After months of wearing braces it's time for the big reveal: your new and improved smile! Your once crooked teeth are now straight and uniform.
But a look in the mirror at your straighter teeth might still reveal something out of place: small chalky-white spots dotting the enamel. These are most likely white spot lesions (WSLs), points on the enamel that have incurred mineral loss. It happens because mouth acid shielded by your braces contacted the teeth at those points for too long.
Most mouth acid is the waste product of bacteria that thrive in dental plaque, a thin film of food particles that can build up on tooth surfaces. High levels of acid are a definite sign that plaque hasn't been removed effectively through brushing and flossing.
But normal hygiene can be difficult while wearing braces: it's not easy to maneuver around brackets and wires to reach every area of tooth surface. Specialized tooth brushes can help, as well as floss threaders that help maneuver floss more easily through the wires. A water irrigator that uses pulsating water to remove plaque between teeth is another option.
However, if in spite of stepped-up hygiene efforts WSLs still develop, we can treat them when we've removed your braces. One way is to help re-mineralize the affected tooth surfaces through over-the-counter or prescription fluoride pastes or gels. It's also possible re-mineralization will occur naturally without external help.
While your teeth are sound, their appearance might be diminished by WSLs. We can improve this by injecting a liquid tooth-colored resin below the enamel surface. After hardening with a curing light, the spot will appear less opaque and more like a normal translucent tooth surface. In extreme cases we may need to consider porcelain veneers to cosmetically improve the tooth appearance.
In the meantime while wearing braces, practice thorough dental hygiene and keep up your regular cleaning visits with your general dentist. If you do notice any unusual white spots around your braces, be sure to see your dentist or orthodontist as soon as possible.
If you would like more information on dental care during 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 “White Spots on Teeth during Orthodontic Treatment.”
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.”
Think you're too old to have your teeth straightened? While we automatically pair “teenager” with “braces,” at least one in five orthodontic patients are adults. And there's many more that could benefit, as many as three-quarters of adults with a correctable bite problem.
But although orthodontics can be performed at any age, it's not a minor undertaking. It will require time, patience and expense. So, before you decide to undergo orthodontics, here are 3 simple questions to ask first.
Why? Like children and teenagers, adults can benefit cosmetically from correcting a poor bite. But there's another great reason besides a more attractive smile: misaligned teeth are more difficult to care for than normal teeth. Orthodontic treatment is an investment and potential cost-saver in your future dental health.
Why not? Even senior adults can successfully undergo treatment. But braces might be ill-advised if you have either poor oral or general health. Periodontal (gum) disease, for example, can cause bone loss, which makes it difficult to safely and successfully move teeth (and the effort could worsen current disease activity in the gums). Medical conditions like bleeding disorders, leukemia or uncontrollable diabetes could interfere as well. You'll need both a dental and medical examination beforehand.
How? We can use braces — or we might be able to use a newer, more popular option with adults called clear aligners. These are a series of computer-designed clear, plastic trays you wear in sequence until you finish the series. Each tray is slightly smaller than the previous tray, moving the teeth in much the same manner as braces. But unlike braces, you can remove aligners for cleaning or a rare special occasion — and they're much less noticeable than metal braces. Although in some cases braces may still be the best option, it's also possible clear aligners could be the option you've been looking for.
So, are you ready for a new smile and a more maintainable mouth? Visit us for the answers to your questions and see if braces (or clear aligners) can transform your life and health.
If you would like more information on orthodontic treatment for adults, 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 “Orthodontics for the Older Adult.”
In many ways, the teenage years are the best time to have orthodontic treatment. It’s a good time emotionally because your teen is likely to have friends who also wear braces; orthodontic treatment becomes a rite of passage they can go through together. It’s also advantageous in a physical sense because all 20 baby teeth have come out, and most of the 32 adult teeth (except the 4 wisdom teeth) have emerged. At the same time, especially with younger teens, jaw growth is not yet complete — allowing orthodontists to harness the growing body’s natural adaptability. We can use a variety of appliances to do that — some of which weren’t around a generation ago!
In many cases, traditional metal braces are still the best way to achieve the desired results. However, these are not the “train tracks” of old. Braces are smaller and lighter, with brackets that are cemented to the front surfaces of teeth rather than to bands that encircle the entire tooth (except in the very back). Braces can be made much less noticeable by using ceramic brackets that are clear or tooth-colored; however, ceramic brackets are easier to break than metal. An even stealthier way to undergo orthodontic treatment is with clear aligners. These removable clear plastic “trays” are custom made with the help of computer software that divides the treatment process into two-week stages. After each two-week period, the tray is changed and the next stage of movement takes place until the teeth are in correct alignment. The Invisalign system has two modifications especially for teens: “eruption tabs” that hold space open for emerging molars, and “compliance indicators” that can tell parents and orthodontists if the teen is keeping the trays in for the prescribed amount of time. We’d be happy to discuss whether clear aligners would be an option for your child.
Keeping It Clean
No matter which type of appliance is used, oral hygiene becomes even more important during orthodontic treatment. Wearing braces presents special challenges in terms of keeping teeth clean; however, it’s extremely important to do an effective job every day so that gums do not become inflamed and cavities do not develop. It’s far easier to clean teeth with clear aligners, which can be removed, but the aligners themselves can build up bacteria, leading to the same types of oral health issues if they are not cleaned each day.
Making It Count
Another way in which orthodontic treatment will not vary regardless of the type of appliance chosen is the necessity of a retention phase. Everyone who has their teeth straightened (and this goes for adults and younger kids, too) must wear a retainer to hold the teeth in their new and improved alignment while new bone grows around them. Yes, braces are easier to wear than they used to be… but no one wants to wear them twice!
If you have questions about braces for your teen, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Clear Aligners for Teenagers” and “The Magic of Orthodontics.”
If you or a family member wears braces, you're used to visiting your orthodontist for adjustments and progress monitoring. But it's just as important that you continue regular visits with your family dentist, especially if you begin noticing abnormalities with your teeth and gums.
We need to be on alert for dental health because risks for disease increase during orthodontic treatment. Most oral infections arise from plaque, a thin film of bacteria and food particles on tooth surfaces. You avoid plaque buildup by brushing and flossing at least once a day and undergoing semi-annual office cleanings for any remaining plaque and calculus (hardened plaque deposits).
Braces, however, can complicate hygiene. It's harder to get into areas blocked by the brackets and wires with your brush or floss. This can quickly give rise to gingivitis, a form of periodontal (gum) disease characterized by gum swelling. If not treated, gum disease could eventually cause the gums to detach from the teeth and lead to bone and tooth loss.
The brackets and wires can also irritate the gums and cause them to swell or overgrow, a condition called hyperplasia. This further complicates proper hygiene, which then increases the risk for infection even more.
It takes more time and effort to brush and floss effectively while wearing braces. But it's necessary to prevent these problems. Interproximal brushes (which fit in the spaces between teeth) can help, as well as special floss threaders. You might also consider a water flosser, which use a high-pressured water spray to remove plaque between teeth.
And, don't neglect seeing us on a regular basis. If you notice gum swelling, redness or bleeding, contact us as soon as possible.
If the swelling is due to hyperplasia, treatment could wait until after the braces come off, as long as there doesn't appear to be any gum detachment from the teeth. If there is, though, you may need to see a periodontist (a gum specialist) for further evaluation. It may be necessary in advanced cases to remove the braces to treat the underlying gum condition.
It pays to keep a close eye on your teeth and gums while wearing braces. Catching problems before they become too serious will help ensure your new smile is just as healthy as it is attractive.
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 “Gum Swelling during Orthodontics.”
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