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WhyaBondedRetainerMightbeaBetterChoiceAfterBraces

A lot of time and effort goes into straightening your smile. But there’s a possibility it might not stay that way—and all that hard work could be lost. The same natural mechanism that enables your teeth to move with braces could cause them to revert to their old, undesirable positions.

So for a little while (or longer for some people) you’ll need to wear a retainer, an appliance designed to keep or “retain” your teeth where they are now. And while the removable type is perhaps the best known, there’s at least one other choice you might want to consider: a bonded retainer.

Just as its name implies, this retainer consists of a thin metal wire bonded to the back of the teeth with a composite material. Unlike the removable appliance, a bonded retainer is fixed and can only be removed by an orthodontist.

Bonded retainers have several advantages. Perhaps the most important one is cosmetic—unlike the removable version, others can’t see a bonded retainer since it’s hidden behind the teeth. There’s also no keeping up with it—or losing it—since it’s fixed in place, which might be helpful with some younger patients who need reminding about keeping their retainer in their mouth.

There are, however, a few disadvantages. It’s much harder to floss with a bonded retainer, which could increase the risks of dental disease. It’s also possible for it to break, in which case it will need to be repaired by an orthodontist and as soon as possible. Without it in place for any length of time the teeth could move out of alignment.

If you or a family member is about to have braces removed, you’ll soon need to make a decision on which retainer to use. We’ll discuss these options with you and help you choose the one—removable or bonded—that’s right for you.

If you would like more information on bonded retainers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Bonded Retainers: What are the Pros and Cons?

FanofSuperheroFilmBlackPantherBreaksSteelWirewithHerMouth

Some moviegoers have been known to crunch popcorn, bite their fingers or grab their neighbor’s hands during the intense scenes of a thriller. But for one fan, the on-screen action in the new superhero film Black Panther led to a different reaction.

Sophia Robb, an 18-year-old Californian, had to make an emergency visit to the orthodontic office because she snapped the steel wire on her retainer while watching a battle scene featuring her Hollywood crush, Michael B. Jordan. Her jaw-clenching mishap went viral and even prompted an unexpected reply from the actor himself!

Meanwhile, Sophia got her retainer fixed pronto—which was exactly the right thing to do. The retention phase is a very important part of orthodontic treatment: If you don’t wear a retainer, the beautiful new smile you’re enjoying could become crooked again. That’s because if the teeth are not held in their new positions, they will naturally begin to drift back into their former locations—and you may have to start treatment all over again…

While it’s much more common to lose a removable retainer than to damage one, it is possible for even sturdy retainers to wear out or break. This includes traditional plastic-and-wire types (also called Hawley retainers), clear plastic retainers that are molded to fit your teeth (sometimes called Essix retainers), and bonded retainers: the kind that consists of a wire that’s permanently attached to the back side of your teeth. So whichever kind you use, do what Sophia did if you feel that anything is amiss—have it looked at right away!

When Black Panther co-star Michael B. Jordan heard about the retainer mishap, he sent a message to the teen: “Since I feel partly responsible for breaking your retainers let me know if I can replace them.” His young fan was grateful for the offer—but even more thrilled to have a celebrity twitter follower.

If you have questions about orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Bonded Retainers.”

YourAgeDoesntHavetoKeepYoufromaStraighterSmile

Bite problems are quite common—as many as 75% of adults may have some form of orthodontic issue. Unfortunately, there's also something else just as common: that many people believe they're too old to correct it.

This belief is a myth—while there are factors that could prevent orthodontic treatment, age isn't necessarily one of them. If your teeth, gums and bone are sound and you're in reasonably good general health, you most likely can have a bite problem corrected even beyond middle age.

Why worry about it, though, if you've lived this long with misaligned teeth? For one thing, straightening teeth with braces or clear aligners can boost your dental health. Teeth that are in normal alignment are easier to keep clean of disease-causing bacterial plaque. You'll also find it easier to chew than if your bite is out of line.

A more attractive, straighter smile can also impact your social and professional life. Having a smile you're not embarrassed to show can boost your self-confidence and image. Research on people who've undergone orthodontic treatment in adulthood have found improvements in social connection and even expanded career opportunities.

Orthodontic treatment can make a difference with your health and life, no matter your age. But while the number of years you've lived won't necessarily make a difference, what those years have brought could rule it out.

If, for example, you've lost significant bone structure due to diseases like periodontal (gum) disease, your teeth may not be able to sustain the new position created by braces or aligners without a form of permanent fixation. If you have systemic conditions like severe cardiovascular disease, bleeding problems, leukemia or uncontrolled diabetes, orthodontic treatment could worsen those conditions. And certain prescription drugs may pose similar problems as well.

That's why you'll need to undergo a thorough dental exam, as well as provide a complete medical history to your orthodontist. If nothing prevents you from treatment, though, you may be able to regain a new smile, better health and a new confidence in life.

If you would like more information on adult 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 “Orthodontics for the Older Adult.”

YoumayNeedOrthodonticTreatmentBeforeObtainingImplants

You have a lot of options for replacing missing teeth, from state-of-the-art dental implants to affordable, but effective partial dentures. But if the teeth in question have been missing for a while, you may first have to undergo orthodontic treatment. Here's why.

While they may feel rigid and firm in the jawbone, teeth are actually held in place by periodontal (gum) ligaments. These elastic tissues lie between the teeth and the bone and attach to both with tiny filaments. This mechanism allows the teeth to incrementally move over time in response to biting pressures or other environmental factors.

When a tooth goes missing the teeth on either side of the space naturally move or "drift" into it to help close the gap. This natural occurrence can reduce the space for a restoration if it has gone on for some time. To make room for a new prosthetic (false) tooth, we may have to move the drifted teeth back to where they belong.

If you're thinking metal braces, that is an option—but not the only one. Clear aligners are another way to move teeth if the bite problem (malocclusion) isn't too severe. Aligners are a series of custom-made, clear, plastic trays worn over the teeth. The patient wears each tray, slightly smaller than the previous one in the series, for about two weeks before changing to the next one. The reduction in size gradually moves teeth to their intended target position.

Many adults prefer clear aligners because they're nearly invisible and don't stand out like metal braces. They're removable, so you can take them out for cleaning or for special occasions. And, we can also attach a prosthetic tooth to the tray that temporarily covers the missing tooth space.

Whichever orthodontic treatment you choose, once completed we can then proceed with restoration to permanently replace your missing teeth. While it can be a long process, the end result is a beautiful smile that could last for years to come.

If you would like more information on your dental restoration options, 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 “Straightening a Smile before Replacing Lost Teeth.”

TreatingaChildsToothInjuryMayRequireSpecialConsideration

Often as children grow older, their participation in sports or similar activities increases. While generally encouraged, this greater activity does increase injury risk, especially to the mouth.

In fact, the late childhood to early adulthood demographic is the most prone portion of the population to incur dental injuries. To complicate matters, their dental development is often incomplete, posing a number of treatment obstacles for an injured tooth.

For example, the primary means for preserving an injured adult tooth is a root canal treatment: damaged or diseased tissue within the pulp, the tooth’s innermost layer, is removed and the empty chamber and root canals filled and sealed to prevent infection. But while a fully matured tooth can function without the nerves and blood vessels of the pulp, a developing tooth needs these tissues for continued tooth formation. Otherwise, tooth development can stall and cause problems later on.

The most common solution for younger teeth is to remove any damaged tooth structure without disturbing the pulp if at all possible followed by a filling. That’s contingent, though, on whether we find the pulp unexposed or undamaged—if it is, we’ll try to remove only damaged or diseased pulp tissue and leave as much healthy tissue intact as possible. To aid with healing and tissue re-growth, we may also place medicinal stimulators between the pulp and the filling.

Jaw development may also pose a challenge if the injured tooth is too far gone and must be removed. Our best choice is to replace it with a dental implant; but if we install the implant while the jaw is still growing, it may eventually appear out of place with the rest of the teeth. It’s best to postpone an implant until full jaw maturity in early adulthood.

In the meantime we could provide a temporary solution like a removable partial denture or a modified bonded bridge that won’t permanently alter nearby teeth. These methods can adequately restore the function and appearance of missing teeth until the jaw is mature enough for an implant.

While injuries with young permanent teeth do pose extra challenges, we have effective ways to address them. With the right approach, the outcome can be just as successful as with a mature tooth.

If you would like more information on dental care in the formative years, 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 “Saving New Permanent Teeth after Injury.”





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