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Posts for tag: orthodontics

EdenSherandtheLostRetainer

Fans of the primetime TV show The Middle were delighted to see that high school senior Sue, played by Eden Sher, finally got her braces off at the start of Season 6. But since this popular sitcom wouldn’t be complete without some slapstick comedy, this happy event is not without its trials and tribulations: The episode ends with Sue’s whole family diving into a dumpster in search of the teen’s lost retainer. Sue finds it in the garbage and immediately pops it in her mouth. But wait — it doesn’t fit, it’s not even hers!

If you think this scenario is far-fetched, guess again. OK, maybe the part about Sue not washing the retainer upon reclaiming it was just a gag (literally and figuratively), but lost retainers are all too common. Unfortunately, they’re also expensive to replace — so they need to be handled with care. What’s the best way to do that? Retainers should be brushed daily with a soft toothbrush and liquid soap (dish soap works well), and then placed immediately back in your mouth or into the case that came with the retainer. When you are eating a meal at a restaurant, do not wrap your retainer in a napkin and leave it on the table — this is a great way to lose it! Instead, take the case with you, and keep the retainer in it while you’re eating. When you get home, brush your teeth and then put the retainer back in your mouth.

If you do lose your retainer though, let us know right away. Retention is the last step of your orthodontic treatment, and it’s extremely important. You’ve worked hard to get a beautiful smile, and no one wants to see that effort wasted. Yet if you neglect to wear your retainer as instructed, your teeth are likely to shift out of position. Why does this happen?

As you’ve seen firsthand, teeth aren’t rigidly fixed in the jaw — they can be moved in response to light and continuous force. That’s what orthodontic appliances do: apply the right amount of force in a carefully controlled manner. But there are other forces at work on your teeth that can move them in less predictable ways. For example, normal biting and chewing can, over time, cause your teeth to shift position. To get teeth to stay where they’ve been moved orthodontically, new bone needs to form around them and anchor them where they are. That will happen over time, but only if they are held in place with a retainer. That’s why it is so important to wear yours as directed — and notify us immediately if it gets lost.

And if ever you do have to dig your retainer out of a dumpster… be sure to wash it before putting in in your mouth!

If you would like more information on retainers, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Why Orthodontic Retainers?

ExposingandPreservingImpactedCanineTeeth

The final emergence of permanent teeth in late adolescence marks the end of a long process beginning in the womb with the formation of our primary or “baby” teeth. Permanent teeth form in a similar way as buds high in the jaw, continuing to grow until the primary teeth ahead of them fall away. The crowns of the new adult teeth eventually break through the gum tissue and emerge (erupt) into view.

At least, that’s normally what should happen; sometimes, though, a tooth may only erupt partially or not at all, a condition known as impaction. The crown remains partially or fully submerged below the gum line, causing the tooth to press against other teeth, potentially damaging them. It can also make periodontal (gum) tissues adjacent to the area more susceptible to disease. Wisdom teeth are especially prone to this kind of impaction, to the extent they’re often surgically removed (extracted) to avoid future problems to adjacent teeth or the bite.

Upper canines (the “eye teeth” normally located directly below the eyes) are also subject to impaction. But because of their highly visible position, extracting them could have an adverse impact on the patient’s smile. In this case, we often attempt instead to expose and ultimately save the tooth.

Before taking any action, however, an orthodontic examination is conducted first to pinpoint the exact position of the impacted tooth and determine how that position might affect moving teeth into a more desired alignment. If we find the impacted canine is in a workable position, the next step is to surgically uncover the tooth from the gum tissue (a minor procedure usually performed by an oral surgeon or periodontist). Once exposed, an orthodontic bracket with a small attached gold chain is bonded to the tooth. The gums are then sutured back into place with the chain exposed and allowed to heal.

At some future point an orthodontist will attach the chain to orthodontic hardware that will pull the impacted tooth into proper position over several months. As a result, the upper canine becomes “un-impacted”; the dangers to surrounding teeth and tissues are also reduced. And, just as important, we can preserve the tooth and with orthodontics achieve an attractive, normal smile.

If you would like more information on the effects and treatment of impacted 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 “Exposing Impacted Canines.”

AWorld-ClassSmile

He’s the world’s highest-paid soccer player: a forward on the Spanish club Real Madrid, and captain of the Portuguese national team. His super-toned body is featured in a series of advertisements, and he’s regularly seen with a supermodel on his arm. So would it surprise you to know that it took a bit of dental work to help Cristiano Ronaldo get a world-class smile?

You might never guess it to look at him now — but when he was 18 years old, and just starting his professional career with Manchester United in England, Ronaldo wore ceramic braces to correct a set of teeth that were quite a bit… off-sides. (As pictures from that time show, his teeth were out of alignment and had irregular spacing.) Yet in a relatively short time, his smile was completely transformed.

Ceramic braces are the treatment of choice for many sports stars and celebrities — and plenty of “regular” folks too. They work just like traditional all-metal braces, exerting a gentle force that slowly moves the teeth into better positions. But they have one major difference: They’re a good deal harder to notice.

That’s because instead of having brackets made of metal, this style of braces uses a high-tech ceramic material to attach the archwire to the teeth. The brackets blend right in with the natural shade of the tooth, so all you can see from a distance is the thin metal wire. That makes them a great orthodontic option for image-conscious celebs (like Tom Cruise and Faith Hill, who both wore them) — as well as anyone who may be concerned that traditional metal braces don’t fit in with their “look”.

In addition to ceramic braces, there are other, less-visible orthodontic treatments that can work just as well in many situations. One is lingual braces, which are similar to traditional braces — except they are applied on the tongue-side of the teeth, making them truly invisible. Another is clear aligners, a series of transparent plastic trays that are worn 22 hours a day and gradually move the teeth into more pleasing positions. What’s the best way to know which system is right for you? Come in and talk to us about your options!

Besides braces, did Cristiano Ronaldo have other cosmetic dental work (like teeth whitening) done? It’s possible, but he’s not saying exactly. Yet, as he told a Portuguese magazine, “I feel good about myself and that’s the most important thing.”

If you would like more information about ceramic braces or other orthodontic treatments, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor articles “The Magic of Orthodontics” and “Orthodontics For The Older Adult.”

JawSurgerymaybeNecessarytoOvercomeSomeTeethMisalignments

Orthodontics is a specialty of dentistry dedicated to the diagnosis and treatment of misaligned teeth, or malocclusions. The goal is to help patients achieve better long-term oral health by improving teeth alignment. Sometimes, though, the misalignment is much more involved than the position of the teeth — it may be that the jaw structure is also misaligned. In that case, the skills of an oral surgeon may be in order.

The jaws are similar in shape to the arch of a horseshoe, hence the referral to either upper or lower sets of teeth as dental arches. In a normal jaw structure, the lower arch fits just inside the upper arch when you bite down and the teeth are able to function correctly. In some individuals, though, the lower arch closes in front of the upper arch, commonly known as an underbite. If the underbite is only slight, the malocclusion can be corrected by repositioning the teeth only, as with braces. If, though, the underbite is more severe it would require a surgical procedure to realign the jaws, also known as orthognathic surgery.

Orthognathic surgery can help relieve a number of functional complications caused by jaw-related malocclusions: difficulty chewing and swallowing; chronic jaw or head pain; or sleep apnea. It can also enhance the patient’s facial appearance by correcting an imbalance between the two lateral sides (asymmetry), or by minimizing a receding chin or protruding jaw.

Its primary benefit, though, is its effect on the patient’s bite and tooth alignment. For this purpose, the orthodontist and oral surgeon work together to achieve the best result possible. In some cases, the orthodontist may perform his or her work first by moving teeth into the proper position. This sets the stage for the oral surgeon to perform orthognathic surgery to complete the correction of the misalignment.

Each individual patient’s case is different — the best plan of action must begin with a full examination by an orthodontist, and a consultation with an oral surgeon if necessary. It may require time and the expertise of two specialties, but the final result will be better health and a better look.

If you would like more information on various orthodontic procedures, 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 “Jaw Surgery & Orthodontics.”

RemovingCertainTeethcanBenefitOrthodonticTreatment

Not only can orthodontic treatment transform your smile, it can also restore function to your teeth and mouth that will improve both your oral and general health. But any treatment to straighten misaligned teeth requires careful planning. Depending on the exact nature of your misalignment, there may be some additional steps we would need to perform before undertaking orthodontic treatment.

One common need is space to help relieve overcrowding. To make room for tooth movement, often a tooth may need to be removed if the crowding is excessive. The most likely candidates are the first bicuspids, teeth located between the cuspids (or eyeteeth, located in line under the eyes) and the second premolar located in front of the molar teeth. The removal of these first premolars won't have a great effect on future form or function. Under the gentle pressure exerted by the braces, neighboring teeth will move and fill in the open space. Today's orthodontist goes to great lengths to avoid removing any teeth; in severe overcrowding, though, this is an acceptable way to create needed space.

Damaged teeth in need of replacement may also be removed before orthodontics and certainly more desirable — if any tooth needed to be removed, you would always choose a damaged tooth first. The object is to first preserve the underlying bone and close the space to avoid replacing that tooth or, if not possible, maintain the correct amount of space for any future restoration.

As living tissue, bone constantly reshapes in response to its environment. If it no longer senses a tooth (or the forces exerted by a tooth when biting or chewing), the bone will slowly disappear through a process known as bone resorption. To counteract this process, we may graft material (like processed donor bone) into the socket to encourage and maintain bone growth. This creates a platform for future tooth replacements like implants or bridgework after orthodontic treatment.

After orthodontics, it may also be necessary to install some type of “placeholder” (temporary bridgework or partial denture) in the area of missing teeth. Keeping the teeth from migrating into the space will improve the chances that any permanent restoration like an implant or fixed bridgework will look natural — as if it belonged there the entire time.

A complete dental examination will indicate whether any teeth need to be removed before undergoing orthodontic treatment. If necessary, taking this strategic step will help ensure we achieve the best result — a winning smile.

If you would like more information on tooth removal and other options to enhance 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 “Tooth Removal for Orthodontic Reasons.”