Posts for tag: orthodontic treatment
At what age should you begin treating a poor bite? Many might say with braces around late childhood or early adolescence. But some bite problems could be addressed earlier—with the possibility of avoiding future orthodontic treatment.
A crossbite is a good example. In a normal bite, all of the upper teeth slightly cover the lower when the jaws are shut. But a crossbite occurs when some of the lower teeth, particularly in back, overlap the upper teeth. This situation often happens when the upper jaw develops too narrowly.
But one feature of a child's mouth structure provides an opportunity to intervene and alter jaw development. During a child's early years, the palate (roof of the mouth) consists of two bones next to each other with an open seam running between them. This seam, which runs through the center of the mouth from front to back, will fuse during puberty to form one continuous palatal bone.
An orthodontist can take advantage of this separation if the jaw isn't growing wide enough with a unique device called a palatal expander. This particular oral appliance consists of four, thin metal legs connected to a central mechanism. The orthodontist places the expander against the palate and then uses the mechanism to extend the legs firmly against the back of the teeth on both sides of the jaw.
The outward pressure exerted by the legs also widens the seam between the two palatal bones. The body will respond to this by adding new bone to the existing palatal bones to fill in the widened gap. At regular intervals, the patient or a caregiver will operate the mechanism with a key that will continue to widen the gap between the bones, causing more expansion of the palatal bones until the jaw has grown to a normal width.
The palatal expander is most effective when it's applied early enough to develop more bone before the seam closes. That's why it's important for children to undergo bite evaluation with an orthodontist around age 6. If it appears a bite problem is developing, early interventions like a palatal expander could slow or stop it before it gets worse.
If you would like more information on interceptive 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 “Palatal Expanders.”
Wearing braces can ultimately give you a healthier and more attractive smile. In the short-term, though, your gums in particular may be in for a rough ride.
While we're all susceptible to gum disease, braces wearers are more likely to encounter it. This stems from two related factors: the difficulty braces pose to oral hygiene; and the potential irritation of soft tissues by the braces themselves.
The main cause for any form of gum disease is dental plaque, a thin bacterial film that accumulates on teeth. Removing plaque through brushing and flossing greatly reduces the risk of any dental disease. But braces wires and brackets make it difficult to brush and floss—as a result, some plaque deposits may escape cleaning, which makes a gum infection more likely.
To exacerbate this, braces hardware can irritate the gums and cause swelling and tissue overgrowth, also known as hyperplasia. The one-two punch of ineffective hygiene with hyperplasia are why braces wearers have a higher incidence of gum problems compared to the general population.
To guard against this, patients with braces need to be extra vigilant about keeping their teeth and gums clean of plaque. It may be helpful in this regard to use specialized tools like interproximal brushes with narrower bristle heads that are easier to maneuver around braces.
And rather than using traditional flossing thread, orthodontic patients may find it easier and more effective to use pre-loaded flossing picks or an entirely different method called oral irrigation. The latter involves a handheld wand that directs a stream of pulsating water between teeth to loosen and flush away plaque.
It's also important for patients to see their dentist as soon as possible for any gum swelling, bleeding or pain. The dentist can determine if it relates to gum disease, hyperplasia or a combination of both, and recommend treatment. In extreme cases, it may be necessary to remove the braces until the gums heal, so catching and treating any gum problem early is a priority.
Regardless of the risk for gum disease, orthodontic treatment is still well worth the investment in your health and appearance. Practicing effective oral hygiene and keeping a watchful eye on your gums will help further lower that risk.
If you would like more information on oral care during 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 “Gum Swelling During Orthodontics.”
The big day finally arrives when your braces come off. And there it is—your new, beautiful, straight smile! But on closer inspection you notice something else: tiny white spots on your teeth.
Those pale, chalky spots are called white spot lesions (WSLs). They occur when acid has contacted the tooth enamel for too long, dissolving essential minerals like calcium in those particular areas. The occurrences of WSLs during and after braces highlights a major challenge during orthodontic treatment—keeping your teeth clean.
Braces' wires and brackets tend to get in the way of brushing and flossing, making it easier to miss plaque—the bacterial film that produces acid—on tooth areas around the hardware. Those missed areas could in time lead to WSLs.
The main objective with WSLs is prevent them from occurring during braces wear as much as possible. To do this, you'll need to increase your time and effort brushing and flossing, especially around orthodontic hardware. You can make it easier, though, by using a few tools that often work better than regular toothbrushes and floss like interproximal toothbrushes, power brushes, floss threaders or water flossers.
You can also help lower your mouth's acidity by avoiding or limiting acidic foods and beverages, including juices, sodas, sports and energy drinks. And, by all means, keep up your regular dental cleaning schedule with your general dentist.
Should WSLs develop while you're wearing braces, don't panic. It's possible they'll diminish on their own, or at least not worsen. We can also foster re-mineralization of the enamel with applied fluoride, short bursts of laser light or a procedure called microabrasion that restores damaged areas below the enamel surface.
For more resistant WSLs, we can also inject a liquid tooth-colored resin into them that when hardened by a curing light can make those areas look translucent like normal enamel. We can also use other cosmetic solutions like bonding or veneers to improve your teeth's appearance.
Like other dental problems, dealing with a WSL is usually more successful if caught and treated early. So, check your teeth often while wearing braces, and if you notice anything unusual don't hesitate to call your dentist.
If you would like more information on oral 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.”
It’s a big moment after months of wearing braces to finally get a glimpse of your new smile. The crooked teeth and poor bite are gone — and in their place are beautiful, straight teeth!
If you’re not careful, though, your new look might not last. That’s because the natural mechanism we used to straighten your teeth may try to return them to their previous poor positions.
Contrary to what many people think, teeth aren’t rigidly set within the jaw bone. Instead, an elastic, fibrous tissue known as the periodontal ligament lies between the teeth and the bone and attaches to both with tiny fibers. Though quite secure, the attachment allows the teeth to move in very minute increments in response to growth or other changes in the mouth.
Orthodontic appliances like braces or clear aligners put pressure on the teeth in the direction we wish them to move. The bone dissolves on the side of the teeth where pressure is being applied or facing the direction of movement and then builds up on the other side where tension is occurring.
The ligament, though, has a kind of “muscle memory” for the teeth’s original position. Unless it’s prevented, this “memory” will pull the teeth back to where they used to be. All the time and effort involved with wearing braces will be lost.
That’s why it’s important for you to wear an appliance called a retainer after your braces have been removed. As the name implies, the appliance “retains” the teeth in their new position until it’s more permanently set. For most people, this means wearing it for twenty-four hours in the beginning, then later only a few hours a day or while you sleep.
The majority of younger patients eventually won’t need to wear a retainer once bone and facial growth has solidified their teeth’s new position. Older adults, though, may need to wear one from now on. Even so, it’s a relatively slight inconvenience to protect that beautiful, hard-won smile.
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 “The Importance of Orthodontic Retainers.”