Posts for tag: orthodontic treatment
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.”
While braces are often the stars for straightening smiles, they're not the only cast members in an orthodontic production. Orthodontists occasionally turn to other appliances if the bite problem is challenging. Whatever the tool, though, they usually have something in common—they use the principle of anchorage.
To understand anchorage, let's first consider the classic kid's game Tug of War. With teams on either end of a rope, the object is to pull the opposing team across the center line before they pull you. To maximize your pulling force, the player at the back of your rope, usually your stoutest member, holds steady or "anchors" the rest of the team.
Like a Tug of War team, braces exert force against the teeth. This stimulates the supporting periodontal ligament to remodel itself and allow the teeth to move. The braces use the teeth they are attached to as anchors, which in a lot of cases are the back teeth. By attaching a thin wire to the brackets or braces on the teeth, the orthodontist includes all the teeth on the arch, from one end to the other. Anchored in place, the wire can maintain a constant pressure against the teeth to move them.
But not all bite situations are this straightforward. Sometimes an orthodontist needs to influence jaw growth in addition to teeth movement. For this purpose, they often use orthodontic headgear, which runs around the back of the head or neck and attaches to orthodontic brackets on the teeth. It still involves an anchor but in this case it's the patient's own skull.
In some situations, an orthodontist may feel he or she needs more anchorage as the teeth alone may not be enough. For this, they might establish a separate or additional anchor point using a temporary anchorage device (TAD). A TAD resembles a tiny screw that's inserted into the jawbone near the tooth intended for movement. The orthodontist can then attach the TAD to braces hardware using some form of elastics. After treatment, they remove the TAD.
These are just a couple examples of specialized tools an orthodontist can use for bite correction. Thanks to them and similar devices, even the most complex bite problem can be overcome to create a healthier and more attractive smile.
If you would like more information on correcting a poor bite, 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.”
If you press your tongue against your teeth, unless something is badly wrong they won't budge. In fact, your teeth are subjected to a fair amount of pressure each day as you chew and eat, and yet they remain firmly in place.
But there's a deeper reality—your teeth do move! No, it's not a paradox—the gum and bone tissues that hold your teeth in place allow for slight, imperceptible changes in the teeth's position. Their natural ability to move is also the basis for orthodontics. Here are 3 more facts you may not know about your teeth's natural ability to move.
Teeth are always on the move. Teeth are held firmly within the jawbone by an elastic gum tissue called the periodontal ligament and a thin layer of bony-like material called cementum. In response to pressure changes, though, the bone dissolves on the side of the teeth in the direction of pressure and then rebuilds behind it, solidifying the teeth's new position, a process that happens quite slowly and incrementally. And it will happen for most of us—some studies indicate more than 70% of people will see significant changes in their bite as they age.
Orthodontics works with the process. Orthodontic appliances like braces or clear aligners apply targeted pressure in the direction the orthodontist intends the teeth to move—the natural movement process does the rest. In the case of braces, a thin metal wire is laced through brackets bonded to the front of the teeth and then anchored, typically to the back teeth. The orthodontist incrementally tightens the wire against its anchors over time, encouraging tooth movement in response to the pressure. Clear aligners are a series of removable trays worn in succession that gradually accomplish the same outcome.
Watch out for the rebound. That nice, straight smile you've gained through orthodontics might not stay that way. That's because the same mechanism for tooth movement could cause the teeth to move back to their former positions, especially right after treatment. To avoid this outcome, patients need to wear a retainer, an appliance that holds or "retains" the teeth in their new positions. Depending on their individual situations and age, patients may have to wear a retainer for a few months, years or from then on.
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 “The Importance of Orthodontic Retainers.”
You may not always be able to tell if your child's bite isn't developing properly. Â That's why you should have them undergo an orthodontic evaluation around age 6 to uncover any emerging problems with tooth misalignment.
Still, there are some visible signs all's not well with their bite. As the primary (baby) teeth give way, the permanent teeth erupt sequentially around ages 6 to 8. As they come in, you should notice that each tooth fits uniformly next to each other without excessive gaps or, on the other end of the spectrum, not crowded together in crooked fashion. Upper teeth should also fit slightly over the lower teeth when the jaws are shut.
If their teeth appearance deviates from these norms, they may have a bite problem. Here are 4 abnormalities you should watch for.
Underbite or deep bite. As we mentioned, the front teeth should cover the lower teeth with the jaws shut. In an underbite, the reverse happens — the lower teeth are in front of the upper teeth. It's also a problem if the upper teeth cover the lower teeth too much (often referred to as “deeply”).
Open bite. This occurs when there's a gap between the upper and lower front teeth while the jaws are shut together. One possible cause is late thumb sucking, which can put undue pressure on the front teeth and cause them to develop too far forward while forcing the bottom front teeth further backwards.
Crossbites. This kind of bite occurs when some of the teeth don't fit properly over their counterparts, while others do. Crossbites can occur anywhere in the mouth, for example the upper front teeth fitting behind the lower front teeth while the back teeth overlap normally, or the reverse (front normal, back abnormal).
Misalignments and Abnormal Eruptions. Sometimes upper teeth may align too far forward, a situation known as protrusion. Conversely, lower teeth (or the jaw itself) may come in too far back (retrusion). Because a primary tooth might be out of position or not lost in the proper sequence, a permanent tooth might noticeably erupt out of its proper position.
If you notice any of these situations with your child's teeth see your dentist or orthodontist soon for a full examination. If caught early, we may be able to take action that will lessen or even eliminate the problem.
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.”