Wearing braces is all about the future: you undergo many months of treatment to gain a lifetime of better mouth function and a more attractive smile.
In the meantime, though, you'll have to deal with a few new realities during treatment: restrictions on foods, limitations with mouth function, and (perhaps) embarrassment over your new “metallic” smile.
There's one reality, though, that trumps all others in importance: your risk for developing dental disease increases significantly during orthodontic treatment. The brackets and wires of your braces make it more difficult to remove bacterial plaque, the main cause of dental disease, which allows places for disease-causing bacteria to thrive. To combat this, you'll need to step up your hygiene efforts to remove daily plaque.
One sign your efforts might not be getting the job done is red, swollen or bleeding gums. Although gums can swell in reaction to the braces themselves, it's often because plaque-induced periodontal (gum) disease has infected the gum tissues.
Gum disease is an aggressive infection. If it isn't stopped it can damage the gums and underlying bone that support your teeth — damage that could eventually lead to tooth loss. To stop it, we must remove plaque from all tooth and gum surfaces, even below the gum line. In some advanced cases it may even be necessary to remove the braces to better treat the disease.
That's why preventing gum disease through effective hygiene is so important. Besides continuing routine visits with your family dentist, you should also brush and floss every day to remove plaque. Be sure you're brushing above and below the braces. It may be helpful to use an interproximal brush specifically designed to maneuver around these tight spaces. You can also use a floss threader or a water irrigator to make the job of flossing easier.
If you do notice gum redness, swelling or bleeding, don't delay — call your dentist at once. An examination will determine if you have gum disease and to what degree, which will guide treatment. The sooner this happens, the less the impact on your dental health and your orthodontic treatment.
If you would like more information on dental care 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 “Gum Swelling During Orthodontics.”
Braces can change a person's life — not just their appearance but their dental health as well. To be honest, though, wearing braces are, well, kind of a drag — especially for teenagers.
Braces can be restrictive and confining; you'll also have to give up certain favorite foods for a while. But more than any of that, they're just plain unattractive. Even being able to choose colors for the brackets and elastic bands can't fully ease a teenager's embarrassment when they smile.
There is, however, an alternative to braces: clear aligners. And they could make orthodontic treatment during this difficult phase of their life much easier to handle.
Clear aligners are a set of clear plastic trays that can be taken in and out of the mouth. Each of the custom-designed trays is slightly smaller than the previous one in the series. After wearing the first tray for a couple of weeks (at least 20 to 22 hours a day), the patient switches to the next tray in the series. They repeat this process until they've worn all the trays. The gradual change from tray to tray moves the teeth to the desired position.
Clear aligners have some distinct advantages over braces, especially for younger patients. They can be removed for cleaning or for a rare special event. They don't limit movement as much as braces. And, they're nearly invisible — other people may not even notice them. And newer aligners are now designed with tiny “power ridges” that increase their movement capabilities. This has made them more useful for teenagers with complicated bite problems and other issues.
There are cases, though, where braces may be the better choice: where you need more control over tooth movement or the patient needs jaw surgery to achieve proper tooth alignment. And their removability could be an issue if the patient won't leave them in their mouth for the necessary time each day.
To find out if clear aligners might be a viable option for your teenager, visit us for a complete orthodontic examination. We can then discuss your best option — clear aligners or braces — to achieve the most desirable outcome for your teenager.
If you would like more information on treating bite problems in teenagers with clear aligners, 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.”
It’s often best health-wise to preserve even the most troubled tooth—including a child’s primary (“baby”) tooth. If that sounds like too much effort for a tooth that lasts only a few years, there’s a big reason why—if it’s lost prematurely, the incoming permanent tooth above it could erupt out of position.
Preserving a decayed primary tooth could include procedures similar to a root canal treatment, commonly used in adult permanent teeth with inner decay. However, we may need to modify this approach to protect the primary tooth’s pulp. This innermost layer plays a critical role in early dental development.
Because an adult tooth has reached maturity, removing diseased pulp tissue has little effect on its permanent health. But the pulp contributes to dentin growth (the layer between it and the outer enamel) in primary and young permanent teeth, so removing it could ultimately compromise the tooth’s long-term health.
Our goal then with a child’s tooth is to remove as much diseased tissue as possible while involving the pulp as little as possible. What techniques we use will depend on how much of the pulp has become infected.
For example, if decay has advanced to but hasn’t yet penetrated the pulp, we may remove all but a small amount of the decayed structure just next to the pulp to avoid its exposure. We may then apply an antibacterial agent to this remaining portion and seal the tooth to curb further infection.
If on the other hand the pulp has become infected, we may try to remove only the infected portion and leave the remaining pulp intact. We’ll only be able to do this, however, if we deem the remaining pulp healthy enough to remain infection-free after the procedure. If not, we may need to remove the entire pulp as with a traditional root canal. This option, though, is a last resort due to the possible effect on dentin growth and the tooth’s long-term health.
As you can see attempts to preserve a primary tooth can be quite involved. But if we can help it reach its full life span, it could mean better dental health for a lifetime.
If you would like more information on caring for primary 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 “Root Canal Treatment for Children’s Teeth.”
Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.
That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!
Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.
Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”
One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.
Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.
Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”Â Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.
If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
Your child’s teeth and gum development is truly a wonder. In just a little more than two decades they’ll gain and lose one set of teeth, while the subsequent permanent set will grow in coordination with other facial and oral structures. All of these structures will finally reach maturity sometime in early adulthood.
Sometimes, though, obstacles can arise: disease, trauma or even genetics can derail normal development and endanger future health. So although nature does most of the heavy lifting, there are things you should do to keep your child’s dental development on track.
For instance, begin oral hygiene practices before their first teeth come in. By wiping their gums after feeding with a clean damp cloth, you can help reduce the numbers of disease-causing bacteria in the mouth. Once teeth appear switch to brushing.
There are also habits to avoid. Don’t kiss your baby directly on the lips—you may transfer to them your own mouth bacteria, which their young immune system can’t yet adequately handle. Also, avoid putting them to bed with a sleep-time bottle filled with sugary fluids (including milk or formula) because the constant contact between the sugar and their teeth could increase their risk for tooth decay, the number one dental disease in young children.
Of course, not all prevention efforts depend on you alone—we’re your partner in helping to keep your child’s dental development progressing normally. We can provide preventive treatments like sealants or topical fluoride to reduce the risk of tooth decay, while continually monitoring for signs of the disease that may require treatment. We also look for signs of emerging bite problems that may require intervention before their effects worsen.
This is all part of regular dental visits, usually at six-month intervals, which are best begun around your child’s first birthday. Not only does this enable us to stay ahead of dental problems, it also helps your child become more comfortable with dental visits and increase the likelihood they’ll continue the habit in adulthood.
As we said, nature is responsible for most of this amazing development without any help from us. But we can assist development and hopefully prevent issues that could diminish their dental health in years to come.
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