Ceramic Braces

 Ceramic (Clear) Braces

For those patients with clear ceramic brackets, or those potential new patients considering them, here is a little information on a common concern – staining.

Ceramic brackets are almost stain-proof, but can get dulled or even darkened by things like espresso and red wine. To restore them from dingy to clear, drink lemon water after you drink beverages that tend to stain.  Also, use an electric toothbrush and let it rest on each tooth (and bracket) for three to five seconds when brushing.

Tomato sauce, curry, cola drinks, teas, coffee, red wine, and some fruit drinks or dark berries will discolor the ligatures around the brackets. Remember the ligatures are changed at your regular appointments, so any staining will disappear before it can become too noticeable.

Selecting a colored ligature will minimize staining. The tiny rubber bands quickly pick up color, but some show stains less than others. Clear ligatures give the most natural appearance that you wanted when selecting the ceramic brackets, but stain most easily.  Pearl or tooth-colored ligatures are next on the easily stained list, but will not show as much color as clear ligatures.  Pastel colors show even less staining and dark ligatures, for instance, grays or black will not show stains. The dark rubber bands make the braces more obvious though, so that may defeat your purpose in selecting the clear brackets. 

So, the bottom line is to watch what you eat, and drink and brush as soon as possible after eating or drinking something that may stain.  

Dr. Miller & Staff

Healthy Eating Habits

Brushing and flossing are vital to keeping your teeth healthy, but what you eat and drink in between your daily cleaning rituals also plays an important role in your oral health.
Plaque – an invisible, sticky layer of bacteria – regularly coats your teeth. When the starches and sugars present in many foods come into contact with this bacteria, acid is produced. This acid breaks down the enamel that protects the outside of your teeth, and over time can cause tooth decay.
If you choose your foods wisely, you can decrease the amount of acid that attacks your teeth. Here are some diet tips for keeping your teeth healthy:

• Limit foods and drinks that are high in sugar, like cookies, candies and sodas – remember even unsweetened fruit juices are high in sugar.
• Read packaging labels to find out how much sugar is included, and make educated choices in the products you purchase.
• Limit dried fruits, which are sticky and cling to the teeth – instead, eat fresh fruit, especially apples, which serve as natural tooth cleaners.
• Avoid snacks between meals – but if you must snack, replace sugary treats with crackers, cheese, yogurt, nuts, and celery or carrot sticks, which produce less acid.
• If you do drink sugary liquids (soda, sports drinks, juices), avoid sipping slowly over a long period of time as this extends the period that acid attacks your teeth.
• If you’re a regular coffee or tea drinker, reduce or eliminate added sugar.
• If your children snack at school, be sure they have access to healthy snacks (veggies, fresh fruits, cheese) instead of packaged foods that are high in sugar.
• If you occasionally treat yourself to a sugary snack, brush your teeth afterwards to reduce the acid effect – if you aren’t near a toothbrush, rinse with water or chew a piece of sugarless gum to stimulate saliva, which helps clean your teeth

Your diet also affects your overall health, which helps determine how well your body can fight off infection. If you aren’t getting certain nutrients, the tissues in your mouth may not be as resistant, leaving you more prone to periodontal (gum) disease. Be sure to eat a balanced diet, including foods from the five food groups:

• Vegetables
• Meat, poultry, fish, eggs, beans, nuts
• Breads, cereals, rice, pasta
• Milk, yogurt, cheese
• Fruits

If you have any questions about your diet and its effect on your oral health, let us know. We’ll be happy to guide you toward healthier eating habits.

Fortunately, most issues with your braces don't qualify as true emergencies, and there are many things you can do at home to manage these minor occurrences. In some instances you'll need to follow up on your self-care with a visit to our office, but in other cases, a few minutes of attention will solve the problem. Here are some common situations you may encounter while in treatment:
Pain or discomfort after placement or adjustment of your braces
It’s common to experience some pain for a few days after placement and adjustments, and this often makes eating uncomfortable. We recommend taking over-the-counter pain relievers such as Tylenol or Advil. You may want to start your first dose before your office visit, then follow up after your visit, to maximize the effects. As for eating, stick to soft foods whenever your sensitivity is high.
Irritation or sores on lips or cheeks
Especially when braces are first placed – before your mouth adapts to their presence – you may experience some irritation on the inside of your cheeks or lips. We recommend keeping orthodontic wax on hand to apply to your braces; follow instructions for application on the package. It may help to dry the area first with a paper towel. Don’t worry about swallowing the wax; this is common during eating and is harmless. If any sores develop, use topical anesthetics like Orabase or Orajel to temporarily numb the area.
Poking or protruding wire
Occasionally a piece of archwire may come out of place and the end of it can poke the inside of your mouth. If this happens and our office is closed, use a pencil eraser or other soft implement to push the wire flat against your teeth. You can also use orthodontic wax to cover the sharp end of the wire. Visit our office as soon as possible and we will clip the wire for you. As a last resort if our office is closed, you can clip the wire yourself with a pair of nail clippers – but if you do so, disinfect them first with rubbing alcohol and be sure to avoid swallowing the clipped piece of wire.
Loose bracket
Sports and hard foods are the usual culprits behind a loose bracket, so we recommend wearing a mouth guard during athletic activities and following our list of foods to avoid carefully. However, if a bracket does come loose, contact us to make an appointment so we can reset it. In the meantime, you can use a disinfectd tweezers to move the bracket back into place, and if necessary, apply orthodontic wax to hold it there until we can see you.
Loose band
If a band around one of your back teeth loosens, make an appointment with us. It’s important for your orthodontic treatment and your overall oral health that the band be secure to your tooth, so we'll want to fix it as soon as possible.
Loose ligature
If a small elastic ligature (the piece that attaches the archwire to the bracket) comes partially or all the way off your braces, use a pair of disinfected tweezers to put it back into place. If a ligature is lost, stop by our office for a replacement.
True emergencies
If you suspect that a bracket or other piece of your braces may have been aspirated (caught in the airway), visit an urgent care center or emergency room; you will need immediate attention to have it removed. Similarly, if you experience a dental emergency including damage to your mouth or teeth, visit an urgent care center for immediate attention.
At any point in your treatment, if you have questions, don’t hesitate to give us a call. Our goal is to provide you with a terrific smile, and – just as important – to be sure you are comfortable and safe throughout the course of your treatment.

Smoking and your Heatlh

These days even the Marlboro Man and Joe Camel know that smoking causes lung cancer and heart disease. But another, less well-known location of smoking-related health problems is your mouth.

Smokers and tobacco-users experience a variety of oral health problems at higher rates than normal, including:

Oral cancers
Gum disease
Tooth loss
Loss of bone in the jaw
Gum recession
Delayed/impaired healing process after oral surgery and other treatments
Decreased success rate of dental implant (tooth replacement) procedures
Mouth sores
Loss of the senses of taste and smell
Bad breath
Tooth and tongue stains

Smokers lose their teeth more often than non-smokers, according to the Centers for Disease Control and Prevention. Data indicates that among people over age 65, about 20 percent of those who have never smoked have lost all their teeth, while more than 40 percent of daily smokers have lost all their teeth. And the American Dental Association estimates that smoking may be responsible for almost 75% of gum disease among adults.

Although many of the statistics surrounding health problems apply to cigarette smokers, recent data shows the fallout is similar for pipe and cigar smokers, as well as for those who use smokeless tobacco products such as chewing tobacco and snuff. In addition to cancer-causing chemicals and addictive nicotine, smokeless tobacco also includes sugar, which increases the risk for tooth decay, and grit, which can wear down the enamel coating on your teeth. Further cancer risks come into play with smokeless tobacco, with users experiencing more cancers of the cheeks, gums, and inner lips than non-smokers.

Because nicotine is an addictive chemical, quitting cigarettes is tough. Cigars and pipes are just as addictive, while chewing tobacco and snuff can be even tougher to quit, due to higher levels of nicotine. The good news is that quitting is possible, and according to the American Cancer Society, 10 years after quitting, the lung cancer rate is half that of a continuing smoker's, and after 15 years, the risk of heart disease is the same as that of a non-smoker's.

If you're interested in protecting your oral health (as well as that of your heart and lungs), we strongly recommend quitting. Based on the experience of those who have successfully quit smoking, the Surgeon General recommends the following steps to help you quit permanently:

Get ready: set a quitting date and remove all smoking materials from your home, office and car.
Get support: let friends, family and colleagues know that you are quitting, join a support group, and let your health care providers know (that's us!).
Learn new skills and behaviors: drink lots of water, distract yourself from smoking urges with other activities, and take actions to reduce your stress level.
Get medication and use it correctly: use an over-the-counter medication or talk to us about your prescription options.
Be prepared for relapse or difficult situations: eat healthy and stay active to avoid weight gain, avoid other smokers, and avoid alcohol because drinking makes it tougher to succeed.

If you are making a decision about quitting and we can help in any way, please let us know. We are dedicated to protecting your oral health, and quitting smoking is a significant step in the right direction.



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Surgical Orthodontics FAQs

Surgical orthodontics, also known as orthognathic surgery, consists of a combination of orthodontic treatment (usually braces) and jaw surgery. This combination is often employed in cases of jaw problems – including bad bites and jawbone abnormalities – that are too severe to be solved by orthodontics alone. What are the benefits of surgical orthodontics? Depending on the particular jaw problem, patients can be relieved of biting and chewing difficulties, as well as breathing difficulties and sleep apnea. The treatment is used to improve both “gummy smiles” in which an excess of gums show above the teeth, and “toothless smiles” in which the lips cover the teeth. For patients with overbite, underbite, cleft palate, or facial injuries, the balance of the face is restored. Who is a candidate for surgical orthodontics? While the initial stage of orthodontic treatment may begin earlier, this type of jaw surgery is only appropriate in adults who have stopped growing. This group generally includes females 16 and older and males 18 and older. In younger patients, early intervention can often correct jaw problems and eliminate the need for future surgery. What results can be expected? When surgical orthodontic treatment is complete, overall dental health is improved, since a bad bite is eliminated and jaws are aligned properly. The treatment also results in a more stable, functional and healthy placement of the jaw. Patients enjoy easier speaking, breathing and eating. Frequently facial appearance is improved as well. Because surgical orthodontics is only employed in response to a significant problem, the improvement can be dramatic and have lasting positive effects. What does the process include? The process begins with orthodontic treatment. We'll use braces to move your teeth into the correct position prior to surgery. During this time, it may seem as if your bite is getting worse; this is because the jaws are still out of place. After the jaws are moved during surgery, you'll find your teeth fitting together better. Once surgery is complete, we will continue the orthodontic treatment to move all of your teeth into their final positions. What happens during surgery? The strategy varies according to the patient’s need. If the lower jaw is the source of the problem, it will be moved forward or backward. If the upper jaw is the issue, it can be moved forward, backward, up or down. In some cases bone will be removed or added to achieve the correct alignment and stability. Are there any risks involved? Surgical orthodontic procedures are performed routinely and carry only the usual risks associated with any type of surgery.

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Top 10 Tips for Cleaning Your Braces

Keeping your teeth clean is more important than ever when you have braces. Food bits have more spots than usual to hide in your mouth, so you must be diligent in order to avoid bad breath, swollen gums, discolored teeth and cavities. If you remove plaque regularly during treatment, you'll experience better results and shorter treatment time. Keep plaque at bay with these top ten tips:

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1. One tooth at a time. When you brush, take time with each individual tooth – at least 10 seconds each – and pay careful attention to the spots where your teeth touch your braces.
2. It’s all about the angles. Brush the tops of your teeth and braces with your brush angled down toward where they meet. Brush the bottoms of your teeth and braces with your brush angled up.
3. The tooth, the whole tooth, nothing but the tooth.  While the front surface of your teeth may seem like the most logical to clean, it’s equally important to clean the inner surface of your teeth (tongue side) as well as the chewing surface. And be sure to clean along your gum line – a key spot for plaque buildup.
4. Step 1: eat, step 2: clean. While you’re in treatment, it’s important to brush after every meal. Bits of food can easily get caught between braces and teeth, and these food bits interact with bacteria in your mouth to cause decay. The longer food is in contact with your teeth, the greater opportunity for plaque to form. If you are eating somewhere that you can’t brush, thoroughly rinse your mouth with water.
5. Like a Boy Scout, always be prepared. The easiest way to be sure you can brush after every meal is to get in the habit of taking a toothbrush, toothpaste and floss with you wherever you go. Designate a special container just for your teeth-cleaning tools and keep it in your purse, backpack, or laptop case.
6. Remove the moving parts. If you have elastic bands or headgear, remove these parts before you brush or floss.
7. Fluoride is your friend. Fluoride helps prevent cavities. Be sure to brush with fluoride toothpaste, and rinse with fluoride mouthwash.
8. Pointy brushes reach tiny places. Interproximal brushes (sometimes called proxa brushes or interdental brushes) are cone-shaped and come in very handy for reaching spots around your braces that standard brushes can’t.
9. Find the floss for you. Regular floss works for some patients, but others find it easier to work with a floss threader, which helps you get the floss into tight places. Other patients like an all-in-one product called Superfloss, which comes with a stiff end for easy threading, a spongy section for cleaning wide spaces, and regular floss for narrow spaces.
10. Make time for the pros. It’s your job to take care of the everyday cleaning. But make sure to visit your dentist regularly while in treatment, to get the deep, thorough cleaning that only a professional can provide.

Sincerely,
Dr. Miller & Staff

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