How to Brush Your Teeth Properly

Flashing your best, most healthy smile means brushing well and often. In fact, the American Dental Association recommends brushing teeth twice a day for dental hygiene and to help promote dental health. Make the most of that time by giving your brushing technique a refresher.

Tooth Brushing Technique
You’ve been brushing your teeth your whole life, but are you getting the most from your efforts? The following technique will help you get the most thorough clean.

On the outer and inner surfaces, brush your teeth at a 45-degree angle in short half-tooth-wide strokes against the gum line.
On chewing surfaces, hold the brush flat and brush back and forth.
On inside surfaces of front teeth, tilt brush vertically and use gentle up and down strokes with toe of brush.
Brush the tongue in a back-to-front sweeping motion to remove food particles and freshen your mouth.

Remember to spend at least 30 seconds on each quadrant of your mouth, adding up to two minutes each time you brush.
Choose the Right Toothpaste
Crest toothpastes contain fluoride, which helps strengthen weak spots and prevent tooth cavities. And whether you’re looking for tartar protection, a rush of flavor, or dentist-inspired protection, we’ve got a toothpaste that’s right for you.

Ready for a brushing experience that awakens the senses? Try our flavor experience toothpastes.
Looking for solutions such as enamel protection? View our dentist-inspired products.
Have sensitive teeth? Try our sensitivity toothpastes.

Change Your Toothbrush
Most dental professionals recommend replacing your toothbrush every three months. To remind yourself, write the date you should change your toothbrush in permanent marker on the handle.

Source: Crest

When Is It Too Old To Get Braces

As braces have become less bulky and visible in recent years, more and more adults are wearing them, for a variety of reasons. Some adults want to correct problems with their teeth or jaws before they cause serious or further damage. Others want to feel better about their appearance by addressing longstanding cosmetic concerns. Keep in mind that even “cosmetic” problems can cause real damage over time. Teeth and jaws that are not aligned properly can lead to premature wear and tear, advanced tooth decay and gum disease, dentures or other reconstructive solutions and even more extensive surgery to correct serious problems.

New techniques and the advent of clear, less noticeable braces means that adults are increasingly turning to braces to correct:

Gaps between teeth (spacing)

Teeth that push against one another (crowding)

Crooked teeth

Overbites

Underbites

Crossbites

How do I know if adult braces are right for me?
If you think you might benefit from braces, ask your dentist to recommend an orthodontist — someone specially trained to fix problems with teeth that are not aligned properly. The orthodontist will look at your teeth and maybe take X-rays to study the underlying bone structure. Based on what he or she finds, a treatment plan will be recommended. While braces are a popular option for fixing misaligned teeth, an orthodontist can tell you whether you may benefit more from other types of orthodontics like removable retainers, headgear or aligners.

Source: Colgate.com

Orthodontics: Braces and More

Orthodontics is a specialty field of dentistry that diagnoses, prevents and treats irregularities of the teeth and face. Treatment can correct an irregular or “bad” bite, also known as a malocclusion.

Orthodontic care involves the use of appliances. There are two main types. Braces are attached to the teeth. Removable appliances are put in and taken out by the patient. These devices can be used to:

Straighten teeth
Correct an irregular bite
Close unsightly gaps
Bring teeth and lips into proper alignment

They also can help with procedures in other areas of dentistry. Examples include cosmetic and implant dentistry.

In young children, orthodontic treatment also may guide proper jaw growth and permanent tooth eruption.

Bite Irregularities

Many people’s teeth are irregular in some way. For example, teeth may be slightly crowded or unevenly spaced. In fact, experts say many adults have an irregular bite. Sometimes the main problem with a “bad” bite is appearance. In other cases, it can cause difficulty in chewing or talking.

You may have inherited an irregular bite, but not all bite problems are genetic. Other causes include:

Trauma — When teeth are broken or knocked out and then replaced, they may fuse with the bone that surrounds them. This is called ankylosis or abnormal root fusion to the bone. If this happens in a growing child, the teeth will not be able to line up properly in the jaw. An irregular bite will result.

Prolonged thumb sucking or pacifier use — These habits can cause bite problems. For example, it may cause your upper teeth to protrude (stick out) in front of your lower teeth. A tongue-thrusting habit when you swallow can cause a similar problem.
Premature loss of primary (baby) teeth — If a primary (baby) tooth is lost too early, the permanent tooth loses its guide. It can drift or come into the mouth (erupt) incorrectly. In some cases, the permanent teeth may be crowded, or they may come in only partially. Sometimes the teeth next to the lost primary tooth can move or tilt into the space left by the missing tooth. This may prevent the permanent tooth from coming in.

Why Seek Orthodontic Care?

Whether to seek orthodontic care is a personal decision. Many people live with crowding, overbites or other types of bite problems and do not seek treatment. However, many people feel more comfortable and self-confident with properly aligned, attractive teeth. Orthodontic care can help improve appearance and build self-confidence. It also may help you to chew better or speak more clearly.

Orthodontic care is not just cosmetic in nature. It also can benefit long-term dental health. Straight, properly aligned teeth are easier to brush and floss. This can help reduce the risk of tooth decay. It also can help prevent gingivitis, an inflammation that damages gums. Gingivitis may lead to infection, which occurs when bacteria cluster around the area where the teeth meet the gums. Untreated gingivitis can lead to periodontitis. This type of gum disease can destroy bone that surrounds the teeth and lead to tooth loss.

People with bad bites also may chew less efficiently. Some people with a severe bite problem may even have problems getting enough nutrition. This especially may occur when the jaws are not aligned correctly. Fixing bite problems can make it easier to chew and digest foods.

When the upper and lower front teeth don’t align right, people also can have speech difficulties. These can be corrected through orthodontic treatment, often combined with speech therapy.

Finally, orthodontic treatment can help to prevent premature wear of back tooth surfaces. As you bite down, your teeth withstand a tremendous amount of force. If your front teeth don’t meet properly, it can cause your back teeth to wear more.

Who Can Benefit From Orthodontic Care?

The American Association of Orthodontists recommends that children have an orthodontic screening no later than age 7. By then, enough of the permanent teeth have emerged to identify potential problems.

Don’t wait until all the permanent teeth erupt in the mouth. Starting orthodontic treatment early in life may have many advantages. For example, while children are still growing, expansion devices can be used to widen the palate. This can help teeth come in straighter by providing more space. It also may help to correct the way the top teeth and bottom teeth meet or come together. Such treatment should be done at an early age for best results.

Many people undergo orthodontic treatment during preteen and teenage years. At this time, most of the permanent teeth have come in and treatment can be most effective. About 3 million teenagers in the United States and Canada wear braces. Millions more would benefit from treatment.

An increasing number of adults now have orthodontic treatment as well. However, adult treatment can be more complicated. It may require more than one dental professional to fully correct a problem. For example, adult patients may be more susceptible to gum problems. They will need to take care of these problems before orthodontic treatment can begin. Sometimes they also have jaw alignment problems that require corrective surgery. One of the biggest limitations in adult treatment is that adults are no longer growing.

Types of Bad Bites

An improper bite doesn’t look good. That is the usual reason that people seek treatment from an orthodontist. In addition, an improper bite causes difficulty in chewing. In people with crowded teeth, it can lead to more cavities or gum disease. Treatment of an irregular bite can improve your overall oral health and stabilize your bite.

Incorrect bites are grouped into categories. Common bite problems include:

Crossbite — Here, the upper teeth rest significantly inside or outside the lower teeth. A crossbite often can make it difficult to bite or chew. It also may cause the jaw to shift to one side as it grows.

Crowding — Permanent teeth may not have room to move into the right position:

If there is not enough room for the teeth
If the teeth are unusually large compared with the size of the dental arch
If the jaw is narrower than it should be
Deep overbite — This occurs when the upper front teeth (incisors) overlap too far over the lower teeth. In some cases, the biting edges of the upper teeth touch the lower front gum tissue and the lower front teeth may bite into the roof of the mouth.

Underbite — A crossbite of the front teeth is commonly referred to as an underbite if the lower teeth are ahead of the upper teeth. This may also be a sign that the jaws are not in the correct position. Sometimes surgery is needed.

Open bite — If your upper and lower front teeth don’t meet when you bite down, this is called an open bite. This may make it impossible to bite off food with the front teeth. It also can affect speech. Because the front teeth don’t share equally in the biting force, the back teeth may receive too much pressure. This makes chewing less efficient. It can lead to premature wear of the back teeth.

Spacing problems — Some people have missing teeth or unusually small teeth in a normal sized jaw. This can result in large spaces between the teeth. People who have lost one or multiple teeth may have uneven spacing because adjacent teeth may drift into the unoccupied areas. Braces can be used to shift the position of these teeth so the missing tooth or teeth can be replaced.

Treatment: Braces and Retainers

Everyone has a slightly different bite, so treatment techniques vary. Braces are the most common approach. They help to move the teeth slowly by applying precise amounts of light pressure over a long period of time.

Most orthodontic treatments occur in two phases:

The active phase — Braces or other appliances are used to move the teeth into proper alignment and correct the bite.
The retention phase — A retainer is used to hold the teeth in their new positions for the long term.

In addition to braces, orthodontists sometimes use special appliances (called functional appliances) to direct the growth of the jaw in young children. These appliances are rarely used in adults. That’s because they are not effective after growth is complete.

Getting Braces
You can choose braces (brackets) made of metal, ceramic or plastic. However, orthodontic treatment is most often done using stainless steel brackets.

Ceramic or plastic brackets often are chosen for the sake of appearance. But plastic brackets may stain and discolor by the end of treatment. Bands made of plastic or ceramic also have more friction between the wire and brackets. This can increase treatment time. Your orthodontist will discuss the available options.

The cost of braces varies, but expect to pay between $2,000 and $6,000. The cost may depend on how severe the problem is. Some insurance plans may cover part of the cost. Others will not cover it at all.

Braces work by applying continuous pressure to move teeth in a specific direction. Braces are usually worn for about one to three years, depending on how severe your problem is. As treatment progresses, teeth change position. Your orthodontist will adjust the braces as needed.

A few decades ago, braces consisted of thick bands of steel wrapped around all of the teeth. These days, stronger bonding agents are available. Smaller braces can be used, and orthodontic bands rarely have to be used on front teeth.

When applying braces, the orthodontist will attach small brackets to your teeth with special dental bonding agents. He or she will then place wires called arch wires through the brackets. The arch wires usually are made of a variety of metal alloys. They act as tracks to create the “path of movement” that guides the teeth to their correct positions.

Wires made of clear or tooth-colored materials are less visible than stainless-steel wires. However, they are more expensive and may not work as well. Tiny elastic bands called ligatures also can be used to hold the arch wires to the brackets. Patients can choose from a multitude of colors at each visit.

Expect some minor discomfort for the first few days after getting braces. Your teeth may be sore. The wires, brackets and bands also may irritate your tongue, cheeks or lips. Your doctor will give you some special soft wax to cover any sharp areas on your braces that may be irritating you. Most of the discomfort disappears within a week or two. You also may have moderate discomfort when wires are changed or adjusted. Taking ibuprofen (Motrin, Advil) or other over-the-counter painkillers can help to ease any discomfort.

Wearing a Retainer
A retainer’s purpose is to maintain tooth positions after treatment is completed and braces are removed. Once your bite has been corrected, bone and gums need more time to stabilize around the teeth.

The recommended length of time for wearing a retainer varies. Most children and teenagers wear retainers until their early to mid-20s or until their wisdom teeth come in or are removed. You should strictly follow your orthodontist’s advice because he or she knows your treatment best.

Risks and Limitations of Orthodontic Care

There are few risks involved in orthodontic treatment. In rare cases, certain patients may have allergic reactions to the metal or latex. People with periodontal (gum) disease have a greater risk of problems during orthodontic treatment. That’s because their gums and the supporting bone may be more likely to break down. This can cause loosening and possible loss of teeth. Orthodontic treatment should not begin until all evidence of gum disease has been treated and eliminated.

It is also possible that root resorption (shortening of roots) may occur during orthodontic treatment. This is usually minor and not significant. In a few cases, however, it may be severe. This can jeopardize the life of the tooth or teeth affected.

Your orthodontist will discuss the risks of your particular treatment.

Your choices can affect whether you achieve the desired results from orthodontic treatment. Adults, in particular, may require treatment by several specialists. They may need implants, treatment of periodontal disease or even corrective jaw surgery in addition to braces.

Many times, results are limited because you don’t want the full treatment. However, compromises often can be reached that improve your condition, even if not ideally. The treatment options and expected outcomes depend on the individual. Not following the doctor’s instructions also can lead to less than ideal results. The orthodontist will review your options fully with you before beginning treatment.

Source: Aetna

What is Gingivitis?

Gingivitis is an inflammation of the gum tissues surrounding the teeth, and is an early stage of gum disease. If left untreated, gingivitis may progress to periodontitis, which can be a major cause of tooth loss in adults. Gingivitis can sometimes be painless and, therefore, people may be unaware they have it. Visit your dentist for an assessment to learn more about gingivitis and good oral hygiene.

What Causes Gingivitis
One of the primary factors contributing to gingivitis is plaque buildup, a sticky colorless deposit of bacteria that regularly forms on teeth. These bacteria build up and can create byproducts that can damage the gums.

While gingivitis is a milder and reversible form of gum disease, it may lead to more serious, destructive forms if left untreated.
Some Signs of Gingivitis

Mild inflammation of the gums due to plaque buildup
Red or swollen gums
Gums that bleed easily

How Can I Help Prevent Gingivitis?
The key is removing plaque, and that starts with good brushing habits. But it’s also essential to have the right products for the job. Crest recommends this oral care routine:

Brush twice a day with a soft-bristled or power toothbrush, such as the Oral-B® Vitality™ Precision Clean electric rechargeable brush. It removes up to two times more plaque than a regular manual toothbrush.
Be sure to use an anti-gingivitis and anti-plaque toothpaste containing fluoride to strengthen teeth and prevent decay, such as Crest® Pro-Health™ Toothpaste. When you brush with Crest Pro-Health Toothpaste, therapeutic stannous fluoride — an anti-microbial agent — helps kill harmful bacteria that cause plaque and gingivitis. All Crest Pro-Health toothpastes are triclosan free.
Rinse thoroughly after brushing with an anti-bacterial rinse, such as Crest Pro-Health Multi-Protection Rinse Mouthwash. It contains a clinically proven anti-microbial agent, cetylpyridinium chloride (CPC), which is attracted to bacteria in your mouth, making it effective at fighting plaque, gingivitis and bad breath.
Floss at least once a day to remove food particles and plaque between teeth with a product like Glide Floss, the #1 dentist-recommended floss brand. Glide gently stimulates gums and helps prevent gingivitis by removing plaque.
1.Removing plaque is an important step to help prevent gingivitis. Try using the Oral-B Vitality Precision Clean toothbrush along with Crest Pro-Health Toothpaste and Crest Pro-Health Multi-Protection Rinse Mouthwash for up to 7x better cleaning.*
Visit your dentist regularly for oral exams and cleanings.

* On teeth with regular use versus a regular manual brush and regular anti-cavity toothpaste.

Source: Crest

Diastema (Gap Between Teeth)

A diastema is a space or gap between two teeth. It appears most often between the two upper front teeth. However, gaps can occur between any two teeth.

A mismatch between the size of the jaw bones and the size of the teeth can cause either extra space between teeth or crowding of teeth. If the teeth are too small for the jaw bone, spaces between the teeth will occur. If the teeth are too big for the jaw, teeth will be crowded.

Spaces develop for a few other reasons as well.

Sometimes some teeth are missing or undersized. This happens most often with the upper lateral incisors (the teeth next to the two upper front teeth). That can cause the upper central incisors to develop a space.

A diastema also can be caused by an oversized labial frenum. The labial frenum is the piece of tissue that normally extends from the inside of your upper lip to the gum just above your two upper front teeth. In some situations, the labial frenum continues to grow and passes between the two front teeth. If this happens, it blocks the natural closing of the space between these teeth.

Habits can also lead to gaps between the teeth. Thumb sucking tends to pull the front teeth forward, creating gaps.

Spaces can develop from an incorrect swallowing reflex. For most people, the tongue presses against the roof of the mouth (palate) during swallowing. Some people develop a different reflex known as a tongue thrust. When they swallow, the tongue presses against the front teeth. Over time the pressure will push the front teeth forward. This can cause spaces to develop.

Periodontal (gum) disease results in the loss of the bone that supports the teeth. In people who have lost a lot of bone, the teeth can become loose. This movement can result in gaps between the front teeth.

Children may have temporary gaps as their baby teeth fall out. Most of these spaces close as the permanent teeth reach their final positions.

Symptoms

A diastema that occurs because of a mismatch between the teeth and the jaw does not have symptoms. However, spaces caused by a tongue thrust habit or periodontal disease will tend to expand or grow with time. The teeth may become loose, and discomfort or pain may occur, particularly during biting or chewing.

Diagnosis

You may notice a space when brushing or flossing. Your dentist can see spaces during an examination.

Expected Duration

If the gap was caused by a mismatch between the permanent teeth and the jaw size, the spaces can be expected to remain throughout life.

Gaps caused by a tongue thrust habit or periodontal disease can get larger with time.

Prevention

Not all spaces can be prevented. For example, if the reason for a space is a missing tooth or a mismatch between the teeth and the jaw size, the spaces cannot be prevented without treatment.

Maintaining your gum health is essential to good oral health. Regular flossing and brushing will help to prevent periodontal disease and its related bone loss.

People with a tongue thrust habit can re-learn to swallow by pushing their tongue up against their palate. Breaking this habit can prevent widening of the spaces between teeth.

Treatment

Sometimes, a diastema is part of a set of problems that require orthodontic treatment. In other cases, a diastema is the only problem. However, some people may seek treatment for reasons of appearance.

Some people get braces, which move the teeth together. Often, no matter where the diastema is, you must wear a full set of braces — on both your upper and lower teeth. That’s because moving any teeth affects your entire mouth.

If your lateral incisors are too small, your dentist may suggest widening them using crowns, veneers or bonding.

If you have a space because you are missing teeth, you might need more extensive dental repair. This might include dental implants, a bridge or a partial denture.

If a large labial frenum is causing the gap, the frenum can be reduced through surgery called a frenectomy. If a frenectomy is done in a younger child, the space may close on its own. If it is done in an older child or an adult, the space may need to be closed with braces.

If the gap is caused by periodontal disease, then periodontal treatment by a dentist or gum specialist (periodontist) is necessary. When gum health is restored, in many cases braces can be used to move the teeth into place. A splint can be used to attach teeth to other teeth and prevent them from moving again. In some cases, a bridge will be required to close the spaces.

When To Call a Professional

If you have a space between your teeth or see one in your child’s mouth, talk with your dentist. He or she will determine the reason for the space and may refer you to an orthodontist, a specialist in treatment with braces. The American Association of Orthodontists recommends that children be evaluated by an orthodontist by age 7. Treatment (if needed) may not begin right away. You and the orthodontist will discuss the overall treatment plan.

If your space is the result of periodontal disease, your dentist may refer you to a periodontist.

Prognosis

If a diastema is closed through orthodontics or dental repair, the space will tend to stay closed. However, to help prevent the space from coming back, wear your retainers as directed by your orthodontist. Your orthodontist may also splint (attach) the backs of the teeth to other teeth with composite (plastic) and a wire to prevent them from moving. Visit your dentist regularly to make sure your dental work is in good repair.

Source: American Association of Orthodontists

 

Dentists and Other Oral Health Care Providers

Many different types of oral health care providers could become involved in the care of your teeth, gums, and mouth. A brief description of these various health care providers is as follows:

General Dentist

A general dentist is your primary care dental provider. This dentist diagnoses, treats, and manages your overall oral health care needs, including gum care, root canals, fillings, crowns, veneers, bridges, and preventive education.

All practicing general dentists have earned either a DDS or DMD degree (doctor of dental surgery or doctor of dental medicine, respectively). There is no difference between the two degrees or the curriculum requirements that dentists must meet. Some schools simply award the one degree, while others award the other.

Generally, three or more years of undergraduate education plus four years of dental school is required to become a general dentist. Additional post-graduate training is required to become a dental specialist.

Dental Public Health Clinics

Dental public health clinics promote dental health through organized community efforts. The clinics serve to educate the public through group dental care programs with the goal of preventing and controlling dental diseases on a community-wide basis. Dental public health clinics offer such services as finding a dentist, developing dental care programs for schools, providing information on fluoridation in the community, answering common questions about oral health, and providing other oral health resources and support materials to their community.

Endodontist

An endodontist is the dental specialist concerned with the causes, diagnosis, prevention, and treatment of diseases and injuries of the human dental pulp or the nerve of the tooth. This specialist may perform simple to difficult root canal treatments or other types of surgical root procedures.

Oral and Maxillofacial Radiologist

A radiologist is the oral health care provider who specializes in the taking and interpretation of all types of X-ray images and data that are used in the diagnosis and management of diseases, disorders, and conditions of the oral and maxillofacial region.

Oral Medicine

Oral medicine is the specialty of dentistry that provides for the care of the medically complex patient through the integration of medicine and oral health care. This includes the diagnosis and management of oral diseases including oral cancer, lichen planus, candidiasis, and aphthous stomatitis. Oral medicine also evaluates complex medical patients prior to open-heart surgery, chemotherapy, and cancer therapy, as well as hospital inpatients.

Oral Pathologist

An oral pathologist is the oral health care provider who studies the causes of diseases that alter or affect the oral structures (teeth, lips, cheeks, jaws) as well as parts of the face and neck. Oral pathologists examine and provide a diagnosis of the biopsy, tissue, or lesion sent to them by other oral health care providers.

Oral and Maxillofacial Surgeon

An oral and maxillofacial surgeon is the oral health care provider who performs many types of surgical procedures in and about the entire face, mouth, and jaw area. Oral and maxillofacial surgeons treat accident victims who suffer facial injuries and offer reconstructive and dental implant surgery. They treat patients with tumors and cysts of the jaws. They also place dental implants. The types of surgeries an oral surgeon may perform include: simple tooth extractions, complex extractions involving removal of soft tissue or overlying bone or remaining roots, impacted teeth (especially wisdom teeth) removal, soft tissue biopsies, removal of tumors in the oral cavity, implant positioning, complex jaw realignment surgeries involving facial or bite discrepancies, fractured cheek or jaw bone repair and soft tissue (cleft palate or lip) repair. Oral and maxillofacial surgeons receive anywhere from 4 to 8 years of additional training after dental school.

Orthodontist

An orthodontist is the oral health care provider who specializes in diagnosis, prevention, interception, and treatment of malocclusions, or “bad bites,” of the teeth and surrounding structures. Malocclusions can result from crowded, missing, or extra teeth or jaws that are out of alignment. This specialist is responsible for straightening teeth by moving them through bone by the use of bands, wires, braces, and other fixed or removable corrective appliances or retainers. This specialist treats children as well as adults who may wish to improve their appearance and bite.

Pediatric Dentist/Pedodontists

A pediatric dentist is the oral health care provider who specializes in the diagnosis and treatment of the dental problems of children from the age of one or two to early adulthood. This dentist can detect, treat, or refer (as needed) problems with decayed, missing, crowded, or crooked teeth. A pediatric dentist has at least two additional years of training beyond dental school. The additional training focuses on management and treatment of a child’s developing teeth, child behavior, physical growth and development, and the special needs of children’s dentistry.

Periodontist

A periodontist is the oral health care provider who specializes in diagnosing, treating, and preventing diseases of the soft tissues of the mouth (the gums) and the supporting structures (bones) of the teeth (both natural and man-made teeth). This dentist diagnoses and treats gingivitis (inflammation of the gums) as well as periodontitis (gum and bone disease). A periodontist may perform the following procedures: simple and deep pocket cleanings, root planing, crown lengthening procedures, soft tissue and/or bone grafting, gingival or flap procedures, soft tissue recontouring or removal (gingivoplasty or gingivectomy), hard tissue recontouring (osteoplasty), and implant placement.

Prosthodontist

A prosthodontist is the oral health care provider who specializes in the repair of natural teeth and/or the replacement of missing teeth on a much larger scale than the general dentist. The prosthodontist uses artificial teeth (dentures), gold crowns (caps), or ceramic crowns to replace the missing or extracted teeth. The prosthodontist is also very involved in the replacement of teeth using dental implants. In addition, specially trained prosthodontists work with patients with head and neck deformities, replacing missing parts of the face and jaws with artificial substitutes.

Source: WebMD

Early Orthodontics May Mean Less Treatment Later

Look at yearbook or prom pictures from the 1950s or ’60s and you’ll see many smiles framed with heavy metal braces. It’s a sight that’s less common in high schools today. Why the change? Children today tend to get braces at a much earlier age. Some patients with special problems begin orthodontic treatment at age 7 or younger.

“The American Association of Orthodontics (AAO) recommends that all children receive an orthodontic screening by age 7,” says Thomas Cangialosi, D.D.S. “Permanent teeth generally begin to come in at age 6 or 7. It is at this point that orthodontic problems become apparent.

“Because bones are still growing, it’s an ideal time to evaluate a child,” Dr. Cangialosi says. “Then we can determine what orthodontic treatment, if any, may be needed either now or in the future.”

Dr. Cangialosi is chairman and professor of Orthodontics at the University of Medicine and Dentistry of New Jersey.

Making Braces Hip

To make braces more acceptable and fun for young people, manufacturers have made brightly colored elastics. These are the tiny rubber bands that hold the wires to the braces. Children can choose elastics with their school colors or a holiday color scheme, such as orange and black for Halloween.

Choosing the color of the elastics allows patients “to feel that they are more involved in their treatment,” Dr. Cangialosi says.

Still Take Getting Used To

Braces today tend to be less uncomfortable and less visible than they used to be. But they still take some getting used to. Food can get caught around brackets and in wires, and flossing and brushing can take more time. After adjustments sometimes the teeth may be a little sore. Tooth discomfort can be controlled by taking a pain reliever, such as ibuprofen (Advil, Tylenol and others) or aspirin if necessary. The use of lighter and more flexible wires has greatly lessened the amount of soreness or discomfort during treatment.

As more and more children get braces, schoolyard nicknames such as “tin grin” and “metal mouth” are heard less often. Because treatment has become more socially acceptable, embarrassment may be less of a concern.

Beyond Braces

Orthodontic treatment in young children is known as interceptive orthodontics. Intervention may begin as early as age 6 or 7. At this age, teeth are still developing. The jaw is still growing. That means certain conditions, such as crowding, may be easier to address.

Before permanent teeth have come in, it may be possible to help teeth to erupt (emerge through the gums) into better positions. It’s common, for example, for the dental arch to be too small to fit all of the teeth. A few decades ago, the solution for crowding was almost always to extract some of the permanent teeth to make space. Then fixed braces were used to position the teeth properly.

Early intervention takes advantage of the fact that a child’s jaw is still growing. For example, a device called a palatal expander may be used to expand the child’s upper dental arch. Once the arch is the proper size, there’s a better chance that the adult teeth will emerge in better position. Sometimes teeth still may be crowded after all of them have erupted. In such cases, some permanent teeth may still have to be extracted to make room to align the teeth properly.

So-called early treatment also may be useful when the dental arches and jaws are not in the correct position. Functional appliances may fix or improve these problems. More treatment usually is needed later on, but it may be shorter and less involved.

“It is important to note that children who receive interceptive orthodontics generally still need braces or other orthodontic appliances later,” Dr. Cangialosi says. “However, this early treatment may shorten and simplify future treatment in selected cases.” This is commonly known as two-phase treatment.

It is important to note that early treatment does not apply to all orthodontic problems. However, it may help in certain cases.

Two conditions that require early intervention are crossbites and protruding front teeth. A crossbite can cause the jaws to grow unevenly. Front teeth that stick out may be fractured or injured in an accident, such as a fall.

Source: Aetna

Got bad breath? Here’s how to make it better

No one likes to hear it, but it’s worse not to know it: You have bad breath.

Bad breath (also known as halitosis or malodor) can be embarrassing and tough on those around you. Some people don’t realize their breath could peel paint because people are afraid to tell them.

“Certainly bad breath can ruin relationships,” John Woodall, DDS, a dentist with Woodall and McNeill in Raleigh, N.C., tells WebMD.

Fortunately, this problem is often easy to fix. What helps: Good oral hygiene, regular visits to your dentist, and ruling out any underlying conditions or other factors (such as some medications, diets, and foods) that could make your breath less than pleasant.

Bad Breath and Other Top Problems in Your Mouth
Do You Have Bad Breath?

Bad breath is often caused by a buildup of bacteria in your mouth that causes inflammation and gives off noxious odors or gases that smell like sulfur — or worse.

Everybody has nasty breath at some point, like when you get out of bed in the morning.

Not sure if your breath is bad? The best way to find out is to ask a trusted friend or your significant other, “‘Does my breath smell?’ Because it’s really hard to tell on your own,” Tina Frangella, DDS, a dentist with Frangella Dental in New York, tells WebMD.

There’s another way to know. It may seem a bit gross, but look at and smell your dental floss after you use it.

“If your floss smells or there is blood on it, then there are foul odors in your mouth,” Woodall says.
What Causes Bad Breath?

There are no statistics on what percentage of the population has bad breath. That’s because studies usually rely on someone reporting whether or not they think they have bad breath and may not be accurate.

But studies show that about 80% of bad breath comes from an oral source. For instance, cavities or gum disease can lead to bad breath, as can tonsils that have trapped food particles; cracked fillings, and less-than-clean dentures.

Several internal medical conditions also can cause your breath to go downhill fast. They include diabetes, liver disease, respiratory tract infections, and chronic bronchitis. You’ll want to see your doctor to rule out things like acid reflux, postnasal drip, and other causes of chronic dry mouth (xerostomia).

Woodall recalls a 30-year-old patient who had chronic bad breath, though her teeth were “immaculate” and her tongue was very clean. Her doctor tested her for acid reflux and other stomach conditions, “gave her some medicine, and her bad breath went away,” Woodall says.

See Your Dentist, Brush Your Teeth

Nixed medical causes for your bad breath? Keep your scheduled dental appointments.

“You really want to see your dentist every six months or at least yearly,” Frangella says.

Good oral hygiene also is key to fighting bad breath. Ideally, you should brush and floss after every meal to help reduce the odor-causing bacteria in your mouth. While a regular toothbrush works just as well if you use it as recommended, Frangella recommends using an electric toothbrush, for two reasons.

“First, because many electric toothbrushes have timers on them and the majority of people do not brush their teeth for the right length of time. And secondly, because electric toothbrushes distribute a uniform motion, which I find helps remove plaque more efficiently than when my patients use manual toothbrushes.”

Some mouthwashes or mouth rinses can help prevent cavities and reduce bacteria-causing plaque and fight bad breath. Stick to an antiseptic or antibacterial rinse that kills bacteria, rather than a cosmetic rinse that just focuses on freshening the breath.

Watch What You Eat

What you eat affects what you exhale. That’s because as food is digested, it’s absorbed into your bloodstream and then is expelled by your lungs when you breathe.

Eat a healthy, balanced diet and regular meals. Certain diets — such as extreme fasting and very low-carb diets — can give you bad-smelling breath.

Consider snacking on raw carrots, celery, or apple slices. “It’s good to have a nice watery vegetable in there – something like celery – that will help clear your mouth of debris,” Frangella says.

Avoid breath busters such as garlic, onions, and some other spicy foods. Chronic garlic users cannot only have chronic bad breath, they also often have body odor, Woodall says.

Six More Ways to Fix Bad Breath

Here are a half dozen more ways to banish bad breath – hopefully for good.

Stay hydrated. If you can’t brush your teeth after a meal, drinking a lot of water can help speed up the process of cleaning harmful bacteria and debris from between your teeth. Drinking milk can even help deodorize some offensive breath odors, Frangella says. Avoid sugary drinks.
Don’t drink too much coffee. It may be tasty, but coffee is a tough smell to get off the back of your tongue. Consider switching to an herbal or green tea, Frangella says.
Don’t smoke or use other tobacco products. Cigarettes, pipes, and snuff can foul your breath. “Smoking can give people horrible breath,” Woodall says. “And some people carry this stuff worse than others.”
Cut back on alcohol. Alcohol can lead to a dry mouth. Too much beer, wine, and hard liquor can make your breath reek for up to eight to 10 hours after you finish drinking, Woodall says.
Chew sugarless gum. Doing so 20 minutes after a meal can help with saliva flow. Gum that’s 100% xylitol-sweetened can help reduce cavities, but it’s also “kind of cooling and gives you really nice fresh breath,” Frangella says.
Be careful with breath mints. Sugar-free mints are OK for a quick fix but only mask the offensive smell and don’t do anything to remove harmful bad bacteria. Tempted to pick up a sugary mint as you leave your favorite restaurant? Don’t. The sugar will only sit on your teeth and make the problem worse, Frangella says.

Source: WebMD

Bringing Teeth into Alignment with Orthodontic Treatment

The American Association of Orthodontists reports that in the United States 4.5 million people are wearing braces or other dental appliances to straighten teeth and provide a healthy, beautiful smile1.

As many of us know, an orthodontist is a dentist with additional clinical training to treat malocclusions (improper bites), which may result from tooth irregularity and jaw issues.

Why Do Teeth Become Crooked?
Terry Pracht, DDS, past president of the American Association of Orthodontics says that both heredity and environmental factors can create crooked teeth and bite problems. Dr. Pracht mentions that hereditary factors include crowded teeth, teeth where there is too much space and malocclusions. He also mentions that crooked teeth can be caused by thumb sucking and tongue thrusting as well as accidents occurring to the jaw(1).

What are Treatment Options to Straighten Teeth or Malocclusions?
There are three stages of orthodontic treatment. The first is when appliances are used to gain space in the mouth. For example, palatal expanders are used to expand the width of the palate and lingual bars are used to expand the lower jaw. The active corrective stage is next when the braces are placed on the teeth. The teeth are then adjusted and then straightened and malocclusions are corrected over a period of time based upon the severity of the irregularity of the teeth and jaw issues. The third stage is the retention stage after braces are removed and when the teeth are monitored through the use of a retainer (removable or fixed) and semi-annual orthodontic visits are conducted to maintain the straightened smile.

Types of Braces
Braces from over 30 or so years ago included large metal bands that were enclosed and cemented around each tooth. Braces can be attached to the cheek side of the teeth as well as the tongue side of the teeth depending on what your orthodontist recommends to you for treatment. Braces, arch wires and bands can be colorful and a lot of fun for children, adolescents and teenagers to choose from.

Today, tiny brackets are placed onto the front surface of the tooth and are made of metal or ceramic. The brackets are bonded to the front tooth surface with a glue-like material and metal bands can be used on the back teeth. Arch wires are placed inside the brackets and are made of a heat-activated nickel-titanium source that can become warm due to the temperature in the mouth, which will allow it to apply constant pressure on the teeth as well as when the arch wires are adjusted at the orthodontist’s office.

Another newer alternative to braces is the Invisalign system which uses a series of clear removable aligners that are worn during the day and night to help in moving teeth into the correct alignment. When eating or brushing and flossing, the aligners may be removed.

Caring for Braces
Your orthodontist, dentist or dental hygienist will provide you with thorough instruction of how to properly clean your braces. There are many toothbrushes you can use both manual (specifically designed for orthodontic patients), power, electric or sonic. Ask your dental professional which is be best for you. Brushing should be conducted at least 2-3 times per day at a 45 degree angle in a back and forth motion. Be sure to remove plaque at the gum line to prevent gingivitis (inflammation of the gum tissue). Be sure to angle the toothbrush at the gum line and then gently brush around the brackets to remove plaque and food debris.

It is very important to clean in between your teeth with a floss threader and floss, a stimudent (tooth pick cleaner) or a proxabrush (interproximal cleaning brush) may be used if there is space between the teeth. Oral irrigators may be recommended to remove food debris and irrigate the gum tissue to remove disease and odor-causing bacteria that may be there if you have gingivitis. An antibacterial toothpaste and over-the-counter antimicrobial mouth rinses could also be used with the oral irrigator or alone.

How to Maintain a Smile After the Braces are Off
After your orthodontist has determined that your braces can be removed, it is very important that a retainer (a plastic appliance) be worn during the day or night as recommended by them. The retainer can be cleaned with warm water or toothpaste and a toothbrush after you wear it and placed in a plastic container when not in use.

See your dental professional for a twice a year professional cleaning and the orthodontist for regular maintenance appointments.

Source: Colgate-Palmolive Company

What is Orthodontics?

Orthodontics is the branch of dentistry that corrects teeth and jaws that are positioned improperly. Crooked teeth and teeth that do not fit together correctly are harder to keep clean, are at risk of being lost early due to tooth decay and periodontal disease, and cause extra stress on the chewing muscles that can lead to headaches, TMJ syndrome and neck, shoulder and back pain. Teeth that are crooked or not in the right place can also detract from one’s appearance.

The benefits of orthodontic treatment include a healthier mouth, a more pleasing appearance, and teeth that are more likely to last a lifetime.

A specialist in this field is called an orthodontist. Orthodontists receive two or more years of education beyond their four years in dental school in an ADA-approved orthodontic training program.

How do I Know if I Need Orthodontics?
Only your dentist or orthodontist can determine whether you can benefit from orthodontics. Based on diagnostic tools that include a full medical and dental health history, a clinical exam, plaster models of your teeth, and special X-rays and photographs, an orthodontist or dentist can decide whether orthodontics are recommended, and develop a treatment plan that’s right for you.

If you have any of the following, you may be a candidate for orthodontic treatment:

Overbite, sometimes called “buck teeth” — where the upper front teeth lie too far forward (stick out) over the lower teeth
Underbite — a “bulldog” appearance where the lower teeth are too far forward or the upper teeth too far back
Crossbite — when the upper teeth do not come down slightly in front of the lower teeth when biting together normally
Open bite — space between the biting surfaces of the front and/or side teeth when the back teeth bite together
Misplaced midline— when the center of your upper front teeth does not line up with the center of your lower front teeth
Spacing — gaps, or spaces, between the teeth as a result of missing teeth or teeth that do not “fill up” the mouth
Crowding — when there are too many teeth for the dental ridge to accommodate

How Does Orthodontic Treatment Work?
Many different types of appliances, both fixed and removable, are used to help move teeth, retrain muscles and affect the growth of the jaws. These appliances work by placing gentle pressure on the teeth and jaws. The severity of your problem will determine which orthodontic approach is likely to be the most effective.

Fixed appliances include:

Braces — the most common fixed appliances, braces consist of bands, wires and/or brackets. Bands are fixed around the teeth or tooth and used as anchors for the appliance, while brackets are most often bonded to the front of the tooth. Arch wires are passed through the brackets and attached to the bands. Tightening the arch wire puts tension on the teeth, gradually moving them to their proper position. Braces are usually adjusted monthly to bring about the desired results, which may be achieved within a few months to a few years. Today’s braces are smaller, lighter and show far less metal than in the past. They come in bright colors for kids as well as clear styles preferred by many adults.
Special fixed appliances — used to control thumb sucking or tongue thrusting, these appliances are attached to the teeth by bands. Because they are very uncomfortable during meals, they should be used only as a last resort.
Fixed space maintainers — if a baby tooth is lost prematurely, a space maintainer is used to keep the space open until the permanent tooth erupts. A band is attached to the tooth next to the empty space, and a wire is extended to the tooth on the other side of the space.

Removable appliances include:

Aligners — an alternative to traditional braces for adults, serial aligners are being used by an increasing number of orthodontists to move teeth in the same way that fixed appliances work, only without metal wires and brackets. Aligners are virtually invisible and are removed for eating, brushing and flossing.
Removable space maintainers — these devices serve the same function as fixed space maintainers. They’re made with an acrylic base that fits over the jaw, and have plastic or wire branches between specific teeth to keep the space between them open.
Jaw repositioning appliances — also called splints, these devices are worn on either the top or lower jaw, and help train the jaw to close in a more favorable position. They may be used for temporomandibular joint disorders (TMJ).
Lip and cheek bumpers — these are designed to keep the lips or cheeks away from the teeth. Lip and cheek muscles can exert pressure on the teeth, and these bumpers help relieve that pressure.
Palatal expander — a device used to widen the arch of the upper jaw. It is a plastic plate that fits over the roof of the mouth. Outward pressure applied to the plate by screws force the joints in the bones of the palate to open lengthwise, widening the palatal area.
Removable retainers — worn on the roof of the mouth, these devices prevent shifting of the teeth to their previous position. They can also be modified and used to prevent thumb sucking.
Headgear — with this device, a strap is placed around the back of the head and attached to a metal wire in front, or face bow. Headgear slows the growth of the upper jaw, and holds the back teeth where they are while the front teeth are pulled back.

Source: Colgate.com