If you are dissatisfied with the way your smile looks, and your dentist is unhappy with the way your teeth fit together — but you don't like the idea of wearing braces — clear aligners may be your best solution. How much do you know about this teeth-straightening alternative? Below are some FAQs on the subject.

What do we mean by clear aligners? Clear aligners are a system for straightening teeth that uses clear plastic removable “trays” that fit over your teeth. As the teeth move to fit the trays, new trays are substituted that are designed to continue to move your teeth into the desired position. This system is an alternative to the traditional system of brackets and wires known as braces.

How can teeth be moved to new positions? The connection that holds a tooth in place in your jaws — the periodontal ligament — is not immobile. It constantly changes its position based on the normal forces of your bite. As the ligament is pushed on one side and pulled on the other, the living cells of your mouth respond by depositing bone and cementum (the protective covering of the tooth's root) on one side and dissolving it on the other. Normally this happens in a balance, maintaining your teeth in their position. We can manage these slight changes by applying constant light forces to move teeth in a predictable way.

How long does it take to move teeth to their optimum position using clear aligners? As with braces, the process is gradual. Total treatment time can range from six months to two years.

Do the trays have to be worn all the time? As you move through the sequence of trays, each is worn for 20 hours per day for two weeks. They may occasionally be removed for important social occasions.

How does an orthodontist design the sequential trays that are used? The trays are designed using a computer, based on an assessment and images of your mouth, teeth and jaws.

What kinds of problems can clear aligners correct? This method works well to correct mild to moderate crowding or spacing. If your back teeth already fit together as they should, the system may be ideal. If you have an extreme overbite or underbite, braces might work better.

Are clear aligners an alternative for everyone? Clear aligners are recommended for adults and recently, teenagers. They are not usually recommended for young children.

Why is it important to have your teeth straightened? Besides the obvious benefit of feeling better about yourself and your appearance, straight and well-aligned teeth work better. You will experience a better-functioning bite and can improve your oral health.

Contact us today to schedule an appointment to discuss your questions about orthodontics and clear aligners. You can also learn more by reading the Dear Doctor magazine articles “Clear Orthodontic Aligners” and “Moving Teeth With Orthodontics.”

Periodontal (gum) disease can lead to serious infection and even loss of teeth; but it can easily be prevented. Here are seven things you can do to prevent gum disease — or stop it in its tracks if you already have it.

1. Understand the causes of gum disease. Diseases of periodontal (from the root words meaning “around” and “tooth”) or gum tissues start with bacteria collecting on your teeth, in the areas where the teeth and gums meet. The bacteria, called plaque or biofilm, irritate the surrounding tissues and cause them to become inflamed and swollen, and to bleed easily on contact. This condition is called gingivitis.
2. Brush correctly and effectively. Brushing twice a day is not just to polish your teeth to pearly whiteness. An important reason to brush is to remove the daily coating of plaque from your teeth. At your next dental appointment, ask me or our staff to show you the most effective way to brush.
3. Floss every day. Daily flossing removes the plaque that settles in between your teeth, in places where your brush can't reach.
4. Have regular professional cleanings. Our hygienist will remove plaque that you missed by brushing and flossing. This plaque hardens into a material called calculus or tartar. In a professional cleaning your hygienist uses special tools to scrape these materials away. The hygienist also measures the distances between your gums and teeth to make sure that inflamed gums have not separated from the teeth, forming pockets in which the bacteria continue to grow.
5. Recognize the signs of developing gum disease. These signs include any of the following: gums that bleed easily when you brush or floss; bad breath; red or swollen gums; and sensitive teeth.
6. Stop smoking. If you haven't stopped smoking for your heart or lungs, here is another reason to quit. Smokers are more likely to develop periodontal disease than nonsmokers. Smoking masks the effects of gum disease, so smokers are less likely to notice the symptoms, allowing the disease to progress to a greater degree before they seek help.
7. See our office right away if your teeth become loose or your gums become red and swollen. If inflamed gum tissues do not heal, the disease continues to progress. The tissues that attach your teeth to your bone, called ligaments, are lost as pockets deepen as the infection advances. Your gums may also become red, swollen, and painful. As the infection gets worse it eats away the bone around your teeth, causing the teeth to loosen and fall out.

So start with prevention and stop periodontal disease in its early stages.

Contact us today to schedule an appointment to discuss your questions about gum disease. You can also learn more by reading the Dear Doctor magazine article “Warning Signs of Periodontal (Gum) Disease.”

It may alarm some people, but finger or thumb sucking is a completely normal activity for babies and young children. In fact, sonograms often reveal babies sucking a finger or thumb while still in the womb! However, if children are allowed to suck fingers, thumbs or pacifiers indefinitely, it can become problematic, with serious consequences particularly as they get older.

The list below contains important facts about thumb sucking and pacifiers that all parents of young infants should know.

• The American Academy of Pediatric Dentistry recommends that parents and caregivers encourage children to stop thumb sucking by age 3.
• Recent studies have shown that pacifier use after the age of two may cause long-term changes in the mouth; thus these researchers recommend stopping pacifier use by 18 months.
• If thumb and finger sucking habits do not stop soon enough, the upper front teeth may tip toward the lip or not come into the correct position in the mouth.
• Most children who suck their thumbs or fingers tend to stop between the ages of 2 and 4.
• For obvious reasons, a pacifier habit is often easier to break than a finger or thumb-sucking habit.
• One tip for encouraging older children to stop this habit gradually is to use behavior modification with appropriate rewards given at pre-determined intervals to refrain from using a pacifier, or sucking fingers or a thumb.

Be sure to inform us if any of your children suck their fingers, thumb or a pacifier so that we can begin monitoring their development. Our general recommendation is that you schedule an appointment around your child's first birthday.

If an adult has lost his or her teeth (a condition called “edentulism”), full removable dentures (false teeth) can restore the person's appearance and ability to bite, chew, and talk properly. Even with our current extensive knowledge about tooth care and restoration, over 25 percent of Americans have lost all their teeth by the time they are 65.

How much do you know about dentures? Test yourself below.

How does tooth loss affect your bones?
Bone is a living substance that is constantly changing and rebuilding itself, depending on signals it receives from surrounding tissues. The bone that surrounds your teeth is called alveolar bone (from “alveolus,” meaning sac-like). To keep healthy, alveolar bone needs stimulation or function such as chewing and your teeth touching your opposing teeth. If you lose your teeth, bone begins to melt away (resorb).

How can we minimize bone loss during tooth extraction?
We can maintain bone volume by using bone grafting techniques. While this sounds scary, it is a relatively easy procedure. The principle of bone grafting is to build a sort of scaffolding on which your body begins to build and maintain its own bone. Bone loss can be prevented by the placement of a few dental implants.

How are dentures designed and created?
The dentures that look best and work best for you are based on your original teeth. We often utilize photographs of how you looked with your natural teeth, along with your input about possible changes you would like to see. First we take detailed impressions (molds) of the residual ridges in which your teeth once rested. From these we make denture bases of a light cured plastic resin. We attach horseshoe-shaped rims made of wax to the bases, to simulate the position of the teeth as we work out their design and spacing, based on both appearance and function. The prosthetic teeth are then tried out in your mouth, adjustments are made, and the dentures are processed in a dental laboratory. The final product substitutes a pink colored plastic (methyl methacrylate) to represent the gums and white plastic material as the teeth, created to make them look as natural as possible.

What is your part in the denture fitting process?
As a patient with new dentures, you must learn to use your jaw joints, ligaments, nerves, and muscles in new ways to help stabilize your dentures and to relearn to speak, bite, chew, smile, and laugh with these new structures. It takes a little practice, but with your removable dentures you can once again enjoy a complete and normal life.

Contact us today to schedule an appointment to discuss your questions about full removable dentures. You can also learn more by reading the Dear Doctor magazine article “Removable Full Dentures.”

Lost teeth can cause a host of problems, including a loss of your jaw bone and a collapsing appearance of your face, along with difficulty chewing and speaking.

Clearly, it is important to replace missing teeth as soon as possible. Options for replacement include the more traditional methods and the newest technique — dental implants. We believe that implants are your best choice for the following reasons.

1. Implants prevent bone loss.

   Dental implants are substitute tooth roots. Like the roots of your original teeth, they stabilize the bone into which they extend — but in a different way.

   The part of the bone that encases the teeth is called alveolar bone, from the word root meaning “sac.” This bone has a special relationship with the teeth it surrounds. It develops as they first erupt into the mouth. If they are lost, the alveolar bone goes, too. It resorbs, or melts away, giving an impression that the bone, gums, and sometimes the lips are collapsing.

   Implants are made of titanium, which has the ability to join biochemically to bone. It takes the place of the original tooth root and prevents resorption.

2. Implants support adjacent teeth.

   Your teeth work in harmony, an all for one, one for all relationship with each other. If one is missing, the remaining teeth will slowly move and shift causing them to receive forces that may not be well received. Losing any tooth increases the pressure on the remaining teeth. Losing a back (posterior) tooth can put pressure on the front teeth and they can be forced out of position. All these movements can change a person's appearance as well as in their ability to speak, bite and chew.

3. They are easier to clean than “traditional” options.

   Fixed bridges are non-removable tooth replacements that attach to adjacent natural teeth. These teeth that are adjacent to the missing tooth have to be cut into small peg shapes on which the bridge is attached. The removal of their enamel may make them more prone to tooth decay and gum disease.

   Older replacement methods include removable options such as plastic “flippers” and partial dentures. These replacements rest on the teeth and gums, making the teeth they attach to receive greater pressure causing more mobility. In addition, they exert pressure on the gums, causing additional bone loss and increasing the potential for bone loss on the neighboring teeth.

   Full dentures, in cases where all teeth are missing, are kept in place by pressing on the gum tissues. This causes even more pressure on the bone, leading to bone loss and changing facial structures.

4. They are longer lasting.

   Studies have shown that removable partial dentures are replaced about every five years; bridges are only 67% successful at 15 years; and implants are over 95% successful for 20 or more years.

5. They are cost effective in the long term.

   Because implants last longer than other alternative tooth replacements, they may seem more expensive at first; but they will be cost effective over the long term.

Contact us today to schedule an appointment to discuss your questions about dental implants. You can also learn more by reading the Dear Doctor magazine article “Dental Implants. Evaluating Your Options.”