Did You Know You Can Use Your Health Savings Account (HSA) to Pay for Braces?

Many families are surprised to learn that they can use money from a Health Savings Account (HSA) or Flexible Spending Account (FSA) to help pay for orthodontic treatment. If you or your child needs braces or Invisalign, using these accounts can make treatment more affordable.

What Is an HSA?

A Health Savings Account, or HSA, is a special savings account that lets you set aside money for qualified medical expenses. The money goes into the account before taxes are taken out of your paycheck. That means you pay less in taxes and keep more of your money.

If you have a high-deductible health insurance plan, you may already have an HSA through your employer or bank.

An FSA works in a similar way, but it is usually offered through your employer and has different rules. Both accounts can often be used for orthodontic treatment.

Can I Really Use It for Braces?

Yes!

The IRS considers orthodontic treatment a qualified medical expense. That means you can usually use your HSA or FSA to pay for:

• Traditional metal braces
• Clear ceramic braces
• Invisalign® clear aligners
• Orthodontic records and X-rays
• Retainers that are part of your treatment

Using HSA or FSA dollars means you are paying with pre-tax money, which can lower the overall cost of treatment.

How Much Can You Save?

The amount you save depends on your tax bracket, but many families save 20% to 30% compared to paying with after-tax income.

For example, if orthodontic treatment costs $6,000, paying with HSA or FSA funds could save you more than $1,000 in taxes. That's money you can use for other family expenses.

How Do You Use Your HSA?

Using your HSA is usually very simple.

Many HSA accounts include a debit card that can be used at your orthodontist's office. If you don't have a card, you can usually pay another way and then reimburse yourself from your HSA account. Be sure to save your receipts for your records.

Planning Ahead

If you know your child may need braces next year, it can be helpful to start contributing to your HSA or FSA now.

Some families also spread orthodontic payments over several months or years. That allows them to use money from more than one year's HSA or FSA contributions, making treatment even easier to fit into the family budget.

Ask Questions Before You Start

Every HSA and FSA plan is a little different. If you have questions about your account, contact your benefits administrator or HSA provider. They can explain exactly how your plan works.

Our office is also happy to help. We can explain payment options, provide receipts if needed, and help you make the most of your HSA or FSA benefits.

A Healthy Smile Is a Great Investment

A healthy, confident smile can last a lifetime. If you have been thinking about braces or Invisalign, don't forget to check your HSA or FSA balance. You may already have tax-free dollars waiting to help pay for treatment.

Using your HSA or FSA is one of the easiest ways to make orthodontic care more affordable for your family.

Do Dental Extractions for Orthodontics Cause Airway Issues?

 Do Dental Extractions for Orthodontics Cause Airway Issues?

When you get braces, your orthodontist may recommend removing one or more teeth to make room for the others to move into the right position. This is called a dental extraction. Some people worry that having teeth removed for braces could cause problems with their airway, making it harder to breathe. But is there any real evidence to support this concern? Let’s take a look at what we know about dental extractions and how they might affect your airway.

Why Do Orthodontists Recommend Extractions?

First, it’s important to understand why extractions are sometimes necessary during orthodontic treatment. If your mouth is too crowded, there might not be enough space for all your teeth to fit properly. This can cause your teeth to overlap, twist, or stick out in odd directions. In these cases, an orthodontist might suggest removing one or more teeth to create enough room for the remaining teeth to be straightened and aligned correctly.

What is the Airway?

The airway is the path air takes when you breathe in and out. It includes your nose, throat, and the passages leading to your lungs. A clear, open airway is essential for easy breathing, both when you’re awake and when you’re sleeping. Some people worry that removing teeth could change the shape of the mouth or jaw in a way that might narrow the airway, making it harder to breathe, especially at night.

What Does the Research Say?

The idea that dental extractions could affect the airway is a concern for some, but what does the scientific research actually say about it? Here are some key points:

1. No Strong Evidence: Most studies have not found a direct link between dental extractions for orthodontics and airway problems. When orthodontists remove teeth, they are careful to plan the treatment so that it doesn’t negatively affect the airway. The goal is always to improve the overall function of the mouth, teeth, and jaw, which includes maintaining a healthy airway.

2. Different for Each Person: Everyone’s mouth and airway are different, so it’s important to remember that what might be true for one person isn’t necessarily true for another. Some people naturally have narrower airways, while others have more space. This means that orthodontists need to evaluate each patient individually to decide whether extractions are the best option.

3. Improved Breathing for Some: In some cases, orthodontic treatment, including extractions, can actually improve breathing. For example, if crowded teeth are causing problems with how the tongue rests in the mouth or how the jaw is positioned, removing teeth can create more space and lead to better airflow and easier breathing.

4. Importance of Proper Diagnosis: The most important factor is a proper diagnosis and a well-thought-out treatment plan. Orthodontists use X-rays, 3D imaging, and other tools to carefully study the mouth, teeth, and airway before deciding on extractions. They take all these factors into account to ensure that the treatment plan won’t cause any airway issues.

What Should You Do If You’re Worried?

If you or your parents are worried about the potential impact of dental extractions on your airway, it’s a good idea to talk to your orthodontist. They can explain why they recommend extractions in your specific case and how they plan to avoid any potential problems with your airway. You can also ask if there are alternative treatment options that don’t involve extractions. It’s important to have an open conversation with your orthodontist so you can feel confident in your treatment plan.

Conclusion

While it’s understandable to be concerned about any treatment that affects your mouth, there isn’t strong evidence that dental extractions for orthodontics cause airway issues. Orthodontists carefully plan each treatment to make sure it’s safe and effective for your teeth and overall health. If you have concerns, be sure to discuss them with your orthodontist, who can help you understand the benefits and risks of your specific treatment plan. Remember, the goal of orthodontic treatment is to create a healthy, beautiful smile that also supports good overall health, including proper breathing!

How Invisalign Has Improved Over the Last 20 Years

 How Invisalign Has Improved Over the Last 20 Years

Invisalign is a popular way to straighten teeth without using traditional metal braces. Instead of brackets and wires, Invisalign uses clear, removable aligners to gradually move your teeth into the right position. Over the last 20 years, Invisalign has come a long way, making it more effective, comfortable, and convenient than ever before. Let’s take a look at how Invisalign has improved and why it’s become a great option for people who want a straighter smile.

What is Invisalign?

Invisalign is a type of orthodontic treatment that uses clear plastic aligners to straighten your teeth. The aligners are custom-made to fit your teeth and are designed to be nearly invisible when you wear them. You’ll switch to a new set of aligners every week or two, and each new set gradually shifts your teeth into the desired position. Because the aligners are removable, you can take them out when you eat, brush your teeth, or play sports.

Early Days of Invisalign

When Invisalign was first introduced in 1999, it was a revolutionary idea. People loved the idea of straightening their teeth without the noticeable metal braces. However, in the beginning, Invisalign had some limitations. The aligners worked well for simple cases, like slightly crooked teeth or small gaps, but they couldn’t handle more complex dental problems, like severe crowding or major bite issues. This meant that many people still needed traditional braces to get the results they wanted.

Major Improvements in Technology

Over the past 20 years, Invisalign has made huge improvements, thanks to advances in technology and research. Here are some of the ways Invisalign has gotten better:

1. Better Materials: The original Invisalign aligners were made from a plastic material that wasn’t as strong or flexible as it could be. Today, Invisalign uses a special material called SmartTrack, which is more comfortable, fits better, and applies just the right amount of pressure to move your teeth. This new material also makes the aligners more effective at moving teeth faster and more accurately.

2. Treating Complex Cases: At first, Invisalign was mostly used for simple orthodontic issues, but now it can handle much more complex cases. Thanks to new attachments and techniques, Invisalign can treat problems like overbites, underbites, crossbites, and even severe crowding. These attachments are small, tooth-colored bumps that help the aligners grip your teeth better and make more precise movements.

3. Faster Treatment Times: In the early days, Invisalign treatment could take a long time, especially for more complicated cases. But with improvements in technology and aligner design, treatment times have become much shorter. Some patients can achieve their desired results in as little as six months, depending on the complexity of their case.

4. More Precise Planning: Invisalign uses advanced 3D imaging technology to create a digital model of your teeth. This allows your orthodontist to plan out your entire treatment from start to finish with great accuracy. The digital planning also means that you can see a preview of what your smile will look like before you even start wearing the aligners. Over the years, this technology has become even more precise, leading to better results and fewer adjustments during treatment.

5. Increased Comfort: One of the best improvements in Invisalign over the years is how much more comfortable the aligners have become. The aligners are now thinner and fit more snugly against your teeth, making them easier to wear and less likely to cause irritation. Plus, because you can take them out to eat and brush your teeth, they fit seamlessly into your daily routine.

Conclusion

Invisalign has come a long way since it was first introduced 20 years ago. With better materials, more advanced technology, and the ability to treat more complex cases, Invisalign has become a powerful tool for creating beautiful, straight smiles. Whether you have a simple case or a more complicated one, Invisalign is now a great option for achieving the smile you’ve always wanted, all without the noticeable metal braces. As technology continues to advance, who knows how much more Invisalign will improve in the future?

Why Should You See an Orthodontist for Braces or Aligners?

 Why You Should See an Orthodontist Instead of a General Dentist for Orthodontic Treatment

When it comes to taking care of your teeth, both general dentists and orthodontists play important roles. You might already visit a dentist regularly for cleanings, fillings, and check-ups. But if you’re thinking about getting braces, clear aligners, or other treatments to straighten your teeth or fix your bite, it’s important to see an orthodontist. While both dentists and orthodontists care for your teeth, orthodontists have special training and skills that make them the right choice for orthodontic treatment. Let’s explore why you should choose an orthodontist for this type of care.

What’s the Difference Between a Dentist and an Orthodontist?

1. Education and Training: Both general dentists and orthodontists start by completing dental school, where they learn how to care for your teeth and gums, treat cavities, and perform other basic dental procedures. However, orthodontists go through additional training after dental school. They attend a special residency program that focuses only on orthodontics, which usually lasts about two to three years. During this time, they learn how to diagnose, prevent, and treat dental and facial irregularities, like crooked teeth or misaligned jaws. This extra training makes orthodontists experts in straightening teeth and correcting bite issues.

2. Specialization: While general dentists handle a wide range of dental issues, orthodontists specialize in one area: aligning teeth and jaws. This means they have a deeper understanding of how to move teeth into the right position, how to fix bite problems, and how to create a healthy, balanced smile. If your teeth are crowded, if you have an overbite or underbite, or if your jaw is misaligned, an orthodontist is the best person to help you.

Why Should You See an Orthodontist for Braces or Aligners?

1. Expertise in Complex Cases: Orthodontists are trained to handle even the most complex dental problems. Whether your teeth are severely crowded, you have a significant bite issue, or your jaw needs to be realigned, an orthodontist has the experience and knowledge to develop the best treatment plan for your unique situation. They can use advanced tools and techniques to make sure your treatment is effective and efficient.

2. Personalized Treatment Plans: Every smile is different, and so is every orthodontic treatment plan. Orthodontists take the time to carefully examine your teeth, jaws, and facial structure to create a personalized treatment plan that fits your needs. They consider things like your age, the condition of your teeth, and your overall dental health to decide the best course of action. This customized approach helps ensure that you get the best possible results.

3. Use of Advanced Technology: Orthodontists have access to the latest technology and tools designed specifically for straightening teeth and correcting bite problems. This includes 3D imaging, digital models of your teeth, and state-of-the-art braces or aligners. These advanced tools allow orthodontists to plan your treatment with precision, making it more comfortable and effective.

4. Focus on Long-Term Results: Orthodontists don’t just focus on getting your teeth straight; they also make sure that your bite is healthy and that your teeth stay in their new positions for the long term. They know how to move your teeth in a way that supports a healthy bite and reduces the risk of future problems. After your braces or aligners come off, your orthodontist will give you a retainer and follow-up care to keep your smile looking great.

Conclusion

While general dentists are great for regular dental care, like cleanings and fillings, an orthodontist is the specialist you need when it comes to straightening your teeth and correcting your bite. With their extra training, specialized skills, and access to advanced technology, orthodontists can provide the best possible care for creating a beautiful, healthy smile. So, if you’re considering braces, clear aligners, or other orthodontic treatments, make sure to see an orthodontist to get the expert care you deserve.

Why You Need to Wear Your Elastics in Orthodontic Treatment

 Why You Need to Wear Your Elastics in Orthodontic Treatment

If you’re going through orthodontic treatment, your orthodontist might have given you tiny rubber bands, called elastics, to wear with your braces. These elastics are a small but powerful part of your treatment, and wearing them as instructed is super important for getting the best results. Let’s dive into why these little rubber bands matter so much and how they help your teeth and bite get into perfect alignment.

What Are Elastics?

Elastics are small rubber bands that are often used with braces to help move your teeth and jaw into the right position. Unlike the bands that are attached to your braces to hold the wire in place, these elastics are connected to tiny hooks on your brackets and can be easily taken on and off. They come in different sizes, colors, and strengths, depending on what your orthodontist needs to achieve with your treatment.

Why Are Elastics Important?

1. Aligning Your Bite: One of the main reasons elastics are used is to correct the way your upper and lower teeth fit together, which is known as your bite. If your bite isn’t aligned properly, it can cause problems like difficulty chewing, jaw pain, or even speaking issues. Elastics help by applying gentle, constant pressure to your teeth and jaw, guiding them into the correct positions over time.

2. Speeding Up Your Treatment: Wearing your elastics as directed can actually help shorten the overall time you need to wear braces. Because elastics provide continuous pressure, they help move your teeth and jaw more efficiently. This means that if you wear them consistently, you could finish your treatment sooner than expected. On the other hand, not wearing your elastics could make your treatment take longer than necessary.

3. Achieving the Best Results: Your orthodontist has a plan for how your teeth and bite should look at the end of your treatment. Elastics play a crucial role in making that plan a reality. By following your orthodontist’s instructions and wearing your elastics, you’re helping ensure that you end up with the best possible results: a healthy, well-aligned smile that will last a lifetime.

How to Wear Your Elastics

1. Follow Instructions: Your orthodontist will tell you exactly how to wear your elastics, including where to place them and how often to change them. It’s important to follow these instructions carefully. If you’re unsure, don’t hesitate to ask your orthodontist to show you how to put them on again.

2. Consistency is Key: To get the best results, you should wear your elastics for the recommended amount of time each day, usually 24 hours, except when eating or brushing your teeth. If you take them out for too long, your teeth can shift back, slowing down your progress.

3. Replace Them Regularly: Elastics can lose their strength over time, so it’s important to replace them regularly, usually at least once a day. Always carry extra elastics with you so you can replace them if one breaks or if you need to take them out for any reason.

What Happens if You Don’t Wear Your Elastics?

If you don’t wear your elastics as directed, your treatment could take longer, and you might not get the results you’re hoping for. Your teeth and bite might not move into the correct positions, which could mean you’ll need to wear your braces longer or even require additional treatment later on. Wearing your elastics as instructed is the best way to make sure your orthodontic treatment is successful.

Conclusion

Elastics might seem like a small part of your orthodontic treatment, but they play a big role in helping you achieve a perfect smile. By wearing your elastics consistently and following your orthodontist’s instructions, you’re taking an important step toward having a healthy, well-aligned bite and beautiful teeth. Remember, the more you wear your elastics, the sooner you’ll be able to see your amazing new smile!

Why Retainers Are Important After Orthodontic Treatment

Why Retainers Are Important After Orthodontic Treatment

Congratulations! You’ve finally finished your orthodontic treatment, and your teeth look amazing. But your journey to a perfect smile isn’t quite over yet. After your braces or aligners come off, your orthodontist will give you a retainer to wear. While it might be tempting to skip wearing it, your retainer is just as important as the braces you wore to get your teeth straight in the first place. Let’s explore why retainers are so important and how they help keep your smile looking great.

What is a Retainer?

A retainer is a custom-made device designed to keep your teeth in their new, straight positions after orthodontic treatment. There are different types of retainers:

1. Removable Retainers: These are made of plastic and wire or clear plastic. You can take them out when you eat, brush your teeth, or for special occasions.

2. Fixed Retainers: Also called bonded retainers, these are wires that are permanently attached to the back of your teeth. They can’t be removed, so they stay in place all the time.

Why Do You Need to Wear a Retainer?

1. Preventing Teeth from Shifting: Even though your teeth are straight now, they have a tendency to move back to their original positions. This is because the tissues and bones around your teeth need time to adjust to the new positions. Without a retainer, your teeth could slowly start to shift back, undoing all the hard work your braces or aligners did. Wearing a retainer helps keep your teeth in their new positions while your mouth adjusts.

2. Maintaining Your Bite: Your orthodontic treatment wasn’t just about making your teeth look nice; it also helped improve your bite, which is how your upper and lower teeth come together. A properly aligned bite makes it easier to chew, speak, and even breathe. Wearing a retainer ensures that your bite stays aligned, preventing any issues that could affect your overall dental health.

3. Keeping Your Smile Beautiful: After all the time, effort, and possibly discomfort you went through to get your teeth straight, you’ll want to keep them looking great. A retainer is like the final step in your orthodontic journey. By wearing it as instructed, you’ll keep your smile looking beautiful for years to come.

How Long Do You Need to Wear a Retainer?

The length of time you need to wear a retainer depends on your specific case. Most people start by wearing their retainer full-time (except when eating or brushing) for a few months to a year after their braces are removed. After that, your orthodontist might let you switch to wearing it only at night. But keep in mind that some people need to wear their retainer at night for many years, or even for life, to keep their teeth from shifting.

Tips for Taking Care of Your Retainer

1. Clean It Regularly: Just like your teeth, your retainer needs to be kept clean. If you have a removable retainer, brush it gently with toothpaste and a soft toothbrush, or soak it in a retainer cleaning solution. If you have a fixed retainer, be sure to brush and floss around it carefully to keep your teeth and gums healthy.

2. Don’t Lose It: Removable retainers can be easy to misplace, so always keep it in its case when you’re not wearing it. And remember, pets love to chew on retainers, so keep yours out of reach!

3. Follow Your Orthodontist’s Instructions: Your orthodontist knows what’s best for your teeth, so follow their advice on when and how to wear your retainer.

Conclusion

Wearing a retainer might seem like a small task, but it’s a crucial part of maintaining your newly straightened teeth. By wearing your retainer as instructed, you’re protecting your investment in a healthy, beautiful smile. Remember, your retainer is your best friend when it comes to keeping your teeth in their perfect new positions!

Understanding TMD: Causes and Treatments

 Understanding TMD: Causes and Treatments

Have you ever heard of TMD? It stands for temporomandibular disorder, which is a condition that affects your jaw and the muscles around it. The temporomandibular joint (TMJ) is like a sliding hinge connecting your jawbone to your skull, allowing you to talk, chew, yawn, and move your mouth in different ways. When something goes wrong with this joint, it can cause discomfort or pain. Let’s dive into what causes TMD and how it can be treated.

What Causes TMD?

TMD can happen for several reasons, and sometimes it’s hard to pinpoint exactly why someone develops it. Here are some common causes:

1. Jaw Injury: If you’ve ever been hit in the jaw or had an accident that affected your face, this can damage the TMJ or the muscles around it. Even if the injury happened a while ago, it can still lead to TMD later on.

2. Teeth Grinding or Clenching: Some people grind their teeth or clench their jaws, especially when they’re stressed or while they’re sleeping. This puts a lot of pressure on the TMJ, which can lead to pain and stiffness.

3. Arthritis: Just like other joints in your body, the TMJ can develop arthritis, which is a condition that causes swelling and pain in the joints. Arthritis in the TMJ can make it difficult to move your jaw smoothly.

4. Jaw Misalignment: If your upper and lower teeth don’t line up properly, this can cause strain on the TMJ. When your bite is off, the joint has to work harder to move your jaw, leading to discomfort.

5. Stress: Believe it or not, stress can play a big role in TMD. When you’re stressed, you might unknowingly tighten your jaw muscles or grind your teeth, both of which can contribute to TMD.

What Are the Symptoms of TMD?

If you have TMD, you might notice some of these symptoms:

• Jaw Pain: This is the most common symptom. You might feel pain around your jaw, ears, or even your neck.

• Clicking or Popping Sounds: When you open or close your mouth, you might hear clicking, popping, or grating sounds. This can be a sign that your TMJ isn’t moving smoothly.

• Difficulty Moving Your Jaw: You might find it hard to open your mouth wide or close it completely. In some cases, your jaw might even get stuck in one position.

• Headaches: TMD can sometimes cause headaches or make existing headaches worse.

How is TMD Treated?

The good news is that TMD is treatable. There are several ways to manage and relieve the symptoms:

1. Home Care: Sometimes, simple home remedies can help. Applying ice or heat to the jaw, eating soft foods, and avoiding chewing gum can reduce stress on the TMJ. Gentle jaw exercises can also help improve movement.

2. Medications: Over-the-counter pain relievers like ibuprofen can reduce pain and swelling. In some cases, doctors might prescribe stronger medications or muscle relaxants.

3. Mouthguards or Splints: If teeth grinding or clenching is causing TMD, wearing a mouthguard while you sleep can protect your teeth and reduce pressure on the TMJ.

4. Physical Therapy: A physical therapist can teach you exercises to strengthen your jaw muscles and improve your jaw’s range of motion. They might also use techniques like ultrasound or massage to relieve pain.

5. Stress Management: Since stress can worsen TMD, finding ways to manage stress, like practicing relaxation techniques or talking to a counselor, can be very helpful.

6. Surgery: In rare cases, when other treatments don’t work, surgery might be needed to correct the problem in the TMJ. This is usually considered a last resort.

Conclusion

TMD might be uncomfortable, but it’s a condition that can be managed with the right care. By understanding the causes and symptoms, you can take steps to protect your jaw and find relief from any pain or discomfort. If you think you might have TMD, it’s important to talk to a doctor or dentist to get the proper treatment. Taking care of your TMJ will help you keep smiling, talking, and eating comfortably for years to come!

Why Extractions Are Sometimes Needed in Orthodontic Treatment

Why Extractions Are Sometimes Needed in Orthodontic Treatment 

When you think about getting braces or other orthodontic treatment, the idea of having teeth pulled, or "extracted," might sound a little scary. But don't worry! Extractions are sometimes necessary to help you achieve a healthy and beautiful smile. Let's dive into why this might be the case. 

What is Orthodontic Treatment? Orthodontic treatment is a way to straighten your teeth, fix bite issues, and improve the overall health of your mouth. Braces, retainers, and aligners are some common tools orthodontists use to do this. The goal is to make sure your teeth are properly aligned, so they work well and look great.

Why Would Teeth Need to Be Pulled? Crowding of Teeth: One of the main reasons an orthodontist might recommend extractions is because of crowding. This happens when there isn't enough room in your mouth for all of your teeth to fit comfortably. When teeth are crowded, they can overlap, twist, or even push other teeth out of place. This makes it harder to clean your teeth properly and can lead to cavities or gum disease. If your mouth is too small for all your teeth, the orthodontist might decide to remove one or more teeth. This gives the remaining teeth the space they need to move into the correct positions. 

Improving Your Bite: Your bite is how your upper and lower teeth come together when you close your mouth. Sometimes, the way your teeth line up can cause problems. For example, if your upper teeth stick out too much (called an overbite) or if your lower teeth stick out too far (an underbite), it can affect the way you chew, speak, and even breathe. In some cases, removing teeth can help fix these bite problems. By creating more space, your orthodontist can move your teeth into better positions, so your bite works the way it should.

Tooth Damage or Decay: If a tooth is damaged or has severe decay, it might need to be removed to keep your mouth healthy. This is less common, but sometimes a damaged tooth can cause other problems, like making it harder to align your remaining teeth properly. Removing the damaged tooth might be the best option for your overall dental health. Improving Appearance: While the main reason for orthodontic treatment is to improve the function of your teeth, it also helps make your smile look better. Sometimes, extractions can help create a more balanced and attractive appearance. For example, if you have teeth that stick out too much, removing a tooth might help bring the other teeth back into place, creating a more even smile. 

What Happens After an Extraction? If you do need to have a tooth pulled, your orthodontist will make sure it's done safely and with as little discomfort as possible. After the extraction, your orthodontist will continue your treatment plan to move your remaining teeth into their new positions. This might involve braces, aligners, or other tools to guide your teeth as they shift into place.

While the idea of having teeth pulled might seem a little daunting, it's important to remember that extractions are sometimes necessary for the best results in orthodontic treatment. By creating the right amount of space, fixing bite issues, and improving the appearance of your smile, extractions can play a key role in helping you achieve a healthy, confident smile that will last a lifetime.

Did my wisdom teeth make my other teeth crooked?

I often have parents of patients ask about wisdom teeth and when they should be removed.  One concern people have is that the wisdom teeth are going to come in and ruin the orthodontic result.  While the wisdom teeth get a lot of blame for the recurrence of crowding in the dental arches, how much of it is really warranted?  Do the wisdom teeth really cause that crowding?  And if not, what does?

Usually the wisdom teeth start to come in (if there is enough room for them) in the late teenage years or early 20s.  Research done at the University of Iowa has shown that as these teeth erupt, they do not put enough force on the adjacent teeth to cause crowding to occur.  Pressure sensors were placed between the teeth to measure the pressure on the teeth with and without wisdom teeth being present, and there was no difference.  Other studies have shown that crowding in the adult teeth will occur with or without wisdom teeth ever being present, and whether they are extracted or not.

So if wisdom teeth aren't to blame, then what causes the teeth to crowd up in these cases?  Orthodontists have a few ideas.  One is that as the lower front teeth wear a bit on the edges, the upper teeth exert a bit more pressure on them pushing them back toward the tongue.  Another possibility is a small amount of late jaw growth which puts a bit of extra pressure against the backs of the upper front teeth.  Also, as we get older there are natural, yet undesirable changes that tend to occur.  One such change is a narrowing of the lower arch as the canines tip in slightly.  This takes away some of the space for the lower incisors causing them to shift.

So what can be done to prevent this relapse from happening?  Although there are valid reasons for removing the wisdom teeth if there is not room for them, preventing the teeth from crowding up shouldn't really be one of them.  The secret to keeping our teeth straight long-term is really no secret.  The answer is long-term retainer wear.  Permanent, bonded retainers are a great way to do this (and will be addressed in a future post) but removable retainers will work just as well, assuming they are worn as directed.  I think the main reason that patients see shifting when they are in their late teens and early twenties is not due to wisdom teeth coming in.  I think it's because they have stopped wearing their retainers and one of the other factors mentioned is in play.  Wear your retainers and your teeth won't move, and you will preserve that beautiful smile for as long as you like.

What to expect with a palatal expander

One of the most common orthodontic appliances used in young children is the palatal expander. These appliances look intimidating to patients and the thought of having to “do the turns” every day scares a lot of parents. What can you expect while your child has an expander in their mouth?

Arch expansion is one of the most common ways to eliminate crowding and crossbites in growing patients. Successful expansion requires that the growth plate in the room of the mouth (the midpalatal suture) is not fused. This fusion usually occurs between 14 and 16 years of age, but if expansion is needed in an older teen or even an adult it can be worth it to make the attempt because it is often successful. If the suture is completely fused in an adult, a surgical procedure may be required to allow the expansion, so starting young is important!

An expander is attached to the upper arch by bands placed around the teeth or plastic bonded over the teeth. Although there are removable expanders, fixed ones have an important advantage in that they cannot be lost or forgotten.

While there may be some initial discomfort when an expander is placed just because there has never been anything like that attached to the teeth before, upper arch expansion is relatively painless. Patients report that they feel pressure on the teeth, in the roof of the mouth, behind the nose, and even between the eyes as their expander is activated. This pressure fades within minutes.

Besides pressure, you can also expect your child to speak differently for the first few days. Additionally, you may hear them slurping as their mouth creates extra saliva after expander cementation. One of the most visible signs that the suture is opening (the desired effect) is the appearance of a space between the upper central incisors. The space is created as the expander pushes the two halves of the palate in opposite directions. Once you have stopped activating the expander, it is normal for the space to close spontaneously, often within a few days. This occurs as the elastic fibers in the surrounding gum tissues return to their original positions. The underlying bone, however, remains expanded. It is also normal for the front teeth to feel a little loose and get sore as they move back together.

To make the first couple of days more bearable for your child as they adapt to their new expander, you may want to find some fun foods for them to eat that don’t require a lot of chewing. Examples include pasta, yogurt, pudding, mashed potatoes, ice cream, etc. A day or two after their delivery appointment, the expander will feel natural in their mouth and normal eating will resume. While expanders are more forgiving of hard and sticky foods than are braces, it is recommended that patient avoid gummy-bear type candies that would get stuck in the expansion screw.

Because there is always some relapse (movement back towards the original size), your orthodontist may choose to over-expand your child’s palate. He will decide how much expansion is necessary as part of the initial diagnosis and treatment plan. After your orthodontist indicates that you’ve reached your target, he will instruct you on how long the retainer should stay in place to stabilize the results. This is usually a few months but may be for the entire length of treatment.

When Should My Child See an Orthodontist?

Have you noticed more young kids with braces on these days? Why so young? Don’t they still have baby teeth? When should I take my child to see the orthodontist for the first time?

According to the American Association of Orthodontists, the best age for children to be seen by an orthodontist for the first time is 7. Why age 7? What can be done at that age? As you might guess, not every orthodontic problem can be treated at age 7. Surprisingly however, most problems can be identified by that age. Here are a few things that I’ll look for at your child’s first visit.

Tooth Loss and Eruption: Teeth are lost in a fairly specific order. Deviations from this pattern may indicate that a child has developmental issues that need attention. Between the ages of 6 and 8, it is normal for a child to lose his first eight primary teeth. Ideally these eight primary incisors are replaced immediately by eight permanent incisors. It is also normal for the child’s first four permanent molars to emerge at age 6 (hence the name “6-year molars”). By age 7, children should have at least four permanent molars and four permanent incisors. If there are more or less teeth than this, there may be problems with crowding, missing, or extra teeth. Sometimes removing a primary tooth early or maintaining a space where a tooth has been lost prematurely can prevent bigger problems later on.

Crowding and Spacing: By age 7 it is possible to tell if a child has a problem with excessive crowding or spacing. Spacing may mean that a baby tooth has been lost prematurely, a tooth never developed, or that the teeth are just too small. Crowding may require that the arches be expanded or that teeth be removed to help improve the situation.

Alignment: Although teeth can be aligned at an older age, crooked teeth are more susceptible to uneven wear or damage due to trauma, and the shape and position of the overlying gum tissues can be compromised. Crooked teeth can also have social implications that if dealt with at an early age ( 7 or 8 ) will have less impact on a child’s self-esteem.

Protrusive Front Teeth: As mentioned earlier, by age 7 it is obvious if the front teeth stick out farther than is safe or attractive. Although I know that I cannot permanently correct overbites before growth has finished, I can help reduce the severity of the problem and make things easier for young patients both dentally and socially while waiting for growth to be complete.

Underbites: Although it is best to wait to finish treatment in patients with underbites until they have finished growing (usually ages 16 through 18), it is important to try and normalize the anterior bite as early as possible to eliminate bite shifting and damage to the front teeth due to traumatic occlusion. If I notice an anterior underbite at age 7, I will recommend trying to at least “jump the bite” at that age even though definitive correction may not be accomplished until later in their teenage years.

Posterior Crossbites: Not only do posterior crossbites create crowding, they may also cause the jaw to shift laterally (to one side or the other). Expanding the upper jaw at age 7 can reduce the crowding and create the space necessary for the eruption of the anteriors as well as eliminate any shifting that may be present due to a constricted upper arch. It is also likely that the jaw shift will create a skeletal growth asymmetry so it is important to eliminate the sideways or forward shift as early as possible.

Anterior Openbites and Deepbites: By age 7 it is possible to detect vertical problems with the bite. Bites that are too deep (where the top teeth completely cover the bottom ones when biting) may indicate that the patient has a small lower jaw. Bites that don’t overlap enough (openbites) may signal that there is a finger or tongue habit that may be causing dental problems. I like to eliminate these destructive habits early so that normal development can occur.

I recommend screening ALL young patients at age 7 so that these and other conditions can be identified and corrected as early as possible. Although some may be able to wait until all the permanent teeth are in, interceptive treatment can make the final results faster, better, and give your children an additional three to four years of having a great smile at an age when their self-image is developing. If you have a child who is 7 or older, why not set up a screening with an orthodontist today?