Posts for tag: orthodontic treatment
What do a teenager with a poor bite, a senior citizen with multiple missing teeth or a middle-aged person with a teeth grinding habit all have in common? They may all depend on a dental appliance for better function or appearance.
There’s a wide variety of removable dental appliances like clear aligners or retainers for orthodontic treatment, dentures for tooth loss or night guards to minimize teeth grinding, just to name a few. But while different, they all share a common need: regular cleaning and maintenance to prevent them from triggering dental disease and to keep them functioning properly.
The first thing to remember about appliance cleaning is that it’s not the same as regular oral hygiene, especially if you have dentures. While they look like real teeth, they’re not. Toothpaste is a no-no because the abrasives in toothpaste designed for tooth enamel can scratch appliance surfaces. These microscopic scratches can develop havens for disease-causing bacteria.
Instead, use liquid dish detergent, hand soap or a specific cleaner for your appliance with a different brush from your regular toothbrush or a specialized tool for your particular appliance. Use warm but not very hot or boiling water: while heat indeed kills bacteria, the hot temperatures can warp the plastic in the appliance and distort its fit. You should also avoid bleach—while also a bacteria killer, it can fade out the gum color of appliance bases.
Be sure you exercise caution while cleaning your appliance. For example, place a towel in the sink basin so if the appliance slips from your hands it’s less likely to break hitting the soft towel rather than the hard sink. And while out of your mouth, be sure you store your appliance out of reach of small children and pets to avoid the chance of damage.
Cleaning and caring for your appliance reduces the risk of disease that might affect your gums or other natural teeth. It will also help keep your appliance working as it was designed for some time to come.
Poor bites, also known as “malocclusions,” can have a dramatic impact on mouth function and appearance. Moving teeth to better positions will solve most of these bite problems — but not all.
A case in point is a malformed maxilla, the skeletal structure formed by the union of the upper jaw and the roof of the mouth (the palate). If the rear portion of the maxilla develops too narrowly, the back teeth will bite abnormally inside the lower teeth while the front teeth bite normally, creating what’s known as a crossbite. People with this kind of malocclusion often shift their lower jaw to one side to bite down completely.
This can be corrected without too much intervention if the problem is diagnosed while the person is young. This is because the maxilla is actually formed from two bones that don’t completely fuse together in the center of the palate until just after puberty. An orthodontic appliance known as a palatal expander takes advantage of this slight gap. The metal appliance is placed along the narrowed portion of the palate in the rear of the mouth: four metal “arms,” two on each side, attach to the inside of the back teeth with a tension device between them that extends the arms outward to put pressure against the teeth.
Every day the patient or a parent uses a special key to turn the tension device and cause it to expand slightly, placing additional outward pressure on the jaw. This will widen the gap in the center of the palate and new bone will grow to fill in the increased space. Over time this will cause the rear portion of maxilla to widen.
While effective, a palatal expander may not work in every case, and it must be done before the two bones fuse permanently. When it can be used, though, it’s a proven treatment that can restore proper bite function, as well as improve your child’s smile.
If you would like more information on palatal expanders to correct certain bite problems, 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 “Palatal Expanders.”
In many ways, the teenage years are the best time to have orthodontic treatment. It’s a good time emotionally because your teen is likely to have friends who also wear braces; orthodontic treatment becomes a rite of passage they can go through together. It’s also advantageous in a physical sense because all 20 baby teeth have come out, and most of the 32 adult teeth (except the 4 wisdom teeth) have emerged. At the same time, especially with younger teens, jaw growth is not yet complete — allowing orthodontists to harness the growing body’s natural adaptability. We can use a variety of appliances to do that — some of which weren’t around a generation ago!
In many cases, traditional metal braces are still the best way to achieve the desired results. However, these are not the “train tracks” of old. Braces are smaller and lighter, with brackets that are cemented to the front surfaces of teeth rather than to bands that encircle the entire tooth (except in the very back). Braces can be made much less noticeable by using ceramic brackets that are clear or tooth-colored; however, ceramic brackets are easier to break than metal. An even stealthier way to undergo orthodontic treatment is with clear aligners. These removable clear plastic “trays” are custom made with the help of computer software that divides the treatment process into two-week stages. After each two-week period, the tray is changed and the next stage of movement takes place until the teeth are in correct alignment. The Invisalign system has two modifications especially for teens: “eruption tabs” that hold space open for emerging molars, and “compliance indicators” that can tell parents and orthodontists if the teen is keeping the trays in for the prescribed amount of time. We’d be happy to discuss whether clear aligners would be an option for your child.
Keeping It Clean
No matter which type of appliance is used, oral hygiene becomes even more important during orthodontic treatment. Wearing braces presents special challenges in terms of keeping teeth clean; however, it’s extremely important to do an effective job every day so that gums do not become inflamed and cavities do not develop. It’s far easier to clean teeth with clear aligners, which can be removed, but the aligners themselves can build up bacteria, leading to the same types of oral health issues if they are not cleaned each day.
Making It Count
Another way in which orthodontic treatment will not vary regardless of the type of appliance chosen is the necessity of a retention phase. Everyone who has their teeth straightened (and this goes for adults and younger kids, too) must wear a retainer to hold the teeth in their new and improved alignment while new bone grows around them. Yes, braces are easier to wear than they used to be… but no one wants to wear them twice!
If you have questions about braces for your teen, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Clear Aligners for Teenagers” and “The Magic of Orthodontics.”
Before we begin correcting a malocclusion (poor dental bite), we need to ask a few questions: How extensive is the malocclusion? How far must we move the teeth to correct it? How might the patient's jaw size impact treatment?
Answering these and other questions help us develop an effective treatment plan. And depending on the answers, we might need to look at other procedures before we install braces—like removing one or more of the teeth.
This isn't a subject to approach lightly: All teeth play an important role in dental function and smile appearance, and ordinarily we want to preserve teeth, not remove them. Sometimes, however, it may be a necessary action to achieve our goal of an improved dental bite.
For example, it might be necessary for correcting a malocclusion caused by severe teeth crowding. This occurs when one or both of the jaws hasn't grown to a sufficient size to accommodate all of the teeth erupting on it. As a result, some of the teeth could come in out of their proper alignment.
If caught early before puberty, we may be able to use other techniques to alleviate crowding, like a device called a palatal expander that influences an upper jaw to widen as it grows. If successful, it could provide later teeth more room to erupt in their proper positions.
But even if additional jaw growth occurs, it may not be enough to avoid a malocclusion or treatment with braces. Alleviating further crowding by removing teeth in little noticed areas could help with subsequent orthodontics.
Removing teeth may also be the answer for other problems like an impacted tooth, in which the tooth has not fully erupted and remains submerged in the gums. It's sometimes possible to use a technique to “pull” the tooth down where it should be; but again, that will still require jaw space that may not be available. The more effective course might be to remove the impacted tooth.
Whether or not tooth extraction will be needed can depend on a thorough orthodontic evaluation and full consideration of all the available options. Even though the ideal situation is to correct a bite with all teeth present and accounted for, it may be for the better good to sacrifice some.
If you would like more information on orthodontic techniques, 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 “Removing Teeth for Orthodontic Treatment.”
Straightening your smile doesn't happen overnight—it can involve months or even years of orthodontic treatment. And although the end result is well worth it, the long process can make it difficult to keep your gums healthy, especially while wearing braces.
Gum swelling in particular is a common problem for braces wearers with two potential sources. First, orthodontic hardware makes it difficult to keep teeth clean of dental plaque, a thin bacterial film that can cause gum disease. Plaque and its hardened counterpart tartar can trigger a gum infection, which in turn triggers inflammation. As a result, affected gums appear swollen and red, and can easily bleed.
Gum tissues may also react to braces pressing against them and develop hypertrophy (or hyperplasia), an increase in individual tissue cell growth. If this overgrowth occurs, it may not get resolved until after your braces have been removed.
As long as the hypertrophy doesn't appear to have weakened gum attachment with the teeth, it's usually not a big concern. But what is a concern is that hypertrophy could increase a braces wearer's difficulties with oral hygiene and give rise to a true gum infection that could endanger dental attachment. Advanced cases could require surgical correction or removal of the braces altogether to adequately treat the infection.
The best way to avoid a worst case scenario is to be as diligent as possible with daily brushing and flossing. Fortunately, there are several tools that can make it easier with braces. Interproximal brushes, tiny brushes that can fit into the narrow spaces between the teeth and the braces, can be used in conjunction with your regular toothbrush.
Flossing is also easier if you use a floss threader or a water flosser. The latter utilizes a pump to emit a pulsating jet of water to break loose plaque between teeth and flush it away. Clinical studies have shown the effectiveness of water flossers for removing plaque in braces wearers as opposed to not flossing at all.
A faithful daily hygiene practice and twice-a-year cleanings and checkups with your regular dentist can help minimize your chances of gum swelling. Doing so will help ensure you'll complete your orthodontic treatment on the way to healthier and more attractive smile.
If you would like more information on teeth and gum 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 “Gum Swelling During Orthodontics.”