Posts for: October, 2017

By Wilmington Dental Associates
October 24, 2017
Category: Dental Procedures
Tags: orthodontics   retainers  
ARetainerHelpsYouKeepYourNewSmileAfterBraces

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.”


By Wilmington Dental Associates
October 09, 2017
Category: Oral Health
Tags: thumb sucking  
MonitoringYourChildsThumbSuckingCouldHelpAvoidFutureBiteProblems

Although distressing to many parents, infants and toddlers sucking their thumb is a common if not universal habit. Most children phase out of it by around age 4, usually with no ill effects. But thumb-sucking continuing into late childhood could prove problematic for a child’s bite.

Thumb sucking is related to how young children swallow. All babies are born with what is called an infantile swallowing pattern, in which they thrust their tongues forward while swallowing to ensure their lips seal around a breast or bottle nipple when they nurse. Thumb-sucking mimics this action, which most experts believe serves as a source of comfort when they’re not nursing.

Around 3 or 4, their swallowing transitions to a permanent adult swallowing pattern: the tip of the tongue now positions itself against the back of the top front teeth (you can notice it yourself when you swallow). This is also when thumb sucking normally fades.

If a child, however, has problems transitioning to an adult pattern, they may continue to thrust their tongue forward and/or prolong their thumb-sucking habit. Either can put undue pressure on the front teeth causing them to move and develop too far forward. This can create what’s known as an open bite: a slight gap still remains between the upper and lower teeth when the jaws are shut rather than the normal overlapping of the upper teeth over the lower.

While we can orthodontically treat an open bite, we can minimize the extent of any treatments if we detect the problem early and intervene with therapies to correct an abnormal swallowing pattern or prolonged thumb sucking. For the former we can assist a child in performing certain exercises that help retrain oral and facial muscles to encourage a proper swallowing pattern. This may also help diminish thumb sucking, but we may in addition need to use positive reinforcement techniques to further discourage the habit.

To stay ahead of possible problems with thumb sucking or the swallowing pattern you should begin regularly taking them to the dentist around their first birthday. It’s also a good idea to have an orthodontic evaluation around age 6 for any emerging bite problems. Taking these positive steps could help you avoid undue concern over this common habit.

If you would like more information on managing your child’s thumb-sucking habit, 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 “How Thumb Sucking Affects the Bite.”


By Wilmington Dental Associates
October 01, 2017
Category: Dental Procedures
Tags: retainer  
AnOrthodonticRetainerInsuranceWellSpentforKeepingYourNewSmile

You’ve invested a lot of time and money in orthodontic treatment to improve your smile. If you’re not careful, though, your teeth could actually move back to their old positions. The reason why is related to the same natural tooth-moving mechanism we use to straighten teeth in the first place.

Teeth are held in place by an elastic, fibrous tissue called the periodontal ligament lying between the teeth and the jawbone and attaching to both with tiny collagen fibers. The periodontal ligament allows for incremental tooth movement in response to pressure generated around the teeth, as when we chew (or while wearing braces).

Unfortunately, this process can work in reverse. Out of a kind of “muscle memory,” the teeth can revert to the older positions once there’s no more pressure from the removed braces. You could eventually be right back where you started.

To avoid this, we have to employ measures to hold or “retain” the teeth in their new positions for some time after the braces come off. That’s why we have you wear a dental appliance called a retainer, which maintains tooth position to prevent a relapse. Depending on what’s best for your situation, this could be a removable retainer or one that’s fixed to the teeth.

Patients typically wear a retainer around the clock in the immediate period after braces, and then eventually taper off to just nighttime wear. Younger patients must wear one for several months until the new teeth positions become more secure and the chances of a rebound diminish. For older patients who’ve matured past the jaw development stage, though, wearing a retainer may be a permanent necessity to protect their smile.

Retainer wear can be an annoyance, but it’s an absolute necessity. Think of it as insurance on your investment in a new, more attractive smile.

If you would like more information on improving your smile through orthodontics, 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.”




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