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ORAL HYGIENE CONCERNS
With the fast pace we live today, the one area of our health that is sometimes neglected is our oral hygiene (brushing and flossing of teeth). There are some major concerns regarding oral hygiene as pertains to orthodontic treatment.
The complete removal of all of the plaque once a day will prevent any decay from occurring. Though we recommend brushing after each meal, this is not always possible. An extra effort in the evening when brushing, flossing, and careful inspection will do wonders towards the prevention of decay. The early stage of tooth decay is permanent white marks on the front surface of the teeth.
GUM TISSUE RECESSION
In the course of treatment, gum recession may be encountered. Gum recession occurs in a very small percentage of patients, however, there are instances that it may occur: vertical movement of a tooth into the dental arch or in the alignment of the lower incisors. If there is an apparent risk, then very light arch wires are used and the treatment is extended to safeguard any potential recession of the gum tissue. This allows for the gum tissue and bone to keep up with the tooth movement.
EXPOSURE OF IMPACTED TEETH
If you or a family member has been diagnosed with an impacted tooth or teeth, a referral to the oral surgeon is required. An impacted tooth means the tooth is blocked from erupting by the bone and/or the adjacent teeth. Once the braces are placed in our office and appropriate space provided over a period of approximately six to eight months, you will then be referred to an oral surgeon for a consultation regarding exposure of the tooth/teeth. In some rare cases, after the braces are placed and once appropriate space is provided, the impacted tooth/teeth may come in on their own and would therefore not require exposure.
EXTRACTION OF ADULT TEETH
Our patients often question the need for extraction of permanent teeth as part of orthodontic treatment. When recommending extractions, future adult changes of a growing individual are taken into consideration. The majority of patients have wisdom teeth developing at the back of the mouth that may place additional forward arch pressure especially in the upper arch. This could result in post treatment protrusion of the front teeth. Studies have shown that the crowding of teeth increases as we grow older so some compensation must be incorporated into the treatment. In addition, the removal of adult teeth may be recommended to close an anterior open bite where the upper and lower front teeth are unable to touch. If the extraction spaces are closed, the bite deepens allowing for proper biting and chewing of foods. Closing an open bite may also provide relief from headaches (even migraines) as the jaw muscles are able to relax with a more natural bite.
When teeth are missing due to an accident, tooth decay, or congenitally missing (not present at birth), these teeth may need to be replaced through your family dentist at the completion of orthodontic treatment. During the course of orthodontic treatment, it will be determined whether teeth will be moved to replace the missing tooth/teeth, with the potential of leaving spaces further back in the mouth, or provide appropriate space for future prosthetics (tooth replacement).