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PracticalTipsforKeepingYourTeethCleanWhileWearingBraces

Wearing braces can pose challenges for your daily life and habits. One in particular is trying to keep your teeth and gums clean.

Braces or not, your oral hygiene needs to be thorough. Every day, your teeth accumulate a thin film of bacteria and food particles called dental plaque that can cause tooth decay or gum disease. It's essential to remove as much as possible each day by brushing and flossing.

That's a more difficult task with braces. The brackets and wires interfere with accessing many of your teeth's surfaces with a toothbrush or floss. As a result, braces wearers on average have a higher incidence of dental disease than non-wearers.

But while it's difficult to keep your mouth clean wearing braces, it's not impossible. Here are some tips and tools for making oral hygiene easier during orthodontic treatment.

A low-sugar diet. Besides items like chips that could damage your braces, you should also limit your consumption of foods and snacks with added sugar.  This carbohydrate is a primary food source for disease-causing bacteria. Limiting sugar in your diet can help reduce plaque buildup.

The right toothbrush. Brushing with braces is easier if you use a soft multi-tufted brush with microfine bristles. The smaller bristles maneuver better around the braces than larger bristled brushes. You'll still need to make multiple passes above and below the wires to be sure you're brushing all tooth surfaces.

Flossing tools. Traditional flossing using just your fingers can be next to impossible to perform with braces. But a tool like a floss holder or threader can make it easier to get between teeth. You might also try a water flosser that removes plaque from between teeth with a pressurized spray of water.

Dental treatments. Your dentist can give your teeth extra protection while you're wearing braces with topically applied fluoride to strengthen enamel. Using mouthrinses with an antibacterial ingredient like chlorhexidine may also reduce harmful bacteria.

Be sure you also keep up regular visits with your family dentist while wearing braces, and especially if you begin to notice puffy and reddened gums or unusual spots on your teeth. The sooner any case of dental disease is detected, the less impact it will have on your dental health.

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

GumDiseaseCanBeStoppedbutYouCouldBeinForaLongFight

It often begins without you realizing it—spreading ever deeper into the gums and damaging tissue attachments, teeth and supporting bone in its way. In the end, it could cause you to lose your teeth.

This is periodontal (gum) disease, a bacterial infection caused by dental plaque, a thin biofilm that accumulates on tooth surfaces. It in turn triggers chronic inflammation, which can cause the gum attachments to teeth to weaken. Detaching gum ligaments may then produce diseased voids—periodontal pockets—that can widen the gap between the teeth and the gums down to the roots.

There is one primary treatment objective for gum disease: uncover and remove any and all plaque and tartar (hardened plaque). If the infection has advanced no further than surface gum tissues, it may simply be a matter of removing plaque at or just below the gum line with hand instruments called scalers or ultrasonic equipment.

The disease, however, is often discovered in more advanced stages: The initial signs of swollen, reddened or bleeding gums might have been ignored or simply didn't appear. Even so, the objective of plaque and tartar removal remains the same, albeit the procedures may be more invasive.

For example, we may need to surgically access areas deep below the gum line. This involves a procedure called flap surgery, which creates an opening in the gum tissues resembling the flap of an envelope. Once the root or bone is exposed, we can then remove any plaque and/or tartar deposits and perform other actions to boost healing.

Antibiotics or other antibacterial substances might also be needed for stopping an infection in advanced stages. Some like the antibiotic tetracycline can be applied topically to the affected areas to directly stop inflammation and infection; others like mouthrinses with chlorhexidine might be used to fight bacteria for an extended period.

Although effective, treatment for advanced gum disease may need to continue indefinitely. The better approach is to focus on preventing a gum infection through daily brushing and flossing and regular dental cleanings. And at the first sign of problems with your teeth and gums, see us as soon as possible—the earlier in the disease progression that we can begin treatment, the better the outcome.

If you would like more information on preventing and treating gum disease, 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 “Treating Difficult Areas of Periodontal Disease.”

ImplantsCouldHelpYouKeepRemainingTeethLonger

It's a common practice among people slowly losing their teeth to have their remaining teeth removed. They find dentures to be less costly than replacing one tooth at a time or caring for those that remain. On the other hand, it's usually healthier for the mouth to preserve remaining teeth as long as possible, replacing them only as necessary.

This latter strategy has up to now been difficult and expensive to achieve. But dental implants are changing that—using these imbedded titanium metal devices with a variety of restorations, we're able to better plan and implement staged tooth replacement.

Most people associate implants with single tooth replacements of a life-like crown cemented or screwed into an abutment attached to the implant post. This can play an early role in a staged replacement plan, but at some point, multiple single-tooth implants can become quite expensive.

Implants, however, have a much broader range of use. A few strategically placed implants can support a variety of restorations, including bridges and removable or fixed dentures. Four to eight implants, for example, can secure a fixed denture replacing all teeth on a jaw, far fewer than the number needed to replace the teeth individually.

Implants may also improve the function of traditional restorations. For instance, dentures can't stop the bone loss that often results from tooth loss—in fact, they will accelerate it as they rub and irritate the bony ridges of the jaw. By contrast, implants stimulate bone growth, slowing or even stopping the process of bone loss.

In a traditional bridge, the outer crowns of the restoration are bonded to the teeth on either side of the missing tooth gap (the middle crowns fill the gap). These support teeth must be permanently altered to accommodate the crowns. But an implant-supported bridge doesn't depend on other teeth for support, thus eliminating the need to permanently alter any teeth.

More importantly, previously placed implants often become part of the next stages of tooth replacement, like building on an addition onto an existing house. All in all, including implants in your ongoing dental restoration can help you enjoy the benefits of preserving your natural teeth for much longer.

If you would like more information on dental restoration options, 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 “Replacing All Teeth but Not All at Once.”

KevinBaconsMango-SlicingTrickandOtherWaystoRidFoodBetweenYourTeeth

During the COVID-19 quarantines, stir-crazy celebrities have been creating some “unique” home videos—like Madonna singing about fried fish to the tune of “Vogue” in her bathroom or Cardi B busting through a human-sized Jenga tower. But an entertaining Instagram video from Kevin Bacon also came with a handy culinary tip: The just-awakened film and TV actor showed fans his morning technique for cutting a mango to avoid the stringy pulp that gets between your teeth. After cutting a mango in half, he scored it lengthwise and crosswise to create squares and then turned the mango inside out for easy eating.

With his mango-slicing video garnering over a quarter-million views, the City on a Hill star may have touched a nerve—the near universal annoyance we all have with food stuck between our teeth. Trapped food particles aren't only annoying, they can also contribute to a bacterial film called dental plaque that's the top cause for tooth decay and gum disease.

Unfortunately, it's nearly impossible to avoid stuck food if you love things like popcorn, poppy-seed muffins or barbecue ribs. It's helpful then to have a few go-to ways for removing food caught between teeth. First, though, let's talk about what NOT to use to loosen a piece of stuck food.

A recent survey of more than 1,000 adults found that when removing something caught between our teeth, we humans are a creative lot. The makeshift tools that survey respondents said they've used in a pinch included twigs, safety pins, screwdrivers and nails (both the hammer and finger/toe variety). Although clever, many such items are both unsanitary and harmful to your gums and tooth enamel, especially if they're metallic or abrasive.

If you want a safe way to remove unwanted food debris, try these methods instead:

Brush your teeth: The gentle abrasives in toothpaste plus the mechanical action of brushing can help dislodge trapped food.

Use dental floss: A little bit of dental floss usually does the trick to remove wedged-in food—and it's easy to carry a small floss container or a floss pick on you for emergencies.

Try a toothpick. A toothpick is also an appropriate food-removing tool, according the American Dental Association, as long as it is rounded and made of wood.

See your dentist. We have the tools to safely and effectively remove trapped food debris that you haven't been able to dislodge by other means—so before you get desperate, give us a call.

You can also minimize plaque buildup from food particles between teeth by both brushing and flossing every day. And for optimally clean teeth, be sure you have regular dental office cleanings at least twice a year.

Thanks to Kevin Bacon's little trick, you can have your “non-stringy” mango and eat it too. Still, you can't always avoid food getting wedged between your teeth, so be prepared.

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

WeMayBeAbleToTreatSomeBiteProblemsEarly

In any given year, 4 million tweens and teens are in the process of having their teeth straightened with braces or clear aligners. It's so common we tend to consider orthodontic treatment for young people as a rite of passage into adulthood.

But it doesn't necessarily have to be that way—it might be possible to stop or at least minimize a poor bite before it fully develops. That's the goal of interceptive orthodontics—treatments that head off or “intercept” a bite problem early.

The goal isn't necessarily to reposition misaligned teeth, but to correct a problem that can lead to misalignment. Here are some examples.

A narrow jaw. A narrowly developing jaw can crowd incoming teeth out of their normal positions. For the upper jaw, though, we can take advantage of a temporary separation in the bones in the roof of the mouth (palate) with a device called a palatal expander. Placed against the palate, the expander exerts outward pressure on the teeth and jaw to widen this separation. The body fills in the gap with bone to gradually widen the jaw.

Abnormal jaw alignment. It's possible for a jaw to develop abnormally during childhood so that it extends too far beyond the other. Using a hinged device called a Herbst appliance, it's possible to interrupt this abnormal growth pattern and influence the bones and muscles of the jaw to grow in a different way.

Missing primary teeth. An important role for a primary (baby) tooth is to hold a place for the future permanent tooth. But if the primary tooth is lost too soon, other teeth can drift into the space and crowd out the intended permanent tooth. To prevent this, we can insert a space maintainer: This simple looped metal device prevents teeth from drifting and preserves the space for the permanent tooth.

Although these and other interceptive treatments are effective, some like the palatal expander do their best work within a limited age frame. To take advantage of interceptive orthodontics in a timely manner, parents should seek a bite evaluation for their child from an orthodontist around age 6. The earlier we detect a growing bite problem, the greater your chances for successful intervention.

If you would like more information on treating emerging bite problems early, 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 “Interceptive Orthodontics.”





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