Now that I got braces, what gadgets are in my mouth?

After much thought and consideration, you've finally decided to get braces. You are on your way to achieving a beautiful smile that you always wanted. Your teeth will line up straighter. Your bite will come together better. You will chew food better. You will speak better.

However, first you want to know what gadgets are in your mouth. Below are some orthodontic components that Dr. Nancy Phan uses in her orthodontic practice:

Braces refer to a combination of brackets, bands and wires used in orthodontic treatment:

• Brackets are handles to move your teeth.
• Bands are rings around your molars to carry a bracket
• Wires are tracks for your teeth to slide. .
• Spacers are little rubber bands that go in between your back molars. They create spaces for insertion of bands or orthodontics devices.

Orthodontic devices refer to apparatus that are inserted in the mouth to aid in tooth movement:

• Expanders are used to widen your jaws and to create spaces. A Palatal expander can separate your palatal bone to make your upper jaw larger and fit better to the lower jaw. It creates space while the jaw is still growing to allow the permanent teeth to erupt more easily. A Quadhelix expander can be used in both upper and lower jaws to create more space.
• A Bite Plate is used to correct a deep bite. When your lower teeth come up too far and hit hard on the back of your upper teeth causing heavy pressure or swollen gums, then a bite plate is needed to correct the deep bite.
• Space Maintainers are used to anchor the back teeth and maximize your orthodontic outcome. A Trans-Palatal arch is used to anchor a molar. A Nance Holding Arch is to hold space for the permanent premolars to come in. A Lingual Holding Arch can be used to hold space or it can also be used to lift an impacted tooth.

Retainers are used after braces come off to hold the shape of the jaw and position of the teeth:

• A Hawley retainer is a removable retainer that has a wire in front of the teeth with an acrylic plate on the back of the teeth and the roof of the mouth to hold teeth in place and maintain the shape of the jaw.
• An Essix retainer or Clear retainer is a shape performance tray that holds teeth in place. It is clear and durable and helps to maintain the position of the teeth after orthodontic treatment.

Other orthodontic devices are added tools to aid the orthodontist in correction of your teeth and jaw. They are customized and recommended based on an individual's age, pubertal growth stage, maturation phase and specific orthodontic needs to correct the bite and jaw.

• A Headgear is an orthodontic appliance that aids in the correction of a long upper jaw or an excessive overjet (or often referred as "overbite").
• A Facemask is an orthodontic appliance that aids in the correction of an anterior crossbites (or often referred as "underbite"). 
• A Bite Corrector is an orthodontic appliance that aids in the alignment of the upper and lower jaws.
• TADs (Temporary Anchorage Devices) are mini-implants or fixed anchorage that assists in the efficiency of orthodontic treatment 
• Soft Tissues Laser, such as a Diode Laser, is used to correct uneven gum height, remove gummy smile, remove excess nodules in the mouth, remove thick frenum, uncover thick fibrous tissues that impact permanent teeth, and many other applications. The benefits of laser surgery are huge, such as no suture, comfortable patient's experience, minimal bleeding, minimal pain, minimize infection, and quick recovery. For example, 2% of the population has tighten frenum, an over-pulling gum tissue that cause teeth to space apart, tongue tie, or gum recession. Patient who has a laser frenectomy can go back to work or school within the next day and have very little pain or swelling.  Dr. Nancy Phan is a Certified Laser Provider for many orthodontic-related procedures.

Contact us at www.CareOrthodontics.com for more information.

Does my child need early orthodontic treatment?

Even though our office offers complimentary orthodontic consultations to children, some parents do not take advantage of this offer. Some parents say, “Why early treatment when my child can wait?” or “Would it cost me more to do early treatment?” These are valid questions, until you know the reasons for early treatment and significant benefits that come with it.

Many orthodontic problems may be diagnosed and treated early to prevent further complications. The American Association of Orthodontists recommends an orthodontic evaluation at age 7. Dr. Phan recommends that children be screened for any bite or jaw growth problems between ages 7-9.

Screening does mean your child always requires orthodontic treatment. Screening allows you to recognize the severity of an orthodontic problem, if there is any. In our office, 20-25% of children benefit from early treatment. The remaining 75-80% do not require early treatment.

Early orthodontic treatment may also be referred to as Phase I treatment, interventional orthodontic treatment, interceptive orthodontic treatment, or limited orthodontic treatment. These terms indicate early correction of a bite problem.

What are examples of early bite problems?

• Severe over bite – where the lower teeth cause cuts on the upper gum
• Severe over jet – where the upper jaw and teeth stick out too far, risking enamel fracture
• Under bite issues- where the lower jaw sticks out too far
• Cross bite issues – where the upper and lower jaws misalign, leading to uneven facial growth
• Mouth breathing habit – causing dry mouth and inflamed gums
• Thumb and finger sucking habit – causing open bite
• Speech impediment – affecting language development
• Early loss of baby teeth – delayed eruption of permanent teeth
• Difficulty chewing or biting – affecting digestion and well-being
• Super crowded teeth – affecting eruption of permanent teeth
• Uneven bite – affecting facial appearance and self-image

Why do they need correction?  

• In a growing child, every effort should be made to help the maxilla and mandible grow at similar speeds. Uneven jaw growth leads to an unfavorable facial profile and requires jaw surgery later in adulthood.
• By manipulating jaw dimension in a growing child, it is possible to reverse the genetic causes of this trait.
• By aligning the jaws, it is possible to achieve a more balanced and symmetrical face.
• By correcting deviated jaw growth, it is possible to reverse facial asymmetry.
• By stopping dysfunctional habits, such as finger sucking or tongue thrusting, it is possible to prevent speech, mastication, and bite problems.
• By creating space, it is possible to prevent impaction of permanent teeth.
• By correcting a malocclusion, it is possible to avoid psychological impacts caused by school bullies or child teasing.

What are the benefits of early treatment? 

Early intervention eliminates harmful oral habits, creates space for ease of permanent teeth eruption, reduces the extra pain associated with surgical requirements, and reduces the risk of jaw surgery in adulthood. Early treatment plays an important role in the prevention of serious bite problems, guides jaw alignment, develops final occlusion, and improves facial aesthetics.

Early detection of jaw and bite problems provides a great opportunity for effective treatment planning, financial planning, and simple treatment. When indicated, early treatment, also known as Phase I treatment, reduces the severity, treatment length and treatment cost of Phase II treatment. Many times, a more severe orthodontic problem can be corrected using a fixed or removable orthodontic appliance.

Call for a consultation.

You can schedule a consultation for your child to evaluate their bite and receive the best advice to care for your child’s smile by calling our office at (408) 971-2885. Please visit our website, www.CareOrthodontics.com, for other beneficial information.

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

Why are retainers important after orthodontic treatment?

The most important reason for wearing retainers is to prevent your teeth from shifting back to their original position. The second reason is to maintain the shape of your jaw, and the third reason is to reduce jaw clenching and grinding.

After completing your orthodontic treatment at Care Orthodontics, Dr. Nancy Phan and team will recommend that you wear retainers. Retainers will hold your teeth, gums and bones in placed until they are stabilized and are less likely to relapse.

There are 3 kinds of retainers. Today, Dr. Phan will share with you the pros and cons and each type:

Hawley retainers:  They are the most common type of retainers and are made out of wire and acrylic. They are removable and are custom made from the impression of your teeth.

• Pros:  These retainers are most durable. They can last up to 15-20 years as long as they are well maintained, kept in their retainer cases, and being worn daily. They can be repaired to accommodate a new crown, a big restoration or even an implant crown or bridge. They allow the person to brush and floss easily.
• Cons:  They require a short adjustment time initially. When first worn this type of retainer may alter your speech a little. Your mouth may salivate a little more until your tongue adjusts to function with these retainers in the mouth.

Clear retainers:  They are removable and transparent. They are custom-made from the entire arch and can be used to hold teeth or to produce minor movements. They are commonly used in Invisalign treatment to move teeth.

• Pros:  These retainers are very esthetic and they are very thin so they are very easy to wear. Most people do not need any adjustment time. Your speech is not affected. In addition, this kind of retainer can be used as a mouth guard to prevent enamel wearing down during grinding.
• Cons:  Their average life time may be 3-10 years depend on the amount of teeth grinding or clenching. Patients who experience heavy clenching and grinding may wear out clear retainers quickly and require a replacement set.

Bonded retainers. They are fixed, non-removable and cemented directly in the back of upper and lower six front teeth.

• Pros:  These retainers stay in the mouth 24-7 unless there is any breakage. For people who forget to wear retainers, for whom teeth have shifted easily, or who prefer to leave retainers in the mouth all the time, this type of retainer is indicated. 
• Cons:  These retainers require the most daily care and maintenance. You need thorough brushing and a special flossing device to keep stains and food away from these retainers. You need to avoid incorrect biting or flossing to prevent bonding breakage. Bonded retainers are not life-time permanent retainers. The bonding can break off and cause your teeth to shift. Broken bonded retainers will need to be repaired or replaced by an orthodontist. In patients who have periodontal diseases such as loss of bony attachment around teeth or have loose teeth, bonded retainers can break easily and require frequent repairs.   

If you have any question about retainers, you can contact us for a consultation appointment at (408) 971-2885 with Dr. Nancy Phan. You can also check our website at www.CareOrthodontics.com for other useful information and tips.

What are the benefits of braces…other than just to straighten teeth?

Everyone wants a naturally straight and beautiful smile. It is no secret that braces can deliver a good smile. However, there are many additional benefits to having braces other than just having straight teeth. You will gain many oral health benefits in addition to the cosmetic ones:

1. Reduce tooth decay and gum disease. Crooked teeth, crowded teeth, overlapped teeth create tight spaces, lead to food traps and difficulty brushing and flossing. Gingivitis and periodontal diseases are different types of gum disease, caused by certain strain of bacteria found in plaque sitting above the gum and deep inside the gum pockets. These bacteria break down bone and tissue attachments to cause teeth mobility and tooth loss. Having straight teeth allows better brushing and flossing, reducing food traps and encouraging healthy gingival and bone.
2. Improve your speech. Your teeth play a significant role in speech. The way your tongue is positioned in relation to your teeth contributes to the formation of sound. When your teeth are too far out forward or backward, they can affect speech and cause lisping, frustration or embarrassment. Aligned teeth allow for more clear and acute speech.
3. Improve your eating. Your top and bottom teeth need to come together evenly to break down food. A person who has an open bite, when the top and bottom front teeth are not aligned, will not be able to bite into a piece of lettuce or into a thin slice of ham with the front teeth. Another person with an overbite or an under-bite will have a hard time chewing food normally. Straight teeth allow better chewing and mastication. 
4. Prevent bone erosion. Bone and gum begin to erode when there are no teeth to support them. Teeth that are far out of alignment can lead to bone and gum erosion, resulted in teeth mobility and teeth sensitivity. With braces, Dr. Nancy Phan can bring poorly fitted teeth back into a healthy range. 
5. Reduce risks of temporal mandibular joint (TMJ) dysfunction. Bad bites can cause stress to the temporal mandibular joint and lead to muscle fatigue, muscle spasm, joint soreness or joint inflammation. By eliminating a bad bite, Dr. Nancy Phan can establish a harmonious occlusion with minimum joint stress. 
6. Improve your digestion. Your teeth play an important role in digestion. Before food gets digested in your stomach, they are first digested by your teeth. When teeth are severely out of line, they do not break down food effectively. With braces, you can achieve more optimal chewing. 
7. Improve your self-esteem. A research by Wakefield and the American Association of Orthodontists revealed that 1/3 of American adults are unhappy with their smile. Bad teeth represent one of the biggest dating turn-offs among men and women. Bad teeth lead to lack of self confidence and lead to missed opportunities on career advancement, social interactions, and a better job interview or a job offering. Having a beautiful smile is the first step to gaining self confidence.

With today's technology, braces are thinner, smaller and far more esthetics than the 1960s -1970s. People can get their teeth corrected with different options such are metal braces, ceramic braces, clear aligners, Invisalign, etc. Healthy teeth can be moved at any age. You are never too old to enjoy a straight and healthy smile!

Call us at 408-971-2885 or check us at www.CareOrthodontics.com to schedule a complimentary consultation for orthodontic treatment. You can enjoy all the benefits of braces discussed in this article.

We can predict your child’s face by the age of 7

As parents, you look at your children from the day they were born and wonder what will become of them? What will they be when they grown up? What will they look like as they get older?

Of course, as with physical appearance, everyone knows that your genes will dictate your children’s facial features. It’s a given that they will look a bit like you and your partner. It has to be…and definitely not look like the neighbor’s face… or there will be issues...!

What if you wish you could change some facial features to make it better for your children? You may have strong upper jaw and an overbite...or you may have a strong lower jaw and a little of an under-bite and you want not want them for your children.

At age 7, the American Association of Orthodontists (AAO) recommends you schedule an orthodontic examination for your child. By the age of 7, the growth pattern in your child’s face continues on the path that the genetic make-up has defined.

At Care Orthodontics, our orthodontist can do an examination and predict your child’s facial growth. We can let you know if there are any dental or cosmetic needs, and let you know if and when any treatment may be indicated. We can provide you a personalized payment plan and help you with obtaining insurance benefits if treatment needed. The best part is:

• Your child’s examination is complimentary
• If no treatment is needed, we will do a follow up exam at 6-12 months at no additional cost
• Your child can join our Kid’s Club and collect Smile tokens for prizes at no charge
• You do not need a referral from your dentist to see us
• Above all, you do not feel pressured into orthodontic treatment until you are ready

At Care Orthodontics, we want to be the orthodontist and expert that you come to love and trust. Above all, we are in existence because we care and we want to make a difference in your smile. We want to give you a best smile possible.

Please feel free to contact us today for you or your child’s orthodontic exam. You can check out our website at www.CareOrthodontics.com