuring out if they are a good candidate for the treatment.

I will ask you if you are self-disciplined. This is truly an important factor in choosing the best method of correcting your bite and creating a beautiful smile. When a patient wears braces we have at our disposal tools to help correct the bite and make the teeth look fabulous without depending on the patient for too much help. Invisalign doesn’t work that way. Invisalign patients need to be self disciplined. They need to wear the aligners 22 hours per day and they need to be able to put them on even if it hurts their teeth. The good news is that if you put your new aligner in right before bed, then by morning your teeth will have mostly adapted and the discomfort limited to night time only.

I will also help to determine if Invisalign is the proper instrument to fix the underlying problems with your teeth. For example, if you have a severe deep bite for example, you will not be a candidate for Invisalign to fix your bite.

Our simple process for getting started is as follows:
Appointment #1: Photos, x-rays and exam
Appointment #2: Impressions
Appointment #3: Start treatment

Treatment is usually for a minimum of 12 months. If you are not sure that you will be able to wear the aligners, we can make temporary retainers so you can give it a try before you move forward with the Invisalign.