All orthodontic patients look forward to the day their braces come off, but even once that day arrives, the work is not quite complete. The final phase then begins: the wearing of the retainer.
Retainers may seem like an afterthought after the heavy lifting of brackets and wires has been done, but using retainers is actually an important step that should be diligently carried out. Neglecting to wear a retainer properly can undo a lot of the work done by braces.
Retainers are removable trays custom-made to fit each patient and meant to be worn for a set period of time after braces are removed. They are normally made of plastic and single wire that goes around the teeth to keep them from shifting. There are also permanent retainers that are affixed to the back of the teeth and can only be installed and removed by a professional.
The purpose of the retainer is to allow the teeth to settle into their new positions. Wearing the retainer holds the teeth in place until the new bone has grown in and the gums have adjusted.
Orthodontists typically recommend a retainer be worn for at least 12 months. In the beginning of this period, it is recommended to wear a retainer at least 12 hours a day, sometimes almost continuously (except when eating) depending on the severity of the problem prior to treatment. The initial phase of using a retainer normally lasts three to six months, after which most patients can cut back to wearing one at nighttime only.
After a year of wearing the retainer, people often stop using them, but in reality, it can be a good idea to wear one three to five times a week for the rest of one’s life. That may be surprising to hear, but remember teeth shift as people age. The occasional use of a retainer can help prevent shifting and maintain your smile.
To clean your retainer, baking soda works well. Make a paste of baking soda and water (distilled or filtered is best), and brush your retainer with your toothbrush. Any time your retainer is not in your mouth, it should be soaking in distilled water. Never allow your retainer to get dried out.
Always keep your retainer in its case when it’s not in your mouth. Do not wrap the retainer in a napkin when you are eating. At our orthodontic office, we’re always molding new retainers that were accidentally thrown in the trash because they were wrapped in a napkin, and they’re not cheap to replace.
And remember, it’s also expensive to redo orthodontic treatment that failed to settle properly because patients didn’t wear retainers as instructed. Keep in mind that retainers are not an afterthought. They’re essential.
Certain nervous habits like twirling your hair or tapping your fingers might annoy your friends, but they’re medically harmless. But when your habits involve your mouth, they can take a toll on your oral health by causing chipping, misalignment, and gingivitis. If you have any of the following habits, you should try to break them. If willpower doesn’t work, look into tricks, devices, or professional assistance to help. Your teeth with thank you.
- Chewing Ice Cubes – After drinking a cool beverage, you might be tempted to chomp on the ice cubes, but this is a bad idea. Chewing on ice cubes can crack and chip your teeth. Teeth were designed for chewing pliable foods, not busting apart hard things.
- Biting your fingernails – Biting your fingernails can eventually lead to chipped teeth and may push them out of position. In addition, unless your hands are washed thoroughly, you might get sick from the germs and bacteria you are ingesting.
- Sucking your thumb – Thumb-sucking is a habit that typically begins in childhood can sometimes be carried into adulthood. It pushes teeth out of alignment and can alter jaw structure, while also introducing germs into the mouth leading to illness.
- Chewing on a pencil – Chewing on wood pencils with metal eraser tips can lead to cracked teeth that require extensive repair. It also causes people to ingest bits of paint and wood that can cause inflammation in oral cavity tissues.
- Teeth grinding at night – Most people who grind their teeth, a disorder called bruxism, do it subconsciously while sleeping. It can cause fractures in teeth, jaw pain, and headaches. If you have facial pain in the morning, ask us to create a dental guard to protect your teeth.
- Opening packages with teeth – If you don’t have a pair of scissors or a knife nearby to open a package, it doesn’t mean that using your teeth is appropriate. This habit can chip tooth enamel and damage dental work.
- Holding items with your teeth – Again, your teeth are not a tool. Don’t use your teeth to hold items such as bobby pins while fixing your hair or nails while hanging a picture on the wall. Even if you make an effort to bite down without much pressure, you can still cause teeth to crack or shift.
- Brushing hard -If you read the package on a new toothbrush, the instructions will probably say to brush gently. Let’s emphasize gently again. Brushing hard won’t remove extra plaque or tartar (a dental cleaning is needed to do that), but it will wear down your gums and tooth enamel.
The website for the National Confectioners Association lists a year’s worth of candy-related holidays. For example, January 3rd is National Chocolate Covered Cherry Day, April 12th is National Licorice Day, and November 7th is National Bittersweet Chocolate with Almonds Day. But watch out! Candy makers are claiming the entire month of June as National Candy Month.
Of course, dentists, orthodontists, and other dental professionals shudder at the thought of National Candy Month. While, it’s OK to have candy now and then, we wouldn’t want anyone to think of June as a month to gorge endlessly on candy, which as you know, can cause tooth decay. So here are five things to consume in order to survive National Candy Month with your teeth intact:
- Fresh fruit
Melons are great during summertime; they’re light, refreshing and very sweet. Select watermelon, cantaloupe, honeydew or others. Or reach for other types of sweet fruit too—oranges and peaches, blueberries and strawberries—you name it. Even the fresh fruits that are higher in sugar such as grapes, bananas, mangoes and cherries are preferable to candy.
- Quality chocolate
The chocolate typically found on candy racks at convenience stores and vending machines contains very little actual cacao, the basic ingredient in chocolate. And this type of mass-market chocolate is high in sugar and saturated fats. It’s not good for your teeth or your body. On the other hand, quality chocolate, which is made from cacao beans, have polyphoneols and tannins which are ingredients that can stop the development of bacteria in the mouth and plaque. Choose dark chocolate without too much sugar to enjoy cacao’s oral and other health benefits.
- Sugar-free options
You can increasingly find sugar-free candy, especially in stores that stock natural and organic foods. These candies may use natural sweeteners like fruit juice or sugar-alternatives like Xylitol which has been shown to inhibit the growth of the oral bacteria that causes cavities. But be careful of the preservatives and other ingredients in sugar-free candies that are acidic, which upsets the pH balance in your mouth and can contribute to tooth decay.
- Snacks that aren’t sweet
Just because the National Confectioners Association says it’s national candy month, you don’t have to buy into their hype. Choose nuts, string cheese, pretzels, or chips. While many snack foods can be classified as junk food and aren’t necessarily good for your teeth, it’s still better for your teeth to avoid junk food with lots of added sugar.
- Your homemade treats
Still crave something sweet? Make them yourself. Look for recipes for granola or muffins. Generally speaking, homemade confections are healthier for you than store bought ones, and you can choose recipes with lower levels of sugar and otherwise have total control over what you’re eating.
Scientists estimate around 70% of people have at least a mild malocclusion, meaning some sort of crooked teeth or misaligned bite. In other words, a perfect bite and smile is the exception rather than the norm. So if you have a “bad” bite, don’t feel bad yourself. You’re in good company after all, and luckily, you live in an age where orthodontic treatment can fix just about any bite problems.
What does an ideal bite look like? The upper teeth should overlap the lower teeth just slightly all around the U-shape of the mouth. If you don’t have that healthy bite, your bite is classified as an overbite, underbite, or crossbite:
As mentioned, a healthy smile has a slight overbite in that the upper teeth will overlap the lower teeth a little. But a bite in which the upper jaw noticeably protrudes beyond the lower jaw is an overbite, or called an overjet when the protrusion passes a certain threshold. Sometimes the overbite is caused by the way the teeth are aligned, and sometimes it’s because of an issue with the overall jaw structure. Overbites, which are a rather common type of malocclusion, can cause speech problems like lisps, difficulty eating, jaw pain, and damage to teeth which leads to tooth decay
Overbites are often corrected by using braces in conjunction with rubber bands or springs that pull the jaw into place over a period of many months. Overbite patients can also be candidates for Invisalign.
Underbites are when the lower teeth protrude beyond the upper teeth. Like with overbites, underbites can lead to jaw pain and the uneven wearing of teeth, eventually causing issues with tooth decay. Likewise, underbites cause the teeth to erode more quickly than normal. About 10% of Americans have underbites, making them not as widespread as overbites but still fairly common.
Underbites are easiest to treat when caught early. Orthodontists often use a palatal expander as a child is growing into a teenager to widen the upper jaw and help it to fit better into the lower jaw. Another device sometimes used is a type of headgear called a reverse pull face mask. In more severe cases, an oral surgeon will break the lower jaw and reset it farther back with medical hardware.
Crossbites, a more complex situation than either overbites or underbites, happen when the upper teeth on one side end up on the inside of the lower teeth when the jaw is closed. Crossbites can cause significant wear on the teeth, leading to gum disease or bone loss. Crossbites may be inherited, but they can also be caused or worsened by poor oral habits like thumbsucking.
As far as orthodontic problems go, crossbites are fairly serious and should be treated young. Often treatments can begin as young as age 7, and early treatment makes the problem easier and less expensive to correct. Various retainers and appliances are used to treat this condition.
These days, you have multiple products to choose from to clean your teeth and maintain good oral health. Do you want the bristles of your toothbrush soft, medium, or hard? And is your toothbrush electric or manual? What types of toothpaste, mouthwash, and dental floss do you prefer?
Having all of these options may seem unnecessary or even a bit silly, but it’s something to be thankful for. Our ancestors, who were without these modern-day conveniences, did their best to keep their mouths healthy using items that would be considered quite strange today.
Take toothbrushes, for instance. Throughout history, many cultures—including ancient Babylonians, Egyptians, and Chinese—used twigs or sticks to clean their teeth. Often, one end of the twig would be frayed into loose strands similar to the bristles on a toothbrush. The other end might be sharpened into a point at the end, not unlike a toothpick. Such “chewing sticks” are still used in many places around the world and are often taken from trees whose material is known (or believed) to have tooth-protecting properties. In some predominately Muslim parts of the world, this stick is known as a miswak and is taken from an arak tree. In Africa, this species of tree (salvador persica) is known as a “toothbrush tree.”
Dental floss also looks a lot different than it once did. There’s speculation among some historians that prehistoric man may have used a type of floss (possibly made from horse hair) for between-teeth cleaning, but nothing conclusive about that has been found. The invention and popularization of modern dental floss is credited to an early 19th century dentist, Dr. Levi Spear Parmly. Dr. Parmly, who lived and practiced in New Orleans, advocated for the use of waxed silk for flossing teeth in his book, A Practical Guide to the Management of Teeth. Though this idea took a while to catch on, by the end of the 19th century many prominent companies of the time—Johnson & Johnson among them—were marketing, packaging, and selling their own varieties of dental floss. The silk used during that time was later replaced by the nylon floss we see today.
Contemporary forms of toothpaste and mouthwash are especially different from what they once were. The ancient Egyptians mixed up their own versions of toothpaste using items as varied as rock salt, spices, honey, herbs, dried flowers, and even goose fat! Toothpastes made just a few hundred years ago utilized burnt bread and soap as key ingredients. A version of mouthwash popular in ancient Greece included olive juice, milk, and vinegar. Elsewhere, rinsing with tortoise blood was done as a way to counteract toothaches.
Many of these methods for maintaining dental health seem laughable to us now, but for many cultures it was all they knew. Modern dentistry has come a long way since then, with technologies and products based on science rather than lore. Maintaining a proper teeth-cleaning routine is certainly a lot more convenient, effective, and tastier than it used to be.
Let’s not forget teeth during National Stress Awareness Month, which comes around every April. Stress is most often associated with conditions like heart attacks, insomnia, and ulcers, but stress can also cause damage to your oral health.
Several oral conditions are often closely linked to stress. Outbreaks of common mouth sores, such as canker sores and fever blisters (cold sores), are thought to be the result of stress, at least in part. Stress may also lead to behaviors that can in turn cause dental problems such as eating sugary foods, failing to brush or floss properly, or chewing on pens, fingernails or other items that will damage your teeth.
Stress can also cause people to grind their teeth, either during the day or while they are asleep. This condition, which is known as bruxism, is one of the most significant dental conditions that stress can bring on. If left untreated, bruxism can lead to a range of problems, including damage to your teeth and dental work, as well as pain throughout your head, neck, jaws, and ears.
If you believe that your oral health is being adversely affected by stress, you should schedule an appointment with your dentist or orthodontist. They might suggest mouth guards, recommend over-the-counter remedies, or prescribe more targeted forms of treatment.
And if you think that stress might be having a negative effect on your overall health and well- being, you don’t have to live life all tense and wound up. There are lots of ways to alleviate stress in your daily life:
- Go for a walk
- Meditate or do yoga
- Do any form of regular exercise
- Take a few deep breaths whenever you feel tense
- Slow down your life and figure out what you can cut out of your schedule
- Structure your cell phone usage so you’re not always connected
- Hang out with friends and family
There are countless other suggestions too. Just find ways to relax that work for you!
The Plaqster has the dreaded monster mouth, but Flossy, Buck McGrinn, Den and General Smiley know what to do to solve Plaqster’s problem. The American Dental Association (ADA) has created these characters to celebrate National Children’s Dental Health Month, which occurs every February to promote good oral health.
It takes work to defeat monster mouth, but McGrinn and Smiley, who like to display their smiles, always remember the code “2min2X” when they brush their teeth for two minutes in the morning and evening, and, like Flossy, floss them once a day. Den wears braces so he is especially careful to take care of his teeth. They are often hungry during the day and need their snacks, but they choose food with little or no sugar, so they won’t get cavities. Instead of lemonade, Coke, or fruit juice, they drink water, milk or sugar-free drinks. Instead of sticky foods (like potato chips and chewy candy) or hard candies and breath mints, they eat cheese, yogurt or fresh fruit.
The American Academy of Pediatrics reports that the number one chronic disease in early childhood is cavities. Cavities are five times more common in early childhood than hay fever. The Centers for Disease Control and Prevention states that more than 40 percent of children have tooth decay by the time they reach kindergarten. The road to oral health therefore begins in infancy when parents should follow these guidelines to prevent tooth decay:
- Wipe the baby’s gums with a soft washcloth after feeding.
- Fill baby bottles with water for naptime or bedtime. Avoid giving your baby juice and other sugary liquids.
- Do not dip a pacifier in anything sweet. Also, break the pacifier habit by age 4 to avoid problems with tooth spacing.
- Encourage your child to drink from a sippy cup by age one.
- Parents should use a soft-bristle toothbrush twice a day on their infant’s baby teeth and should schedule their child’s first dental appointment around the time of his or her first birthday.
Concerns about teeth decay continue, of course, into the school years. The National Education Association (NEA) says that reports show that students miss 51 million hours of school every year because of oral health problems. And children who have experienced recent oral pain are four times more likely than their peers who have had no mouth pain to have lower grade point averages.
In addition to maintaining healthy diets, children need to learn how to take care of their teeth. Parents should follow these recommended steps:
- When you know your children understand not to swallow toothpaste, brush their teeth with a kid’s fluoride toothpaste twice daily.
- Take your children to the drugstore to choose their own toothbrushes.
- Brush your teeth when they are brushing theirs to encourage their efforts.
- Begin flossing their teeth when two teeth touch. Feel free to use floss holders and teach them how to use them.
National Children’s Dental Health Month offers a great opportunity for parents to augment their children’s understanding of the importance of oral health with stories and games. Word games, activity sheets, and other goodies (in English and Spanish) can be downloaded from this link on the American Dental Association’s website. You’ll find more good stuff on this page of the National Education Association web site.