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Clear aligners Orthodontic treatment e.g. Invisalign is a method of orthodontic treatment which uses a series of custom made, clear, removable aligners to move teeth  sequentially into a more favorable position aesthetically and functionally speaking. It became very popular in the last two decades and could be used as a viable alternative to traditional metal brackets and wires orthodontics

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Advantages

Cosmetics the aligners are completely transparent, therefore they are 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.

More comfortable than braces, that is due to the fact that if designed properly  clear aligners apply a lower force  to the teeth with Invisalign/clear aligners than that with traditional braces.

Easier to eat during treatment, that is due to the removable nature of the device, food can be consumed without the encumbrance of metallic braces.

Better oral hygiene , since it’s a removable appliance , 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 far less than that with the traditional braces.

Disadvantages

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

Clear aligner therapy/Invisalign usually  cost more than traditional braces, due to the high lab bill paid to manufacturing company.

Because the aligners are removed for eating, they could be lost. That is why it’s recommended that the patient keep the last set aligners in case this happens. Two protective plastic containers are provided at the beginning of treatment to keep the aligners 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 the improvement in the technology, the aligner’s material,  and the advancement of the software/ AI have made the treatment more predictable that what it was a decade a go.

Although the advancement has been noticeable for the the last few years, the system still has some limitations that only traditional braces can solve. Your dentist/orthodontist will decide the most the proper way to treat your teeth.

In our office we offer a complimentary 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.

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 creating a C-shape, the floss is curved around a tooth contour and gently going 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.

My patients ask me this question on daily basis. Generally speaking, our professional smile analysis (which might includes digital scanning 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, facial type, 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).
6. Plastic surgeon or Oro maxillofacial surgeon referral.

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

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.

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.

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., the scientific evidence doesn’t support that.

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  fluoride rinse regularly during orthodontic treatment. It’s helpful to look for the ADA stamp of approval on the bottle, prior to purchasing it.

In the recent years, some published medical research have suggested that some mouth wash are causing imbalance pH and alteration of the oral microbiome.

The therapeutic (prescription only) mouth wash are to be prescribed by the dental practitioner for a short term only. They are indicated for a short term use to help treat specific infection, prior to implant placement, oral surgery, and post-operatively after gum tissue and oral surgery.

Bad breath (Halitosis) 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. Tooth decay and gum tissue inflammation is a major contributor to bad breath.

Dry mouth is very common problem that has devastating effect on the oral cavity and bad breath is one of them.

The majority of bad breath cases can be managed by maintaining good oral hygiene, good brushing, flossing , and improve diet . 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.

Tonsil stones, diabetes, and  digestive system especially stomach problems could also contribute to bad breath.

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

Dental implants have become very popular due to their predictability and high success rate in the last two decayed.  Multiple factors influence the success rate of dental implants, like general health, smoking, some medication and also the location of the implant is placed in the jaw. Multiple studies in the last 20 years have demonstrated that dental implants have a success rate of up to 95% over 10 years follow up period.

Can Anyone Get Dental Implants?

In general, any reasonably healthy person that is fit enough to have a routine dental extraction or oral surgery can be considered a good candidate for a dental implant. Cone Beam CT Scan is highly recommended in the planning phase to evaluate bone quality, quantity and determining the location of important anatomical landmarks like the nerves and sinuses.

There are certain conditions that reduce the success rate of dental implants or make the procedure contraindicated, that includes.

1. Patients with Osteoporosis and or on osteoporosis medication.
2. Compromised immune system patients.
3. Uncontrolled diabetes.
4. Heavy smokers and alcoholics.
5. Patients with history of radiation, especially head and neck  radiation.
6. Patients with extremely poor oral hygien.

During our free consultation here at my office we discuss all these factors (if they apply) in details.

Acid reflux, or gastro-esophageal reflux disease (GERD), is a condition 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 few millions . A high percentage of the adult population affected by GERD are not aware of it, it’s called silent GERD.

The PH in the mouth is 6.7 – 7.3, 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, decay, chipping, erosion and staining of teeth.

The American Dental Association consider GERD as exceptionally damaging to the teeth during sleep due to the migration of gastric acid into the mouth causing considerable tooth structure damage (erosion) . That could also be exacerbated by the reduction of saliva production during sleep.

In addition to having your MD handling the medical side of the issue , life style changes especially diet is very important. Avoid acidic carbonated drinks, fatty, spicy food, alcohol, and smoking, 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 MD for evaluation of GEDR and the dentist to address any tooth structure damage.

According to Wikipedia Herpes labialis, or orolabial herpes, is an infection of the lip by herpes simplex virus (HSV-1). An outbreak typically causes small blisters or sores on or around the mouth commonly known as cold sores or fever blisters. It t take up to 3 weeks for the blisters to heal, but the herpes virus remains dormant in the facial nerve, it might reoccurs in the future.

HSV-1 affected 57.7% of Americans tested in a 1999–2004 study. By age 50, 80%–90% of adults have the virus. More than 50 million adults in the U.S. develop symptomatic episodes every year. Cold sore has a rate of frequency that varies from rare episodes to 12 or more recurrences per year. People with the condition typically experience one to three attacks annually. The frequency and severity of outbreaks generally decrease over time.
According to WebMD, you can’t cure HSV or a cold sore, but you can alleviate the pain it causes by avoiding spicy or acidic foods, applying ice, and using over-the-counter remedies. Look for medicines that contain numbing agents such as phenol and menthol to reduce cracking and soften scabs. Abreva is an over-the-counter topical remedy used to help speed healing and minimize pain from a cold sore.

If your cold sore is especially painful or irritating, your doctor may prescribe an anesthetic gel to alleviate pain or an antiviral oral medication to speed healing or prevent recurrence. You can follow the instructions bellow, to prevent or minimize the cold sore effect.

It’s important to remember to wash your hands after touching a cold sore. Don’t rub your eyes after touching your cold sore; you could develop an ocular herpes infection, which may lead to blindness if left untreated. Don’t touch your genitals after touching your cold sore; you could develop genital herpes. Replace your toothbrush. Don’t kiss someone who has a cold sore or use that person’s utensils, towels, or razors. Apply sunscreen to the face and lips before prolonged exposure to the sun. Cold sores could get complicated with bacterial infections, so keeping them clean, and avoid irritants is important.