Posts for tag: orthodontic treatment
Applying braces or clear aligners to move misaligned teeth is only part of an orthodontist's overall mission to eliminate poor bites (malocclusions). Sometimes a malocclusion isn't caused by the teeth at all—the size of the jaw is the problem!
One type in particular, a cross-bite, often happens because the upper jaw has developed too narrowly. As a result, many of the upper teeth fit inside the lower, the opposite of normal. But a tool called a palatal expander can alleviate the problem if it's applied at an early enough age.
The device works because the upper jawbone initially forms as two halves that fit together along a center line in the roof of the mouth (the palate) running from the back of the mouth to the front. These two bone halves remain separate during childhood to facilitate jaw growth, but eventually fuse around puberty.
Consisting of two sets of wire arms joined together by a hinge mechanism in the middle, the expander device is positioned up against the palate. The orthodontist extends each arm to press against the inside of the back teeth, then adds more outward pressure by turning the mechanism in the middle with a small key. During wear, the patient or caregiver will turn the mechanism in the same way to keep up the pressure on the two sides of the jaw.
This continual pressure keeps the two bones moving away from each other and maintaining a center gap between them. In response, more bone forms on the two halves to fill the gap. In time, the newly formed bone should widen the jaw enough to correct any developing malocclusion.
Timing is everything with a palatal expander—if not used before the jaw bones fuse, the patient will need a surgical procedure to separate the bones to pursue treatment. To catch the problem early enough, children should have an orthodontic evaluation on or before they turn six. An orthodontist may be able to identify this or other emerging bite problems and intervene before it becomes worse. Taking this approach can help save you and your child more expensive orthodontic treatment down the road.
If you would like more information on correcting poor bites, 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 “Palatal Expanders: Orthodontics is more than just Moving Teeth.”
Wearing orthodontic braces brings challenges to daily life. During treatment a patient will need to avoid certain foods and habits, take more time to brush and floss properly, and may endure occasional discomfort. But the effect of metal braces on appearance can be especially difficult, especially for peer-conscious teens.
Clear aligners, though, offer an alternative to braces that could make some of these challenges easier, particularly with your appearance. Aligners are clear plastic trays that fit over the teeth to move them. They can be removed by the wearer for easier brushing and flossing or for special occasions. Best of all, they're much less noticeable than metal braces.
Clear aligners were developed thanks to advances in digital technology. An orthodontist uses a computer application incorporating the data from photographs, x-rays or CT scans of a patient's teeth and jaws to produce a series of clear plastic trays. The patient then wears each tray for about two weeks before changing to the next tray in the sequence.
The trays apply pressure much like metal braces to gradually move teeth to the desired position on the jaw. Each tray is slightly smaller in size than the previous tray in the sequence, so that the progression of tooth movement continues with each succeeding tray. The treatment time is about the same as with conventional braces.
This new orthodontic tool works well for many common bite problems, but until recently they've been limited in scope. But new designs in trays and attachments called buttons added to teeth to provide more leverage have greatly increased their use for more complex bite issues.
Clear aligners also have one other disadvantage, ironically due to one of their principal benefits, removability. Although they can be taken out, they must be worn consistently to achieve results. Some younger patients may not have the maturity level and discipline to responsibly wear their aligners as they should.
That's one issue you'll need to discuss with your orthodontist if you're considering clear aligners for your teen. But if they can maintain wearing consistency, and they have a bite problem that can be corrected with aligners, both you and your teen may find this choice more agreeable and attractive than braces.
If you would like more information on 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.”
You have a lot of options for replacing missing teeth, from state-of-the-art dental implants to affordable, but effective partial dentures. But if the teeth in question have been missing for a while, you may first have to undergo orthodontic treatment. Here's why.
While they may feel rigid and firm in the jawbone, teeth are actually held in place by periodontal (gum) ligaments. These elastic tissues lie between the teeth and the bone and attach to both with tiny filaments. This mechanism allows the teeth to incrementally move over time in response to biting pressures or other environmental factors.
When a tooth goes missing the teeth on either side of the space naturally move or "drift" into it to help close the gap. This natural occurrence can reduce the space for a restoration if it has gone on for some time. To make room for a new prosthetic (false) tooth, we may have to move the drifted teeth back to where they belong.
If you're thinking metal braces, that is an option—but not the only one. Clear aligners are another way to move teeth if the bite problem (malocclusion) isn't too severe. Aligners are a series of custom-made, clear, plastic trays worn over the teeth. The patient wears each tray, slightly smaller than the previous one in the series, for about two weeks before changing to the next one. The reduction in size gradually moves teeth to their intended target position.
Many adults prefer clear aligners because they're nearly invisible and don't stand out like metal braces. They're removable, so you can take them out for cleaning or for special occasions. And, we can also attach a prosthetic tooth to the tray that temporarily covers the missing tooth space.
Whichever orthodontic treatment you choose, once completed we can then proceed with restoration to permanently replace your missing teeth. While it can be a long process, the end result is a beautiful smile that could last for years to come.
If you would like more information on your dental restoration options, 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 “Straightening a Smile before Replacing Lost Teeth.”
There are many new and exciting ways now to transform an unattractive smile into one you'll be confident to display. But not all “smile makeover” techniques are new — one in particular has been around for generations: using braces to correct crooked teeth.
Braces have improved the smiles (and also dental health) for millions of people. But as commonplace this orthodontic treatment is, it wouldn't work at all if a natural mechanism for moving teeth didn't already exist. Braces “partner” with this mechanism to move teeth to better positions.
The jawbone doesn't actually hold teeth in place — that's the job of an elastic gum tissue between the teeth and bone called the periodontal ligament. Tiny fibers extending from the ligament attach to the teeth on one side and to the bone on the other. In addition to securing them, the dynamic, moldable nature of the ligament allows teeth to move incrementally in response to forces applied against them.
To us, the teeth feel quite stationary (if they don't, that's a problem!). That's because there's sufficient length of the tooth roots that are surrounded by bone, periodontal ligament and gum tissue. But when pressure is applied against the teeth, the periodontal ligament forms both osteoblasts (bone-forming cells) and osteoclasts (bone-resorbing cells) causing the bone to remodel. This allows the teeth to move to a new position.
Braces take advantage of this in a controlled manner. The orthodontist bonds brackets to the outside face of the teeth through which they pass a thin metal wire. They attach the ends of the wire to the brackets (braces), usually on the back teeth. By using the tension placed in the wire, the orthodontist can control the gradual movement of teeth to achieve proper function and aesthetics. The orthodontist continues to monitor the treatment progress, while making periodic adjustments to the tension.
It takes time, but through this marvelous interplay between nature and dental science you'll gain a more healthy and beautiful smile.
If you would like more information on improving your smile with 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 “Moving Teeth with Orthodontics.”
If you’re about to undergo orthodontic treatment, you’re going to face a challenge keeping your teeth and gums clean wearing braces. That in turn could increase your chances for tooth decay or periodontal (gum) disease, which could diminish your future dental health and disrupt your current orthodontic treatment.
The main hygiene tasks of brushing and flossing are more difficult with braces because of the fixed hardware on the teeth. Your toothbrush or floss can’t always easily maneuver around the wires and brackets, increasing the chances you’ll miss some areas. These neglected areas can then accumulate dental plaque, a thin film of bacteria and food particles that’s most responsible for disease.
But although difficult, effective oral hygiene isn’t impossible. First and foremost, you’ll need to take more time to be thorough with brushing and flossing than you might normally without braces.
Second, there are some specialized hygiene tools to make the job easier. Instead of a regular toothbrush try an interproximal brush. This special brush has a long and thin bristled head (resembling a pipe cleaner) that can maneuver in and around orthodontic hardware much easier than a regular brush.
For flossing, use a floss threader, a device through which you thread floss on one end and then pass the other sharper end between your teeth. Once through, you release the floss from it and floss as usual, repeating the process with the threader for each tooth. Another option is an oral irrigator, a device that emits a pressurized spray of water between teeth to loosen plaque and flush it away. Many orthodontic patients have found this latter option to be quite effective.
Finally, continue seeing your regular dentist for regular appointments in addition to your orthodontist. Besides cleaning those hard to reach areas, your dentist can also provide other preventive measures like topical fluoride for strengthening enamel and prescription mouth rinses that inhibit bacterial growth. You should also see your dentist immediately if you notice signs of disease like spots on the teeth or swollen or bleeding gums.
Keeping your teeth clean while wearing braces is a top priority. Doing so will help ensure your new smile after braces is both an attractive and healthy one.
If you would like more information on dental care during 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 “Caring for Teeth during Orthodontic Treatment.”