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Posts for tag: orthodontic treatment

By E. Thomas Elstner Jr., DMD
April 08, 2019
Category: Oral Health
BeatDentalPlaqueWhileWearingBraceswithTheseToolsandTips

Wearing braces will probably never make your list of Most Pleasurable Life Experiences: you'll have to avoid certain foods and habits, endure some occasional discomfort, and perhaps feel some embarrassment about your appearance. The good news, though, is that at worst, these are mostly no more than inconveniences and additionally they're well worth the straighter, more attractive smile you'll achieve.

But there's one downside to braces that can lead to something more serious. The braces hardware makes brushing and flossing more difficult—and that could increase your risk of dental disease.

The principal goal of oral hygiene is to remove dental plaque, a thin film of accumulated bacteria and food particles that can cause tooth decay or periodontal (gum) disease. Without effective brushing and flossing, plaque can build up quickly and make the chances of having either of these two diseases more likely.

Not only does the braces hardware hinder your toothbrush's or floss's access to the parts of the teeth it covers, but it can also create "hiding places" for plaque build-up. Several studies have found that braces wearers on average have up to two to three times the plaque build-up of non-braces wearers.

There are ways, though, to make hygiene easier while wearing braces, particularly with flossing. Floss threaders or interproximal brushes can both be used to access between teeth while wearing braces. Another option is a water flosser or irrigator that sprays pressurized water between teeth (and beneath brackets and wires) to remove plaque. And braces wearers can get a prevention boost with topical fluoride applications or antibacterial mouth rinses to reduce disease-causing bacteria.

Besides taking a little extra time with brushing and flossing, you can also boost your mouth's health with good nutrition choices, less sugar consumption and keeping up regular dental visits. And, you should also see your dentist promptly if you notice any signs of tooth or gum problems—the sooner you have it checked and treated, the less damage any dental disease is likely to cause.

It's not easy keeping your teeth and gums plaque-free while wearing braces. But with a little extra time and effort, a few helpful tools and your dentist's support, you can maintain a healthy mouth during orthodontic treatment.

If you would like more information on best hygiene practices 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.”

By E. Thomas Elstner Jr., DMD
February 07, 2019
Category: Dental Procedures
3WaysOrthodonticTechniquesCouldPreventaPoorBite

While orthodontists can effectively correct most poor bites (malocclusions), some can be quite complex requiring much time and expense. But there's good news—we often don't have to wait on a malocclusion to fully develop if we catch it in time. Thanks to interceptive orthodontics, we may be able to intervene much earlier and eliminate or reduce the degree of difficulty with treatment.

Interceptive orthodontics is a group of techniques and devices used in early childhood to help deter a possible malocclusion. Here are 3 ways this approach could make a difference in your child's bite development.

Guiding jaw growth. On a normal-sized upper jaw, the permanent teeth usually have ample room to erupt. Not so with a smaller jaw: incoming teeth become crowded and may erupt out of alignment or too close to each other. Orthodontists often use a device called a palatal expander to aid an under-sized jaw in its development. The device fits along the roof of the mouth between the teeth and applies gradual outward pressure on them. This encourages the jaw to widen as it grows, thus providing more room for erupting teeth to come in properly and decrease the chances of obstructive sleep apnea in the future.

Reshaping and repositioning jaw bones. An overbite can occur when the jaws aren't properly aligned, often due to poor muscle and bone development. This is where devices like the Herbst appliance are useful. Its hinge mechanism encourages the lower jaw to grow further forward. The jaws can thus develop in a more normal way, minimizing the development of a malocclusion.

Maintaining space. Primary ("baby") teeth are important for dental development because they help guide future permanent teeth to erupt properly; they also keep nearby teeth from drifting into the intended space. But when a primary tooth is lost prematurely due to disease or trauma, the space can become vulnerable to this kind of "drift." With a simple mechanism called a space maintainer we can hold open the space created by a prematurely lost primary tooth until the permanent tooth is ready to erupt.

These and other techniques can help stop bad bites from developing in young children, minimizing or even eliminating the need for future orthodontic treatment. That means a healthier mouth for your child and less impact on your wallet.

If you would like more information on interceptive orthodontics, 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 “Interceptive Orthodontics: Timely Intervention can make Treatment Easier.”

CorrectingaPoorBiteImprovesDentalHealthasWellasSmileAppearance

Overbites, underbites, crossbites—these are just a few of the possible malocclusions (poor bites) you or a family member might be experiencing. But no matter which one, any malocclusion can cause problems.

Besides an unattractive smile, a malocclusion makes it more difficult to chew and to keep the teeth and gums clean of disease-causing bacterial plaque. Thus correcting a malocclusion improves dental health; a more attractive smile is an added bonus.

This art of correction—moving teeth back to the positions where they belong—is the focus of a dental specialty called orthodontics. And, as it has been for several decades, the workhorse for achieving this correction is traditional braces.

Braces are an assembly of metal brackets affixed to the teeth through which the orthodontist laces a metal wire. The wire is anchored in some way (commonly to the back teeth) and then tightened to apply pressure against the teeth. Over time this constant and targeted pressure gradually moves the teeth to their new desired positions.

The reason why this procedure works is because teeth can and do move naturally. Although it may seem like they’re rigidly set within the jawbone, teeth are actually held in place by an elastic tissue network known as the periodontal ligament. The ligament lies between the tooth and bone and keeps the tooth secure through tiny fibers attached to both it and the bone. But the ligament also allows teeth to continually make micro-movements in response to changes in chewing or other environmental factors.

In a sense, braces harness this tooth-moving capability like a sail captures the wind propelling a sailboat. With the constant gentle pressure from the wires regularly adjusted by the orthodontist, the periodontal ligament does the rest. If all goes according to plan, in time the teeth will move to new positions and correct the malocclusion.

In a way, braces are the original “smile makeover”—once crooked teeth can become straight and more visually appealing. More importantly, though, correcting a poor bite improves how the mouth works, especially while eating, and keeping things clean. A straighter smile isn’t just more attractive—it’s healthier.

If you would like more information on correcting misaligned 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 “Moving Teeth with Orthodontics.”

AnchorageDevicesProvideMoreAccuracyLessTreatmentTimeforBraces

Braces are a common part of many teenagers’ life experience — but not every bite problem is alike. Sometimes, there’s a need for accurately moving only a few teeth while making sure others don’t. This is where Temporary Anchorage Devices (TADs) can help streamline that effort and even reduce treatment time.

Orthodontics wouldn’t work at all if we didn’t already have a natural tooth movement mechanism in our mouths. That ability rests with the periodontal ligament, a tough, elastic tissue between the teeth and the bone that firmly attaches to both with tiny collagen fibers. Though quite secure in holding teeth in place, the ligament attachment also allows teeth to move in response to changes in the bone and jaw structure.

Braces are made of brackets cemented to tooth surfaces through which tiny wires pass. The wires are anchored, usually to other teeth or groups of teeth, and tightened to apply pressure against the other teeth. The ligament does the rest: as the teeth are “pressured” to move in a certain direction, new bone, ligament and an anchoring substance known as cementum forms behind it to secure the tooth in its new position.

The anchorage teeth are not intended to move. In some situations, though, it’s difficult to keep them from not moving — much like trying to keep a boat anchor from not dragging through sand on the sea bottom. TADs help alleviate this problem: it’s a mini-screw or mini-implant that’s temporarily placed in the jawbone to which the tension wire can be secured. They’re placed in the best positions for isolating the teeth that need to be moved without compromising the position of nearby teeth that don’t.

With the site numbed with a local anesthetic, we install the TAD through the gum tissue into the bone with a special device; their screw-shaped design holds them securely in place. They’re then removed when the orthodontic treatment is complete.

While a simple procedure, precise placement requires collaboration between the orthodontist and the oral surgeon or dentist who installs them. They also need special attention during daily hygiene to keep them clean. Still, with difficult bite situations they can help bring about the right outcome — a straight and beautiful smile.

If you would like more information on orthodontic treatment options, 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 “What are TADs?

By E. Thomas Elstner Jr., DMD
October 28, 2017
Category: Dental Procedures
FAQInterceptiveOrthodonticsforChildren

Have you heard about interceptive orthodontics? This type of early intervention could benefit perhaps 10รข??20% of children who need orthodontic treatment, making a positive impact on tooth and jaw development, facial symmetry, and overall self esteem. In case you’re not familiar with it, here are the answers to some common questions about interceptive orthodontic treatment.

Q: What’s the difference between interceptive orthodontics and regular orthodontics?
A: Standard orthodontic treatment typically involves moving teeth into better positions (usually with braces or aligners), and can be done at any age. Interceptive orthodontics uses a variety of techniques to influence the growth and development of teeth and jaws, with the aim of improving their function and appearance. Because it works with the body’s natural growth processes, interceptive treatment is most effective before the onset of puberty (around age 10-14), when growth begins to stop. It is generally not appropriate for adults.

Q: What are the advantages of early treatment with interceptive orthodontics?
A: When it’s done at the right time, interceptive treatment offers results that would be difficult or impossible to achieve at an older age without using more complex or invasive methods — for example, tooth extraction or jaw surgery. That’s why the American Association of Orthodontists, among other professional organizations, recommends that all kids have their first orthodontic screening at age 7.

Q: What are some common issues that can be treated with interceptive orthodontics?
A: One is crowding, where there is not enough room in the jaw to accommodate all the permanent teeth with proper spacing in between. A palatal expander can be used to create more room in the jaw and avoid the need for tooth extraction. Another is a situation where the top and bottom jaws don’t develop at the same rate, resulting in a serious malocclusion (bad bite). A number of special appliances may be used to promote or restrict jaw growth, which can help resolve these problems.

Q: How long does interceptive orthodontic treatment take?
A: Depending on what’s needed, a child might wear a device like a palatal expander or another type of appliance for 6-12 months, followed by a retainer for a period of time. Or, a space maintainer may be left in place for a period of months to hold a place for a permanent tooth to erupt (emerge from the gums). Interceptive treatment ends when a child’s jaw stops growing.

Q: Will braces still be needed after interceptive treatment?
A: Often, but not always, the answer is yes. However, interceptive treatment may shorten the period of time where braces need to be worn, and can help prevent many problems later on.

If you have additional questions about interceptive orthodontics, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Early Orthodontic Evaluation.”