The big day finally arrives when your braces come off. And there it is—your new, beautiful, straight smile! But on closer inspection you notice something else: tiny white spots on your teeth.
Those pale, chalky spots are called white spot lesions (WSLs). They occur when acid has contacted the tooth enamel for too long, dissolving essential minerals like calcium in those particular areas. The occurrences of WSLs during and after braces highlights a major challenge during orthodontic treatment—keeping your teeth clean.
Braces' wires and brackets tend to get in the way of brushing and flossing, making it easier to miss plaque—the bacterial film that produces acid—on tooth areas around the hardware. Those missed areas could in time lead to WSLs.
The main objective with WSLs is prevent them from occurring during braces wear as much as possible. To do this, you'll need to increase your time and effort brushing and flossing, especially around orthodontic hardware. You can make it easier, though, by using a few tools that often work better than regular toothbrushes and floss like interproximal toothbrushes, power brushes, floss threaders or water flossers.
You can also help lower your mouth's acidity by avoiding or limiting acidic foods and beverages, including juices, sodas, sports and energy drinks. And, by all means, keep up your regular dental cleaning schedule with your general dentist.
Should WSLs develop while you're wearing braces, don't panic. It's possible they'll diminish on their own, or at least not worsen. We can also foster re-mineralization of the enamel with applied fluoride, short bursts of laser light or a procedure called microabrasion that restores damaged areas below the enamel surface.
For more resistant WSLs, we can also inject a liquid tooth-colored resin into them that when hardened by a curing light can make those areas look translucent like normal enamel. We can also use other cosmetic solutions like bonding or veneers to improve your teeth's appearance.
Like other dental problems, dealing with a WSL is usually more successful if caught and treated early. So, check your teeth often while wearing braces, and if you notice anything unusual don't hesitate to call your dentist.
If you would like more information on oral care while wearing 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 “White Spots on Teeth During Orthodontic Treatment.”
Correcting a bite problem involves more than applying braces. Orthodontists must consider a wide range of factors, including the type of bite problem involved, complications like impacted or missing teeth, and their patient's overall dental condition.
Orthodontists must also keep in mind the future—how will a treatment implemented now impact a patient's appearance and dental function many years from now? In reality, orthodontists perform these treatments within a dynamic growth environment, especially involving children and teenagers whose mouth and facial structures are still maturing.
And although these growth changes slow in adulthood, they don't stop—orofacial structures continue to change throughout life. For example, a person's lips steadily thicken in size until the mid-teen years, and then slowly thin out over the rest of their lifetime. The distance between the lips both at rest and while smiling may also narrow in later years. Other changes continue to occur in the bones and soft tissues of the mouth and face.
Fortunately, this structural growth follows a fairly consistent track. Although variations do occur, an orthodontist can project the growth changes their patients will undergo as they age, and use that knowledge to plan out bite treatment. With this understanding, orthodontists plan not only what treatments will be needed, but when to perform them, and to what extent.
This may involve a number of treatment stages, spaced out to coincide with regular development. An orthodontist may focus first on general bite correction to bring the teeth and jaws into a reasonable state of alignment. Later, they'll use more refined methods to fine-tune corrections that better align with later adult growth.
More intensive treatments may be necessary to build a foundation for future treatment. For example, orthognathic surgery may be needed to correct a severe case of an over-extended lower jaw. During the procedure, surgeons move the lower jaw to a joint position higher on the skull. This retracts the lower jaw into a more normal alignment with the upper jaw, and can dramatically change the facial profile for the better.
Each orthodontic patient is different, and each requires their own a unique treatment plan. That plan has a greater chance of long-term success by applying knowledge of future growth changes.
If you would like more information on orthodontic treatment, 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 “Understanding Aging Makes Beauty Timeless.”
Buffalo Bills wide receiver Stefon Diggs wrapped up the NFL regular season in January, setting single-season records in both catches and receiving yards. The Bills handily beat the Miami Dolphins, earning themselves the second seed in the AFC playoffs, and Diggs certainly did his part, making 7 catches for 76 yards. But what set the internet ablaze was not Diggs' accomplishments on the field but rather what the camera caught him doing on the sidelines—flossing his teeth!
The Twitterverse erupted with Bills fans poking fun at Diggs. But Diggs is not ashamed of his good oral hygiene habits, and CBS play-by-play announcer Kevin Harlan expressed his support with “Dental hygiene is something to take note of, kids! There's never a bad place to floss” and “When you lead the NFL in catches and yards, you can floss anytime you want.”
We like to think so. There's an old joke among dentists:
Q. Which teeth do you need to floss?
A. Only the ones you want to keep.
Although this sounds humorous, it is borne out in research. Of note, a 2017 study showed that people who floss have a lower risk of tooth loss over periods of 5 years and 10 years, and a 2020 study found that older adults who flossed lost an average of 1 tooth in 5 years, while those who don't lost around 4 teeth in the same time period.
We in the dental profession stress the importance of flossing as a daily habit—and Stefon Diggs would likely agree—yet fewer than 1 in 3 Americans floss every day. The 2016 National Health and Nutrition Examination Survey (NHANES), conducted by the CDC's National Center for Health Statistics, revealed that only 30% of Americans floss every day, while 37% floss less than every day and 32% never floss.
The biggest enemy on the football field may be the opposing team, but the biggest enemy to your oral health is plaque, a sticky film of bacteria and food debris that builds up on tooth surfaces. Plaque can cause tooth decay and gum disease, the number one cause of tooth loss among adults. Flossing is necessary to remove plaque from between teeth and around the gums where a toothbrush can't reach. If not removed, plaque hardens into tartar, which can only be removed by the specialized tools used in the dental office. Regular professional dental cleanings are also needed to get at those hard-to-reach spots you may have missed.
If Diggs can find time to floss during a major NFL game, the rest of us can certainly find a couple minutes a day to do it. While we might not recommend Diggs' technique of flossing from one side of the mouth to the other, we commend his enthusiasm and commitment to keeping his teeth and gums healthy. Along with good dental hygiene at home—or on the sidelines if you are Stefon Diggs—regular professional dental cleanings and checkups play a key role in maintaining a healthy smile for life.
May 9-15 is National Women's Health Week, which begins each year on Mother's Day. It's an important opportunity to focus on the unique health challenges women face, and ways to better meet those challenges. Among the many health aspects that deserve attention, one of the most important is the health of a woman's teeth and gums over the course of her life.
Although preventing and treating dental disease remains a primary focus throughout life, women do face a number of different situations during various life stages that often require additional attention. Here are 3 such life moments for a woman that may give rise to oral and dental problems.
Adolescence. The changes that occur in their physical bodies as girls enter puberty may make their gums more sensitive to bacterial plaque, a thin biofilm that forms on teeth. This can cause painful swelling, a condition that may become even more acute if they wear braces. To counteract this, it's important for girls in their teens to not neglect daily brushing and flossing to remove excess plaque, and to make regular dental visits at least every six months.
Pregnancy. Each of the estimated 40 million U.S. women who have given birth share a common experience—they've all undergone the hormonal changes that accompany pregnancy. Such changes can adversely affect dental health: The hormonal shifts, and the sugar cravings that often accompany them, increase the risk for dental disease, especially gum infections. As with adolescence, daily oral hygiene and regular dental visits (as well as a healthy diet) are important for staying a step ahead of possible tooth decay or gum disease.
Menopause. Women in menopause or who have passed through it can encounter new oral problems. Persistent dry mouth caused by a lack of adequate saliva flow, for example, can cause irritation and significantly increase the risk of dental disease. Osteoporosis and some medications for its treatment could also interfere with dental care. Besides daily oral hygiene, older women can ease dry mouth symptoms with saliva boosters or drinking more water. They should also work with their physicians to minimize any oral effects from their medications.
Many aspects of dental care remain constant regardless of a woman's season of life. Daily oral hygiene should be a lifetime habit, as well as seeing a dentist at least twice a year. But there are times when a unique stage of life requires something more—and it's always better to be proactive rather than reactive in meeting new challenges to oral health.
You've lost some teeth, and now you have to decide how to replace them. A fixed bridge or a partial denture are certainly good options. But the best choice today that dentistry has to offer is dental implants.
Implants have exploded in popularity among both dentists and patients, offering exceptional quality in life-likeness and durability. But they do have one drawback that might cause you to hesitate in choosing them: They're usually more expensive than other common tooth replacement systems, even more so if you're replacing each individual missing tooth with an implant.
But before you pass on them for something more affordable, take another look at dental implants. Here are 4 reasons why implants could be the wiser option for tooth replacement.
Life-like and functional. Other restorations can effectively mimic the appearance of real teeth, and they're reasonably functional. But implants score at the top in both categories because they replace more of the tooth—not just the crown, but the tooth root as well.
Bone friendly. Other restorations can't stop the gradual bone loss often caused by missing teeth, and dentures in particular can accelerate it. But implants are made of titanium, a bio-compatible metal that's also bone-friendly—bone cells readily grow and adhere to its surface. This accumulated growth around the implant site helps slow or stop bone loss.
Long-term savings. The integration of bone and implant creates a durable hold that can last for several years, possibly outlasting other restorations in the same situation. Taking into account all the costs—installation, maintenance and possible replacement—that can occur over the life of a restoration, implants could actually cost less in the long run.
Versatile. Implants can be used for more than single tooth replacements—they can be incorporated with other restorations like bridges or dentures to provide better support. Marrying implants with traditional tooth replacement systems can be less costly than implants individually while enhancing benefits like durability and bone strength.
Dental implants may not be right for everyone, particularly those who've experienced advanced bone loss. But if a thorough dental exam shows you're a good candidate, dental implants could be well worth the investment in your health and appearance.
If you would like more information on dental implant restorations, 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 “Dental Implants: Your Best Option for Replacing Teeth.”
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