Monday, April 8, 2013

Why are my braces still on?



Why are my braces still on?  A short skit with 5 Questions!
Those of you who have been in braces at our office may have experienced my “Are your teeth straight” stand-up comedy act!  It goes something like this:
Q. Are your teeth straight? (I never ask this question unless they really are pretty much straight!)
A.  Yes they are… (Sometimes we have to give the patient a mirror to look at their own teeth)
Q. So if your teeth are straight… “Why are your braces still on?”
A. Because my “bite” is off (sometimes we have to explain to our patients that you can have straight upper and lower arches but still have some type of overbite, overjet, openbite, etc.)
Q. So what do you think fixes your “bite”?
A. Robber bands!
Q. What happens if you do not wear your rubber bands as we instructed?
A. My bite will not get fix and MY BRACES WILL NOT COME OFF.
Q. So who is in charge of how much longer the braces are on?
A. You… the patient, are in charge, not the doctor, not your parents!

Friday, April 5, 2013

What is the biggest misconception about orthodontic treatment?



Q. What is the biggest misconception about orthodontic treatment?

A. If I could just tell people one thing about orthodontics it would be this: Teeth are NOT like fence post that are set in concrete.  With a fence post, you place it where you want it, pour concrete around the base, hold it in place (retain) and, when the concrete sets up, the fence post is stable and should never move.  Now this is NOT what happens with teeth!  Teeth are never fixed to the jaw bones.  They always have the capability to move.  So why don’t they…why do crooked teeth stay crooked until the orthodontist moves them…why do straight teeth stay straight if a patient is blessed with straight teeth and never needed orthodontic treatment?  The answer is that, in both cases, the teeth still can move…they just don’t “want” to move, at least not right then.  In both cases, the teeth are stable (crooked and straight) in their respective positions because the forces on them from the bite, tongue, lips and cheeks balance out (for you science types: static equilibrium).  Change the forces with braces, or with just normal aging, and the teeth will move. This is why we never tell a patient to stop wearing their retainers.  Even if the teeth might stay straight for years, forces change over time, and the teeth will move. Retainers will hold teeth in position because they can overcome any unbalanced forces that might affect the teeth.
Now all of this is not to say that in makes NO difference where the orthodontist puts the teeth.  Ideally, we try and find the most stable position possible for each patient.  If we do this, then the teeth will tend to stay straight, with or without retainers (not that we recommend not wearing retainers).  And this is where diagnosis comes in.  Let’s say a patient has extremely crowded teeth due to very large teeth and a small mouth. The teeth are stable in their crooked position, but if we just expand the arches to make room for all the teeth, are we not moving them out to an unstable position?  But if we extract some teeth (so we can leave the remaining teeth in the arch, but straight), then the final result should be much more stable.
My wife had orthodontic treatment 50 years ago and, like many people, she stopped wearing her retainers after a few years.  Yet, because she had teeth taken out for crowding, her final result was stable and, even 50 years latter, her teeth look great.  Now this doesn’t happen for everybody, but this is what we try to achieve, and this is the reason why we try so hard to get everything perfect and why we reluctantly are forced to extract teeth in some patients. Now some people will say that treating people without extractions is a more “conservative” way of doing orthodontics.  But is getting a stable result with extractions more radical than leaving someone with an unstable result that will collapse the second they stop wearing their retainers?
Bottom line: want to keep your teeth as perfect as the day the braces came off?  Then wear your retainers!

Tuesday, March 5, 2013

Prehistoric man had better teeth than we do!

I found an interesting article today, about why ancient man had better teeth then present day man.  I thought that my readers may find this interesting as well.  There is a link below.



Read all about this:

Prehistoric man had better teeth then we do!

Monday, March 4, 2013

Invisalign breakthrough

             We have used Invisalign since 1999, and we were one  of the very first practices in the country to use this amazing technology.  Since its introduction, there have been numerous upgrades in the computer algorithms that allow us to program the tooth movement and make it more efficient. 

             There has also been upgrades in the attachments, those little bumps that are glued to some teeth to allow more difficult movements.

             In all this time however, there has not been any change in the "plastic" used for the aligners.  The company has during this time been researching a better plastic and this January SmartTrack  is now the new standard for all Invisalign appliances.  So why is the new  SmartTrack plastic better?...well the characteristics that were important were:

1. The aligners should be esthetic for daytime wear
2. The aligners should produce gentle consistant forces
3. The aligners should fit well and have excellent elasticity

And, after much testing, SmartTrack material proved to be far superior to the old material.

So what does this mean for Invisalign patients?...simply more aesthetic, more comfortable and more efficient orthodontic treatment!

Thursday, February 21, 2013

White spots and decalcification

What are white spots you ask? 

White spots, called decalcification,  appear when plaque (a sticky film made up of bacteria and food residue) builds up and is not removed from the teeth and brackets.  The white spots are discolorations that can be permanent scars on the teeth.  The bacteria in the plaque produces acid that eat into the enamel, leaving marks on the teeth. Eventually these areas of decalcification can turn into full blown cavities. The brackets that are placed on the teeth protect only the areas underneath, but poor oral hygiene allows plaque to build up on the unprotected areas (around the brackets and especially between the bracket and the gum line). The best way to prevent decalcification is to maintain good oral hygiene and to swish with the fluoride rinse we prescribe.  Besides poor oral hygiene, excessive amounts of sugar and high acid drinks can cause decalcification.  

Soft drinks, fruit juices and “sports” drinks are especially dangerous to the teeth.

Good oral hygiene is very important in helping your mouth stay healthy.  In addition to decalcification, the plaque also causes gum tissue to swell and bleed due to infection (gingivitis).  Please remember when you are brushing to check and make sure all of your teeth and braces are plaque free and to rinse with your fluoride mouth rinse every night.



Wednesday, February 20, 2013

Speed, Fast and Damon braces



Q.) I have heard about the new hi-tech braces like the Speed, Fast and Damon brackets that are suppose to radically shorten treatment time and “grow” jaws to avoid extractions.  Do you use them?



             A.) Orthodontic companies are always coming on the market with new appliances, promising orthodontists that they can perform “miracles”. Over the years we have tried many of these supposedly supper braces…. and guess what?  Braces are pretty much braces…. it’s the skill of the orthodontist that determines the quality and speed of the treatment.             Not that we do not invest in the best appliances, but there is no magic way of doing orthodontic treatment.  If there were…every orthodontist would be using it!             As of now we know of no good scientific study that shows any of these brackets to be any better or faster than the traditional brackets we use.
           
         We are always open to new ideas.  As a matter of fact we were the first orthodontic practice in the Midwest to use Invisalign (which really does work wonders!) 
So if some new appliance does prove to be superior you can be assured we will be one of the first to adopt it.

Tuesday, February 19, 2013

Why are my braces still on? A short skit with 5 Questions!



Those of you who have been in braces at our office may have experienced my “Are your teeth straight” stand-up comedy  act!  It goes something like this:


Q. Are your teeth straight?          (I never ask this question unless they really are pretty much straight!)
              A.  Yes they are…(sometimes we have to give the patient a mirror to look at their own teeth)
Q. So if your teeth are straight?: “Why are your braces still on?”
              A. Because my “bite” is off (sometimes we have to explain to our patients that you can have straight upper and lower arches but still have some type of overbite, overjet, openbite, etc.)

Q. So what do you think fixes your “bite”?
              A. Rubber bands!

Q. What happens if you do not wear your rubber bands as we instructed?
             A. My bite will not get fix and MY BRACES WILL NOT COME OFF.

Q. So who is in charge of how much longer the braces are on?
             A. You… the patient, is in charge, not the doctor, not your parents!

Monday, February 18, 2013

Orthodontic retention



Q. What is the biggest misconception about orthodontic treatment?

A. If I could just tell people one thing about orthodontics it would be this:
      Teeth are NOT like fence post that are set in concrete.  With a fence post, you place it where you want it, pour concrete around the base, hold it in place (retain) and, when the concrete sets up, the fence post is stable and should never move. 

Now this is NOT what happens with teeth!  Teeth are never fixed to the jaw bones. 

They always have the capability to move.  So why don’t they; why do crooked teeth stay crooked until the orthodontist moves them; why do straight teeth stay straight if a patient is blessed with straight teeth and never needed orthodontic treatment?  The answer is that, in both cases, the teeth still can move…they just don’t “want” to move, at least not right then.  

        In both cases, the teeth are stable (crooked and straight) in their respective positions because the forces on them from the bite, tongue, lips and cheeks balance out.  Change the forces with braces, or with just normal aging, and the teeth will move. This is why we never tell a patient to stop wearing their retainers.  Even if the teeth might stay straight for years, forces change over time, and the teeth will move. Retainers will hold teeth in position because they can overcome any unbalanced forces that might affect the teeth.

         Now all of this is not to say that it makes NO difference where the orthodontist puts the teeth.  Ideally, we try and find the most stable position possible for each patient.  If we do this, then the teeth will tend to stay straight, with or without retainers (not that we recommend not wearing retainers). 

         This is where diagnosis comes in.  Let’s say a patient has extremely crowded teeth due to very large teeth and a small mouth. The teeth are stable in their crooked position, but if we just expand the arches to make room for all the teeth, are we not moving them out to an unstable position?  But if we extract some teeth (so we can leave the remaining teeth in the arch, but straight), then the final result should be much more stable.
           
           My wife had orthodontic treatment 50 years ago and, like many people, she stopped wearing her retainers after a few years.  Yet, because she had teeth taken out for crowding, her final result was stable and, even 50 years later, her teeth look great.  Now this doesn’t happen for everybody, but this is what we try to achieve, and this is the reason why we try so hard to get everything perfect and why we reluctantly are forced to extract teeth in some patients.

Saturday, February 16, 2013

Too difficult for Invisalign?

Q.    I was told by my dentist that my problem was too difficult for Invisalign®.  What can I do if I really don’t want a full set of braces?


              A. As one of the first orthodontic office in the country to use Invisalign we have had a great deal of experience with this technique.  Because of this, and being orthodontists, we feel comfortable treating much more difficult cases than most general dentists.  As a matter of fact we even have orthodontists referring their patients who insist on Invisalign to us. Here are some reasons why we may be able to help you:

             1.      Experience does matter, like any new doctor using Invisalign, we started out only doing simple cases and worked our way up to more complex problems…10 plus years of experience with Invisalign lets us do things many other doctors would not attempt.
           
               2.      Last year Invisalign came out with a major revision (G-4) that allows much better control over tooth movement…a big improvement over previous versions.

               3.      This year, after 10 years with the original Invisalign plastic material, Align Technology has begun using SmartTrack, the new standard aligner material for Invisalign. SmartTrack is a proprietary new material that is highly elastic and delivers gentle, more constant force for improved patient comfort all while improving control of tooth movements with Invisalign clear aligner treatment

             4.      Combo treatment. For those patients who truly are too difficult for Invisalign only we sometimes are able to do the difficult movements with partial braces and finish with Invisalign®.

              5.      We’re realistic. We understand that not every adult has the time, money, and interest in achieving an “ideal” correction.  With severe skeletal problems, often “ideal” corrections require extended treatment times or jaw surgery…we accept the fact that many adult patients will be happy with straight teeth and a less than perfect “bite”