Snowball Effect

April 3rd, 2024

Winter and its snowball fights are behind us, true, but there might be another kind of snowball heading your way. When you neglect the small steps involved in your everyday orthodontic routines, little problems can start to snowball into bigger ones, affecting your dental health and delaying your orthodontic progress.

Here are three areas where letting the small steps in your routine slide can have consequences:

Dental Hygiene

It can be harder to get your teeth their cleanest while you’re wearing braces. After all, there are wires to get behind and brackets to brush around, and you still need to get that floss in between your teeth. But neglecting your dental hygiene can have big consequences:

  • Demineralization

The bacteria in plaque create acids that strip the minerals from tooth enamel. This process is called demineralization. Wherever plaque is allowed to build up, you’ll start to see white spots in the enamel. This discoloration is a sign that minerals are missing, and is often found around brackets, where it’s harder to brush. White spots can be treated cosmetically, but better to avoid them as much as possible, because eventually they can become . . .

  • Cavities

As demineralization continues, the enamel becomes weaker and weaker, until a hole forms in the tooth—a cavity. Besides damaging your tooth, a cavity can put you behind your orthodontic schedule if you need parts of your braces removed for treatment.

  • Gum Disease

When plaque builds up around the gums, gum tissue becomes inflamed and irritated—this is gingivitis, or early-stage gum disease. Symptoms often include puffy gums, redness, bleeding, and bad breath. Mild gum disease becomes more serious over time, so treat gingivitis early—or, even better, prevent gum disease with careful brushing and flossing.

Looking After Your Appliances

  • Follow Care Instructions

Orthodontic appliances need love, too! Any instructions you get for their care are for a good reason. Brackets can become loose when you bite down on chewy foods. Wires can break when you eat hard candy. Aligners can warp if you leave them on a hot dashboard. If you follow instructions carefully, you won’t need to postpone your progress while you wait for repairs.

  • Use Your Protective Case

If you wear aligners, or a removable appliance, or a retainer, don’t forget to protect these items when you’re not wearing them. This means placing them in their cases, not wrapped in a napkin on your lunch tray, or in the bottom of your gym bag, or anywhere your dog can reach them!

  • Be Proactive If Accidents Happen

Unfortunately, accidents do happen, and loose brackets, broken wires, lost ligatures, and cracked or warped aligners can interrupt orthodontic progress and cause you pain and discomfort. Give our Portland or Vancouver orthodontic office a call to see if minor damage to an appliance can be handled at home, or whether you should be seen before your next regular appointment for repairs.

Following Your Orthodontic Plan

There’s more to following your orthodontic schedule than arriving on time for appointments. Depending on your treatment, you might be responsible for keeping track of the time you spend wearing:

  • Elastics

Elastic bands can be used to help align your upper and lower jaws. If you don’t wear your bands as directed, you won’t make progress as quickly as you could. And remember to replace your elastics as often as recommended, because after hours of s-t-r-e-t-c-h-i-n-g they lose their effectiveness.

  • Aligners

Most aligners are worn for around 22 hours each day. If you don’t follow your orthodontist’s instructions and wear your aligners for the recommend hours each day, your teeth won’t be in the proper alignment when your next set of trays is ready to begin work.

  • Retainers

If you have a retainer and don’t wear it, your teeth will start to shift position. Skip wearing your retainer long enough, and you might need a return to your braces or aligners to repair any new misalignment.

Don’t ignore what seem like little dental and orthodontic responsibilities. Keep up with daily cleaning and brushing, take care of your appliances, and follow your orthodontic plan, and you’ll finish your treatment with a beautiful and healthy smile—right on schedule.

How to Care for Your Invisalign® Aligners

March 27th, 2024

Is it possible to straighten the teeth without braces? Yes, it is. Welcome to the world of Invisalign aligners. Invisalign aligners are made from a clear, thermoplastic material that is custom made to fit your teeth. Unlike conventional braces, Invisalign aligners are removable. More importantly, the clear thermoplastic material makes the aligners invisible, which is ideal if the thought of metal braces and elastics make you self-conscious. For the best results, proper handling and care of your Invisalign aligners is important. Follow these steps to take care of your aligners:

1. Do not eat or drink hot beverages while wearing aligners. It's a good idea to get in the practice of removing the aligners before eating and drinking. Because the aligners are made of plastic resin, heat can distort and damage them. Also, eating while wearing the aligners will cause sugar and other food particles to stay on your teeth, which contributes to plaque and tooth decay.

2. Clean the aligner trays regularly. Invisalign aligners are exposed to the same bacteria and plaque that your mouth is, so you need to clean them as regularly as you clean your teeth. However, avoid cleaning the aligners with harsh chemicals. We recommend using a cleaning kit or some other type of specific solution. When it comes to cleaning Invisalign aligners, carefully follow the instructions given by Dr. David Baker.

3. Store aligners in a cool, dry, safe place. When you’re not wearing the aligners, store them in the case provided by our office. If you don’t use the case, they can easily be lost. Keeping them out of reach of small children and pets is also a good idea. The last thing you want is for Fido to think your Invisalign aligners are chew toys.

4. Don’t chew gum while wearing aligners. There’s one thing that conventional braces and Invisalign aligners have in common: chewing gum damages both of them.

5. Don’t soak aligners in mouthwash. Many popular mouthwashes contain a color pigment. It’s possible that soaking Invisalign aligners in mouthwash will tint or stain them.

For more tips and tricks for a successful Invisalign experience, contact our Portland or Vancouver office!

What’s the Function of Functional Appliances?

March 20th, 2024

Whenever we bite down, we’re applying force with our jaw muscles. Functional appliances direct these forces to create healthier tooth and jaw alignment. They’re used to help correct bite problems and to encourage symmetrical jaw growth.

Functional appliances aren’t always necessary. Because every child’s teeth and bite are different, orthodontic treatment at our Portland or Vancouver office is carefully tailored to your child’s individual needs.

  • For the child with minor tooth misalignment, traditional braces or aligners might be all that’s needed.
  • For the child with a minor malocclusion, or bite problem, an orthodontist might use elastics (rubber bands) to bring teeth into healthy alignment.
  • For the child who has a more serious malocclusion, involving both tooth and jaw alignment, an orthodontist might recommend a functional appliance.

A severe Class II malocclusion can be caused when the upper jaw or teeth are positioned too far forward, and/or the lower jaw is too small or positioned too far back. Common Class II malocclusions include:

  • Open bite—the front teeth don’t touch when the back teeth bite down, or the back teeth don’t touch when the front teeth close.
  • Overbite—some overbite is normal. A deep overbite occurs when the upper teeth significantly overlap the lower teeth.
  • Overjet—the upper front teeth protrude further horizontally than they should.

Today’s functional appliances come in a variety of designs to treat Class II malocclusions. They can be fixed or removable. They can be used with or without braces. Some are designed to expand the upper palate to make sure there’s room for all the permanent teeth. What they all do is advance the position of the lower teeth and jaw to create a healthier, more comfortable bite.

Fixed devices are attached to the teeth and meant to be used full-time. These include the Forsus™ device, the Herbst® appliance, and the MARA appliance.

  • Forsus Device

This appliance works with braces. A spring coil rod is most often attached to bands on the first molars on the upper jaw. It’s then connected to the arch wire on the lower jaw. Just like elastics—but more effective!—these spring coil rods provide gentle forward pressure that encourages the lower jaw and teeth forward.  

  • Herbst Appliance

The Herbst appliance also applies forward pressure to the lower jaw using telescoping rods connecting the upper and lower teeth. The rods expand as the mouth opens, and telescope together as it closes, positioning the lower jaw further forward while the upper jaw is held back. The Herbst can be worn alone or with braces, and can also be used to expand the upper palate.

  • MARA Appliance

The MARA (Mandibular Anterior Repositioning Appliance) uses an adjustable “elbow” piece connecting bands on upper and lower molars to guide the lower jaw and teeth forward when the jaw closes.

Removable appliances such as Bionator and Twin Block appliances can also improve Class II malocclusions. They are meant to be worn for a specific number of hours each day, and can be taken out for sports or other activities as needed. Because it’s essential to get all the necessary hours in, removable appliances require commitment!

  • Bionators

A bionator is made of wire and acrylic, and it looks a lot like a retainer. The wire fits around the upper front teeth. It’s attached to a smooth piece of acrylic that sits behind the upper teeth and is shaped to guide the lower jaw forward when biting down. The bionator can also be adjusted to expand the upper palate.

  • Twin Block Appliance

The twin block appliance uses two separate pieces made of wire and smooth acrylic. Both pieces are modeled to fit precisely over the upper and lower arches. The acrylic “blocks” fit over the biting surfaces of the teeth, working together like a 3D puzzle. When your child bites down, the upper blocks slide into place behind the lower blocks, pushing the lower jaw and teeth forward. The top plate can also be adjusted to expand the upper palate if needed.

Because these appliances are best used while a child’s bones are still growing and developing, dentists and orthodontists recommend an orthodontic evaluation by age seven. Early treatment with a functional appliance can help correct serious bite problems before or together with braces. In some cases, functional appliances may reduce the need for headgear or surgery.

Todays’ orthodontic technology has made functional appliances more comfortable and efficient than ever before. Talk to Dr. David Baker to discover how an individualized treatment plan and a custom appliance can give your child a healthy bite and a lasting smile.

Overbite or Overjet?

March 6th, 2024

The words “overbite” and “overjet” certainly sound similar. Both conditions concern your front teeth. Both conditions fall under the same category of bite problems—Class II malocclusions, if you want to be technical. So it’s not surprising that they’re often used interchangeably. But while there are similarities, overbite and overjet are also distinctly different.

  • Overbite/Overjet Geometry

In a healthy bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth. The key word here is “slightly.” With a Class II malocclusion, the upper front teeth project further beyond the lower teeth than they should.

Of course, teeth and bites are as individual as we are, so there are variations in just how and just how much the overlap occurs. In diagnosing an overbite vs. an overjet, the difference comes down to a matter of vertical vs. horizontal.

An overbite, or deep bite, occurs when the top teeth vertically overlap the bottom teeth more than they should for a healthy bite. Generally, when a person’s top teeth cover more than a quarter of the bottom teeth when biting down, or more than two to three millimeters, that person is said to have an overbite.

An overjet, commonly known as protruding or buck teeth, is the result of a horizontal overlap that is broader than normal. This causes the top teeth to project outward toward the lips more than they do in a typical bite. An overjet is usually diagnosed when the horizontal distance between the top and bottom teeth exceeds two to three millimeters.

  • Overbite/Overjet Causes

The causes for both an overbite and an overjet might be dental (caused by tooth alignment), or skeletal (caused by bone development), or a combination of both. These bite problems can run in families. They are also affected by the size and position of the jaws and the shape and position of the teeth.

Early oral habits, such as prolonged and vigorous thumb-sucking or pacifier use, can also contribute to the development of a Class II malocclusion, particularly an overjet. Consistent pressure from thump or pacifier pushes the teeth outward as they erupt, which encourages them to protrude. These oral habits can affect the shape of the palate and jaw, too.

  • Overbite/Overjet Treatments

There are many types of treatment available to correct teeth and bite misalignments. Dr. David Baker will tailor your treatment to your specific malocclusion for the best orthodontic outcome.

If you have a mild malocclusion, and minor dental issues are the main cause of that malocclusion, either braces or clear aligners can be effective for an overjet or an overbite. Elastics (rubber bands) are often used as part of this treatment.

If the malocclusion is due to bite problems caused by uneven upper and lower jaw development, devices called functional appliances can be used with braces to help guide the growth of the jawbones while young patients’ bones are still forming. These include appliances that work inside the mouth to help the upper and lower jaws grow proportionally, and external appliances such as headgear.

In some cases, where the malocclusion is skeletal in nature as well as dental, surgical treatment might be necessary to reshape the jawbone itself. Orthodontic treatment is usually needed as well both before and after surgery.

  • Overbite/Overjet Consequences

Over time, a deep overbite can cause damaged gum tissue, worn enamel, and fractured teeth. When teeth protrude because of an overjet, they can lead to self-consciousness and are more at risk for injury. Both malocclusions share dental and medical consequences, including concerns about facial and jaw appearance, problems speaking or chewing, headaches, and face and jaw pain.

Class II malocclusions aren’t all the same, and orthodontic patients aren’t all the same either. You may have a minor malocclusion or a significant one. You may have an overbite, or an overjet, or a combination of different bite and alignment concerns. Your malocclusion may not bother you at all, or it may cause pain, discomfort, or self-consciousness.

That’s why every overbite or overjet should be evaluated by an orthodontist. When you visit our Portland or Vancouver orthodontic office, Dr. David Baker will be able to diagnose the exact nature of your malocclusion, the reason for it, and your best individualized treatment plan. An overbite and an overjet are different malocclusions, but you and your orthodontist want the same outcome for each: a healthy, attractive, and confident smile!

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