It’s been a long road with your braces, but now they’re finally off. Hopefully the first glimpse of your new smile more than made up for the time and effort they required.
But while braces removal is a big milestone, it’s not the end of your treatment—not, that is, if you want to keep that new smile! You’ll now need to wear an appliance called a retainer for a few years or, in some cases, from now on.
Orthodontic retainers are a must after braces for the same reason braces work in the first place—your teeth can move. While the teeth attach to the jawbone via the roots, they’re firmly held in place by an elastic gum tissue network called the periodontal ligament. This tough but elastic tissue lies between the teeth and gums and attaches securely to both with tiny fibers.
While the ligament provides stability, it’s also dynamic—constantly remodeling to allow the teeth to move in response to biting pressure and other mouth factors. Orthodontists use this mechanism when moving teeth to better positions. The braces apply pressure on the teeth in the desired direction and the periodontal ligament responds as the teeth move.
Afterward, however, the ligament can still retain a kind of “muscle memory” for a time of the teeth’s old positions. Free of the pressure once supplied by the braces the teeth have a tendency, especially early on, to “rebound” to where they were.
A retainer helps prevent this by exerting just enough pressure to “retain” the teeth in their new positions. In the beginning this may require wearing the appliance around the clock, but you may be able later to reduce wear time to just a few hours a day. Rebounding is unpredictable, so you should continue to follow your orthodontist’s recommendations on retainer wear.
Wearing a retainer may seem like a drag, but it’s absolutely essential. Being diligent about it will help ensure that the beautiful smile you and your orthodontist worked so hard to obtain stays with you for years to come.
If you would like more information on getting a new smile through 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 “The Importance of Orthodontic Retainers.”
Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.
In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.
Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.
What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.
Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.
A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”
Cardiovascular disease and periodontal (gum) disease are two different conditions with their own set of symptoms and outcomes. But they do share one common element: inflammation. In fact, this otherwise normal defensive response of the body might actually create a link between them.
When tissues become damaged from disease or injury, the body triggers inflammation to isolate them from the rest of the body. This allows these tissues to heal without affecting other tissues. If inflammation becomes chronic, however, it can damage rather than protect the body.
This happens with both cardiovascular disease and gum disease. In the former, low-density lipoproteins (LDL or “bad cholesterol”) in animal fat leave behind remnants that can build up within arteries. This stimulates inflammation of the vessel’s inner linings, which accelerates hardening and increases the risk of heart attack or stroke.
With gum disease, bacteria living in a thin, built-up film of food particles on the teeth called plaque infect the gum tissues, which in turn trigger inflammation. A struggle ensures between the infection and inflammation, causing the gum tissues to weaken and detach from the teeth. Coupled with erosion of the supporting bone, the risk of tooth loss dramatically increases.
Recent research now seems to indicate the inflammatory responses from these two diseases may not occur in isolation. There is evidence that gum inflammation could aggravate inflammation in the cardiovascular system, and vice-versa. The research, though, points to some possible good news: treating inflammation in either disease could have a positive effect on the other.
Making heart-friendly lifestyle changes like losing extra weight (especially around the waist), improving nutrition, and exercising regularly can help reduce LDL and lower the risk of arterial inflammation. Likewise for your gums, daily oral hygiene and visiting the dentist at least twice a year reduces the risk for gum disease. And at the first sign of a gum infection—swollen, reddened or bleeding gums—seeking immediate treatment will stop it and reduce any occurring inflammation.
Taking steps to prevent or reduce inflammation brought on by both of these diseases could improve your health and save your life.
If you would like more information on how your oral health affects your whole body, 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 Link between Heart & Gum Disease.”
What do young saber tooth tigers, which have been extinct about 10,000 years, have in common with human kids today? At first glance, not a lot. Smilodon fatalis, the big cat of North America, reached adulthood at around age three and weighed up to 600 pounds. But these ice-age mammals are probably best known for their dagger-like canine teeth, which (as shown by many well-preserved skeletons) grew up to 7 inches long. And that’s where the comparison between kids and kitties gets interesting.
The toothy felines had primary (baby) teeth and adult teeth, which developed in a similar way to human dentition. The primary teeth came in first, persisted during the young cat’s development, and shared space in the mouth as the adult teeth were erupting (growing in) — with one big difference. According to a recent study reported in the academic journal PLOS ONE, those colossal canines grew at an astonishing rate: up to 6 millimeters per month! By comparison, human primary teeth emerge from the gums at around 0.7mm per month, while permanent teeth may grow up to 2mm per month.
It’s understandable why those tiger teeth developed so rapidly: Life in the Ice Age was hard, and predators needed every advantage just to stay alive. But while human baby teeth take longer to develop (and to go away), they, too, are vitally important.Â For one thing, the primary teeth let kids bite, chew, speak (and smile) properly, until they are replaced by adult teeth — a process that isn’t usually finished until a child reaches the age of 12-13. So those “baby” teeth allow kids to have good nutrition — and positive social interactions — for a significant part of childhood!
There’s another important thing primary teeth do before they’re gone: They help ensure that the succeeding teeth come in properly, by holding a space in the jaw that will later be filled by a permanent tooth. If baby teeth are lost prematurely, those spaces can close up, resulting in permanent teeth that emerge too close together, or in the wrong places. This condition, called malocclusion (bad bite), can usually be corrected by orthodontics. But it’s better to avoid the inconvenience (and cost) of braces, if possible.
That’s why it’s so important to take care of your child’s baby teeth. Even though they won’t be around forever, they have a vital role to play right now. So be sure proper attention is paid to your child’s oral hygiene: That means avoiding sugar, and remembering to brush and floss every day. And be sure to come in regularly for routine exams, cleanings, and needed care. It’s the best way to keep those little teeth from “going extinct” too soon!
If you have questions or concerns about your child’s baby teeth, please call our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Importance of Baby Teeth” and “Early Loss of Baby Teeth.”
If you've undergone treatment for periodontal (gum) disease, you know how involved it can be. After several sessions of plaque and calculus (hardened plaque deposits) removal, your swollen, red gums finally begin to regain their healthy pink color.
But with gum disease, the battle may be over but not necessarily the war. If we don't remain vigilant, there's a high chance you'll experience a re-infection.
That's why periodontal maintenance (PM) is so important for gum disease patients after treatment. Plaque, the thin film of bacteria and food particles responsible for the infection, can grow again on your tooth surfaces as it did before. You'll have to practice diligent, daily brushing and flossing to curb that development.
But it's also important to keep up regular dental visits for advanced cleaning to remove hard to reach plaque and calculus. For most people that's usually twice a year, but for gum disease patients it could be up to four times a year, especially just after treatment. And there's more to these visits than cleaning.
Since our goal is to reduce the chances of re-infection as much as possible, we'll thoroughly examine your teeth, gums and any implants for signs of disease (we'll also include an oral cancer screening). We want to assess the health of your teeth and gums and to see how well you're doing hygiene-wise with plaque control.
If we find signs of gum disease, we'll discuss this with you and schedule a new round of treatment. The sooner we initiate treatment, the better your outcome. In some cases, we may perform procedures that make it easier to access and clean areas where plaque tends to build up.
Overall, we want to prevent the occurrence of any future disease and treat it as soon as possible if it re-occurs. Keeping up diligent PM will help ensure your gums continue to stay healthy.
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