Four horrific dental health mistakes

Here are four horrific dental health mistakes:

1. Using mail-order orthodontics.

Mail-order service is a new trend in health care. In some cases, it makes sense, for example, mail-order contacts.

However, moving teeth is a complicated process. Each at-home aligner you use creates tooth movement. And, teeth don’t always move as planned. For this reason, using aligners for unsupervised tooth movement can lead to teeth moving in undesired ways .

And, if the aligners are damaged or broken, wearing them can lead to serious problems with your bite, causing long-term damage to your teeth or gums. Have your treatment supervised by a professional so that you get the desired outcome.

2. Do-it-yourself (DIY) treatment.

DIY treatment strikes fear into the heart of any dentist or orthodontist, and this is not because we are worrying about losing market share. We have all seen crazy things happen to people who try at-home remedies for their dental problems.

Believe it or not, it is very difficult to move teeth into a position that is both nice to look at and doesn’t cause tooth problems or headaches. But people really do try to do it themselves. If you don’t believe me, get online and search “DIY braces fail.” Ouch! Just because you can find metal and wire at Home Depot does not mean that DIY braces are a good idea.

3. Not correcting bite.

The best possible scenario (other than being lucky to have naturally perfect teeth) is to correct your bite early. Many times, people with what appear to be very straight teeth need orthodontics more than people with minor or moderately crooked teeth, because their bite is off.

The consequences of a bite being off include jaw joint (TMJ) pain, tooth pain, muscular pain, tooth wear, and gum wear.

Prevention by correcting your bite early is the best option. Your bite is something that can be off for a while and not cause you a lot of problems—until it does. Some people’s bites catch up with them in their twenties and some in their sixties—or at any age in between. Eventually, your bite will catch up with you.

Dealing with bite issues proactively is much less painful, less labor intensive, and less expensive than dealing with bite problems later. Problems with your bite can literally come back to bite you.

4. Just using Google or another online search to decide what treatment you need..
In today’s world, it is absolutely warranted to be skeptical of anyone and everything, including doctors. I get it.

But, Google, blogs, or your friend’s cousin’s uncle who had braces are not the best place for treatment recommendations. These are great places to start when researching which specialist to visit first. However, there is a lot of misinformation about all health care—including orthodontics—on the Internet.

Instead, find an orthodontist. Get your best information in-person at visits with several orthodontic specialists. If you get a few opinions that are consistent, chances are that the treatment is in your best interest.  You will know when you have walked into an office you can trust.

When (Not) to Get Your Permanent Teeth Pulled

This may be the most important warning I give you: think twice before having permanent teeth removed.

Before you read any further, know that extractions are no longer needed in over 99 percent of orthodontic patients. As a prospective patient, you need to advocate for yourself in your own treatment. If you are recommended to have permanent teeth extracted, be sure to get a second opinion.

Orthodontics has changed dramatically in the past twenty years. Most orthodontic cases throughout the seventies and eighties required the extraction of permanent teeth. Unfortunately, extracting teeth can result in long-term detrimental effects on many patients’ facial structures and compromise the health of their gums and bones as well as contribute to the potential for sleep apnea.

Nobody wants to go through having teeth pulled if it can be avoided. A full complement of teeth often results in a fuller, more beautiful smile.

So what has changed to allow orthodontists to avoid the extraction of so many teeth?

  •      The test of time. As more and more people were treated with braces over the years, orthodontists were able to see what happened to these patients as they became adults and aged. What they saw was not encouraging. Orthodontists realized that as people age, their lips tend to flatten out naturally. In patients who had permanent teeth extracted, this flattening was magnified significantly due to reduced support for the lips. As orthodontists began seeing this negative aging process caused by extractions, they began seeking other ways to treat.
  •      Controlled research. In the eighties, the University of Michigan began researching what caused people to have crowded teeth. Many times, orthodontists told people that their teeth were just too big to fit. Were people’s teeth too big? Interestingly enough, research has shown that this was not the case at all. In fact, virtually everyone had the same sizes of teeth, but those who had crowding had much smaller dental arches than those who had no crowding. The conclusion was that orthodontic treatment options should focus more on creating additional room for crowded teeth instead of removing teeth.
  •      Bonds instead of bands. Do you remember those rings around teeth with braces? Until the late seventies, braces included rings around the teeth, called bands. They were the only way to connect braces to the teeth. Bands around each tooth added about five millimeters of material between the teeth. Because of this, even in mildly crowded cases, there just was not enough room to fit all the teeth in the mouth and teeth needed to be pulled. Now, orthodontists use bonding. Bonding is a thin layer of adhesive that connects a brace to the front surface of a tooth.
  •      Better wires. Today’s wires deliver a force on the teeth that is much lighter and gentler on the teeth than that of the stainless steel wires used with traditional braces. Due to this gentleness, teeth are now able to move in a way that allows the bone to adapt and change with the movement, and orthodontists are able to treat more cases without tooth extractions.
  •      Better braces. The final piece to the puzzle arrived on the scene in the new millennium. Braces traditionally have required something to hold the wire in place (also referred to as “tightening” the braces). This was done with either small wire ties or those fun little colored elastics. Although these ties kept the wires in place, they caused friction and kept the teeth from sliding freely. Around the year 2000, a new type of brace was invented that does not require ties to hold the wire in place. Instead, a door or clip opens and closes to hold the wire in place. There is no friction against the wire, so the teeth are free to slide, and the orthodontist does not need to push as hard to get the teeth to move (which means less pain!).

Having permanent teeth extracted is not a pleasant experience, and long-term results have shown that permanent-tooth extractions can result in unwanted aging changes if performed on the wrong patient. The current recommendation is to make more room to accommodate the teeth rather than remove them. The perfect combination of technology has arrived, allowing orthodontists to accomplish the desired nonextraction treatment.

Questions You Should Be Asking Your Orthodontist

Choosing the right orthodontist for your family can be overwhelming, and making a wise decision can seem daunting. Today, finding a provider can be more confusing than ever as the number of options are ever-growing. To help sift through all the choices, you should ask your orthodontist these important questions.

Are your results guaranteed?

Many years ago, orthodontists would tell patients that they could stop wearing retainers a year or two after braces were removed. Then teeth shifted, and the wisdom teeth were blamed. Now we know that to keep your teeth straight for a lifetime, you must wear retainers indefinitely, regardless of wisdom teeth or any other factor. But let’s face it: not all people will do as instructed—dogs may eat retainers, or the retainers may be accidentally thrown away (or lost under the bed). In these cases, some teeth will shift, and, for some former patients, teeth will need to be restraightened. It is important to know what will happen and how much it will cost should you need to repeat braces at some point in the future.

Is the quoted treatment fee all inclusive?

Many offices that seem to cost less at first have hidden fees that pop up during treatment. Broken braces (all patients—kids and adults—have broken braces from time to time), extra visits, treatment that extends past the estimated treatment time, canceled appointments, Invisalign refinements, retainers, and more can trigger hidden fees at many offices, raising the costs to much more than you bargained for. For Invisalign, make sure refinements are included! Read the fine print, and make sure that the fee you are quoted is the only fee you will pay.

Are there affordable payment options?

Braces—even with the best doctors—can and should be affordable. Zero-down, no-interest payment plans should be available for those who can’t afford a large down payment. Extended payment plans should be available to allow for lower monthly payments. For extended plans, you may need to pay a little interest. However, the rate should be low (think 5 or 6 percent), not high like that of a credit card. Also, if you use a third-party financing service, be careful of penalty interest. For example, many companies offer 0 percent financing, but if you miss a single payment, they pile on penalty charges of over 20 percent—of the entire cost of treatment.

Is your office up to date with the latest technology?

The world is changing rapidly. So, too, is the world of orthodontics. Advances in braces technology, clear aligners, and accelerated treatment make straightening teeth more comfortable, more efficient, faster, easier, and less noticeable than ever before. Braces can even be placed behind your teeth, but only if the orthodontist spends considerable time, energy, and effort to invest in learning and mastering the latest techniques. If any doctor suggests extractions, headgear, or more than two years of treatment, make sure to get another opinion.

College Students: How to Care For Your Oral Health Away From Home

With so many other things on their mind and lots of new responsibilities, it might be difficult for college students to make oral health a priority in their life. But, it’s extremely important to prioritize oral hygiene as there are many avoidable problems that can and do occur.

I have a few simple oral health tips for college students that will, if applied, reduce dental problems and help save time and energy in the long-run:

  1. Brush and floss when you wake and when you sleep.

Yes, this sounds like a no-brainer, but it really can be easy to get out of the habit with a major life change. Old routines are thrown out the door and many new, exciting things are happening.

By brushing and flossing, you remove plaque and food particles in between your teeth and gums. The biggest problems with teeth and gums, such as gingivitis, can be prevented by keeping them free of debris.

  1. Know how to brush and floss.

To get the most benefit from brushing and flossing, you have to do it correctly. The American Dental Association (ADA) has a great infographic on brushing teeth and here is a video by the ADA with proper instructions on flossing.

While there may be conditions that make it difficult, here are two common hurdles and workarounds:

  • Sensitive gums – If you have sensitive gums that bleed easily, choose a soft floss that slides easily and comfortably between the teeth. Also, somewhat counterintuitively, bleeding gums are an indication your should be brushing and/or flossing that area more and not less.  Bleeding indicates inflammation which is caused by excessive buildup of germs from not keeping that area clean.  So, be sure to pay extra attention to the bleeding areas and the bleeding will resolve shortly.
  • Braces – Wearing braces doesn’t mean you can’t floss. Many brands sell specialized floss with stiff ends that can be easily threaded beneath the main wire of your braces.
  1. Consume less sugar.

When we eat foods that contain sugar, bacteria produce acids that eat away at our teeth and cause tooth decay (also known as cavities). Need I say more?

The most important thing is to recognize sugar on labels and know what foods have sugar in them. Food and drink packaging really stretches the truth with words like “natural flavoring” and “from real fruit juice,” which really is just plain sugar. Regular soft drinks and sodas are terrible for your teeth. High fructose corn syrup is another word for sugar.

Many times we don’t realize just how much sugar we are consuming. You may think you’re making a healthy choice with dried fruit, snack bars, or yogurt. But many of these food items have a surprisingly high amount of sugar. I remember the many late nights I was up studying.  I wouldn’t have made it through biochemistry without coffee. Just be careful to limit how many mocha-frappe-latte-chino’s you drink as they are loaded with sugar.  You don’t need to trade good grades for a mouthful of cavities.

5 Things to Consider Before Choosing Your Ortho

Orthodontic treatment is a huge commitment for an individual, and their family. But, in my opinion, the results of a great Ortho are well-worth the investment.

It can feel like there are countless factors to consider when trying to decide whether or not to pursue treatment, and who to trust with your oral health. Simplify your decision-process by considering these five things before choosing an orthodontist:

  1. Consider yourself.

Before choosing a provider, it is necessary to look in the mirror and have a realistic conversation with yourself. Are you willing to put in the time, effort, and money necessary to make this improvement?

Orthodontics is a team sport. For amazing, long-term results, you will need to show up to appointments, follow directions, and keep up with maintenance. Like most things in life, you will get out what you put in.

  1. Consider their skills.

The world of orthodontics is constantly changing. Advances in braces technology, clear aligners, and accelerated treatment make straightening teeth more comfortable, more efficient, faster, easier, and less noticeable than ever before

But none of this can happen unless the orthodontist spends considerable time, energy, and effort to learn and master the latest techniques. There are, unfortunately, many orthodontists who have not kept up with current improvements in treatment and technology. There are also many people in the dental world who will be deceptive as to their level of skill, training, and experience.  Don’t be afraid to ask them to show you photos of their completed treatments that are similar to yours needs.

  1. Consider the price tag.

When discussing fees with an orthodontist, be sure to look for hidden fees that could pop up during treatment. Read the fine print and make sure that the fee you are quoted is the only fee you will pay. It is common to have a lower price up front and many unexpected charges later in treatment.

While it is important to make sure you are not getting overcharged, choosing based on price alone may not always be the wisest decision. Remember, you often get what you pay for, and it may be worth paying a few extra dollars to ensure high-quality treatment. Orthodontics is an investment that should last a lifetime.

  1. Consider their reputation.

Do your research! Check social media sites like Google Plus and Facebook to see what others are saying about the office you’re considering.

On Yelp, make sure to look at the filtered reviews. Yelp has historically prioritized certain reviews for pay, so use caution when evaluating the validity of Yelp reviews. Facebook and Google Plus tend to be more reliable: they allow all reviews to be posted visibly, and they are not influenced by payment.

Ask your friends and neighbors what they have heard about local orthodontists. It may be worth your while to drive a little farther to get higher-quality treatment and better customer service. Also, advances in treatment technology allow fewer visits to achieve a quality result.  Your time is valuable too!

  1. Consider your gut.

Use your gut feeling, and if anything doesn’t seem right to you, get a second opinion. Since most orthodontic exams are free, all you invest in a second opinion is your time.

Orthodontic treatment doesn’t have to be a scary or unpleasant experience. It should be fun! Look for personal touches, fun contests, and rewards programs in an office to see how much it truly cares about making the patient experience special. Each visit should be something to smile about!

Considering Orthodontic Treatment Part 4: Pulling Permanent Teeth

After your initial exam with an orthodontic provider to check for misaligned teeth and a “bad bite,” one or more treatment plans will be presented. If your doctor recommends pulling any permanent teeth, it’s wise to stop and think twice.

The question you should be asking is, “Is there a better option than pulling out my permanent teeth?”

The Consequences of Pulling Teeth

Removal of permanent teeth is more of a last resort than a treatment of choice. Unless this is a “last resort” case, a doctor may be recommending extractions when modern orthodontic techniques could treat equally or better, without removing teeth.

Pulling permanent teeth can compromise the health of gum and bones, and result in long-term negative effects on facial structures. The negative effects seen in the aging process are a huge deterrent to extraction. As people age, their lips naturally flatten out. The test of time shows that, in patients who had permanent teeth extracted, this flattening is significantly magnified because support for the lips was reduced.

Nobody wants the pain of permanent tooth removal if a fuller, more beautiful smile can be achieved through a less painful, more effective, treatment.

Advances That Prevent Pulling Teeth

In the past, up to 75 percent of orthodontic cases included the removal of permanent teeth. Fortunately, the number of cases best treated by extractions has drastically reduced with early orthodontic intervention and advanced treatment options. Improved wires, better braces and research proving the cause of crowding are three advances that allow orthodontists to avoid pulling permanent teeth.

  1. The Real Reason for Crowded Teeth

In the past, orthodontists believed that crowding was due to teeth that were just too big to fit in one’s mouth. Research has shown that this is not the case at all. Crowding is a result of smaller dental arches. Instead of pulling permanent teeth, orthodontic treatment should focus on creating additional room for crowded teeth.

  1. Gentler Wires

Today’s wires provide a much lighter and gentler force on the teeth than traditional, stainless steel wires. This gentleness allows the bone to adapt and change with the movement of teeth, increasing the ability to treat more cases without pulling teeth.

  1. Better Braces

Traditionally, braces were tightened with small wire tires or colored elastics. They kept the wires in place but caused friction and prevented the teeth from sliding freely. Now, braces have a door or clip that opens and closes to hold the wire in place. This new type of brace does not require ties or elastics, so teeth are free to slide and don’t need to be pushed as hard to move.  In our office, the Damon System braces have completely changed the way we treat certain cases and have mostly eliminated the need for permanent tooth extraction in our patients.

Make Room

These discoveries and advanced technologies allow orthodontists to make room for teeth, rather than to remove them. If a doctor recommends the extraction of permanent teeth, be sure to advocate for yourself and consider getting a second opinion. Once teeth are removed, they’re gone for good!

Considering Orthodontic Treatment Part 2: Choosing the Best Provider

So, you’ve decided to schedule an initial exam for you or your little one to see if it’s time to start orthodontic treatment. An online search, recommendations from coworkers and friends, dentist referrals, and even business signs offer more than enough providers for you to choose from. Many are confused about the type of professionals out there, and who to choose. The big question is, “Who is the best provider for my orthodontic treatment?”

Types of Providers

Before we answer who, let’s review three of the most common providers:

  1. Orthodontist

An orthodontist is a dentist who attended a two- to three-year orthodontic residency after completing dental school. Orthodontists are highly-trained, highly-skilled specialists. They focus on tooth alignment, bite problems, managing TMJ, and designing smiles. Orthodontists do not offer other dental services such as cleanings, fillings, root canals, and tooth extractions.

  1. Dentist

A family, general, cosmetic, or primary-care dentist has completed dental school but has not completed an orthodontic residency. These dentists are responsible for ongoing evaluation of your overall dental care, diagnosing and treating many dental health conditions, and diagnosing conditions for specialists to evaluate and treat.

  1. Mail-order

A new trend in health care, mail-order orthodontics are available. These companies are run by businesspeople, not doctors, and treatment is not supervised by a professional.

Who is the Best Orthodontic Provider?

As convenient as mail-order or DIY services sound, moving teeth is a complicated process that requires a trained professional. It’s very important for orthodontic treatment to be supervised as dental appliances can get damaged, teeth don’t always move as planned, and correction involves much more than making teeth look straight. I strongly recommend you eliminate option three and work with an orthodontic provider who will supervise your treatment and give you beautifully straight teeth and a healthy bite.

These same concerns exist when seeking a dentist or orthodontist. It takes years of training to treat orthodontic cases well and, unfortunately, there are doctors who do not have the proper training and experience. So, how do you determine if a provider is a trained professional that will provide quality care?

The ideal doctor will have completed a full-time, accredited residency. Weekend courses are not sufficient training. A truly qualified provider has consistently and continually pursued education and training over the course of years. Specialized treatment after dental school is necessary to provide the highest possible level orthodontic care.

This is not to say that only orthodontists can provide treatment. Cases range from simple to very complex and, depending on where a case falls on the spectrum, some dentists have the experience to provide the necessary treatment. However, a good dentist will be upfront about their orthodontic training and experience and will refer you out if needed.

Do your research when it comes to orthodontic treatment! Don’t be afraid to ask tough questions and get a second opinion. In my next post, we will address importance of your bite, giving you even more reason to find a well-trained, experienced doctor. And, you can find more information on choosing a provider, as well as key questions to ask them, in my new book World Class Smiles, Made in Detroit.

Considering Orthodontic Treatment Part 1: When to Start

You may have arrived at this post with your head spinning. You’re considering orthodontic treatment for yourself or a loved one, searching online for more information, feeling overwhelmed by the ever-changing techniques and treatment options, and looking for some direction. Or, maybe, you aren’t that far yet. You have yet to explore the choices for orthodontic care and you’re just uncertain if this is even a good idea.

Wherever you are in your exploration of orthodontic care, I hope this post arms you with clear, helpful information. I have put together a series of posts to sort through the information, techniques, options, and choices together, so you can come away a little bit wiser and more confident.

The question we will address in this first post is, “When is the right time to start treatment?”

The Right Time to Start Orthodontic Care

You will likely end up with several different answers regarding what, when, and how orthodontic care should be done. Depending on whom you ask, you may even end up with conflicting opinions! Let’s look at best practices for when to start treatment:

Children Should Get an Orthodontic Exam by Age Seven or Eight

Wait…what?!  Believe it or not, there are some conditions which are treated better at a younger age when certain parts of the jaws are still growing and/or when teeth are still developing.  Whether treatment starts at a young age or not, The American Association of Orthodontists recommends that all children at least visit an orthodontist by age seven. This may seem early but, the reality is, different kids have different problems; different problems have different treatment; different treatments have different timing. It’s best to get an exam at age seven or eight to screen for problems that can be addressed with early intervention. In our office, just 20 percent of cases present problems that call for early intervention, but this initial exam is important in ruling them out.

Early Orthodontic Care is Best for Certain Conditions

If a child has conditions that are better treated when the patient is younger, the typical recommendation is for two-phase treatment, with the second phase happening when the child is older and the remaining teeth have come in. There are four major things an orthodontist will take into consideration during the initial exam.

  1. Proper jaw growth
  2. Room for teeth to grow in
  3. The number of teeth
  4. Airway obstructions and snoring

If the orthodontist notices issues with any of these four things, they may suggest treatment. Fortunately, there are excellent options available that can keep smaller problems from growing into a major toothache (ha!).

Every child deserves an amazing, healthy smile he or she can be proud of and most orthodontists today offer complimentary exams, so my best recommendation is to take this opportunity to have your little one screened. They will consider your child’s unique characteristics and recommend the right time to start orthodontic treatment.

In my next post on considering orthodontic treatment, we will talk about choosing your best provider.

The Pros and Cons of Invisalign, Clear Braces, and Cosmetic Orthodontic Treatment

A beautiful smile is both desirable and accessible. Adults, now more than ever, are seeking orthodontic treatment to help create the smiles they have always dreamed of.

With so many adults now seeking orthodontic treatment, the question often is, “Do I have to be a ‘metal mouth’?” The answer is no… there are non-traditional, cosmetic, or clear options, including Invisalign, clear braces, lingual braces, instant orthodontics, and accelerated orthodontics.

These non-traditional approaches have their own pros and cons, so I have provided a brief summary of the different choices for you.


Invisalign Pros:

  • It is the most aesthetic option for moving teeth
  • Aligners can be removed for eating
  • It makes teeth cleaning easy

Invisalign Cons:

  • It cannot treat difficult cases
  • Discipline is required to wear the trays all day and night for many months
  • It is often offered by dentists with very limited training, which may lead to less-than-ideal results

Clear Braces

Clear Braces Pros:

  • The system can treat more difficult problems
  • Braces are much clearer than they used to be
  • Braces are virtually unnoticeable in photos

Clear Braces Cons:

  • Braces are slightly less aesthetic than Invisalign
  • Braces are prone to the same problems that conventional braces have, such as poking wires and breakage

Lingual Braces

Lingual Braces Pros:

  • They are more aesthetic than clear braces
  • They can be an alternative to Invisalign for more difficult cases

Lingual Braces Cons:

  • They make speaking more difficult
  • They are not comfortable
  • They are more expensive than other options
  • Treatment can take longer, with more visits

Instant Orthodontics

Instant Orthodontics Pros:

  • This method can quickly restore worn, broken, or discolored teeth
  • Work can be done in weeks instead of months or years

Instant Orthodontics Cons:

  • It is typically by far the most expensive of all options
  • It requires grinding down teeth and replacing them with porcelain
  • It requires several replacements throughout your lifetime
  • It doesn’t typically correct the bite the way traditional orthodontics does

Accelerated Orthodontics

Accelerated Orthodontics Pros:

  • Achieve high-quality treatment in a fraction of the time

Accelerated Orthodontics Cons:

  • Brand names and marketing can be misleading; you may not be getting what you are promised

Contemporary orthodontic treatment offers more options than ever before to avoid metal braces, but keep in mind that every individual is unique and requires a customized treatment plan from a well-trained orthodontist for the best results.