Maybe you had braces as a child, or you are thinking of having your own (it's never too late) or your child's teeth straightened through orthodontia. But how much do you really know about this branch of dentistry? Here are six questions people often ask about orthodontia.

Q. How did the word “orthodontia” originate?
A. From Latin roots meaning “straight” and “teeth”

Q. Teeth are anchored in bone. How is it possible to move them?
A. Living bone is not unchanging. The bone, ligament, and the outer layer of a tooth's root (called cementum) react to the stresses of biting and chewing. Due to this stimulation the bone is constantly being resorbed (broken down) and rebuilt as it is pushed from one side of a tooth and pulled from the other. Under normal conditions, there is a balance resulting in a steady state. Orthodontia takes advantage of this process to slowly change the teeth's position in the desired way.

Q. My dentist talks about the periodontal ligament. What does this mean?
A. The ligament is a fibrous tissue that connects the teeth to their bone and takes part in the dynamic process of resorption and rebuilding of the bone.

Q. What kinds of conditions can orthodontia correct?
A. Treatment can improve the teeth's position and relations to each other (being too crowded or badly spaced) and the way the upper and lower jaws relate. It can enhance the appearance of a person's teeth and face, and can also improve the teeth's function in biting and chewing.

Q. What is the best first step to orthodontic treatment?
A. Talk to your general dentist about your concerns. If you are referred to an orthodontist, the next step is to assess your situation using molds of your teeth that show the way the upper and lower teeth meet (your bite). Special x-rays will be taken to show the locations of your teeth and relation of your upper and lower jaw. Your dental team may also use photographs of your smile and computer imaging to get a clear view of how your teeth are now and how they may be moved.

Q. What are some of the methods of treatment?
A. In the traditional method, small metal brackets are attached to the crowns of the teeth. Thin wires, called arch wires, are strung through attachments on the brackets. These wires are used to apply controlled force to direct the teeth in the desired direction. Another method is to use removable clear plastic aligners. A series of aligners is designed by a computer, to be changed from one to the next as the positions of the teeth slowly change.

Contact us today to schedule an appointment to discuss your questions about braces and orthodontia. You can also learn more by reading the Dear Doctor magazine articles “Moving Teeth with Orthodontics” and “The Magic of Orthodontics.”

If you've lost one or more of your teeth due to tooth decay, trauma, gum disease or a failed root canal, there are a variety of ways that our office can help you to restore your smile and increase your confidence. Crowns, conventional bridges and dentures aren't your only options for replacing missing teeth. Dental implants, surgically placed below the gums, are another alternative for replacing missing teeth.

Getting Started: If you would like to explore the option of having dental implants to replace one or more teeth, you will first need a comprehensive exam. The ideal candidate for implants is in good general and oral health. Adequate bone in your jaw is needed to support an implant. Smokers and those with uncontrolled chronic diseases like diabetes may not be good candidates for dental implants because healing may be impaired or slow. In addition, dental implants aren't appropriate for children or teens until their jaw growth is complete.

The Process: Dental implant surgery can be performed in our office using either a local or general anesthetic. The implants actually replace tooth roots; they are placed into the bone surgically. Generally made of commercially pure titanium, this metal has the remarkable ability to fuse with the bone as it heals forming a union known as osseointegration (“osseo” – bone; “integration” – to fuse with). This process takes two to six months depending upon many factors of which bone quality is the most important.

The next step is to place an abutment (a small connector) which attaches the implant to the crown. The crown is the part of the tooth that is normally seen in the mouth above the gums.

Assessment of your individual situation and deciding if dental implants are right for you takes knowledge and experience. Contact us today to schedule an appointment to discuss any questions you may have regarding dental implants. Read more about this topic in the Dear Doctor magazine article “Dental Implants: Options for Replacing Missing Teeth.”

What is composite resin bonding?
This term refers to a kind of tooth-colored material that is a mixture of a plastic resin and a glass filler. The glass gives the mixture, or composite, strength and translucency that is similar to a natural tooth. The composite is bonded to the tooth by slightly abrading or roughening the tooth so that the resin fills in small cuts in the tooth surface and bonds with it. The end result functions and looks like part of the original tooth.

What is bonding used for?
This technique is a good way to restore chipped or stained teeth or to change a tooth's shape or color. It can also be used to restore parts of a tooth near the gum line where the gums have receded and left the root partially exposed.

What are the advantages of bonding?
Composite resin tooth restorations have several advantages.

• They take only a single dental visit because they are done right in the dental chair rather than having to be sent to a dental lab for preparation.
• They are less expensive than many other dental restorations.
• They leave most of the original tooth intact since little tooth preparation or drilling has to be done in order to make the composite material bond to the tooth.
• They can be made in a wide range of colors and can be matched well with the teeth around them.
• Because little of the original tooth has to be removed, they are a good choice for teens, whose dental arches (upper and lower jaws) are still developing.

What are the disadvantages of bonding?
The composite resin material is not as strong as the original tooth material, so the bonded restorations may not last over a long time. If it does last, the material may also stain as it ages.

When should you choose bonding?
Composite resin bonding is a good choice for a quick and attractive tooth restoration that may be replaced later by something more permanent, such as porcelain veneers.

Contact us today to schedule an appointment to discuss your questions about bonding. You can also learn more by reading the Dear Doctor magazine article “Repairing Chipped Teeth.”

We'd like to take a moment to clarify why it is so important to wear the retainer(s) given to you after your orthodontic treatment. These devices, which literally “retain” your teeth in their new and improved positions, are not just for kids. Anyone who has recently had their teeth moved through orthodontics needs to wear them for the prescribed length of time. Here's why:

Though your teeth may now look perfectly aligned, research has shown that there is no “right” position for your teeth to be in that can assure they don't move again — no matter what age you are when treated for malocclusion (“mal” – bad; “occlusion” – bite). In fact, most people will see changes to their bite and tooth alignment as they get older, with or without orthodontic treatment.

For one thing, there is a natural tendency for bottom front teeth to undergo a gradual “uprighting” with age. This can cause them to crowd as they move toward the tongue. And it happens regardless of whether wisdom teeth are present.

In the case of teeth that have been straightened recently, a type of “memory” of their original position may cause them to drift back to it. This tendency gradually lessens, but it may be a problem for up to 18 months.

That's why it's crucial to follow our instructions for wearing retainers. Keep in mind that the plan we have given you is designed to achieve the best possible results in your individual case. Some people will need to wear retainers 24 hours per day, some just at night, and still others on an as-needed basis. You may have received a removable retainer or one that is secured to the back of your teeth. The important thing is to secure the results you've worked so hard to achieve.

If you have any questions about orthodontic retainers, please contact us, or schedule an appointment for an orthodontic consultation.

You can read more about this topic in the Dear Doctor magazine article “The Importance of Orthodontic Retainers.”

Dental implants are in much demand when it comes to replacing missing teeth. And although they have long-term success rates of well over 95% when properly placed, the dental profession's current rule-of-thumb is to not use them as a treatment option for teenagers because jaw and facial growth are not complete.

As with most things in life, timing can be everything. However, having missing teeth as a teen can contribute to significant loss of self-esteem and psychological issues. All this means is that we must review each patient's needs on a case-by-case basis so that we can determine the optimal time to place implants while maintaining your teen's self-esteem. However, the good news is that there are some temporary tooth replacements available until the timing is right for implants.

Unlike natural teeth, which move and change position along with normal growth and jaw development, implants don't. Because implants replace tooth roots by fusing with the jawbone, their position is fixed. If placed before normal jaw growth and maturity are complete, they appear to sink as the jaws grow and leave them behind!

Given the above details, you can clearly see why it is critical for jaw and facial growth to be complete prior to placing a dental implant. To determine this timeline, we will work with our dental team, which include orthodontists (specialist in the study of the growth, development and moving teeth into the right positions). Working together, we will best be able to assess when the time is right to plan and place dental implants — usually around late teens.

To learn more on this subject, continue reading the Dear Doctor magazine article “Teenagers & Dental Implants.” You can also contact us today to schedule an appointment for your teenager or to discuss your questions about dental implants or other treatment options.