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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.

2. 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.

3. 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.

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.

2. 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.

3. 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.

4. 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!

5. 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!

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.

2. 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.

3. 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!

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.

2. 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.

3. 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.

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.

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

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.

Orthodontic treatment is an investment in health, self-confidence, and the future. It’s a significant monetary investment as well. After doing all the research and asking all the questions to find the right orthodontic provider, navigating the payment arrangements comes next. Think braces.

Now more than ever, do your due diligence to save money where possible.

Insurance

Approximately 50 percent of those seeking orthodontic treatment do not have coverage. If you have orthodontic insurance, congratulations!

A few tips for getting the most benefit from your orthodontic insurance:

• Some insurance policies require a one-year waiting period, so you may have to sign up now for benefits next year
• If you may be interested in orthodontics in the future, get a free exam and check with your insurance supplier about coverage as soon as possible
• Beware of DHMO insurances.  Although these may look good at first glance and provide little out-of-pocket expense for treatment, they pay very little to the doctor.  This virtually guarantees you will receive lower quality materials and cost-cutting measures, which could provide a less-than-ideal result or experience.  All braces and all doctors are not created equal, so be sure to do your homework if you are looking at an office that accepts DHMO insurance for treatment.
• Find the doctor you like because, for almost all orthodontic insurance, you will still get the same insurance benefit for in- or out-of-network doctors
• Ask your orthodontist for a complimentary benefits check

Flexible Spending and Health Savings Accounts

FSAs and HSAs allow the use of pretax dollars for qualified health-care expenses, which include orthodontics. Both types of accounts are a significant tax advantage and can be the most powerful way to save money on orthodontic treatment.

A few things to remember:

• FSA funds expire each year, so pay attention to your company’s deadlines
• Most companies require you to let them know ahead of time how much you would like to set aside
• If your employer does not provide access to an FSA account, ask a financial planner if you can participate in an HSA account.  These accounts actually allow you to save significantly more money per year toward health care expenses and also do not expire at the end of each year.
• Know your enrollment periods; failing to sign up in time could cost you significantly more in after-tax dollars to pay for your treatment

Flexible Financing

Most offices will offer several options to pay for treatment, which may include:

1. Paying in full to receive a certain percentage off
2. Making a down payment and taking on one to two years of monthly payments
3. Opting for an extended financing plan

Avoid Hidden Fees

If you opt for an extended financing plan, watch for missed payment fees or surprise charges. You also shouldn’t need to pay higher than a 7 or 8 percent APR for an extended payment plan. Shorter payment plans are available with a 0 percent APR.

When comparing orthodontists’ prices, look closely at the cheapest. Many offices offer low prices up front but hit you with fees later in treatment, making the total cost much higher. Fees for broken brackets, missed appointments, and cancellations and extra charges for retainers and the like can dramatically increase your total cost.  Also, it is safe to assume that cheaper treatment fees are made possible by cheaper materials, lesser trained orthodontic team members, and other cost-cutting.

Also beware of any office that charges additional monthly fees after a certain point. For example, many lower-priced offices will charge extra if treatment extends beyond twenty-four months—creating an incentive for them to keep your braces on longer.

Fixing Bad Treatment

Not all braces are not created equal. Many cheap braces are made of cheap metals and lower-grade metals are much more likely to create irritation and sensitivity in patients.  Cutting corners in manufacturing makes braces inconsistent in their dimension which makes treatment take longer or will compromise the quality of the results.

Consider quality while shopping because the cheapest orthodontic treatment in town may come with a significant hidden cost in dollars, time, comfort, and your end-results.

The time, energy, and dollars you are spending for dental health, a new smile, and a healthy bite are investments that should last a lifetime. Use insurance, spending/savings accounts, flexible financing, while wisely avoiding hidden fees and the cost of fixing bad treatment, to maximize your investment.

When is the right time to start orthodontic treatment? The best timing for treatment varies for every person. These four questions will help determine a good timeframe for you or your loved one.

Do You Have a “Bad Bite”?

Orthodontic treatment not only moves crooked teeth so they are beautiful and straight, it corrects major bite problems. Although “bad bites” can seem subtle, and may not present noticeable symptoms, a bite that doesn’t fit well together can result in long-term consequences. A few symptoms of bite problems are:

• Tooth Pain – When it comes to your bite, even a fraction of a millimeter can irritate a nerve and cause tooth pain.
• TMJ Pain – If you have a hard time opening your mouth or have significant pain during jaw movement, you may have TMJ problems.
• Muscular pain –Headaches with an unexplainable source may be caused by bite issues.
• Tooth wear – Significant wear can occur if teeth do not fit together properly.
• Gum wear – If your bite is off, the gums and supporting bone can prematurely wear.

Prevention by correcting your bite early is the best option. Even if these symptoms are not present now, your bite is something that can be off for a while and not cause a lot of problems—until it does. Dealing with bite issues proactively is much less painful, may take less effort, and can be less expensive than dealing with bite problems later.

What is Your Sleep Like?

Sleep apnea is catching the attention of more and more medical professionals. Sleep apnea is a condition in which a person will temporarily stop breathing while he or she is sleeping. Repetitive bouts of not breathing, called episodes, can cause serious health problems. Sleep apnea left untreated over time is now believed to be a significant factor in premature death as well as many other health issues.

There are several types of sleep apnea, the most common and most treatable being obstructive sleep apnea, or OSA. A very common symptom of OSA is snoring. If snoring is present with repeated bouts during which it appears the person is holding his or her breath, seek an evaluation for obstructive sleep apnea. An expander can be a very effective, and sometimes life-changing, treatment for obstructive sleep apnea.

How Many Teeth Do You Have?

The correct number of teeth for an adult is thirty-two, and it is not unusual for people to have missing or extra teeth. Both the presence and absence of the correct number of permanent teeth are important factors in orthodontic treatment.

Missing or extra teeth are often diagnosed for the first time in the orthodontist’s office.

X-rays used by general dentists do not provide as wide of view as a panoramic x-ray or a 3-D cone-beam computed tomography scan (CBCT) used at the orthodontist.

Having extra teeth causes the other teeth to develop out of place and often leads to crowding, rotations, and impacted teeth. Because extra teeth can cause lots of unwanted trouble, early screening is key. Two-phase treatment is oftentimes necessary to undo the issues caused by extra teeth.

Missing teeth are more common than extra teeth. While it is very important to identify that teeth are missing, treatment is typically not initiated until all other permanent teeth have grown in. The management of missing teeth is a difficult and complicated topic, so early identification and management will help with developing an appropriate treatment plan to achieve the best results.

How Old Are You?

If you have young children, I recommended having them screened at age seven or eight so an orthodontist can look for some of these problems that require early intervention. Most of the time, your child will be told to wait until they are older to start treatment. But, some may have the above-mentioned problems calling for earlier help.

If you are an adult considering orthodontic treatment, it is never too late. More and more adults are seeking orthodontic treatment to help create the smiles they have always dreamed of. And, fortunately, modern orthodontics offer many cosmetic options.

Choosing the best orthodontic provider, office and treatment plan for you or your loved ones can be a difficult decision. With an infinite amount of information available to consumers at the click of a button, the choices of care are endless. One Google search may leave your head spinning.

Here are the five things you need to do when visiting an orthodontist and considering treatment:

1. Check their credentials and experience.
   It takes years of training to be able to treat orthodontic cases well. It’s important to find a provider who consistently and continually—over the course of years, not days or weekends—pursues education and training.  A qualified provider will have gone through a full-time, accredited residency. They will provide the highest possible level of orthodontic care. During your visit, ask to look at before-and-after photos. Most doctors who have treated many cases will keep books of before-and-after photos and can show you photos of cases like yours. The goal is to determine the training level of your future orthodontic provider.
2. Pay close attention to the numbers.
   It may not be wise to choose the cheapest provider out there, but it is important to analyze the cost of treatment.
   Most offices will offer several payment options, so make sure to ask the office manager about flexible financing. If you’re able to pay in full, you’ll typically save a small percentage. If you choose to make a down payment and take on one to two years of monthly payments, watch for surprise charges for missing a payment.
   Be wary of other hidden fees. Many offices offer low prices up front but hit you with fees later in treatment, making the total cost much higher. Fees for broken brackets, missed appointments, and cancellations and extra charges for retainers and the like can dramatically increase your total cost.
3. Ask more about their treatment plan.
   In addition to straightening crooked teeth, the treatment plan should be focused on correcting your bite. Many patients, and unfortunately many dental providers, do not have a concept of how important the bite is to overall dental health. If you have crooked teeth, you likely also have a bite problem, and you will benefit greatly from having any bite problems corrected. You may not notice an issue now but, sooner or later, unnoticed bite problems will catch up with you. Although “bad bites” can seem subtle, and may not present noticeable symptoms, a bite that doesn’t fit well together can result in long-term consequences like tooth pain, TMJ, muscular pain, tooth wear, and gum wear.
   When talking about their treatment plan, if your doctor recommends pulling any permanent teeth, you should seek to understand why and if there is a better option. Removal of permanent teeth is more of a last resort than a treatment of choice. And, unless this is a “last resort” case, a doctor may be recommending extractions when modern orthodontic techniques could treat equally or better, without removing your permanent teeth.
4. Get a second opinion before you start treatment.
   When shopping for an orthodontist, many people think they are all exactly alike, but they absolutely are not.  There are different levels of skill, commitment, and expertise and there is a spectrum of orthodontic cases, from simple all the way to very, very difficult. Not all doctors are created equal. Most orthodontic exams are free, all you invest in a second opinion is your time, so it is wise to get a second opinion. Once you have visited several orthodontic specialists and get opinions that are consistent, chances are that the treatment plan is in your best interest.
5. Most importantly, use your gut!
   Orthodontic treatment doesn’t have to be a scary or unpleasant experience. In fact, I believe it can be fun! Look for personal touches, a helpful staff, and a well-run office to see how much they truly care about making your experience special. Each visit should leave you with something to smile about.