Orthodontists are able to achieve attractive results with traditional braces moving several teeth into a better position. In a way, braces are the original “smile makeover.”
But orthodontic treatment can also be useful if only a few teeth (like the two upper front teeth) need to be moved slightly. A treatment known as minor tooth movement takes only a few months as opposed to years for traditional multiple teeth movement, and with removable appliances that may use small springs or elastics to place gentle pressure on teeth to move them.
So, what constitutes a minor tooth movement scenario? As with any dental condition, the first step is a complete dental examination, particularly the bite. We also need to determine if enough room exists to close any space without compromising the bite with the opposing teeth, and if the teeth and their roots are in a good position to allow minor movement — otherwise, more extensive treatment may be called for. The surrounding gum tissues and bone also need to be healthy and disease-free, especially in adults.
We may also need to look more closely at the actual cause for a front tooth gap. If the gap is the result of the tongue habitually pressing against the back of the teeth and pushing them forward, it may then be difficult or impossible to close the gap with minor tooth movement techniques. The cause may also originate from the frenum (a thin, muscular tissue that rises up from between the upper front teeth toward the lip) if it has extended too far between the teeth. In this case we may first need to surgically remove some of the frenum tissue before attempting orthodontics or the teeth may gradually move back apart after closing the gap.
Although minor tooth movement normally doesn’t take as long as braces, it may still require several months. And just like with braces, you will need to wear a retainer for several months afterward until the bone stabilizes around the new position. Still, minor tooth movement could have a major impact on your smile.
If you would like more information on orthodontic treatments, 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 “Minor Tooth Movement.”
On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.
“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”
Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.
Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.
A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.
Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.
So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.
If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”
Finally — your braces are off! A look in the mirror reveals a straighter, more attractive smile. Unfortunately, it may also show something not so attractive — tiny, chalky spots on your teeth.
These “white spot lesions” are created by acid remaining too long in contact with the enamel, causing it to lose minerals at those places. The acid comes from plaque (a thin film of bacteria and food particles) that brushing and flossing fail to remove. Snacking on foods and beverages with added sugar or high acid content may also make it worse.
Besides their unattractiveness, these spots can lead to tooth decay — so it’s important to try to prevent it. Limiting sugar-added snacks and acidic beverages to mealtimes will help, but the main key to preventing lesions is more thorough brushing and flossing.
Because of the braces, this can take longer to do than if you weren’t wearing them. It’s also more difficult maneuvering your toothbrush or floss around the orthodontic hardware. You can improve thoroughness and access by using a powered brush or one specially designed for use with braces. And, a water flosser that removes plaque between teeth with a pulsating spray of water is an effective alternative to string floss.
Even if (despite your best efforts) some lesions form, we can still treat them. Resuming normal hygiene practices after braces may take care of it — if not, we can strengthen the affected areas of the enamel with pastes, gels, or other topical fluoride applications. We can also use a technique called caries infiltration that injects tooth-colored resin (often used for cosmetic dentistry) beneath the white spot to harden it, and leave it more translucent in resemblance of normal enamel. If these fail to produce satisfactory results, we can use cosmetic bonding that permanently covers the tooth with resin or veneers.
It’s best, though, if you can prevent the lesions while you’re wearing braces. Besides daily hygiene, be sure to keep up regular dental visits for teeth cleaning. Your efforts will go a long way toward keeping your newly aligned teeth bright and blemish-free.
If you would like more information on dental care and hygiene 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 “White Spots on Teeth during Orthodontic Treatment.”
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?”
You may not always be able to tell if your child's bite isn't developing properly. Â That's why you should have them undergo an orthodontic evaluation around age 6 to uncover any emerging problems with tooth misalignment.
Still, there are some visible signs all's not well with their bite. As the primary (baby) teeth give way, the permanent teeth erupt sequentially around ages 6 to 8. As they come in, you should notice that each tooth fits uniformly next to each other without excessive gaps or, on the other end of the spectrum, not crowded together in crooked fashion. Upper teeth should also fit slightly over the lower teeth when the jaws are shut.
If their teeth appearance deviates from these norms, they may have a bite problem. Here are 4 abnormalities you should watch for.
Underbite or deep bite. As we mentioned, the front teeth should cover the lower teeth with the jaws shut. In an underbite, the reverse happens — the lower teeth are in front of the upper teeth. It's also a problem if the upper teeth cover the lower teeth too much (often referred to as “deeply”).
Open bite. This occurs when there's a gap between the upper and lower front teeth while the jaws are shut together. One possible cause is late thumb sucking, which can put undue pressure on the front teeth and cause them to develop too far forward while forcing the bottom front teeth further backwards.
Crossbites. This kind of bite occurs when some of the teeth don't fit properly over their counterparts, while others do. Crossbites can occur anywhere in the mouth, for example the upper front teeth fitting behind the lower front teeth while the back teeth overlap normally, or the reverse (front normal, back abnormal).
Misalignments and Abnormal Eruptions. Sometimes upper teeth may align too far forward, a situation known as protrusion. Conversely, lower teeth (or the jaw itself) may come in too far back (retrusion). Because a primary tooth might be out of position or not lost in the proper sequence, a permanent tooth might noticeably erupt out of its proper position.
If you notice any of these situations with your child's teeth see your dentist or orthodontist soon for a full examination. If caught early, we may be able to take action that will lessen or even eliminate the problem.
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