Removing Braces

Removing braces is an exciting step for anybody undergoing orthodontic treatment. At Ross Orthodontics, we can say that this is usually a smooth process without much potential for complications. However, since patients are more comfortable when they feel well-informed, we wanted to provide a more detailed explanation of how braces are removed.

Orthodontic brackets are held in place by dental cement. Since dentists are so worried about brackets coming loose if the patient eats something sticky or doesn’t wear a mouthguard, you can probably tell the cement is only as strong as it needs to be. After removing the wire and bands for the last time, we use another pair of reverse-action pliers to compress the brackets, causing the dental cement to snap away from them. This allows us to lift the brackets out without needing to exert force against the patient’s enamel, although the patient may feel mild pressure.

We’ll leave the cement on to ensure the teeth remain protected until all the brackets are removed. The metal bands surrounding the molars are leveraged out using pliers with flat tips. Once the cement is scraped away, we can examine the patient for signs of decay such as white spots and make an impression to use as the basis for a retainer. Patients may want to avoid eating anything sticky immediately after the brackets are removed, since their teeth may still be sensitive. But they should soon be able to resume normal eating habits when they aren’t wearing their retainer.

To learn more about Ross Orthodontics, visit Smiles by Ross. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

 

Sleep Apnea and Orthodontics

Do you suffer from temporomandibular joint disorder (TMJ/TMD)? If so, you may be at risk for obstructive sleep apnea. This condition is believed to be severely underdiagnosed, leaving many people untreated and at serious risk of sleep deprivation. However, Dr. Gregory Ross is an expert in orthodontics and dental sleep medicine, and since some people are unaware of the connection between those specialties, we want patients to know what we can do to help.

Bruxism, or nighttime teeth grinding, is often the result of the body’s air passages being blocked by the position of the tongue. As the body attempts to open a passage by moving the mandible, the teeth grind together, putting them at risk for tilting or cracking and causing pain to the temporomandibular joint. Sleep apnea also causes the patient to be taken out of deep sleep throughout the night, causing them to be fatigued the next day and increasing their long-term risk for heart disease and depression.

At Ross Orthodontics, we can provide patients with custom-fitted night guards. These oral appliances protect the teeth from being eroded or broken by night time jaw movement. Dr. Ross is also a long-time researcher of sleep apnea and can provide more complex oral appliances to better position the mandible to avoid airway obstruction. We also use orthodontic treatment to correct tilted teeth.

To learn more about Ross Orthodontics, visit Smiles by Ross. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

 

Dry Mouth and Braces

We want patients at Ross Orthodontics to be as comfortable as possible when undergoing orthodontic treatment, which is why we’re interested in preventing dry mouth. Also known as xerostomia, dry mouth not only puts braces patients at greater risk for irritation, it also increases the risk of gingivitis. However, it may be treatable with some simple lifestyle changes.

Saliva isn’t just a lubricant; it’s also a part of the immune system. It washes away food debris, denying food to decay-causing bacteria, and it regulates the mouth’s pH level to make it inhospitable to fungi. But when saliva production is inhibited or can’t keep up with dry conditions, the mouth is likelier to develop infections, which could be particularly troublesome to people with mouth lesions.

In the short term, patients with braces can use dental wax to prevent mouth injuries, but dry mouth deserves attention. Alcohol, sugar, and caffeine are all contributors to it, so patients should avoid drinks such as soda. They may also want to try throat moisturizers or stimulating saliva production by sucking sugar-free hard candy. Some medications cause dry mouth as a side effect, particularly those for ADHD, so patients may need to consult with other doctors about changing them.

To learn more about Ross Orthodontics, visit Smiles by Ross. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

Orthodontics and Juvenile Idiopathic Arthritis

Orthodontic treatment doesn't just make people’s smiles beautiful; they also help provide relief from serious health conditions. At Ross Orthodontics, we are experienced providers of orthodontic treatment to people whose teeth have shifted as a result of diseases such as juvenile idiopathic arthritis.

When joint tissue comes under attack by the body’s own immune system, it swells and hardens, putting pressure on the joint. Sometimes, this is enough to cause joint deformities. The temporomandibular joint, which connects the lower jaw to the head, is particularly complex and prone to damage. In children with arthritis, deformation of the temporomandibular joint can result in teeth grinding jaw deformities, leading to malocclusions such as an open bite.

An idiopathic disease is one without a known cause, and every case of juvenile arthritis is different. However, we can work with rheumatologists to devise treatment plans that will fix a child’s teeth with minimal discomfort. Children with arthritis are at greater risk for dental decay due to difficulty cleaning their teeth, but straightened teeth are much easier to care for. Caregivers should also keep in mind that oral liquid medications are commonly high in sugar and it’s a good idea to brush after consuming them, especially while wearing orthodontic brackets.

To learn more about Ross Orthodontics, visit Smiles by Ross. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

 

Signs of Gingitivits

People wearing traditional braces have some additional hygiene challenges. At Dr. Gregory Ross’s orthodontic office, we educate patients about how to brush and floss around their wires, but patients need to have the tools to recognize when something is wrong. That’s why this week, we want our patients to learn the signs of gum disease.

Gingivitis is the earlier and milder form of gum disease. It is caused by infections in the gum pockets. When food gets caught, it is consumed by bacteria. The bacteria produce acid, which sticks to the plaque that naturally covers teeth. The trapped acid damages the surrounding body tissues, and inflammation is the immune system’s response to damage.

One of the major warning signs of gingivitis is bleeding during teeth brushing. Other signs are gums that are puffy, red, or feel tender when touched or during consumption of hot or cold liquid. Although gingivitis is more common among people who are pregnant or diabetic, people with braces should always treat it as a reason to improve their brushing and flossing. Brushing near the gum line and flossing with a swinging motion will help keep food out of the gum pockets.

To learn more about Ross Orthodontics, visit Smiles by Ross. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

 

Orthodontic Instruments

We understand at Ross Orthodontics that dental instruments are a source of curiosity or apprehension for a lot of people. Because orthodontic offices have specialized equipment, we wanted to explain to our braces patients how some of our tools work.

At a typical appointment, the instruments we use most frequently will be the handheld mirror and the explorer. Explorers have metal hooks at the ends which general dentists used to break tartar and probe gum pockets to check for infections. We also use them to apply elastic bands to orthodontic brackets.

Several kinds of pliers are used in orthodontics, almost all of which are reverse-action to prevent anything from accidentally falling into the patient’s mouth. A Howe plier is used to place wires into orthodontic brackets, and pliers with distal end cutters are used to trim and taper their ends once in place. Pliers with needle-nose tips are used to stretch elastics that are fitted in between the patient’s molars to make room for metal bands. The bands are pushed onto the teeth and shaped with burnishers, which are flat metal instruments also used by general dentists to sculpt fillings.

To learn more about Ross Orthodontics, visit Smiles by Ross. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

 

White Spot Lesions

When undergoing orthodontic treatment with traditional braces, patients must be vigilant against tooth decay. At Ross Orthodontics, we want patients to be fully informed about how to prevent this problem, which is why we’re spotlighting white spot lesions in this week’s blog post.

White spot lesions are what we call the dental infections when they are in their earliest stage. They have a chalkier appearance than the healthy enamel when an infection is active and take on a shiny appearance once the decay is stopped. They may also become stained, in which case they will look yellow or brown.

Because of the difficulty many patients have brushing around fixed brackets, white spot lesions commonly develop there. If left untreated, the result will be that when the brackets are removed, the patient will have hollow square-shaped discoloration patterns on their teeth. Good brushing is necessary to prevent this, but it also helps for patients to get fluoride treatments. The enamel regains minerals overtime, but there are therapies available to speed this process. White spots can form very quickly, so patients would do well to starve the bacteria by avoiding sugary foods and drinks.

To learn more about Ross Orthodontics, visit Smiles by Ross. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

 

Causes of Gap Teeth

Gap teeth are one of the most common reasons for people to seek orthodontic treatment. At Ross Orthodontics in Forest Lake and Hudson, we have a number of ways to provide treatment for this condition, but patients will need to understand what causes a gap to develop in the first place in order to get treatment that lasts.

If a gap (also called a diastema) between the front top incisors is the only problem, a general dentist may simply cover it up with veneers. However, it is often the case that the teeth are crooked or misaligned in some other way that would require repositioning. This can happen with the teeth are not large or numerous enough to take up space in the ridge of the mouth. Traditional braces and Invisalign can reposition the teeth, but it is necessary for the patient to wear a retainer afterward.

Gap teeth frequently occur along with overbites. When somebody is in the habit of sucking their thumb or pushing against their teeth with their tongue, the same forces that move the teeth outward also draw them apart. Tongue thrusting may be due to anxiety or difficulty swallowing, the latter of which requires attention from an ear, nose, and throat specialist. If the labial frenum, the strip of tissue connecting the inside of the upper lip to the jaw, is overly thick, it could also be pushing the top teeth apart.

To learn more about Ross Orthodontics, visit Smiles by Ross. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

 

Palate Expansion

Sometimes, children’s jaws are too narrow to accommodate all of their teeth. One solution to this is extraction, but at Dr. Gregory Ross’s orthodontic offices, we believe in saving children’s teeth whenever possible. That’s why, as an alternative solution, we provide palate expanders.

Children’ skull bones have not fully fused together and may be manipulated with pressure. A palate expander is an orthodontic device which is made of two movable parts connected by a screw in the middle and which is worn over the upper molars and roof of the mouth. Once or twice a day, the patient or their caregiver uses a key to turn the screw, causing the movable parts of the expander to move in opposite directions. This gradually broadens the palate, allowing more room for the teeth to shift into position. It can also be used on children who have a cross-bite, which is when the lower teeth on one side close on the outside of the upper teeth. Palate expanders come in fixed and removable versions and the removable kind can be thought of similarly to retainers. However, adults are usually not able to undergo this treatment because their bones are no longer flexible enough.

To learn more about Ross Orthodontics, visit Smiles by Ross. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

 

TMD and Fibromyalgia

Orthodontists do a lot more than braces. At the offices of Dr. Gregory Ross, we provide treatments for people who are suffering from nighttime teeth grinding as a result of temporomandibular joint disorders (TMD or TMJD). This behavior is done in response to pain in the joint which connects the jaw to the rest of the head, but it can worsen pain in the head, neck, and shoulder. TMD is also commonly associated with fibromyalgia, which makes it important for fibromyalgia patients to get assessed for TMD.

Fibromyalgia is a disease which causes pain throughout the body and problems with cognition and memory. It is poorly understood but believed to be neurological in nature. Besides TMD headaches, fibromyalgia also contributes to migraines. It is most often seen in women, although usually in ones who are older than those who have TMD alone. There are a number of pain-management therapies available for fibromyalgia patients, but it’s important to ensure that their bite alignment isn’t compromised by night time teeth grinding without worsening their discomfort. Night guards are a useful first step toward preventing teeth grinding, and if the teeth do need realignment, Invisalign can shift them with less pressure than traditional braces.

To learn more about Ross Orthodontics, visit Smiles by Ross. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

 

Holiday Foods with Braces

The final round of holiday feasts is fast approaching, which is why at Ross Orthodontics, we want to ensure that our patients enjoy food and drink safely as the year draws to a close. Some foods that are tough or sticky are clearly not a good match with orthodontic wires, but we have lots of ideas for what people with braces can eat.

A lot of traditional Christmas main courses are soft enough to not endanger orthodontic wires. These include ham, ravioli, turkey, and, if very tender, brisket. Carrot sticks and radishes won’t do for appetizers, but boiled vegetables make a fine side, and braces provide an excuse for picking the cheese cubes and olives off a platter. Potatoes are safe when mashed or prepared as pancakes, and squash is a seasonal treat which is usually prepared in a way patients with braces may enjoy.

However, making food soft enough is not the only issue. Popcorn is soft, but the fragments get lodged in orthodontic brackets. Lots of holiday foods are high in sugar, which is why it is important to remove them from braces as soon as possible (and to remember to bring along a Christmas tree toothbrush and floss threader while traveling). Eggnog and wine are also high in sugar, so it’s a good idea follow up holiday toasts with a thorough brushing.

To learn more about Ross Orthodontics, visit Smiles by Ross. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

 

When Should a Child Start Orthodontics?

Ross Orthodontics provides treatment to patients of all ages, but parents may well wonder what age treatment should start at. To answer that question, it’s necessary to understand at what age different orthodontic treatments are most effective.

Orthodontists recommend that children first be assessed after some of their permanent teeth have come in when they’re about seven years old. This will give us a chance to catch severe problems that are already affecting the child’s oral health and quality of life, such as an underbite or narrow arch, but it’s unusual otherwise for treatment to begin at that age. If the child loses a baby tooth prematurely due to trauma, it may be necessary for them to wear a space maintainer until the permanent tooth can erupt. Major orthodontic work, including extractions and braces, is usually done between the ages of ten and fourteen, after most permanent teeth have erupted. Adults can certainly benefit from orthodontic work, especially for cosmetic problems such as gaps and slight crookedness. But young teenagers still have some flexibility in their skull bones which allows them to undergo treatment for serious structural problems such as impacted canines, while still being mature enough to maintain their hygiene.

To learn more about Ross Orthodontics, visit SmilesbyRoss.com. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

 

Orthodontics and Diabetes

At Ross Orthodontics, our team of specialists is prepared to care for each of our patients’ unique medical needs. One of the health conditions with the biggest impact on oral health is diabetes, and we want our patients to understand how this affects orthodontic therapy.

Braces require the wearer to increase their oral hygiene vigilance. If a person has severe periodontal disease, their braces will have to be removed for their own safety. This can be a problem for people with diabetes because they are especially prone to chronic inflammation and experience periodontal disease at higher rates. At the same time, teeth that have undergone orthodontic treatment are much easier to keep clean, so diabetic patients particularly benefit from it. One solution to this conundrum is Invisalign, the system of removable aligners. Invisalign does not create any additional hygienic challenges, so diabetic patients are at a lower risk of developing gingivitis. It also puts less pressure on the teeth, which is thought to benefit diabetic patients. If a person’s blood sugar is controlled, it may still be possible for them to undergo traditional braces. In those cases, we will carefully inspect the health of their teeth and gums during each monthly appointment.

To learn more about Ross Orthodontics, visit SmilesbyRoss.com. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

 

Dry Mouth with Orthodontics

One of the most common pieces of advice for people suffering from dry mouth is to chew sugar-free gum, but that’s not an option for people with braces. At Ross Orthodontics, we’re sensitive to our patients’ difficulty with dry mouth (also known as xerostomia) and want to help them find solutions.

Dry mouth is a common side-effect of medication but can also result from braces interfering with saliva flow or saliva being used up combatting irritation. Many people also get orthodontics as a way of correcting malocclusions that contribute to dry mouth by causing breathing difficulty. All of these people can benefit from the use of throat moisturizers, some of which are available cheaply over-the-counter and the stronger of which can be prescribed. They also benefit from the use of humidifiers in the bedroom and office, or any room they have to spend a lot of time in. While it is obvious that people with dry mouth need to stay hydrated, not everybody is aware that alcoholic, sugary, and caffeinated drinks actually contribute to dryness and should be reduced if the patient is in frequent discomfort. One thing that is never advisable is chewing ice; this habit can cause chipped teeth and wreck orthodontic devices.

To learn more about Ross Orthodontics, visit SmilesbyRoss.com. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

 

Keeping Retainers Clean

Keeping retainers and aligners clean is another part of oral hygiene people have to adapt to while undergoing orthodontic work. At Ross Orthodontics, we want our patients to get the most benefit out of our aesthetically-pleasing Invisalign products, which is why we’re educating them on proper maintenance.

Anytime you remove your retainer is an opportunity to rinse it. It is easier to brush away plaque when a retainer is wet, and a retainer should also be rinsed before being put back in. However, retainers should only be cleaned with room-temperature or cool water—hot water can distort their shape, requiring them to be replaced. Retainers need to be brushed at least once a day. We recommend using a soft-bristled toothbrush (not the same one you use on your teeth) and brushing thoroughly, but gently; otherwise, you may scratch the plastic surface, creating a space that is easier for bacteria to colonize.

Toothpastes designed for enamel therapy may contain gritty minerals which can cause scratches since teeth have natural protective films that artificial devices lack. On the other hand, toothpastes that are made specifically for dentures work well on retainers. Remember that the protective case needs to be cleaned regularly as well and that the cleaner your mouth is before you put your retainer in, the fewer opportunities there will be for plaque to build on it.

To learn more about Ross Orthodontics, visit SmilesbyRoss.com. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

 

Consequences of Thumb Sucking

At Ross Orthodontics, we often see children whose parents and primary dentist are concerned about how their teeth are coming in. One of the most frequent problems is an open bite, in which the incisors are pushed outward. This problem can be genetic but is usually caused by thumb sucking.

Many parents may be alarmed to hear this since thumb sucking is such a common behavior. Before the age of five, there is not much to worry about. Very young children’s facial bones have not completely solidified and can bounce back from suction. But once the permanent teeth start coming in, thumb sucking (or sucking on anything else) can permanently push the teeth forward.

Efforts to break the habit work best when the child feels included in solving the problem. However, thumb sucking is sometimes done as a way of relieving chronic stress. In these cases, even if the child does abandon thumb sucking, they may take to thrusting their tongue against their incisors instead, which has the same result. It may be necessary to consult with a child psychologist about fixing this problem. In the meantime, there are orthodontic devices which can discourage pushing the tongue forward.

To learn more about Ross Orthodontics, visit SmilesbyRoss.com. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

 

How Long Will I Have to Wear a Retainer?

Treatment at Ross Orthodontics is meant to ensure a lifetime of healthy teeth for our patients, but teeth require constant maintenance. Once a patient’s teeth have been guided into place, they will probably need to wear a retainer.

Exactly how long or often a retainer is needed varies a lot by individual. Typically, gap teeth require the longest use of retainers, but almost everybody needs to wear a retainer for nearly twenty-four hours a day during the first few weeks after their braces are removed. Most people need to wear them for twenty-four hours a day for a year (except when eating or playing sports), and people often need to wear them in their sleep for a period as long as they were undergoing orthodontics. Ultimately, while few people need to wear a retainer for the rest of their lives, everyone who has undergone orthodontics should have a well-fitted retainer which they wear sometimes. Retainers should be snug, but if you are unsure whether yours is a good fit, bring it to us.

To learn more about Ross Orthodontics, visit SmilesbyRoss.com. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

 

Impacted Canines

One of the most common problems Dr. Gregory Ross treats in his Forest Lake and Hudson offices is impacted canines. The canines (also called cuspids or eye-teeth) of the upper jaw have a tendency to get stuck and advanced orthodontic work is needed to guide them into place.

The canines occupy the part of the jaw arch with the greatest change in rate of curvature. As such, they are important for stabilizing the other teeth, in addition to their function piercing food. As children undergo x-rays at their bi-annual check-ups, one of the things their dentists will look for is whether the canines will have room to erupt fully.

If a canine does not have enough surface area for a bracket to be attached to, more may need to be exposed by cutting away gum tissue. Once a bracket is attached, it may be connected to the other brackets with a loop-shaped wire called a ballista spring or with a short chain. This is so that pressure can be exerted on the canine without disproportionately affecting the other teeth. While there are many orthodontic procedures that benefit adults, only children have maxillary bones that are soft enough to be adaptable to guided canine eruption.

To learn more about Ross Orthodontics, visit SmilesbyRoss.com. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

 

Why Malocclusions are Common

So many people have undergone orthodontic treatment that it’s reasonable to wonder why everybody seems to need it. While some orthodontic work is cosmetic, most people have such bad malocclusions that their ability to clean their teeth and their long-term health would be jeopardized without significant correction. But rather than being an accident of nature, this is a trade-off of civilization.

Anthropologists have found that people who live traditional lifestyles and ancient people had much better dental health and rarely had badly misaligned teeth. However, as people adopted agriculture, the size of their jaws shrank, while their teeth remained the same size. Scientists found that this pattern held throughout the world. It seems that children who grow up eating soft cereal products, such as bread and rice, never develop the large jaws necessary to hold all thirty-two adult-sized teeth. The stress of chewing tough root vegetables and large strips of meat is necessary to build up bone, as well as muscle mass. As a result, modern people need not only often need orthodontic correction, but wisdom tooth removal and sleep apnea treatments, as well.

To learn more about Ross Orthodontics, visit SmilesbyRoss.com. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.

 

Orthodontics before Implants?

A common problem for adults considering orthodontic work is whether to get it ahead of their other treatments. While every case is different, it is generally better to get orthodontic work done before receiving implants.

Consider what an implant is: a titanium screw which fuses with the jaw bone over a period of several months. Orthodontics involves moving teeth through the jaw bone, but implants do not have living ligaments and will not respond to pressure as living teeth do. The probably will not move at all. If an implant does migrate, it has to be removed and discarded as a failure or treated with guided bone regeneration.

It is also likely that, before receiving orthodontic treatment, the patient will not even have room for an implant. But does all this mean that a person who already has implants has no hope for correcting a misaligned bite? Not necessarily; other teeth can still be moved, and an implant-supported tooth can be a useful anchor for wires. If the patient only needs cosmetic orthodontic work, the amount the living teeth need to be moved may be too negligible to be affected by the location of an implant-supported crown.

To learn more about Ross Orthodontics, visit SmilesbyRoss.com. Offices are located in Forest Lake, Minnesota and Hudson, Wisconsin.