Posts for tag: orthodontic treatment
We’re all familiar with tried and true traditional braces and perhaps with newer clear aligners for realigning teeth. But there’s an even more novel way that’s quickly becoming popular: lingual braces.
This type of braces performs the same function as the traditional but in an opposite way. Rather than bonded to the front of the teeth like labial (“lip-side”) braces, these are bonded to the back of the teeth on the tongue (or “lingual”) side. While labial braces move teeth by applying pressure through “pushing,” lingual braces “pull” the teeth to where they need to be.
Although lingual braces are no better or worse than other orthodontic methods, they do have some advantages if you’re involved in sports or similar physical activities where mouth contact with traditional braces could cause lip or gum damage, or if your work or lifestyle includes frequent snacking or eating, which requires continually removing clear aligners. And like aligners, lingual braces aren’t noticeable to the outside world.
But lingual braces typically cost more: as much as 15-35% more than traditional braces. They can initially be uncomfortable for patients as the tongue makes contact with the hardware. While most patients acclimate to this, some don’t. And like traditional braces, it’s hard to effectively brush and floss your teeth while wearing them. This can be overcome, though, by using a water flosser and scheduling more frequent dental cleanings while you’re wearing them.
For the most part, lingual braces can correct any poor bite (malocclusion) correctable with labial braces. The treatment time is also comparable, ranging from several weeks to a couple of years depending on the malocclusion. And, as with any other orthodontic method, you’ll need to wear a retainer once they’re removed.
Lingual braces have only been available in a limited fashion for a few years, but their availability is growing as more orthodontists train in the new method. If you’re interested in the lingual braces approach, talk to your orthodontist or visit www.lingualbraces.org to learn more.
If you would like more information on lingual 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 “Lingual Braces: A Truly Invisible Way to Straighten Teeth.”
Although tooth decay is a major problem to watch for in your child’s teeth, it isn’t the only one. As their teeth transition from primary (“baby”) to permanent, you should also be on the lookout for a developing poor bite or malocclusion.
Although the signs can be subtle, you may be able to detect an emerging malocclusion, starting usually around age 6, if you know what to look for. Here are 4 signs your child may be developing a poor bite.
Excessive spacing. This is something that might be noticeable while the child still has their primary teeth. If you notice an excessive amount of space around the front teeth, the sizes of the jaws and the teeth may be disproportional.
Abnormal overlapping. The upper teeth normally just cover the bottom teeth when the jaws are closed. But a malocclusion may be forming if the lower teeth cover the upper (underbite), the upper teeth extend too far over the lower (deep bite) or there’s space between the upper and lower front teeth (open bite).
Different overlapping patterns. Watch as well for some of the teeth overlapping normally while others don’t, a sign of a cross bite. For example, the back upper teeth may cover their counterparts in a normal fashion while the lower front teeth abnormally overlap the top front. The roles here between front and back teeth can also be reversed.
Abnormal eruptions. Permanent teeth normally follow a pattern when erupting, but certain factors could disrupt the process. For example, a jaw that’s developed too small can cause crowding as incoming teeth vie for space; as a result, some permanent teeth may erupt out of their proper position. Likewise, if a baby tooth is out of its normal position or prematurely lost, the permanent tooth may erupt out of position too.
The good news with each of these developing bite problems is that we can correct them or at least minimize their future effect if caught early. So if you notice any of these signs or anything else out of the ordinary, see an orthodontist as soon as possible. It’s also a good idea to have your child undergo a thorough orthodontic evaluation around age 6.
If you would like more information on bite problems in children, 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 “Problems to watch for in Children Ages 6 to 8.”
Overbites, underbites, crossbites—these are just a few of the possible malocclusions (poor bites) you or a family member might be experiencing. But no matter which one, any malocclusion can cause problems.
Besides an unattractive smile, a malocclusion makes it more difficult to chew and to keep the teeth and gums clean of disease-causing bacterial plaque. Thus correcting a malocclusion improves dental health; a more attractive smile is an added bonus.
This art of correction—moving teeth back to the positions where they belong—is the focus of a dental specialty called orthodontics. And, as it has been for several decades, the workhorse for achieving this correction is traditional braces.
Braces are an assembly of metal brackets affixed to the teeth through which the orthodontist laces a metal wire. The wire is anchored in some way (commonly to the back teeth) and then tightened to apply pressure against the teeth. Over time this constant and targeted pressure gradually moves the teeth to their new desired positions.
The reason why this procedure works is because teeth can and do move naturally. Although it may seem like they’re rigidly set within the jawbone, teeth are actually held in place by an elastic tissue network known as the periodontal ligament. The ligament lies between the tooth and bone and keeps the tooth secure through tiny fibers attached to both it and the bone. But the ligament also allows teeth to continually make micro-movements in response to changes in chewing or other environmental factors.
In a sense, braces harness this tooth-moving capability like a sail captures the wind propelling a sailboat. With the constant gentle pressure from the wires regularly adjusted by the orthodontist, the periodontal ligament does the rest. If all goes according to plan, in time the teeth will move to new positions and correct the malocclusion.
In a way, braces are the original “smile makeover”—once crooked teeth can become straight and more visually appealing. More importantly, though, correcting a poor bite improves how the mouth works, especially while eating, and keeping things clean. A straighter smile isn’t just more attractive—it’s healthier.
If you would like more information on correcting misaligned 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 “Moving Teeth with Orthodontics.”
When your braces finally come off, you’ll hopefully be astounded by what you see –once-crooked teeth replaced by a more attractive smile. But you might also see something you didn’t expect: noticeable white spots on some of your teeth.
These spots called white spot lesions (WSLs) appear lighter than the surrounding tooth enamel due to mineral loss just beneath the surface. This happens because bacterial or food acids have contacted the enamel surface for too long and dissolved the underlying calcium and other minerals. This results in a small discolored and chalky-like area in the enamel.
WSLs are common during orthodontics because wires and brackets create hard to reach places for brushing and flossing, which can accumulate bacterial plaque. The bacteria produce acid, which weakens the enamel at these places. The tiny white spots that result are more than just unattractive—they can become entry points into the tooth for decay. That’s why they should be dealt with as soon as possible—and preferably before they’re created.
To that end, you’ll need to do as thorough a job as possible brushing and flossing while undergoing orthodontic treatment. To improve your thoroughness try using an interproximal toothbrush that can maneuver more closely around braces hardware than a regular brush. You can also improve your flossing with a floss threader or a water flosser, a device that sprays pressurized water to loosen and flush away plaque.
If you do develop WSLs, there are some things we can do to treat them. We can attempt to re-mineralize the affected enamel with the help of topical fluoride (either pastes or gels for home use or with an office application) or a re-mineralizing agent. We can also use techniques like microabrasion, which restores damaged areas beneath the surface, or inject a liquid, tooth-colored resin beneath the WSL’s surface to improve appearance and protect against decay.
If while wearing braces you do notice any white spots or other tooth discoloration let your dentist or orthodontist know right away. The sooner your dental providers can begin dealing with potential WSLs the better your chances for a healthy and beautiful outcome after braces.
If you would like more information on oral hygiene 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 “White Spots on Teeth During Orthodontic Treatment.”
Orthodontics shares a principle with the classic tug of war game: if you want things to move in the right direction you need a good anchor. Anchors help braces and other appliances apply constant pressure to misaligned teeth in the direction they need to go to correct a malocclusion (poor bite).
Orthodontic treatments work in cooperation with an existing oral mechanism that already moves teeth naturally in response to biting forces or other environmental factors. The key to this mechanism is an elastic tissue known as the periodontal ligament that lies between the tooth and the bone. Besides holding teeth in place through tiny attached fibers, the ligament also allows the teeth to move in tiny increments.
Braces’ wires laced through brackets affixed to the teeth exert pressure on them in the desired direction of movement –the periodontal ligament and other structures do the rest. To maintain that pressure we need to attach them to an “anchor”—in basic malocclusions that’s usually the back molar teeth.
But not all malocclusions are that simple. Some may require moving only certain teeth while not moving their neighbors. Younger patients’ jaws and facial structures still under development may also need to be considered during orthodontic treatment. That’s why orthodontists have other anchorage methods to address these possible complications.
One example of an alternate anchorage is a headgear appliance that actually uses the patient’s skull as the anchor. The headgear consists of a strap running around the back of the head and attached in front to orthodontic brackets (usually on molar teeth). The pressure it exerts can trigger tooth movement, but it can also help influence jaw development if an upper or lower jaw is growing too far forward or back.
Another useful anchorage method is a tiny metal screw called a temporary anchorage device (TAD) that is implanted into the jawbone above the teeth through the gums. Orthodontists then attach elastic bands between implanted TADs and specific braces’ brackets or wires to exert pressure on certain teeth but not others with pinpoint accuracy. After treatment the TADs can be easily removed.
Using these and other appliances allows orthodontists to customize treatment to an individual patient’s particular malocclusion. With the right anchor, even the most complex bite problem can be transformed into a beautiful and healthy smile.
If you would like more information on 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 “Orthodontic Headgear & Other Anchorage Appliances.”