Posts for tag: orthodontics
After months of treatment we’ve removed your braces and your new smile emerges. Upon closer view, however, you notice a number of chalky white spots on your teeth.
These pale areas are white spot lesions (WSLs), the result of mineral breakdown from the long-term contact of acid with the enamel surface. The underlying cause is built-up bacterial plaque due to inadequate oral hygiene, and as such WSLs are the beginning stages of tooth decay.
While anyone can develop WSLs, brace wearers are highly susceptible because of the extra care required to clean around orthodontic hardware. Poor dietary habits such as frequent snacking on sugary or acidic foods and beverages also increase the risk of WSLs.
To reduce the risk of developing this condition, brace wearers must give extra attention and effort to daily oral hygiene, including brushing and flossing. The extra effort required in brushing can be aided by specialized toothbrushes designed to clean around brackets and wires, along with prescription-level fluoride toothpastes for added enamel strength. Floss threaders or a water flosser, a device that uses pulsating water under high pressure, may help you maneuver around hardware to remove plaque between teeth. It's also important to maintain a healthy mouth environment by limiting intake of sugary or acidic snacks and beverages, avoiding tobacco or excessive alcohol or caffeine, and drinking plenty of water to keep your mouth from drying out.
If you’ve already developed lesions, it’s important to stop the decay process before it causes more damage. One way is to assist your body’s natural mechanism for re-mineralizing tooth enamel with fluoride pastes or gels or re-mineralizing agents, or undergoing micro-abrasion to repair a tooth’s surface.
To improve a tooth’s appearance a procedure known as “caries infiltration” involves injecting a liquid tooth-colored resin into the lesion, which is then hardened with a curing light. The spot becomes less noticeable and appears more like normal enamel. For extensive defects, conventional bonding with composite resins or porcelain veneers can be used to cosmetically cover the tooth.
Getting ahead of the problem with effective oral hygiene and good dietary and lifestyle practices will keep WSLs at bay while you undergo orthodontic treatment. If they do develop, however, there are ways to minimize their effect and restore the look of your teeth.
It’s something you think about often—especially when you look in a mirror or at a photo of yourself. You wish something could have been done about it a long time ago. But now you think you’re too old to correct your misaligned teeth—your “crooked” smile.
Actually, you can transform your smile through orthodontics, whatever your age. Millions of your peers have done just that—currently, an estimated one in five orthodontic patients is an adult.
If orthodontics isn’t right for you it won’t be because of age, but most likely the condition of your gums and underlying bone or your overall health. That first factor is extremely important: if you’ve lost a significant amount of bone due to periodontal (gum) disease, there may not be enough to support the force of moving the teeth during orthodontics.
Health conditions like severe heart-valve disease, uncontrolled diabetes or drugs to treat arthritis or osteoporosis can also make tooth movement difficult. And, if you have restricted saliva flow (dry mouth), wearing orthodontic devices could be uncomfortable and increase your risk of tooth decay.
If, however, your mouth and body are reasonably healthy (and you don’t have a difficult bite problem to correct), there’s no reason why you can’t undergo orthodontic treatment. The only other thing that might hold you back is concern over your appearance during treatment. Many adults balk at the possible embarrassment of wearing metal braces “at their age.”
If this is a concern, you may have an alternative: clear aligners. These are a series of computer-generated clear plastic trays that conform to the individual contours of your teeth. Each tray is slightly different—you wear one for a short period of time (usually two weeks) before moving on to the next tray to successively and gradually move your teeth. They’re nearly invisible to others and, unlike fixed metal braces, you can take them out for a rare special occasion.
The only way you’ll know whether correcting your misaligned teeth is a viable option is to undergo a full orthodontic evaluation. From there we can help you decide if and how you want to gain a straighter, more attractive smile.
If you would like more information on adult orthodontics, 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 “Orthodontics for the Older Adult.”
If you’ve ever looked at younger photos of yourself, you’re sure to notice differences with your present appearance. Of course, your basic features might appear much the same. But maybe your lips seemed a little thicker back then, or your nose a bit less prominent.
This is because your facial features don’t stop growing when you reach adulthood—they continue to change throughout your life. For example, lips reach their maximum thickness by around age 14 for girls or age 16 for boys; they’ll remain at that level of thickness for a few years before gradually thinning throughout adulthood. The nose will also continue to grow, becoming more prominent especially as changes in the lower part of the face can make the chin appear shorter.
Although each of us ages at different rates and in different ways, these general physical trends are somewhat predictable. That’s why we can use the knowledge of how our facial physiology changes with age to fine tune orthodontic or other cosmetic dental treatments. The most optimum approach is to consider treatment in the early stages of bite development during childhood or early adolescence.
This means we’re doing more than correcting a patient’s current bite: we’re also taking into account how tooth movement now might affect the jaw and facial structures later in life. By incorporating our understanding of age-related changes into our treatment we might be able to provide some hedge against the effects of aging.
This approach starts with early comprehensive dental care, preferably before a child’s first birthday, and an orthodontic evaluation at around age 6 to assess bite development. It may also be necessary to initiate interceptive treatment at an early age to lessen or even eliminate a growing bite problem to help ease the extent of future treatment. And if a bite requires correction, early evaluation can help create a timetable for effective treatment in later years.
Taking this approach can correct problems now affecting both dental health and appearance. But by acknowledging the aging process in our treatments, we can build the foundation for a beautiful smile well into the future.
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.”
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.