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What do you need to know about braces?

The importance of braces goes way beyond having straight teeth. I would like to sum up some of these extremely important (in my opinion) reasons to have braces. First crowded teeth cause cosmetic and, aesthetic problems that can make people self cautious about their smile.

Second crowded teeth are normally more difficult to clean, and the food gets stuck and trapped a lot more in-between. This will make these teeth more susceptible to decay, and the gum tissue more prone to gingivitis.

Third, crowded teeth have less bone support, and less healthy gum tissue. In other word, they have less support and weaker.

Forth crowding, spacing, rotations, cross bite, excessive overbite etc., could cause an improper and sometimes traumatic bite. Traumatic bite could lead to wear and breakage of teeth with time.

It’s important to remember that worn out and broken teeth not only look bad, they cause shifting of the bite, which can through off the TMJ, which in turn could cause clicking, popping, and tenderness of the joint, headaches, and migraines. Worn out teeth are not as sharp and functional as normal teeth, hence causing the muscles to function a lot more to chew food.

Basically, an orthodontic treatment should achieve straight teeth that function within a well balanced bite, so teeth will last longer. This is goal is reached by, correcting, or improving all the above listed problems.
Let’s not forget that a nice smile will promote self –esteem that is a valuable tool for everybody’s social, and carrier success.

Braces are recommended for younger individuals to avoid problems. However, in the recent years more adults are having orthodontic treatment, to stop an existing problem from causing more damage.
In our office, we monitor kids as young as 5 years old), to see if there is a problem, or a potential for a problem. We also provide a free orthodontic exam and screening

Invisalign facts, pros and cons

Invisalign is a proprietary method of orthodontic treatment which uses a series of clear, removable teeth aligners, in some case it could be used as an alternative to traditional metal dental braces.

Advantages

The first advantage of the treatment is cosmetic: the aligners are completely transparent, therefore far more difficult to detect than traditional wire and bracket braces. This makes the method particularly popular among adults who want to straighten their teeth without the look of traditional metal brace. In addition, the aligners are marketed as being more comfortable than braces. Due to the removable nature of the device, food can be consumed without the encumbrance of metallic braces.

The second advantage of Invisalign, since it’s removable, eating during treatment is normal (no food get stuck on the brackets and wires),in addition cleaning the teeth and gum tissue is much easier than traditional braces. Because of that, the overall incidence of decay and gum tissue inflammation is less.

Disadvantages

Unlike traditional fixed braces, they are largely dependent on a patient’s habits and their cooperation. The success of the Invisalign aligners is based on a patient’s commitment to wear the aligners for a minimum of 20–22 hours per day, only removing them when they are eating, drinking, or brushing their teeth.

Invisalign is usually much more expensive than traditional braces, due to the high lab bill paid to align technology.

Because the aligners are removed for eating, they could be lost. Invisalign recommends that the patient keep the previous aligners in case this happens. However, Invisalign provides two plastic containers to keep the braces in, so they are less subject to loss or damage. In case of an aligner loss or breakage of an aligner, treatment will be delayed and coast will increase. Clinching and grinding teeth could cause damage and weakening of the aligners.

In my experience I have notice some kind of unpredictability of teeth movement when using plastic aligners, vs. the conventional braces. Metal brackets and braces move teeth with a lot more predictability. Furthermore, Invisalign has some limitations in the system ability to achieve certain teeth movement the way traditional braces does.

In our office we offer a free consultation to our patients to help them make the educated decision about their orthodontic treatment. So, if you or any of your family, and friends that are interested, please don’t hesitate to call us.

Flossing made easy!

One the main complaints of our patients is that the floss gets shredded or my gums start bleeding when I floss. I usually ask my patients to demonstrate their flossing technique for me. During the last fifteen years I have observed hundreds of my patients flossing, I have came across the same couple of the problems in the technique they are using.

First, instead of using a gentle, saw like movement to ease the floss in between teeth, most of my patients try to force, or shove the floss in between teeth. That usually causes trauma, and bleeding from the gum tissue. The solution is easy, use waxed floss, and just try to gently ease it through. For those who have a very tight contact between the teeth, you might want to consider using a dental tape, which is floss that has a tape like cross section, designed to navigate tight contacts.

Second, I noticed most of my patient after inserting the floss between the teeth, try to pull it up and out immediately, thinking that that spot has been cleaned. The proper way is to guide the floss between each tooth and under the gum line to remove particles of food, or plaque stuck between teeth. Ideally using a C-shape, the floss is curved around a tooth and placed under the gum line, and then gently moved away from the gum line, the floss scrapes the side of each tooth, and can also clean the front or back of the tooth. A clean section of floss can be used to clean each tooth to avoid transmitting plaque bacteria from one tooth to another.

Flossing should be done at least once a day. If you follow all the above for a month and your gum tissue is still oozing blood during flossing, this could indicate gingivitis, or periodontitis (gum tissue inflammation). A professional cleaning at the dentist might be needed.

I don’t like my smile what should I do?

My patients ask me this question on daily basis. Generally speaking, our professional smile analysis (which might includes molds and photos), help us to pin point the patient concern. The problem could involve one or all of the followings; the color, shape, position or the size of teeth. Based on your teeth, TMJ, smile and bite analysis, one or a combination of treatment options below are need to achieve your cosmetic goals with predictability.

  1. Teeth whitening
  2. Bonded filling to change the shape and color of teeth with bonded fillings if possible
  3. Veneers and metal free cosmetic crowns
  4. Orthodontic treatment, conventional or clear Invisalign
  5. Orthognathic surgery (aligning of the jaws surgically)
Benefits of flossing

Dental floss is basically a tool that is used for mechanical teeth and gum tissue cleaning, where the brush can’t reach. Flossing will eliminate the plaque in-between the teeth, hence preventing gum tissue inflammation (gingivitis), cavities, and bad breath.

Dental plaque is a biofilm, usually a pale yellow, which develops mostly between the teeth, and by the gum line; it’s formed by colonizing bacteria trying to attach themselves to the tooth’s smooth surface, using the food as a source of growth. If not cleaned properly, the plaque could develop into tarter, or calculus within couple of weeks, it provides a perfect environment for more plaque formation. The calculus once it’s formed, it can’t be cleaned with brushing, only a professional cleaning with an ultrasonic, and hand instruments at the dentist, could get rid of it.

The acidic byproduct of the bacteria in the plaque causes inflammation of the gum tissue, and cavity formation.

Dental plaque is like rotten food. The rotten food also releases isovaleric acid, which can smell like sweat; putrescine, which gives off a smell of rotten meat; skatole, which can smell like human feces; and cadaverine, which has a smell likened to decomposing bodies. By flossing every day, will eliminate most, if not all the problem of bad breath

Oral care during pregnancy

It’s a scientifically proven fact that your oral health is an important part of your overall health, and untreated dental disease can be harmful to you and your baby. Be sure to include your oral health in your daily self-care routine and, keep your dentist informed of any changes in your oral health during pregnancy. Your dentist and his team could be your best ally to help you avoid any oral related problems during pregnancy. Some studies have suggested that premature baby deliveries might be related to poor oral hygiene.

Hormonal changes, frequent snaking and improper oral care, could lead to gingivitis (inflammation of the gum tissue), and decay. Bleeding of the gum tissue with lumps is one of the most frequent reasons for a pregnant woman to seek a dental care. In order to avoid dental emergencies, getting a clean bill of oral health prior to getting pregnant is highly recommended.

The best recipe to avoid oral emergencies is brushing twice at day for two minutes minimum, along with flossing and using any interdental cleaning aid, like water pick. Using an ADA approved mouth wash. The frequency of eating becomes higher especially during the third trimester. A special attention should be paid towards the quality of the food and drinks. Consult your dentist and OBGYN to help you make the right dietary decisions.

Mouth rinse facts and myths

Let me start by saying that mouth rinsing is not a substitute for proper oral care (brushing and flossing). The FDA classifies mouth rinses into cosmetic (over the counter), and therapeutic rinse (prescription only).
The cosmetic mouth wash help loosen the plaque attachment to teeth prior to brushing, they also provide a temporary control to the bad breath producing bacteria and give the patient a temporary sense of a refreshed mouth. The dental community and some studies are skeptic about the value and effectiveness of these products. In addition most of these products contain high percentage of alcohol, which is known to cause oral cancer. Although many manufactures have tried hard to advertise their product to consumers, as the solution to all your mouth problems, like the control and prevention of decay, gum tissue inflammation, bad breath, and teeth whitening, etc…

I suggest using these products in moderation, don’t skip or substitute brushing and/or flossing with a mouth rinse. Parents remember to keep them away from the reach of your children under the age of 12. It’s worth noting that, we recommend the use of high fluoride rinse regularly during orthodontic treatment. It’s helpful to look for the ADA stamp of approval on the bottle, prior to purchasing it.

The therapeutic prescription only mouth washes are to be recommended by us (dentists), to our patient for a short term only. They are indicated for a short term use to help treat specific gum tissue situations, prior to implant placement, oral surgery, and post-operatively after gum tissue and oral surgery.

Bad breath management

Bad breath occurs when a noticeable unpleasant odors are exhaled in breathing. It is estimated to be the third most frequent reason for seeking dental aid, due to tooth decay, gum tissue and bone inflammation.

In most cases 90% of bad breath originates in the mouth. The intensity of the bad breath might change during the day due to eating certain food like onion, garlic, seafood etc. Morning breath is caused due to the mouths inactivity and reduction of oxygen exposure while sleeping. It normally dissipates after eating, brushing and rinsing. Bad breath could also originate from respiratory track and tonsils, or gastrointestinal problems. During dental exam, we can evaluate your teeth, gum tissue and tongue to determine if the source of your problem is oral.

The majority of bad breath cases can be managed by maintaining good oral hygiene, good brushing, flossing and using a mouthwash (like Listerine). Some research has found that mouthwash could be effective in controlling bad breath producing bacteria for few hours. Cleaning your tongue by using your toothbrush or a tongue blade can also help the mechanical elimination of germs.

Eat healthy, a lot of fruits and vegetables, avoid onions, garlic, alcohol and high sugar diet. Drink a lot of water, avoid sodas and power drinks.

How successful are dental implants?

Success rates of dental implants vary, depending on where in the jaw the implants are placed. In general, dental implants have a success rate of up to 98%. With proper care, they last a lot longer than bridges.

Can Anyone Get Dental Implants?

In most cases, anyone healthy enough to undergo a routine dental extraction or oral surgery can be considered for a dental implant. Patients should have healthy gums and enough bone to hold the implant. They also must be committed to good oral hygiene and regular dental visits. Heavy smokers, people suffering from uncontrolled chronic disorders such as diabetes or patients who have had radiation therapy to the head/neck area need to be evaluated on an individual basis. Also patient with auto immune disease have a lower rate of success.

If you are considering a dental implant, please Call us for a free consultation.

The effect of acid reflux on teeth

Acid reflux, or gastro-esophageal reflux disease (GERD), is a condition is usually caused by changes in the barrier between the stomach and the esophagus, which normally holds the top of the stomach closed. This may cause gastric acid reflux from the stomach to the esophagus, and maybe the mouth. In the US, the number of people affected by GERD tops 20 million.

The PH in the mouth is 5.5 – 6, that is almost balanced. When the digestive acid makes it to the mouth due to GERD, it has a very acidic PH of 1.3 – 3. This will lead to weak and eroded enamel, which will be very susceptible to decay. We often discover signs of GERD during a dental exam. Patients may not present any symptoms in the mouth, however sometimes the oral Symptoms could range from mild sensitivity to a severe pain and discomfort, chipping, erosion and staining of teeth.

In addition to having your MD handling the medical part, life style changes especially diet is very important. Avoid acidic carbonated drinks, fatty, spicy food, alcohol, and smoking, eat frequent small portions, and elevate the head level when going to sleep. Brushing, flossing and using fluoridated tooth paste and mouth wash. Don’t forget to have your periodic visits to the dentist to address any tooth structure damage.