Posts for tag: orthodontic treatment
Sometimes you need only a single solution to improve your smile: teeth whitening to brighten stained teeth; porcelain veneers or crowns to mask dental flaws; or a life-like dental implant to replace a missing tooth. But not all dental situations are that simple and sometimes require a combination of treatments.
A case in point: restoring a missing tooth within a poor bite. The absent tooth itself may be the cause of the bite problem if it’s been missing for some time: The nearby teeth tend to move or “drift” into the empty space, leaving no room for implant placement.
When this happens, you’ll first need orthodontic treatment to correct the bite problem. Not only will this open the space for the implant, it also comes with its own benefits. It obviously improves your smile appearance—but straighter teeth are also easier to keep clean of bacterial plaque, which reduces your disease risk. You may also experience better digestion after your teeth are properly aligned and able to function as they should during eating.
The traditional way to improve a bite is through metal braces. But there are some downsides: For one, braces can make it difficult to keep teeth adequately clean, making wearers more susceptible to tooth decay and gum disease. Braces are also quite visible and can detract from a person’s appearance (even more so if a missing tooth is involved).
Unless your situation requires braces, you can choose clear aligners as an alternative. These clear, computer-generated plastic trays are worn in sequence to gradually move teeth to their desired positions. Unlike braces, you can remove aligners for eating, cleaning or rare special occasions. And, they’re barely noticeable to others.
If you also have a missing tooth, you can have a temporary prosthetic (“false”) tooth built into your aligner trays. In this way you can still enhance your smile while undergoing aligner treatment.
Once your bite has been corrected, we can then proceed with restoring your missing tooth permanently with a dental implant. Although orthodontics adds to the time and expense of restoration, its often necessary to achieve the best result. Your future smile will be the better for it.
After living with braces for a couple of years, the “big reveal” finally happens and you see your new smile for the first time. But then you’re told you have to wear another mouth appliance—around the clock to start and then just at night. After all the new smile excitement, wearing a retainer can be a little anticlimactic.
But this part of your orthodontic treatment is as important as the earlier tooth movement phase. That’s because your new “forever smile” doesn’t necessarily come with a “forever” guaranty. In fact, your teeth could quickly begin moving back to where they were before braces if you don’t wear a retainer.
The reason why is because of a tough but elastic gum tissue called the periodontal ligament. This ligament lies between the teeth and the jawbone, attaching to both through tiny extending fibers. The periodontal ligament actually does most of the anchoring work to hold your teeth in place.
The ligament is also why we’re able to move your teeth to different positions: As braces apply pressure to the teeth and jaw in the direction of desired movement, the ligament remodels itself to allow the teeth to take up these new positions.
The tissues involved, though, still retain a kind of “memory” of where the teeth used to be. This creates an immediate tendency for the teeth to revert to these old positions. To prevent this, we use a retainer that when worn keeps or “retains” the teeth in their new positions until they’ve stabilized and the old tissue “memory” fades.
There are different types of retainers, some removable and some fixed in place. Choosing the best one for a particular patient will depend on the complexity of the bite treatment, the patient’s age and level of self-responsibility and the preferences of the orthodontist. Whichever type of retainer you eventually use, it’s important you wear it to preserve all of the time and effort that went into transforming your smile.
Wearing a retainer might not be high on your “exciting things to do” list. But it’s the best way to guarantee you’ll enjoy your new smile for years to come.
If you would like more information on keeping your new smile after 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 “The Importance of Orthodontic Retainers.”
We often associate orthodontics with moving several teeth on the upper or lower arches (or both) with braces or clear aligners. But not all patients require a major endeavor — sometimes only one or a few teeth need to be moved, and not very far.
A slight gap between the two upper front teeth is one type of situation that only requires minor tooth movement: just a few teeth need to be moved and usually just a millimeter or two. The appliances needed to achieve this are also relatively simple in design: removable retainers or small scale fixed braces with small springs or elastics that place pressure against the teeth. The process may also only take a few months rather than two years as with major tooth movement.
Preparing for the procedure, though, must be undertaken with great care. We need to first determine if moving the teeth even slightly could affect the bite with the opposite teeth. We must also ensure the roots of the teeth intended for movement are in good position for allowing the space to be closed.
We must then consider the other supporting structures for the teeth. It’s important for gums and bone to be healthy — if not, treating any found disease may be necessary first before beginning orthodontics. And, if the gap between the two upper teeth was created by an abnormally large frenum, the small strip of tissue connecting the lip to the upper gum, it may be necessary to remove it before tooth movement can begin to ensure the closed gap stays closed.
Like any other orthodontic treatment, minor tooth movement first requires a thorough examination with x-ray imaging to determine the exact tooth position, bite issues and the surrounding gum and bone health. We can then be reasonably certain if this straightforward procedure is right for you, and could help you obtain a more attractive smile.
If you would like more information on different orthodontic treatment choices, 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 “Minor Tooth Movement.”
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.”
While orthodontists can effectively correct most poor bites (malocclusions), some can be quite complex requiring much time and expense. But there's good news—we often don't have to wait on a malocclusion to fully develop if we catch it in time. Thanks to interceptive orthodontics, we may be able to intervene much earlier and eliminate or reduce the degree of difficulty with treatment.
Interceptive orthodontics is a group of techniques and devices used in early childhood to help deter a possible malocclusion. Here are 3 ways this approach could make a difference in your child's bite development.
Guiding jaw growth. On a normal-sized upper jaw, the permanent teeth usually have ample room to erupt. Not so with a smaller jaw: incoming teeth become crowded and may erupt out of alignment or too close to each other. Orthodontists often use a device called a palatal expander to aid an under-sized jaw in its development. The device fits along the roof of the mouth between the teeth and applies gradual outward pressure on them. This encourages the jaw to widen as it grows, thus providing more room for erupting teeth to come in properly and decrease the chances of obstructive sleep apnea in the future.
Reshaping and repositioning jaw bones. An overbite can occur when the jaws aren't properly aligned, often due to poor muscle and bone development. This is where devices like the Herbst appliance are useful. Its hinge mechanism encourages the lower jaw to grow further forward. The jaws can thus develop in a more normal way, minimizing the development of a malocclusion.
Maintaining space. Primary ("baby") teeth are important for dental development because they help guide future permanent teeth to erupt properly; they also keep nearby teeth from drifting into the intended space. But when a primary tooth is lost prematurely due to disease or trauma, the space can become vulnerable to this kind of "drift." With a simple mechanism called a space maintainer we can hold open the space created by a prematurely lost primary tooth until the permanent tooth is ready to erupt.
These and other techniques can help stop bad bites from developing in young children, minimizing or even eliminating the need for future orthodontic treatment. That means a healthier mouth for your child and less impact on your wallet.
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: Timely Intervention can make Treatment Easier.”