Author: Ask Dr. Reynolds

As a new mom, you have so many things to think about. It’s likely that oral health, dental care, and orthodontics for your new child are far down on your priority list – especially when your little one doesn’t even have any teeth yet! But it’s never too early to make a plan for the future so you know what you’ll do when the time comes. Here’s some practical advice from an orthodontist to new moms:

Hit Oral Hygiene Milestones

Before teeth have even erupted, you can help keep baby’s mouth clean by wiping down her gums at least twice a day with gauze or a moist washcloth.

Plan to start brushing as soon as baby’s teeth come in, around 6 months old. The American Dental Association (ADA) recommends using fluoride toothpaste the size of a grain of rice on a child-sized toothbrush twice a day.

By age 3, your child should have a full set of baby teeth – 20 of them – at which point the ADA recommends upping the amount of toothpaste from the size of a grain of rice to the size of a pea.

Around age 6, your child should be able to brush on his own. He’ll have the coordination to do it himself. At this point, he can also “graduate” to using an adult-sized amount of fluoride toothpaste on his brush.

Same for flossing. Plan to floss your child’s teeth as soon as two teeth are touching, and let her floss on her own when she’s got the coordination for it, anywhere from 7-10 years old.

Visit the Dentist – And the Orthodontist – Early

The American Academy of Pediatric Dentistry recommends an initial visit to the dentist when the first tooth erupts, or no later than baby’s first birthday. From then on, make twice yearly check-ups a part of your child’s routine. It’s your choice whether to have your child visit a pediatric dentist or a family dentist. Some children who dislike the dentist have an easier time at the pediatric dentist’s office, which was built with children in mind.

What about the orthodontist? The American Association of Orthodontists recommends (PDF) all children see an orthodontist by the age of 7. This may sound like it’s way too early, but going this early is actually very prudent. Some issues can be addressed more quickly and more when caught early, such as issues with the growth of the jaw bone, remaining baby teeth, impacted teeth, the number of teeth growing in, and more.

Fortunately, the majority of children this age will not need treatment. If treatment is needed, it can often be until the age of 12 or 13 or later. If treatment is needed, however, starting it early can save time, trouble, and money.

Model Good Behavior

Modeling good oral health behavior yourself is one of the best ways to show your child just how important good oral hygiene is. Your child should know that you brush and floss, see your dentist regularly, and avoid sugary snacks in excess. Basically, you should be doing yourself all the things you’re telling your child.

It’s never too early to start a routine or oral health care for your little one. Remember that the habits you help instill now will be with your child for life, ensuring healthy teeth and a beautiful smile.

Tooth pain can be caused by a variety of things including physical trauma, tooth decay, or even a sinus infection. Some occasional tooth sensitivity may be normal for you and nothing to worry about, but certain types of tooth pain warrant a visit to the dentist or orthodontist. Here’s what you should know about toothaches.

Physical Damage to the Tooth

A fall, object to the face, or even hard candy or other piece of food can lead to physical damage such as a cracked or loose tooth. This is considered an emergency and you should try to see your dentist or orthodontist as soon as possible if it’s during business hours. Otherwise, seek help at an urgent care facility or E.R. and plan to follow up with your practitioner soon after.

If a tooth has come out of the socket completely, or a large chunk of a tooth has broken off, keep it clean and moist by holding it in your mouth or placing it in a cup of milk until you’re seen.

Severe Pain

Pain so severe that you can’t concentrate on what you’re doing should be addressed by a professional. Don’t just keep popping painkillers and hoping it will go away. Pay special attention if this pain:

• Gets worse with hot or cold
• Gets worse when chewing or putting pressure on the tooth
• Is accompanied by fever
• Is accompanied by pus and fluids in the area

Call your orthodontist’s or dentist’s office and let them know that you’re in severe pain. Hopefully, they will be able to see you right away and help fix the source of the pain.

Long-Lasting Pain

Pain that’s not severe but that doesn’t go away is something to have checked. Two days or more of constant pain is not normal and indicates an underlying problem, such as tooth decay or gum recession. In many cases, the earlier you address the problem, the easier it will be to fix, so don’t delay in setting up an appointment to see your healthcare professional.

Long-term pain can also be caused by clenching or grinding, which are symptoms of a problem with the temporomandibular joint (TMJ). An orthodontist can help you with the underlying problem, typically a “bad bite,” to address the clenching and grinding.

After Having Work Done on Teeth

If you’ve just had some major dental work done and you’re in bad pain afterwards, you may need to go back for another visit. A little soreness after a cavity filling, crown, or root canal is normal, but excessive pain is not. The work might need to be tweaked or redone completely. If it hurts, it’s best to have it looked at.

One time you can safely skip a visit for toothaches? If you’ve just been to the orthodontist and had your braces tightened. This is likely to cause pain, but the pain shouldn’t be severe and will not last more than a day or two.

Before Long-Distance Travel

Any tooth pain, even if it’s mild or short-lived, should be looked at if you have travel plans in the future, especially if your travel destination is remote or doesn’t have good access to reliable dental care. A small pain now can turn into a big pain later, disrupting your travel plans, costing a lot of money, and causing a lot of pain. A little prevention now can be worth so much later.

Prevent Toothaches in the First Place

The best thing you can do is avoid the pain of toothache in the first place, which you can do by brushing and flossing daily, having regular professional cleanings, and going in for a yearly check-up with your dentist. If you wear braces or any other appliances, or have in the past, a regular visit with your orthodontist to check up on your bite is smart, too.

When it comes to your oral health, it’s better to be safe than sorry. Err on the side of caution and call your dentist or orthodontist when you’re experiencing a toothache.

The job of a retainer is straightforward: Keep the teeth in place.

After orthodontic treatment, teeth have a tendency to want to move back to where they came from. It takes a while for the mouth to become accustomed to the new arrangement, and that’s why retainers are necessary. If they’re not used, especially in the first months after ending treatment, the risk of relapse is high. Remember, everything in the human body is subject to change over time. Teeth are not immune. There are many forces at work on your teeth including speaking, chewing, and pressure from your cheeks, tongue and lips. These forces can all cause tooth movement without retainers.

There’s actually more than one type of retainer. Most of the time (and in the rest of this blog), when we talk about retainers we’re talking about removable retainers, which can be put in and taken out of the mouth at any time. There are also permanent (often called ‘fixed’) retainers, which are wires bonded to the back of a number of teeth to keep them in place. hey are, as the name suggests, permanent, and can only be removed by your dentist or orthodontist.

A retainer from your orthodontist or dentist can cost hundreds of dollars. It costs a lot because it’s custom-made for your mouth and is created to be very durable. Getting a replacement retainer is expensive, so remember to take good care of your retainer! It should be in your mouth or in its storage case – nowhere else. It’s more likely to be damaged or accidentally thrown away when it’s removed and casually laid aside or wrapped in a napkin.

It Needs Regular Cleaning

Each day, make sure to clean your retainer according to instructions from your orthodontist. Otherwise, you risk bacteria growing on it, which you don’t want to put back into your mouth.

Remember to bring it along with you to any orthodontic, dental, or hygiene appointments. It can be checked for fit and thoroughly cleaned in the office, too.

It May Be With You For a While

Once braces are off, your orthodontist will talk to you about your retainer, how often you should wear it, and for how long. It may be anything from nighttime only to 24 hours a day (apart from eating and brushing). It may be for 6 months or two years or forever.

Not too long ago, it was standard to recommend wearing retainers for a year or two after the end of treatment with braces. However, that often led to teeth moving back towards their original positions. Now, orthodontists suggest wearing retainers indefinitely to keep your teeth where they are. Otherwise, teeth could shift to the point where braces are necessary again.

It Only Works If You Wear It!

Retainers are fantastic at doing their job when used properly. To keep your teeth straight and your bite good, wear your retainer according to your orthodontist’s instructions. Know that your orthodontist has come up with your oral care plan very deliberately and is interested in helping you maintain the beautiful smile you invested so much in.

It may a nuisance to wear a retainer, but it’s a small price to pay to keep your smile beautiful.

Brush in the morning. Brush at night. Floss. Sleep. Repeat. Your daily dental care routine is probably pretty simple. In fact, the habits might be so ingrained, you don’t even think about them anymore. But what if there were some simple changes you could make to your daily routine that could greatly help your oral health? There are! Here are a few:

Brush Better

Brushing your teeth is essential for maintaining a healthy smile. However, it is possible to overdo it. Using too much force when you brush can actually cause damage, wearing off the tooth’s delicate enamel and causing gums to recede. The fix is easy; just be more gentle when brushing. Use what I call my ‘brushing rule of thumb’. Look at your thumbnail. It should appear slightly pink. Now, press your thumb firmly against a table–your thumbnail will start to turn white (instead of pink) as the pressure increases. When brushing, if your thumbnails are turning white from the pressure you are using on your brush, you are likely brushing too hard. If this is hard for you to do (or perhaps your nails are painted and you can’t tell), some of the fancier electric toothbrushes have pressure gauges to let you if you are too firm with your brushing.

Another culprit: Hard-bristled toothbrushes. Like forceful brushing, using a toothbrush with too-stiff bristles is hard on your teeth’s surfaces and gums. If this is you, replace your current brush with one that has soft bristles.

Floss Smarter

It’s great to be enthusiastic about flossing, but don’t overdo it! Just like over-vigorous brushing, flossing that’s too forceful can cause gums to bleed excessively and recede over time. (Note that a little bit of blood from the gums after not flossing for a while is considered normal, but healthy gums should not bleed. So, if you see bleeding you likely need to floss more.)

Also, do you use the same small part of floss to clean between many teeth? Bad idea. You may be transferring bacteria from one part of your mouth to the other. Instead of reusing floss, move to a new, clean section of floss after each tooth. The American Dental Association recommends using about 18 inches, so you’ll have plenty of clean floss to work with.

Don’t Forget Your Jaw

Oral health isn’t just about teeth, you know. A healthy jaw is fundamental to a good bite and beautiful smile.

Lots of people clench their jaw, which can be a sign, or even a cause, of temporomandibular disorder (TMD), a disorder of the temporomandibular joint (TMJ). The trouble is, it can be tough to even realize you’re doing it. One trick is to put a little sticker up in a place you see often throughout the day, such as the corner of your computer screen or on the refrigerator door. [1] Whenever you see it, check in with your jaw to make sure you’re not clenching. Just remember “lips together, teeth apart.” That’s what you’re going for.

What about at nighttime, when you may clench your jaw and grind your teeth in your sleep without noticing? If you think you’re clenching or grinding, and/or you have unexplained headaches, speak with a professional (a dentist is good, an orthodontist is better!) about whether you have TMD. Together, you can discuss options for addressing it, such as night guards or orthodontia to fix your bite.

Care for Your Appliances

If you’ve got a retainer, night guard, or other removable dental appliance, you have extra to take care of. It’s imperative that you clean your appliances regularly and thoroughly. Uncleaned appliances can harbor harmful bacteria, yeast, and mold that can damage teeth, cause bad breath, or even make you sick.

Your orthodontist or dentist may suggest a weekly cleaning with a denture cleaning tablet or foam, but for daily care, brushing your appliance with toothbrush and toothpaste is a good start. Store your retainer or night guard in water when not in use to stop microbes growing. And don’t forget the container, too: make sure that’s squeaky clean before storing your appliance in it.

Stop These Bad Habits

These things can damage your teeth and put stress on your jaw. If you have any of these bad habits, kick them now!

• Biting your nails
• Chewing on ice
• Chewing on pens and pencils
• Using your teeth to open things

As you can see, it doesn’t take a lot of effort to up your daily dental care routine, it just takes consistency and mindfulness. We promise the results are well worth it!

DIY is great – for certain things. While do-it-yourself has a place in the home, it doesn’t have a place when it comes to orthodontic care. Unfortunately, DIY orthodontia is a growing trend that’s doing more harm than good. Here’s what you should know about DIY braces and why you should avoid them.

DIY Braces: A Destructive Trend

DIY orthodontia has been a growing trend over the last few years. More and more companies have sprung up online to sell cheap at-home teeth straightening kits and clear aligners. Teens have posted videos on YouTube, some gaining tens of thousands of views, demonstrating how to straighten teeth on your own.

What they don’t show is what can go wrong when you DIY without the help of a trained, licensed orthodontist. If you’re brave, Google “DIY braces fail” to see what can happen. This is no joke.

One of the main results of this type of DIY is ending up with a smile you don’t like. Teeth may end up in the wrong location, out of position with other teeth, and/or angled incorrectly. Instead of closing gaps between teeth, at-home braces could lead to even more gaps.

Here are some of the other potential health consequences that can occur if you undertake teeth straightening on your own:

• Worsening of existing dental problems like decaying teeth or diseased gums
• Tooth wear
• Tooth loss
• Irreparable damage to remaining teeth
• Damage to underlying bone
• Damage to gums
• Infection
• Emotional stress

Are You Really Saving Time and Money DIYing?

Why would people want to DIY in the first place? Two main reasons: Time and money. They want fast results, and they don’t want it to cost much.

Unfortunately, there’s no magic solution to achieving a straight smile quickly. To get the right bite and alignment, orthodontic treatment typically takes a minimum of eight months, depending on the issues. Any faster than that is not going to provide the desired long-term results.

As for money, while the initial costs of at-home kits are far less than traditional orthodontic care, it can end up costing much more money in the long run. That’s because treatment to fix the problems caused by DIY braces is likely to be more expensive than it would have been to fix the initial problem alone.

While orthodontia can be expensive, there are always options for people who need orthodontic care but don’t have the money to pay out-of-pocket.

Working with an Orthodontist Instead

From the outside, it may look like straightening teeth is a simple matter. Attach the braces and let them work their magic. However, this is not the case. It takes regular monitoring of treatment and a solid understanding of anatomy to create a beautiful, functional smile. It takes experience and knowledge to make appropriate corrections in treatment as it progresses.

That’s why it’s best to work with an orthodontist directly if your goal is straight teeth. Orthodontists are dentists who have spent two to three years after dental school learning about the anatomy and function of the mouth, neck, and head, and how to straighten teeth gently and reliably. Skilled and knowledgeable orthodontists know about the latest in orthodontic treatment options and can help find the right treatment for each patient’s needs. You can be sure you’ll end up with a smile that’s not just beautiful, but healthy.

For all these reasons, speak to an orthodontist first if you want straight teeth, and avoid DIY and at-home braces at all costs!

“How can I make treatment go faster?” This is a common question from people undergoing orthodontic treatment. After all, no one likes wearing braces. What they want is the result at the end. Is there any way to make that happen faster? Yes, there is! Accelerating orthodontic treatment can happen a few different ways, including mentally and mechanically.

Accelerating Treatment Mentally

To make treatment go faster, start by not going slower.

That may seem obvious, but it’s not always what happens in practice. Sometimes, the patient or provider is so eager to start treatment that they start it too early.

What’s too early? In most cases, too early means before all the baby teeth have fallen out. When orthodontic treatment starts before all the baby teeth have fallen out, treatment becomes more complicated and more lengthy.

In other words, don’t start treatment too soon. It not only can add extra months or even years to treatment, but an increase in risk of tooth decay.

(Note that there are some cases where it does make sense to start orthodontia before all the baby teeth have fallen out, for instance when there’s a problem with tooth or jaw development, blocked or impacted teeth, or significant overbite.)

Accelerating Treatment Mechanically

Technology for braces has come a long way in the past few decades. New advances mean that there are ways to speed up treatment depending on the type of braces used. Self-ligating braces are the solution here.

Let’s look at the basics of braces to understand how self-ligating braces are different from traditional braces.

Braces consist of both the individual braces that attach to each tooth and the wire that links them all together. In traditional braces, ligatures – small wires or elastic rubber bands – hold the wire to the brace. They provide the force that moves the teeth.

If force moves the teeth, then wouldn’t applying more force move the teeth more quickly? As it turns out, no. Push too hard, and the tooth resists moving, while at the same time leading to unwanted side effects like inflammation around the tooth, gum problems, and pain. Teeth move more slowly, leading to a longer treatment time.

In contrast to traditional braces, self-ligating braces don’t need the ligature because of the way they’re designed. Self-ligating braces don’t use as much force as traditional braces to move teeth, which means that teeth can move faster without the accompanying problems. This is what makes them preferred for patients looking to shorten their treatment time.

Plus, while around 35% of people going the route of traditional braces need to have at least one permanent tooth removed for orthodontia to work, people choosing self-ligating braces are much less likely to need teeth removed. Depending on the kind of self-ligating braces, it can be as low as 1 in 100 people. This is another big advantage of self-ligating braces over traditional.

Accelerating Treatment with a Skilled Orthodontist

This is not Orthodontics 101. Only orthodontists who are highly trained can safely and reliably accelerate orthodontic treatment. For that reason, it’s important to vet your orthodontist carefully and undergo treatment with one you believe has the education, experience, and knowledge to help you achieve your goals.

At the same time, it’s important to understand what’s realistic and what’s not. No matter how skilled or experienced your orthodontist is, expect treatment to take a minimum of eight months (and possibly much more, depending on your situation). If you see someone offering a product or service that promises a beautiful smile in less than that time, be very wary.

In the end, it’s important to communicate with your orthodontist about your expectations, and the two of you can come up with the right treatment plan for you together.

If you’re like most people, you made some New Year’s Resolutions for 2018. Was one of those resolutions to pay attention to your smile? Hope so! A healthy smile is not just about looking good, after all. Here’s why you should make maintaining a healthy smile a top priority this year.

A Beautiful Smile is Healthy

• Discolored teeth can be a sign that the enamel has worn off and exposed the dentin underneath. When it gets to this point, fillings are often not enough to fix the tooth, and crowns are the only solution.
• Teeth that are cracked, worn, or misaligned can indicated a bad bite while missing teeth can cause problems for surrounding teeth, leading to more decay.
• A bite that’s off can lead to TMD (temporomandibular disorder), which can cause clicking noises, pain in the jaw joint, and unexplained headaches.
• Receding gums can lead to damage of the underlying bone and loss of teeth.
• Gum disease is associated with heart disease, stroke, and diabetes.

Paying attention to your oral health is not just good for your smile, but for your health overall. Plus, addressing problems as they arise means avoiding more expensive, more invasive fixes down the road.

A Beautiful Smile is Good for Self-Esteem

Feeling good about your smile is an important component of self-esteem. Too many people cover up their smile or stop themselves from smiling because of embarrassment over their teeth. What a shame!

A beautiful, healthy smile gives you the confidence to smile proudly and be yourself without hiding. It’s something everyone should have the privilege of experiencing. Working towards a beautiful smile isn’t just an investment in having nice teeth, but an investment in self-confidence and in your future.

A Beautiful Smile is Achievable!

Unlike going to the gym every day, this is a resolution that’s easy to keep. Simple habits (that you probably already have) like brushing regularly and flossing daily go a long way towards keeping that smile bright and healthy. Getting a cleaning from a dental hygienist and seeing the dentist once or twice a year is simple, too.

If you need more treatment to get the smile you want, such as crowns or braces, make this year the year you get it. Too expensive? Don’t assume that you can’t afford treatment. Health insurance, flexible spending and health savings accounts, and payment plans offered by your dentist or orthodontist are some of the options you have.

Remember that tooth, mouth, and bite problems don’t get better with time. In fact, they often get worse if left alone, meaning that what might have been a simple fix is now more invasive and more expensive. So take action now and make a resolution to take care of your smile in 2018!

Mouth pain isn’t just unpleasant, it’s a sign that something’s wrong. That’s why you should never ignore mouth pain, whether you feel it in the tooth, jaw joint, or surrounding muscle. Here are some common types of pain associated with the mouth – and what you can do about it.

Tooth Pain

One common cause of tooth pain is a bite that’s misaligned. A bite that’s off even by a millimeter can lead to tooth pain.

When undergoing orthodontia, this type of pain happens sometimes as the tooth moves from where it was to where it’s supposed to be, and isn’t a cause for concern. Other times, tooth pain from a “bad bite” may indicate that a tooth has moved out of position or that recent dental work has irritated a nerve.

Joint Pain

Joint pain, specifically pain in the jaw joint, or temporomandibular joint (TMJ), can be another indicator of a bad bite.

First, let’s understand what the jaw joint is in order to understand why it can cause pain.

The jaw is made up of two parts, the top part (the temporal bone in the skull) and the bottom part (the mandible). Between these two parts is a disk, made from fibrous connective tissue, which cushions the joint and keeps the bones from grinding together.

If the disk experiences trauma, it can become “wrinkled” and lead to cracking or popping sounds when the jaw opens and closes. For some people, these noises don’t indicate any problem. For others, the cracking and popping may be associated with pain, indicating underlying problems with the joint.

Problems with the jaw joint are called temporomandibular disorder (TMD). It can lead to pain in the joint itself, pain opening or closing the jaw, pain in the surrounding muscle, or a combination of the three.

Muscle Pain

The muscles responsible for chewing and opening and closing the mouth can become inflamed, causing pain. This pain may be short-lived, brought on by excessive chewing in a short period of time (for example, chewing gum for several hours). Or it can be longer-lasting, which is a sign of TMD.

In addition to pain in the muscles themselves, headaches are a common result of inflamed jaw muscles.

What To Do

The tooth pain, joint pain, and muscle pain described above have one thing in common: Bite. By addressing the bite, the underlying problem is fixed and the pain goes away. A bite can be off for years before any pain manifests, but when it does, it needs correction or the problem will only get worse.

Talking to an orthodontist is the best thing to do if you experience mouth pain. It’s also a good idea to talk to an orthodontist if you suffer from unexplained headaches and have already seen your family physician and/or specialists without any relief. Ask to be evaluated for TMD. If you are experiencing TMD, your orthodontist can talk to you about treatment options, which may include anything from massage of the jaw muscles to relieve pain to orthodontia to fix the bite.

Remember that when you feel pain, your body is alerting you that something’s wrong. The good news is that the sooner you know what the underlying problem is, the sooner you can fix it.