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.
Lately, you’ve noticed your young child’s primary teeth don’t appear to be coming in straight. Is it a problem?
The answer to that question is best answered by an early orthodontic evaluation performed by an orthodontist. It’s advisable for a child as young as 7 to undergo such an exam.
While a child’s primary teeth have a short life span of a few years, that doesn’t make them less important than the permanent teeth that replace them. In fact, they’re extremely influential for permanent tooth development — each one serves as a guide for its replacement to erupt in a proper position. A future malocclusion (bad bite) that becomes more apparent later in life would have been well underway years before.
Orthodontists have the training and expertise to spot these emerging problems in their early stages. Early detection can reduce the extent — and costliness — of future orthodontic treatment by introducing preventative or interceptive measures — even while there’s still a mix of primary and permanent teeth in the mouth. For example, a child wearing a simple type of retainer that influences the development of the bite could minimize or even correct a growing malocclusion.
You can also take advantage of opportunities to discover potential orthodontic problems early through a general or pediatric dentist. By having regular dental cleanings and checkups, the dentist might observe early bite development that should be reviewed by an orthodontist. If not, it’s still a good idea to undergo an orthodontic evaluation no later than age 7.
Given the stage of jaw and facial structure development, waiting until puberty to focus on orthodontic problems may be too late for some problems — and much more expensive than if caught and treated earlier. Getting ahead of these issues earlier in your child’s dental development will help ensure they’ll have a healthy bite throughout their life.
If you would like more information on early orthodontic monitoring, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Early Orthodontic Evaluation” and “Preventative & Cost Saving Orthodontics.”
Orthodontics can produce an amazing smile transformation. With today’s advanced appliances and techniques even the most difficult malocclusions (bad bites) can be overcome. All of this innovation, however, depends on one basic anatomical fact: though firmly set in the mouth, our teeth can still move.
Teeth are actually held in place by the periodontal ligament, a strong, elastic tissue that attaches to them through tiny collagen fibers on one side of the ligament and to the jawbone with similar fibers on the other side. When pressure is placed against a tooth, the bone on the opposite side of the force begins to dissolve (resorb), allowing the tooth to move. As it moves, new bone is built up behind the tooth, to stabilize it. Orthodontists take advantage of this natural mechanism through orthodontic hardware like braces that applies pressure in the desired direction of movement, while the ligament and bone do the rest.
There is, though, a downside to this process. The teeth, bone and gum tissues can contain a kind of “memory” for the former natural position of the teeth. Over time, the lower front teeth tend to take a gradual migratory movement back towards their original position. Also, as we age the lower front teeth may crowd each other as there is a genetic influence for teeth to move to the midline of the face, causing a pressure that allows the skinny lower front teeth to slip behind each other. As a result of both of these tendencies, corrected teeth may retreat from their new positions.
To stop these tendencies, we use an appliance known as a retainer after braces or other hardware is removed. As the name implies, this appliance “retains” the teeth in their new position. For structural “memory,” the retainer will keep the teeth in their new position until the impulse to return to the old one has faded, about eighteen months. Retainers can also slow or stop the natural genetic influence of movement, but it may mean wearing a retainer for an indefinite period, especially individuals who’ve undergone orthodontic treatment later in life.
The length of time you’ll need to wear a retainer after braces — and what type, whether a removable appliance or one permanently attached — will depend on a number of factors including the type of malocclusion, your individual mouth structure and age. We’ll recommend the best option that ensures the best chance of keeping your teeth in their new position.
If you would like more information on retainers after 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 “Why Orthodontic Retainers?”
Compared to traditional braces, orthodontic clear aligners seem miraculous in many ways, almost too good to be true. You may be wondering if they really work. The answer is yes — but they are not for everyone.
Clear orthodontic aligners are an alternative to traditional braces that are used to move your teeth and transform your smile without much interference to your daily life. They are removable trays made of a clear plastic material that is essentially invisible.
When using aligners, a sequence of slightly different trays is custom-made to fit over your teeth. You must wear each one 20 hours a day for two weeks before changing to the next in the series. The aligners are computer generated, designed by state-of-the-art techniques based on models and images of your own teeth. They work because slight changes in the sequential aligners gradually shift your teeth. If they are worn consistently, the process takes from six months to two or three years.
Advantages over traditional braces are:
Clear aligners are a good solution for correcting mild to moderately crowded or incorrectly spaced teeth. They are most effective if your back teeth already fit together properly. Clear aligners are usually effective in correcting simpler or tipping movements of teeth in two dimensions. For more complex movements, traditional braces may be required. Clear aligners are usually recommended for adults whose teeth and jaws are fully developed, and not for children.
Traditional braces are fixed brackets attached to the teeth through which narrow, flexible wires are threaded. They may be necessary if your teeth do not meet properly, creating too much overbite or underbite. Closing spaces where teeth are missing, rotating teeth, or other complicated situations probably make you a better candidate for traditional braces.
Each particular situation is unique. To find out if clear aligners are right for you, make an appointment with us for an assessment and diagnosis of your own situation. For more information see the Dear Doctor magazine article “Clear Orthodontic Aligners.”
OK, so you've been getting orthodontic treatment for what seems like a long time, and finally, your braces are about to come off! Now you're home free, right?
Well, almost… but now comes the final part of your treatment: the retention phase. That means you'll need to wear a retainer. Most people find that a retainer is more comfortable than braces — but because it is often removable, there's the temptation to just leave it off. Don't do it! Here are the top five reasons why you should always wear your retainer as instructed:
1) A retainer helps to make your teeth stable in their new positions.
Your teeth aren't rigidly set in stone (or in bone) — instead, they are held in place by a hammock-like set of ligaments, and the bone that surrounds them is somewhat pliable. That's a good thing… because, otherwise, they would be even harder to move! But it means that it will take some time for the bone and ligament around the teeth to re-form and stabilize in its new position. A retainer holds them in position while that is happening.
2) If you don't wear it, your brand-new smile may not stay looking the way it should.
Did you know that your bone and gum tissue have some “memory?” Unfortunately, it's not the kind that could help you on a science quiz — but teeth can “remember” where they used to be located… and, if you leave them alone, they may try and go back there! A major goal of the retainer is to keep your new smile looking great! If you don't wear it, and your teeth shift back, you risk losing all the time (and money) you invested.
3) There are different types of retainers available; one of them might be just right for you.
At one time, all retainers were made of pink plastic and silvery wire, and were removable. That kind is still available, but now you may have a choice of different colors or patterns — you might even be able to customize yours! Another alternative that may be appropriate is a clear retainer that fits over your teeth, making it nearly invisible. In some cases, you can have a thin wire bonded to the inside of the teeth instead of a removable retainer. It doesn't show, and you don't have to worry about taking it out.
4) As time goes on, you'll probably need to wear your retainer less and less.
At first, you'll probably need to wear your retainer all the time, but after a while you may only have to wear it at night — a lot easier to manage! Think of it as a way of easing yourself out of orthodontic treatment — and into a brand-new smile. The retention stage also helps your teeth avoid damage by allowing the process to end slowly and gently.
5) Lots of celebrities wear them.
If we know who, we aren't telling — but let's just say that several young entertainers and a recently married British Prince have worn retainers, or are still wearing them. So, you're in good company!
If you would like more information about orthodontic 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 articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.”