A:

Brushing and flossing help control the plaque and bacteria that cause dental disease.

Plaque is a film of food debris, bacteria, and saliva that sticks to the teeth and gums.  The bacteria in plaque convert certain food particles into acids that cause tooth decay.  Also, if plaque is not removed, it turns into calculus (tartar).  If plaque and calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease.

Plaque formation and growth is continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids.

Toothbrushing – Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.

• Brush at a 45 degree angle to the gums, gently using a small, circular motion, ensuring that you always feel the bristles on the gums.
• Brush the outer, inner, and biting surfaces of each tooth.
• Use the tip of the brush head to clean the inside front teeth.
• Brush your tongue to remove bacteria and freshen your breath.

Electric toothbrushes are also recommended.  They are easy to use and can remove plaque efficiently.  Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.

Flossing – Daily flossing is the best way to clean between the teeth and under the gumline.  Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

• Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
• Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
• Curve the floss into a “C” shape around each tooth and under the gumline.  Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Rinsing – It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush.  If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.

A: The American Association of Orthodontics recommends that children get an orthodontic evaluation no later than age 7. Though orthodontic treatment can be done at any age, timely treatment ensures maximum dental health.

A:

You should have your teeth checked and cleaned at least twice a year, though your dentist or dental hygienist may recommend more frequent visits.

Regular dental exams and cleaning visits are essential in preventing dental problems and maintaining the health of your teeth and gums.  At these visits, your teeth are cleaned and checked for cavities.  Additionally, there are many other things that are checked and monitored to help detect, prevent, and maintain your dental health.  These include:

• Medical history review: Knowing the status of any current medical conditions, new medications, and illnesses, gives us insight to your overall health and also your dental health.
• Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss.  X-rays also help determine tooth and root positions.
• Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
• Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
• Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
• Examination of existing restorations: Check current fillings, crowns, etc.
• Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for sometime and is now firmly attached to the tooth surface.  Calculus forms above and below the gum line, and can only be removed with special dental instruments.
• Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of living bacteria, food debris, and saliva.  The bacteria produce toxins (poisons) that inflame the gums.  This inflammation is the start of periodontal disease!
• Teeth polishing: Removes stain and plaque that is not otherwise removed during toothbrushing and scaling.
• Oral hygiene recommendations: Review and recommend oral hygiene aids as needed (electric dental toothbrushes, special cleaning aids, fluorides, rinses, etc.).
• Review dietary habits: Your eating habits play a very important role in your dental health.

As you can see, a good dental exam and cleaning involves quite a lot more than just checking for cavities and polishing your teeth.  We are committed to providing you with the best possible care, and to do so will require regular check-ups and cleanings.

A:

The following are some of the most popular orthodontic braces:

• Traditional braces – These braces are strong and tend not to stain the teeth.  They are comprised of individual brackets which are cemented to each tooth and accompanied by an archwire which constantly asserts gentle pressure on the teeth.  Traditional braces are generally metal but are also available in a clear synthetic material and “tooth colored” ceramic.  The ceramic brackets are generally more comfortable than the metal alternative, but can become discolored by coffee, wine, smoking and certain foods.
  
  
• Invisalign^® – Invisalign aligners are favored by many adults because they are both removable and invisible to onlookers.  Invisalign^® aligners are clear trays, and should be worn for the recommended amount of time each day for the quickest results.  Invisalign^® aligners are more comfortable and less obtrusive than traditional braces, but also tend to be more costly.  Not all patients are candidates for Invisalign^®.
   

A:

A malocclusion is an incorrect relationship between the maxilla (upper arch) and the mandible (lower arch), or a general misalignment of the teeth.  Malocclusions are so common that most individuals experience one, to some degree.  The poor alignment of the teeth is thought to be a result of genetic factors combined with poor oral habits, or other factors in the early years. Moderate malocclusion commonly requires treatment by an orthodontist. 

A: One of the most commonly asked questions about dental braces is whether placing them causes any pain or discomfort.  The honest answer is that braces do not hurt at all when they are applied to the teeth, so there is no reason to be anxious.  In most cases, there may be mild soreness or discomfort after the orthodontic wire is engaged into the brackets, which may last for a few days.

A:

Absolutely! Crooked or misaligned teeth look unsightly, which in many cases leads to poor self esteem and a lack of self confidence.  Aside from poor aesthetics, improperly aligned teeth can also cause difficulties biting, chewing and articulating clearly.  Generally speaking, orthodontists agree that straight teeth tend to be healthier teeth.

A: A normal, healthy diet is still enjoyable while in braces.  You can still eat many of your favorite foods, but there will be some foods that you will need to stay away from.  We provide each patient with a list of foods to avoid.  This tells the patient which foods to stay away from and why.

A: Some cases can be completed in less than a year. More difficult cases take longer.  The average case will take from 2-3 years. Our appointment system and the Doctors' mechanics are designed to reduce the number of times you will need to be seen and the overall length of treatment.  Treatment time varies with the severity of the case, patient cooperation,and growth and development.  The Doctors will attempt to estimate treatment time at the initial appointment.

A:

There are a few basic things to consider for proper use and maintenance of your retainer.

Don’t lose the appliance – Removable retainers are very easy to lose.  It is advisable to place your retainer in the case it came in while eating, drinking and brushing.  Leaving a retainer folded in a napkin at a restaurant or in a public restroom can be very costly if lost because a replacement must be created.  A brightly colored case serves as a great reminder.

Don’t drink while wearing a retainer – It is tempting to drink while wearing a retainer because of the unobtrusive nature of the device.  However, excess liquid trapped under the trays can vastly intensify acid exposure to teeth, increasing the probability of tooth decay.

Don’t eat while wearing a retainer – It can be difficult and awkward to eat while wearing a removable retainer and it can also damage the device.  Food can get trapped around a Hawley retainer wire or underneath the palate, causing bad breath.  When worn on the upper and lower arches simultaneously, VFR retainers do not allow the teeth to meet.  This means that chewing is almost impossible.

Clean the retainer properly – Removable retainers can become breeding grounds for calculus and bacteria.  It is essential to clean the inside and outside thoroughly as often as possible.  Hawley retainers can be cleaned with a toothbrush.  Because harsh bristles can damage the PVC surface of a VFR, denture cleaner or a specialized retainer cleaner is recommended for this type of device.

Wear the retainer as directed – This phase of treatment is critical. The hard work has been done, the braces are off and now it is tempting not to wear the retainer as often as the orthodontist recommends.  Retainers are needed to give the muscles, tissues and bones time to stabilize the teeth in their new alignment.  Failure to wear the retainer as directed can have regrettable consequences, such as teeth returning to their original position, added expense and lost time.

A:

Straighter teeth perform chewing, biting, and speaking functions more effectively than crooked teeth.   In addition, a straight smile boosts confidence, is aesthetically pleasing to look at, and can help stave off a wide variety of dental ailments.

There are several types of malocclusion including overbite, underbite, crossbite, and overcrowding.  Each of these alignment problems negatively impacts the functionality and cosmetic appearance of the teeth.

Here is a brief overview of some of the main disorders associated with crooked teeth:

Periodontitis – Periodontitis or gum disease begins with a bacterial infection.  The bacterial infection is caused by inadequate oral hygiene. Crooked teeth are hard to effectively clean, which means that debris, plaque, and bacteria can build up in hard-to-reach areas. Straight teeth are much easier to clean and are at less risk of contracting gum disease.

Temporomandibular Disorder (TMJ) - Crooked teeth can lead to improper jaw alignment, which in turn causes a painful condition known as TMJ. Severe headaches, jaw pain, lockjaw, and grinding of teeth characterize this debilitating disorder. 

Tooth injury – Straight teeth create a strong wall, which means injuries are less likely to occur.  Crooked teeth are weaker and often protrude, making them far more vulnerable to external injury.

Uneven wear – Crooked teeth cause some of the teeth to work harder than others when biting and chewing.  Straight teeth share the workload evenly, meaning less risk of injury and better aesthetics.

Teeth can be straightened using either orthodontic braces or customized aligning trays.  Orthodontic braces are usually affixed to the teeth for a set duration.  The brackets and archwires are tightened regularly by the orthodontist and removed when treatment is complete.  Fixed braces can be placed on the front side or back side of the teeth and are effective for most types of malocclusion.

Aligning trays are fully removable and are used where the malocclusion is less severe, and the teeth need to move a shorter distance.  These trays are replaced every few weeks for the duration of the treatment, and have proven to be equally effective for straightening teeth.

If you have questions about orthodontics and straightening teeth, please contact our office.

A:

Orthodontics is one of many dental specialties.  The word “orthodontics” is derived from the Greek words orthos, meaning proper or straight and odons meaning teeth.  Orthodontics is specifically concerned with diagnosing and treating tooth misalignment and irregularity in the jaw area.  Initially, orthodontic treatments were geared toward the treatment of teens and pre-teens, but these days around 30 percent of orthodontic patients are adults.

There are many advantages to well-aligned teeth, including easier cleaning, better oral hygiene, clearer speech and a more pleasant smile.  Though orthodontic treatment can be effective at any age, the American Dental Association suggests that an orthodontic assessment should be performed around the age of seven.  The earlier orthodontic treatment begins, the more quickly the problem can be successfully resolved.

What problems can be treated with orthodontics?

Orthodontics is a versatile branch of dentistry that can be used alone, or in combination with maxillofacial or cosmetic dentistry.

Here are some of the common conditions treated with orthodontics:

• Anteroposterior deviations – The discrepancy between a pair of closed jaws is known as an anteroposterior discrepancy or deviation.  An example of such a discrepancy would be an overbite (where the upper teeth are further forward than the lower teeth), or an underbite (where the lower teeth are further forward then the upper teeth).
  
  
• Overcrowding – Overcrowding is a common orthodontic problem.  It occurs when there is an insufficient space for the normal growth and development of adult teeth.
  
  
• Aesthetic problems – A beautiful straight smile may be marred by a single misaligned tooth. This tooth can be realigned with ease and accuracy by the orthodontist.  Alternatively, orthodontists can also work to reshape and restructure the lips, jaw or the face.

Orthodontic Solutions

Orthodontics is a technologically advanced field which offers many sophisticated solutions to malocclusions and other cosmetic problems.  The orthodontist will generally perform a visual examination, panoramic X-rays, and study models (bite impressions) in order to assess the exact nature of the discrepancy.

When a diagnosis has been made, there are a variety of orthodontic treatment options available.

Here is an overview of some of the most common treatments:

• Fixed orthodontic braces – A metal or ceramic dental base is affixed to each tooth, and a dental wire is inserted through each base.  The orthodontist is able to gradually train the teeth into proper alignment by regularly adjusting the wire.  When the desired results are achieved, the fixed dental braces are completely removed.
  
  
• Removable appliances – There are a wide range of removable appliances commonly used in orthodontics, including headgear that correct overbites, Hawley retainers that improve the position of the teeth even as the jawbone reforms, and facemasks which are used to correct an underbite.
  
  
• Invisalign^® – This is a newer, removable type of dental aligner that is completely transparent.  Invisalign^® does not interfere with eating because of its removable nature, and mechanically works in the same way as the traditional metal dental braces.  Not all patients are candidates for Invisalign^®.

If you have any questions or concerns about orthodontics, please contact our office.

A:

In much the same way as doctors choose to specialize in areas such as cardiology and neurology, dentists can also choose to specialize.  Orthodontics is a dental specialty which aims to prevent, diagnose and treat facial and dental irregularities, such as malocclusions (bad bites).  Many orthodontic practices are limited to dentofacial orthopedics and general orthodontics but can successfully treat patients of any age.

Orthodontists are fully qualified dentists who embark on a further three years of university-based study and gain extensive clinical experience in an orthodontic residency program.  The American Association of Orthodontists (AAO) is the regulating body for this branch of dentistry.  Selecting an orthodontist who is a member of this organization adds the assurance that treatment is being administered by an individual with specialty education in oral biology and biomechanics.  The AAO recommends that children should first be examined by the orthodontist around the age of seven, to ensure that jaw and tooth irregularities are not beginning to form.

What does an orthodontist do?

Orthodontists are experts in correcting misalignments of the teeth and jaw.  There are many debilitating problems associated with misalignment, for example, speech defects, difficulties chewing and difficulty maintaining adequate oral hygiene.

Here is a brief overview of some of the most common issues an orthodontist can successfully treat:

• Anteroposterior deviations – Common examples of anteroposterior deviations include underbite (the lower teeth are positioned further forward than upper teeth) and overbite (the upper teeth are positioned further forward than the lower teeth).  Both of these deviations can cause difficulty articulating and chewing.
  
  
• Overcrowding – Overcrowding is one of the most common problems orthodontists treat.  On occasion, lack of jawbone space means adult teeth cannot erupt in alignment with existing teeth.  The orthodontist is able to realign the teeth using a number of unobtrusive devices and treatments.
  
  
• Aesthetic issues – In some cases, the shape of the whole face is negatively impacted by malocclusions or a bad bite.  The orthodontist can restructure and realign the jaw, lips and teeth to create a beautiful, even smile.

How does an orthodontist realign jaws and teeth?

Initially, the orthodontist conducts a thorough examination of the jaw and teeth.  Panoramic X-rays and study models (bite impressions) will be taken prior to the orthodontist making treatment recommendations. The orthodontist will recommend the best treatment plan for the patient’s particular condition.

Here is a brief overview of some of the treatments orthodontists may use:

• Dental braces – The combination of brackets (which are affixed to each individual tooth), and an archwire (which connects each bracket) are commonly placed to gently train the teeth into proper alignment.  Dental braces can be made of metal, ceramics or clear (“invisible”) materials.
  
  
• Headgear and facemasks – These devices are generally used to correct a developmental problem, such as an overbite or an underbite.  In addition to the dental braces, the orthodontist will design the headgear and/or facemask which fit around the head and attaches to the braces.  This structure will further encourage the teeth and jawbone into alignment.
  
  
• Retainers – After the orthodontist has realigned the teeth using dental braces, removable devices or a headgear, a retainer may then be provided to ensure that the teeth do not begin to move back toward their original positions.  Retainers are generally worn until the underlying bone has reformed into the correct position.

If you have any questions about orthodontists and the treatments they provide, please contact our office.

A:

One of the most commonly asked questions about dental braces is whether placing them causes any pain or discomfort.  The honest answer is that braces do not hurt at all when they are applied to the teeth, so there is no reason to be anxious.  In most cases, there is mild soreness or discomfort after the orthodontic wire is engaged into the brackets, which may last for a few days.

There are two common types of fixed dental braces used to realign the teeth: ceramic fixed braces and metal fixed braces.  Both types of fixed appliances include brackets which are affixed to each individual tooth and an archwire the orthodontist fits into the bracket slot to gently move the teeth into proper alignment.  Elastic or wire ties will be applied to hold the wire in place.  Some orthodontists may use self-ligating brackets which do not require a rubber or wire tie to secure the wire.

Fixed dental braces are used to treat a wide variety of malocclusions, including overbite, underbite, crossbite, and overcrowding.  If the orthodontist has determined that the malocclusion has been caused by overcrowding, it is possible that teeth may need to be extracted to increase the amount of available space to properly align the teeth.

What to expect when getting braces

Here is an overview of what you can expect when getting braces:

• Placement day – The placement of braces will not be painful in the slightest.  It may take longer to eat meals, but this is largely because it takes some time to adjust to wearing the braces.  In some cases, the teeth may feel more sensitive than usual.  Hard, difficult to chew foods should be avoided in favor of a softer, more liquid-based diet for the first few days after placement of braces.
• Two days after placement – The first several days after placement of braces can be slightly uncomfortable.  This is because the teeth are beginning the realignment process and are not used to the pressure of the archwire and orthodontic elastic bands.  The orthodontist will provide relief wax to apply over the braces as necessary.  Wax helps provide a smooth surface and alleviates irritation on the inner cheeks and lips.  Additionally, over-the-counter pain medication (e.g., Motrin^® and Advil^®) may be taken as directed to relieve mild soreness.
• Five days after placement – After five days, any initial discomfort associated with the braces should be completely gone.  The teeth will have gradually acclimated to the braces, and eating should be much easier.  Certain hard foods may still pose a challenge to the wearer, but normal eating may be resumed at this point.
• Orthodontic appointments – Regular orthodontic appointments are necessary to allow the orthodontist to change the archwire, change the rubber or metal ties, and make adjustments to the braces.  Fixed braces work by gradually moving the teeth into a new and proper alignment, so gentle pressure needs to be applied constantly.  The first several days after an orthodontic adjustment may be slightly uncomfortable, but remember that this discomfort will quickly fade.
• Dealing with discomfort – Over-the-counter pain medication and orthodontic relief wax will help alleviate any mild soreness and discomfort following placement of braces and orthodontic adjustments.  Another effective remedy is to chew sugar-free gum, as this increases blood flow which helps reduces discomfort and can also encourage the teeth to align quicker.

If you have any questions or concerns about orthodontic treatment, please contact our office.

A: There are many factors that determine the cost of your Invisalign treatment: how extensive the issues you want to correct are, how long your treatment plan will last, and the specific treatment details prescribed by Dr. Nay.  Regardless of the situation, however, We strive to make Invisalign and Invisalign Teen affordable to everyone. You can get a beautiful, healthy and straight smile for as low as your monthly cell phone bill.