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- Are Bad Habits Affecting Your Smile?
- Your teeth can be moved with very slight pressure in the right or wrong direction. Bad habits such as thumb or finger sucking, fingernail biting, tongue thrusting and mouth breathing can move teeth in the wrong direction and affect jaw growth. Before orthodontic treatment can succeed these habits must permanently stop. Some orthodontic braces and therapies can help you stop these bad habits.
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Patient's Handbook
- 4 Bicuspid Extraction
- In this orthodontic situation the size of the jaw is not in balance with the size of the teeth and it is necessary to remove the four bicuspid teeth to make room. The doctor may use this space to eliminate the crowding and properly align teeth. The spaces will be completely closed at the end of the treatment and the smile will appear more balanced.
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- TMJ
- Temporomandibular Joint Dysfunction "TMJ" TMJ Dysfunction refers to a family of problems related to the jaw (temporomandubular or TM) joint. The structures that make it possible to open and close the mouth are very specialized and work together when you chew, speak and swallow. These structures include muscles, ligaments, bone and jaw joints. Any problem that prevents this complete system from working properly may result in a TMJ disorder.
When muscles and joints do not work properly, the muscles may spasm or cramp. Consequently, this spasm can become part of a cycle that results in tissue damage, pain, muscle tenderness and more spasms.
Oral habits that are often associated with stress are most commonly factors that can cause dysfunction and pain of the jaw joint and its muscles. (About 90% of headaches result from tension.) TMJ problems may also be caused by jaw, head and neck injuries or by diseases such as arthritis.
Some of the common signs and symptoms of TMJ disorders include:- Pain in or around the ear
- Stuffiness or ringing in the ears
- Tenderness of the jaw muscles
- Clicking or popping in the jaw
- Jaws that lock open or closed
- Pain when yawning or chewing
- Head and neck aches
If you have been experiencing these conditions, the doctor will conduct a complete exam to properly diagnose the causes. Common methods for orthodontic treatment of TMJ disorders include braces such as a bite plate, a mouth splint and braces. Medication, biofeedback, physical therapy, and even surgery may be needed in severe cases. The doctor will discuss your unique condition and possible treatment options for you.
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- Upper Expansion
- One orthodontic difficulty is caused by an upper jaw that is too narrow. When children are still growing, the doctor will use an expander to guide natural growth and widen the upper jaw. This will create enough room for the crowded teeth and make sure the upper and lower teeth fit together properly.
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- Lip Bumper
- A lip bumper uses the pressure of the lips to create space along the entire dental arch. This will help the doctor eliminate crowding in the lower teeth. Normally, the lip bumper is worn all the time. It is comfortable to wear and doesn't interfere with the lip or its motion when speaking or eating.
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- Extractions
- Are Your Teeth Too Big?
A person rarely will have too many teeth. However, when teeth are very large, it looks, sometimes, as if there are too many teeth in the mouth. We call this "crowding." At age seven or even earlier, we can predict if the adult mouth will be crowded.
If severe crowding will result as you get older, we know that certain permanent teeth will have to be removed. This will allow the remaining teeth to erupt into a more normal position.
Stubborn Baby Teeth
If your permanent front teeth do not have room enough to erupt properly, then it is often advisable to remove certain baby teeth in sequence. This is called "serial extraction". This helps to minimize the severe crowding and rotations of the front teeth. It also reduces the chance for tooth decay and tissue damage that can occur when teeth are crowded.
The result is straighter teeth and a healthier, better looking mouth. The removal of baby teeth does not permanently solve the problem, nor does it eliminate the necessity for removal of permanent teeth later. However, we have found that this is one of the kindest procedures for guiding permanent teeth into a more normal relationship.
Serial extraction affects each individual jaw separately but does nothing to coordinate the two. The way the two jaws meet and relate to each other is called our "bite".
Orthodontic braces are usually required at a later date to complete the correction. Only certain patients are candidates for serial extractions. Often it is best to keep the primary teeth so that we have something to push against to make room for permanent teeth and help reduce bone shrinkage which occurs when teeth are extracted.
The Extraction Letter
If we find that you need tooth extractions, you will be given a referral to a local dentist or oral surgeon for the procedure. This paper is to be taken to the doctor so he knows what teeth are to be removed. You will be advised as to when the extractions need to be done. Our receptionist can help you coordinate your appointments. (Please keep your appointment with our office even if the extraction is not done.)
Exposing Teeth
When a permanent tooth is trapped from erupting, we will refer you to an oral surgeon. This special doctor will open your gum and put a little button and gold chain on the hidden tooth. Then you will come to our office to have the chain attached to your archwire. Over time the tooth will be moved into its proper place.
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- Retainers
- At the completion of the first and second phases of your orthodontic treatment you begin the period we call "retention." To retain means to hold. In the case of your teeth, they must be held in their new positions.
Teeth have good memories! If we did not retain the teeth following orthodontic movement, they would tend to move back to their original positions.
The two most common types of retainers we use are "Invisible" and "Hawely" retainers.
Invisible retainers are made of a clear, durable plastic-type material that is designed to fit snugly right over your teeth.
The Hawely is made with colored acrylic and a wire that goes around the outside of your teeth to prevent movement.
Positioner
On certain types of completed cases we find it wise to use a special rubber or plastic mouthpiece. By making minor corrections on the plaster models of your teeth, we are able to make subtle changes. Should you have this type of finishing appliance you will receive specific instructions concerning its care and wear.
How Long Do I Wear Them?
Retainers should be worn constantly* for the first six weeks after your braces are removed. (*Except, of course, while you are eating or brushing.) After that you may only need to wear them a certain number of hours or even just at night, and eventually you will not need to wear them every day. Your retainers are to help you keep your bite right by wearing them for the rest of your life. The orthodontic technicians and doctor will keep you informed on the time that you need to wear them.
Please bring your retainers to every appointment in our office! But remember: We will never tell you to totally stop wearing your retainers! The retainer's plastic taste will disappear quickly, your speech will return to normal and soreness will go away after a few days of wearing your retainer. If you have a localized sore spot after three or four days, call for an appointment.
Your teeth can move throughout your life whether you've worn braces or not, with or without wisdom teeth. For that reason we ask our patients to keep their retainers for a lifetime. You may only have to try them on once in awhile (no less than once a month.) But you should always be sure your retainers fit. Their proper fitting assures your teeth are not moving.
How Do I Care For My Retainers?
Clean retainers by brushing them with toothpaste and occasionally with denture cleaner, using warm (not hot) water. When retainers are not in your mouth, keep them in the box given you. NEVER put your retainers on a lunch tray, in a napkin or in your pocket. Resist the urge to play with the retainers with your tongue. Keep them away from pets who like to chew! Please notify our office if you break or lose your retainers. There may be an additional charge for repair or replacement.
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- Orthodontic Treatment
The initial visit to our office is an examination which allows us to review your medical and dental history and study the need for orthodontic care.
If treatment is pursued, you may be scheduled for "records" (x-rays, plaster models and photographs) to aid diagnosis and treatment planning. The treatment would then begin with a series of appointments to cover oral hygiene habits, placement of the braces and training about appliance wear and care.
Does It Hurt? Orthodontic treatment requires the use of braces to move teeth by applying gentle pressure or force. When such pressure is applied to the teeth, the patient may feel some tenderness after an interval of about six to eight hours. This tenderness usually persist for a few days. The intensity and duration of the discomfort will vary with each patient.
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- Glossary of Orthodontic Terms
- Archwire- A removable wire that fits around the arch into the bracket slot.
- Band- A ring of metal that is cemented around a tooth.
- Bite- Another name for the way your teeth fit together when you bring them into a normal chewing position.
- Bond- The seal created by orthodontic cement to hold appliances in place.
- Bracket- The appliance cemented to the tooth that holds the archwire.
- Crossbite- When a lower tooth slips to the outside of an upper tooth. (Your upper teeth should fit slightly on the outside of your lower teeth.)
- Deband- The occasion of having your braces removed and transitioning into the retension phase of treatment.
- Elastics- Small rubber band that are hooked from one tooth to another, to serve as an activating force to move teeth.
- Headgear- This is the means by which we use a strap around the back of the neck or the top of the head to pull from the outside to move the teeth.
- Headgear Band- A band on the upper molars where inner bow of headgear fits into a small tube.
- Headplate- This is a "cephalometric" x-ray that we take of your head, from side to side, and sometimes from the front. This allows us to measure the growth of your face. Small plastic rods rest in your ears as we take the picture to help us hold your head in the exact position we need.
- Hooks- A small wire loop used to attach elastics (rubber bands). Some brackets have built-in hooks. Impressions- We use a soft clay-like material, which is placed in a small tray that fits over your teeth. In just a few minutes, your teeth leave a print in this material. This creates a mold for us to use.
- Ligature Wire-The tiny wire that ties archwires into brackets.
- Loose Band or Bracket- The bond has been broken between the band and the tooth. This is an emergency situation. See the section on "Emergencies".
- Malocclusion- The technical term for crooked teeth or an improper bite.
- Models- Models are the white plaster records of your teeth which come from the impressions. We pour the white plaster into the mold. When the plaster hardens we can use it as a model to make your removable appliances and have an initial record for the progress of your treatment.
- Neckstrap- The part of your headgear that fits around your neck.
- Overbite or Underbite- The term to describe the upper teeth biting too far over or behind the lower teeth causing severe problems and facial changes.
- Panorex- This is a "panoramic" x-ray that allows us to view the upper and lower jaw, all the teeth, supporting bone, sinuses and a non-detailed look at the jaw joint. The Panorex machine will move in a circle around your head. It is very important that you do not move while it is in operation.
- Separator- Small component that is placed between your teeth to make room for band placement. See the page on "Separators".
- Ties and Chain- Rubber modules that tie the archwires into the brackets.
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- Emergencies
- Please notify the office right away if an emergency should arise. Often we may be able to instruct you over the phone so that you can take care of a problem at home. We Need To Know RIGHT AWAY if you are in pain from a poking wire or other problem.
If you call and we're not in the office, follow the instructions left on the recording or leave a message. We'll return your call as soon as possible.
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- Eating Habits and Orthodontics
- Foods That Are Appealing But Damaging to Your Orthodontic Appliances. A careful orthodontic patient can probably eat almost any food and do no damage to his or her braces. However, these types of food may cause trouble, as may other foods. Use common sense or, if you are in doubt, ask us about a particular food you enjoy eating.
AVOID EATING:- HARD FOODS
- STICKY AND/OR CHEWY FOODS
- FOODS HIGH IN SUGAR CONTENT
- HARD FOODS may do damage by bending wires, loosening cement under the bands or breaking the little brackets and tubes which are attached.
- STICKY AND/OR CHEWY FOODS damage braces by bending wires and pulling cement loose.
- FOOD HIGH IN SUGAR CONTENT should be avoided whenever possible. If you eat any of them, brush your teeth immediately. If it's not convenient to brush, always rinse your mouth with clear water after eating very sweet food such as cake or pie.
DO NOT EAT- Popcorn, Nuts, Peanut Brittle.
- Ice (not even if you're careful).
- Lemons (pure lemon juice can hurt your tooth enamel).
- Corn-on-the-cob (cut it off the cob).
- Corn chips, crisp taco shells, corn nuts, sunflower seeds in the shell.
- Taffy, Caramels, Starburst, Now-N-Later
- Jolly Ranchers, fruit chews, beef jerky. etc.
- Bubble Gum - a thousand times NO!
- Pizza Crust (the hard outer edge)
MAYBE With EXTREME Care- Carrot Sticks (only if you cut into carrot curls that are thin).
- Apples (only if cut into thin wedges; don't bite).
- Hard French Bread (only if you take small pieces and are very careful).
- Diet Drinks.
- Sugarless gum (not bubble) if in small amounts. Check with your doctor for approval.
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- Thumb Habit Appliance
- This is a common but unhealthy habit of many children and adults. Finger sucking or even habitually holding glasses or a pipe in your teeth can move teeth out of position. Children's jaws are still developing, finger sucking may contribute to malformation. In addition to jaw and tooth alignment problems, this habit may contribute to improper swallowing. The Thumb Habit Appliance consists of bands cemented onto the first molars that holds special prongs. These prongs point outward to poke you and discourage the habit of putting your thumb or fingers in your mouth.
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- Tongue Thrust Therapy
You swallow about 2,000 times each day. Even when you are sleeping! Each time you swallow your tongue puts four to six pounds of pressure on your teeth. (It only takes two ounces to move a tooth!) Proper swallowing is important to your dental health. Some people have the unhealthy habit of pushing their tongue forward when swallowing. This puts pressure on the teeth and can cause improper development and unwanted tooth movement.
Proper swallowing for a proper bite:- Bite down hard with teeth together and the tip of your tongue on the roof of your mouth behind, but not touching, your front teeth. Swallow.
- Practice swallowing correctly 30 times every day in front of a mirror. Separate your lips in order to see that you are not pushing your tongue between your teeth.
- Keep one small elastic band in your mouth to remind yourself to swallow correctly. Start with one hour then increase. Keep the elastic on the right spot at the roof of your mouth.
- Drink with a straw. This keeps the tongue in the proper place while swallowing and also helps train the tongue.
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- Mouth Breathing
- Continual breathing through your mouth can cause orthodontic problems. If you have this habit you may be referred to a speech therapist or an Ear, Nose and Throat (ENT) specialist with your orthodontic care.
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- Braces
The Orthodontic Appliance (commonly called braces) helps the Orthodontist control and move the teeth with maximum accuracy and efficiency.
Bonded Brackets
If this method is used in your treatment, these bonded brackets are the same as those welded to the bands. In some cases, bonding directly to the teeth is more effective than conventional bands.
Bands
These are thin strips of metal carefully fitted to the tooth and cemented into place. Little handles on the metal strips give the Orthodontist a way of grasping and controlling the teeth.
Rubber Bands
Rubber bands provide a force which helps teeth move. This is usually done by applying pressure of one group of teeth against the other. Unless otherwise instructed, rubber bands must be worn 24 hours per day. Failure to do so would cause the teeth not to move properly.
Arch Wires
Arch wires are the guide or track for the teeth to be moved. The arch wire is adjusted every time you visit the orthodontist. Each time it is moved, the tooth is closer to being where it should be.
Elastics
During previous phases of treatment, small "elastics" or rubber bands are used as a gentle but continuous force to help individual tooth movement and to align one arch to the other. Teeth have never failed to move when elastics are worn consistently as directed! But, when they are worn one day and left off the next, your treatment slows to a standstill. Why? Your tooth moves back and forth and actually sets up a resistance that prevents normal movement.
Follow instructions EXACTLY and you will get better, faster, more comfortable results. Usually, after three days, discomfort from the elastics lessens. However, if you leave them off "to let my teeth feel better", your teeth could shift back to the original positions -- even after just one day! In fact, if you miss just one day of wearing elastics you will add three weeks to your treatment time. Elastics come in different sizes, strengths and colors. Your orthodontic technician will tell you which kind to use. If you are running low on your home supply, come by the office for a fresh pack. Fresh elastics should be put on after every meal.
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- Separators
- Separators are small doughnut-shaped elastics or springs placed between your teeth. They help us to create space between your teeth so that "bands" can be accuratelv placed. Your teeth will be very sensitive when we place the separators. It will feel like something is caught between your teeth. This discomfort should disappear in a few days. To relieve soreness, rinse your mouth with hot salt water and/or take a pain reliever. You can also use a topical anesthetic such as Orajel or Anbesol.
Please follow the manufacturer's directions. A separator usually needs three days to a few weeks to do it's job. If a separator comes out soon after it is placed, please call our office to have it replaced. If it comes out a day or two before your band fitting appointment, then it shows that enough space has been created and you can leave it out.
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