Braces Medford Tag

imagesStarting braces treatment as the age of 43, I was prepared to receive some funny looks from friends and strangers when they noticed my “metal mouth”. My expectation was that the common perception of braces treatment comes with a bit of a social stigma at any age, but especially for someone in their forties or beyond.

Now that I have completed treatment, I can report that my experience, surprisingly, was quite the opposite.

With today’s smaller clear brackets, it usually took people five to ten minutes into a conversation to even realize that I was wearing braces at all. And when they did notice, their reaction was always one of genuine curiosity than anything else.

People wanted to know what I was having corrected — I had upper and lower crowding — and what my experience had been so far. I explained that the first few weeks were a bit of an adjustment, but after that I rarely noticed my braces. The only habits that I had to change were knowing how to choose braces friendly foods and brushing and flossing around the braces after eating as they are definitely traps for food.

Everyone was interested in SureSmile and how the technology enhanced the way that my orthodontist delivered care. Then the conversation would often turn to the treatment that they had received as a child and how they wished a treatment like SureSmile had been available then. For those who had not worn braces as a child, nearly all were interested in what braces might be able to do for them as an adult.

My personal conclusion is that as a society, our attitudes toward braces have changed significantly in the last few decades. What was once thought as a treatment for kids with more serious dental problems is now common for many teens, even a rite of passage.   And for adults who didn’t have the benefit of treatment as children, many are appreciating what straight teeth can do for one’s appearance and oral health. With advances in treatment such as clear brackets or hidden brackets (lingual braces) and especially technologies, such as SureSmile, that shorten treatment time while also enabling great results, it’s easier now for adults to consider braces.

imagesDental abnormalities affecting the position or alignment of the teeth can dramatically affect the esthetics and functionality of your smile. Orthodontic treatment — with braces, retainers or clear aligners — corrects conditions such as crowded or crooked teeth, overbite (when top teeth extend beyond bottom teeth), underbite (when bottom teeth are too far forward or upper teeth are too far back), incorrect jaw position and jaw-joint disorders.

Orthodontic correction also may be necessary when the upper and lower jaws do not meet properly, resulting in an uneven bite (malocclusion). If not properly managed, an uneven bite could lead to the development of temporomandibular joint disorder (TMJ).

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Protruding, crowded or irregularly spaced teeth and jaw problems may be genetic. Certain situations and habits, such as accidents (tooth injury), not wearing protective devices like mouth guards during athletic activity, and premature tooth loss, thumb sucking and tongue thrusting also may contribute to conditions requiring orthodontic correction.

Benefits of Orthodontic Correction

The correction of problematic conditions like overbite, underbite, crooked teeth or crowding will give you straighter teeth, a better bite, a more attractive smile and healthier teeth and gums. Additionally, an improved facial appearance increases your self-esteem and confidence in social settings.

Crooked and/or crowded teeth make it difficult to perform proper oral hygiene, which can lead to tooth decay, gum disease and tooth loss. A bad bite can interfere with chewing and speaking, as well as cause abnormal wear on tooth enamel, excess stress on supporting bone and gum tissue, and headaches, earaches and jaw problems.

If left untreated, these problems may worsen and require additional dental care and cost. For this reason, orthodontic correction can be viewed as a smile enhancer and potential long term money saver.

Types of Orthodontic Correction

Your orthodontist or dentist will guide you in making the best choice of orthodontic treatment based on your unique situation and needs.

Braces, also called orthodontic appliances, are the most common type of orthodontic correction. Braces shift the position of the teeth, or hold them in place. Fixed braces are worn all the time and can only be removed by your dentist. Conversely, removable braces can be taken out of your mouth; however, your orthodontist or dentist will advise against repeated, long-term removal of the appliance for optimal results.

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Brackets, which attach the wires to the teeth, come in three varieties: metal, ceramic or plastic. Although more noticeable, metal braces are the strongest and work best for complex bite problems. Ceramic brackets, which are slightly weaker and more brittle than metal braces, are clear or tooth-colored, making them more attractive to some patients. Inside, or ibraces — which have brackets that attach to the back of teeth so they are hidden from view — appeal to patients seeking the strength and efficiency of metal braces coupled with the esthetic appeal of “invisibility.”

Aligners, an alternative to traditional braces, are a series of clear (invisible), customized removable appliances. Unlike metal braces, aligners do not trap food particles and plaque between your teeth. Each aligner is worn for approximately two weeks, only to be removed for eating, brushing and flossing. A recommended option for adults with mild spacing problems, invisible aligners are not suitable for children and adolescents with non-permanent teeth.

Space maintainers are another form of orthodontic correction, though not as comprehensive an option as braces. If a baby tooth is lost prematurely, space maintainers steady the remaining teeth around the missing tooth gap, helping to keep the jaw’s natural position in place. This prevents the teeth around the gap from moving into the empty space, which otherwise could cause overcrowding and crooked teeth when the permanent tooth eventually erupts. If this condition is left untreated, it could possibly require extensive and expensive orthodontic treatment later on. Small, hardly noticeable and easy to adjust to, custom-fit space maintainers are an easier and less expensive option for holding teeth in place.

Removable computer-generated appliances can treat selective cases in which orthodontics would otherwise be needed. However, these appliances may cost more. Depending on the complexity of your case and what must be achieved when moving your teeth, removable appliances with wires may be used.

A palatal expander frequently is used when the upper arch isn’t as wide as it should be. Such an appliance is best for developing children between the ages of eight and 10.

Length of Orthodontic Correction

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The length of time you will have to wear orthodontic appliances depends on your condition and treatment plan. The more complex your spacing or bite problem, and the older you are, the longer the treatment period.

Most patients wear full braces between one to three years, followed by some time wearing a retainer to hold the teeth in their new positions. A typical length to wear a retainer is one year. However, some adults must wear a retainer at night for the rest of their lives.

Who Performs Orthodontic Correction?

Most dentists are trained to treat minor orthodontic problems. If your general dentist determines you or your child should see a specialist for treatment, you will be referred to an orthodontist. An orthodontist has two to three years of specialized orthodontic training beyond dental school and focuses on the diagnosis, prevention, and treatment of dental and facial irregularities.

 

The relationship will last years, so do your due diligence

banner_5Getting braces or other orthodontic work can require frequent appointments and hefty payments, so choosing the right doctor is a must. “You are entering a relationship that could last years,” says , Dr. Sarkis Euksuzian an orthodontist in Medford & Moorestown, NJ.

Some tips:

Ask for lots of recommendations. Don’t just stop with your dentist: Check in with friends, neighbors, co-workers and nearby relatives. Visit the websites of potential practices.

Request a no-obligation consultation. At these initial meetings — often free — discuss treatment goals, the doctor’s experience in correcting specific problems, payment options and insurance policies. Ask to see before-and-after patient photos. In large practices, it’s also smart to meet the office manager.

Don’t be afraid to seek a second (or third) opinion. Getting braces is a major commitment, so compare treatment approaches, prices and office atmosphere, including cleanliness and staff friendliness.

Be sure the doctor is board-certified in orthodontics. General dentists can take a few courses that allow them to perform orthodontic treatments, but they are not orthodontists. Rather, orthodontists are dentists who have undergone extra years of training, clinical experience and peer review.

Consider convenience. Ask about office hours, policies on changing appointments and how a practice handles emergency situations. If possible, select an office close to your home or work or your child’s school, because you might be heading there at least monthly for years.

Be comfortable with your orthodontist as a person. You want to look forward to the visits, not dread them. If a child will be the patient, bring him or her to meet a potential doctor.

Invisalign Medford and Moorestown NJ

If you have been told that you are not a candidate for Invisalign, even after asking for this treatment option, then you should get a second opinion.  This should preferrably be from an othodontist that has a significant amount of experience with Invisalign.  The reason is simple.  Virtually all cases, no matter how difficult, can be treated with Invisalign.  So, why are patients still told they can’t use Invisalign, and must instead wear full braces for their entire treatment?  We have broken this down into the following reasons, based on patient interviews presenting for second opinions.

Medford Orthodontist1-Lack of Practitioner Experience

These are the practitioners with the best intentions, who want the best outcome for their patients.  However, due to lack of experience with Invisalign, they believe full braces to be not only easier (for the doctor), but also better (for the patient).  These viewpoints are wrong, in my opinion, based upon the basic science of tooth movement.  Teeth are moved as a result of physiologic forces being applied in a given desired direction.  It does not matter whether these forces are applied as the “pull” of archwires (braces) or the “push” of aligners (Invisalign).  While there are a few movements that the pull of wires can biomechanically accomplish better than Invisalign, there are many more movements that Invisalign can perform better due to the push on an infinite number of tooth contacts.  In extreme movements that only wires could more efficiently perform, application of a few braces for a few months can accomplish this.  Our patients are more happy to wear braces on a few teeth for a few months (when rarely needed) and Invisalign the rest of the time, as opposed to wearing braces for the full period of treatment.

2-Lack of Will

Just as in braces, Invisalign can only move teeth in each arch within certain parameters.  Some limitations are biomechanical, and some are skeletal constraints.  As a result, we use expanders, molar distalizers, functional appliances, surgical corrections, etc..  These are all treatment modalities needed as adjuntive appliances, whether treating with braces or Invisalign, to allow for optimal treatment outcome regarding alignment and bite correction.  The only difference is, with Invisalign, it just takes a little more planning and thought for proper sequencing of treatment.  Consequently, this may lead to the patient who expresses a desire for Invisalign to be told they are best treated otherwise.  While Invisalign combined with other modalities may incur some additional expense, these options should still be presented so that the patient can make an informed decision.

3-Lack of Intent

There are a lot more practitioners advertising that they provide Invisalign treatment than there are that actually do provide the treatment on a regular basis.  When a patient desires a more attractive smile, but are told they could only be treated with full braces, some patients opt for other treatment alternatives instead, such as crowns, veneers, etc..  While this may not be intentional, these patients should have been referred to a specialist so the patient can make an informed decision after knowing all the facts.  While veneers or crowns are essential in many cases to restore worn or discolored dentition, they are never the best choice for creating a   “staighter appearance” of the teeth.

In closing, nearly all malocclusions can be treated with Invisalign, and this is a preferred treatment modality due to all its inherent advantages.  The only patients that should not be treated with Invisalign are those that make a conscious, informed decision not to due to cost, lenth of treatment, or compliance issues.  I welcome any constructive comments or questions, as well as any input into future topics of discussion.

Orthdontics Medford NJAt Euksuzian Orthodontics, we don’t have to tell you that keeping your teeth clean during treatment is very important. Braces have a habit of collecting additional food while eating that can cause a multitude of problems if not cared for correctly.So you don’t offend others with unsightly food caught on your braces, or to avoid bad breath, swollen gums, decalcification or discoloring of teeth and cavities, here are are five tooth brushing tips from Dr. Sarkis Euksuzian and our team for orthodontic patients to keep in mind while wearing braces:

1. There is more to brush than what you see. Most patients spend their time brushing the parts of their teeth and the braces they can see. However, it’s just as important to clean the inside areas of your teeth as well as the chewing surface of each tooth. Brush all surfaces inside, outside, along the top of the teeth and the gum line for best results.

2. Make sure you spend enough time doing a good job. Did you know the ADA recommends you brush your teeth for approximately three minutes to do a good job… even if you aren’t wearing braces? At one point you may have received a three minute egg timer to time brushing from your dentist. It seems like the time will never end when watching the grains of salt flow to the bottom. Most popular songs today are approximately three minutes long. Listen to an ipod or radio while you are brushing instead of using a timer. If you start brushing at the beginning of a song… and stop when over… you can dance around for three minutes while brushing, without the time dragging.

3. Use dental floss often. Food is often trapped between teeth and flossing with braces is easier with a floss threader, especially when trying to thread the floss under your main wire.  Dental floss threaders save time and are very easy to use once you get the hang of it. They are available in the toothbrush aisle in any grocery or drug store.

4. Be prepared. In order to brush after every meal you must be prepared. Always keep a toothbrush in your purse, backpack, or laptop case. The TOOB brush was designed with orthodontic patients in mind. It’s easy to use, you can refill it with your own toothpaste, and it travels anywhere.

5. Regular dental cleanings and checkups are still important. It’s your job to take care of the everyday cleaning. However, we recommend you visit your dentist regularly while wearing braces to eliminate any plaque you may have missed while brushing or using dental floss.