Posts for tag: orthodontics
Moving your teeth to a more functional and attractive alignment is a big undertaking. You can invest months — even years — and a lot of expense to correct a bad bite. But all that effort could be for nothing if your teeth return to their original positions.
The very aspect of dental physiology that makes orthodontics possible can work against you in reverse. Your teeth are not actually rigidly fixed in the bone: they're held in place by an elastic gum tissue known as the periodontal ligament. The ligament lies between the tooth and the bone and attaches to both with tiny fibers.
While this mechanism holds the teeth firmly in place, it also allows the teeth to move in response to changes in the mouth. As we age, for example, and the teeth wear, the ligament allows movement of the teeth to accommodate for the loss of tooth surface that might have been created by the wear.
When we employ braces we're changing the mouth environment by applying pressure to the teeth in a certain direction. The teeth move in response to this pressure. But when the pressure is no longer there after removing the braces or other orthodontic devices, the ligament mechanism may then respond with a kind of “muscle memory” to pull the teeth back to where they were before.
To prevent this, we need to help the teeth maintain their new position, at least until they've become firmly set. We do this with an oral appliance known as a retainer. Just as its name implies it helps the teeth “retain” their new position.
We require most patients to initially wear their retainer around the clock. After a while we can scale back to just a few hours a day, usually at nighttime. Younger patients may only need to wear a retainer for eighteen months or so. Adults, though, may need to wear one for much longer or in some cases permanently to maintain their new bite.
Although having to wear a retainer can be tedious at times, it's a crucial part of your orthodontic treatment. By wearing one you'll have a better chance of permanently keeping your new smile.
If you would like more information on caring for your teeth 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.”
The final emergence of permanent teeth in late adolescence marks the end of a long process beginning in the womb with the formation of our primary or “baby” teeth. Permanent teeth form in a similar way as buds high in the jaw, continuing to grow until the primary teeth ahead of them fall away. The crowns of the new adult teeth eventually break through the gum tissue and emerge (erupt) into view.
At least, that’s normally what should happen; sometimes, though, a tooth may only erupt partially or not at all, a condition known as impaction. The crown remains partially or fully submerged below the gum line, causing the tooth to press against other teeth, potentially damaging them. It can also make periodontal (gum) tissues adjacent to the area more susceptible to disease. Wisdom teeth are especially prone to this kind of impaction, to the extent they’re often surgically removed (extracted) to avoid future problems to adjacent teeth or the bite.
Upper canines (the “eye teeth” normally located directly below the eyes) are also subject to impaction. But because of their highly visible position, extracting them could have an adverse impact on the patient’s smile. In this case, we often attempt instead to expose and ultimately save the tooth.
Before taking any action, however, an orthodontic examination is conducted first to pinpoint the exact position of the impacted tooth and determine how that position might affect moving teeth into a more desired alignment. If we find the impacted canine is in a workable position, the next step is to surgically uncover the tooth from the gum tissue (a minor procedure usually performed by an oral surgeon or periodontist). Once exposed, an orthodontic bracket with a small attached gold chain is bonded to the tooth. The gums are then sutured back into place with the chain exposed and allowed to heal.
At some future point an orthodontist will attach the chain to orthodontic hardware that will pull the impacted tooth into proper position over several months. As a result, the upper canine becomes “un-impacted”; the dangers to surrounding teeth and tissues are also reduced. And, just as important, we can preserve the tooth and with orthodontics achieve an attractive, normal smile.
If you would like more information on the effects and treatment of impacted teeth, 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 “Exposing Impacted Canines.”
Magician Michael Grandinetti mystifies and astonishes audiences with his sleight of hand and mastery of illusion. But when he initially steps onto the stage, it’s his smile that grabs the attention. “The first thing… that an audience notices is your smile; it’s what really connects you as a person to them,” Michael told an interviewer.
He attributes his audience-pleasing smile to several years of orthodontic treatment as a teenager to straighten misaligned teeth, plus a lifetime of good oral care. “I’m so thankful that I did it,” he said about wearing orthodontic braces. “It was so beneficial. And… looking at the path I’ve chosen, it was life-changing.”
Orthodontics — the dental subspecialty focused on treating malocclusions (literally “bad bites”) — can indeed make life-changing improvements. Properly positioned teeth are integral to the aesthetics of any smile, and a smile that’s pleasing to look at boosts confidence and self-esteem and makes a terrific first impression. Studies have even linked having an attractive smile with greater professional success.
There can also be functional benefits such as improved biting/chewing and speech, and reduced strain on jaw muscles and joints. Additionally, well-aligned teeth are easier to clean and less likely to trap food particles that can lead to decay.
The Science Behind the Magic
There are more options than ever for correcting bites, but all capitalize on the fact that teeth are suspended in individual jawbone sockets by elastic periodontal ligaments that enable them to move. Orthodontic appliances (commonly called braces or clear aligners) place light, controlled forces on teeth in a calculated fashion to move them into their new desired alignment.
The “gold standard” in orthodontic treatment remains the orthodontic band for posterior (back) teeth and the bonded bracket for front teeth. Thin, flexible wires threaded through the brackets create the light forces needed for repositioning. Traditionally the brackets have been made of metal, but for those concerned about the aesthetics, they can also be made out of a clear material. Lingual braces, which are bonded to the back of teeth instead of the front, are another less visible option. The most discrete appliance is the removable clear aligner, which consists of a progression of custom-made clear trays that reposition teeth incrementally.
How’s that for a disappearing act?!
If you would like more information about orthodontic treatment please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine article “The Magic of Orthodontics.”
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