Family Dentistry of Ocean City
Robert W. Yaskin, D.M.D. LLC
421 15th Street
Ocean City, NJ 08226
Search through our library of dental topics, including articles, fun facts, celebrity interviews and more.
Orthodontic treatment is a big investment. But given the benefits for future good health and a more attractive smile, it's well worth it.
In the here and now, though, braces wearers face a different threat to their dental well-being — dental disease. Wearing braces can actually increase the risk of disease and make it more difficult to fight.
Tooth decay and periodontal (gum) disease, the two most common forms of dental disease, usually arise from plaque, a thin film of bacteria and food particles on tooth surfaces. The bacteria produce acid, which erodes enamel and makes the teeth susceptible to decay. Certain bacteria can also infect the gums and eventually weaken their attachment to teeth. Thorough brushing and flossing everyday removes this disease-triggering plaque buildup.
But braces' hardware can make brushing and flossing more difficult. The brackets attached to the teeth and wires laced through them make it more difficult for floss and brush bristles to access all the areas around the teeth. Plaque can build up in certain spots; it's estimated braces wearers have two to three times the plaque of a person not wearing braces. Acid can also remain in contact with some of the enamel surface for too long.
It's important, therefore, if you wear braces to make a concerted effort to brush and floss thoroughly. Besides improving technique and taking more time, you might also consider additional aids. You can obtain toothbrushes specially designed for use with braces, as well as floss holders or threaders that make it easier to access between teeth. Another flossing alternative is an oral irrigator that sprays water under pressure between teeth is an alternative to flossing.
As a precaution against acid damage, we can boost enamel protection with additional fluoride applied to your teeth. We may also prescribe antibacterial rinses to keep the bacteria population low.
Above all, be sure to look out for signs of disease like swollen or bleeding gums or pain. As soon as you sense something out of the ordinary, be sure and contact us.
If you would like more information on keeping your teeth disease-free while wearing 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 “Caring for Teeth During Orthodontic Treatment.”
Wearing braces isn't just for teenagers — straightening teeth can be just as viable a need when you're an adult. For example, it may be necessary to first move teeth away from an empty tooth socket before you obtain a dental implant or other restoration.
But braces could have complications, especially if you have periodontal (gum) disease. These infections caused by plaque, a thin film of bacteria and food particles, inflame and weaken gum tissues and erode supporting bone. It can be treated and brought under control — but keeping it under control requires daily brushing and flossing, along with frequent office cleanings and checkups.
Braces can make this more difficult: it's harder to brush and floss effectively through the hardware of brackets and wires, which can give plaque a chance to build up. Patients susceptible to gum disease are more likely to have re-infections while wearing braces. The hardware can also cause enamel to come in prolonged contact with acid, which can dissolve its mineral content and open the door to tooth decay.
Clear aligners are an alternative to braces that can accomplish tooth movement while minimizing infection flare-ups for people with gum disease. Aligners are a series of customized clear plastic trays worn over the teeth, with each succeeding tray incrementally moving the teeth further than the preceding one. After wearing one tray for a specified time period, you then switch to the next tray. The teeth gradually move to the desired new position over the course of the aligner series.
This option is especially advantageous for gum disease patients because the trays can be removed temporarily for brushing and flossing. There are also other benefits: we can hide a missing tooth space with a temporary false tooth attached to the aligner; and, they're nearly invisible so it won't be obvious to others you're undergoing orthodontic treatment.
Not all orthodontic situations benefit from this alternative, while some cases may call for a combination approach between aligners and braces. But in the right setting, clear aligners are a good choice for not only obtaining better teeth position, but also helping you avoid a new encounter with dental disease.
Metal braces are often considered a rite of passage for teenagers whose teeth need straightening. While some teens have no problem with this, others are more self-conscious and would like a less noticeable and less restrictive form of orthodontic treatment (“ortho” – to straighten; “odont” – teeth). After all, traditional braces can sometimes require diet modification, regular tightenings can cause discomfort, and the hardware itself can irritate the inside of the mouth. All of these things can limit a teen's ability to function normally during an already difficult stage of life.
That's why many teens today are opting for removable clear aligners, which have been popular with adults for years. In this system of orthodontic treatment, transparent, flexible, plastic “trays” are custom-made to move an individual's teeth into better alignment in a step-by-step fashion. Each tray moves the teeth a little bit further, according to a precise plan developed with specialized computer software by an orthodontist, or a general dentist who has received special training. It's not available from every dentist, but we are happy to be able to offer it here.
It used to be that clear aligners were not recommended for teens for two main reasons. For one thing, because they are removable rather than attached to the teeth, it was assumed a teenager would not be as conscientious as an adult about wearing them nearly 24 hours a day, which is necessary to achieve the desired results. Now, however, clear aligners for teens have colored “compliance indicators” that fade over time. With this new tool, dentists and parentsâ??and teens themselves — can monitor compliance and progress.
The other main problem in prescribing clear aligners for teens had been that their second molars are still growing into position. This problem, too, has been solved. Clear aligners now have “eruption tabs” that serve as space-holders for teeth that have yet to grow in.
Finally, in recent years, improvements have been made to the whole clear aligner system that allow it to be used for more serious malocclusions (bad bites). So it's actually a viable option for more orthodontic patients in general — teens as well as adults.
If you would like to learn more about clear aligners for your teenager, please contact us or schedule an appointment for a consultation. You can also find out more in the Dear Doctor magazine article “Clear Aligners For Teenagers.”
Teeth crowding is a difficult bite problem (malocclusion) that often involves the entire jaw structure to be evaluated. Normally occurring when the jaw doesn’t have adequate space for normal tooth eruption, teeth coming in later put pressure on other teeth, causing them to develop improperly.
Crowding also makes it difficult to realign teeth with braces because there’s simply not enough room for sufficient movement to take place. The solution may then be to consider the removal of some of the teeth to create enough space for orthodontic treatment.
Not just any tooth can be removed, however — we must first conduct a careful analysis to determine which can be removed to facilitate optimum movement of the remaining teeth without disrupting normal mouth function or affecting appearance. The teeth most frequently removed for this purpose are the bicuspids, located between the cuspids or eyeteeth (which are positioned directly under the eyes) and the molars, the largest teeth in the back of the mouth. Sometimes one premolar tooth on each side of the jaw can be removed without sacrificing future form or function.
There are a few important considerations we must keep in mind when extracting teeth for orthodontic reasons; perhaps the most important is preserving bone at the extraction site. Because continuing bone growth depends on the forces generated by teeth when we bite or chew, bone near a missing tooth socket will tend to diminish over time. If there’s insufficient bone during orthodontic treatment, it may result in gum recession and root exposure — not only damaging to the teeth themselves but also to a person’s smile appearance. To avoid this, we sometimes will consider inserting a bone graft, which will stimulate bone growth, into the empty socket immediately after extraction. While this isn’t commonly done, it’s being considered if the patient’s bone is thin and a concern during healing.
We must also consider how to accommodate other, unrelated tooth loss to assure the final result is visually appealing. It may be necessary in these cases to maintain the space at the missing tooth site for a future restoration once the orthodontics is completed. This takes planning as well as the use of restorations like dental implants, bridges or partial dentures.
Regardless of your bite issues, the field of orthodontics has the appliances and techniques to overcome even the most complicated condition. When necessary, using procedures like tooth extraction can help turn an unappealing, dysfunctional bite problem into a beautiful smile.
If you would like more information on orthodontic teeth extractions, 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 “Tooth Removal for Orthodontic Reasons.”
If you are planning orthodontic treatment for yourself or your child, you may have heard about different types of orthodontic appliances (braces) and you may be wondering which type is best for you.
Orthodontic treatment is the process used to improve the positioning of your teeth and bite so that you look better and your teeth function properly. Movement of the teeth is accomplished by harnessing the natural regenerative powers of the body to remodel living tissue, in this case, the bone, which adapts to the new position into which the teeth are moved. Orthodontic appliances accomplish the movement by placing small light and constant forces on the teeth to move them into new and better positions.
There are currently three main types of orthodontic appliances to move your teeth. After careful analysis of your bite and needs, we can help you select the best option for your particular situation.
Fixed appliances, commonly known as braces, so-called because they are fixed to the teeth thereby bracing them together, small brackets are bonded to the teeth and light flexible wires are threaded through them. Controlled tension on these wires pulls or pushes the teeth into position.
Clear brackets are a second, more aesthetic type of fixed appliance. While they are less visible, they tend to be more fragile.
Use of fixed appliances, whether brackets are metal or clear, is usually recommended in more complex cases because they enable the orthodontist to accomplish more complex three-dimensional tooth movements in the most efficient and predictable manner. Please note that, during treatment, you should avoid eating hard foods or participating in extreme contact sports so you will not damage your teeth or the appliances.
Clear aligners are a third, more recent option for repositioning teeth. They are removable appliances, generally used in situations that are milder in nature and easier to correct. After careful assessment, a series of computer-generated, custom made clear plastic trays are made to move the mal-aligned teeth. Tooth movement is progressive with each successive aligner or tray, moving the teeth minutely, until the new desired position(s) is achieved. Clear aligners are usually used for simpler or tipping movements of teeth.
With any of these options, simple movements of teeth may take a few months, and more complex movements take up to two or three years.
Orthodontic treatment is an ingenious scientific discovery that has allowed the dental profession to accurately and precisely move teeth for improved aesthetic appearance and functional position. Contact us today to schedule an appointment or to discuss your questions about orthodontics. You can also learn more by reading the Dear Doctor magazine article “The Magic of Orthodontics.”