Posts for tag: orthodontics
There are an assortment of techniques and treatments in an orthodontist's toolkit, braces being the most common and best known. Of course, there wouldn't be any tools at all if teeth couldn't move naturally.
Teeth aren't directly connected to the jawbone. An elastic tissue called the periodontal ligament lies between each one, with tiny fibers attaching to the tooth on one side and to the bone on the other. The ligament's elasticity and other qualities allow micro-movements of the teeth as we bite.
The ligament can also adapt to changes in the mouth and teeth by allowing the teeth to move to different positions. That's the basic concept behind braces: we thread a thin wire through brackets attached to the teeth, which we then attach to anchor points (usually back teeth not intended to move) and apply tension to it. Gradually over time, the target teeth move.
But what if your malocclusion (poor bite) is more complicated or the back teeth can't supply enough anchorage for moving the intended teeth? That's where we take advantage of other sources of anchorage.
One such source is the patient's skull, which we can make use of through special headgear worn a few hours a day. The device consists of a strap under tension that runs around the back of the head or neck to a wire housing attached to brackets on the target teeth. If you want to “pull” the teeth forward, the strap would come over the chin, forehead or a combination of both.
We may sometimes want to isolate some teeth to move without moving nearby teeth, such as moving front teeth backward to close a space without affecting teeth further to the rear. We can create a separate anchor point in the jaw with a TAD or temporary anchorage device.
TADs are tiny screws made of stainless steel inserted temporarily into the bone. We loop an elastic band over the TAD on one end and to a bracket or tension wire attached to the target teeth on the other. When we've achieved the teeth's new position we can easily remove the TAD from the bone.
These various tools make it possible to correct difficult or complex malocclusions. They may not always look attractive, but they'll help ensure the final result is.
If you would like more information on available orthodontic treatments, 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 “Orthodontic Headgear & Other Anchorage Appliances.”
Wearing braces takes time, but if all goes well the changes to your smile will be well worth it. In the meantime, though, you’ll have to contend with one particular difficulty—keeping your teeth clean of disease-causing, bacterial plaque.
Don’t worry, though—while keeping dental disease at bay with braces can be challenging, it is doable. Here are 4 tips for minimizing your chances of tooth decay or periodontal (gum) disease during orthodontic treatment.
Eat less sugar. Like any living organism, bacteria must eat—and they’re especially amenable to sugar. The more they have access to this favorite food source, the more they multiply—and the greater your risk of tooth decay or gum disease. Eating fewer sugary foods and snacks and more dental-friendly ones helps restrict bacteria populations in your mouth.
Brush thoroughly. Brushing with braces can be difficult, especially in areas blocked by orthodontic hardware. You need to be sure you brush all tooth and gum surfaces around your braces, including above and below the wire running through the brackets. A soft multi-tufted microline bristle brush is a good choice for getting into these hard to reach places. Brushing around braces takes more time, but it’s essential for effective plaque removal.
Use flossing tools. Flossing is important for removing plaque from between teeth—but, unfortunately, it might be even more difficult to perform with braces than brushing. If using string floss proves too daunting consider using a floss threader or a similar device that might be easier to maneuver. You can also use a water irrigator, a hand-held device that sprays water under pressure to loosen and flush away between-teeth plaque.
Keep up regular dental visits. While you’re seeing your orthodontist regularly for adjustments, you should also see your general dentist at least every six months or more. Besides dental cleaning, your dentist also monitors for signs of disease and can prescribe preventive measures like antibacterial mouth rinses. Of course, if you see abnormalities, like white spots on your teeth or red, puffy or bleeding gums, contact your dentist as soon as possible. The sooner a problem can be addressed the less impact it may have on your orthodontic treatment and overall oral health.
If you would like more information on caring for teeth and gums 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.”
If you're currently undergoing orthodontic treatment, you're no doubt looking forward to the day your braces come off. But that won't end your treatment just yet — you'll need to wear a retainer.
Teeth are held secure in the bone of the jaw by an elastic tissue known as the periodontal ligament. As the braces “pull” the teeth to their new position, the ligament stretches and the bone remodels around the teeth. But the ligament also has a tendency to rebound as the tension eases when the braces are removed. The teeth could then return to their original position, especially during the first few months.
To prevent this patients wear an orthodontic appliance known as a retainer. It maintains some of the tension once supplied by the braces to help keep or “retain” the teeth in their new position. Depending on your age and other factors, you'll have to wear one for at least eighteen months; some patients, especially adults, may have to wear one indefinitely.
You may be familiar with a removable retainer, one you can take in and out of your mouth. But there's another type called a bonded retainer that's fixed to the teeth and can only be removed by a dentist. With this retainer a dentist bonds a thin piece of wire to the back of the teeth where it can't be seen. You can feel it, though, with the tongue: an unusual sensation at first, but one easily grown accustomed to.
Unlike their removable counterparts, bonded retainers aren't noticeable, either to others or the wearer. They're especially appropriate for patients who may not be as diligent in wearing a removable retainer.
It does, though, have some disadvantages. The position of the wire running horizontally across several teeth can make flossing difficult. And as with any retainer, removing it could increase the risk of the teeth moving out of alignment.
There are a number of factors to discuss with your orthodontist about which type of retainer is best for your situation. If you do choose a bonded retainer, be sure you work with the dental hygienist on how best to floss the affected teeth. And if you do have it removed, have a removable retainer prepared so you can preserve that smile you've invested so much into obtaining.
Magician Michael Grandinetti mystifies and astonishes audiences with his sleight of hand and mastery of illusion. But when he initially steps onto the stage, it’s his smile that grabs the attention. “The first thing… that an audience notices is your smile; it’s what really connects you as a person to them,” Michael told an interviewer.
He attributes his audience-pleasing smile to several years of orthodontic treatment as a teenager to straighten misaligned teeth, plus a lifetime of good oral care. “I’m so thankful that I did it,” he said about wearing orthodontic braces. “It was so beneficial. And… looking at the path I’ve chosen, it was life-changing.”
Orthodontics — the dental subspecialty focused on treating malocclusions (literally “bad bites”) — can indeed make life-changing improvements. Properly positioned teeth are integral to the aesthetics of any smile, and a smile that’s pleasing to look at boosts confidence and self-esteem and makes a terrific first impression. Studies have even linked having an attractive smile with greater professional success.
There can also be functional benefits such as improved biting/chewing and speech, and reduced strain on jaw muscles and joints. Additionally, well-aligned teeth are easier to clean and less likely to trap food particles that can lead to decay.
The Science Behind the Magic
There are more options than ever for correcting bites, but all capitalize on the fact that teeth are suspended in individual jawbone sockets by elastic periodontal ligaments that enable them to move. Orthodontic appliances (commonly called braces or clear aligners) place light, controlled forces on teeth in a calculated fashion to move them into their new desired alignment.
The “gold standard” in orthodontic treatment remains the orthodontic band for posterior (back) teeth and the bonded bracket for front teeth. Thin, flexible wires threaded through the brackets create the light forces needed for repositioning. Traditionally the brackets have been made of metal, but for those concerned about the aesthetics, they can also be made out of a clear material. Lingual braces, which are bonded to the back of teeth instead of the front, are another less visible option. The most discrete appliance is the removable clear aligner, which consists of a progression of custom-made clear trays that reposition teeth incrementally.
How’s that for a disappearing act?!
If you would like more information about orthodontic treatment please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine article “The Magic of Orthodontics.”
Wearing braces isn't just for teenagers — straightening teeth can be just as viable a need when you're an adult. For example, it may be necessary to first move teeth away from an empty tooth socket before you obtain a dental implant or other restoration.
But braces could have complications, especially if you have periodontal (gum) disease. These infections caused by plaque, a thin film of bacteria and food particles, inflame and weaken gum tissues and erode supporting bone. It can be treated and brought under control — but keeping it under control requires daily brushing and flossing, along with frequent office cleanings and checkups.
Braces can make this more difficult: it's harder to brush and floss effectively through the hardware of brackets and wires, which can give plaque a chance to build up. Patients susceptible to gum disease are more likely to have re-infections while wearing braces. The hardware can also cause enamel to come in prolonged contact with acid, which can dissolve its mineral content and open the door to tooth decay.
Clear aligners are an alternative to braces that can accomplish tooth movement while minimizing infection flare-ups for people with gum disease. Aligners are a series of customized clear plastic trays worn over the teeth, with each succeeding tray incrementally moving the teeth further than the preceding one. After wearing one tray for a specified time period, you then switch to the next tray. The teeth gradually move to the desired new position over the course of the aligner series.
This option is especially advantageous for gum disease patients because the trays can be removed temporarily for brushing and flossing. There are also other benefits: we can hide a missing tooth space with a temporary false tooth attached to the aligner; and, they're nearly invisible so it won't be obvious to others you're undergoing orthodontic treatment.
Not all orthodontic situations benefit from this alternative, while some cases may call for a combination approach between aligners and braces. But in the right setting, clear aligners are a good choice for not only obtaining better teeth position, but also helping you avoid a new encounter with dental disease.