Keeping your teeth and gums healthy isn't always easy—and it's even more of a challenge if you're wearing orthodontic appliances like braces. That's why a fair percentage of patients wearing braces also contend with tooth decay or periodontal (gum) disease.
The reason is simple: The orthodontic hardware makes it difficult to fully reach all parts of teeth surfaces with your toothbrush or floss. As a result, you can miss removing some of the accumulated plaque, the thin film of bacteria and food particles most responsible for dental disease. And it only takes a short amount of time (just days with gum disease) for a bacterial infection to begin.
But while avoiding dental disease is difficult while wearing braces, it's not impossible. Here are 4 ways you can minimize your dental disease risk while undergoing orthodontic treatment.
Be diligent with your daily hygiene. Even though it's more difficult, don't slack on daily brushing and flossing. It does require more time to work the brush around and between the wires and brackets, but taking the time will help you clear away more plaque you might otherwise miss. It may also help to switch to a multi-tufted, microfine bristled toothbrush if you're not already using one.
Use a water irrigator. If straight thread flossing is proving too difficult (and even with a floss threader), try using a water irrigator. This device emits a pulsating spray of pressurized water that loosens and flushes away plaque between teeth. Clinical studies consistently show water flossing is effective for reducing plaque in orthodontic patients.
Lower your sugar intake. Sugar left over in the mouth is a prime food source for bacteria that cause tooth decay or gum disease. Reducing sugary foods and snacks can help reduce bacterial populations and lower your disease risk. You can also fortify your oral health with healthier foods that contain calcium and other minerals.
Keep up regular dental visits. In addition to your orthodontic adjustments, don't neglect your regular visits with your family dentist. Semi-annual cleanings help remove any plaque and calculus (calcified plaque) you may have missed. Your dentist can also monitor your health and boost your disease prevention through topical fluoride treatments or prescribed antibacterial mouth rinses.
If you would like more information on dental care while wearing braces, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Caring for Teeth During Orthodontic Treatment.”
“To gain something, sometimes you have to give up something else.”
No, that isn't the latest viral meme on the Internet. It's actually a practical consideration that could arise in orthodontics.
In this case, the “something” to gain is a straighter, more attractive smile; the “something” you may have to part with is a few teeth. This may be necessary if there are too many teeth on a dental arch for its capacity, a situation called crowding. A lack of space is the main reason teeth come in misaligned.
Before we can correct this, we'll need to free up space to allow for tooth movement by removing one or more of the existing teeth. The ideal candidates are those that are near to the teeth we wish to move but not highly visible. The first bicuspids are the most frequent choices for removal: they're located behind the cuspids or eyeteeth (the pointed teeth right under the eyes).
Ideally, we'll remove the target teeth some time before we apply braces to give the gums a chance to heal. At the same time we want to preserve the bone that once supported the teeth we've extracted. This is because when we chew the forces generated by the teeth stimulates bone replacement growth. When a tooth is no longer there the supporting bone doesn't receive this stimulation and may ultimately reduce in volume.
We may try to prevent this by placing a bone graft in the empty socket immediately after removing the tooth. The graft serves as a scaffold to encourage new bone to grow. Hopefully when we're ready to apply braces, the bone will be strong and healthy to handle the movement of the teeth.
As the teeth move under the influence of braces, they'll begin to fill up the space created by tooth removal. Once it's completed, the extracted teeth won't be missed — the other teeth now straightened will completely fill out the smile.
The different steps in this process must be carefully planned and executed precisely, and it will take months or even years to complete. In the end, though, this complicated bite problem can be corrected and replaced with an attractive, straight smile.
If you would like more information on correcting a poor bite, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Removal for Orthodontic Reasons.”
Most of us are quite familiar with what traditional braces look like. But occasionally we see more complex-looking devices being worn by young orthodontic patients: thicker wires that extend outside the mouth, with straps that may go behind the neck or over the chin. What are these devices, and why are they sometimes needed?
In general, orthodontic appliances with external parts braced by the head, neck or chin are referred to as “headgear.” These devices may be used to handle a number of particular orthodontic situations, but they all have one thing in common: They provide the additional anchorage needed to move teeth into better positions.
It may come as a surprise that teeth, which seem so solid, can actually be moved fairly easily over time. This is because teeth are not fixed directly into bone, but are instead held in place by a hammock-like structure called the periodontal ligament. Using a light, controlled force — such as the force of springy wires and elastics in traditional braces — teeth can be moved slowly through the jaw bone, like a stick being pulled through sand.
Of course, to pull a stick through sand, you need a firm anchorage — your legs, for example, bracing against a rock. Most of the time, the back teeth, with their large, multiple roots, provide plenty of support. But sometimes, the back teeth alone aren’t enough to do the job.
If a very large space between teeth is being closed, for example, the back teeth might be pulled forward as the front teeth are pulled back; this could result in poor alignment and bite problems. In other cases, the front teeth may need to be pulled forward instead of back. The back teeth can’t help here; this is a job for headgear.
Some types of headgear have a strap that goes behind the head or neck; they use the entire head as an anchorage. Other types, called “reverse pull” headgear, have a strap that comes over the chin or the forehead; they can pull teeth forward. Headgear can even influence the proper growth of facial structures — that’s why it is usually seen on preteens, whose growth isn’t yet complete.
Headgear is usually worn for 12 hours per day, for a limited period of time. In some cases, rather than headgear, appliances called “temporary anchorage devices” (TADS) may be recommended. These are tiny screws that are implanted into the jawbone in a minimally invasive procedure, and serve a similar function.
While it may not look pretty, orthodontic headgear is capable of moving teeth into their proper positions in a relatively short period of time — and ending up with a great-looking smile is what orthodontics is all about.
The 2019 Grammy Awards was a star-studded night packed with memorable performances. One standout came from the young Canadian singer Shawn Mendes, who sang a powerful duet of his hit song "In My Blood" with pop diva Miley Cyrus. But that duo's stellar smiles weren't always quite as camera-ready as they looked that night.
"I had braces for four and a half years," Mendes told an interviewer not long ago. "There's lots and lots and lots of photo evidence, I'm sure you can pull up a few." (In fact, finding one is as easy as searching "Sean Mendes braces.")
Wearing braces puts Mendes in good company: It's estimated that over 4 million people in the U.S. alone wear braces in a typical year—and about a quarter of them are adults! (And by the way: When she was a teenager, Miley Cyrus had braces, too!)
Today, there are a number of alternatives to traditional metal braces, such as tooth-colored braces, clear plastic aligners, and invisible lingual braces (the kind Cyrus wore). However, regular metal braces remain the most common choice for orthodontic treatment. They are often the most economical option, and can be used to treat a wide variety of bite problems (which dentists call malocclusions).
Having straighter teeth can boost your self-confidence—along with helping you bite, breathe, chew, and even speak more effectively. Plus, teeth that are in good alignment and have adequate space in between are easier to clean; this can help you keep your mouth free of gum disease and tooth decay for years to come.
Many people think getting braces is something that happens in adolescence—but as long as your mouth is otherwise healthy, there's no upper age limit for orthodontic treatment. In fact, many celebrities—like Lauren Hutton, Tom Cruise and Faith Hill—got braces as adults. But if traditional braces aren't a good fit with your self-image, it's possible that one of the less noticeable options, such as lingual braces or clear aligners, could work for you.
What's the first step to getting straighter teeth? Come in to the office for an evaluation! We will give you a complete oral examination to find out if there are any problems (like gum disease or tooth decay) that could interfere with orthodontic treatment. Then we will determine exactly how your teeth should be re-positioned to achieve a better smile, and recommend one or more options to get you there.
If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Lingual Braces: A Truly Invisible Way to Straighten Teeth.”
Straightening your teeth with braces or other orthodontic gear is a positive step toward a healthier and more attractive smile. You'll likely be pleased with your smile when they're removed.
But you may also notice something peculiar once the braces are off—dull, white spots on your teeth. These spots, usually located under or around braces hardware, are where mouth acid has “demineralized” calcium and other minerals in the enamel. As beginning tooth decay, these spots are a sign your hygiene efforts weren't sufficient in cleaning your teeth of plaque.
In many cases, the spots will improve on their own after the braces are removed. We can also strengthen the enamel with fluoride pastes or gels, or inject tooth-colored resin within the spot to restore the enamel's translucence and improve appearance.
But the best approach is to try to prevent white spots from occurring at all. Here's what you need to do.
Keep up your oral hygiene. Even though more difficult with braces, you still need to brush and floss to protect your teeth from tooth decay. To make it easier, take advantage of special brushes designed to clean around orthodontic brackets and wires. A floss threader can also help you better access between teeth—or switch to a water flosser instead of floss thread.
Practice a “tooth-friendly” diet. A diet high in sugar and acid could short-circuit your best hygiene efforts. Certain beverages are big offenders: sodas, energy and sports drinks, and even “natural” juices. Instead, eat foods high in vitamins and minerals like fresh fruits and vegetables, lean proteins and low-fat dairy.
Get your teeth cleaned regularly. While you're seeing your orthodontist for scheduled adjustments, don't neglect regular cleanings with your family dentist. Professional cleanings at least every six months reduce the risk of dental disease. These regular visits are also a good time for your dentist to check your teeth for any signs of dental problems associated with your braces.
It's not easy to keep your teeth clean while wearing braces, but it can be done. With help from a few handy tools and continuing care from your dental professionals, you can avoid unsightly white spots.
If you would like more information on dental care while wearing braces, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “White Spots on Teeth During Orthodontic Treatment.”
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