Why should I have an orthodontist put on my braces?

Many people are curious about general dentists and orthodontists. The common misconception is that both can put your braces on, and both give you the same results. The truth is that most general dentists are not trained to handle braces. The results are not comparable.

In dental school, most dentists receive only introductory courses in orthodontics, not enough to provide comprehensive treatment. Some pursue extra courses after dental school to learn how to apply braces, but general dentists are not orthodontists. They do not go through all the required hours of training or take the required tests. They are not certified by the Commission of Dental Accreditation (CODA), a division of the American Dental Association (ADA) that oversees and monitors the nine specialties existing in dentistry.

General dentists routinely oversee the health of your teeth and gums. They perform exams, cleanings and checkups. They treat oral diseases such as cavities and infected lesions, and restore teeth and gums. They monitor and maintain your general oral health.  

Orthodontists routinely work on diagnosis, prevention and correction of malocclusion, or poor bite. Their job is to focus on the reconstruction of your smile. Their day-to-day activities focus on correcting the position of the teeth, bite, face and jaw to create beautiful smiles. Orthodontists do not practice general dentistry.

All orthodontists must go through two to three years of additional post-graduate study after dental school to specialize in orthodontia, the straightening of the teeth and jaw. They attend an accredited specialty program recognized by the ADA and the American Association of Orthodontists (AAO).  They must pass all the prerequisite courses and clinical training hours to be certified as a dental specialist. 

Orthodontics is one of the nine specialties in dentistry. Orthodontists focus on different types of bad bites such as over-bite, under-bite, open-bite and bite asymmetry. They are responsible for bite correction in children and adults using braces, arch wires, orthodontic devices, dental orthopedic appliances and removable appliances, such as Invisalign clear aligners. They may also work with an oral maxillofacial surgeon to plan and treat surgical cases, such as cleft palette or treatment for patients who need a combination of braces and jaw surgery to correct their bite.

Just as you go to a family physician for a physical check-up but go to a plastic surgeon for cosmetic surgeries, you go to a specialist because they have advanced training and they do these procedures daily. The same applies to your dentist and your orthodontist. Dr. Nancy Phan is a specialist in orthodontics. For more information, visit us at www.CareOrthodontics.com.

What is the difference between snoring and sleep apnea?

What is snoring?

Snoring occurs when you make hoarse sounds during sleep. It is caused by the vibration of the soft palate. It presents due to narrowing and laxity of airway tissues. Snoring does not restrict the airway and it does not cause sleep disturbances.

Studies estimate that 30% to 50% of the U.S. population experience snoring. Light snoring can be a minor annoyance. Excessive, loud and habitual snoring can disturb your loved one. Snoring does not cause breathing or sleep disturbances. However, it can progress into upper airway resistance syndrome, which causes sleep disturbances and becomes sleep apnea. Snoring can be a sign of sleep apnea. Snoring can increase a person's risk for stroke. [Source: Lee et al.]

In summary, as long as there is no airway restriction, then the term “snoring” is used. It is important that you recognize the differences between snoring and sleep apnea.

What is sleep apnea?

Sleep apnea is a condition when your breathing stops during your sleep, sometimes occurring 20-30 times per hour. Each time you stop breathing, the lack of oxygen supply available to the brain causes you to wake up in order to restart the breathing process. The continuous process of wake-sleep, wake-sleep cycles prevent you from achieving deep sleep and causes you to feel constant drowsiness and fatigue during the day.

Sleep apnea is defined as restriction of the airway passage for a minimum time leading to oxygen saturation drop. Apnea is a complete or almost complete blockage of the airway for a certain time.

What are the signs of sleep apnea?

Snoring is one symptom of sleep apnea. However, snoring does not always indicate sleep apnea. It may be a social inconvenience but may not cause cessation of breathing, and may not require immediate treatment. Currently, 1.2 million Americans suffer from sleep apnea.

To diagnose sleep apnea, look for these symptoms:

• Choking or gasping that follows loud snores at night
• Breathing cessation episodes
• The need to wake up frequently with shortness of breath
• Sore throat and dry mouth after waking
• Insomnia or difficult sleeping
• Headaches, drowsiness, and irritability upon waking in the morning
• Falling asleep unintentionally during the day

What are the different types of sleep apnea?

The types of sleep apnea are usually diagnosed by a sleep apnea specialist in a sleep lab.

There are 3 types of sleep apnea:

1. Obstructive sleep apnea (OSA) is the common type. It occurs due to a physical blockage, typically caused by the tongue, uvula and soft palate, which collapse and block the airway in the back of the throat.
2. Central sleep apnea (CSA) is a less common type. It occurs due to lack of proper signals from the brain sent to the breathing muscles.
3. Complex sleep apnea is a less common type. It is a combination of obstructive and central sleep apnea. [Source: Dental IQ]

 

Medical and dental conditions associated with sleep apnea

• People who have high blood pressure, frequent heartburn and hypothyroidism have high associations with sleep apnea.
• People who have heavy clenching, grinding, bruxing, temporal mandibular joint symptoms and frequent headaches have high associations with sleep apnea. [Source: Health checklist]

If you have these conditions, along with disruptive sleep patterns, you should see your physician to get diagnosed with sleep study tests to rule out sleep apnea.

Should it be treated?

A light snoring can be a minor annoyance to your spouse or family member but may not need treatment. Severe snoring can be a sign of sleep apnea and should be diagnosed and treated. Sleep apnea should be treated immediately. If left untreated, sleep apnea can lead to high blood pressure, risk of heart failure, and stroke. It interferes with sedation and surgical recovery. Due to unintentionally falling asleep during the day, it negatively affects work and school. It also leads to a higher risk of injury while operating heavy machinery.

In the next post, Dr. Nancy Phan will discuss different treatment options for sleep apnea.

If you find this blog helpful, let us know. Dr. Nancy Phan and the team at Care Orthodontics want you to have a beautiful and healthy smile. We create beautiful smiles with Care!

1. http://www.dentistryiq.com/articles/2013/11/using-oral-and-dental-devices-to-treat-snoring-and-sleep-apnea.htm
2. Lee SA, Amis TC, Byth K, et al. Heavy snoring as a cause of carotid artery atherosclerosis. Sleep 2008, 31:1207-1213
3. Bruce, Dan. Health history checklist for sleep-related breathing disorders. Dental Economics 03 2015, 80-84

I heard things about Invisalign. Does it work?

I have patients who come in for an orthodontic consultation and tell me that they only want braces, not Invisalign. When I inquire further, they say that they have friends who have worn Invisalign and do not recommend it because, "Invisalign does not work." Their true concerns are, "can Invisalign give me the same results as braces?" and, "is it a good product?" Let's compare these two products and get to the bottom of these concerns.

The first question is: Can Invisalign move teeth? Yes, it can. If braces can move teeth then Invisalign can move teeth. Braces move teeth by fixed mechanics in which brackets and wires are attached to the teeth and cause tooth movement. Invisalign moves teeth by removable mechanics in which the plastic materials and added auxiliaries push on teeth.

The mechanics of which teeth move are the same in braces and Invisalign. The basic principle is that force applied to the teeth, whether through fixed or removable appliances, gets transferred from the crown of a tooth to the root of tooth then spreads through the adjacent bone. Eventually that original force triggers a bone biology process to cause cell turn-over to soften bone around a tooth and move that tooth in the direction of the acting force. A tooth can move forward, backward, up, and down, or it can rotate, depending on the direction and amount of force applied.

The next question is: What kind of bite can View Invisalign videos fix? Invisalign can fix almost any bite just as braces; however, the big answer depends on the experience and expertise of the treating doctor. As a patient, if you go to a general dentist who treats a few cases a year and has not gone through rigorous training of orthodontic forces and mechanics, then you may not get the same great results as you would with an orthodontist who treat many cases. In general, an orthodontist goes through additional two to three years after completing a general dentist degree and needs to take additional testing required to be certified as an Orthodontic Specialist. By definition, they are specialists in the field of biological forces, dental mechanics, and tooth movement. Just as a painter and the paint material, you need both a good paint product, and a great painter to give you the final masterpiece and long-lasting beautiful artwork.

At Care Orthodontics, Dr. Nancy Phan and team practice orthodontics exclusively. We use braces and Invisalign day in and day out and we can give you a beautiful smile that you yearn for. In rare instances, if you start out with Invisalign and for some reasons decide that it is not working for you, Dr. Phan can switch you to braces. For most cases, Dr. Phan starts and completes Invisalign treatment only by aligners and finishes cases beautifully. We are here to customize your treatment and provide you the best care and comfort.

You can schedule a complimentary exam with us by going to: www. CareOrthodontics.com. You can also check us on Facebook at www.facebook.com/CareOrthodontics