Posts for category: Dental Procedures
When considering “smile makeover” options, it’s easy to focus on whitening, veneers or implants — techniques and materials focused mainly on the teeth and gums. But if you don’t also consider the bigger picture of how your upper and lower teeth come together to form your bite, these efforts may be a lot like picking out paint colors for a house with foundation problems.
That’s why orthodontics, the dental specialty concerned with the bite, could be a consideration in your smile makeover plan. Moving teeth into better positions not only improves your teeth’s function and health it could also help facilitate any cosmetic changes that follow.
The first step, of course, is to visit an orthodontist, a dentist with advanced training and experience in tooth alignment and function, for a comprehensive evaluation. Orthodontists are also knowledgeable in the growth and development of the bite, and so can develop a treatment approach that reflects the patient’s needs, whether a child or adult.
Treatments vary, depending on your particular needs. Fixed appliances like metal or clear braces that can’t be removed by the patient are the standard treatment for most malocclusions (bad bites). Clear aligners, removable trays that fit over the teeth with programmed incremental movements of the teeth, find the greatest application with adults. Orthodontists may also use specialized appliances, like temporary anchorage devices (TADs), which work to isolate teeth that need to be moved from those that don’t.
In comprehensive makeovers, orthodontists will work with a team of other dentists and specialists, including periodontists (specializing in the gums, bone and other supporting structures of the teeth) and oral surgeons. In these cases, orthodontic treatment may occur before or after other treatments with the overall goal of producing a beautiful, transformed smile.
If you would like more information on how orthodontics can transform your smile, 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 “The Magic of Orthodontics: The Original Smile Makeover.”
After months of wearing braces, the big day has arrived — they’re finally off! Your teeth have been realigned and your smile is dazzling. You’re finished with orthodontic treatment, right?
Not quite — because if you want to keep your new smile you have one more treatment phase to go — wearing a retainer. Without this phase there’s a distinct possibility you could lose all the time, effort and expense of braces because your teeth could revert to their previous position.
To understand why, we have to consider how teeth can move in the first place. Although it may seem like your teeth are rigidly fastened to the jawbone, they’re actually held in place by the periodontal ligament, a strong, elastic gum tissue that lies between the teeth and the bone. Tiny fibers from the ligament attach to the teeth on one side and to the bone in a similar manner on the other side.
When pressure is applied to the tooth as happens with braces, the bone around the side of the tooth in the direction of the force will begin to dissolve (resorb), allowing the tooth to move in that direction. New bone will then build up on the other side to stabilize the tooth. Once the pressure is removed (when we take the braces off), there’s a tendency for the teeth, bone and gums to “remember” the old position and try to revert back.
The answer is a removable mouth appliance known as a retainer. Custom-designed to fit the teeth’s new position, the retainer helps hold the teeth in place until the bone completely sets around them. In the beginning, you may need to wear the retainer around the clock and then later only at night while you sleep. While you may only need to wear it for a few months (especially if you’re an adolescent or young adult) some patients may need to wear some form of retainer indefinitely. Your orthodontist will advise you how long depending on your individual situation.
While retainers may seem like an inconvenience, they’re extremely important for keeping or “retaining” the teeth in their new and better position. Following through on this important phase of treatment will help ensure you’ll keep your new smile for a long time to come.
If you would like more information on retainers, 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 “Why Orthodontic Retainers?”
Braces utilize the mouth’s existing teeth-moving mechanism by applying pressure in the direction of the desired movement. This is done with a wire laced through metal brackets affixed to the outside of the teeth that’s then usually anchored to brackets on the back teeth to maintain constant tension.
This anchorage set-up alone, however, may not work effectively with all bite situations, which might require other points of anchorage. That’s where these other tools in the orthodontist’s toolkit can come in handy.
Headgear. These appliances not only aid with moving teeth but they also help influence the proper growth of facial structures (as when one of the jaws is too far forward or too far back). Because of this influence on jaw growth you’ll only find them used with pre-teens. The most typical application is a strap running around the back of the head or neck (or sometimes over the chin or forehead) that attaches in the front to brackets usually bonded to the molars. In this case the back of the patient’s skull serves as the anchor point.
Temporary anchorage devices (TADs). Orthodontists sometimes wish to isolate the teeth to be moved from nearby teeth that shouldn’t be. For example, they may want to move front teeth back to close a space without the back teeth moving forward. In this case, it may be necessary to create a separate anchorage point in the jaw. This can be done with TADs, which are made of either biotolerant (stainless steel, chromiumâ??cobalt alloy), bioinert (titanium, carbon), or bioactive (hydroxyapatite, ceramic oxidized aluminum) materials and shaped like mini-screws. Orthodontists insert them into the bone and then attach them to the braces using elastics (rubber bands). After completing orthodontic treatment they’re easily removed.
Elastics. We’ve already mentioned them, but elastics deserve their own category because they can be used in various kinds of anchorage. They play an important role, for example, in cross-arch anchorage that maintains tension between the upper and lower jaws. They can also be used to help move one or more groups of teeth — or isolate certain teeth from moving. They truly are flexible (no pun intended) in their uses for fine-tuned tooth movement.
All these devices can be used in various combinations to match and correct whatever bite situation a patient may have. The end result is straighter and better-functioning teeth — and a more attractive smile.
If you would like more information on orthodontic treatment, 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 “Orthodontic Headgear & Other Anchorage Appliances.”
Malocclusions (bad bites) may cause more than an appearance problem — with teeth and jaws not working together properly, you’re at higher risk for dental disease or accelerated tooth wear. Fortunately, most malocclusions can be corrected through orthodontics, a specialty for moving teeth to better functioning and more attractive positions.
If you’re considering orthodontic treatment for a malocclusion, here are the basics on 3 of the most common orthodontic appliances used for straightening misaligned teeth.
Metal Braces. These appliances have a proven track record for correcting most forms of malocclusion. Braces consist of metal brackets bonded to the front teeth and an anchor band to the back teeth. A thin metal wire passes through the brackets to attach to the bands in the back. Gradually increased tension in the wire incrementally moves the teeth to the desired position.
Clear Bracket Braces. While metal braces do an effective job of tooth movement, they leave less to be desired in appearance. Made of polymer material rather than metal, clear bracket braces offer a more appealing look. But while they’re similar in construction to the metal version, they’re more susceptible to breakage. Wearers must be extra cautious and avoid hard foods or extreme physical sports contact.
Clear Aligners. The previous appliances are fixed and can’t be removed by the wearer. Clear aligners take a different approach with removable plastic trays that fit snugly over the dental arch. A series of trays are computer generated to carefully match the patient’s mouth structure, each incrementally smaller than the previous one in the series. After wearing the first tray for two or three weeks, the wearer changes to the next (and slightly smaller) tray in the series, repeating the process until all the trays have been worn. Of the three options, the clear aligners offer the best appearance; however, they’re best suited for cases that don’t require complex movements.
We can advise you which option is best for you after a complete evaluation, factoring in age, lifestyle and the complexity of your malocclusion. Regardless of the choice, the aim is the same — achieving a healthier mouth, better function and a more attractive smile.
If you would like more information on orthodontic treatment, 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 “The Magic of Orthodontics.”
The braces are finally off! But to keep your new, straighter smile you'll need to wear a retainer for some time. That's because the same structural mechanism used to move your teeth could undo what we've just accomplished.
That mechanism resides in an elastic tissue called the periodontal ligament that lies between the teeth and the bone and attaches to both with tiny fibers. While the ligament holds the teeth securely in place, it also allows for slight movement in response to bite changes. Braces "pull" the teeth in the desired new direction, and the ligament responds.
But with that pressure gone after the braces' removal, a kind of "muscle memory" can set in that moves the teeth back towards their original positions. A retainer, a dental appliance worn on the teeth, exerts just enough pressure to "retain" or keep the teeth from regressing.
Retainers are effective, but the most common type has a feature that poses potential problems: it can be removed by the wearer. Because of this, less disciplined patients might be tempted not to wear their retainer as directed. There's also a higher risk of losing one and incurring additional cost to replace it.
But there is another type, the bonded retainer, which stays permanently in the mouth until removed by an orthodontist. It's composed of a thin piece of metal that's firmly attached to the back of the teeth with dental composite material. Not only does a bonded retainer solve the problems mentioned before, it also can't be seen from the outside like a removable retainer.
A bonded retainer does have one disadvantage: because it can't be removed, it can obstruct the teeth during brushing and flossing and require more effort. You won't have as much difficulty with a removable retainer keeping teeth and gums clean. You can overcome this disadvantage, though, with specialized tools like a water flosser or a floss threader to make hygiene easier.
To choose which type of retainer is best for you or your family member, have a talk with your orthodontist. And if you choose a bonded retainer and later have it removed, be sure to switch immediately to a removable one if your orthodontist advises. With either retainer, you'll be able to preserve that hard-earned smile for years to come.
If you would like more information on bonded retainers, 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 “Bonded Retainers: What are the Pros and Cons.”