Smiles

The real breakthrough in clear aligner therapy came from a very unlikely source. In the late ’90s, two Stanford grad students, Zia Chiisti and Kelsey Worth, determined that there had to be a better way to move teeth other than braces. They posited that a multiple series of clear aligners, over an extended period of time, could effect a significant amount of tooth movement—similar to what could be achieved with fixed appliances. After raising a large amount of venture capitol, Align Technology was born. In 1999, Invisalign was launched to the public after being approved by the FDA the prior year. At first, orthodontists were very resistant to adopting Invisalign because the founders had no orthodontic credentials or expertise. However, Invisalign quickly became popular with consumers and the dental community had to take notice.

Chipping or wear of teeth: Healthy, well functioning teeth do not exhibit damage and deterioration with normal use. Teeth will wear if there is parafunctional activity such as daytime clenching or nighttime grinding. Daytime clenching can be stopped through heightened awareness (reminding one’s self not to clench) while teeth can be protected at night with the use of a nightguard. Teeth will also wear if they are not in a favorable position. Examples include teeth in crossbite or an edge-to-edge bite. The best option is to move the teeth into their proper position via orthodontic treatment. It can become very expensive to repair worn teeth. Furthermore, shortened teeth are very unaesthetic.

Accelerated movement of teeth: Most of us will experience some tooth movement throughout our lifetime. A bigger concern is when teeth appear to displace at an accelerated rate. This is typically seen in the lower arch—in particular with the incisors. Commonly, one or more of the mandibular incisors will begin to move either outward or inward, then the shifting incisor will then cross over an adjacent tooth. If you notice movement of your teeth, see an orthodontist for either a retainer (to stop the movement) or for retreatment with Invisalign. If crowding becomes too great, it may require the extraction of a tooth in order to achieve ideal alignment.

Increased gum recession: Gum recession under any circumstance is a sign of gingival distress and/or an unhealthy oral environment. Proper home care and regular dental check ups will minimize gum loss and maintain optimal gingival health. Remember, the gums or gingiva are the covering for the important bony housing of the roots of the teeth. Therefore, gum recession = bone loss. And too much bone resorption puts one’s tooth or teeth at risk for increased mobility and possible loss. It is especially important to catch gum recession early on, because once the recession develops, it cannot be easily repaired—even with a graft. Rapid gum recession is usually due to different reasons than poor oral hygiene. Possible causes include overly aggressive tooth brushing (especially with a stiff bristled toothbrush), a high frenum attachment, traumatic occlusion (teeth coming into early contact) or teeth in crossbite (usually seen when a lower incisor is displaced forward). Tooth related issues that are causing recession can be addressed with orthodontic intervention.

Palatal Impingement: Palatal impingement is when the incisal (top) edges of the lower incisors bite into the palatal tissue behind the upper incisors. This is the most severe form of vertical overbite. Over time, damage to the gum tissue in the palate can cause stripping of the gingiva, which may ultimately result in loss of the upper front teeth. It can also be very uncomfortable or painful—the tissue directly behind the maxillary central incisors is very sensitive. This tissue is called the incisive papilla and can easily become irritated or inflamed with trauma (think pizza burn). Since palatal impingement involves a significant overlap of the front teeth, the other consequences of the “deep bite” are wear on the anterior teeth and lower incisor crowding. This situation can be temporarily corrected with a retainer (to protect the palate) or more permanently with orthodontic intervention.

Abractions: Abractions are a dental term for teeth that lose tooth structure where the teeth and gum come together (along the gum line). The damage is typically wedge or “V”-shaped and is not related to cavities, bacteria or infection. One usually notices abfractions when food begins to get caught in the wedge or the teeth develop sensitivity to hot and cold. Over time, the loss of enamel can make the teeth vulnerable to tooth decay and ultimately affect their structural integrity. Abfractions are due to long-term stress on the teeth and common causes are bruxing (teeth grinding), mal-aligned teeth (especially tipped-in posterior teeth), acid reflux, eating disorders or dry mouth. Options for treatment include fillings, a mouthguard (if bruxing), special toothpaste (like Sensodyne for sensitivity) and orthodontics that can be helpful if the occlusion is the cause of the abfractions.

Discoloration of teeth: Unfortunately, teeth generally darken or yellow with age. This is due to the fact that enamel thins, dentin (yellow inner layer) thickens and translucency diminishes. Other factors that darken teeth are environmental such as smoking, eating certain foods and drinking red wine/coffee and taking some medications. A bigger concern is when a tooth suddenly changes color with or without associated pain. This situation is uncommon but not rare. It usually occurs when the tooth has had trauma and it is the result of the tooth “dying”. It may happen shortly after the trauma or quite some time later — long after the injury. The tooth likely will need to have a root canal to remove the infected nerve. If there is a crack in the root from the trauma, the tooth may need to be removed and an implant placed.

Now, where does the pain or joint noise come from? The pain can come from different sources, but the two common culprits are the muscles and jaw joints. Muscular pain can be due to overstimulation of the jaw closing muscles of which there are 2 primary muscles: the masseter and temporalis. The masseter muscle is the muscle you feel when you press on your cheek, and the temporalis is the muscle by your temple that extends back behind your ear. The other source of pain can come from your joint. This can be due to a forward disc position where the condylar head is touching the tissue behind the disc, which is more highly innervated. The pain can also arise from a degenerative change in the joint due to arthritis or injury. As per noise, this is typically due to the disc being displaced forward when opening then popping back into place as the jaw is shifted.

If you have questions about the benefits of Invisalign treatment, please call Visage Orthodontics to schedule a visit with Dr. Tanner, your Santa Fe Invisalign specialist. Dr. Tanner will review everything in detail and develop a customized treatment plan to fit your lifestyle and budget.

A confident and beautiful smile is right around the corner!

What makes a smile beautiful? Most of us agree that it starts with straight white teeth. But lets take a deeper dive into some of the more subtle and perhaps not-so-subtle factors that can enhance or detract from the beauty of a smile:

• Lip support

• Smile width

• Smile arc

• Gingival display

• Dental symmetry

Lip support: Our teeth play a very important role in how much support they provide our lips. When teeth are properly positioned, the lips are able to gently touch without straining when we close our mouth. Sometimes, teeth can be positioned too far forward (either with or without crowding), and the result is lip incompetence. As the lips are closed, the mentalis muscle strains and flattens the chin, making the profile look more convex. In this situation, teeth need to be extracted as part of orthodontic care in order to reduce the protrusion and relax the lip posture.

Smile width: The width of one’s smile can have a big influence on facial esthetics. The buccal corridor is the dark space between the teeth and the corners of the mouth. This dark space is essential in creating a visual contrast with the white of your teeth and also helps your smile look balanced. Too much space in the buccal corridor can make it look like you’re missing teeth; but if you don’t have enough space, your smile can look toothy and full. Many people have inward collapse of their back teeth, and orthodontic uprighting can significantly enhance the smile while alleviating any crowding.

Smile Arc: The smile arc is the curve of your teeth. Ideally, the line of your teeth—which is defined by both the incisal edge and gum line—should create a slight upward curve that narrows as it recedes into the buccal corridor. A harmonious smile arc also follows the curvature of the lower lip. 100% of the upper front teeth should be revealed along with a small amount of the gums upon full smile. In addition, the incisal edges of the lateral incisors should be .5mm shorter than the central incisors to avoid the “picket fence” look of the front teeth.

Glnglval display: How much gum you show has a significant effect on how attractive your smile is. Many times, upper front teeth over-erupt, pulling the gums down with them. This results in excessive gingival display or a “gummy smile”. Orthodontically intruding or lifting up these teeth can establish the proper amount of gum upon smiling. There can also be situations where a single tooth has an uneven gingival margin due to over-eruption, and proper positioning can create a more uniform gingival display.

Dental symmetry: The symmetry of the smile is the last important factor. Before getting his teeth fixed, many people recognized that Tom Cruise had an issue with his smile—his upper midline was significantly off relative to the middle of his face. This type of situation can happen even when teeth are straight and is likely due to a shift of the dentition from a single missing tooth. Another factor that plays into a harmonious smile is the level or tip of the respective dental arches. If one side of the arch is up or down relative to the opposite side, this can make the smile appear crooked or imbalanced. Lastly, if an arch has a tooth or teeth that are dramatically undersized (typically upper lateral incisors), the symmetry of the smile is lost. In this case, small spaces need to be opened next to the undersized teeth so that they can be restored to their proper dimension post orthodontic treatment.

There are so many factors to consider when setting up a case for success with orthodontics—it is not as simple as just straightening teeth. Treatment planning for a beautiful smile takes into consideration moving teeth to enhance lip posture, facial esthetics and gingival response to achieve a harmonious and attractive outcome. Choose an expert to help make those decisions!

What conditions can be linked to poor oral health?

• Cardiovascular disease: Some research suggests that heart disease, clogged arteries and stroke might be linked to the inflammation and infections that oral bacteria can

• Endocardltls: This infection of the inner lining of your heart chambers or valves (endocardium) typically occurs when bacteria or other germs from another part of your body, such as your mouth, spread through your bloodstream and attach to certain areas in your heart

• Pregnancy and birth complications: Periodontitis has been linked to premature birth and low birth weight

• Pneumonia: Certain bacteria in your mouth can be pulled into your lungs, causing pneumonia and other respiratory diseases

https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/dental/art-20047475

Pretty scary!!!

Okay…What can be done to maintain optimal oral health?

Here are 5 keys to ensure that your mouth and oral cavity are in tiptop shape and that you are winning the war against harmful bacteria:

1 – Maintain a regular routine with your oral home care.

Be sure to brush at least twice a day and floss once a day. Flossing is critical step that should not be skipped. A toothbrush cannot get the surfaces where your teeth touch one another–it is only effective cleaning the front and back sides of your teeth. Floss allows the food not only to be removed between the teeth but also below the gum line. It cannot be emphasized enough the importance of flossing! Here is a handy tip: floss before brushing. It is the most effective way to remove all the food and plaque.

2 – See your dentist at least twice a year for a dental check-up and teeth cleaning.

Twice a year visits are a general guideline–there are many patients who benefit from cleanings 3 to 4 times per year. These patients build tartar at a faster rate than the average person, no matter how meticulous they are cleaning their teeth (or they just may not be good brushers and need extra help). In addition, seeing a dentist on a regular basis can nip problems in the bud, which ultimately prevents the progression of minor problems to more severe issues like periodontitis or tooth decay.

3 – Be mindful what you eat.

Food and drink that contain a lot of sugar can be real culprits for tooth decay. In addition, sticky (starchy) foods and foods/drinks that are highly acidic can also damage your teeth. Examples of foods and drinks to avoid or limit are: sour candies, taffy, caramels, bread, crackers, potato chips, carbonated drinks, dried fruits, pickles, citrus fruit, and high carb sports drinks. One good option is to clean your teeth immediately after eating or drinking one of these items, or at a minimum, rinse vigorously with water. On the flip side of the coin, what foods help clean your teeth? Think fibrous fruits and vegetables like apples, celery and carrots, which scrub your teeth. In addition, eating berries (blueberries, cranberries and raspberries) that contain anthocyanin, can prevent the attachment and colonization of bacteria in the mouth.

4 – Avoid bad habits that are harmful to the oral cavity.

Cigarette .5.ID.9.king. pipe smoking, chewing tobacco and vaping are not only bad for your health but are also damaging to oral structures. Did you know that a smoker has three to six times the risk for gum disease as a nonsmoker? Smoking and chewing tobacco weakens your immune system and makes it harder for the gums to heal. In addition, smokers are at a much higher risk to develop oral cancer. Here is a scary fact: 90% of people who have cancer of the mouth, tongue, lips or throat used tobacco. Besides, smoking makes your teeth yellow and causes bad breath–yuck!

5 – Straighten your teeth!

Crooked teeth are much more difficult to keep clean and thus maintain optimal dental and periodontal health. In addition, the bony support that encapsulates the roots of the teeth can be compromised when teeth are out of position leading to unfavorable occlusal forces and potential bone loss. Investing in lnvisalign to straighten your teeth can benefit not only your oral health but also the health of your body!

Now, let’s assume the teeth are straight and it is the color of the teeth that is the concern. What can be done? It is important to understand the root cause of the discoloration. There are two different types of staining of our teeth – extrinsic (on the surface of the tooth) and intrinsic (within the internal portion of the tooth). Extrinsic stains are caused by our environment – what we eat, if we smoke or chew tobacco and how well we take care of our teeth. Intrinsic staining is more complex – there can be hereditary component, an age component and certain drug interactions (tetracycline staining and fluorosis).

If you have questions about the benefits of Invisalign treatment, please call Visage Orthodontics to schedule a visit with Dr. Tanner, your Santa Fe Invisalign specialist. Dr. Tanner will review everything in detail and develop a customized treatment plan to fit your lifestyle and budget.

A confident and beautiful smile is right around the corner!

Perhaps a shallow dive into the research on retention will shed a little more light as to what has been discovered about tooth movement following orthodontic treatment:

• There is not a direct correlation between impacting wisdom teeth and the crowding of lower incisors.

• Malocclusions that started with spacing between the teeth have just as much chance to relapse (i.e. spaces returning) as teeth that were crowded.

• Expansion or flaring of front teeth during orthodontics showed a greater chance of relapsing after the completion of treatment

• Unwanted tooth movement also occurs as a result of the normal aging process. These changes include the deterioration of the alignment of the anterior teeth

• It is difficult to predict which orthodontic cases will exhibit relapse therefore every case should be treated on the basis that relapse will occur and that life-long retention is required

• Even with the best of retention protocols, most orthodontic cases will exhibit some movement (5 to 10%) of the teeth

If you have questions about the benefits of Invisalign treatment, please call Visage Orthodontics to schedule a visit with Dr. Tanner, your Santa Fe Invisalign specialist. Dr. Tanner will review everything in detail and develop a customized treatment plan to fit your lifestyle and budget.

A confident and beautiful smile is right around the corner!

So, why do most of us experience crowding of our teeth at some point in our lives?
The answer to this question can be both simple and complex – intertwining evolution, heredity, and environment.

The prevalence of dental crowding in the US population is estimated at 66%. Interestingly, an analysis of human skulls from 10,000+ years ago shows almost no evidence of crowding or impacted teeth – including those pesky wisdom teeth. Why the difference between then and now? The reason for these ideal prehistoric arches is due to the diet of the cavemen.

Early humans needed powerful jaw muscles and consequently large jaws to masticate their raw food. Also, the course diet caused teeth (in their respective arches) to wear against one another thus negating crowding with age. Over the millennia, tools were introduced, hunter-gathers shifted toward an agrarian society and diets became softer. The need for powerful jaw muscles diminished and jaw size shrank – unfortunately, tooth size stayed about the same. As a result, the prevalence of crowding began to increase. This trend continues today with our modern society and our processed food.

No wonder most of us don’t have enough room for our wisdom teeth!

In addition to this evolutionary trend, a large factor that plays into whether we as individuals have crowded teeth is the role of genetics. Both tooth size and jaw size are inheritable traits. Our parents contribute genetic material that influences how large our teeth will be and the size of our jaws. In the worst-case scenario, one parent passes along the gene for large teeth while the other parent passes along the gene for small jaws. The result: Lots and lots of crowding! In a situation like this, the normal complement of 32 teeth must be reduced to 24 teeth (by extracting the first bicuspids and third molars) to accommodate the remaining teeth.

Thank goodness for orthodontics!

One question that always comes up in regards to crowding is the role of third molars. Especially since many of us have perfectly straight teeth until our late teens or early twenties. A significant number of studies have been done on the correlation between wisdom teeth and crowding. A systematic review of the literature published in The Scientific World Journal showed that third molars are not the culprit in lower anterior crowding. So what is going on? Over time, there are subtle changes that occur which collectively result in a breakdown of the alignment of the teeth. Most changes begin in the lower arch and ultimately show up in the upper arch since the lower arch can act as a mold or “retainer” for the upper arch. Typically what happens with age is that the lower arch narrows especially by the canines, the lower molars slowly move forward and the arch length decreases. With these movements, something has to give and it usually starts with crowding of the lower incisors.

All hope is not lost! If you are a parent of a young child, be proactive and have the dentist monitor your child’s dental development. Don’t be afraid to seek an orthodontic evaluation if you have concerns. You don’t need a referral and exams are complimentary. If you have already been through orthodontic treatment – keep wearing your retainers. Remember, it is a lifetime commitment if you want to keep your teeth straight. If you are an adult and experiencing shifting of your teeth, don’t wait – the crowding will only worsen with time.