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Posts for tag: orthodontics

By William Ralstin, D.D.S.
September 24, 2018
Category: Oral Health
Tags: oral hygiene   orthodontics  
WhiteSpotsonYourTeethAfterBracesMayBeAnEarlySignofEnamelLoss

After months of treatment we’ve removed your braces and your new smile emerges. Upon closer view, however, you notice a number of chalky white spots on your teeth.

These pale areas are white spot lesions (WSLs), the result of mineral breakdown from the long-term contact of acid with the enamel surface. The underlying cause is built-up bacterial plaque due to inadequate oral hygiene, and as such WSLs are the beginning stages of tooth decay.

While anyone can develop WSLs, brace wearers are highly susceptible because of the extra care required to clean around orthodontic hardware. Poor dietary habits such as frequent snacking on sugary or acidic foods and beverages also increase the risk of WSLs.

To reduce the risk of developing this condition, brace wearers must give extra attention and effort to daily oral hygiene, including brushing and flossing. The extra effort required in brushing can be aided by specialized toothbrushes designed to clean around brackets and wires, along with prescription-level fluoride toothpastes for added enamel strength. Floss threaders or a water flosser, a device that uses pulsating water under high pressure, may help you maneuver around hardware to remove plaque between teeth. It's also important to maintain a healthy mouth environment by limiting intake of sugary or acidic snacks and beverages, avoiding tobacco or excessive alcohol or caffeine, and drinking plenty of water to keep your mouth from drying out.

If you’ve already developed lesions, it’s important to stop the decay process before it causes more damage. One way is to assist your body’s natural mechanism for re-mineralizing tooth enamel with fluoride pastes or gels or re-mineralizing agents, or undergoing micro-abrasion to repair a tooth’s surface.

To improve a tooth’s appearance a procedure known as “caries infiltration” involves injecting a liquid tooth-colored resin into the lesion, which is then hardened with a curing light. The spot becomes less noticeable and appears more like normal enamel. For extensive defects, conventional bonding with composite resins or porcelain veneers can be used to cosmetically cover the tooth.

Getting ahead of the problem with effective oral hygiene and good dietary and lifestyle practices will keep WSLs at bay while you undergo orthodontic treatment. If they do develop, however, there are ways to minimize their effect and restore the look of your teeth.

If you would like more information on dental care during orthodontic treatment, please contact us or schedule an appointment for a consultation.

By William Ralstin, D.D.S.
December 15, 2017
Category: Dental Procedures
Tags: orthodontics   adult braces  
YourAgeWontNecessarilyDecideAgainstStraighteningYourSmile

It’s something you think about often—especially when you look in a mirror or at a photo of yourself. You wish something could have been done about it a long time ago. But now you think you’re too old to correct your misaligned teeth—your “crooked” smile.

Actually, you can transform your smile through orthodontics, whatever your age. Millions of your peers have done just that—currently, an estimated one in five orthodontic patients is an adult.

If orthodontics isn’t right for you it won’t be because of age, but most likely the condition of your gums and underlying bone or your overall health. That first factor is extremely important: if you’ve lost a significant amount of bone due to periodontal (gum) disease, there may not be enough to support the force of moving the teeth during orthodontics.

Health conditions like severe heart-valve disease, uncontrolled diabetes or drugs to treat arthritis or osteoporosis can also make tooth movement difficult. And, if you have restricted saliva flow (dry mouth), wearing orthodontic devices could be uncomfortable and increase your risk of tooth decay.

If, however, your mouth and body are reasonably healthy (and you don’t have a difficult bite problem to correct), there’s no reason why you can’t undergo orthodontic treatment. The only other thing that might hold you back is concern over your appearance during treatment. Many adults balk at the possible embarrassment of wearing metal braces “at their age.”

If this is a concern, you may have an alternative: clear aligners. These are a series of computer-generated clear plastic trays that conform to the individual contours of your teeth. Each tray is slightly different—you wear one for a short period of time (usually two weeks) before moving on to the next tray to successively and gradually move your teeth. They’re nearly invisible to others and, unlike fixed metal braces, you can take them out for a rare special occasion.

The only way you’ll know whether correcting your misaligned teeth is a viable option is to undergo a full orthodontic evaluation. From there we can help you decide if and how you want to gain a straighter, more attractive smile.

If you would like more information on adult 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 “Orthodontics for the Older Adult.”

By William Ralstin, D.D.S.
December 15, 2017
Category: Dental Procedures
Tags: orthodontics  
CoaxingImpactedTeethtotheRightPositioncanImproveYourSmile

What makes an attractive smile? Of course, shiny, straight and defect-free teeth are a big factor. But there’s another equally important element: all your teeth have come in.

Sometimes, though, they don’t: one or more teeth may remain up in the gums, a condition known as impaction.¬†And if they’re in the front like the upper canines (the pointed teeth on either side of the front four incisors) your smile’s natural balance and symmetry can suffer.

Impaction usually happens due to lack of space on a small jaw. Previously erupted teeth crowd into the space of teeth yet to come in, preventing them from doing so. As a result the latter remain hidden within the gums.

While impaction can interfere with the smile appearance, it can cause health problems too. Impacted teeth are at higher risk for abscesses (localized areas of infection) and can damage the roots of other teeth they may be pressing against. That’s why it’s desirable for both form and function to treat them.

We begin first with an orthodontic examination to fully assess the situation. At some point we’ll want to pinpoint the impacted teeth’s precise location and position. While x-rays are useful for locating impacted teeth, many specialists use cone beam CT (CBCT) technology that produces highly detailed three-dimensional images viewable from different vantage points.

If the tooth is in too extreme a position, it might be best to remove it and later replace it with a dental impact or similar restoration once we’ve completed other necessary orthodontic treatment. But if the tooth is in a reasonable position, we might be able to “move” the tooth into its proper place in the jaw in coordination with these other tooth-movement efforts to make room for it.

To begin this process, an oral surgeon or periodontist surgically exposes the tooth crown (the normally visible portion) through the gums. They then bond a small bracket to the crown and attach a small gold chain. An orthodontist will attach the other end to orthodontic hardware that will exert downward pressure on the tooth to gradually bring it into normal position.

Dealing with impacted teeth of this nature is often part of a comprehensive effort to correct the bite. If we’re successful, it could permanently transform both the smile and overall dental health.

If you would like more information on treating impacted teeth, 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 “Exposing Impacted Canines.”

By William Ralstin, D.D.S.
June 06, 2017
Category: Dental Procedures
ConsiderClearAlignersInsteadofBracesforYourTeen

Your teenager is about to take a big step toward better health and a more attractive appearance — orthodontic treatment. You both know the benefits: better chewing function, lower risk of dental disease, and, of course, a straighter and more beautiful smile.

But your teen might also dread the next couple of years of wearing braces. And it's hard to blame them: although they're effective, wearing braces restricts eating certain snacks and foods, they require extra time and effort for brushing and flossing, and they're often uncomfortable to wear. And of high importance to a teenager, they may feel embarrassed to wear them.

But over the last couple of decades a braces alternative has emerged: clear aligners. This form of bite correction requires fewer food restrictions, allows greater ease in hygiene, and is considered more attractive than braces. In fact, most observers won't notice them when a wearer smiles.

Clear aligners are a series of clear plastic trays created by computer that are worn in a certain sequence. During wear each tray exerts pressure on the teeth to gradually move them in the desired direction. The patient wears a single tray for two weeks and then changes to the next tray in the sequence, which will be slightly different than the previous tray. At the end of the process, the teeth will have been moved to their new positions.

Clear aligners aren't appropriate for all bite problems. When they are, though, they offer a couple of advantages over braces. Unlike braces, a wearer can remove the aligner to brush and floss their teeth or for rare, special or important social occasions. And, of course, their appearance makes them less likely to cause embarrassment while wearing them.

In recent years, design improvements have increased the kinds of bites aligners can be used to correct. For example, they now often include “power ridges,” tiny features that precisely control the amount and direction of pressure applied to the teeth. They've also become thinner and more comfortable to wear.

If you're interested in clear aligners as a treatment option, talk with your orthodontist about whether your teen is a good candidate. If so, they could make orthodontic treatment for achieving a more attractive and healthy smile less of an ordeal.

If you would like more information on clear aligners as an orthodontic option, 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 “Clear Aligners for Teens.”

ALong-TermOrthodonticStrategyCouldHelpEnsureanAttractiveSmileLaterinLife

Orthodontics relies on certain mechanics in the mouth to move teeth to better positions. As the specialty has advanced, we've become ever more precise in moving teeth with braces, the “workhorse” of orthodontics, and other specialized appliances and techniques.

But although cooperating effectively with the mouth's natural ability for tooth movement is crucial for success, there's another aspect to consider if that success will be long-term: the growth and development of oral and facial structure. And not just development during childhood and adolescence: indeed, facial structure continues to change throughout a lifetime, including the senior years. Research has shown that although the rate of growth slows over time, it doesn't stop even for someone 80 years or older.

Our emerging understanding in this area has had an important impact on how and when we perform orthodontic treatment. As we develop a treatment strategy for an individual patient we consider not only the immediate outcome of a treatment, but also how it may change their facial appearance in the future. By taking continuing facial growth into consideration, we're more likely to achieve a new smile appearance that remains attractive later in life.

A key factor is to be sure we're initiating treatments at appropriate ages. We may detect developing bite problems as early as age 6, which might prompt preventive treatment at that time to diminish or even eliminate the problem. But it may also be prudent to wait on full-scale orthodontic treatment until late childhood or puberty. Furthermore, some form of orthodontic treatment might need to continue into early adulthood to ensure the most optimal outcome.

By taking a longer view of the treatment process, we're better able to work within the natural growth and development taking place now and in the future. As a result, a person is more likely to enjoy an attractive and youthful appearance even in their later years.

If you would like more information on aging factors for cosmetic enhancement, 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.”



Fort Worth, TX Dentist D.D.S. and Lindsey Howedel, D.D.S.
2941 Oak Park Cir Fort Worth, TX 76109 817-926-8700 Dental Tooth Contact For Pricing options