By: J. Shahangian, DDS, MS- San Diego Board Certified Pediatric Dentist
Problems with Braces and Retainers
Sometimes, the wiring in braces causes irritation for your child. I recommend that you wrap the end of the wire with a small piece f beeswax, gauze or cotton ball, until you can come and visit me in my office. Call my office as soon as possible if the wiring becomes loose or falls out. Keep any wiring pieces with you, and bring them to your appointment.
Bitten Lip or Tongue
The first step to take is to rinse your child’s mouth out. The next step is to ice the mouth to minimize any swelling. Take your child to the emergency room if the bleeding does not stop.
Lacerations and Cuts
Cuts on your face and the inner tissue of your child’s mouth should be taken seriously because of possible infection and tissue damage.
In cases of severe trauma, surgery is need to treat a broken jaw, nose, chin, maxillofacial, or other facial bone.
Additional treatment may be required after jaw surgery. This additional treatment may include using tiny wires, rubber bands, metal braces, plates, and screws to re-align the fractured jaw after surgery. By stabilizing the jaw, the bone is able to fully heal. Other supplementary treatment may be necessary to ensure the jaw bone is fully healed such as using dental splints.
 http://www.sunnysidedentistryforchildren.com/library/102/LacerationsandCuts.html, accessed January 3, 2012
By: J. Shahangian, DDS, MS- San Diego Board Certified Pediatric Dentist
All About Braces
Although it is more commonly known for braces, the field of orthodontics is a special discipline of dentistry that focuses on improving your child’s smile, and oral health by re-aligning the teeth and jaw of your child.
With the fast advancement of technology, braces today are less conspicuous and than the old style of gun-metal wire straps. New braces are comfortable even though they still use wire straps. Old braces can now be replaced by newer braces that are either clear, or next to invisible because the new braces can even be placed on the back of the tooth.
The three main types of braces:
- Brackets, are bounded to the teeth and are usually made from ceramic, plastic, or metal
- Lingual braces are invisible to people because the braces are attached to the back of the teeth
- Bands are the typical kind of braces that wrap around the teeth and have metal straps
Around age seven, teeth are evaluated, and the orthodontist will determine whether your child needs braces.
Orthodontia is a thorough process that includes many stages. Before your child can wear braces, the orthodontist has to run many tests to confirm braces are needed. First, the orthodontist will look at your child’s past dental/medical records, and then the orthodontist will do a thorough clinical examination. Next, the orthodontist will make plaster molds of your child’s teeth, do X-rays, and take pictures of your child’s teeth and face.
The orthodontist will determine the best treatment plan for your child. For example, the orthodontist will determine whether your child needs space maintainers vs. braces to realign your child’s teeth.
The “active treatment” refers to the stage where the orthodontist actually puts in place the orthodontic appliances. From time to time, the orthodontist may adjust the appliances so that the teeth grow in straight. These visitations vary from person to person. Sometimes, two phases for the active treatment are needed for early orthodontic intervention. The overall success of the orthodontic treatment and length of time which your child wears braces is dependent upon how well your child follows the treatment.
Your child will typically wear retainers after the braces are taken off. This post treatment ensures that the teeth are aligned properly in their new position. In severe orthodontic cases, there may be need for surgery.
The technology for braces has greatly advanced which means that today’s braces are a lot less noticeable. The part of the braces that wires together, known as brackets, are usually bound to the front part of the teeth. There are many kinds of brackets including tooth-colored, clear, and metal brackets. Today, wires known as “space age” materials are more flexible and make the teeth straightening process more comfortable and faster. In fact, brackets can be placed on the back of teeth.
Although the length of time that patients wear braces varies, on averages patients wear braces for about two years. This variation depends of the how closely your child follows treatment instructions, the severity of the orthodontic problem, and the overall health of the supporting bones, gums, and teeth. Moreover, typically adult treatment will take a little longer.
Your child may experience temporary discomfort when your child’s braces are re-tightened. Sometimes, the wiring of the braces becomes loose and needs re-tightening. This process is necessary to ensure the teeth and jaw are re-aligned into the proper position, but it may cause pressure on the bands or brackets. For this reason, your child may experience mild pain and soreness on the teeth and jaw, but this discomfort is temporary.
There are several precautions that parents must take for children who wear braces. For example, avoid feeding your child junk food such as soda pop, chips, and sweets because the sugar causes plaque and acid. This type of alimentation also promotes gum disease and tooth decay. Moreover, avoid feeding your child sticky sugary food such as caramel because these foods can loosen or damage the brackets. You must also make sure to cut up food into smaller pieces, and avoid feeding your child hard crunchy foods such as hard candy and nuts because it can break the braces.
In order to have a successful orthodontic treatment of braces, you must help your child maintain good oral hygiene. Make sure your child cleans his/her braces and bands on a regular basis. There are many crevices on the braces where food can get trapped so it is important you help your child carefully brush and rinse after every meal. Make sure your child has a soft bristle brush and also uses fluoride toothpaste. Also, make sure to teach your child to look into a mirror to make sure no food particles are trapped on the teeth and braces. Making sure your child flosses between teeth, braces, and wires with floss threader is equally important. If this proper oral hygiene is not taken, your child’s teeth could become stained. Make sure you make an appointment with me every six months so I can check that your child’s teeth and gums are healthy.
 http://www.sunnysidedentistryforchildren.com/library/2049/AllAboutBraces.html, accessed January 3, 2012
By: J. Shahangian, DDS, MS- San Diego Board Certified Pediatric Dentist
Orthodontics is a specialized field of dentistry that deals with the correcting teeth alignment to better the overall oral health and facial structure of your child.
Here is a list of ways which orthodontic treatment will help your child.
- Improves some speech problems
- Lessens the treatment time for later corrective orthodontics
- Diminishes the risk of damage to overjet upper teeth
- Improves eruption patterns
- Ensures the correct width of dental arches
- Influences proper jaw growth
- Reduces the chances of impacted teeth
- Diminishes the chance of damage to the jaw joint
- Creates a reserve or place holder for the erupting permanent teeth
- Improves lip closure
- Guides permanent teeth into the proper
“Malocclusion” is a misalignment of the teeth and may be caused by a misaligned jaw, missing teeth, extra teeth, or having crowded teeth. Malocclusions, also known as “bad bite”, is mainly genetic, but may be a result losing teeth in accident, losing teeth too late or too early, or not having adequate oral habits for long periods of time.
Usually, children between the ages of 10-14 use braces to correct orthodontic problems. The reason why braces are worn at this age is due to your child’s teeth development because at this age, your child’s teeth are still malleable and able to be straightened out. However, more and more, patients of all ages are benefiting from orthodontic treatments to improve their smiles. Early diagnosis can help bypass full orthodontic treatment. (If the orthodontist concludes that your child needs braces, it is important to first consult your child because braces can cause emotional damage due to your child’s sensitivity towards his/her appearance.)
Here is a list of common condition your child may have that can fixed by doing orthodontic treatment:
- Crowded teeth – This may be caused by erupted teeth that are too large or/and a small dental arch. Crowded teeth can cause receding gum lines because the crowded teeth make the gums thin and thus they recede.
- Impacted teeth – Impacted teeth refers to wisdom teeth that are not able to grow in properly, do not have healthy gums, and lack the proper bite relationship. Often times, wisdom teeth become impacted and require extraction or being pulled. Another danger is impacted teeth can cause improper bite relationship.
- Protruding upper teeth – The main cause for protruding front teeth is finger or thumb sucking during childhood. The clinical term is “overjet”, and refers the upper front teeth protruding forward. This condition can have serious problems because the front teeth are not able to have contact with the bottom teeth, and are more able to be knocked out, broken, or chipped. A possible indication of overjet teeth is a poor bite relationship of the back molars, and more importantly, uneven jaw growth.
- Deep overbite– “Deep bite”, also known as deep overbite, refers to the bottom teeth (lower incisors) either biting into or too close to the gums behind the upper teeth. Significant bone damage can occur if the lower incisors bite the gums or palate behind the upper incisors. In addition, this causes wearing down of the incisor teeth.
- Underbite– The condition known as “underbite”, refers to lower jaw protrusion, and only occurs in a small fraction of children. Children with underbite have a longer lower jaw compared to the upper jaw. A “crossbite” is created due to the protrusion of the lower front teeth. The orthodontist will monitor the tooth and jaw growth of your child and will recommend the proper treatment.
- Open bite – The term open bite refers to the inability of the lower and the upper incisors making contact while biting down. Pressure is placed on the back teeth during chewing. This causes substantial tooth wear and makes chewing less efficient.
- Spacing – The term spacing refers to excess space in between teeth. This can be caused by a lost tooth or having small teeth, or having a wide dental arch. For the most part, the only dental problem associated with this is a poor aesthetic appearance.
- Crossbite – “Crossbite” is a common orthodontic condition where the upper bite crosses over the lower bite. If caught early, this condition can be easily fixed.
Orthodontics is a branch of dentistry that deals with properly aligning teeth and jaws to improve facial structure (and your child’s smile), as well as overall oral health.
Orthodontic treatment will help your child by:
guiding permanent teeth into the proper positions
improving lip closure
reserving or gaining space for erupting permanent teeth
reducing the potential for to jaw joint damage
reducing the likelihood of impacted permanent teeth
influencing proper jaw growth
ensuring the proper width of dental arches
improving eruption patterns
lowering the risk of damage to protruded upper teeth
shortening treatment time for later corrective orthodontics
improving some speech problems
An orthodontic problem is called a malocclusion, or “bad bite.” Some examples of causes of malocclusion include crowded teeth, extra teeth, missing teeth or misaligned jaws. Most malocclusions are inherited, although some can be acquired. Acquired malocclusions can be caused by accidents, early or late loss of baby teeth, or oral habits that are continued over a long period of time.
Patients of almost any age, but mostly children, can benefit from treatment for orthodontic problems. Typically, braces are worn between the ages of 10 and 14; this is the period of development in which the head and mouth are still growing and teeth are more accessible to straightening. Earlier orthodontic intervention can sometimes prevent the need for full orthodontic treatment. (If you have been advised that your child needs braces, it is very important to discuss the matter carefully with your child. It can be traumatic because of your child’s sensitivity to his or her looks.) More and more adults are also wearing braces to correct minor problems and to improve their smiles.
Here’s a look at some of the conditions your child may have that may be alleviated or reversed by orthodontic treatment.
Crowded teeth – Teeth may be aligned poorly because the dental arch is small and/or the teeth are large. The bone and gums over the roots of extremely crowded teeth may become thin and recede as a result of severe crowding.
Impacted teeth – In many cases, wisdom teeth do not grow in properly, have a proper bite relationship, or have healthy gum tissue around them. Often, wisdom teeth improperly erupt and become impacted, requiring them to be extracted, or pulled. Impacted teeth may also be caused by improper biting relationships.
Protruding upper teeth – Thumb and finger sucking habits in young children is often the culprit for protruding upper teeth. The clinical term for this is “overjet,” which happens when your child’s upper front teeth protrude outward. Because they don’t have normal contact with the lower front teeth, protruding front teeth are especially prone to being broken, chipped, or even knocked out. In some cases, overjet may indicate a poor bite of the back teeth, or molars, and more seriously, uneven jaw growth. Children with protruded upper teeth often have a lower jaw that is short in proportion to the upper jaw.
Deep overbite – A deep overbite or “deep bite” is caused by the lower incisor (front) teeth biting too close or into the gum tissue behind the upper teeth. When the lower front teeth bite into the palate or gum tissue behind the upper front teeth, significant bone damage and discomfort can occur. A deep bite can also contribute to excessive wear of the incisor teeth.
Underbite – Underbite, or lower jaw protrusion, usually occurs in a small percentage of children. Underbite is a condition in which the lower jaw is longer than the upper jaw. The lower front teeth protrude, creating a “crossbite.” Orthodontic treatment involves monitoring jaw and tooth growth.
Open bite – Open bite is usually the result of the upper and lower incisor teeth failing to make contact when biting down. This causes all the chewing pressure to be placed on the back teeth, making chewing less efficient and may contribute to significant tooth wear.
Spacing – If teeth are missing or small, or the dental arch is very wide, space between the teeth can occur. The most common complaint from those with excessive space is poor appearance.
Crossbite – Crossbite typically occurs when the upper teeth bite inside the lower teeth. This condition can be easily alleviated if caught early.
Lots of kids have problems with their teeth not growing in nice and straight. It doesn’t mean something is wrong with you. If you don’t do anything about this and your teeth could look very crooked and uneven when you grow up. Also, you could have problems with your “bite,” or the way your teeth hit each other when you close your mouth. This could put pressure on your jaw and give you other kinds of problems later on.
Braces are usually worn between the ages of 10 and 14; this is the period of development in which your head and mouth are still growing and teeth are more flexible, and easier, to straighten.
There are three kinds of braces:
Brackets, usually made form metal or plastic, and are bonded, or glued, to your teeth.
Lingual braces, which are brackets that attach to the back of your teeth, hidden from view.
Bands, which are the old-fashioned type that cover most of your teeth with metal strips that wrap around the teeth.
All types of braces use wires to move the teeth to the desired position.
If you need braces, this is usually what happens: After the dentist examines your mouth, a plaster mold is taken of your teeth, photos of your face and teeth and X-rays of your mouth and head are taken. This is done to make sure that you get just the right kind of braces.
While you are wearing your braces, they’ll need to be adjusted by your dentist now and then so that your teeth are growing in the right way. After you get your braces taken off (usually in about two years or less), you probably will need to wear a retainer, which is a lightweight, plastic-like plate the fits in between your rows of teeth. The retainer, which you take out of your mouth when you sleep at night, helps keep your teeth in their new positions.
Are Braces Uncomfortable?
Sometimes, your dentist will need to re-tighten the interconnecting wires of your braces. This causes mild pressure on the brackets or bands to shift teeth or jaws gradually into a desired position. Your teeth and jaws may feel slightly sore after such a visit, but the discomfort doesn’t last long.
How Do I Clean My Teeth With Braces On?
If you wear braces, you should try not eating things like sweets, chips and pop. Sugary and starchy foods generate acids and plaque that can cause tooth decay and promote gum disease. Cut healthy, hard foods like carrots or apples into smaller pieces. And by all means, avoid sticky, chewy sweets such as caramel, which can cause wire damage and loosen brackets. Avoid hard and crunchy snacks such as popcorn, nuts and hard candy, because these can break braces.
It is very important to brush your teeth regularly while wearing braces. If you don’t, the metal bands could leave permanent stains on the enamel of your teeth. Braces have tiny spaces where food particles and plaque get trapped. Brush carefully after every meal with fluoride toothpaste and a soft-bristled toothbrush. Rinse thoroughly and check your teeth in the mirror to make sure they’re clean. Floss between braces and under wires with the help of a floss threader. Have your teeth cleaned every six months to keep your gums and teeth healthy.
Orthodontics, best known by its tools of the trade – braces – is a special discipline of dentistry concerned with aligning the teeth and jaws to improve your child’s smile and oral health.
Braces today are smaller and less conspicuous – and a bit more sophisticated than the conventional gun-metal wire straps. While they still utilize wire straps, newer appliances are much more comfortable. In fact, traditional metal braces can be replaced by clear braces and braces from behind.
Braces generally come in three varieties:
Brackets, usually made from metal, plastic or ceramic, are bonded to teeth.
Lingual braces are brackets that attach to the back of teeth, hidden from view.
Bands are the traditional type that covers most of your teeth with metal strips that wrap around the teeth.
Clear retainer-like appliances
If required, orthodontic evaluations are appropriate for most children beginning around seven years old.
Orthodontia is a multi-stage process. First, pretreatment records are made to make an accurate diagnosis. They include medical/dental history, clinical examination, plaster study models of teeth, photos of your face and teeth, and X-rays of your mouth and head. This information will be used to decide on the best treatment.
A custom treatment plan includes recommendations for a specific treatment appliance, such as braces or space maintainers, which are best suited to correct your child’s orthodontic problem.
During the “active treatment” phase, orthodontic appliances are in place. Appliances are adjusted periodically so that the teeth are moved correctly and efficiently. The time required for orthodontic treatment varies from person to person. Two phases of active treatment are somtimes needed for early orthodontic intervention. An important factor in how long your child wears braces is how well he or she cooperates during treatment.
During the post treatment, or “retention” phase, the child typically wears a retainer so that the teeth stay in their new positions. For severe orthodontic problems, surgery may be necessary.
Today`s braces are generally less noticeable than their predecessors. Brackets, the part of the braces that hold the wires, are bonded to the front of the teeth. These brackets can be metal, clear, or tooth-colored. Wires that are used for braces today are also less noticeable. Today`s wires are made of “space age” materials that exert a steady, gentle pressure on the teeth, making the tooth-moving process faster and more comfortable for patients. In some cases, brackets may be put on the back of the teeth.
Patients typically wear braces for about 24 months, although this varies based on the severity of the problem, the health of the teeth, gums and supporting bone and how closely the patient follows instructions. Usually, adult treatment takes a little longer.
During the treatment phase of orthodontia, it is necessary to periodically re-tighten the interconnecting wires. This causes mild pressure on the brackets or bands to shift teeth or jaws gradually into a desired position. Your child’s teeth and jaws may feel slightly sore after such a visit, but the discomfort is short-lived.
If your child wears braces, avoid some kinds of foods, such as sweets, chips and pop. Sugary and starchy foods generate acids and plaque that can cause tooth decay and promote gum disease. Cut healthy hard foods like carrots or apples into smaller pieces. And by all means, avoid sticky chewy sweets, such as caramel, which can cause wire damage and loosen brackets. Avoid hard and crunchy snacks such as popcorn, nuts, and hard candy, because these can break braces.
Oral hygiene is extremely important during the treatment phase of orthodontia. Insufficient cleaning while wearing braces can cause enamel staining around brackets or bands. Braces have tiny spaces where food particles and plaque get trapped. Brush carefully after every meal with fluoride toothpaste and a soft-bristled toothbrush. Rinse thoroughly and check your teeth in the mirror to make sure they`re clean. Floss between braces and under wires with the help of a floss threader. Have your teeth cleaned every six months to keep your gums and teeth healthy.
Space maintainers can be very important to your child’s long-term oral health. If your child loses a baby tooth early through guidance eruption, decay or injury, his or her other teeth could shift and begin to fill the vacant space. When your child`s permanent teeth emerge, there`s not enough room for them. The result is crooked or crowded teeth and difficulties with chewing or speaking.
Space maintainers are used to hold the spot left by the lost tooth until the permanent tooth emerges. The space maintainer might be a band or a temporary crown attached to one side of the vacant space. Later, as the permanent tooth emerges, the device is removed.