Posts for tag: orthodontic treatment
If your teenager is in need of orthodontic treatment, you might automatically think braces. But while this decades-old appliance is quite effective, it isn’t the only “tooth movement” game in town any more. Clear aligners are another choice your teenager might find more appealing.
Clear aligners are a sequential set of computer-generated plastic trays that are worn by a patient one after the other, usually for about two weeks per tray. The trays are fabricated using 3-D computer modeling of the patient’s mouth, each one slightly different from the last to gradually move teeth to the desired new positions.
So, why choose clear aligners over braces?
They’re nearly invisible. Because they’re made of a clear polymer material, they’re not nearly as noticeable as metal braces. In fact, they may go completely unnoticed to the casual observer.
They’re removable. Unlike metal braces, which are fixed in place by an orthodontist, clear aligners can be removed by the wearer. This makes brushing and flossing much easier, and they can also be removed for eating or special occasions. That said, though, they should be worn at least 20 to 22 hours each day to be effective.
They’re becoming more versatile. With some complicated malocclusions (poor bites), braces and other orthodontic appliances may still be necessary. But innovations like added power ridges in clear aligners can more precisely control which teeth move and which don’t. This has greatly increased the number of poor bite scenarios where we can appropriately use clear aligners.
If you’d like to consider clear aligners, just remember they require a bit more self-discipline on the part of the wearer than braces. And once the treatment finishes, they’ll still need to wear a retainer just as with metal braces to help keep the repositioned teeth from reverting to their old positions.
If you think your teen is up to the challenge and their particular situation can be corrected with this innovative technology, then clear aligners could be a great choice.
If you would like more information on clear aligners 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 “Clear Aligners for Teens.”
While braces are a tried and true method for achieving a more attractive smile, they may also give rise to problems with dental disease. This is because their hardware — the brackets and bands that serve as tracks for the tensioning wires — make it more difficult to access the tooth and gum surfaces to clean away plaque. This thin film of food remnant may then become a haven for bacteria that cause gum disease or tooth decay.
One of the more common conditions to occur while wearing braces is gingivitis. This is an initial inflammation of the gum tissues caused by bacterial plaque that hasn’t been removed by brushing or flossing. As the inflammation grows unchecked, the infection could advance deeper into the tissues to become a more serious form of gum disease that threatens the survival of affected teeth.
Difficult as it may be for those wearing braces, the best way to avoid gingivitis is through more thorough oral hygiene practices. Fortunately, there are many hygiene products that can help you get around many of the access difficulties posed by braces. Smaller toothbrushes known as interproximal brushes and floss threaders, small aids that thread dental floss under braces wires, can access the spaces between teeth more readily than conventional brushes or floss. Water flossers (which use water under pressure to remove plaque between teeth) and motorized toothbrushes can further increase efficiency. We can also reduce bacterial growth in the mouth if need be with prescription-strength antibacterial mouthrinses.
If, however, gingivitis or gum overgrowth (another common occurrence during orthodontic treatment) continues to be a problem, we may need to take other actions including surgery. In extreme cases, the braces may need to be removed to adequately treat the gums and allow them time to heal before proceeding with orthodontics.
Extra care with daily hygiene and regular dental checkups and cleanings in addition to your orthodontic visits will help keep gum problems at bay while you’re wearing braces. Taking this extra care will stop or minimize the effect of disease as you continue on to the ultimate goal of your orthodontic treatment — a more beautiful smile.
“To gain something, sometimes you have to give up something else.”
No, that isn't the latest viral meme on the Internet. It's actually a practical consideration that could arise in orthodontics.
In this case, the “something” to gain is a straighter, more attractive smile; the “something” you may have to part with is a few teeth. This may be necessary if there are too many teeth on a dental arch for its capacity, a situation called crowding. A lack of space is the main reason teeth come in misaligned.
Before we can correct this, we'll need to free up space to allow for tooth movement by removing one or more of the existing teeth. The ideal candidates are those that are near to the teeth we wish to move but not highly visible. The first bicuspids are the most frequent choices for removal: they're located behind the cuspids or eyeteeth (the pointed teeth right under the eyes).
Ideally, we'll remove the target teeth some time before we apply braces to give the gums a chance to heal. At the same time we want to preserve the bone that once supported the teeth we've extracted. This is because when we chew the forces generated by the teeth stimulates bone replacement growth. When a tooth is no longer there the supporting bone doesn't receive this stimulation and may ultimately reduce in volume.
We may try to prevent this by placing a bone graft in the empty socket immediately after removing the tooth. The graft serves as a scaffold to encourage new bone to grow. Hopefully when we're ready to apply braces, the bone will be strong and healthy to handle the movement of the teeth.
As the teeth move under the influence of braces, they'll begin to fill up the space created by tooth removal. Once it's completed, the extracted teeth won't be missed — the other teeth now straightened will completely fill out the smile.
The different steps in this process must be carefully planned and executed precisely, and it will take months or even years to complete. In the end, though, this complicated bite problem can be corrected and replaced with an attractive, straight smile.
If you would like more information on correcting a poor bite, 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 “Tooth Removal for Orthodontic Reasons.”
Most children's permanent teeth erupt on a fairly predictable schedule. Sometimes, though, one or more teeth might not develop as they should — or at all.
These absent teeth pose functional problems for chewing and hygiene, which can affect long-term dental health. But they can also have a disruptive effect on an otherwise attractive smile if the missing teeth are the upper lateral incisors in the most visible part of the smile.
You normally find this pair of teeth on either side of the upper central incisors (the two front-most teeth). On the other side of the lateral incisors are the canine or eye teeth, known for their pointed appearance. Without the lateral incisors, the canines tend to drift into the space next to the central incisors. This can produce an odd appearance even a layperson will notice: only four teeth where there should be six!
It's possible to correct this abnormality, but it will take time and expense. The first step is usually to move the teeth in the upper jaw with braces to their correct position. This puts teeth where they should be and also opens space between the canines and central incisors so we can eventually replace the missing teeth with dental implants.
But the key to all this is timing. It's usually appropriate to undertake tooth movement with braces during late childhood or adolescence. But implants shouldn't be installed until the person's jaw fully matures, usually in early adulthood. An implant placed before then could eventually become misaligned.
To accommodate the time between bite correction and implant placement, the patient can wear a retainer appliance that will keep the newly created space open. We can also attach artificial teeth to the retainer to camouflage the empty space.
It usually takes a team of a family dentist, an orthodontist and a surgeon to see this kind of “smile makeover” project through, possibly over several years. But the gains in better aesthetics and health are well worth the time and expense.
If you would like more information on replacing non-developing teeth, 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 “When Permanent Teeth Don't Grow.”
You may not always be able to tell if your child's bite isn't developing properly. Â That's why you should have them undergo an orthodontic evaluation around age 6 to uncover any emerging problems with tooth misalignment.
Still, there are some visible signs all's not well with their bite. As the primary (baby) teeth give way, the permanent teeth erupt sequentially around ages 6 to 8. As they come in, you should notice that each tooth fits uniformly next to each other without excessive gaps or, on the other end of the spectrum, not crowded together in crooked fashion. Upper teeth should also fit slightly over the lower teeth when the jaws are shut.
If their teeth appearance deviates from these norms, they may have a bite problem. Here are 4 abnormalities you should watch for.
Underbite or deep bite. As we mentioned, the front teeth should cover the lower teeth with the jaws shut. In an underbite, the reverse happens — the lower teeth are in front of the upper teeth. It's also a problem if the upper teeth cover the lower teeth too much (often referred to as “deeply”).
Open bite. This occurs when there's a gap between the upper and lower front teeth while the jaws are shut together. One possible cause is late thumb sucking, which can put undue pressure on the front teeth and cause them to develop too far forward while forcing the bottom front teeth further backwards.
Crossbites. This kind of bite occurs when some of the teeth don't fit properly over their counterparts, while others do. Crossbites can occur anywhere in the mouth, for example the upper front teeth fitting behind the lower front teeth while the back teeth overlap normally, or the reverse (front normal, back abnormal).
Misalignments and Abnormal Eruptions. Sometimes upper teeth may align too far forward, a situation known as protrusion. Conversely, lower teeth (or the jaw itself) may come in too far back (retrusion). Because a primary tooth might be out of position or not lost in the proper sequence, a permanent tooth might noticeably erupt out of its proper position.
If you notice any of these situations with your child's teeth see your dentist or orthodontist soon for a full examination. If caught early, we may be able to take action that will lessen or even eliminate the problem.