Beyond Your Smile
STRAIGHT TEETH ARE HEALTHY FOR YOUR FACE
Welcome to our new Blog! My orthodontic practice, Beyond Your Smile, is based on the idea that the dental arch – the shape into which your teeth are aligned – is an anatomical structure of the face. As an orthodontist, I raised a question: can a dental arch from which teeth have been extracted, or that includes stripped down teeth, actually be considered a “normal” anatomical structure in terms of size and shape? While looking for the answer, I developed a breakthrough orthodontic technique called Dentometrics.
There sometimes are cases that call for limited orthodontic treatment to be carried out in conjunction with restorative procedures in order to attain the desired results. For instance, when extracted or missing teeth cause other teeth to drift out of alignment, temporary use of a “space maintainer” can keep the space open until a fixed bridge can be introduced. In cases where people with under- or over-sized teeth have abnormal spacing between their teeth, orthodontic treatment may be used to redistribute the space and de-emphasize the size difference between neighboring teeth. Similarly, straightening misaligned front teeth before the placement of porcelain veneers or crowns can eliminate the need for major tooth reduction or oversized restorations.
P.S. Adjunctive orthodontic treatment is frequently undertaken in conjunction with periodontal treatment to improve the health of the gums.
One potential benefit of having a youngster undergo an orthodontic evaluation by age seven is that the exam can uncover breathing problems that may benefit from orthodontic treatment. The fact is that harmful nursing and pacifier habits can encourage the upper jaw (maxilla) to narrow. Since the bone tissue of the maxilla also forms the lower framework of the nasal passages, a narrowed upper jaw may lead to restricted breathing through the nose, which forces mouth-breathing. Not only an unattractive habit, mouth-breathing can cause drying of the mouth to the point where teeth are deprived of saliva’s protective effect and gums may lose their elasticity. Early treatment that widens the upper palate may help alleviate this problem.
P.S. Children who are not treated for mouth-breathing can develop long, thin faces, thin mouths, high palate, crooked teeth, and exposed gums when smiling.
HOW DO YOUR TEETH LINE UP?
It can be visually jarring when the line between the two upper front teeth is not consistent with the midline of the face. To find the midline of your face, locate the halfway point between the pupils of your eyes. Then, draw an imaginary line downward. The dividing line between the two central incisors should fall on this line. Failure to do so poses no significance physiologically, but an extreme variation may detract from personal appearance. If so, orthodontic therapy can correct the condition. In some severe cases, surgery may also be called into play as part of the treatment. Believe it or not, Tom Cruise underwent orthodontic treatment years ago to correct this very problem.
P.S. It may be misleading to use the nose to reference the midline of the face because nearly all of us have noses that deviate to one side or the other.
The “wisdom” teeth (third molars) are the ones that come in at the very back of the mouth, usually between the ages of 17 and 24. While some patients automatically assume that these are largely superfluous teeth (our ancestors had greater need for them due to their generally more primitive diets), that isn’t necessarily the case. If there is sufficient room in the mouth to accommodate these third molars and they erupt properly, they may remain. However, if there is not enough room for them and/or they were to become impacted (unerupted), it is generally recommended that they be extracted. While most orthodontic treatment is conducted before wisdom teeth appear, the orthodontist can monitor their progress and make adjustments accordingly.
P.S. When wisdom teeth are fully visible and functional, they can be aligned the same as any other tooth in the mouth during orthodontic treatment.
TOOTH STRAIGHTENING BY MAIL?
While the Invisalign tooth-straightening system uses a series of clear plastic aligners to straighten teeth under an orthodontist’s supervision, some companies have been offering direct-to-consumer clear aligners that bypass the orthodontist. Is this a good idea? The American Association of Orthodontists doesn’t think so and warns consumers against moving teeth without an initial exam and continuing supervision by an orthodontist. To begin with, bypassing the orthodontist completely omits an all-important oral health assessment and diagnosis. Beyond that, consumers of mail-order aligners must take their own impressions, which form the basis of treatment. Most direct-to-consumer companies only offer 20 sequential aligners, while orthodontists often use three to four times that number. Tooth straightening at home poses risks that outweigh any monetary savings.
P.S. Many orthodontists deem that an in-person exam is critical to looking for untreated cavities and underlying gum infections that should be addressed before any teeth straightening is done.
Whether it is due to wanting to project a better image on social media sites or a desire to get ahead at work, more adults are seeking to undergo orthodontic treatment than ever before. Just as increasing numbers of adults have embraced minimally invasive skin rejuvenating techniques to improve their appearance, many are also recognizing that a straight-toothed smile is an achievable form of self-improvement. Of particular interest to older patients are fixed braces with clear plastic or tooth-colored ceramic brackets, clear aligners, and lingual braces (which are fitted to the backside of the teeth, thereby rendering them invisible to onlookers). These orthodontic appliances and tooth aligners get the desired results without drawing undue attention.
P.S. Many adults who did not receive needed orthodontic treatment as adolescents are now choosing to undergo treatment with the knowledge that their appearance is largely assessed on the basis of their smile.
HOLD YOUR POSITIONS
No one likes to lose ground after winning hard-fought gains. When orthodontic patients reach a point when their active treatment is over, they must come to realize that one more important step in treatment remains. The final stage of treatment, called “retention,” involves the use of retainers to hold the teeth in their corrected positions until the patient’s bones and gums adapt to the change. With this goal in mind, patients must wear their retainers exactly as they have been instructed. Otherwise, they run the risk of having their teeth return to their original positions, thereby negating the effects of treatment. The retention process takes time to ensure that the results of treatment will be maintained.
P.S. The Hawley retainer is a removable retainer made of a combination of acrylic and wires that is specially made from impressions of patients’ teeth so that it will fit snugly and comfortably.
What you may not know about crooked teeth is that it is not simply an aesthetic issue. Often, it indicates a developmental deformity of mid-facial structures. Before teeth erupt into the mouth, they develop within the facial-jaw bones. If these bones are not perfectly formed, the teeth will not be aligned.
Other factors contributing to deformed facial bones are injury or decay of baby teeth leading to early exfoliation (tooth loss), and bad oral habits. The result is the displacement of teeth and conjoining structures.
In any case, it is important to understand crooked teeth beyond aesthetics. Please follow this blog in the weeks and months ahead to find out how orthodontic treatment can benefit the overall health of you and your family.
THE THRUST OF THE MATTER
“Tongue thrusting” is the term used to describe the abnormal habit of placing the tongue against the upper front teeth while swallowing. This action exerts one to six pounds of pressure against the structure of the mouth. As a result, the front teeth are pushed forward into abnormal positions, causing an “open bite” in which the top and bottom front teeth do not meet vertically. While nearly all infants are tongue-thrusters, most children will outgrow the habit and adopt a normal swallowing pattern by age six. Only three percent of children will continue to tongue thrust by age twelve. Few people other than dental professionals are trained to recognize the habit. Early diagnosis and treatment can restore a normal bite.
P.S. A persistent tongue-thrusting habit can often lead to a protrusion of the upper front teeth and constriction of the dental arches.
WATCH YOUR LIP
Some people have a habit of biting their lower lips, which not only leads to chapped lips, but it also pushes teeth out of their proper positions. When the lower lip is persistently bitten or sucked, it may cause the upper front teeth to jut out over the lowers. Conversely, biting or sucking the top lip can cause the top front teeth to be pushed in. In either case, orthodontic treatment may be necessary to coax teeth back to their proper positions. The best approach is one that prevents the habit before it causes damage. Parents who notice that their children bite their lips after their permanent teeth begin to come in should see the orthodontist for an evaluation.
P.S. A lip-biting habit can be broken with the use of an orthodontic appliance known as a “lip bumper.”
When an improper alignment of the molars leads the lower front teeth to sit too far behind the upper front teeth, the malocclusion is known as “overjet.” Protruding upper teeth are commonly associated with a lower jaw that is deficient or underdeveloped in proportion to the upper jaw. The condition is technically known as excessive overjet and is popularly known as “buck teeth.” This type of malocclusion may develop for a variety of reasons, ranging from crowded teeth that push the top incisors forward to habits such as thumb-sucking. In addition, the abnormal swallowing habit known as “tongue-thrusting” can exacerbate the condition. Orthodontic treatment provides all the necessary correction for a more attractive and better-functioning bite.
P.S. Overjet can lead to upper front teeth that are prone to injury.
When orthodontists use braces to move teeth, they rely on a process known as “bone remodeling.” As the braces exert a constant, gentle force on the tooth root, pressure is transferred to the surrounding (alveolar) bone and causes the bone to dissolve in the path of movement while new bone grows in its wake. As one might imagine, this is a slow process. However, in an effort to cut treatment time, the “Aevo System” utilizes low-intensity, pulsed ultrasound to accelerate alveolar bone remodeling. Non-invasive, low-intensity pulsed ultrasound (LIPUS) therapies have previously proven effective in accelerating the repair of long-bone fractures. Now, it is being employed as an at-home treatment to accelerate bone remodeling and reduce tooth root resorption.
P.S. Bone remodeling tends to occur with greater speed in young people because younger bone is less dense, has a greater blood supply, and has more cells available for remodeling.