Q: I am a 38 year old executive. I am not satisfied with my smile but cannot
conduct business with braces on my teeth.
A: According to the American Association of Orthodontics,
there are a million adults in the United States and Canada who have braces
on their teeth to align them and effect a pleasing smile. This means you probably
know an adult who is wearing braces -- but does not necessarily mean you know
it. By using a series of clear, removable aligners, Invisalign straightens
your teeth with results you'll notice sooner than you think. The course of
treatment involves changing aligners approximately every two weeks, moving
your teeth into straighter position step by step, until you have a beautiful
smile. And unlike braces, these clear aligners can be removed while you eat
and brush your teeth. Invisalign is virtually invisible, so there's no reason
you cannot have your teeth straightened without unwarranted attention to your
mouth. In fact, very few people will notice at all - unless you tell them.
They're comfortable to wear and remove easily when you eat, brush, and floss.
Q: My 6-year-old has been going to the dentist regularly.
What should I watch for that would indicate an orthodontic problem?
A: Every orthodontic problem determines its own best
starting time, which will be coordinated with the child's growth pattern. An
early examination by the orthodontist enables evaluation of the problem and
early determination of the appropriate time to treat the child for maximum
improvement. The American Association of Orthodontics recommends that every
child should be examined by the orthodontist by the age of 7.
Early Warning Signs:
- Difficulty in chewing or biting
- Early of late loss of primary (baby) teeth
- Thumb or finger sucking
- Open mouth breathing or snoring
- Overlapping or crowding
- Clicking or popping of the jaws
- A developing underbite, overbite, protruding front teeth of other abnormal
bite development
Q: What can happen if orthodontic problems are left
untreated?
A: Crooked and crowded teeth are harder to clean
and maintain than straight teeth, which bite properly with their counterparts in
the opposite jaw. This may lead directly to tooth decay, staining, gum disease,
movement of other teeth in the opposing arch, and even tooth loss. Other
orthodontic problems (in correct tooth position or malocclusion) can cause
abnormal wear of the teeth, excessive stress on the supporting bone and gum
tissues, or misalignment of the jaw joints. Tooth position, in its extreme, can
affect speech and digestion.
An investment in orthodontic treatment now may offset
more costly treatment in the future. In addition, an untreated malocclusion may
result in harmful effects, not only to the oral health of the individual, but also
to his or her self-esteem. A person's self-consciousness often disappears as
orthodontic treatment brings teeth, lips and face into the proper position.
Q: My dentist told me I have periodontal disease and
that as part of my entire treatment I must see an orthodontist to reposition my
teeth. Why do I need braces for gum disease?
A: First let us explain the term "gum disease."
This is really a misnomer and should be "disease of the supporting structures
of the teeth." These structures include the bone and soft tissue surrounding the
teeth. The importance of these structures is obvious. The teeth will not survive
over the long haul if the support of foundation is poor or diseased. Just as a
house with a faulty foundation will eventually fail, so will the supporting
structures of the teeth.
Sometimes this disease process is due to the position of
the teeth (e.g., the occlusion). Therefore if the teeth come together or bite
in a way that produces or enhances the disease process, there can be periodontal
or gum disease. Here it is necessary to resolve or fix the bite problem through
treatment. Braces put the teeth in a better position. As in the example of the
house, first you must fix the foundation, then you can fix the house.
Q: Why should I replace missing back teeth? They don't
show.
A: As with the previous question, I would liken
back teeth to the foundation of a house. The foundation of a house usually does
not show either BUT if it is not intact and whole, then the house may
shift and even fall in. The back teeth are the foundation of a healthy bite.
These are the teeth that "hold up the bite." When one or more is missing, it puts
excessive stress on the remaining teeth. The stress may cause periodontal disease
and/or movement of teeth. This could result in a bad bite. The terminology is
"posterior bite collapse."
When one tooth is lost, the teeth on either side lean
into the space. These teeth are now out of position and biting forces may move
them even more. If the teeth have moved a lot, it may be necessary to see an
orthodontist to move them back into position. Sometimes orthodontics can be done
to close the spaces and still have a healthy bite. In order to support the bite
properly and to maintain healthy back teeth, bridges, implants or braces may
be used.
Q: My children are young. One child uses a pacifier
and the other sucks his fingers. Do these habits make teeth stick out and cause
the need for braces?
A: Sucking on fingers and pacifiers are habits that
may cause teeth malalignment and/or developmental problems of the jaws. This
happens to some degree depending on force and duration of the sucking habit.
Finger sucking usually causes more of a problem than the pacifier due to the
distribution of forces. The fact is that digits are sucked for a longer period
of time. Therefore it is recommended that pacifiers be used if one of the other
is deemed necessary by the parent.
Behavior modification is well documented as
a means of breaking the habit in those children past the age of 4 who have a real
interest in stopping. This can be done by positive encouragement daily. In
some cases, this is insufficient and an orthodontic appliance must be placed
to stop the habit. This is done as intervention since continued use can cause
"buck teeth," narrowing of the upper jaw, crowding and backward movement of
lower teeth.
Many times merely stopping the habit will spontaneously return the
teeth and jaws to their proper position. It will certainly stop any additional
movement. It still may be necessary to move the teeth orthodontically, even
though the habit has been stopped. Therefore, it is very beneficial for you as
the parent to attempt to reward behavior modification training to stop the habit.
If this is unsuccessful or teeth remain out of alignment after 6 months, I suggest
you see an orthodontist for his opinion regarding possible orthodontic
intervention.