Benefits of Braces | Adults | Children and Teens | How Braces Work | Invisalign | Duration | Retainers | Teeth Grinding | Jaw Disorders | Maxillo-facial Surgery | Sleep Apnea

Benefits of Braces

Why Braces?

For most people, a beautiful smile is the most obvious benefit of orthodontics. After your braces come off, you’ll feel more self-confident. But there’s much more!

Your dentist may have discussed with you the benefits of having healthy teeth and proper jaw alignment. Crooked and crowded teeth are hard to clean and maintain. This can result in tooth decay, worsen gum disease and lead to tooth loss. Other orthodontic problems can contribute to abnormal wear of tooth surfaces, inefficient chewing function, excessive stress on gum tissue and the bone that supports the teeth, or misalignment of the jaw joints. These can lead to chronic headaches and face or neck pain. Treatment by an orthodontist can be less costly than the additional care required to treat dental problems arising as a result of orthodontic problems.

Braces for ALL Ages

Adults

Orthodontic treatment can be successful at any age, and adults especially appreciate the benefits of a beautiful smile. One of every three patients in orthodontic treatment in our office is over 21. Adults also may have experienced some breakdown or loss of their teeth and bone that supports the teeth, and may require periodontal treatment before, during and/or after orthodontic treatment. Bone loss can also limit the amount and direction of tooth movement that is advisable.

The good news is that after teeth are moved to a more comfortable and physiologic position, many existing problems may be halted and even reversed.

Children

If your child loses a baby tooth early, through decay or injury, his or her other teeth could shift and begin to fill the vacant space. When your child’s permanent teeth emerge, there’s not enough room for them. The result is crooked or crowded teeth and difficulties with chewing or speaking. Space maintainers are nifty devices that can help teeth grow in normally following premature tooth loss, injury or other special problems. The devices can help ensure that proper spaces are maintained to allow future permanent teeth to erupt.

According to research done by the American Association of Orthodontics, it is best for the orthodontist to see children by age 7 to advise if orthodontic treatment is required and the best time for that patient to be treated. The first permanent molars and incisors have usually come in by that time, and back and front teeth growth and misaligned teeth can be evaluated. When treatment is begun during tooth exchange, the orthodontist can guide the growth of the jaw and incoming teeth.

Treatment at a young age can also regulate the width of the upper and lower jaws, gain space for permanent teeth, avoid the need for permanent tooth extractions, reduce the likelihood of impacted permanent teeth, correct thumb-sucking, and helps eliminate abnormal swallowing or speech problems. In other words, treatment of young children ages 7 through 11, can simplify later treatment.

Types of Appliances

Braces (Fixed Appliances)

Orthodontic appliances can be made of metal, ceramic or plastic. They may be removable or they may be attached and bonded to the teeth. By placing a constant gentle force in a carefully controlled direction, braces slowly move teeth to a corrected position.

This is a great time to wear braces!

You can choose brackets that are clear or metallic color. You can choose the color of the ties that hold the wire in brackets. Wires are also less noticeable than they used to be, and the latest materials move teeth faster and with less discomfort to patients.

Invisible (nearly) – No-Brace Treatment

Invisalign® and other clear aligner treatment

Almost invisible, removable and comfortable aligners will give you the beautiful, straight teeth you’ve always wanted. Best of all, there’s no ‘braces’. Aligners are so clear that it’s difficult for others to know that you’re wearing them. Aligners are great for adults and teenagers.

Treatment uses a series of clear, removable aligners. Each one moves the teeth closer to the desired end result. Just as each step in a stairway brings you to the next floor, this method of orthodontics has been proven effective in clinical research and orthodontic practice worldwide.

You’ll wear each aligner for about two weeks or less, removing them for oral hygiene (brushing, etc.) and eating. You’ll visit us about once every 6 to 8 weeks to ensure that all is going well. Total treatment time varies and depends on how complex the original problem is. Most crowding or spacing problems are corrected in 6 to 15 months.

Dr. Zipkin diagnoses the problem and directs the laboratory in the set-up and manufacture of aligners. This is all accomplished, magically, over the internet by reviewing 3-Dimentional virtual models of the patient’s teeth at each aligner stage. Dr. Zipkin indicates the final position of each tooth so that treatment goals can be maximized.

Invisible – Braces on the Tongue-Side of Teeth

Methods for this treatment are similar to regular braces (brackets and wires) but much more difficult, as access to the tongue side is much more limited.

Duration of Treatment

For children or teens, treatment time typically ranges from one to three years, depending upon the growth of the patient’s mouth and face, and the severity of the problem. Patients grow at different rates and will respond variously to orthodontic treatment, so the time to case completion may differ from the original estimate. The patient’s diligent use of any prescribed rubber bands is an important factor in achieving the most efficient treatment. Interceptive, or early treatment procedures, may take as few as six months.

For adults, treatment time depends upon many other factors than growth. Most adult cosmetic procedures are completed in 6 to 12 months.

After Braces or Aligners – Now What?

Retainers

Everyone seems to have heard of retainers but what do they do? They are orthodontic ‘appliances’ (everything is an ‘appliance’) either attached to teeth, or removable that retain the tooth positions. They may be called maintainers.

During treatment, teeth move because the bone that holds them ‘softens’ to allow the movement. Teeth get loose but don’t fall out. The bone re-hardens and the teeth become firm again. That’s the miracle of orthodontic movement. It is possible to move teeth one half inch within the bone and still remain healthy!

After all that movement, the body needs to accept the new positions healthfully so that ‘going back’ to a previous position is avoided. Dr. Zipkin will advise how, when, and for how long you should be in retention.

Teeth Grinding (Bruxism)

Teeth grinding, also called bruxism, is often viewed as a harmless, though annoying habit. Some people develop bruxism from an inability to deal with stress or anxiety.

However, teeth grinding can literally transform your bite relationship, and worse, severely damage your teeth and jaws, over long periods of time.

Teeth grinding can cause abrasion to the chewing surfaces of your teeth. This abnormal wear and tear will prematurely age and loosen your teeth, and open them to problems such as hypersensitivity (from the small cracks that form, exposing your dentin.) Bruxism can also lead to chronic jaw and facial pain, as well as headaches.

If no one has told you that you grind your teeth, here are a few clues:

• Your jaw muscles are often sore, especially in the morning.
• You hear popping sounds when you open and close your mouth.
• You notice small dents or scalloping on the side of your tongue.
• Your teeth are wearing down from rubbing.

Bruxism is treatable. Therapy usually involves use of special appliances to protect the teeth while you sleep. Biofeedback, behavior modification (tongue exercises) and rebalancing your bite are other possibilities. Rebalancing can be accomplished with tooth movement (orthodontics) and reshaping the teeth for optimal fit (equilibration).

Jaw Disorders

People who grind their teeth can sometimes develop a serious problem with their jaw, which, let untreated, can adversely affect the teeth, gums and bone structures of the mouth. One of the most common jaw disorders is related to a problem with the temporomandibular joint, the joint that connects your lower jaw to your skull, allows your upper and lower jaw to open and close, and facilitates chewing and swallowing.

People with temporomandibular joint disorders (TMD) often have a clicking or popping sound when opening and closing their mouths. Such disorders are often accompanied by frequent headaches, neck aches, and in some cases, tooth sensitivity.

Minor cases of TMD involve discomfort in the jaw muscles. More serious conditions involve improperly aligned joints or dislocated jaws. Extreme forms of TMD involve an arthritic condition of the jaw joint.

Some treatments for TMD include muscle relaxants, biofeedback, wearing a small plastic appliance in the mouth during sleep, application of wet heat, acupuncture, and electrical relaxation of muscles.

Dr. Zipkin has been successfully treating people with this disorder for 36 years!

Maxillofacial Surgery

When facial reconstruction, including procedures involving the oral cavity is called for, a specialist is needed. Surgical procedures of the neck and head areas are performed by a maxillofacial surgeon.

Common maxillofacial procedures include denture-related procedures and jaw surgery.

Jaw Correction

Protruding chins, crooked or buck teeth, or misaligned teeth are good candidates for maxillofacial surgery.

In some people, jaws do not grow at the same rate; one may come in larger than the other, or simply not be aligned properly with other bony structures in the skull. This can cause problems other than appearance issues. An improperly aligned jaw can cause problems with the tongue and lips, as well as chewing problems. Jaw surgery can move jaws into the proper place.

Other kinds of problems involve other upper facial features such as the nose and cheek.

In addition to surgical correction, orthodontic appliances such as braces may be needed to restore bite and proper alignment of the jaw. In some cases, tiny wires or small rubber bands may be used to promote faster healing. In other cases, small ‘fixation’ screws are inserted in the jaws to facilitate easy movement of the jaws following surgery.

Snoring and Sleep Apnea

It has been estimated that 60% of men and 40% of women between the ages of 40 and 60 snore. Snoring occurs when there is a partial obstruction of the airway which causes the palatal tissues to vibrate. Snoring is a social problem, particularly for the spouse, but obstructive sleep apnea poses a significant health risk for the patient, in that it can lead to irregular heartbeat, high blood pressure and strokes.

Sleep Apnea

As many as 20 million people in North America may have sleep apnea. Sleep apnea is a type of sleep disorder which is a serious, potentially life-threatening condition characterized by brief interruptions during sleep. There are basically three types of apnea:

• Central Apnea – The upper airway is open but no oxygen gets into the system. This occurs because the patient is not getting a chemical response from the brain to stimulate the lungs and diaphragm to assist with breathing.

• Obstructive Sleep Apnea – The lungs are operating normally, but no oxygen is entering the system because there is an obstruction, usually the tongue, moving back and closing off the throat.

• Mixed Apnea – This is a combination of central and obstructive sleep apnea.

In September 1995, the American Sleep Disorder Association (ASDA) endorsed oral appliance therapy as the third currently acceptable treatment modality for snoring and sleep apnea. The two most common solutions include continuous positive air pressure, or the removal of either the excess palatal tissue or the uvula.

Obstructive Sleep Apnea (OSA)

Obstructive sleep apnea occurs when the airway is completely blocked for certain periods of time. The signs and symptoms of OSA include snoring, excessive daytime sleepiness, gasping or choking during the night, non-refreshed sleep, fragmented sleep, clouded memory, irritability, personality changes, decreased sex drive, impotence, and morning headache.

Factors that affect obstructive sleep apnea are as follows:

• Age
• Obesity
• Alcohol
• Sedative hypnotics (sleeping pills)

Children can also snore and suffer from OSA. Often they are highly allergic, and their airway is blocked due to enlarged adenoids, tonsils or swollen nasal mucosa. Clinical signs would indicate a turned up nose, allergic ‘shiners’ under the eyes, mucous draining out of the nose, mouth breathing, and a nasal sound to the voice. Other signs are bed wetting, irritability, difficulty in concentrating at school and hyperactivity.

At the present time, OSA is defined as a medical problem and the diagnosis must be made by a medical doctor or sleep physician (pulmonologist) who is specially trained in the area of sleep medicine. It is mostly being controlled and treated by the medical professional. Despite the fact that the American Sleep Disorder Association finally endorsed oral appliance therapy as the third acceptable (and potentially less complicated) treatment method for snoring and sleep apnea, the vast majority of medical doctors are not aware of the value of oral appliances.

As time goes by, the public will become more aware of the health risks associated with snoring and sleep apnea. It is the dental professionals’ responsibility to educate their members, the public and the medical profession about the important role that dentists and oral appliances play in the treatment of snoring and obstructive sleep apnea.

Hygiene Issues

People who wear braces must be diligent in ensuring that food particles and other debris do not get trapped in the network of brackets and wires. In addition, permanent ‘white scars’ can be left on the enamel if the area surrounding the brackets and wire is not cleaned on a daily basis.

Bacteria live in the food and debris. Waste products from these bacteria are acid, which can remove calcium from the enamel and promote tooth decay. Daily oral hygiene such as brushing, flossing and rinsing are a necessity. People with orthodontic appliances can benefit from using water picks, which emit small pressurized bursts of water than can effectively rinse away such debris.

Bad Breath (Halitosis)

Bad breath is a common affliction with many people. When it doesn’t go away, or advances, it becomes known as chronic halitosis.

Bad breath is caused by decaying particles of food and bacteria that pass into your bloodstream and to the lungs, where odor is emitted from breathing.

While people spend lots of money on products that treat the symptoms of bad breath, they often neglect to take steps to address the root causes of bad breath, such as bacteria, and decaying food particles in remaining spaces between the teeth, on the gums, and on the tongue. In many cases, good daily oral hygiene, including brushing, flossing and rinsing, can keep bad breath in check. This also applies to denture-wearers.

Another form of bad breath comes from odors emitted from the stomach (gastro-intestinal). If there is no periodontal disease (which causes bad breath) and the mouth and tongue are clean, it may be time to visit your MD. The doctor will determine if this is a medical problem.

Plaque

Plaque is an insidious substance: a colorless, sticky film that blankets your teeth and creates an environment in which bacteria erode tooth enamel, cause gum irritation, infection in inner structures such as pulp and the roots, and in extreme cases, tooth loss.

Some of the biggest culprits causing plaque are foods rich in sugar and carbohydrates, including soda beverages, some juices, candy and many kinds or pasta, breads and cereals.

Plaque also can attack fillings and other restorations in your mouth, which can lead to more costly treatment down the road. It builds up around braces more easily. Excellent brushing can significantly reduce the possibility of cavities and permanent "white scars". Tooth surfaces can be sealed before braces are placed to safeguard against bacterial acids.

Canker/Cold Sores

People sometimes confuse canker sores and cold sores, but they are completely unrelated. Both can be painful, but knowing the differences can help you keep them in check.

A canker sore is typically one that occurs on the delicate tissues inside your mouth. It is usually light-colored at its base and can have a red exterior border. In most cases, patience is the best medicine for treating canker sores. A healthy diet and good oral hygiene are usually the best remedy, but some special rinses and anesthetics can help alleviate the pain.

A cold sore or fever blister, on the other hand, usually occurs on the outside of the mouth, usually on or near the nose of lips. A cold sore is contagious because it is caused by the herpes simplex virus, and it is usually painful and filled with fluid. Because it is viral, don’t touch the sore, as you can transfer herpes to eyes or other parts of your body…AND NO KISSING!

Eating With Braces

What can you eat? Let’s talk about what you shouldn’t eat! If you’ve been wanting to drop a few pounds, the first week wearing braces is just your opportunity.

For the first day or so, stick to soft foods. Avoid tough meats, hard breads, and raw vegetables. Before long, you’ll be able to bite a cucumber again. But you’ll need to protect your orthodontic appliances when you eat for as long as you’re wearing braces.

Chewing on hard things (for example: pens, pencils or fingernails) can damage the braces. Damaged braces will cause treatment to take longer. We will advise you more specifically.

Foods to Avoid – Hard, Sticky, Crunchy, Chewy!

• Chewy foods: bagels, hard rolls, licorice
• Crunchy foods: popcorn, ice, chips
• Sticky foods: caramels, gum
• Foods you have to bite into: corn on the cob, apples, carrots