After months of wearing braces, the big day has arrived — they’re finally off! Your teeth have been realigned and your smile is dazzling. You’re finished with orthodontic treatment, right?
Not quite — because if you want to keep your new smile you have one more treatment phase to go — wearing a retainer. Without this phase there’s a distinct possibility you could lose all the time, effort and expense of braces because your teeth could revert to their previous position.
To understand why, we have to consider how teeth can move in the first place. Although it may seem like your teeth are rigidly fastened to the jawbone, they’re actually held in place by the periodontal ligament, a strong, elastic gum tissue that lies between the teeth and the bone. Tiny fibers from the ligament attach to the teeth on one side and to the bone in a similar manner on the other side.
When pressure is applied to the tooth as happens with braces, the bone around the side of the tooth in the direction of the force will begin to dissolve (resorb), allowing the tooth to move in that direction. New bone will then build up on the other side to stabilize the tooth. Once the pressure is removed (when we take the braces off), there’s a tendency for the teeth, bone and gums to “remember” the old position and try to revert back.
The answer is a removable mouth appliance known as a retainer. Custom-designed to fit the teeth’s new position, the retainer helps hold the teeth in place until the bone completely sets around them. In the beginning, you may need to wear the retainer around the clock and then later only at night while you sleep. While you may only need to wear it for a few months (especially if you’re an adolescent or young adult) some patients may need to wear some form of retainer indefinitely. Your orthodontist will advise you how long depending on your individual situation.
While retainers may seem like an inconvenience, they’re extremely important for keeping or “retaining” the teeth in their new and better position. Following through on this important phase of treatment will help ensure you’ll keep your new smile for a long time to come.
If you would like more information on 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 “Why Orthodontic Retainers?”
Fans of the primetime TV show The Middle were delighted to see that high school senior Sue, played by Eden Sher, finally got her braces off at the start of Season 6. But since this popular sitcom wouldn’t be complete without some slapstick comedy, this happy event is not without its trials and tribulations: The episode ends with Sue’s whole family diving into a dumpster in search of the teen’s lost retainer. Sue finds it in the garbage and immediately pops it in her mouth. But wait — it doesn’t fit, it’s not even hers!
If you think this scenario is far-fetched, guess again. OK, maybe the part about Sue not washing the retainer upon reclaiming it was just a gag (literally and figuratively), but lost retainers are all too common. Unfortunately, they’re also expensive to replace — so they need to be handled with care. What’s the best way to do that? Retainers should be brushed daily with a soft toothbrush and liquid soap (dish soap works well), and then placed immediately back in your mouth or into the case that came with the retainer. When you are eating a meal at a restaurant, do not wrap your retainer in a napkin and leave it on the table — this is a great way to lose it! Instead, take the case with you, and keep the retainer in it while you’re eating. When you get home, brush your teeth and then put the retainer back in your mouth.
If you do lose your retainer though, let us know right away. Retention is the last step of your orthodontic treatment, and it’s extremely important. You’ve worked hard to get a beautiful smile, and no one wants to see that effort wasted. Yet if you neglect to wear your retainer as instructed, your teeth are likely to shift out of position. Why does this happen?
As you’ve seen firsthand, teeth aren’t rigidly fixed in the jaw — they can be moved in response to light and continuous force. That’s what orthodontic appliances do: apply the right amount of force in a carefully controlled manner. But there are other forces at work on your teeth that can move them in less predictable ways. For example, normal biting and chewing can, over time, cause your teeth to shift position. To get teeth to stay where they’ve been moved orthodontically, new bone needs to form around them and anchor them where they are. That will happen over time, but only if they are held in place with a retainer. That’s why it is so important to wear yours as directed — and notify us immediately if it gets lost.
And if ever you do have to dig your retainer out of a dumpster… be sure to wash it before putting in in your mouth!
If you would like more information on retainers, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Why Orthodontic Retainers?”
A crown — a life-like “cap” made of dental porcelain that permanently covers an existing tooth — is an effective way to restore a still-viable decayed or broken tooth’s appearance. Properly fitting the crown over the tooth requires some healthy tooth structure above the gum line.
But what if the tooth has broken down to the gum line? In this case, we would need to perform a common procedure known as crown lengthening to expose more of the tooth.
Crown lengthening is a minor surgical procedure performed with local anesthesia to numb the tooth, surrounding gum tissues and supporting bone. We first make tiny incisions inside the gum-line on both the cheek and tongue side of the tooth to expose the bone, and then carefully remove a small amount of bone from either side of the tooth; this will expose or “lengthen” the tooth. Once finished, we suture the gum tissue back into place with self-dissolving sutures against the bone and tooth.
Most procedures take only sixty to ninety minutes, and the mild discomfort afterward is usually managed with pain relievers like ibuprofen. While the gum tissues may appear to be healed after a week, we typically wait six to eight weeks to perform the final crown restoration to give the tissues time to fully mature.
Crown lengthening may not work in all situations, especially with a severely fractured tooth. In these cases, we may need to evaluate the long-term viability of the tooth and consider other restorative options. Depending on your bite, it may also be necessary to treat with orthodontics first: not only will the tooth move into a better position, but the treatment may move both the gum and bone down with the tooth. Subsequent crown lengthening will then only affect the intended tooth and not adjacent ones, resulting in a more even smile.
The first step is for us to decide after a thorough examination if you would benefit from crown lengthening. If so, this minor surgical procedure could pave the way for better mouth function and a more attractive smile.
Dental patients around the country love Invisalign because of its simplicity and effectiveness at straightening the teeth. But in order to get Invisalign braces you first have to be evaluated by an orthodontist. Only select patients with relatively minor cosmetic problems are good candidates for Invisalign. Get an idea of what usually qualifies a patient for this popular braces treatment, which is offered at Stewart Dental, a popular Rockwall TX dentist office.
Your Overall Dental Health
One of the considerations that your orthodontist must take into account before starting you on Invisalign is your general dental health. Before your teeth are shifted with an orthodontic treatment, they should be healthy, strong and infection-free. If you have cavities, abscesses or dental infections, that should be taken care of before getting Invisalign.
Your Cosmetic Issues
Another consideration that your Rockwall TX dentist Dr. Ronald W. Stewart will evaluate before suggesting Invisalign is the cosmetic issue that you want to correct. Patients who have serious orthodontic issues are usually best suited for traditional braces. But if you have a minor problem, like gaps or slight crowding, Invisalign might be just right for you. Also, age is a consideration—patients who are teenagers or older are the best candidates for invisible aligners.
Your Commitment to the Treatment Plan
Unlike metal braces that are secured to the surfaces of your teeth and can’t be removed, Invisalign braces can be taken out at will. Your dentist Dr. Ronald W. Stewart will inform you of the importance of keeping them on as much as possible for the fastest and most effective results. You have to have the commitment and discipline to wear your aligners daily. You should only take them out briefly to eat and sparingly in social situations.
Ask Stewart Dental
The best way to determine if you’d be a good candidate for Invisalign is to make an appointment at Stewart Dental in Rockwall, TX. This practice is committed to providing personalized oral health care that meets your unique dental needs. Call the office today at (972) 771-9559 to schedule a consultation.
Let’s say you’re traveling to Italy to surprise your girlfriend, who is competing in an alpine ski race… and when you lower the scarf that’s covering your face, you reveal to the assembled paparazzi that one of your front teeth is missing. What will you do about this dental dilemma?
Sound far-fetched? It recently happened to one of the most recognized figures in sports — Tiger Woods. There’s still some uncertainty about exactly how this tooth was taken out: Was it a collision with a cameraman, as Woods’ agent reported… or did Woods already have some problems with the tooth, as others have speculated? We still don’t know for sure, but the big question is: What happens next?
Fortunately, contemporary dentistry offers several good solutions for the problem of missing teeth. Which one is best? It depends on each individual’s particular situation.
Let’s say that the visible part of the tooth (the crown) has been damaged by a dental trauma (such as a collision or a blow to the face), but the tooth still has healthy roots. In this case, it’s often possible to keep the roots and replace the tooth above the gum line with a crown restoration (also called a cap). Crowns are generally made to order in a dental lab, and are placed on a prepared tooth in a procedure that requires two office visits: one to prepare the tooth for restoration and to make a model of the mouth and the second to place the custom-manufactured crown and complete the restoration. However, in some cases, crowns can be made on special machinery right in the dental office, and placed during the same visit.
But what happens if the root isn’t viable — for example, if the tooth is deeply fractured, or completely knocked out and unable to be successfully re-implanted?
In that case, a dental implant is probably the best option for tooth replacement. An implant consists of a screw-like post of titanium metal that is inserted into the jawbone during a minor surgical procedure. Titanium has a unique property: It can fuse with living bone tissue, allowing it to act as a secure anchor for the replacement tooth system. The crown of the implant is similar to the one mentioned above, except that it’s made to attach to the titanium implant instead of the natural tooth.
Dental implants look, function and “feel” just like natural teeth — and with proper care, they can last a lifetime. Although they may be initially expensive, their quality and longevity makes them a good value over the long term. A less-costly alternative is traditional bridgework — but this method requires some dental work on the adjacent, healthy teeth; plus, it isn’t expected to last as long as an implant, and it may make the teeth more prone to problems down the road.
What will the acclaimed golfer do? No doubt Tiger’s dentist will help him make the right tooth-replacement decision.
If you have a gap in your grin — whatever the cause — contact us or schedule an appointment for a consultation, and find out which tooth-replacement system is right for you. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Crowns & Bridgework.”
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