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ABondedRetainerCouldbeaPreferredChoiceoveraRemovableOne

If you've known anyone who has worn braces, you know what comes after — wearing a retainer. This can be kind of a letdown after all those months with braces, but it's absolutely necessary.

That's because teeth have a tendency to “rebound” to their pre-orthodontic positions once the force to move them stops after the braces are removed. Retainers help keep or “retain” moved teeth in their new positions and prevent them from reverting to the old.

When you think “retainer,” you probably picture a removable appliance with a wire that fits over the front of the teeth. While that may be the most common type, it isn't the only one. There's another called a bonded retainer, a thin piece of wire bonded to the back of the teeth that need to be retained. Unlike the other type, a dentist must remove a bonded retainer when it's no longer needed.

The biggest advantage of a bonded retainer is its invisibility — the wire is behind the teeth so no one can see it as with a removable retainer. The wire is bonded to the teeth with a dental composite material and then light-cured to create a strong attachment.

Another advantage is especially pertinent to younger patients. Because it's permanently attached and can't be taken out, there's no constant reminding of the patient to wear it — and no more worries about replacing a lost one.

They can, though, be difficult to floss around leading to potential plaque buildup that increases disease risk. It's very important you receive proper hygiene instruction for cleaning under the bonded retainer. Another concern is that they can break under excessive chewing pressure. And as with the more common retainer, we wouldn't want to remove it as that will result in the teeth's relapse to their old positions.

To learn which retainer is best for your situation, you should discuss the options with your orthodontist. Regardless of which type you choose, though, a retainer is a must for protecting your investment in that new smile.

If you would like more information on orthodontics and 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.”

RemovingOneorMoreTeethCouldImproveOrthodonticOutcomes

Moving teeth through orthodontics may involve more than simply wearing braces. There are many bite conditions that require extra measures before, during or after traditional orthodontic treatment to improve the outcome.

One such measure is extracting one or more teeth. Whether or not we should will depend on the causes behind a patient's poor dental bite.

Here, then, are 4 situations where tooth extraction before orthodontics might be necessary.

Crowding. This happens when the jaw isn't large enough to accommodate all the teeth coming in. As a result, later erupting teeth could erupt out of position. We can often prevent this in younger children with space maintainers or a palatal expander, a device which helps widen the jaw. Where crowding has already occurred, though, it may be necessary to remove selected teeth first to open up jaw space for desired tooth movement.

Impacted teeth. Sometimes an incoming tooth becomes blocked and remains partially or fully submerged beneath the gums. Special orthodontic hardware can often be used to pull an impacted tooth down where it should be, but not always. It may be better to remove the impacted tooth completely, as well as its matching tooth on the other side of the jaw to maintain smile balance before orthodontically correcting the bite.

Front teeth protrusion. This bite problem involves front teeth that stick out at a more horizontal angle. Orthodontics can return the teeth to their proper alignment, but other teeth may be blocking that movement. To open up space for movement, it may be necessary to remove one or more of these obstructing teeth.

Congenitally missing teeth. The absence of permanent teeth that failed to develop can disrupt dental appearance and function, especially if they're near the front of the mouth. They're often replaced with a dental implant or other type of restoration. If only one tooth is missing, though, another option would be to remove the similar tooth on the other side of the jaw, and then close any resulting gaps with braces.

Extracting teeth in these and other situations can help improve the chances of a successful orthodontic outcome. The key is to accurately assess the bite condition and plan accordingly.

If you would like more information on orthodontic options, 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 “Removing Teeth for Orthodontic Treatment.”

By Upper East Smiles
March 09, 2020
Category: Oral Health
Tags: oral hygiene   braces  
StopWhiteSpotsBeforeTheyAppearWhileWearingBraces

Braces can be a long, involved process, but gaining a more attractive smile and better oral health is worth it. Sometimes, though, braces can produce unintended short-term consequences.

Brace brackets and wires do the work of moving teeth to better positions. They can, however, hinder the wearer's hygiene efforts to remove plaque, a thin film of bacteria and food particles, from tooth surfaces. Plaque buildup increases the risk of dental disease and other ill effects.

One such effect while you're wearing braces is the formation of tiny spots that look pale and chalky on otherwise smooth and polished enamel. These are white spot lesions (WSLs), where acid has remained for too long on the tooth enamel. They occur because acid-producing bacteria escape removal during brushing and flossing due to the braces hardware.

We want to try to prevent WSLs while wearing braces, and not just because they're unattractive. You're actually looking at enamel erosion, which could lead to cavity development at those weakened spots.

Although difficult for you as a braces wearer, daily brushing and flossing is crucial to WSL prevention. You'll need to take more time to be sure you're reaching all around the wires and brackets. You can improve your effectiveness with special brushes for braces and floss threaders or water irrigators. You can also help keep acid levels low by cutting back on acidic foods and beverages, especially sodas, coffee or spicy foods.

Even if you develop WSLs we can treat them effectively, especially if caught early. One way is by aiding enamel re-mineralization through saliva stimulation (the mouth's acid neutralizer) or applying fluoride to the teeth to strengthen enamel. We can also use caries infiltration, a technique that injects tooth-colored resin below the surface of the lesion. This strengthens the weakened enamel and gives the area the appearance of translucence like normal enamel.

While you're wearing braces, focus diligently on keeping your teeth clean of plaque and keep up your regular cleaning visits with us. If you notice any unusual discolorations or abnormalities, see us as soon as possible. Stopping WSLs from developing will help ensure your teeth are healthy and attractive after the braces come off.

If you would like more information on dental care with braces, 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 “White Spots on Teeth during Orthodontic Treatment.”

By Upper East Smiles
March 06, 2020
Category: Dental Procedures
Tags: braces  

How braces from your orthodontist in Upper East Side, New York can help your smile.

If you have an uneven, crooked smile, or if your jaws are poorly aligned and it is uncomfortable to chew, braces can help. In fact, braces can help with a lot of smile problems. Dr. Jessie Choi, orthodontist at Upper East Smiles in Upper East Side, New York can help you achieve a straight, beautiful smile.

Braces can help with many smile problems. Some of the most common problems treated with braces include:

  • Correcting crowding and tooth rotation
  • Closing gaps between teeth
  • Correcting an overbite or underbite
  • Correcting a crossbite or open bite
  • Helping impacted teeth erupt normally

When you choose braces to give you a straight smile, you will enjoy a smile that is much easier to keep clean, as brushing and flossing become easier. Chances are less plaque will accumulate on your teeth if they are straight too.

Braces also correct poor jaw alignment. When your jaws and teeth come together properly, it decreases the stress on your teeth, which means less chance of tooth wear, and less chance of you needing dental restorations later on. There is also less stress on your jaws, which means less chance of jaw and facial pain, and less chance of TMJ problems.

You can review some of the most frequently asked questions and answers about braces by clicking on this link on the Upper East Smiles website: https://www.uppereastsmiles.com/orthodontics.html

Let's face it, a straight smile is much more attractive, and can give you the self-confidence you deserve. To find out more about braces and how they can help your smile, talk with an expert. Call Dr. Jessie Choi, an orthodontist of Upper East Smiles in Upper East Side, New York at (646) 864-1808. Call today.

By Upper East Smiles
February 28, 2020
Category: Dental Procedures
ViggoMortensensRed-CarpetSmile

The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!

That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.

If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.

For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.

If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.

When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement

If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”





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