Wearing braces can pose challenges for your daily life and habits. One in particular is trying to keep your teeth and gums clean.
Braces or not, your oral hygiene needs to be thorough. Every day, your teeth accumulate a thin film of bacteria and food particles called dental plaque that can cause tooth decay or gum disease. It's essential to remove as much as possible each day by brushing and flossing.
That's a more difficult task with braces. The brackets and wires interfere with accessing many of your teeth's surfaces with a toothbrush or floss. As a result, braces wearers on average have a higher incidence of dental disease than non-wearers.
But while it's difficult to keep your mouth clean wearing braces, it's not impossible. Here are some tips and tools for making oral hygiene easier during orthodontic treatment.
A low-sugar diet. Besides items like chips that could damage your braces, you should also limit your consumption of foods and snacks with added sugar. This carbohydrate is a primary food source for disease-causing bacteria. Limiting sugar in your diet can help reduce plaque buildup.
The right toothbrush. Brushing with braces is easier if you use a soft multi-tufted brush with microfine bristles. The smaller bristles maneuver better around the braces than larger bristled brushes. You'll still need to make multiple passes above and below the wires to be sure you're brushing all tooth surfaces.
Flossing tools. Traditional flossing using just your fingers can be next to impossible to perform with braces. But a tool like a floss holder or threader can make it easier to get between teeth. You might also try a water flosser that removes plaque from between teeth with a pressurized spray of water.
Dental treatments. Your dentist can give your teeth extra protection while you're wearing braces with topically applied fluoride to strengthen enamel. Using mouthrinses with an antibacterial ingredient like chlorhexidine may also reduce harmful bacteria.
Be sure you also keep up regular visits with your family dentist while wearing braces, and especially if you begin to notice puffy and reddened gums or unusual spots on your teeth. The sooner any case of dental disease is detected, the less impact it will have on your dental health.
If you would like more information on dental care while undergoing 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 “Caring for Teeth During Orthodontic Treatment.”
“Orthodontic treatment” and “braces” almost seem like synonymous terms. But while braces certainly are orthodontic, it isn't the only tool in an orthodontist's toolkit.
A good example is a device is known as a Herbst appliance. It's used in situations where the upper jaw is outpacing the growth and development of the lower jaw during childhood. If not corrected, this could cause the top teeth to protrude abnormally beyond the lower teeth.
The Herbst appliance gently and gradually coaxes the lower jaw to grow in a more forward direction, thus “catching up” with the upper jaw. The top part of the device consists of two metal tubes hinged to small elastic bands, which are cemented to the cheek side of the upper back teeth (molars), one on either side of the jaw.
Two smaller tubes are attached in like fashion to the lower teeth, and then inserted into the larger tubes. As the lower jaw moves, the smaller tubes move within the larger to create pressure that gently pushes the jaw forward. Over time, this can sync the growth progress of both the upper and lower jaws, and reduce the chances of a poor bite.
For best results, a Herbst appliance is usually placed to coincide with a child's most rapid period of jaw growth, usually between 11 and 14. They could be placed as early as 8 or 9, however, in situations where the front teeth are already protruding well beyond the lips. In any event, the goal is to positively influence the growth of the lower jaw to alleviate or at least minimize the need for future orthodontic treatment.
As a fixed device, there's no need for a child or parent to tend to it as with other methods, like orthodontic headwear worn in conjunction with braces. A Herbst appliance can, however, alter the normal sensations associated with eating, swallowing and speaking, which may take a little adjustment time for the child. Wearers will also need to be extra vigilant with daily brushing and flossing because of a higher risk of tooth decay.
These, though, are minor inconveniences compared with the benefit of improved bite development. As such, a Herbst appliance could be a positive investment in your child's dental future.
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 “The Herbst Appliance.”
X-rays are so interwoven into dental care that we often don't think twice about them. Even so, we shouldn't take this invisible form of radiation lightly—regular exposure at high levels can affect the human body, especially in children.
The ability of x-rays to pass through tissue greatly improves our ability to diagnose tooth decay and other dental diseases. But x-rays can also potentially harm those same tissues. Because children are more sensitive to x-ray energy, they run a greater risk for cellular damage that could lead to cancer later in life.
In reality, though, these potential risks from x-rays are extremely low—so low, in fact, dental professionals regard their use as altogether safe for children. Here's why.
The ALARA principle. Dentists and other healthcare providers perform x-ray diagnostics based on a principle known as ALARA (“As low as reasonably achievable”). This means dentists only utilize x-rays to gain the most diagnostic benefit at the lowest amounts of radiation exposure. As such, ALARA guides both the development of x-ray equipment and the protocols involved in using them.
Equipment advances. Today's x-ray devices are safer and more efficient, restricting x-ray emissions to a single beam without scattering radiation into the environment. A child's radiation exposure is further lowered with the use of digital x-rays, which produce images in less time than conventional film. Because of these and other advances, children are exposed to less radiation during x-rays than what they typically receive in a day from the outside environment.
Safe practices. Following the ALARA principle, dentists are quite conservative in their use of x-rays in children. The most common means of x-ray is the bitewing, which captures images primarily of the back teeth that are more prone to decay. Bitewings, which require a lower x-ray dosage than a full mouth x-ray, are usually spaced at least six months apart or longer depending on a child's risk for dental disease.
The efficiency of modern radiographic equipment coupled with their judicious use has drastically reduced the amount of x-ray radiation to which a child may be exposed, thus lowering their risk of future health issues. The benefit for saving a child's teeth from disease is well worth their use.
If you would like more information on x-ray safety, 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 “X-Ray Safety for Children.”
Between the final game of the World Series in late October and spring training in February, major league baseball players work on their skills preparing for the new season. Reporters on a Zoom call to the New York Yankees' training camp wanted to know what star outfielder Aaron Judge had been doing along those lines. But when he smiled, their interest turned elsewhere: What had Aaron Judge done to his teeth?
Already with 120 homers after only five seasons, Judge is a top player with the Yankees. His smile, however, has been less than spectacular. Besides a noticeable gap between his top front teeth (which were also more prominent than the rest of his teeth), Judge also had a chipped tooth injury on a batting helmet in 2017 during a home plate celebration for a fellow player's walk-off home run.
But now Judge's teeth look even, with no chip and no gap. So, what did the Yankee slugger have done?
He hasn't quite said, but it looks as though he received a “smile makeover” with porcelain veneers, one of the best ways to turn dental “ugly ducklings” into “beautiful swans.” And what's even better is that veneers aren't limited to superstar athletes or performers—if you have teeth with a few moderate dental flaws, veneers could also change your smile.
As the name implies, veneers are thin shells of porcelain bonded to the front of teeth to mask chips, cracks, discolorations or slight gaps between teeth. They may even help even out disproportionately sized teeth. Veneers are custom-made by dental technicians based on a patient's particular tooth dimensions and color.
Like other cosmetic techniques, veneers are a blend of technology and artistry. They're made of a durable form of dental porcelain that can withstand biting forces (within reason, though—you'd want to avoid biting down on ice or a hard piece of food with veneered teeth). They're also carefully colored so that they blend seamlessly with your other teeth. With the right artistic touch, we can make them look as natural as possible.
Although porcelain veneers can accommodate a wide range of dental defects, they may not be suitable for more severe flaws. After examining your teeth, we'll let you know if you're a good candidate for veneers or if you should consider another restoration. Chances are, though, veneers could be your way to achieve what Aaron Judge did—a home run smile.
If you would like more information about porcelain veneers, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Veneers: Strength & Beauty As Never Before.”
Introduced to the United States in the 1980s, dental implants have quickly become the go-to restoration for tooth replacement. And for good reason: they're not only incredibly life-like, they're highly durable with a 95% success rate.
But as desirable as they are, you may face a major obstacle getting one because of the condition of the bone at your implant site. To position the implant for best appearance and long-term durability, we must have at least 4-5 mm of bone available along the horizontal dimension. Unfortunately, that's not always the case with tooth loss.
This is because bone, like other living tissue, has a growth cycle: Older cells die and dissolve (resorb) and newer cells develop in their place. The forces transmitted to the jaw from the action of chewing help stimulate this resorption and replacement cycle and keep it on track. When a tooth is lost, however, so is this stimulus.
This may result in a slowdown in cell replacement, causing the eventual loss of bone. And it doesn't take long for it to occur after tooth loss—you could lose a quarter of bone width in just the first year, leaving you without enough bone to support an implant. In some cases, it may be necessary to choose another kind of restoration other than implants.
But inadequate bone isn't an automatic disqualifier for implants. It's often possible to regenerate lost bone through a procedure known as bone augmentation, in which we insert a bone graft at the missing tooth site. The graft serves as a scaffold for new bone cells to grow upon, which over time may regenerate enough bone to support an implant.
Even if you've had a missing tooth for some time, implementing bone augmentation could reverse any loss you may have experienced. In fact, it's a common practice among dentists to place a bone graft immediately after a tooth extraction to minimize bone loss, especially if there will be a time lag between extraction and implant surgery.
Bone augmentation could add extra time to the implant process. But if successful, it will make it possible for you to enjoy this popular dental restoration.
If you would like more information on dental implant restoration, 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 “Dental Implants After Previous Tooth Loss.”
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