My Blog
2KindsofOrthodonticRetainersThatCanProtectYourNewSmile

While retainers are often viewed as a nuisance, they’re crucial to protect the gains made with bite correction. Without them, all of the progress achieved through braces or clear aligners could be lost.

Here’s why: The same elastic gum tissue called the periodontal ligament that holds teeth in place also allows them to move incrementally in response to changes in the mouth. That’s why we can move teeth with braces or aligners, which put pressure on the teeth toward a desired direction of movement while the periodontal ligament does the rest.

But the mechanics can also work in reverse: With pressure relieved when the braces are removed, the teeth could revert to their original positions through a kind of “muscle memory.” The light pressure provided by a retainer is enough to keep or “retain” teeth in their new positions.

The best known retainer is a removable appliance. Initially, a patient wears it continuously and only takes it out during oral hygiene. Wear duration may later be reduced to night time only and eventually not at all, depending on a patient’s individual needs.

While effective, removable retainers do have some downsides. Like braces, they’re visible to others. And because they’re removable, they’re frequently misplaced or lost, leading to the added expense of a new one.

An alternative is a bonded retainer, a thin piece of wire attached to the back of the newly moved teeth to keep them in place. Because it’s behind the teeth it’s not visible—and there’s no misplacing it because only a dentist can take it out.

A bonded retainer is a good option, especially if a patient is immature and not as diligent about wearing or keeping up with their appliance. But it can make flossing difficult to perform, and if they’re removed or broken prematurely, the teeth could revert to their former positions.

If you decide to go with a bonded retainer, be sure you get some tips from your dental hygienist on how to floss with it. And if you decide later to have it removed early, be sure to replace it with a removable retainer. Either of these two options can help you keep your new and improved smile.

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 magazine article “Bonded Retainers.”

RemovableorBondedRetainersHelpProtectYourNewStraighterSmile

The straightening process for a crooked smile doesn't end when the braces come off. There's one more crucial phase to undergo to make sure we don't lose the progress you've achieved: wearing an orthodontic retainer.

Although often viewed as a nuisance, retainers are important because they prevent realigned teeth from reverting to their old positions. This is possible because the periodontal ligament, the gum attachment that allows us to move teeth in the first place, can contain “muscle memory” that naturally tries to draw teeth back to where they once were.

A retainer prevents this from happening: During wear the subtle pressure they exert keeps or “retains” the teeth in their new positions until they're firmly established, usually after several months. While most patients initially wear a retainer around the clock, this will gradually taper off until they're worn primarily during sleep hours.

While retainers come in many different styles and sizes, most fall into one of two categories: removable or non-removable (bonded). The first type, a custom-made appliance a patient can easily take in and out of the mouth, has its advantages. Removing it makes it easier to clean the teeth. They're also adaptable to reduced wear schedules for eating, brushing and flossing, or for special occasions.

But a removable retainer may be noticeable to others. Its removability can also lead to problems. Out of the mouth they're prone to be lost, resulting in additional replacement costs. And immature patients may be easily tempted to take them out too often—or not wear them at all.

A bonded retainer solves many of these potential problems. Because the retainer wire is securely bonded to the back of the teeth, it's not visible to others. And because it can't be removed except by an orthodontist, there's virtually no chance of losing it or haphazard wear.

On the other hand, bonded retainers can occasionally break, requiring repair or replacement. And flossing is more difficult than with a removable retainer, although a little training from a dental hygienist can make that easier.

The choice of retainer depends on the individual and their priorities. But whether removable or bonded, a retainer is absolutely essential for protecting your new, hard-earned smile.

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 magazine article “Bonded Retainers.”

3ReasonsaRootCanalTreatmentMightFailandWhatYouCanDoAboutIt

It's not an exaggeration to say the modern root canal treatment has saved millions of teeth over the last century. Without this procedure, there's not a lot we can do to stop advanced tooth decay from infecting and destroying a tooth.

What's more, a root canal treatment could extend the life of a tooth for decades. Notice we said could—although most root canals do have satisfactory outcomes, there's still a chance a tooth may become re-infected. Here are 3 possible causes for an unsuccessful root canal treatment, and what you can do to lessen their impact.

The severity of the infection. Tooth decay usually begins at the enamel layer, softened by the acid produced by bacteria. Untreated, the infection can then spread through the next tooth layer of dentin until finally infecting the innermost pulp. From there the infection can move through the root canals to the bone, dramatically increasing the danger to the tooth. Root canal treatments have a higher chance of success the earlier they're performed in the disease progression, so see your dentist at the first sign of pain or other tooth abnormality.

The root canal network. An effective root canal procedure eliminates all dead or diseased tissue in both the pulp chamber and the root canals (these are then filled to prevent future infection). But this may prove difficult with teeth that have intricate root canal networks because of a higher risk of overlooking some of the canals. It may be best in such cases for an endodontist, a specialist in treating interior tooth issues, to perform the procedure using their advanced techniques and microscopic equipment.

The age of the tooth. Root canal treatment can weaken a tooth's structural integrity, especially with older teeth. This can make them more susceptible to fracture and a higher chance of infection. We can avoid this outcome by placing crowns on root-canaled teeth: The crown provides structural strength to the tooth and can add further protection against infection. Older teeth may also benefit from the placement of a small support post within it to further add stability before applying the crown.

If you would like more information on root canal treatment, 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 “Root Canal Treatment: How Long Will It last?

WhatsThatonYourTeethNickJonasHowtoAvoidaSimilarSmileOops

Think no one is looking at your smile when you’re out in public? Nick Jonas’ recent experience might convince you otherwise. While the Jonas Brothers were performing during the 2020 Grammys, fans watching on television picked up on some dark matter between his teeth.

To say Twitter lit up is an understatement. For many, it was that thing you couldn’t unsee: Forget the performance, what was that between his teeth? Jonas later fessed up by tweeting, “…At least you all know I eat my greens.”

We’re sure Nick and his brothers take care of their teeth, as most any high-profile entertainer would. You can probably attribute his dental faux pas to trying to squeeze in some nourishment during a rushed performance schedule.

Still, the Grammy incident (Spinachgate?) shows that people do notice when your teeth aren’t as clean as they should be. To avoid that embarrassment, here are some handy tips for keeping your teeth looking their best while you’re on the go.

Start with a clean mouth. You’re more apt to collect food debris during the day if you have built-up plaque on your teeth. This sticky bacterial biofilm attracts new food particles like a magnet. Remove plaque by thoroughly brushing and flossing before you head out the door.

Rinse after eating. Although your saliva helps clear leftover food from your mouth, it may not adequately flush away all the debris. You can assist this process by swishing and rinsing with clean water after a meal.

Keep a little floss handy. Even after rinsing, stubborn bits of food can remain lodged between teeth. So just in case, keep a small bit of emergency floss (or a floss pick) in your purse or wallet to remove any debris you see or feel between your teeth.

Watch what you eat. Some foods—like popcorn, sticky snacks or fibrous vegetables—are notorious for sticking in teeth. Try to avoid eating these foods right before a public appearance where your smile may be critical.

And here’s an added bonus: Not only will these tips help keep your smile attractive on the go, they’ll also help keep it healthy. Rinsing with water, for example, helps lower your mouth’s acid level after eating, a prime factor in tooth decay. And flossing, both as a regular practice and for occasional stuck food, decreases plaque and subsequently your risk of tooth decay and gum disease.

Remember, a healthy mouth is the starting place for a beautiful smile. Keep it that way with dedicated hygiene habits at home or on the go.

If you would like more information on tips for better oral hygiene, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Daily Oral Hygiene.”

By Carl H. Tegtmeier, DMD
May 24, 2020
Category: Oral Health
Tags: orthodontics   oral hygiene  
4WaystoAvoidDentalDiseaseWhileWearingBraces

Keeping your teeth and gums healthy isn't always easy—and it's even more of a challenge if you're wearing orthodontic appliances like braces. That's why a fair percentage of patients wearing braces also contend with tooth decay or periodontal (gum) disease.

The reason is simple: The orthodontic hardware makes it difficult to fully reach all parts of teeth surfaces with your toothbrush or floss. As a result, you can miss removing some of the accumulated plaque, the thin film of bacteria and food particles most responsible for dental disease. And it only takes a short amount of time (just days with gum disease) for a bacterial infection to begin.

But while avoiding dental disease is difficult while wearing braces, it's not impossible. Here are 4 ways you can minimize your dental disease risk while undergoing orthodontic treatment.

Be diligent with your daily hygiene. Even though it's more difficult, don't slack on daily brushing and flossing. It does require more time to work the brush around and between the wires and brackets, but taking the time will help you clear away more plaque you might otherwise miss. It may also help to switch to a multi-tufted, microfine bristled toothbrush if you're not already using one.

Use a water irrigator. If straight thread flossing is proving too difficult (and even with a floss threader), try using a water irrigator. This device emits a pulsating spray of pressurized water that loosens and flushes away plaque between teeth. Clinical studies consistently show water flossing is effective for reducing plaque in orthodontic patients.

Lower your sugar intake. Sugar left over in the mouth is a prime food source for bacteria that cause tooth decay or gum disease. Reducing sugary foods and snacks can help reduce bacterial populations and lower your disease risk. You can also fortify your oral health with healthier foods that contain calcium and other minerals.

Keep up regular dental visits. In addition to your orthodontic adjustments, don't neglect your regular visits with your family dentist. Semi-annual cleanings help remove any plaque and calculus (calcified plaque) you may have missed. Your dentist can also monitor your health and boost your disease prevention through topical fluoride treatments or prescribed antibacterial mouth rinses.

If you would like more information on dental care 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 “Caring for Teeth During Orthodontic Treatment.”





This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.