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Posts for tag: orthodontic treatment

RemovableorBondedRetainersHelpProtectYourNewStraighterSmile

The straightening process for a crooked smile doesn't end when the braces come off. There's one more crucial phase to undergo to make sure we don't lose the progress you've achieved: wearing an orthodontic retainer.

Although often viewed as a nuisance, retainers are important because they prevent realigned teeth from reverting to their old positions. This is possible because the periodontal ligament, the gum attachment that allows us to move teeth in the first place, can contain “muscle memory” that naturally tries to draw teeth back to where they once were.

A retainer prevents this from happening: During wear the subtle pressure they exert keeps or “retains” the teeth in their new positions until they're firmly established, usually after several months. While most patients initially wear a retainer around the clock, this will gradually taper off until they're worn primarily during sleep hours.

While retainers come in many different styles and sizes, most fall into one of two categories: removable or non-removable (bonded). The first type, a custom-made appliance a patient can easily take in and out of the mouth, has its advantages. Removing it makes it easier to clean the teeth. They're also adaptable to reduced wear schedules for eating, brushing and flossing, or for special occasions.

But a removable retainer may be noticeable to others. Its removability can also lead to problems. Out of the mouth they're prone to be lost, resulting in additional replacement costs. And immature patients may be easily tempted to take them out too often—or not wear them at all.

A bonded retainer solves many of these potential problems. Because the retainer wire is securely bonded to the back of the teeth, it's not visible to others. And because it can't be removed except by an orthodontist, there's virtually no chance of losing it or haphazard wear.

On the other hand, bonded retainers can occasionally break, requiring repair or replacement. And flossing is more difficult than with a removable retainer, although a little training from a dental hygienist can make that easier.

The choice of retainer depends on the individual and their priorities. But whether removable or bonded, a retainer is absolutely essential for protecting your new, hard-earned smile.

If you would like more information on bonded 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 “Bonded Retainers.”

KeepYourNewStraightenedSmileStraightWithanOrthodonticRetainer

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.”

2KindsofOrthodonticRetainersThatCanProtectYourNewSmile

While retainers are often viewed as a nuisance, they’re crucial to protect the gains made with bite correction. Without them, all of the progress achieved through braces or clear aligners could be lost.

Here’s why: The same elastic gum tissue called the periodontal ligament that holds teeth in place also allows them to move incrementally in response to changes in the mouth. That’s why we can move teeth with braces or aligners, which put pressure on the teeth toward a desired direction of movement while the periodontal ligament does the rest.

But the mechanics can also work in reverse: With pressure relieved when the braces are removed, the teeth could revert to their original positions through a kind of “muscle memory.” The light pressure provided by a retainer is enough to keep or “retain” teeth in their new positions.

The best known retainer is a removable appliance. Initially, a patient wears it continuously and only takes it out during oral hygiene. Wear duration may later be reduced to night time only and eventually not at all, depending on a patient’s individual needs.

While effective, removable retainers do have some downsides. Like braces, they’re visible to others. And because they’re removable, they’re frequently misplaced or lost, leading to the added expense of a new one.

An alternative is a bonded retainer, a thin piece of wire attached to the back of the newly moved teeth to keep them in place. Because it’s behind the teeth it’s not visible—and there’s no misplacing it because only a dentist can take it out.

A bonded retainer is a good option, especially if a patient is immature and not as diligent about wearing or keeping up with their appliance. But it can make flossing difficult to perform, and if they’re removed or broken prematurely, the teeth could revert to their former positions.

If you decide to go with a bonded retainer, be sure you get some tips from your dental hygienist on how to floss with it. And if you decide later to have it removed early, be sure to replace it with a removable retainer. Either of these two options can help you keep your new and improved smile.

If you would like more information on bonded 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 “Bonded Retainers.”

By Nathan Gelder DMD
August 31, 2020
Category: Dental Procedures
DIYOrthodonticsisaRecipeforDentalDisaster

Do-It-Yourself (DIY) is a deeply held American trait for building, renovating or repairing things without the services of a professional. The Internet has only made this tradition easier: There are scores of videos showing people how to do things on their own like build a deck, fix a dryer or bake an award-winning soufflé.

But some things are best left to the experts, which if you tried to do using too little knowledge or a lot less training could turn out disastrous. A prime example is becoming your own orthodontist and using dubious home methods to straighten your teeth. If that sounds preposterous, the American Association of Orthodontists recently reported it does happen, with one in ten of their members saying they have treated patients who attempted their own smile-straightening projects.

Often found on social media, these methods usually involve household items like rubber bands or dental floss to straighten teeth. Like other forms of DIY, the object is to save money. In the end, though, these self-orthodontic methods could result in dental damage that could cost much more to repair (if indeed it's repairable) than what might have been spent with professional orthodontics in the first place.

Utilizing extensive training, experience and artistry, orthodontists work with the mouth's natural ability to move teeth in a precise manner for a planned outcome. They carefully consider each individual patient's jaw and facial structures, along with the severity and complexity of their bite problem, as they design and implement a treatment plan involving braces, clear aligners or other orthodontic appliances.

A rigged homemade device to move teeth can't adequately take these factors into account. As a result, you may be risking permanent gum and bone damage—and you may even lose teeth in the process. Even if repairable, such damage could require oral surgery, cosmetic dentistry or more extensive orthodontic procedures.

In the end, you're highly unlikely to be successful at DIY orthodontics—and you won't save any money. A healthy and beautiful smile is well worth the cost of professional, high-quality orthodontics.

If you would like more information on orthodontic options, please contact us or schedule an appointment for a consultation.

By Nathan Gelder DMD
March 04, 2020
Category: Dental Procedures
IfYoureConsideringBracesHeresHowTheyWork

If you or a family member has problems with teeth alignment or your bite, you may be considering braces. This tried and true method can straighten out most smiles — but there's more to braces than you may realize.

For one thing, orthodontic treatment wouldn't work if it weren't for the natural mechanism for tooth movement that already exists in the mouth. It may seem your teeth are rigidly set in the jawbone but that's not how they maintain their attachment: that's the job of an elastic connective tissue known as the periodontal ligament that lies between the tooth and the bone. The ligament has tiny fibers that attach to the tooth on one side and to the bone on the other to actually hold the teeth in place, much like a hammock secured between two posts.

The ligament attachment also allows the teeth to move incrementally in response to environmental factors or the aging process. We harness this natural movement ability with braces to move teeth to a more desirable position. We first attach small brackets to the front crowns of the teeth (the visible portion) and then string arch wires through them. We then attach the wires to anchor points where we can adjust the amount of tension they're exerting through the brackets against the teeth. By gradually increasing that tension, the teeth respond as they would when any force is applied against them and begin to move.

By precisely controlling that movement we can transform a patient's smile. But we believe the advantages are more than cosmetic: the teeth will function better and will be easier to care for and keep clean. These benefits, though, have to be balanced with heightened risks for root resorption (something that occurs only about 10% of the time) in which the ends of the roots can shrink, or loss of mineral content in teeth enamel where the hardware makes it more difficult to remove bacterial plaque. These risks can be reduced by closely monitoring dental health during the entire treatment process and through stepped up efforts in daily oral hygiene.

The starting point for deciding on an orthodontic treatment is a thorough dental examination with x-rays or CT scan imaging. Once we have a complete picture of your misalignment problems and any other extenuating circumstances, we can recommend a treatment plan just for you.

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 “Moving Teeth with Orthodontics.”