ortho 2.14 tier 3

The best way to ensure a clean and healthy smile are brushing and flossing. Food particles can accumulate on teeth and in braces, and over time turn into plaque. The bacteria that results from this accumulation can lead to gum disease, tooth decay, and even loss of teeth. To avoid these problems while you are in orthodontic treatment, take special care of your braces, teeth, and gums to ensure you will have the best possible result.

BRUSHING

Use a toothbrush with soft bristles and a small strip of fluoride toothpaste. When you brush your teeth, move the brush in small, circular motions to reach food particles that may be under your gum line. Hold the toothbrush at an angle and brush slowly and carefully, covering all areas between teeth, between braces, and the surface of each tooth. It will take you several minutes to thoroughly brush your teeth. Brush up on the lower teeth, down on the upper teeth, and the outside, inside, and chewing surface of your front and back teeth. Brush your tongue and the roof of your mouth before you rinse.

Especially during orthodontic treatment, brush your teeth four times daily to avoid the accumulation of food particles in your teeth and braces:

In the morning after breakfast
After lunch or right after school
After supper
At bedtime
You will need to replace your toothbrush more often due to your appliances. As soon as the bristles start to wear down or fray, replace your toothbrush with a new one. It may be difficult for your toothbrush to reach some areas under your archwire. Do not swallow any toothpaste; rinse your mouth thoroughly with water after you finish brushing. It is important to floss and use an antibacterial mouthwash and fluoride treatment throughout your orthodontic treatment and beyond for optimal oral hygiene.
FLOSSING

For areas between the teeth that a toothbrush can’t reach, use dental floss to remove food particles and plaque. Flossing takes more time and patience when you are wearing braces, but it is important to floss your teeth every day.

Use the reuseable floss threader provided by our office to floss under your archwire daily. Pull a small length of floss from the dispenser through the threader and slide it up and down along the front of each tooth. You will be able to feel when the tooth is clean and hear the squeak of the floss against your clean teeth. Use care around your archwire and do not floss too forcefully around it or put too much pressure on it. After you floss between your archwire and braces, floss between your other teeth and gums.

If you are flossing without the floss threader, pull a small length of floss from the dispenser. Wrap the ends of the floss tightly around your middle fingers. Guide the floss between all teeth to the gum line, pulling out food particles or plaque. Unwrap clean floss from around your fingers as you go, so that you have used the floss from beginning to end when you finish. Floss behind all of your back teeth.

Floss at night to make sure your teeth are clean before you go to bed. When you first begin flossing around your braces, your gums may bleed a little. If the bleeding does not go away after the first few times, inform a staff member at your next appointment.
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1. Is it required that my family dentist schedule my appointment with the orthodontist?
2. At what age should I schedule an appointment for an orthodontic screening?
3. Will my teeth straighten out as they grow?
4. How do I schedule an appointment for an initial exam?
5. What will happen at the initial examination appointment?
6. What will I learn from the initial examination?
7. Will I need to have teeth extracted for braces?
8. How long will it take to complete treatment?
9. How much will braces cost? Are financing options available? How does my insurance work?
10. How often will I have appointments?
11. Can I schedule all of my appointments after school?
12. Can I drop my child off for an appointment?
13. Do braces hurt?
14. Can I return to school the day I receive my braces?
15. Do you give shots?
16. Do you use recycled braces?
17. Can I still play sports?
18. Do I need to see my family dentist while in braces?
19. Are there foods I cannot eat while I have braces?
20. How often should I brush my teeth while in braces?
21. What is an emergency appointment? How are those handled?
22. Can orthodontic correction occur while a child has baby teeth?
23. What is Phase One (early) Treatment?
24. Will my child need full braces if he/she has Phase One treatment?
25. Will my child need an expander?
26. Is it too late to have braces if I am already an adult?
27. Can I wear braces even though I have crowns and missing teeth?
28. Why should you choose an orthodontic specialist?

1. Is it required that my family dentist schedule my appointment with the orthodontist?
No, it is not. Many of our patients are referred by their family dentist, yet many other patients take the initiative to schedule an examination themselves.
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2. At what age should I schedule an appointment for an orthodontic screening?
The American Association of Orthodontists recommends an orthodontic screening at age 7. By this age, several permanent teeth in most children have erupted allowing us to effectively evaluate your orthodontic condition.
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3. Will my teeth straighten out as they grow?
No, they will not. The space available for the front teeth does not increase as you grow. In most people, after the permanent molars erupt, the space available for the front teeth decreases with age.
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4. How do I schedule an appointment for an initial exam?
If you or your child can potentially benefit from orthodontic treatment, simply call our office, send us an e-mail, or fill out our appointment request form online. We will be happy to schedule an appointment for you. When you call to schedule your appointment, our front office staff will request some basic information from you.
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5. What will happen at the initial examination appointment?
Upon arriving, each patient and parent will be seen by the staff and doctor who will acclimate you to our office and prepare for the initial exam. We will take the necessary photographs and x-rays to allow us to make a proper diagnosis. The doctor will then complete a brief, but thorough, exam.

To read more about your first visit, see our First Visit Page.
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6. What will I learn from the initial examination?
There are five essential questions that we will cover during the initial examination:

· Is there an orthodontic problem and if so, what is it?
· What must be done to correct the problem?
· Will any teeth need to be removed?
· How long will the treatment take to complete?
· How much will the treatment cost?
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7. Will I need to have teeth extracted for braces?
Removing teeth is sometimes required to achieve the best orthodontic result. Straight teeth and a balanced facial profile are the goal of orthodontics. However, because new technology has provided advanced orthodontic procedures, removing teeth is not always necessary for orthodontic treatment.
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8. How long will it take to complete treatment?
Treatment time obviously depends on each patient’s specific orthodontic problem. In general, treatment times range from 12 to 30 months. The “average” time frame a person is in braces is approximately 22 months.
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9. How much will braces cost? Are financing options available? How does my insurance work?
It is impossible to give an exact cost for treatment until we have examined you. We will cover the exact cost and financial options during the initial examination. We have many financing options available to accommodate your needs, and we will review these with you. We will also review your insurance policy, and help to maximize your benefit and file your claims.
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10. How often will I have appointments?
Appointments are scheduled according to each patient’s needs. Most patients in braces will be seen every 5 to 10 weeks. If there are specific situations that require more frequent monitoring, we will schedule appointments accordingly.
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11. Can I schedule all of my appointments after school?
Unfortunately, we cannot schedule all appointments for students during after-school hours. However, because most appointments are scheduled 5 to 10 weeks apart, most patients will miss minimal school due to their orthodontic treatments. We will, however, make a sincere effort to meet your scheduling needs.
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12. Can I drop my child off for an appointment?
Yes. We understand your busy schedule, and we are happy to help you make the most of your time. On some occasions, we may request to speak with a parent when they return, so we ask that parents check in with their patient manager before dropping off their child.
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13. Do braces hurt?
Generally, braces do not “hurt.” After certain visits, teeth may be sore for a few days. In these situations, pain medications such as Advil or Tylenol will ease the discomfort. However, after most visits, patients do not feel any soreness at all! We often remind our patients, “It does not have to hurt to work!”
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14. Can I return to school the day I receive my braces?
Yes. There is no reason to miss school because of an orthodontic appointment.
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15. Do you give shots?
No. Shots are not necessary in orthodontic treatment.
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16. Do you use recycled braces?
Absolutely not! It is our belief that each patient should be provided with their own braces to achieve the best orthodontic result possible.
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17. Can I still play sports?
Yes. We recommend a mouth guard for all sports.
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18. Do I need to see my family dentist while in braces?
Yes! Regular checkups with your family dentist are important while in braces. Your family dentist will determine the intervals between cleaning appointments while you are in braces.
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19. Are there foods I cannot eat while I have braces?
Yes. Once treatment begins, we will explain the complete instructions and provide a comprehensive list of foods to avoid. Some of those foods include: ice, hard candy, raw vegetables and all sticky foods (i.e. caramel and taffy). You can avoid most emergency appointments to repair broken or damaged braces by carefully following our instructions.
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20. How often should I brush my teeth while in braces?
Patients should brush their teeth at least four times each day: after each meal and before going to bed. We will show each patient how to floss their teeth with braces, and may also provide a prescription for a special fluoride if necessary.
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21. What is an emergency appointment? How are those handled?
If your braces are causing extreme pain, or if something breaks, you should call our office. In most cases we can address these issues over the telephone. If you require an emergency appointment, we will set aside time for you.
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22. Can orthodontic correction occur while a child has baby teeth?
Yes. Some orthodontic problems are significant enough to require early intervention. However, if a patient is not yet ready for treatment, we will follow that patient’s growth and development until the time is right for treatment to begin.
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23. What is Phase One (early) Treatment?
Phase One treatment, if necessary, is usually initiated on children between the ages of 7 and 10. Phase One treatment lasts about 12-21 months. The primary objective for Phase One treatment is to address significant problems to prevent them from becoming more severe, and to improve self-esteem and self-image.
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24. Will my child need full braces if he/she has Phase One treatment?
It is best to assume that your child will need full braces even after Phase One treatment. The period following Phase One treatment is called the “resting period,” during which growth and tooth eruption are closely monitored. Throughout this period, parents and patients will be kept informed of future treatment recommendations.
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25. Will my child need an expander?
At the completion of the initial examination, we will determine whether a patient will need an expander.
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26. Is it too late to have braces if I am already an adult?
A surprising percentage of our patients are adults. In fact, 25% of all orthodontic patients are adults. Health, happiness, and self-esteem are vitally important to adults. No patient is “too old” to wear braces!
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27. Can I wear braces even though I have crowns and missing teeth?
Yes. A tooth with a crown will move just like a tooth with a simple filling. When teeth are missing, orthodontic treatment will aid in the alignment of the remaining teeth.
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28. Why should you choose an orthodontic specialist?
Teeth, and sometimes entire facial structures, are permanently changed by orthodontic treatment. It is important that the treatment be appropriate and properly completed. Orthodontic specialists have extensive and specialized training that enables them to provide their patients with professional, personalized treatments.
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Higley Orthodontic Specialist, Miami, Fl DDS, MS, PA. We love seeing new patients and we are excited to talk about your family’s orthodontic care.

Our Miami orthodontist office is at the forefront of using proven high tech procedures, materials and equipment. We understand the importance of choosing an orthodontist office that truly cares about the quality of service it provides. That is why we go to great lengths to make sure that your experience with us is a pleasant one. Though we take our work very seriously we pride ourselves on doing it in a fun way. We want you to enjoy coming to see us and to feel comfortable with the treatment you receive.

We provide a friendly, courteous and fun atmosphere. We have the privilege of treating you to a high tech experience and we take pride on doing it in a fun way. Please take a few minutes to explore our web site and find out more about Higley Orthodontic Specialist.

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Q: At what age should someone see an orthodontist?
A:Most Authorities Agree that six or seven is a good age for your child’s first orthodontic examination. Conditions may be found that can be corrected at this early age by interceptive measures. This often will lessen or eliminate the need for help at an older age. That in turn can be a savings in the total cost of your child’s orthodontic correction. Breakage of the two upper front teeth often happens between the ages of 6 to 7 years old. When children have protruding teeth and hit something, the teeth are broken 82% of the time. When the teeth are positioned correctly in the mouth, they are only broken 9% of the time.

EARLY TREATMENT INCREASES THE CHILD’S SELF-CONCEPT

WE CAN HELP CHILDREN WITH BREATHING PROBLEMS, which can be treated at an early age, that even Nose Doctors (Rhinologists) cannot help even with surgery. This is a painless procedure.

Q: What is an orthodontist?
A: An orthodontist is a dental specialist who has successfully completed at least two academic years of continuous advanced studies in an orthodontic program of a dental school or institution approved by the American Dental Association. This advanced training includes such diverse studies as physics, embryology, genetics, human growth and development, biophysics and engineering. Only those dentists with this advanced education can announce that they are orthodontists.

Q: What causes crooked teeth?
A: Crowded teeth, thumb sucking, tongue thrusting, premature loss of baby teeth, a poor breathing airway caused by enlarged adenoids or tonsils can all contribute to poor tooth positioning. And then there are the hereditary factors. Extra teeth, large teeth, missing teeth, wide spacing, small jaws – all can be causes of crowded teeth.

Q: Why should I be concerned about my child’s bite?
A: A bad bite can be detrimental to the future of your child’s mouth. Restorations, crowns or bridges are often impossible for a dentist to perform without prior repositioning of the teeth by an orthodontist. Properly aligned and supported teeth are healthy &, easier to clean, and therefore more likely to last throughout a patient’s lifetime.

Q: What part does heredity play?
A: Heredity is A complicated combination of factors. Both parents may have perfectly aligned teeth. And the first child’s teeth may erupt unevenly. Then comes the second child and it is as if hereditary factors are working against each other. The child’s teeth appear normal, but their alignment is going to cause problems in the future. So, assume neither the best nor the worst. Have your orthodontist evaluate your child’s bite and proceed from there.

Q: How do orthodontists straighten teeth?
A: Tooth movement is actually a normal response to light pressure. Pressure is applied by using a variety of orthodontic hardware (appliances), the most common being a brace or bracket attached to the teeth and connected by an archwire. Periodic changing of these archwires puts pressure on the teeth. At different stages of treatment your child may wear elastics, a positioner or a retainer. We do not use headgear because we have found better ways to do the same things that do not require so much cooperation from the patient.

Q: Will it hurt?
A: There may be some discomfort for the first 2-3 days when the teeth are starting to move. With the type of arch wires that we use. there should not be discomfort after that.

Q: What about extra-curricular activities?
A: We heartily encourage your child to pursue extra-curricular interests. Athletics can be a regular part of this routine. Certain musical instruments can actually be helpful during treatment. Speech may at first be somewhat affected, but only for a day or two. So we tell our patients that orthodontics is a normal part of this phase in their lives and that treatment should not preclude any activities they usually pursue within their school’s programs.

Q: Will I look funny?
A: Not necessarily. Minor corrections can be accomplished with braces completely concealed within the mouth. More involved treatment may require braces on the teeth to successfully move them to the desired positions. Braces are the handles used to move your teeth in a positive manner. We use small (mini) brackets bonded to the outer surfaces of the teeth. Plastic braces may be used for minor corrections. Ceramic brackets, which are similar in color to teeth, are less obvious to the casual observer and offer the versatility of regular stainless steel braces. The latest ones are translucent enough to actually allow the natural shading of the teeth to show through. In all cases, regardless of the braces used on your teeth, the activating part of your braces is the wire that goes from tooth to tooth. It is not uncommon to observe half of the children in a school class having some sort of braces. Many kids consider braces “neat” and the “in” thing.

Q: How long will treatment take?
A: Orthodontic correction can vary from the comparatively simple closing of front spaces in a few months, to the realignment of unsightly and disfiguring teeth. In the young child or the adolescent, treatment is as much a critical matter of timing and guidance as anything else. The normal treatment time varies from eighteen months to two years depending on the complexity of the problem.

Q: How often will I need office visits?
A: Appointments average about once a month. In the initial stage, the appointments are more frequent. Once the appliances (braces) are in place, appointments are scheduled at longer intervals. For children, every effort will be made to schedule appointments after school hours or on Saturdays. Occasionally, your child may have to come during school hours. School authorities are usually understanding.

Q: How much will it cost?
A: Do not assume your treatment will cost the same as someone else’s. Because no two problems are the same, treatment plans and accompanying costs will vary among patients. Those factors affecting the simplicity or complexity of your problem will be explained in detail by us. We offer very reasonable payment plans (no interest), conveniently spread over the estimated treatment period. We have 3-18 month loans at 0% interest (no interest) available.

Q: Will my dental insurance pay for it?
A: Today many dental policies include orthodontic benefits. For questions concerning eligibility a pre-determination of available benefits can be requested from your insurance company representative. The percentage of reimbursement varies from plan to plan.

Q: Will the improvement be permanent?
A:The combined experience of orthodontists across the country points to a 95% permanent improvement rate. Teeth, like all parts of the body are constantly changing and adapting. Where growth guidance is accomplished, the results are usually permanent. Jaw relationships affecting facial contours can be expected to remain for life. However, there are certain types of facial patterns that continue to change even past adolescence. (Should this be the case with your child, of course it will be discussed thoroughly so you are made aware of any detrimental growth indications.) Conscientious retainer wear following treatment will minimize minor movement or relapse.
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If you’ve decided it’s time for braces or Invisalign, your next step is choosing where you will go for treatment. Many general dentists are offering orthodontic treatment with braces or Invisalign. They offer “one-stop shopping” for their existing dental patients. Makes everything easier and more convenient, right? Consider this…orthodontists not only complete the four years of dental school, but 2-3 more years to specialize in orthodontics. They have made the choice to do orthodontics and ONLY orthodontics. An orthodontist doesn’t do just a few cases here and there, every minute of their practice is devoted to resolving orthodontic issues. Whether you choose braces, bite appliances, or Invisalign, you are best left in the hands of an expert. Think of it like this, if you had to have heart surgery and your general practitioner said he could do it, would you let him/her do it or go to a heart specialist? Your orthodontist has years of experience looking at numerous kinds of cases and patients and will see best how to treat them. Dr. Stephen L. Carter at Carter Orthodontics has practiced for over thirty years…make him your orthodontic specialist!

What is an impacted tooth? It’s a tooth that is “stuck” in the gums and will not erupt on its own. The most likely teeth to be impacted are the “wisdom” teeth, but other teeth can be impacted, as well. In instances where the wisdom teeth are impacted, many times they can be left alone if not causing any discomfort or infection. When a tooth other than a wisdom tooth is impacted however, it is usually necessary to either extract it or “expose” the tooth and bring it slowly into its proper position. Leaving these other teeth alone can likely cause infection, contribute to poor dental hygiene, or compromise supporting bone structure.

In the past, many dentists would simply extract the tooth. This would result in a gap where the tooth would have been, becoming a trap for food and plaque, not to mention create bone loss. A dental implant or bridge would be necessary to optimize the functionality of the bite and oral health. If the tooth and it’s root are healthy, an oral surgeon can uncover the tooth by creating a flap in the gum tissue and bond a bracket and chain or special spring to the surface of the unerupted tooth. The chain or spring then leads out through the gum tissue. Your orthodontist can then use the chain to gently pull the impacted tooth through the gum tissue and into its proper position. This option helps maintain all the patient’s teeth and bone! As the tooth comes through the gum tissue, orthodontic brackets help guide the tooth into the ideal position in the arch along with the other teeth.

So…you just got back from your first orthodontic exam…what were they saying?? Overbite? Underbite? Deep bite? Huh? Let’s help clear that up!

Ideally, a perfect bite where all the teeth fit together like a neat puzzle would be what is considered a Class I bite or occlusion. The upper first molars (also called 6yr molars and are the molars furthest forward) should sit slightly outside of the lower first molars with the first half of the top tooth cradled in the middle of the lower one. They fit together a lot like legos! When the teeth vary from this position, orthodontics can help!

Class II occlusion means that those upper first molars fit in front of those lower first molars, causing what is called overjet. This can result in a “buck-toothed” appearance or having a “weak” chin. People might say this is an “overbite”, but an “overbite” or “deep bite” is when the top front teeth hang way over the bottom teeth. They should overlap slightly, but when they cover too much of the bottom front teeth, it can throw the jaw off and cause problems.

A Class III bite is when the upper first molars fit together with the lower second molars—too far back. This brings the lower jaw to sit in front of the the upper teeth, creating an “underbite”. This is a particularly difficult bite to battle because the top teeth trap the lower teeth and can’t allow the jaw to move back where it belongs.

Any variance from that Class I ideal bite can cause uneven wearing on the teeth, TMJ disorder, inability to chew properly on both sides of the mouth, gum disease, and impaired speech. Orthodontics is more than just straight teeth!

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As we leave adolescence far, far behind, thoughts of orthodontic treatment are left far behind, too. As adults, we may remember going through braces as a teen or had parents who may not have been able to afford orthodontic treatment. Because that’s who wears braces, right? Teens! Not anymore! People of ALL ages are seeking orthodontic treatment more today than ever before. In fact, adults now make up more than 25% of those in orthodontic treatment!

Why should adults get treatment? Though adult bone growth is complete, straightening the teeth and aligning the jaws is still possible. Good orthodontic treatment has many benefits to an adult’s overall health. Crooked teeth are harder to clean and can cause deterioration of tooth enamel and gums. Poor gum health has been shown to have a direct link to heart disease. Also, digestion can be adversely affected by inadequate chewing due to poor tooth and jaw alignment.

TMJ and bruxism (grinding of teeth) are also growing problems with adults. Poor alignment of teeth and jaws are usually a primary cause of these types of painful issues. Adults often say orthodontic treatment gave them a “brace lift” because bone structure can be affected during the expansion of the arches and alignment of the jaws. Treatment can result in fuller lips, a more contoured appearance, and possibly the advancement of the lower jaw, creating a stronger jawline and eliminating the “double chin”.

Still not sold? Don’t like the fact braces are too noticeable? Limit your diet? Too painful to lips and cheeks? Invisalign is a great option for many adults. Invisalign is a series of clear aligners and small tooth-colored attachments on the teeth to gradually straighten your teeth and jaws. Since there are no brackets to knock off with sticky, hard food, Invisalign allows patients to eat whatever they want!

Impatient? Orthodontic treatment takes too long? Acceledent is a revolutionary new product used in conjunction with either braces or Invisalign for 20 minutes a day. It can cut your treatment time by 50%! Acceledent can be a fantastic option for adults wanting to finish treatment in time for big events like a wedding or class reunion.

There are soooooo many options and benefits today to getting orthodontic treatment…no more excuses!

One of the greatest things about those “sweet” holidays-Valentine’s Day, Easter, and Halloween-is to have a guilt-free excuse to eat lots and lots of candy! Unless, of course, you have some kind of expansion appliance or braces in your mouth! Booooooo! Lots of the sticky, sweet stuff winds up wrapped around that metal or (gasp!) breaks something! Not to mention, all that sugar LOVES to sit and lounge on your precious enamel and encourages cavities. Double boooooo!!!!! Hold on, hold on…just because you’ve decided that now’s the time to straighten your teeth and fix your bite doesn’t mean you can’t enjoy those beloved sugary treats once in a while. You just have to be more careful about which ones you put in your mouth and don’t forget to BRUSH afterwards! So let’s break it down…

Candy you CAN have :

Chocolate, chocolate, chocolate
melt-in-your mouth treats like Pop-Rocks
Suckers (as long as you LICK them and NOT CRUNCH them)
Fun Dip & Pixi Stix
Did I say CHOCOLATE???
Candy you need to AVOID :

Hard, chewy kind like Skittles, Starburst, Tootsie Rolls
Anything with nuts
Anything with caramel, marshmallows, or toffee
Gum
Gummy bears, Sour gummies, or Laffy Taffy
Did I miss some candy? Of course, but just use your noodle and if it seems iffy, avoid it! So just remember, as long as you continue to brush and floss like a champ after you eat anything, you keep seeing your general dentist for regular check-ups and cleanings, and you use good sense about what you eat, you CAN enjoy those fun candy holidays!

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Invisalign
Invisalign is a new technology which we offer on selected cases. The Invisalign technology uses a series of clear vacuum molded “aligners” which gradually shift your teeth into the correct positions. Invisalign is usually reserved for our adult or mature teenage patients, While not for everyone, Invisalign may fit your needs.

Herbst Appliance
The Herbst appliance is used to correct the front to back relationship of the upper and lower jaws, often referred to as Class II problems. The rod and tube that is affectionately called “the shock absorber” actually connects the upper and lower jaws. This really does not interfere with opening and closing your mouth or with eating. You might find side to side movement is somewhat restricted.

Things You Will Need To Get Used To
1. The bottom screws will irritate the lip. Your lip will toughen up like a callous, but it will take a few days for it to happen. You can put Orabase on the inside of the lip and cheek where it is sore. You can also place orthodontic wax over the screws to make it smoother. On rare occasions, it may be necessary for us to give you cotton rolls. These cotton rolls are placed inside your cheek to keep your lip and cheek away from the screw while you are sleeping.
2. When the lower jaw is brought forward, the back teeth do not come together like they did prior to the placement of the appliance, so be patient. Those teeth will come together so that you can chew normally in about a week.

3. Most of the time, there is not tenderness in the teeth when the Herbst appliance is placed. Every once in a while, a patient may feel some tenderness which is normally short lived. It will disappear in a few days.

Possible But Not Probable Problems
1. If you open very wide, sometimes the rods and tubes can pop apart. If they do, just open wide and put the rods and tubes back together. If you cannot get them together, you can leave them apart and call for an appointment to put them back together again. If, when the rods and tubes are apart, you are not in pain, they can wait to be put back together until the next day or over the weekend because the muscles will hold the jaw in position. If they are causing pain, call the office and we will put them back together as soon as possible. If you are having a problem with the rods and tubes disengaging quite often, then please call the office and we will make the rods and tubes longer so they will not come apart as easily. We don’t like to do that unless it is necessary because we don’t want to move your jaw too far or too fast because it grows better if we move it gradually.

2. Occasionally, a screw may come loose. If this happens, you will have a rod or tube dangling in your mouth. If this is causing pain, then call our office and we will replace the rod and tube as soon as possible. If it is not causing pain, it can wait until the next day or over the weekend.

3. Infrequently, the Herbst can come loose or break; there is nothing indestructible we can put in your mouth. If you have a problem with something breaking or becoming loose, please contact our office. If it is not causing you pain and you can function, you can wait until the next day or over the weekend. However, if you cannot function normally or there is pain, please contact the office and we will correct the problem as quickly as possible.

The Herbst appliance is one of our most frequently used appliances. We feel it is one of the best ways to treat Class II bite problems. It is fully contained within your mouth and does not show. It is glued in the mouth, so it is always working. This is absolutely critical for a quick and complete resolution of orthodontic problems. We generally leave the Herbst in for one year.

Pendex Appliances
The pendex appliance is a combination upper jaw expander and space gainer. It is glued onto the teeth and usually left in place for a period of 4 to 8 months.

Upper Expander
The upper expander is used to make your upper jaw wider.
1. You will have more saliva in your mouth for a few days until your brain gets used to the
idea that the expander is not something to eat. Once this happens, you will find that excess saliva is not a problem.

2. EATING: In the beginning, you may have a difficult time chewing certain foods.
However, within a few days, you will find you are able to eat normally. Start out with smaller bites and more easily chewed foods. While you are eating, food may get stuck in the appliance. Take a drink of water and swish it around. This should flush out any food. A small water syringe is also helpful for dislodging food particles. We will be glad to give you one of these free of charge.

3. BRUSHING YOUR TEETH: Brush your expander just like your own teeth. Take
special care to brush along the gum line so that these tissues do not become inflamed. Some inflammation of the gum tissue is common. This will quickly go away after the expander is removed. Regular use of an over the counter fluoride is encouraged.

4. ROUGH SPOTS: We try to make sure everything is smooth before you leave the office. However, your tongue and lips can find areas that we cannot. If you have a rough spot, call our office and we will schedule an appointment to take care of it.

5. LOOSE APPLIANCE: If this happens, stop turning the appliance and call our office. If you can get the appliance out of your mouth yourself, go ahead and do so, but call us as soon as possible.

6. SPACES: You may initially get a large space between your front teeth. Do not be
concerned, as this is a normal and expected result of the expansion. The majority of this space will often close on its own once the expansion is stopped.

7. SPEAKING: While speech may be affected initially, you will find you quickly adapt to
the expander. Within a few days, speech will return to normal.

8. DISCOMFORT: During expansion, you may feel pressure in your teeth and along the
side of your nose and sinus area. If the pressure is excessive, you can reduce the turns to once a day. Many times, taking an Advil _ hour before the appliance is activated is helpful in relieving the pressure. Most patients find the pressure decreases with increasing expansion.

9. The normal length of wear for your expander will be 4 to 5 months. The actual
expansion will occur only during the first 2 to 3 weeks.

10. Please remember that if you have any questions or concerns, do not hesitate to call
the office. We are here to help you in whatever way we can.

Removable Appliances
Removable appliances, unlike conventional braces, are used to retain teeth in their corrected positions and in some cases, to influence growth of the jaws in order to affect changes in facial structure. In addition, they are often used before and in conjunction with fixed appliances.

Removable appliances are not utilized to treat all orthodontic problems. It takes skill, and experience to recognize conditions that will respond favorably to removable appliances. Timing of such therapy also is very important.

Because removable appliances can easily be taken out by the patient, there may be a tendency not to wear them as we have prescribed. This means your teeth, jaws and muscles may move back toward their original positions.

Removable appliances require care. Although you may notice an effect on eating and speaking along with an increase in the flow of saliva, you will eventually adjust to the appliance.

Positioners
The positioner is a custom made mouthpiece which is utilized to make final and minor adjustments to the bite. This appliance is made from impressions of your teeth which are sent off to a special laboratory. When Dr. McClimans feels you are ready, the braces will be removed and the positioner placed. You will wear a positioner as your initial retention appliance. In six weeks, after final records are taken, you will receive upper and lower retainers to wear long term.

Initially, the positioner should be worn four hours per day and slept in at night. After one week, you will be checked, and if all is well, the wearing time will be reduced to two hours per day along with regular nighttime wear. During the day, the positioner should be worn for a minimum of 20 minutes at a time, followed by a period of rest. While the positioner is in place, exercise by clenching, holding, and relaxing the teeth. If the positioner falls out at night, get in more wearing time during the day. Some people find it helpful to suggest to themselves before going to sleep that they will keep the positioner in all night.

When the positioner is removed in the morning, rinse with water to remove saliva and store in the box provided. From time to time, the positioner should be brushed with a toothbrush and toothpaste to assure good oral hygiene. If you experience gum irritation, please contact our office so that you can be seen and the positioner adjusted. These six weeks of positioner wear are critical to a stable orthodontic result. Teeth can move quickly without adequate retention force; please follow instructions as prescribed.

Retainers are utilized, generally after the positioner. They are utilized to hold your teeth in their new positions until your bone, gums, and muscles adapt to the new teeth positions. You must wear your retainer as instructed, otherwise your teeth may move toward their original positions and the benefit of wearing your braces will be lost.

Dr.McClimans will determine how long you need to wear your retainer. Time varies with each patient. Some people may need retainers for an extended period of time in order to eliminate shifting of the teeth. In some cases, permanent retention may be necessary.

The retention period is an important part of your overall treatment and should not be neglected!

Remember, wear them in your mouth, not in your pocket. Retainers work when you follow our instructions.

Clean your retainers! After meals, clean all parts of the retainer with a brush, dishwashing soap and water. Use of dish soap will prevent scratching of the polished plastic, which can occur with the use of toothpaste.

Handle your retainers with care. Retainers are easy to lose. If you take your retainers out, always place them in your retainer case for safety. Click here for more information on caring for your retainers.
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Pros and cons of clear orthodontics
When you are trying to arrange orthodontic treatment to treat misalignments and jaw malocclusions, it’s a good idea to look at all the options and the pros and cons of these treatments before you make a decision about your own situation. Of course, your dentist will be able to tell you what sort of brace is going to be best for you and the first thing you should do when starting this process is to make an appointment and get your teeth assessed. The condition of your teeth will dictate what sort of appliance would be most effective and clear braces may not be an option for you if the misalignments are severe.

Let’s take a look at some of the pros and cons of clear brace treatment, so that you can be fully informed when your appointment date arrives;

What are the pros of clear orthodontics?
They are invisible – This is probably the biggest reason most patients request this sort of orthodontic system; the transparent resin fits over the teeth and allows the colour of the enamel to show through, so it makes it seem like there is no brace being worn at all. Although it won’t necessarily be 100% invisible, the appliance is likely to be much more discreet than traditional metal ‘train tracks’ and other designs. Some people might not feel uncomfortable with wearing a noticeable brace, but others may feel too self-conscious – which is where clear brace systems can really come in handy.

They are removable – Aligners are not permanently attached to the teeth; the shield can be removed to make eating and cleaning easier. It is important that the braces are not left out for longer than about an hour because this could lead to relapse in tooth position and would seriously hinder orthodontic progress. When the braces are first supplied, they should be accompanied by a storage box that can be used to hold the aligners whenever they are not being worn – this is the best way to make sure they don’t get broken or lost.

They are gentle – Compared to other forms of dental appliance, clear braces are thought to be much gentler on the teeth and the roots; with traditional metal braces, the teeth are put under a lot of pressure and this can lead to root resorption – shortening – due to the trauma that affects them when they are being shifted in the sockets. Resorption is not typically a problem with removable aligners because each one only puts a very tiny amount of pressure onto the teeth to move them; the sequence may include thirty appliances or more, each used one after the other to form continuous movement of the roots and to stretch the periodontal fibres that support them.

They are more comfortable – Because they are so gentle on the teeth and they can be taken out to make eating more pleasant, clear braces are generally considered to be much more comfortable than other methods of realignment. Although there is likely to be some level of discomfort with all types of orthodontic treatment, it is thought to be less of a problem with this sort of removable brace – the discomfort should be easily controlled with normal off-the-shelf painkillers, such as ibuprofen.

If you like the sound of a comfortable, discreet brace that is gentle on your teeth, get in touch with the Pearl Dental Clinic – a surgery in the Kingston area of London. You need to organise a consultation to get the treatment process started, but you could be on your way to a more attractive smile within a couple of weeks.

What are the cons of clear orthodontics?
They are expensive – There is no getting away from the fact that this sort of treatment is going to be expensive; most types of clear brace system will start at about a thousand pounds for minor cases, but could be as much as four thousand pounds if a large number of aligners are needed. Although this is a lot of money to most people, you have to be aware that the manufacturing process is more expensive than with traditional methods because so many appliances will be required to perform the desired movement.

If you are thinking about getting clear braces but you can’t afford them at the moment, you might like to consider a dental loan to cover the cost; this means that a loan company would pay for your treatment and then you would reimburse them at an affordable monthly rate. You should mention this idea to your dentist if you want to arrange a loan before your treatment begins.

They are not suitable for everyone – Whilst they are extremely versatile, clear braces may not be suitable for everyone who wants to get them; this is because the aligners are made from a material that is not especially flexible, so they will not fit over teeth that are severely misaligned. If your dentist tells you that aligners are not going to be appropriate for your condition, they may be suitable to refine the movement and make your teeth look perfect to complete the treatment.

They require more commitment – Due to the fact that clear braces are removable, they are slightly more easily forgotten when taken out and can get lost or damaged if they are not stored correctly during mealtimes. If you are going to go ahead with aligner treatment, you have to be prepared to commit to the process in order to get the best out of it; this means wearing your braces for at least twenty-two hours out of the day and all through the night. This is probably going to be slightly more complicated to deal with than fixed braces might be, but it is the nature of the treatment and you should consider this beforehand – if you are not confident that you can keep this up for months or possibly years, you should probably think about swapping to a fixed brace that you won’t be able to neglect or lose.
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What are Six Month Smiles?
Choosing a brace can sometimes be an overwhelming or confusing process, which is why your dentists opinion should obviously play a big part in your decision; however, it could help to do some research of your own beforehand, so that you know exactly what your options are before you decide what kind of orthodontic work you would like to get. Let’s take a look at Six Month Smiles to see if this sort of brace would be suitable for you;

What are Six Month Smiles?
This is a type of orthodontic system that is often referred to as ‘clear braces’ because of the components that are used to create the appliance; Six Month Smiles are made from brackets and wires, much like traditional fixed braces, but instead of using metal brackets, the appliance is made up of transparent resin brackets that allow the enamel shade to show through from the other side. Clear brackets might not make the brace as invisible as removable aligners might be but this is as close as you are going to get with a fixed appliance. This kind of brace is designed to be much more discreet than traditional ‘train tracks’ and this makes Six Month Smiles a great alternative for people who don’t want to wear a noticeable appliance. Some people are put off orthodontic treatment because the braces will be obvious when their teeth are showing; a clear fixed brace can open up a world of dentistry to people who have not previously considered it an option. Although they are not 100% invisible, they are much more discreet than normal train tracks and blend in better with the surface of the tooth.

Six Month Smiles are relatively new to the orthodontic market so they might not be as widely available but as more and more people request them it is likely that they will be on offer at a greater number of clinics, which means that you should not have too much trouble finding a provider who can offer you this kind of brace system. If you would like to benefit from Six Month Smiles specifically, you should first contact prospective clinics either by phone or online to see what sort of braces they can provide.

How are the braces fitted?
Because they are very similar to normal fixed braces, Six Month Smiles are fitted in much the same way as traditional train-tracks, each bracket is fixed to a misaligned tooth and then joined together with a wire that is threaded through each one; the wire is secured to the brace with elastic bands that are blended to the tooth enamel so that the appliance is more discreet than metal braces. This is not a very long process but it will obviously take slightly longer if the teeth are more crooked and more brackets have to be applied. As soon as the wire is fixed in place, the brace will start to put pressure onto the teeth to move them into alignment; this is inevitable with any sort of brace and the pain should subside after a couple of days, as the periodontal fibres get used to the change in pressure.

How long does treatment take?
The treatment time with fixed braces can vary greatly from patient to patient; it could be a few months or it may even be several years, depending on the initial position of the teeth. With Six Month Smiles, as the name suggests, the aim is to complete the treatment within a period of six months, although this may not be possible with every patient and you should be aware that it can take longer if your teeth are very crooked.

It is also worth mentioning that it takes more time to move adult teeth than it usually does to shift adolescent teeth; this is because younger teeth are not as firm in the socket so they can move more easily. This is obviously not a concrete rule for every patient but it is something to remember if you are not a teenager; this should not put you off getting orthodontic treatment but you should remember that it can take a little bit longer with adult teeth. For this reason, most dentists will try to arrange orthodontic treatment when their patients are still in their teenage years; although these days there is a larger number of older people who want to get braces and they can still benefit greatly from all kinds of orthodontic systems.

Will Six Month Smiles be suitable for me?
If you would like to get braces but the thought of wearing a noticeable appliance for the duration of your treatment puts you off, you might be interested in a clear fixed appliance as an alternative. If your teeth are too badly crooked for removable aligners then it is likely that a fixed brace will be your only option, which means that it’s probable that a Six Month Smiles appliance would be suitable for you rather than a metal wire and bracket design. In order to check that your teeth are in good condition and that braces are not going to damage them further, the dentist will carry out a series of x-rays to find out what sort of state the roots are in beneath the tissue. If you have had orthodontic treatment before it is possible that the roots will have retracted and this may make it unsafe to apply more braces as it could damage the teeth irreparably. Your dentist needs to be sure that another course of treatment will not do more harm than good; a small amount of root retraction should not prevent you from getting braces but if there has been noticeable shortening the dentist will have to estimate the risk to dental health.

If you are interested in this sort of brace and you would like to find out whether it would be available to you, contact the Pearl Dental Clinic; this is a surgery in the Kingston area of London that can provide all types of orthodontic appliance to improve your teeth and make them healthier too. Get in touch with the reception team now to find out more about the systems that are on offer.
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Do’s and don’ts of treatment with clear braces
Although new orthodontic systems have made treatment with braces much easier than it used to be, there are still some things that you can do to contribute to a positive outcome – it’s not just a matter of sitting back and letting the dentist do all the work. Clear braces will obviously perform the actual tooth movement but you can still make a difference to the way your orthodontic treatment progresses – in both a positive and negative way unfortunately!

If you are thinking about getting clear braces but you would like to know more about the process, contact the Pearl Dental Clinic; this is a London surgery that can provide the very latest orthodontic systems to improve your teeth and give you a smile to be proud of. There is always someone available to take your call and discuss the treatment options, so get in touch today. In the meantime, let’s take a look at some of the important do’s and don’ts associated with clear brace care;

Do’s;
DO – Wear your brace properly. If you continually remove the brace or wear it incorrectly somehow, this will significantly alter the outcome and could even drag the treatment out much longer than necessary. Some people will develop bad habits, like popping the aligner on and off without thinking about it; this can do a lot of damage because it changes the pressure on the roots constantly, which could cause lasting trauma or root resorption (shortening).

DO – Wear your brace all the time. Dentists recommend that a clear aligner is worn for at least twenty-two hours of the day, which obviously includes all through the night as well. Anything less than this and you are looking at an extended treatment time, possible relapse to the original position, and a very frustrated dentist!

DO – Get into a routine. The easiest way to get used to a new orthodontic appliance quickly is to fit it into your dental hygiene routine. It’s fairly simple to remember that your brace should be cleaned whenever your teeth are, and the sooner you get used to the few extra minutes cleaning a day, the sooner you will find that it comes as second nature to you.

DO – Keep your aligner clean. It’s true that the transparent resin is highly durable, but if you allow bacteria to build up along the aligner, this can really affect the health of your teeth – it might even lead to problems like gum disease or gingivitis. All you need to do to keep your braces clean is brush them using a soft-bristled toothbrush, and run them under the tap a couple of times a day just to keep them fresh. You might want to invest in some denture cleaner or mouthwash to make sure the aligner is in the best possible condition, but don’t use toothpaste because some whitening products have harsh abrasives in them that will scratch the surface of the resin and make it appear cloudy – which basically defeats the purpose of making the appliance see through in the first place.

DO – Remove the braces at mealtimes. Unless you are undergoing treatment for bite malfunction, you should take the braces out when you are eating; the aligner will cover the entire biting surface, making it hard to bite and tear foodstuffs. It is important that you remember to put the appliance back in as soon as you have finished eating; don’t leave it longer than half an hour to an hour, otherwise there may be some problems with the movement relapse.

Don’ts:
DON’T – Leave your aligner near extreme temperatures. Although the transparent resin used to create clear braces is a highly durable substance, it is not impervious to harm; if you leave the aligner close to a heat source or inside the freezer for any reason (not that you would think to do that!) it can do real damage to the resin, causing cracks and fractures to appear. Extra aligners may be included in your treatment package, but it’s best to avoid the need for one in the first place.

DON’T – Neglect your teeth. It’s very easy for patients who are undergoing orthodontic treatment to forget about the actual health of their teeth, but it is important to maintain a good level of oral hygiene throughout the course, otherwise you might find you have problems to deal with after you are finished with the braces. Tooth decay and gum disease are both conditions that can easily be avoided with good dental hygiene, and they would certainly make things more complicated in the long-run. You should brush twice a day, floss regularly, and use mouthwash to rinse out those hard to reach areas.

DON’T – Avoid your dentist. Even if you have been given all the aligners you need to continue treatment at home, you still need to stay in contact with your dentist as often as they deem it necessary; this is so that any signs of dental problems can be identified during the early stages and the right treatment applied. With a typical course of orthodontics, this might be once a month, just to make sure that the right movement is being achieved and there are no problems with the aligners. Many dentists also don’t like to put all the responsibility on the patient with regards to swapping aligners, so they often like to check-in regularly just to be sure that everything is going smoothly.

DON’T – Leave your braces lying around. If you leave your aligner next to the sink or on the table during mealtimes, you are likely to find that it gets broken or lost quite quickly. When you are first fitted with the braces, you should be provided with a storage box to hold it when you are not wearing the device – which should only be a couple of hours out of the day. This storage box can really come in handy during mealtimes, and it means no one else has to look at your braces while they are trying to eat!

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