Posts for: July, 2020
While retainers are often viewed as a nuisance, they’re crucial to protect the gains made with bite correction. Without them, all of the progress achieved through braces or clear aligners could be lost.
Here’s why: The same elastic gum tissue called the periodontal ligament that holds teeth in place also allows them to move incrementally in response to changes in the mouth. That’s why we can move teeth with braces or aligners, which put pressure on the teeth toward a desired direction of movement while the periodontal ligament does the rest.
But the mechanics can also work in reverse: With pressure relieved when the braces are removed, the teeth could revert to their original positions through a kind of “muscle memory.” The light pressure provided by a retainer is enough to keep or “retain” teeth in their new positions.
The best known retainer is a removable appliance. Initially, a patient wears it continuously and only takes it out during oral hygiene. Wear duration may later be reduced to night time only and eventually not at all, depending on a patient’s individual needs.
While effective, removable retainers do have some downsides. Like braces, they’re visible to others. And because they’re removable, they’re frequently misplaced or lost, leading to the added expense of a new one.
An alternative is a bonded retainer, a thin piece of wire attached to the back of the newly moved teeth to keep them in place. Because it’s behind the teeth it’s not visible—and there’s no misplacing it because only a dentist can take it out.
A bonded retainer is a good option, especially if a patient is immature and not as diligent about wearing or keeping up with their appliance. But it can make flossing difficult to perform, and if they’re removed or broken prematurely, the teeth could revert to their former positions.
If you decide to go with a bonded retainer, be sure you get some tips from your dental hygienist on how to floss with it. And if you decide later to have it removed early, be sure to replace it with a removable retainer. Either of these two options can help you keep your new and improved smile.
If you would like more information on bonded retainers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Bonded Retainers.”
Professional Hockey player Keith Yandle is the current NHL “iron man”—that is, he has earned the distinction of playing in the most consecutive games. On November 23, Yandle was in the first period of his 820th consecutive game when a flying puck knocked out or broke nine of his front teeth. He returned third period to play the rest of the game, reinforcing hockey players’ reputation for toughness. Since talking was uncomfortable, he texted sportswriter George Richards the following day: “Skating around with exposed roots in your mouth is not the best.”
We agree with Yandle wholeheartedly. What we don’t agree with is waiting even one day to seek treatment after serious dental trauma. It was only on the following day that Yandle went to the dentist. And after not missing a game in over 10 years, Yandle wasn’t going to let a hiccup like losing, breaking or cracking nearly a third of his teeth interfere with his iron man streak. He was back on the ice later that day to play his 821st game.
As dentists, we don’t award points for toughing it out. If anything, we give points for saving teeth—and that means getting to the dentist as soon as possible after suffering dental trauma and following these tips:
- If a tooth is knocked loose or pushed deeper into the socket, don’t force the tooth back into position.
- If you crack a tooth, rinse your mouth but don’t wiggle the tooth or bite down on it.
- If you chip or break a tooth, save the tooth fragment and store it in milk or saliva. You can keep it against the inside of your cheek (not recommend for small children who are at greater risk of swallowing the tooth).
- If the entire tooth comes out, pick up the tooth without touching the root end. Gently rinse it off and store it in milk or saliva. You can try to push the tooth back into the socket yourself, but many people feel uneasy about doing this. The important thing is to not let the tooth dry out and to contact us immediately. Go to the hospital if you cannot get to the dental office.
Although keeping natural teeth for life is our goal, sometimes the unexpected happens. If a tooth cannot be saved after injury or if a damaged tooth must be extracted, there are excellent tooth replacement options available. With today’s advanced dental implant technology, it is possible to have replacement teeth that are indistinguishable from your natural teeth—in terms of both look and function.
And always wear a mouthguard when playing contact sports! A custom mouthguard absorbs some of the forces of impact to help protect you against severe dental injury.
If you would like more information about how to protect against or treat dental trauma or about replacing teeth with dental implants, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dental Implants: A Tooth-Replacement Method That Rarely Fails” and “The Field-Side Guide to Dental Injuries.”
Millions of people wear some form of removable oral appliance. The range is pretty extensive, from orthodontic clear aligners and retainers to full or partial dentures. But while they may vary in purpose, they all require the same thing: regular cleaning and maintenance.
And there's a right way to care for them, and a wrong way. The right way ensures you'll get the most out of your appliance—the wrong way might drastically curtail their longevity. Here, then, are 4 things you should and shouldn't do to keep your appliance in tip top condition.
Clean it properly. Only use cleaning agents appropriate for an oral appliance's materials. That means avoiding the use of toothpaste—the abrasives in it won't harm tooth enamel, but they can scratch some appliance materials. Instead, use dish detergent, hand soap or a recommended cleaner with a little warm water. Also, use a different brush than your regular toothbrush.
Avoid hot water and bleach. Hot or boiling water and bleach kill bacteria, but they will also damage your appliance. Hot water can warp an appliance's soft plastic and alter its fit. Bleach can blanch plastic meant to mimic gum tissue, making them less attractive; even worse, it can break down appliance materials and make them less durable.
Protect your appliance. When you take out your appliance, be sure to store it high out of reach of curious pets or young children. And while cleaning dentures in particular, place a small towel in the sink—if they slip accidentally from your hand, there's less chance of damage if they fall on a soft towel rather than a hard sink basin.
Don't wear dentures 24/7. Dentures can accumulate bacterial plaque just like your teeth. This can increase your risk of an oral infection, as well as create unpleasant mouth odors. To minimize this, take your dentures out at night while you sleep. And be sure you're cleaning them daily by hand, soaking them in an appropriate solution or with an ultrasonic cleaner.
Your oral appliance helps keep your dental health and function going. Help your appliance continue to do that for the long haul by taking proper care of it.
If you would like more information on how best to maintain your oral appliance, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “10 Tips for Cleaning Your Oral Appliance.”