Posts for tag: orthodontic treatment
Although tooth decay is a major problem to watch for in your child’s teeth, it isn’t the only one. As their teeth transition from primary (“baby”) to permanent, you should also be on the lookout for a developing poor bite or malocclusion.
Although the signs can be subtle, you may be able to detect an emerging malocclusion, starting usually around age 6, if you know what to look for. Here are 4 signs your child may be developing a poor bite.
Excessive spacing. This is something that might be noticeable while the child still has their primary teeth. If you notice an excessive amount of space around the front teeth, the sizes of the jaws and the teeth may be disproportional.
Abnormal overlapping. The upper teeth normally just cover the bottom teeth when the jaws are closed. But a malocclusion may be forming if the lower teeth cover the upper (underbite), the upper teeth extend too far over the lower (deep bite) or there’s space between the upper and lower front teeth (open bite).
Different overlapping patterns. Watch as well for some of the teeth overlapping normally while others don’t, a sign of a cross bite. For example, the back upper teeth may cover their counterparts in a normal fashion while the lower front teeth abnormally overlap the top front. The roles here between front and back teeth can also be reversed.
Abnormal eruptions. Permanent teeth normally follow a pattern when erupting, but certain factors could disrupt the process. For example, a jaw that’s developed too small can cause crowding as incoming teeth vie for space; as a result, some permanent teeth may erupt out of their proper position. Likewise, if a baby tooth is out of its normal position or prematurely lost, the permanent tooth may erupt out of position too.
The good news with each of these developing bite problems is that we can correct them or at least minimize their future effect if caught early. So if you notice any of these signs or anything else out of the ordinary, see an orthodontist as soon as possible. It’s also a good idea to have your child undergo a thorough orthodontic evaluation around age 6.
If you would like more information on bite problems in children, 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 “Problems to watch for in Children Ages 6 to 8.”
If you've known anyone who has worn braces, you know what comes after — wearing a retainer. This can be kind of a letdown after all those months with braces, but it's absolutely necessary.
That's because teeth have a tendency to “rebound” to their pre-orthodontic positions once the force to move them stops after the braces are removed. Retainers help keep or “retain” moved teeth in their new positions and prevent them from reverting to the old.
When you think “retainer,” you probably picture a removable appliance with a wire that fits over the front of the teeth. While that may be the most common type, it isn't the only one. There's another called a bonded retainer, a thin piece of wire bonded to the back of the teeth that need to be retained. Unlike the other type, a dentist must remove a bonded retainer when it's no longer needed.
The biggest advantage of a bonded retainer is its invisibility — the wire is behind the teeth so no one can see it as with a removable retainer. The wire is bonded to the teeth with a dental composite material and then light-cured to create a strong attachment.
Another advantage is especially pertinent to younger patients. Because it's permanently attached and can't be taken out, there's no constant reminding of the patient to wear it — and no more worries about replacing a lost one.
They can, though, be difficult to floss around leading to potential plaque buildup that increases disease risk. It's very important you receive proper hygiene instruction for cleaning under the bonded retainer. Another concern is that they can break under excessive chewing pressure. And as with the more common retainer, we wouldn't want to remove it as that will result in the teeth's relapse to their old positions.
To learn which retainer is best for your situation, you should discuss the options with your orthodontist. Regardless of which type you choose, though, a retainer is a must for protecting your investment in that new smile.
If you would like more information on orthodontics and 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.”
After months of wearing braces it's time for the big reveal: your new and improved smile! Your once crooked teeth are now straight and uniform.
But a look in the mirror at your straighter teeth might still reveal something out of place: small chalky-white spots dotting the enamel. These are most likely white spot lesions (WSLs), points on the enamel that have incurred mineral loss. It happens because mouth acid shielded by your braces contacted the teeth at those points for too long.
Most mouth acid is the waste product of bacteria that thrive in dental plaque, a thin film of food particles that can build up on tooth surfaces. High levels of acid are a definite sign that plaque hasn't been removed effectively through brushing and flossing.
But normal hygiene can be difficult while wearing braces: it's not easy to maneuver around brackets and wires to reach every area of tooth surface. Specialized tooth brushes can help, as well as floss threaders that help maneuver floss more easily through the wires. A water irrigator that uses pulsating water to remove plaque between teeth is another option.
However, if in spite of stepped-up hygiene efforts WSLs still develop, we can treat them when we've removed your braces. One way is to help re-mineralize the affected tooth surfaces through over-the-counter or prescription fluoride pastes or gels. It's also possible re-mineralization will occur naturally without external help.
While your teeth are sound, their appearance might be diminished by WSLs. We can improve this by injecting a liquid tooth-colored resin below the enamel surface. After hardening with a curing light, the spot will appear less opaque and more like a normal translucent tooth surface. In extreme cases we may need to consider porcelain veneers to cosmetically improve the tooth appearance.
In the meantime while wearing braces, practice thorough dental hygiene and keep up your regular cleaning visits with your general dentist. If you do notice any unusual white spots around your braces, be sure to see your dentist or orthodontist as soon as possible.
If you would like more information on dental 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 “White Spots on Teeth during Orthodontic Treatment.”
If you or a family member has problems with teeth alignment or your bite, you may be considering braces. This tried and true method can straighten out most smiles — but there's more to braces than you may realize.
For one thing, orthodontic treatment wouldn't work if it weren't for the natural mechanism for tooth movement that already exists in the mouth. It may seem your teeth are rigidly set in the jawbone but that's not how they maintain their attachment: that's the job of an elastic connective tissue known as the periodontal ligament that lies between the tooth and the bone. The ligament has tiny fibers that attach to the tooth on one side and to the bone on the other to actually hold the teeth in place, much like a hammock secured between two posts.
The ligament attachment also allows the teeth to move incrementally in response to environmental factors or the aging process. We harness this natural movement ability with braces to move teeth to a more desirable position. We first attach small brackets to the front crowns of the teeth (the visible portion) and then string arch wires through them. We then attach the wires to anchor points where we can adjust the amount of tension they're exerting through the brackets against the teeth. By gradually increasing that tension, the teeth respond as they would when any force is applied against them and begin to move.
By precisely controlling that movement we can transform a patient's smile. But we believe the advantages are more than cosmetic: the teeth will function better and will be easier to care for and keep clean. These benefits, though, have to be balanced with heightened risks for root resorption (something that occurs only about 10% of the time) in which the ends of the roots can shrink, or loss of mineral content in teeth enamel where the hardware makes it more difficult to remove bacterial plaque. These risks can be reduced by closely monitoring dental health during the entire treatment process and through stepped up efforts in daily oral hygiene.
The starting point for deciding on an orthodontic treatment is a thorough dental examination with x-rays or CT scan imaging. Once we have a complete picture of your misalignment problems and any other extenuating circumstances, we can recommend a treatment plan just for you.
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 “Moving Teeth with Orthodontics.”
In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.
When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”
Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.
There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.
By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.
So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.