My Blog

Posts for tag: orthodontic treatment

By Dr. Clementine C. Ignacio, DMD
November 19, 2020
Category: Dental Procedures
TargetedToothRemovalCouldAidTreatmentforCertainBiteProblems

Before we begin correcting a malocclusion (poor dental bite), we need to ask a few questions: How extensive is the malocclusion? How far must we move the teeth to correct it? How might the patient's jaw size impact treatment?

Answering these and other questions help us develop an effective treatment plan. And depending on the answers, we might need to look at other procedures before we install braces—like removing one or more of the teeth.

This isn't a subject to approach lightly: All teeth play an important role in dental function and smile appearance, and ordinarily we want to preserve teeth, not remove them. Sometimes, however, it may be a necessary action to achieve our goal of an improved dental bite.

For example, it might be necessary for correcting a malocclusion caused by severe teeth crowding. This occurs when one or both of the jaws hasn't grown to a sufficient size to accommodate all of the teeth erupting on it. As a result, some of the teeth could come in out of their proper alignment.

If caught early before puberty, we may be able to use other techniques to alleviate crowding, like a device called a palatal expander that influences an upper jaw to widen as it grows. If successful, it could provide later teeth more room to erupt in their proper positions.

But even if additional jaw growth occurs, it may not be enough to avoid a malocclusion or treatment with braces. Alleviating further crowding by removing teeth in little noticed areas could help with subsequent orthodontics.

Removing teeth may also be the answer for other problems like an impacted tooth, in which the tooth has not fully erupted and remains submerged in the gums. It's sometimes possible to use a technique to “pull” the tooth down where it should be; but again, that will still require jaw space that may not be available. The more effective course might be to remove the impacted tooth.

Whether or not tooth extraction will be needed can depend on a thorough orthodontic evaluation and full consideration of all the available options. Even though the ideal situation is to correct a bite with all teeth present and accounted for, it may be for the better good to sacrifice some.

If you would like more information on orthodontic techniques, 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 “Removing Teeth for Orthodontic Treatment.”

By Dr. Clementine C. Ignacio, DMD
September 30, 2020
Category: Dental Procedures
ThisOrthodonticDeviceCouldReducetheNeedforFutureBraces

Each year, millions of children and teenagers wear braces or clear aligners to straighten a crooked smile. But there may be a way to treat some of these bite problems and avoid braces—by intercepting the problem at an earlier age.

This can often be done if the bite problem stems from abnormal jaw development rather than misaligned teeth. An example of this occurs when the upper jaw growth outpaces the lower jaw, causing the upper teeth to protrude beyond the lower teeth. Aside from the effect on appearance, protruding front upper teeth may extend beyond the protection of the lip and be more prone to injury.

A device called a Herbst appliance could prevent this from happening. The top of the device has two hinged metal tubes that connect to elastic bands bonded to the back teeth on both sides of the upper jaw. The bottom also has tubes affixed in the same way to the bottom teeth, except they're slightly smaller and fit within the upper tubes.

The lower tubes sliding within the upper tubes produces slight pressure against the lower jaw to ease it forward. This gradually influences the lower jaw to grow at a pace equal with the upper jaw to decrease the chances of poor bite development. Unlike other corrective methods, the Herbst appliance fixed in place and out of the way won't interfere with sports or other physical activities.

An installed Herbst appliance may change a patient's sensations during swallowing, eating or speaking, but most children adapt to the changes within a few days. And, because the device can create challenges for keeping the back teeth clean, many dentists recommend adding a fluoride rinse to daily brushing and flossing as an added boost against tooth decay.

The Herbst appliance is most effective during the period of most rapid physical growth between the ages of 11 and 14, but if the teeth are already beginning to protrude it can be undertaken as early as 8 or 9. Either way, this important orthodontic tool could help address a complicated bite problem and reduce the need for more costly orthodontic treatment later on.

If you would like more information on early interventions for poor bites, 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 Herbst Appliance.”

By Dr. Clementine C. Ignacio, DMD
July 12, 2020
Category: Dental Procedures
InterceptiveOrthodonticsStoppingPoorBitesBeforeTheyDevelop

Approximately 4 million tweens and teens are currently undergoing orthodontic treatment for a poor bite (malocclusion) that can cost their families thousands of dollars in braces or clear aligners. But treatment doesn't always have to follow this track: Found early, many malocclusions can be corrected or minimized before they fully develop.

Known as interceptive orthodontics, this particular approach to bite correction often begins as early as 6-10 years of age. Rather than move existing teeth, interceptive orthodontics focuses instead on redirecting jaw growth and intervening in other situations that can cause malocclusions.

For example, a child's upper jaw may not be growing wide enough to accommodate all incoming permanent teeth, crowding later arrivals out of their proper positions. But taking advantage of a gap during early childhood that runs through the center of the palate (roof of the mouth), orthodontists can increase jaw width with a device called a palatal expander.

The expander fits up against the palate with “legs” that extend and make contact with the inside of the teeth. With gradually applied pressure, the expander widens the central gap and the body naturally fills it with new bone cells. The bone accumulation causes the jaws to widen and create more room for incoming teeth.

Another way a malocclusion can develop involves the primary or “baby” teeth. As one of their purposes, primary teeth serve as placeholders for the future permanent teeth forming in the gums. But if they're lost prematurely, adjacent teeth can drift into the vacant space and crowd out incoming teeth.

Dentists prevent this with a space maintainer, a thin metal loop attached to the adjoining teeth that puts pressure on them to prevent them from entering the space. This spacer is removed when the permanent tooth is ready to erupt.

These and other interceptive methods are often effective in minimizing the formation of malocclusions. But it's often best to use them early: Palatal expansion, for example, is best undertaken before the central gap fuses in early puberty, and space maintainers before the permanent tooth erupts.

That's why we recommend that children undergo an orthodontic evaluation around age 6 to assess their early bite development. If a malocclusion looks likely, early intervention could prevent it and reduce future treatment costs.

If you would like more information on interceptive 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 “Interceptive Orthodontics.”

TooOldtoStraightenYourSmileNotIfYoureLikeTheseA-ListCelebrities

If you're well past your teen years, you probably have several reasons for not straightening your crooked smile: the expense, the time and the embarrassment of being a 30-, 40- or 50+- something wearing braces. But we have five reasons why adult orthodontic treatment can be a smart choice: Tom Cruise, Kathy Bates, Carrie Underwood, Danny Glover and Faith Hill.

That's right: Each of these well-known entertainers and performers—and quite a few more—underwent treatment to improve a poor dental bite. And not as teenage unknowns: Each on our list wore braces or clear aligners as famous adults (the paparazzi don't lie!).

Here are a few of the reasons why these celebrities chose to change their smile through orthodontics—and why you can, too.

Age isn't a factor. Straightening misaligned teeth isn't reserved only for tweens and teens—there are a growing number of adults well into their middle and senior years undergoing orthodontic treatment. As long as your teeth are relatively sound and your gums are healthy, it's altogether appropriate to undergo bite correction at any age.

A boost to your dental health. Gaining a more attractive smile through orthodontics is in some ways an added benefit. The biggest gain by far is the improvement straightening your teeth can bring to your long-term health. Misaligned teeth are more difficult to keep clean of dental plaque, which can increase your disease risk. They also may not function as well as they should while chewing food, which can affect your digestion.

Traditional braces aren't the only way. If the thought of displaying all that hardware makes you cringe, it's not your only option. One of the most popular alternatives is clear aligners, custom plastic trays that are nearly invisible on your teeth—and you can take them out, too. Another method growing in popularity are lingual braces: All the hardware is behind the teeth and thus out of sight. And you can, of course, opt for traditional braces—just ask Tom Cruise!

Oh, yes—a new smile! Orthodontics was truly the first “smile makeover.” It can improve your appearance all by itself, or it can be part of a comprehensive plan to give you an entirely new look. While the gains to your health are primary, don't discount what a more attractive smile could do for you in every area of your life.

The best way to find out if orthodontics will work for you is to visit us for an initial exam and consultation. Just like our A-list celebrities, you may find that orthodontics could be a sound investment in your health and self-confidence.

If you would like more information about orthodontic treatments, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “The Magic of Orthodontics: The Original Smile Makeover.”

By Dr. Clementine C. Ignacio, DMD
February 03, 2020
Category: Dental Procedures
StopBiteProblemsEarlyWithInterceptiveOrthodontics

Every year many parents learn their “tweenager” or teenager needs their bite corrected, often with specialized orthodontics. Imagine, though, if these families could go back in time to when their child’s poor bite was just developing to stop or slow it from forming.

Time travel may still be science fiction, but the approach suggested isn’t. It’s called interceptive orthodontics, a group of techniques and procedures performed during the early stages of jaw development. The focus is usually on getting abnormal jaw growth back on track, enough so that a poor bite won’t form.

The upper jaw, for example, may be growing too narrow, reducing the amount of available space for tooth eruption. If it isn’t corrected, teeth can erupt out of position. To correct it, an orthodontist places a palatal expander in the roof of the child’s mouth (palate). The appliance applies gentle pressure against the inside of the teeth, which stimulates the jaws to develop wider.

The expander works because of a separation in the bones at the center of the palate, which later fuse around puberty. The pressure applied from the expander keeps this gap slightly open; the body then continues to fill the widening expansion with bone, enough over time to widen the jaw. If you wait until puberty, the gap has already fused, and it would have to be reopened surgically to use this technique. Ideally, then, a palatal expander should be employed at a young age.

Not all interceptive techniques are this extensive—some, like a space maintainer, are quite simple. If a primary (baby) tooth is lost prematurely, teeth next to the empty space tend to drift into it and cause the intended permanent tooth to erupt out of place due to a lack of space. To prevent this an orthodontist places a small wire loop within the space to prevent other teeth from moving into it.

These are but two examples of the many methods for stopping or slowing a developing bite problem. To achieve the best outcome, they need to be well-timed. Be sure, then, to have your child undergo an orthodontic evaluation around age 6. If an interceptive orthodontic approach is needed, it could eliminate the need for more extensive—and expensive—treatment later.

If you would like more information on treatments to get ahead of bite problems, please contact us or schedule an appointment for a consultation.