Reasons for Braces and Orthodontic Treatment

Reasons for Braces and Orthodontic Treatment

Why Braces Are Used and How They Improve Your Oral Health

By Shawn Watson
Updated November 14, 2016
Source

The reasons for braces and orthodontic treatment vary from patient to patient. Approximately 3 million American and Canadian teens have braces, with the number of adults beginning orthodontic treatment rising at a steady rate. Your dentist will typically be the first person to mention orthodontic treatment, and will likely send you or your loved one to see an orthodontist for a consultation.

Who is a Candidate for Braces?

The American Association of Orthodontists (AAO) recommends that children should be seen for their first orthodontic consultation no later than age 7.

While the age of 7 may seem unusually early to consider braces, this pre-screening will give the orthodontist the opportunity to use preventative measures to possibly correct situations that may lead to braces in the future, and /or advise the parent on future orthodontic treatment planning. Adults seeking orthodontic treatment may consult with their dentist at any time, since it is never too late to consider correcting your teeth.

The initial consultation with the orthodontist is typically a visual evaluation of the patient’s teeth and facial structure, with discussion to follow. If the orthodontist requires more in-depth information, or the patient agrees to begin treatment, diagnostic records are then taken of the patient. These diagnostic tools, consisting of x-rays, models of the patient’s teeth, and photographs of the patient’s face and teeth, are used by the orthodontist to study and formulate a treatment plan to present to the patient.

Although most orthodontists do not require a referral from your general dentist, it may be helpful if you obtain one when it comes time to choosing a dentist that is right for you.

Why Do I Need Braces?

Braces are used to move teeth into the ideal position and align how they bite together, known as occlusion.

Malocclusion is used to describe the misalignment of teeth between the upper and lower dental arches, using the first molars as a reference point. There are three different types of misalignment, defined by the Angles Classification Method. Developed by Dr. Edward Angle, considered by many the founding father of orthodontics, this method of classification is widely used by dentists around the world:

  • Class I – Considered the ideal relationship between the upper and lower teeth. Crowding or spacing may be present with Class I bite.
  • Class II – Commonly known as “over bite.” The patient’s lower first molar is positioned posterior, or more towards the back of the mouth. The upper jaw, or maxilla, appears to protrude forward. Class II bite has two sub classes that also describe the position of the upper front teeth, but in both cases, the molar relationship is the same.
  • Class III – The patient’s lower first molar is positioned anterior, or closer to the front of the mouth. The lower jaw, or mandible, protrudes forward, and is best described as an “under bite.”

While some patients may have the ideal bite, they may suffer from varying degrees of crowding or spacing, another factor associated with a misaligned bite. Crowding is a condition that causes the teeth to overlap, rotate, and in some cases, grow into the incorrect position in the mouth, or in more extreme cases, cause the tooth to become trapped in the bone. Crowding may be caused because the dental arch is too small for the adult teeth, or the adult teeth are larger than normal.

Crowding may also be caused by losing the primary or baby teeth early, or retaining them in the mouth longer than normal. These factors may inhibit the adult tooth, forcing it to erupt or grow into an incorrect position. Crowding makes it difficult to brush and floss the teeth correctly, possibly resulting in tooth decay or gingivitis.
Alternatively, varying degrees of spacing may be present, due to smaller teeth or jaw size. The most obvious example of spacing is the diastima, a space between the upper two front teeth, known as the centrals, made famous by Madonna.

More Than Just Straight Teeth

Misaligned teeth and an incorrect bite may affect more than just the appearance of your smile. The following conditions may potentially be corrected by orthodontics:

  • Speech impediments
  • Jaw or TMJ pain
  • Difficulty chewing and eating
  • Sleep apnea caused by mouth breathing and snoring
  • Grinding or clenching of the teeth
  • Gum disease and tooth decay

Patients experiencing any of the above symptoms should contact their dentist to determine the cause of their condition. Aesthetics do, however, play an important role when it comes to deciding if braces are right for you. Self confidence may improve for patients that have concerns with the appearance of their teeth or facial shape.

Many treatment options are available for correcting the look of your teeth and smile.

Talk to Your Dentist

Healthy teeth and gums, improved facial structure, and enhanced self esteem are just few of the many benefits of correcting your teeth with braces. To find an orthodontist in your area, visit the American Association of Orthodontics website, or book an appointment with your family dentist.

Source: The American Association of Orthodontists.

14 Ways You Might Be Brushing Your Teeth Wrong

14 Ways You Might Be Brushing Your Teeth Wrong

By Amanda Schupak
December 1, 2015
Source

1. Your toothbrush bristles aren’t soft enough.

When you bought your toothbrush did it say “Soft” or “Extra Soft” on the package? No? Then it’s probably the wrong toothbrush. Hard bristles can weaken tooth enamel. You also want the head of the brush to be small enough to easily reach all your teeth.

2. You’re brushing too hard.

Going at your chompers like you’re sandblasting a floor is just going to do more damage to your tooth enamel and can even hurt your gums and lead to gum recession. If you simply can’t control your strength, an angled handle can help ease the pressure on your teeth.

3. You’re holding your toothbrush too tightly.

If you’re holding your toothbrush with Kung Fu grip, it’ll make you more likely to saw away in a manner that can wear away your enamel. Find a brush with a handle that is easy to hold with a light grip.

4. And at the wrong angle.

The American Dental Association recommends holding the surface of the toothbrush bristles at a 45-degree angle to the front of your teeth. Then, brush in small strokes (think one-tooth-at-a-time) or in tiny circles. Don’t forget the insides, too, as well as the chewing surfaces.

5. You don’t watch what you’re doing.

Multitasking is a great way to do two things poorly. Rather than checking Instagram or wandering around the house while you brush, look at yourself in the mirror. (Oh, hey there.) Focus to make sure you get all your teeth, all the way up to the gum line—even those guys way in the back.

6. You don’t brush for long enough.

The ADA says you should brush for at least two minutes. Some dentists recommend going up to four minutes. Check the clock—or invest in a powered toothbrush with a timer.

7. You skip brushing before bed.

Of course, after a long day (or a long night) sometimes we all just want to say phooey to our hygiene routines and flop in bed. But just think of it this way: That’s seven or eight (or 11) uninterrupted hours for bacteria to do their dirty work, irritating your gums and causing tooth decay, and for plaque to harden into tartar.

8. You forget to brush your tongue, too.

Your tongue is actually one of the biggest sources of bad breath on account of all the microbes and food debris that get stuck on it. Get that gunk off. According to the ADA, studies have shown that just brushing your tongue can reduce bad breath by as much as 70 percent.

9. You fail at flossing.

To paraphrase the late, hilarious standup Mitch Hedberg, we know it’s as hard to start flossing as it is to stop smoking. But there’s a reason your dentist is always giving you a hard time about it. The food hiding between your teeth that so eludes your toothbrush’s bristles harbors bacteria that cause tooth decay. Oh, and PS, dragon breath, that stuff stinks, too.

10. Your toothbrush is too old.

Bristles become frayed and worn over time, which makes them less effective at cleaning and potentially more damaging to the teeth. Plus, cracked or broken bristles are havens for bacteria. Get a new brush every three or four months.

11. You disinfect your toothbrush constantly.

This can actually just make your toothbrush age faster. The best way to clean your toothbrush is to rinse it thoroughly under the tap and store it upright to air-dry.

12. You keep your toothbrush in a covered holder.

It’s OK for protecting it while traveling, but routinely storing your brush in a closed, moist container is more conducive to microbial growth.

13. You replace your toothbrush every time you get sick.

No need! Whatever germs are on your brush are the same ones your body just built up a bunch of antibodies against. Don’t waste your money.

14. You use your boo’s brush.

Your body is not prepared to fight of someone else’s germies, however, so using their toothbrush increases your risk of infections.

13 Awful Things That Happen If You Don’t Brush And Floss Your Teeth

13 Awful Things That Happen If You Don’t Brush And Floss Your Teeth

by: Lauren F Friedman
Feb. 14, 2014, 10:00 AM
Source

Can’t ever find the time to take care of your teeth? About half of Americans don’t floss daily, and one in five don’t brush twice daily — so you’re not alone.

But you may want to reconsider.

“Taking care of your teeth and gums isn’t just about preventing cavities or bad breath,” the American Dental Association warns. “The mouth is a gateway into your body’s overall health.”

It’s almost impossible to prove a cause-effect relationship between dental neglect and various conditions because researchers would have to create a control group that ignored their teeth completely for a long time — something that would likely be harmful enough to be considered unethical. But there’s mounting evidence that shows an association between poor dental hygiene and a wide variety of ills.

You should visit the dentist at least once a year, and the ADA recommends that you brush twice a day for two minutes and floss once a day. If you choose to ignore their advice, you’ll get cavities, sure — but here are 13 other things you’re at risk of, some more common than others.

1. Gum disease

Most people don’t realize this, but your gums are not supposed to bleed when you brush and floss. If yours do, you probably have gum disease — or are at least well on your way. Gingivitis, the milder form of gum disease, makes gums red, swollen, and quick-to-bleed — part of a response to the bacteria in the plaque that builds up between your teeth and gums. More than half of Americans have gingivitis.

If plaque spreads, the immune response heightens and can destroy tissues and bones in the mouth, creating pockets between the teeth that can become infected. (Other conditions unrelated to oral hygiene habits can also have these effects.) At this severe stage, gum disease is called periodontitis, and it can become chronic. Google “periodontitis,” and you might become more vigilant about oral hygiene.

Source: American Academy of Periodontology; Clinical Calcium, 2012

2. Tooth loss

If you’ve never worried about losing your teeth, you should start. Adults 20 to 64 have lost an average of seven (permanent) teeth, and 10% of Americans between 50 and 64 have absolutely no teeth left. Both cavities and gum disease can end in tooth loss.

Source: National Institute of Dental and Craniofacial Research

3. Bad breath

Bad breath, clinically called halitosis, may affect as much as 65% of the population. A number of conditions can have halitosis as a symptom, but the number one by far is poor oral hygiene. Food particles that linger long after meals can start to stink, and the less you brush and floss, the more potentially malodorous bacteria build up in your mouth. The coating on your tongue is also a key contributor to bad breath, and some research has suggested that cleaning your tongue — along with regular brushing and flossing, of course — may help reign in this problem.

Source: Internal and Emergency Medicine, 2011; International Journal of Oral Science, 2012; Nursing Research, 2013

4. Dementia

A large, long-term study of residents at a Laguna Hills retirement community suggests that there may be a link between poor dental health and dementia, although it’s possible that people with better oral hygiene have better health habits in general. Researchers followed 5,468 people for 18 years and found that — among those who still had teeth — those “who reported not brushing their teeth daily had a 22% to 65% greater risk of dementia than those who brushed three times daily.” In addition, a small study found that the brains of patients with Alzheimer’s had more bacteria associated with gum disease than did those belonging to the cognitively healthy.

Source: Journal of the American Geriatrics Society, 2012; Journal of Alzheimer’s Disease, 2013

5. Pneumonia

When pathogens lurk in your mouth, you inhale them right into your lungs, where they can wreak all kinds of havoc. One major review pointed to this process as the reason for an association between poor oral hygiene and hospital-acquired pneumonia. Improving oral hygiene — through some methods beyond brushing and flossing in this case — reduced the incidence of such pneomonia by 40%. Another study of 315 patients in a Brazilian hospital found that those with periodontitis were almost three times as likely to have pneomonia.

Source: Annals of Periodontology, 2003; Journal of Periodontology, 2013; Gerondontology, 2013

6. Erectile dysfunction

A connection between dental disease and erectile dysfunction may seem remote, but preliminary research suggests that the conditions could be linked. They both have been tied to Vitamin D deficiency, smoking, and general inflammation, but the exact reason for the association is still a mystery. One study in rats found that periodontitis impaired penis function. While it’s unclear whether the same direct effects would be found in humans, in a group of patients between 30 and 40, 53% of those with erectile dysfunction had severe periodontitis, while only 23% of those without ED did. “We think that it will be of benefit to consider periodontal disease as a causative clinical condition of ED in such patients,” the authors wrote.

Source: The Journal of Sexual Medicine, 2011; The Journal of Sexual Medicine, 2012; Journal of Clinical Periodontology, 2012

7. Brain abscess

Often caused by bacterial infection, an abscess is a collection of pus, with swelling and inflammation around it. In the brain, it is fatal if left untreated. “A poor dental condition, notably destructive periodontal disease, can be a risk for life-threatening” disease in other parts of the body, noted a team of scientists who pinpointed a patient’s extremely poor dental health as the likely cause of his life-threatening brain abscess. Brain abscesses are rare, and there has been no systematic study linking them to bad dental hygiene. But the authors noted at least 12 other case reports of brain abscess that pointed to poor dental hygiene as the probable cause.

Source: Journal of Clinical Periodontology, 2011

8. Diabetes

Dentists have long known that diabetes is a risk factor for periodontitis, but now research is beginning to indicate that the relationship may be bidirectional. Extremely poor dental health may also be a risk factor for insulin resistance (often called “pre-diabetes”) and diabetes, largely because it increases inflammation. Some studies have even indicated that in patients with both conditions, reigning in periodontitis may improve diabetes control.

Source: Annals of Periodontology, 1998; Diabetes Care, 2010; Diabetes & Metabolism Journal, 2012; Journal of Applied Oral Science, 2013

9. Kidney disease

About 3.7% of U.S. adults have chronic kidney disease, but certain people are more at risk. People with periodontal disease were 4.5 times more likely to have chronic kidney disease, making poor dental health a stronger predictor for CKD than high cholesterol. Adults with no remaining teeth were also 11 times more likely to have chronic kidney disease. While dental disease is not the strongest risk factor — people older than 60 are 27 times more likely to have chronic kidney disease than younger people, for example — another study confirmed that periodontitis may be a significant risk for kidney disease, even after controlling for underlying health conditions that contribute to both.

Source: American Journal of Kidney Disease, 2008; Journal of Periodontology, 2010

10. Heart disease?

Multiple studies have suggested that there may be a connection between gum disease and heart disease, both of which are associated with inflammation. “Adding oral health self-care… is prudent to improve patients’ oral health and possibly reduces [coronary heart disease],” concluded one study. “Periodontal disease caused by pathogen bacteria… could represent one of several possible causal factors of heart disease,” concluded another.

The authors of a 2008 review for the U.S. Preventative Services Task Force recommended that periodontal disease be considered a marker of risk for heart disease, independent of traditional risk factors — even though they noted a lack of evidence demonstrating a causal relationship.

But a scientific statement from the American Heart Association in 2012 urged caution: Periodontal disease and heart disease share many underlying risk factors; there’s no reason to think that dental problems directly cause heart disease; and treating periodontitis reduces inflammation but does nothing to alter the course of heart disease, the authors concluded.

Source: Journal of General Internal Medicine, 2008; Current Opinion in Nephrology and Hypertension, 2010; General Dentistry, 2012; Circulation, 2012

11. Pregnancy complications

Gingivitis affects 60 to 75% of pregnant women, and it’s especially important that expectant mothers tend to their teeth. When pregnant women have serious dental problems, their infants are more likely to develop cavities. Poor maternal oral health is also associated with low birth weight and preterm birth, although there’s not enough evidence yet to know whether it’s an independent risk factor. Researchers suspect that one of two mechanisms may be at play: Either overall inflammation is heightened, or oral bacteria that enter the bloodstream eventually colonize the placenta, causing an inflammatory response.

Source: Journal of Clinical Nursing, 2010; Ginekologia Polska, 2012; Dental Clinics of North America, 2013

12. Ulcers

In people with periodontitis, the plaque that forms in the pockets beneath the gum line can become a reservoir for Helicobacter pylori, the bacterium that is asymptomatic in most but is responsible for stomach ulcers when it flares up. Helicobacter pylori can be transmitted orally, and large epidemiological studies have found a positive association between periodontitis and a positive test for the bacterium, which is also a risk factor for stomach cancer. Different researchers have come to somewhat different conclusions, but the bacterial pockets that form during periodontitis unquestionably pose a risk for various kinds of bacterial growth and infection.

Source: Gut, 1995; American Journal of Public Health, 2002; Clinical Microbiology Reviews, 2010

13. Cancer

“Recent evidence suggests that the extent and severity of periodontal disease and tooth loss may be associated with an increased risk of malignant disease,” concluded one researcher, after reviewing previous studies suggesting an association between poor oral health and cancer. Gum disease and dental problems are also associated with HPV, which causes up to 80 percent of oral cancers. While smoking is a major risk factor for both gum disease and cancer, a study last year of 3,439 people identified poor oral health as an independent risk factor for HPV, even when smoking habits were accounted for. Other preliminary research has suggested that periodontitis may promote the growth of cancerous cells in the mouth.

Source: Dental Update, 2010; South Asian Journal of Cancer, 2012; Cancer Prevention Research, 2013

Dental Hygiene for Babies

Dental Hygiene for Babies

Helping You Care for Your Baby’s Teeth and Gums

By Shawn Watson – Reviewed by a board-certified physician.
Updated September 02, 2016

Babies require daily dental hygiene care in order to prevent mouth irritation and tooth decay. When you take the time to develop good brushing and flossing habits from an early age, it will make this often monotonous task part of their daily routine; for a lifetime of healthy teeth and gums.

The Beginnings of Oral Health Care

Dental hygiene should begin shortly after a child is born. After every feeding, a clean, warm wash cloth should be used to gently cleanse the inside of the mouth.

Thrush, a treatable fungal infection caused by Candida (yeast), often appears in areas of the mouth that may have torn tissue, caused by the constant sucking on a pacifier, bottle, or during breastfeeding. The tiny tears remain moist and, if not removed manually, the yeast may cause the painful condition. Signs of thrush include:

  • White patches that appear to coat the tongue, inside tissue of the cheek, and gums
  • Irregular-shaped patches that are not able to be wiped away, sticking to the tissue
  • Pain when feeding or using a pacifier

If left untreated, a nursing mother may develop thrush on her breast, although it is not typically considered contagious. See your doctor or dentist and he may prescribe a medication to clear up the infection.

So Much Pain for Such Small Teeth

Teething can begin around 3 months of age, but it typically begins when your child is 6 to 7 months old. Signs of teething may include:

  • Excessive drooling
  • Irritability
  • “Gumming” or biting
  • Appearance of a rash around the mouth, or on the face
  • Excessive crying
  • Loss of appetite
  • Feverish
  • Changes in bowel movements

Help ease the pain of teething by using a clean, cool washcloth to gently massage the gums. Offer the child a cool teething ring or a teething biscuit, if that is appropriate for the age of the child.

Always supervise your child when using a teething biscuit because of the potential choking hazard. Talk to your doctor or dentist before using over-the-counter pain reducers or desensitizing gel.

Did You Know?

One in every 2,000 babies is born with one or more teeth. This is referred to as a natal tooth. Teeth that appear in the first month of life are referred to as neonatal teeth.

The first teeth that will appear are usually the lower incisors, commonly known as the two front teeth. By the age of three, children should have their complete set of 20 “pearly whites.” When the first teeth start to appear, buy a toothbrush designed for the age of your child, usually this is indicated on the packaging, and gently cleanse the entire tooth without toothpaste. Beginning at around 18 months, you may choose to introduce a tooth cleansing paste that is safe to swallow and does not contain fluoride. Many brands of children’s toothpaste are available in your local retail store. When in doubt, ask the pharmacist to recommend a brand for you.

Different types of baby toothbrushes are on the market; choose one that is right for you and your child.

Early Childhood Cavities

Early Childhood Cavities (ECC), more commonly known as “baby bottle tooth decay” is a condition that affects children up to the age of three, or as long as they remain using a bottle. Although rare, ECC may indicate the potential risk for severe tooth decay when the child develops his adult teeth. ECC is caused by:

  • Sugars and carbohydrates in the child’s diet
  • Beverages that contain sugar such as milk, infant formula, fruit juice, or any other liquid that contains or is sweetened with sugar.
  • Bacteria transferred from the caregiver to the child
  • The frequency of feedings
  • Allowing a child to fall asleep with a bottle that contains any liquid other than pure water.

Prevent early childhood decay by:

  • Offering a pacifier rather than a bottle during naps and bed time
  • Speak with your dentist for advice on how to expose your child to fluoride, if it is not available through your water supply. Fluoride is recommended by the
  • American Dental Association to strengthen teeth, which may prevent tooth decay.
  • If using a bottle during periods of sleep, fill the bottle with only pure water.

Sources:

The American Dental Association. Oral Health Topics – “Early Childhood Tooth Decay (Baby Bottle Tooth Decay)”

The American Dental Association. Oral Health Topics – “Teething”

The Canadian Dental Hygienists Association. Oral Health Matters for You and Your Baby.

Vincent Iannelli, M.D., Verywell.com Guide to Pediatrics “Thrush- An Oral Yeast Infection”

Nutrition and Good Oral Health

Nutrition and Good Oral Health

By Tammy Davenport
Updated July 12, 2016

Choosing the right foods in your diet is an important aspect of having healthy teeth and good oral hygiene. Establishing good nutritional habits in kids and teenagers can be especially beneficial for good eating patterns and food choices throughout their lives.

How Nutrition affects oral health

The foods that you eat come in contact with the germs and bacteria that live in the mouth. If you don’t brush, plaque will accumulate on the teeth.

Plague thrives on the starches and sugars that are found in a great deal of foods. When plaque combines with the sugars and starches, an acid is produced that attacks enamel on the teeth, and eventually causes decay. According to the American Dental Association, the acid attacks the teeth for 20 minutes or more.

Choosing a Healthy Diet

Choosing a healthy diet may sound easy, however, fruits, milk, cereals, bread and some vegetables contain sugars and / or starches. Carbonated sodas, sweet fruit drinks, and sugary snack foods should be limited.

You don’t have to avoid these foods, just keep in mind that you should eat a balanced diet, brush your teeth twice a day and floss daily.

Healthy Tips

  • Drink plenty of water
  • Eat a variety of healthy foods from the five major food groups
  • Cut down on snacking in between meals
  • Limit snacks and drinks that are high in sugar
  • Brush twice a day
  • Floss Daily
  • Visit your dentist for regular check-ups

Dentists Can Identify People With Undiagnosed Diabetes

Dentists Can Identify People With Undiagnosed Diabetes

15 Jul 2011

In a study, Identification of unrecognized diabetes and pre-diabetes in a dental setting, published in the July 2011 issue of the Journal of Dental Research, researchers at Columbia University College of Dental Medicine found that dental visits represented a chance to intervene in the diabetes epidemic by identifying individuals with diabetes or pre-diabetes who are unaware of their condition. The study sought to develop and evaluate an identification protocol for high blood sugar levels in dental patients and was supported by a research grant from Colgate-Palmolive. The authors report no potential financial or other conflicts.

“Periodontal disease is an early complication of diabetes, and about 70 percent of U.S. adults see a dentist at least once a year,” says Dr. Ira Lamster, dean of the College of Dental Medicine, and senior author on the paper. “Prior research focused on identification strategies relevant to medical settings. Oral healthcare settings have not been evaluated before, nor have the contributions of oral findings ever been tested prospectively.”

For this study, researchers recruited approximately 600 individuals visiting a dental clinic in Northern Manhattan who were 40-years-old or older (if non-Hispanic white) and 30-years-old or older (if Hispanic or non-white), and had never been told they have diabetes or pre-diabetes.

Approximately 530 patients with at least one additional self-reported diabetes risk factor (family history of diabetes, high cholesterol, hypertension, or overweight/obesity) received a periodontal examination and a fingerstick, point-of-care hemoglobin A1c test. In order for the investigators to assess and compare the performance of several potential identification protocols, patients returned for a fasting plasma glucose test, which indicates whether an individual has diabetes or pre-diabetes.

Researchers found that, in this at-risk dental population, a simple algorithm composed of only two dental parameters (number of missing teeth and percentage of deep periodontal pockets) was effective in identifying patients with unrecognized pre-diabetes or diabetes. The addition of the point-of-care A1c test was of significant value, further improving the performance of this algorithm.

“Early recognition of diabetes has been the focus of efforts from medical and public health colleagues for years, as early treatment of affected individuals can limit the development of many serious complications,” says Dr. Evanthia Lalla, an associate professor at the College of Dental Medicine, and the lead author on the paper. “Relatively simple lifestyle changes in pre-diabetic individuals can prevent progression to frank diabetes, so identifying this group of individuals is also important,” she adds. “Our findings provide a simple approach that can be easily used in all dental-care settings.”

Source: Columbia University Medical Center