Correcting a bite problem involves more than applying braces. Orthodontists must consider a wide range of factors, including the type of bite problem involved, complications like impacted or missing teeth, and their patient's overall dental condition.
Orthodontists must also keep in mind the future—how will a treatment implemented now impact a patient's appearance and dental function many years from now? In reality, orthodontists perform these treatments within a dynamic growth environment, especially involving children and teenagers whose mouth and facial structures are still maturing.
And although these growth changes slow in adulthood, they don't stop—orofacial structures continue to change throughout life. For example, a person's lips steadily thicken in size until the mid-teen years, and then slowly thin out over the rest of their lifetime. The distance between the lips both at rest and while smiling may also narrow in later years. Other changes continue to occur in the bones and soft tissues of the mouth and face.
Fortunately, this structural growth follows a fairly consistent track. Although variations do occur, an orthodontist can project the growth changes their patients will undergo as they age, and use that knowledge to plan out bite treatment. With this understanding, orthodontists plan not only what treatments will be needed, but when to perform them, and to what extent.
This may involve a number of treatment stages, spaced out to coincide with regular development. An orthodontist may focus first on general bite correction to bring the teeth and jaws into a reasonable state of alignment. Later, they'll use more refined methods to fine-tune corrections that better align with later adult growth.
More intensive treatments may be necessary to build a foundation for future treatment. For example, orthognathic surgery may be needed to correct a severe case of an over-extended lower jaw. During the procedure, surgeons move the lower jaw to a joint position higher on the skull. This retracts the lower jaw into a more normal alignment with the upper jaw, and can dramatically change the facial profile for the better.
Each orthodontic patient is different, and each requires their own a unique treatment plan. That plan has a greater chance of long-term success by applying knowledge of future growth changes.
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 “Understanding Aging Makes Beauty Timeless.”
In any given year, 4 million tweens and teens are in the process of having their teeth straightened with braces or clear aligners. It's so common we tend to consider orthodontic treatment for young people as a rite of passage into adulthood.
But it doesn't necessarily have to be that way—it might be possible to stop or at least minimize a poor bite before it fully develops. That's the goal of interceptive orthodontics—treatments that head off or “intercept” a bite problem early.
The goal isn't necessarily to reposition misaligned teeth, but to correct a problem that can lead to misalignment. Here are some examples.
A narrow jaw. A narrowly developing jaw can crowd incoming teeth out of their normal positions. For the upper jaw, though, we can take advantage of a temporary separation in the bones in the roof of the mouth (palate) with a device called a palatal expander. Placed against the palate, the expander exerts outward pressure on the teeth and jaw to widen this separation. The body fills in the gap with bone to gradually widen the jaw.
Abnormal jaw alignment. It's possible for a jaw to develop abnormally during childhood so that it extends too far beyond the other. Using a hinged device called a Herbst appliance, it's possible to interrupt this abnormal growth pattern and influence the bones and muscles of the jaw to grow in a different way.
Missing primary teeth. An important role for a primary (baby) tooth is to hold a place for the future permanent tooth. But if the primary tooth is lost too soon, other teeth can drift into the space and crowd out the intended permanent tooth. To prevent this, we can insert a space maintainer: This simple looped metal device prevents teeth from drifting and preserves the space for the permanent tooth.
Although these and other interceptive treatments are effective, some like the palatal expander do their best work within a limited age frame. To take advantage of interceptive orthodontics in a timely manner, parents should seek a bite evaluation for their child from an orthodontist around age 6. The earlier we detect a growing bite problem, the greater your chances for successful intervention.
If you would like more information on treating emerging bite problems early, 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.”
Fermented and distilled beverages have been a part of human culture for millennia. They help us celebrate the joys of life and the companionship of family and friends. But alcohol also has a darker side, if over-consumed: a cause for many social ills, a vehicle for addiction and a contributor to “unwell” being. The latter is particularly true when it comes to oral health.
April is National Alcohol Awareness Month, a time when advocates, public officials and healthcare providers call attention to the negative effects that alcohol can have on society at large and on individuals in particular. In regard to oral health, here are a few ways alcohol might cause problems for your mouth, teeth and gums.
Bad breath. Although not a serious health problem (though it can be a sign of one), halitosis or bad breath can damage your self-confidence and interfere with your social relationships. For many, bad breath is a chronic problem, and too much alcohol consumption can make it worse. Limiting alcohol may be a necessary part of your breath management strategy.
Dry mouth. Having a case of “cottonmouth” may involve more than an unpleasant sensation—if your mouth is constantly dry, you're more likely to experience tooth decay or gum disease. Chronic dry mouth is a sign you're not producing enough saliva, which you need to neutralize acid and fight oral bacteria. Heavy alcohol consumption can make your dry mouth worse.
Dental work. Drinking alcohol soon after an invasive dental procedure can complicate your recovery. Alcohol has an anticoagulant effect on blood, making it harder to slow or stop post-operative bleeding that may occur with incisions or sutures. It's best to avoid alcohol (as well as tobacco) for at least 72 hours after any invasive dental procedure.
Oral cancer. Oral cancer is an especially deadly disease with only a 57% five-year survival rate. Moderate to heavy alcohol drinkers have anywhere from 3 to 9 times the risk of contracting cancer than non-drinkers—and generally the higher the alcohol content, the higher the risk. As with other factors like tobacco, the less alcohol you drink, the lower your risk for oral cancer.
Given its risks to both health and well-being, many people refrain from alcohol altogether. If you do choose to drink, the American Cancer Society and other health organizations recommend no more than two drinks per day for men and one per day for women. Being responsible with alcohol will enhance both the overall quality of your life and your oral health.
If you would like more information about the effect of alcohol and other substances on oral health, please contact us schedule a consultation. To learn more, read the Dear Doctor magazine article “Diet and Prevention of Oral Cancer.”
For nearly two decades, singer-songwriter Taylor Swift has dominated the pop and country charts. In December she launched her ninth studio album, called evermore, and in January she delighted fans by releasing two bonus tracks. And although her immense fame earns her plenty of celebrity gossip coverage, she's managed to avoid scandals that plague other superstars. She did, however, run into a bit of trouble a few years ago—and there's video to prove it. It seems Taylor once had a bad habit of losing her orthodontic retainer on the road.
She's not alone! Anyone who's had to wear a retainer knows how easy it is to misplace one. No, you won't need rehab—although you might get a mild scolding from your dentist like Taylor did in her tongue-in-cheek YouTube video. You do, though, face a bigger problem if you don't replace it: Not wearing a retainer could undo all the time and effort it took to acquire that straight, beautiful smile. That's because the same natural mechanism that makes moving teeth orthodontically possible can also work in reverse once the braces or clear aligners are removed and no longer exerting pressure on the teeth. Without that pressure, the ligaments that hold your teeth in place can “remember” where the teeth were originally and gradually move them back.
A retainer prevents this by applying just enough pressure to keep or “retain” the teeth in their new position. And it's really not the end of the world if you lose or break your retainer. You can have it replaced with a new one, but that's an unwelcome, added expense.
You do have another option other than the removable (and easily misplaced) kind: a bonded retainer, a thin wire bonded to the back of the teeth. You can't lose it because it's always with you—fixed in place until the orthodontist removes it. And because it's hidden behind the teeth, no one but you and your orthodontist need to know you're wearing it—something you can't always say about a removable one.
Bonded retainers do have a few disadvantages. The wire can feel odd to your tongue and may take a little time to get used to it. It can make flossing difficult, which can increase the risk of dental disease. However, interdental floss picks can help here. And although you can't lose it, a bonded retainer can break if it encounters too much biting force—although that's rare.
Your choice of bonded or removable retainer depends mainly on your individual situation and what your orthodontist recommends. But, if losing a retainer is a concern, a bonded retainer may be the way to go. And take if from Taylor: It's better to keep your retainer than to lose it.
If you would like more information about protecting your smile after orthodontics, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Importance of Orthodontic Retainers.”
There are great health benefits to eating better, including for your teeth and gums. But to determine your ideal diet, you'll have to come to terms with carbohydrates, the sugars, fiber and starches found in plants or dairy products that convert to glucose after digestion.
Carbohydrates (also known as carbs) are important because the glucose created from them supplies energy and regulates metabolism in the body's cells. But they can also create elevated spikes of glucose in the bloodstream that can cause chronic inflammation. Besides conditions like diabetes or heart disease, chronic inflammation also increases your risk of periodontal (gum) disease, a bacterial infection arising from dental plaque.
Many concerned about this effect choose either to severely restrict carbs in their diet or cut them out altogether. But these hardline approaches deprive you of the benefits of carbs in maintaining good health. There's a better way—and it starts with understanding that not all carbs are the same. And, one difference in particular can help you properly manage them in your diet.
Here's the key: Different carbs convert to glucose at different digestive rates of speed measured on a scale known as the glycemic index. Carbs that digest faster (and are more apt to cause glucose spikes in the bloodstream) are known as high glycemic. Those which are slower are known as low glycemic.
Your basic strategy then to avoid blood glucose spikes is to eat more low glycemic foods and less high glycemic. Foods low on the glycemic index contain complex, unrefined carbohydrates like most vegetables, greens, legumes, nuts or whole grains. High glycemic foods tend to be processed or refined with added sugar like pastries, white rice, or mashed potatoes.
Low glycemic foods also tend to have higher amounts of minerals and nutrients necessary for healthy mouths and bodies. And fresh vegetables in particular often contain high amounts of fiber, which slows down the digestion of the accompanying carbohydrates.
Eating mainly low glycemic foods can provide you the right kinds of carbs needed to keep your body healthy while avoiding glucose spikes that lead to inflammation. You're also much less likely to experience gum disease and maintain a healthy mouth.
If you would like more information on nutrition and dental health, 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 “Carbohydrates Linked to Gum Disease.”
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