First, there were braces; then came removable clear aligners—both great ways to straighten teeth. But braces with their metal brackets and wires aren't the most attractive look. And, although nearly invisible aligners improve appearance, they don't work in every bite situation (although their range has improved of late).
But now a third choice has emerged: lingual braces. Like their traditional counterparts, lingual braces are fixed in place—but on the back side of the teeth rather than the front. Instead of "pushing" teeth toward new positions, they "pull" them, arriving at the same "destination" by another path.
This new method came about simultaneously by two different orthodontists a world apart and for different reasons. A Beverly Hills dentist was looking for an invisible form of treatment similar to clear aligners for his appearance-conscious patients. A Japanese dentist wanted an alternative that would reduce the risk of damage or injury posed by traditional braces to his martial arts patients.
Lingual braces (referring to their proximity to the tongue) address both of these concerns. All of the brackets and wiring are positioned out of sight. And because they're shielded by the teeth, they're not as likely to be damaged or cause injury following hard contact to the face—a great benefit for athletes, law enforcement officers and, yes, martial artists.
Even so, lingual braces won't replace the other two methods any time soon. You'll need to consider other factors, such as that lingual braces can cost up to a third more than traditional braces. And although their availability is steadily growing, not all orthodontists have been trained to offer lingual braces, so you may have to widen your search radius for a provider near you.
You may also find it takes a bit of time to get used to the feel of lingual braces. Upper braces can affect speech ability, at least initially, and the lower ones can interfere with tongue comfort. Most people, though, do adjust to them within a week or so.
But by and large, lingual braces do offer a fixed option that's out of sight, out of mind. With this newer orthodontic choice, you now have three good options for achieving a healthier mouth and a more attractive smile.
If you would like more information on methods for straightening 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 “Lingual Braces.”
Correcting a bite problem involves more than applying braces. Orthodontists must consider a wide range of factors, including the type of bite problem involved, complications like impacted or missing teeth, and their patient's overall dental condition.
Orthodontists must also keep in mind the future—how will a treatment implemented now impact a patient's appearance and dental function many years from now? In reality, orthodontists perform these treatments within a dynamic growth environment, especially involving children and teenagers whose mouth and facial structures are still maturing.
And although these growth changes slow in adulthood, they don't stop—orofacial structures continue to change throughout life. For example, a person's lips steadily thicken in size until the mid-teen years, and then slowly thin out over the rest of their lifetime. The distance between the lips both at rest and while smiling may also narrow in later years. Other changes continue to occur in the bones and soft tissues of the mouth and face.
Fortunately, this structural growth follows a fairly consistent track. Although variations do occur, an orthodontist can project the growth changes their patients will undergo as they age, and use that knowledge to plan out bite treatment. With this understanding, orthodontists plan not only what treatments will be needed, but when to perform them, and to what extent.
This may involve a number of treatment stages, spaced out to coincide with regular development. An orthodontist may focus first on general bite correction to bring the teeth and jaws into a reasonable state of alignment. Later, they'll use more refined methods to fine-tune corrections that better align with later adult growth.
More intensive treatments may be necessary to build a foundation for future treatment. For example, orthognathic surgery may be needed to correct a severe case of an over-extended lower jaw. During the procedure, surgeons move the lower jaw to a joint position higher on the skull. This retracts the lower jaw into a more normal alignment with the upper jaw, and can dramatically change the facial profile for the better.
Each orthodontic patient is different, and each requires their own a unique treatment plan. That plan has a greater chance of long-term success by applying knowledge of future growth changes.
If you would like more information on orthodontic treatment, 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.”
Dorit Kemsley isn't shy. Best known to fans as an outspoken and sometimes outrageous cast member of the reality show Real Housewives of Beverly Hills, Kemsley is never reticent about “mixing it up” with fellow castmates or their significant others. Recently, though, she confessed to something that left her less than confident: her smile.
Kemsley has been self-conscious about her smile because her teeth looked noticeably short, worn down from an unconscious habit of grinding her teeth. Although teeth grinding is more common among children (who normally grow out of it by adolescence), it can persist into adulthood, usually from difficulties managing high stress (a likely component in the fashion designer/reality show star's busy life).
Stress-induced teeth grinding can occur during waking hours or, more likely, during deep sleep. The accumulating, long-term effects from the habit can lead not only to worn teeth but to weakened gum support, a high risk of tooth fracture or jaw pain and dysfunction.
So, how do you know if you grind your teeth, especially if it's only happening at night? Typical signs include sore jaws after awaking from sleep, increased tooth pain or sensitivity or, like Kemsley, a noticeable difference in your tooth length. Your family or sleeping partner may also complain about the “skin-crawling” noise you make during the night.
There are ways to lessen the effects of teeth grinding. The first step is to have us verify the underlying cause for the habit. If it's tension from stress, then you might reduce the habit's occurrences by learning better stress management or relaxation techniques through individual counseling, group support or biofeedback therapy. We can also fit you with a mouth guard to wear at night or through the day that reduces the force generated during teeth grinding.
And if you've already experienced accelerated tooth wear like Kemsley with a resultant “small teeth” smile, you might pursue the same solution as the RHOBH star: dental veneers. These thin, life-like wafers of porcelain are custom-made to mask imperfections like chips, staining, slight tooth gaps and, yes, worn teeth.
Veneers are often less expensive and invasive than other cosmetic techniques, yet they can have a transformative effect, as Kemsley's Instagram followers have seen. In conjunction with other dental treatments needed to repair any underlying damage caused by a grinding habit, veneers are an effective fix for the smile you present to the world.
If you suspect you may have a grinding habit, see us for a complete examination. From there, we'll help you protect your teeth and your smile.
Dentists remove millions of teeth each year, often because of tooth decay or gum disease. But disease isn't the only reason—a tooth extraction might make it easier to straighten a crooked smile.
Realigning teeth for therapeutic or cosmetic reasons is a regular undertaking in dentistry, but the process itself often differs from person to person. Each individual patient requires their own treatment plan taking into account factors like the kind of bite problem involved, the size of the jaw and the space available to move teeth.
This plan could indeed involve removing teeth. For example, an abnormally small jaw could cause crowding. Not only can crowding move teeth out of position, it may also leave little to no room for moving teeth. Although dentists can minimize crowding by influencing jaw development in early childhood, removing teeth for more space is usually the only option available to older adolescents and adults.
Similarly, teeth can fail to erupt properly and remain partially or fully submerged beneath the gums (known as impaction). There is an orthodontic method for pulling an impacted tooth fully onto the jaw, but only if the tooth isn't too far out of alignment. Otherwise, it may be better to remove the impacted tooth and then correct any gaps with braces or a dental implant.
There's also a situation on the opposite side of the spectrum that could benefit from teeth removal—when one or more permanent teeth fail to form, known as congenitally missing teeth. This can cause gaps in the smile or a “lopsided” appearance where a tooth on one side of the jaw is present while its counterpart on the opposite side of the jaw is missing.
The missing tooth can be replaced by an implant, bridge or other restoration. But another option may be to remove the existing counterpart tooth, and then close the gaps. This can result in a much more attractive smile that might be simpler and less costly than replacing the missing tooth.
Again, the decision to remove teeth to improve smile appearance depends on the patient and their particular dental condition. But in the right situation, it could make straightening a smile easier and more effective.
If you would like more information on orthodontic treatments, 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.”
For some, the excitement over their braces coming off gets dampened a bit with the prospect of now having to wear a retainer. But it has to be—newly realigned teeth have a tendency to revert to their previous positions out of a kind of “muscle memory.” A retainer prevents that from happening.
But as essential as it is, the standard retainer is almost as noticeable as braces, a major reason why many patients are less than enthusiastic about wearing them. And, because it's common for them to become lost when out of the mouth, replacing one becomes an added expense.
But there's another option—the bonded retainer. This retainer consists of a metal wire bonded to the back of the teeth to prevent them from moving. Because it's fixed in place, only a dentist can remove it.
The bonded retainer addresses the previous two issues associated with a removable retainer. Because it's behind the teeth rather than in front, it's out of sight to others. And, because it's fixed in place, there's no danger of losing it.
But unlike its removable cousin, which can be taken out for oral hygiene, the bonded retainer can make flossing more difficult. And, by nature, a bonded retainer must be worn all the time; a removable retainer allows for a more flexible schedule later in the treatment of a few hours a day.
So, which retainer option is best for you or another family member? A bonded retainer may be more attractive for appearance's sake, if it must be worn indefinitely, or if there's a high probability of the teeth moving out of alignment. And, it might be the right choice where there's a concern about a patient's ability to keep up with a removable retainer.
If you do decide to go with a bonded retainer, ask your dental hygienist for training on using floss with the fixed appliance—this can help improve oral hygiene. Whatever you choose, bonded or removable, your retainer will help you keep that new, beautiful, straightened smile.
If you would like more information on orthodontic retainers, 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 “Bonded Retainers.”
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