Changes In Orthodontics

Orthodontic treatment has come a long way in the past ten years. Years ago, the process of placing braces could take several long, uncomfortable appointments. Braces were attached to teeth with steel bands around each tooth. Smaller braces that are bonded directly to the tooth surface, high-tech adhesives and computer-software have made orthodontic treatment a much more comfortable and simplified process. Treatment today is certainly more efficient and predictable due to the modern materials we use and the improved techniques.

NASA has contributed to orthodontics making incredible breakthroughs in technology. They developed heat activated nickel-titanium alloy wires that effectively move teeth when the wires reach mouth temperature. These new wires apply gradual, precise and gentle pressure, and yet retain their teeth-moving abilities longer than their predecessors. In contrast, stainless steel wires were less resilient and needed more frequent adjustments.

Some of today’s braces are translucent or tooth-colored. Additionally, metal brackets are now smaller and less noticeable. With multi-colored elastic ties that attach the wires to the brackets, today’s braces are also fun. Many young orthodontic patients enjoy color coordinating their rubber bands as a fashion accessory.

Bracket adhesives have also advanced. Some continuously release fluoride to help protect tooth enamel, while others are made to withstand moisture.

Aligners can now be used to precisely move teeth without the use of braces. Please ask us about Invisalign during your next appointment.

As technology advances so does our ability to diagnose, treat and enhance the quality of treatment for our patients.

Your Child’s first Dental visit: What to Expect!

The arrival of baby teeth is momentous because they allow children to graduate to a variety of new foods. In addition to celebrating this new stage in your baby’s development, you should also begin to think about a first visit to the dentist. Although parents of infants may not yet be concerned with dental care, the American Academy of Pediatric Dentistry recommends that the first dentist visit for children take place before a baby’s first birthday. Initially, dental visits are mostly informative in nature, but even at this early age, dental professionals help to establish a proper oral care routine that can last a lifetime.

Finding a Dentist

To find a dentist, check with your pediatrician or insurance company about providers in your area. Additionally, you may want to ask friends and family members for referrals. Narrow your search based on locations and office hours that fit best into your schedule. Try to interview several dental practices before selecting the one where you and your child feel most comfortable. In addition to calling for information, many dental practices also have websites with FAQs to help answer your questions.

Prepare in Advance

Ensure that your child is well rested and not hungry around the time of the appointment. It may be helpful to write down a list of questions ahead of time to ask the dentist. Very importantly, check with your dental insurance provider about copays and coverage before the day of your child’s first dentist visit. Most dental providers ask for proof of dental and medical insurance at time of service. Last, bring a list of your child’s current medications, and be prepared to fill out a health history form.

Although it is not necessary to prepare extremely young children in advance of a dental appointment, you may want to discuss the first visit with an older child. If your child experiences some anxiety over a dental appointment, try to ease his worries by reading books about dentists or by watching television shows to help to visualize what the visit will be like.

What to Expect during Your Child’s First Dentist Visit

During the first visit, the dentist will typically educate parents on proper gum and tooth care for babies. You may also discuss pacifier use and how proper nutrition helps to maintain healthy teeth. The dental professional should also demonstrate brushing techniques for parents so that they are able to knowledgeably assist young children with oral care. At the end of the appointment, the dentist should also provide you with the opportunity to ask questions.

By establishing a good working relationship with a childdentist, parents will ensure that their child receives proper dental care beginning at an early age. Setting a precedent for dental appointments at an early age helps children to become accustomed to a proper oral care routine.

The Science And Art Of Smile Design

Patients have asked why this office puts an emphasis on cosmetic dentistry. The answer is easy. Cosmetic dentistry involves some of the more creative aspects of dentistry, rather than the simple, straightforward and routine mechanical side. There are so many things to evaluate when trying to remake someone’s smile. The challenge of figuring out the puzzle so that the patient will look their best is really intriguing and fun, and the results are highly satisfying.

The finished product of a smile design is the result of a lot of work with excellent communication and cooperation between our dental office, the lab and the patient. Please call our office, if you would like to evaluate or discuss your smile.

The Instant Makeover

More and more these days, instant sorts of makeovers are shown on television shows and in the news. It seems that once a person makes the commitment to proceed, they want to get moving quickly. Our practice has noticed that too, and we are doing many more “makeovers” where we finish the entire treatment in a short period of time.

It seems like many people just hit a point where they have “had it” with their smile or their appearance, and decide it’s time to look better. The next steps are important, because how happy a person is with the results, depends on how the treatment is approached and accomplished.

Here is what we do when someone presents with some true esthetic concerns and is ready to do something about them:

 First of all, we interview the patient to determine their true desires, needs and wants. Everything starts with getting a good understanding of what the patient wants and expects.

 We have to do a complete exam to understand the underlying health of the teeth, gum and bone, and how the bite, or occlusion, is working.

 We take photographs, and impressions of the teeth for what we call study models. Sometimes we ask the dental lab to create the desired appearance in an ideal wax smile. It is a fun process.

Once we know where we want to be at the finish, the process of getting there is usually just a couple of long and relaxed appointments.

In the First Visit the teeth are prepared and impressions are taken; the patient leaves with plastic temporary restorations that are an actual preview of the desired end point. These provisional restorations allow us to personalize shape, size and color so that before the final porcelain restorations, we know that the patient is going to love their smile. This works really well, relieving much of the anxiety of someone not knowing how they will look.

The patient generally receives the final restorations in the Second visit, where we take off the temporary crowns/veneers and try in the permanent ones. If they are fitting and looking like we want, these restorations are permanently bonded to the teeth. Subsequent visits are made as necessary for any follow up or adjustments.

Sippy Cup: Friend Or Foe?

The sippy cup is a spill proof, lid-covered drinking cup designed to help parents teach their toddlers how to drink without spilling. Children can toss it, drop it and turn it upside down, but they can’t spill its contents. That’s thanks to a valve in the top that releases liquid only when a child puts his lips around the tip and sucks. Day after day countless parents reach for that sippy cup their toddlers love so well, proud that the bottle is a thing of the past, and thrilled that their car seats and living room carpets will be spared! These parents though, should think twice before resorting to extended use of the sippy cup.

Many parents operate under the mistaken impression that the sippy cup is better than allowing the child to sleep with a bottle. The damage done by the bedtime bottle is fueled by the fact that no saliva flows during sleep to clear liquids from the mouth or dilute them. Liquids bathe the teeth all night. The sippy cup filled with sweetened liquids can cause the same damaging effects. The child’s teeth are immersed in the liquid during drinking and many parents allow unlimited access to the sippy cup.

The American Academy of Pediatric Dentistry recommends that children be weaned from the bottle by 12-14 months of age and be encouraged to drink from a cup. Parents are cautioned however that the repetitive consumption of liquids that contain fermentable carbohydrates (milk, juice, soft drinks etc.) from a bottle or sippy cup should be avoided.

 Be very selective about the liquids that you give your child from the sippy cup. Avoid milk, juice, and soft drinks. Try water or sugar free beverages instead.

 Use the sippy cup only as a transition to a regular cup or adult drinking glass with no lid.

 Consider cup design carefully. A pop-up straw reduces the amount of time the liquid is in contact with the teeth.

 Some speech pathologists have expressed concern about over use of the sippy cup and liken its use to a thumb-sucking habit, the effects of which are well documented.

Crossbite: It’s A Mix-Up

The word “crossbite” is one of the few dental terms that is almost self-explanatory. An individual with a crossbite will have teeth that are out of place when biting. One set of teeth will fall either inside or outside the opposing set when they are in contact; therefore, a crossed bite. The most common crossbite is one in which one or more of the upper teeth bite inside the lower teeth. Another type occurs when the upper teeth bite completely outside of the lower teeth. A third type of crossbite also exits which is a combination of the first two.

There are many reasons that crossbites develop. For example, an upper primary tooth that is late in exfoliating [getting loose and coming out] can cause the permanent tooth to erupt inside or outside its correct position. Another example occurs when upper permanent teeth are very crowded. Because of this lack of space, one or more of the newly erupting teeth will have to go inside their correct position. This adverse position of the upper tooth/teeth will cause the bite to be inside the lower teeth. Conversely, if the lower teeth are crowded, one of them can erupt to the outside of its normal position locking its correctly positioned upper mate to the inside.

Crossbites are responsible for many serious conditions. An example is a larger upper front tooth biting inside a smaller lower front tooth. This situation can cause a loss of support bone on the front of the lower tooth. If this condition remains untreated, the lower front tooth can lose enough of the support bone to necessitate its removal. Unfortunately, that can occur before all of the permanent teeth have erupted. Another problem can occur if the crossbite interferes with the proper positioning of the lower jaw on closing. Again, if not treated, temperamandibular joint and growth problems can arise. Other problems that can develop are uneven wear of the teeth, difficulty in chewing, uneven or reduced growth of one or both jaws, problems in getting the teeth clean because of the improper alignment and a self conscience smile.

The younger a crossbite patient is treated, the more positive will be the results. Treatment should be initiated even if the condition is noted when only the primary teeth are present. The ability of the jaws to grow and mature as nature intended is the best result a child can get.

Patients with crossbites in their permanent teeth, teenager or adult, can also be successfully treated to an excellent outcome. However, the correction will be different for this type of patient than it would be for a younger one. Once we reach an age that growth has mostly or completely occurred, the orthodontist has limits to the types of treatment that can be used. That is why early treatment is recommended and encouraged.

Another type of crossbite develops when the lower jaw hereditarily develops further forward than the upper jaw. When this happens, usually all of the lower teeth are forward of their normal position in relation to the upper teeth. The facial profile is concave and the lower front teeth usually all bite forward of the upper front teeth. When this growth pattern occurs, it is urgent that complete orthodontic records [models, head x-rays and photos] be secured as early as possible. Then our trained doctors can develop a long-range treatment plan to treat the particular patient. Early diagnosis and treatment can sometimes avoid surgery when growth is completed. Again, early treatment is best.

Ingredients In Some Mouthwashes Include Alcohol

Besides water and sweeteners such as sorbitol and sodium saccharine, many commercial brands of mouthwash include other active ingredients such as eucalyptol, hexetidine, thymol, hydrogen peroxide, methyl salicylate, enzymes, fluoride and calcium. Many brands of mouthwash such as Scope or Listerine contain from 6.6% to 26.9% of alcohol, more than beer or wine [Pediatrics for Parents, March 1993]. These formulations rely on a high alcohol content to temporarily kill bacteria that causes bad breath. This is almost counterproductive since antiseptic mouthwashes with high alcohol content may lead to dry mouth, which makes you more prone to bad breath than a moist mouth; and if swallowed may be dangerous, especially for children. Drinking plenty of water can be important in treating unpleasant mouth odors.

No matter what type of mouthwash you choose, you should rinse for the amount of time stated on the product. Avoid using mouthwash in excess of the recommended amount or frequency. Mouthwashes or rinses should not take the place of daily tooth brushing and flossing, which are essential to remove particles of food on and between teeth. Mouthwash, when used appropriately, is used to kill bacteria that cause bad breath and gingivitis. No mouthwash is capable of killing the bacteria that causes gum disease.

Second-generation products such as TheraBreath and Closys II use odor-eliminators, typically oxidizers, such as zinc ion technology to eliminate bad breath immediately, but don’t prevent new bad breath from developing.

A third-generation mouthwash, SmartMouth uses a patented odor-eliminating zinc ion technology to neturalize the bacteria that causes bad breath and prevent it from recurring. SmartMouth’s zinc ion technology was invented and patented at the Dental Medicine program at the State University of New York, Stonybrook.

This two-bottle mouthwash system, when used twice daily as directed, has been clinically proven to reduce chronic bad-breath, keeping breath fresh twenty-four hours a day and even eliminating morning breath.

Call the office and ask us about alcohol-free alternative mouthwashes. The good news is that there are plenty of alcohol-free mouthwashes available in your local drugstores today!

Dental Sealants Prevent Decay

The application of systemic or topical fluoride since the early 1970’s has lowered the incidence of tooth decay on the smooth surfaces of the teeth. However, about 90% of the decay found in children’s teeth occurs in tooth surfaces with pits and fissures. To solve this problem, dental sealants were developed to act as a physical barrier so that cavity-causing bacteria cannot invade the pits and fissures on the chewing surfaces of back [posterior] teeth.

A sealant is a plastic resin material that is usually applied to the chewing surfaces of the back teeth—premolars and molars. This material is bonded into the depressions and grooves (pits and fissures) of the chewing surfaces and acts as a barrier, protecting enamel from attack by plaque and/or acids.

Dental sealants are usually professionally applied. The dentist, hygieniest or assistant cleans and dries the teeth to be treated; then paints a thin layer of liquid plastic material on the pits and fissures of the tooth. A blue spectrum natural light is shined on the applied material for a few seconds to cure the plastic. Some brands of sealants cure chemically.

After curing, the plastic becomes a hard, thin layer covering the treated portions of the tooth. Despite the incredible pressures placed on teeth during chewing each day, dental sealants often remain effective for five years or longer, although sealants do wear naturally and should be checked at regular intervals. If sealants wear or become damaged, they can be repaired or replaced simply by applying new sealant material to the worn or damaged portions.

Children should receive sealants shortly after the eruption of their first permanent molars, around age 6 and again at age 12 when their second molars appear.

During the child’s regular dental visits, we will check the condition of the sealants and reapply them when necessary.

5 Clues Your Child Is not Brushing


1. The toothbrush is dry.
It’s tough to keep the toothbrush dry if you’re actually brushing! Make sure to check your child’s toothbrush every day (and night ) – before it has time to dry.
2. You can still see food particles.
After your child has brushed, ask for a smile. If you can still see bits of food on or in between your child’s teeth, send your child back to the bathroom for a do-over.
3. Teeth don’t pass the “squeak test.”
Have your child wet his or her finger and rub it quickly across the outside and inside of his or her teeth. If the teeth are clean, you will hear a squeaking sound.
4. Breath is everything but fresh.
If your child is brushing and flossing regularly, his or her breath should be fresh. The foul odor associated with bad breath is most often caused by food particles — either food left in between teeth or food trapped in the grooves on the tongue.
5. Your child has a toothache.
Even if you can’t tell if your child is brushing well, a toothache is a red flag. Make sure your child sees the dentist right away – a filling or other treatment may be in order.
Remember, brushing is just one part of your child’s total oral health regimen. In order to remove stubborn plaque and tartar buildup and prevent other dental problems, regular exams and cleanings are a must. Plus, your dentist can help reinforce the importance of good oral hygiene with your child.

A Closer Look at Bonding


It’s not unusual to feel shy about smiling if your teeth aren’t everything you would like them to be. Stained teeth might inhibit you from smiling as often or as big as you normally would. Chipped teeth and gapped teeth can have a similar effect. But with a little dental bonding, you can start smiling again with confidence.
Dental bonding is one of the easiest and most cost-effective ways to make cosmetic improvements to your teeth.
During a bonding procedure, a tooth-colored resin, or plastic, is bonded to your tooth with an ultraviolet “curing” light. Unlike veneers and crowns, which are sometimes used to make similar improvements, a bonding procedure usually takes just 30-60 minutes per tooth and is often complete in just one dental visit. Another advantage of dental bonding: It requires less prep work than veneers or crowns, so more of your tooth enamel remains intact.
Bonding can even be used to replace existing amalgam (silver) fillings with natural-looking composites. It’s also ideal for treating cavities in the front teeth, where aesthetics are especially important.
Keep in mind that dental bonding isn’t the cure-all for every tooth defect. Bonding doesn’t work well on back teeth or larger cavities. But for the smaller changes, bonding can have a huge impact on the way you feel about your smile.