You can't correct a poor bite with braces or clear aligners overnight: Even the most cut-and-dried case can still require a few years to move teeth where they should be. It's a welcome relief, then, when you're finally done with braces or aligner trays.
That doesn't mean, however, that you're finished with orthodontic treatment. You now move into the next phase—protecting your new smile that took so much to gain. At least for a couple of more years you'll need to regularly wear an orthodontic retainer.
The name of this custom-made device explains its purpose: to keep or “retain” your teeth in their new, modified positions. This is necessary because the same mechanism that allows us to move teeth in the first place can work in reverse.
That mechanism centers around a tough but elastic tissue called the periodontal ligament. Although it primarily holds teeth in place, the ligament also allows for tiny, gradual tooth movement in response to mouth changes. Braces or aligner trays take advantage of this ability by exerting pressure on the teeth in the direction of intended movement. The periodontal ligament and nature do the rest.
But once we relieve the pressure when we remove the braces or aligners, a kind of “muscle memory” in the ligament can come into play, causing the teeth to move back to where they originally were. If we don't inhibit this reaction, all the time and effort put into orthodontic treatment can be lost.
Retainers, either the removable type or one fixed in place behind the teeth, gently “push” or “pull” against the teeth (depending on which type) just enough to halt any reversing movement. Initially, a patient will need to wear their retainer around the clock. After a while, wear time can be reduced to just a few hours a day, usually during sleep-time.
Most younger patients will only need to wear a retainer for a few years. Adults who undergo teeth-straightening later in life, however, may need to wear a retainer indefinitely. Even so, a few hours of wear every day is a small price to pay to protect your beautiful straightened smile.
If you would like more information on orthodontic retainers, 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 Importance of Orthodontic Retainers.”
Little things add up. Like your three meals a day, which could total over 87,000 by the time you're eighty. If you average a full night's sleep every night, you will have whiled away over a quarter of a million hours in slumber by your diamond birthday. And if you're the typical American, you will also have spent over 900 hours (or nearly 40 days) brushing your teeth.
If that last example sounds like a lot, it's actually not: If it's a daily habit, that's about two minutes of brushing a day. But that little bit of time could have an incredible impact on your dental health over a lifetime. That's why dental providers commemorate October as National Dental Hygiene Month to call attention to just how important those 900-plus hours can be to a healthy mouth.
Brushing is important because of what a few strains of bacteria can do to your oral health. While most of your mouth's microscopic inhabitants do no harm (and some are even beneficial), the malevolent few cause tooth decay and gum disease, both of which could lead to tooth loss.
These bacteria live in and feed off of a thin biofilm of food particles called dental plaque. Over time, plaque and tartar (a hardened, calcified form) can build up on tooth surfaces. As it grows, so does the mouth's bacterial population and the risk for disease. In fact, just a few days of undisturbed plaque growth is enough time for a gum infection to get started.
Brushing your teeth removes this plaque accumulation, which reduces the bacterial levels in your mouth. A thorough brushing of all surfaces usually takes about two minutes, but it must be done every day to keep plaque at bay. So, yes, a little time spent brushing every day can be a big deal. That said, though, it's not the be-all and end-all of oral hygiene. You should also floss daily since plaque accumulates just as readily in the spaces between teeth where brushing can't reach. We, along with the American Dental Association, recommend brushing twice a day and flossing once a day for optimal oral health.
But no matter how proficient you are with brushing and flossing, you may still miss some spots. Be sure, then, that you also see us regularly for dental cleanings to thoroughly clean your teeth of plaque and fully minimize your risk of dental disease.
Oral hygiene only takes a little of your time each day. But it does add up—not only in the “days” you'll spend doing it, but in a lifetime of better dental health.
If you would like more information about getting the most out of your daily oral hygiene, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Daily Oral Hygiene.”
Approximately 4 million tweens and teens are currently undergoing orthodontic treatment for a poor bite (malocclusion) that can cost their families thousands of dollars in braces or clear aligners. But treatment doesn't always have to follow this track: Found early, many malocclusions can be corrected or minimized before they fully develop.
Known as interceptive orthodontics, this particular approach to bite correction often begins as early as 6-10 years of age. Rather than move existing teeth, interceptive orthodontics focuses instead on redirecting jaw growth and intervening in other situations that can cause malocclusions.
For example, a child's upper jaw may not be growing wide enough to accommodate all incoming permanent teeth, crowding later arrivals out of their proper positions. But taking advantage of a gap during early childhood that runs through the center of the palate (roof of the mouth), orthodontists can increase jaw width with a device called a palatal expander.
The expander fits up against the palate with “legs” that extend and make contact with the inside of the teeth. With gradually applied pressure, the expander widens the central gap and the body naturally fills it with new bone cells. The bone accumulation causes the jaws to widen and create more room for incoming teeth.
Another way a malocclusion can develop involves the primary or “baby” teeth. As one of their purposes, primary teeth serve as placeholders for the future permanent teeth forming in the gums. But if they're lost prematurely, adjacent teeth can drift into the vacant space and crowd out incoming teeth.
Dentists prevent this with a space maintainer, a thin metal loop attached to the adjoining teeth that puts pressure on them to prevent them from entering the space. This spacer is removed when the permanent tooth is ready to erupt.
These and other interceptive methods are often effective in minimizing the formation of malocclusions. But it's often best to use them early: Palatal expansion, for example, is best undertaken before the central gap fuses in early puberty, and space maintainers before the permanent tooth erupts.
That's why we recommend that children undergo an orthodontic evaluation around age 6 to assess their early bite development. If a malocclusion looks likely, early intervention could prevent it and reduce future treatment costs.
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 “Interceptive Orthodontics.”
This year's Carol Burnett Award, presented at the Golden Globes, goes to Ellen DeGeneres for her “outstanding contributions to the television medium on or off the screen.” This is the latest in a long list of honors for the comedienne, talk show host and activist that includes Emmys, Grammys and Teen Choice Awards. And one not quite as well-known: a 2004 “Flossy” award.
DeGeneres received this honor from the National Flossing Council in recognition of her passionate promotion of oral hygiene, particularly flossing. She wrote about its virtues in her 2003 book, The Funny Thing Is…., saying, among other things, “Don't even think for a second that you can get away with not flossing.”
DeGeneres's motivational cheerleading for flossing is helpful and necessary because, well, many of us just don't like doing it. It requires more manual dexterity than its more popular sibling, brushing. And the tendency for the floss to gunk up with plaque residue for some is simply unpleasant.
Mainly, though, many folks think brushing is enough. Not so fast, according to dental professionals. While brushing removes disease-causing bacterial plaque from broad tooth surfaces, it can't effectively get into the spaces between teeth. It takes flossing to clear plaque from these more difficult areas.
But don't fret: There are ways to make flossing an easier—and more pleasant—task.
Ask us for help. As we said before, flossing does take some hand dexterity and coordination to perform. You may also wonder if you're doing it effectively. We can provide training and tips on how to be a more effective flosser at your next visit.
Practice, practice, practice. You probably think nothing of riding a bicycle, and yet it probably took you weeks or months as a kid to become proficient. Similarly, your first attempts at flossing might feel awkward, but you'll improve with practice, so don't give up.
Brush before you floss. Most people floss before brushing, but if you tend to encounter a lot of soft plaque debris that makes flossing “icky” for you, then try brushing first to clear a good portion of it out of the way before you floss. Just be aware, most professionals believe that flossing first is better because it loosens up debris between teeth so the bubbles from the toothpaste can carry it away. But any flossing is better than no flossing!
Try flossing tools. For some people, floss picks, small pre-threaded tools you can use with one hand, seem easier to maneuver than regular floss thread. If you have issues with manual dexterity, an oral irrigator can make the task easier: This handheld device uses a stream of pressurized water to loosen and flush away plaque between teeth.
So, follow Ellen DeGeneres's advice she gave Tulane University graduates during a commencement speech: “Remember to exfoliate, moisturize, exercise…and floss.” The latter, along with brushing, will certainly help keep your teeth and gums healthy.
We Americans love our sports, whether as participants or spectators. But there's also a downside to contact sports like soccer, football or basketball: a higher risk of injury, particularly to the mouth and face. One of the most severe of these is a knocked out tooth.
Fortunately, that doesn't necessarily mean it's lost: The tooth can be reinserted into the empty socket and eventually return to normal functionality. But it must be done as soon as possible after injury. The more time elapses, the lower the chances of long-term survival.
That's because of how teeth are held in place in the jaw, secured by an elastic, fibrous tissue known as the periodontal ligament. When a tooth is knocked out some of the ligament's periodontal cells remain on the tooth's root. If these cells are alive when the tooth is reinserted, they can regenerate and reestablish attachment between the ligament and the tooth.
Eventually, though, the cells can dry out and die. If that has already happened before reinsertion, the tooth's root will fuse instead with the underlying bone. The tooth may survive for a short time, but its roots can eventually dissolve and the tooth will be lost.
Your window of opportunity for taking advantage of these live periodontal cells is only 5-20 minutes with the best chances in those earlier minutes. You should, therefore, take these steps immediately after an injury:
- Find the tooth, hold it by the crown (not the root end), and rinse off any debris with clean water;
- Reinsert the root end into the empty socket with firm pressure;
- Place clean gauze or cloth in the person's mouth between the tooth and the other jaw, and ask them to bite down gently and hold their bite;
- Seek dental or emergency medical care immediately;
- If you're unable to reinsert the tooth, place it quickly in a container with milk and see a dentist immediately.
You can also obtain an Android or IOS smartphone app developed by the International Association of Dental Traumatology called ToothSOS, which will guide you through this process, as well as for other dental emergencies. The quicker you act, the better the chances that the injured person's knocked out tooth can be rescued.
If you would like more information on what to do in a dental emergency, 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 “When a Tooth is Knocked Out.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.