Posts for tag: orthodontic treatment
The straightening process for a crooked smile doesn't end when the braces come off. There's one more crucial phase to undergo to make sure we don't lose the progress you've achieved: wearing an orthodontic retainer.
Although often viewed as a nuisance, retainers are important because they prevent realigned teeth from reverting to their old positions. This is possible because the periodontal ligament, the gum attachment that allows us to move teeth in the first place, can contain “muscle memory” that naturally tries to draw teeth back to where they once were.
A retainer prevents this from happening: During wear the subtle pressure they exert keeps or “retains” the teeth in their new positions until they're firmly established, usually after several months. While most patients initially wear a retainer around the clock, this will gradually taper off until they're worn primarily during sleep hours.
While retainers come in many different styles and sizes, most fall into one of two categories: removable or non-removable (bonded). The first type, a custom-made appliance a patient can easily take in and out of the mouth, has its advantages. Removing it makes it easier to clean the teeth. They're also adaptable to reduced wear schedules for eating, brushing and flossing, or for special occasions.
But a removable retainer may be noticeable to others. Its removability can also lead to problems. Out of the mouth they're prone to be lost, resulting in additional replacement costs. And immature patients may be easily tempted to take them out too often—or not wear them at all.
A bonded retainer solves many of these potential problems. Because the retainer wire is securely bonded to the back of the teeth, it's not visible to others. And because it can't be removed except by an orthodontist, there's virtually no chance of losing it or haphazard wear.
On the other hand, bonded retainers can occasionally break, requiring repair or replacement. And flossing is more difficult than with a removable retainer, although a little training from a dental hygienist can make that easier.
The choice of retainer depends on the individual and their priorities. But whether removable or bonded, a retainer is absolutely essential for protecting your new, hard-earned smile.
If you would like more information on bonded 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.”
Sometimes you need only a single solution to improve your smile: teeth whitening to brighten stained teeth; porcelain veneers or crowns to mask dental flaws; or a life-like dental implant to replace a missing tooth. But not all dental situations are that simple and sometimes require a combination of treatments.
A case in point: restoring a missing tooth within a poor bite. The absent tooth itself may be the cause of the bite problem if it’s been missing for some time: The nearby teeth tend to move or “drift” into the empty space, leaving no room for implant placement.
When this happens, you’ll first need orthodontic treatment to correct the bite problem. Not only will this open the space for the implant, it also comes with its own benefits. It obviously improves your smile appearance—but straighter teeth are also easier to keep clean of bacterial plaque, which reduces your disease risk. You may also experience better digestion after your teeth are properly aligned and able to function as they should during eating.
The traditional way to improve a bite is through metal braces. But there are some downsides: For one, braces can make it difficult to keep teeth adequately clean, making wearers more susceptible to tooth decay and gum disease. Braces are also quite visible and can detract from a person’s appearance (even more so if a missing tooth is involved).
Unless your situation requires braces, you can choose clear aligners as an alternative. These clear, computer-generated plastic trays are worn in sequence to gradually move teeth to their desired positions. Unlike braces, you can remove aligners for eating, cleaning or rare special occasions. And, they’re barely noticeable to others.
If you also have a missing tooth, you can have a temporary prosthetic (“false”) tooth built into your aligner trays. In this way you can still enhance your smile while undergoing aligner treatment.
Once your bite has been corrected, we can then proceed with restoring your missing tooth permanently with a dental implant. Although orthodontics adds to the time and expense of restoration, its often necessary to achieve the best result. Your future smile will be the better for it.
Braces are a common experience among teens and pre-teens. And although the treatment can be a major financial undertaking, more and more families pursue it to help their child attain a straighter, more attractive smile.
But orthodontics isn’t first and foremost a cosmetic treatment. Although an improved appearance is a benefit, the main reason for treatment is therapeutic—it can improve your child’s current and future dental health.
The teeth’s relationship to the jaws and gums makes moving them possible. Rather than simply being fixed within their jawbone socket, teeth are actually held in place by a strong, elastic tissue called the periodontal ligament. The ligament lies between the teeth and jawbone and attaches to both with tiny extending fibers. This attachment secures the teeth in place.
But the ligament also has a dynamic quality—it can reshape itself when necessary and allow teeth to move gradually into new positions. This is most necessary during the early years of mouth and jaw development, but it can also occur throughout life. Orthodontics takes advantage of this mechanism by applying precise pressure to the teeth in the direction of desired movement. The periodontal ligament does the rest by reshaping and allowing the teeth to move in response to this pressure.
The result is straighter teeth and a more normal bite. With the teeth now where they should be, it’s also easier to clean them of disease-causing dental plaque, whereas misaligned teeth are more prone to plaque accumulation that can be difficult to remove. And because the whole mouth including teeth are involved when we talk, teeth positioned in a more normal bite will improve speech.
Orthodontics is a long-term process, often encompassing more than the actual time wearing braces. Both orthodontists and pediatric dentists recommend a bite evaluation by an orthodontist around the age of 6. If it does appear an abnormal bite is forming, it may be possible to intervene and stop or at least slow the development. This could have a more positive impact on any future treatment.
Braces and other treatments can make a difference in your child’s self-image and social relationships. But the main beneficiary will be their dental health.
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.”
Once upon a time, braces were the way to straighten a smile. They were—and continue to be—an effective orthodontic treatment especially for younger patients. But braces do have a few drawbacks, one of the biggest being appearance: when you're wearing braces, everyone can see you're wearing them.
That changed a couple of decades ago with the introduction of clear aligners. Removable plastic trays that incrementally move teeth, aligners have quickly become popular for a number of reasons. Perhaps their biggest attraction is that they're barely noticeable.
There's now a third option for correcting crooked teeth: lingual braces. They're similar to the traditional version, but with one big difference: all of the hardware is on the back side of the teeth.
Ironically, two orthodontists an ocean apart developed the idea, and for different reasons. A Beverly Hills orthodontist was looking for an invisible tooth-moving method that would appeal to his image-conscious patients. The other in Japan wanted to offer his martial arts patients, who risked injury from facial blows with traditional braces, a safer alternative.
These two motivations illustrate the two biggest advantages to lingual braces. The brackets and other hardware are attached to the back of the teeth (on the tongue side, hence the term "lingual") and exert the tooth-moving force by pulling, in contrast to the pushing motion of labial ("lip-side") braces. They're thus invisible (even to the wearer) and they won't damage the soft tissues of the cheeks, lips and gums if a wearer encounters blunt force trauma to the mouth.
They do, however, have their disadvantages. For one, they're often 15-35 percent more expensive than traditional braces. They're also a little more difficult to get used to—they can affect speech and cause tongue discomfort. Most patients, though, get used to them within a week. And, being a relatively new approach, not all orthodontists offer them as a treatment option yet.
If you're interested in this approach to teeth straightening, speak with your orthodontist to see if they're right for you. But if you do take this route, you may have a more pleasing and safe experience.
If you would like more information on orthodontic treatment with lingual 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 “Lingual Braces: A Truly Invisible Way to Straighten Teeth.”
Bite problems aren't limited to teeth simply out of position. The problem could be some teeth aren't there—visibly, that is. They still exist below the gums and bone, but they've been crowded out and blocked from erupting. We call this condition impaction.
Any tooth can become impacted and affect the bite, but a person's smile suffers more if it involves visible front teeth. This is especially so if the teeth in question are upper canines or "eye teeth"—the smile doesn't look normal without these pointed teeth on either side of the central and lateral incisors.
Impacted teeth can also contribute to more than a cosmetic problem: they're more susceptible to abscesses (pockets of infection) or root damage both to themselves or neighboring teeth. To minimize these potential health issues, we'll often remove impacted teeth surgically (as is often done with wisdom teeth).
But because of their important role in not only appearance but also bite function, we may first try to assist impacted canines to fully erupt before considering extraction. It takes a bit of orthodontic "magic," but it can be done.
Before we can make that decision, though, we want to precisely locate the impacted teeth's positions and how it may affect other teeth. This initial evaluation, often with advanced diagnostics like CT scanning or digital x-rays, helps us determine if the impacted teeth are in a workable position to save. If they're not, we may then need to consider removing them and ultimately replacing them with a dental implant or similar restoration.
But if their position is workable and there are no other impediments, we can proceed with helping them erupt. To do this we'll have to first expose them by creating a small opening in the gums through minor surgery. We then bond a small bracket to the tooth, to which we'll attach a small chain that we then attach to orthodontic braces. This enables us to exert continuous pressure on the tooth.
Over time, the pressure coaxes the tooth to erupt. We may still need to apply other forms of orthodontics and cosmetic procedures, but using this procedure to rescue impacted canines can produce a healthier and more attractive smile.
If you would like more information on treating complex 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 “Exposing Impacted Canines.”