Posts for: July, 2018
Moving your teeth to a more functional and attractive alignment is a big undertaking. You can invest months — even years — and a lot of expense to correct a bad bite. But all that effort could be for nothing if your teeth return to their original positions.
The very aspect of dental physiology that makes orthodontics possible can work against you in reverse. Your teeth are not actually rigidly fixed in the bone: they're held in place by an elastic gum tissue known as the periodontal ligament. The ligament lies between the tooth and the bone and attaches to both with tiny fibers.
While this mechanism holds the teeth firmly in place, it also allows the teeth to move in response to changes in the mouth. As we age, for example, and the teeth wear, the ligament allows movement of the teeth to accommodate for the loss of tooth surface that might have been created by the wear.
When we employ braces we're changing the mouth environment by applying pressure to the teeth in a certain direction. The teeth move in response to this pressure. But when the pressure is no longer there after removing the braces or other orthodontic devices, the ligament mechanism may then respond with a kind of “muscle memory” to pull the teeth back to where they were before.
To prevent this, we need to help the teeth maintain their new position, at least until they've become firmly set. We do this with an oral appliance known as a retainer. Just as its name implies it helps the teeth “retain” their new position.
We require most patients to initially wear their retainer around the clock. After a while we can scale back to just a few hours a day, usually at nighttime. Younger patients may only need to wear a retainer for eighteen months or so. Adults, though, may need to wear one for much longer or in some cases permanently to maintain their new bite.
Although having to wear a retainer can be tedious at times, it's a crucial part of your orthodontic treatment. By wearing one you'll have a better chance of permanently keeping your new smile.
If you would like more information on caring for your teeth after 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 “The Importance of Orthodontic Retainers.”
Did you see the move Cast Away starring Tom Hanks? If so, you probably remember the scene where Hanks, stranded on a remote island, knocks out his own abscessed tooth — with an ice skate, no less — to stop the pain. Recently, Dear Doctor TV interviewed Gary Archer, the dental technician who created that special effect and many others.
“They wanted to have an abscess above the tooth with all sorts of gunk and pus and stuff coming out of it,” Archer explained. “I met with Tom and I took impressions [of his mouth] and we came up with this wonderful little piece. It just slipped over his own natural teeth.” The actor could flick it out with his lower tooth when the time was right during the scene. It ended up looking so real that, as Archer said, “it was not for the easily squeamish!”
That’s for sure. But neither is a real abscess, which is an infection that becomes sealed off beneath the gum line. An abscess may result from a trapped piece of food, uncontrolled periodontal (gum) disease, or even an infection deep inside a tooth that has spread to adjacent periodontal tissues. In any case, the condition can cause intense pain due to the pressure that builds up in the pus-filled sac. Prompt treatment is required to relieve the pain, keep the infection from spreading to other areas of the face (or even elsewhere in the body), and prevent tooth loss.
Treatment involves draining the abscess, which usually stops the pain immediately, and then controlling the infection and removing its cause. This may require antibiotics and any of several in-office dental procedures, including gum surgery, a root canal, or a tooth extraction. But if you do have a tooth that can’t be saved, we promise we won’t remove it with an ice skate!
The best way to prevent an abscess from forming in the first place is to practice conscientious oral hygiene. By brushing your teeth twice each day for two minutes, and flossing at least once a day, you will go a long way towards keeping harmful oral bacteria from thriving in your mouth.
If you have any questions about gum disease or abscesses, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Periodontal (Gum) Abscesses” and “Confusing Tooth Pain.”
If you’re seeing your dentist regularly, that’s great. But if that’s all you’re doing to stay ahead of dental disease, it’s not enough. In fact, what you do daily to care for your teeth is often the primary factor in whether or not you’ll maintain a healthy mouth.
Top of your oral care to-do list, of course, is removing daily plaque buildup from teeth and gums. This sticky film of bacteria and food particles can cause both tooth decay and periodontal (gum) disease. You do that with effective daily brushing and flossing.
Effective brushing starts with the right toothbrush—for most people a soft-bristled, multi-tufted brush—and fluoride toothpaste. As to technique, you should first avoid brushing too hard or too often (more than twice a day). This can damage your gums and cause them to recede, exposing the tooth roots to disease. Instead, use a gentle, scrubbing motion, being sure to thoroughly brush all tooth surfaces from the gumline to the top of the teeth, which usually takes about two minutes.
The other essential hygiene task, flossing, isn’t high on many people’s “favorite things to do list” due to frequent difficulties manipulating the floss. Your dentist can help you with technique, but if it still proves too difficult try some different tools: a floss threader to make it easier to pull floss through your teeth; or a water flosser, a handheld device that directs a pressurized water stream on tooth and gum surfaces to loosen and flush away plaque.
And don’t forget other tooth-friendly practices like avoiding sugary snacks between meals, drinking plenty of water to avoid dry mouth, and even waiting to brush or floss about an hour after eating. The latter is important because acid levels rise during eating and can temporarily soften enamel. The enzymes in saliva, though, can neutralize the acid and re-mineralize the enamel in about thirty minutes to an hour. Waiting to brush gives saliva a chance to do its job.
Lastly, keep alert for anything out of the ordinary: sores, lumps, spots on the teeth or reddened, swollen, bleeding gums. All these are potential signs of disease. The sooner you have them checked the better your chances of maintaining a healthy mouth.
If you would like more information on caring for your teeth at home, 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 “10 Tips for Daily Oral Care at Home.”