It’s never too late to achieve your perfect smile, and now more than ever, adults are seeking orthodontic treatment. In fact, approximately 25% of orthodontic patients are adults.

Adult orthodontic treatment differs from child and adolescent treatment in a few ways. Since the bone development in adults is complete, orthodontic appliances cannot change jaw structure as they can in patients whose bones are still growing. If you are an adult with severe jaw misalignment, you might be a good candidate for surgery.

Periodontal disease is also important to address before orthodontic treatment. Braces and aligners rely on applying gentle pressure to teeth so that they can move through their surrounding bone. If the tissue and bones aren’t healthy, the excess pressure can result in bone loss and weakened teeth. Periodontal disease can be prevented with regular cleanings and good oral hygiene habits.

All orthodontic appliances use light, constant force to move teeth into alignment, but how we apply these forces vary. Braces and aligners vary by material used and visibility, and include:

• Traditional Metal Braces

Small, metal brackets are attached to the teeth, and a small metal wire runs through them beginning at one molar, going across all teeth, and ending at the opposite molar.

• Clear Braces

Clear braces are less visible than metal braces and are made of ceramic, plastic, or a combination of both They still have a visible metal wire and can be more susceptible to breakage.

• Clear Aligners

Unlike all other options, clear aligners are removable. They are made as a series of clear plastic trays that fit over your teeth exactly. Each aligner makes an incremental change to your smile, and you move through the series of aligners until you’ve reached your perfect smile.

• Lingual Braces

Lingual braces are metal like traditional braces, but they are attached to the back of your teeth (tongue side) so that no one can see them. The downside is that they might be more difficult to adjust to, and can be more expensive than other treatment options.

Once the braces are off, it’s crucial to wear your retainer. The retainer holds teeth in place, which in turn, supports new bone development around the newly positioned teeth. If the bone isn’t supported, teeth can revert to their old positions.

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It’s important to take good care of your teeth as you age. Elderly patients often need more frequent visits to stay healthy, as they are at a higher risk of oral complications, including extraction, tooth decay, and periodontal (gum) disease.

Electric Toothbrush

One of the best things you can do for your oral health, especially during your golden years, is to invest in an electric toothbrush. Whereas a traditional toothbrush takes a bit more elbow grease, electric toothbrushes clean your teeth while requiring minimal physical effort. This is perfect if you struggle with mobility. It cleans your mouth without jeopardizing your physical wellbeing.

Modify Your Traditional Toothbrush

If you are unable to invest in an electric toothbrush, there is a way to modify your traditional toothbrush. Try elongating the handle of your toothbrush. This way you can easily reach your back molars and other harder to reach areas. Look around your home for a few simple materials. Specifically, foam, rubber, or even tongue depressors can assist you. Wrap these around your toothbrush handle closer to its end. You should now have a longer toothbrush and brushing your teeth should be much easier.

Caretakers Can Help Too

If you live with or take care of an older individual, your help is important too. Gently remind them to brush twice a day and floss as well. If they have problems with physical tasks, assist them. You can also offer to give them rides to their dental appointments or even schedule the appointments for them. As dental care can be expensive, many communities offer public health programs for older patients, offering discounted or even free services. Reach out to your local social services or public health office to learn more.

Routine Checkups

Dental hygiene is extremely important for anyone, but even more so for senior citizens. It’s vital that senior citizens come in for routine checkups so that we can monitor their dental health. Sometimes poor dental health can be an indicator that something else is going on inside the body. Gently remind your senior of this and help them set up their next appointment.

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Air abrasion is a drill-less technique that involves an instrument used to blast away small areas of early onset tooth decay, as well as help dentists perform other dental procedures. It is recommended for children or other patients who are fearful of traditional drilling. Air abrasion can only be used if you have minimal decay.

How Air Abrasion Works

A fine stream of particles, such as silica, aluminum oxide, or baking soda, is directed at the stained or decayed portion of the tooth. The particles are propelled by compressed air or gas that runs through the air abrasion instrument. As this steady and powerful stream is directed at the tooth, particles of decay on its surface are blasted away. As the particles detach from the tooth, they are quickly suctioned through a tube.

Air Abrasion Advantages

There are a few advantages to using air abrasion over the traditional drilling method, such as:

• No heat, pressure, or vibration is generated to cause discomfort
• Reduces the need for anesthesia, especially if a cavity is very shallow
• More healthy tissue is saved with this process
• Reduces the risk of fracturing or chipping a tooth

Air abrasion can also assist your dentist with other procedures, including:

• Removing old composite restorations
• Preparing a tooth’s surface for bonding or sealants
• Removing surface stains and tooth discoloration

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The single-tooth anesthesia wand provides increased comfort and decreased anxiety when it comes to dental procedures requiring anesthetization. The wand looks like a small pen with an extremely small needle at the tip. The anesthesia wand works by numbing the individual tooth your dentist needs to work on. The device is unique in the way that it delivers a flow of anesthesia all controlled by a computer.

Because of the wand’s less intimidating appearance, it is a great option if you are nervous around shots and needles or if you experience extreme dental phobia or anxiety. It is especially useful for children who aren’t yet accustomed to injections.

Anesthesia Wand Benefits

There are many benefits that come with using the anesthesia wand, including:

• Single-tooth numbness: Since the wand only anesthetizes one tooth, you won’t leave your dentist’s office with a completely numb mouth.
• Complete computer control: The device automatically controls and regulates the flow rates and pressure during injection, which maximizes injection predictability and precision.
• Dynamic pressure-sensing technology: The technology monitors the exit pressure of the anesthetic for precise needle position during the administration process. Your dentist also receives visual and audio feedback from the unit, aiding in the correct placement for the injection.

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Our bodies are home to bacteria which are common in our mouths, but which can be dangerous elsewhere. For some people, especially those who have chronic medical conditions, specific cardiac conditions, or whose immune systems are compromised, bacteria that spreads throughout the bloodstream and into the heart can lead to a serious bacterial infection called infective endocarditis.

Generally, premedication is advised if you have one of these risk factors:

• A history of infective endocarditis
• Certain congenital heart conditions (heart conditions present since birth)
• An artificial heart valve
• A heart transplant

The American Association of Endodontists extends recommendations to patients who have undergone joint replacement surgery within the past two years, suffer from Type I diabetes, or have immune deficiencies from diseases such as lupus, rheumatoid arthritis, or HIV; cancer patients whose immune systems are suppressed because of radiation or chemotherapy; people who have had organ transplants; and people with hemophilia.

For these patients, any dental procedure may cause bleeding, and prophylactic antibiotic administration is recommended as a preventive measure.

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Root canal therapy is often enough to treat infection in the inner tooth successfully. If pain or inflammation return, however, these symptoms can indicate a new or recurring infection. In such cases, an apicoectomy is a common surgical procedure used to save the tooth and restore the health of the surrounding bone and gum tissue.

Every tooth contains pulp tissue, both inside the crown above the gum line and in the canals within the roots. These canals are small tunnels which travel from the pulp chamber in the crown to the tip of each root.

Nerves and blood vessels connect pulp tissue to the nervous and circulatory systems in the body, entering and exiting the tooth from very small openings in the root tip. An infection in the root pulp can spread to the gum and bone tissue around it through these openings.

An apicoectomy, also known as a root-end resection, is the surgical removal of the apex, or tip, of a tooth’s root. This allows your dentist to access and remove any damaged and infected tissue within and around the root. Apicoectomies are common endodontic surgeries, performed with state-of-the-art diagnostic and surgical tools.

• Often local anesthesia is all that is needed. If you are interested in sedation, discuss your options with your dentist. Once the area around the root is numb, an incision is made in the gum tissue to allow access to the root and any affected bone tissue.
• Your dentist will carefully remove a few millimeters from the tip of the root, then clean the infected part of the root and remove any inflamed or infected tissue from the bone surrounding it. The root will be filled and the tip sealed.
• Sutures will be used to close the incision, which will dissolve on their own or be removed at a follow-up visit.
• Your dentist will let you know just how to take care of the site after surgery. You should follow post-op instructions carefully to reduce any swelling, and be sure to follow any dietary suggestions and restrictions.
• Pain or sensitivity after the procedure can be treated with over-the-counter anti-inflammatory pain relief such as ibuprofen, or your dentist might prescribe prescription pain relief. Your dentist will also prescribe antibiotics as necessary to treat infection.

Most often, an apicoectomy is performed when infection occurs after a root canal procedure. (Your dentist may also recommend this procedure if you have calcium deposits in the root, if a crown or bridge makes a typical root canal impractical, or if the root of a tooth or the bone around it suffer trauma.) Common symptoms of infection include:

• Pain which can be mild or very intense
• Sensitivity to pressure or temperature
• An abscess, pus, or discolored discharge near the tooth
• Swelling, redness, or tenderness in the gums and tissues around the tooth
• A foul taste in the mouth or persistent bad breath

If you have recurring or new pain or symptoms of infection after a root canal, see your dentist promptly. Left untreated, infection can destroy tooth, gum, and bone tissue. An apicoectomy can be your best option to preserve your tooth and protect your dental health.

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What is Halitosis?

Halitosis, also known as chronic bad breath, is often the result of improper care of your oral health. When you eat, food particles gather throughout your mouth, sticking to the surfaces of your tongue, in between your teeth, and on your gum tissue. Your oral bacteria break down these substances and release certain odors from the mouth. If left unmanaged, these odors eventually develop into halitosis. By learning what causes halitosis and what you can do to avoid it, you can maintain fresh breath.

What causes halitosis?

There are a few factors that cause halitosis, including:

• Poor dental hygiene: Poor brushing and flossing habits, or lack thereof, are common causes of bad breath. The bacteria in plaque feed on food particles left in the mouth and create odor-causing waste products. Basic oral hygiene should include brushing and flossing your teeth at least twice a day and seeing your dentist twice a year for checkups and professional cleanings.
• Gum disease: Halitosis is a frequent symptom of gum disease. When plaque and tartar build up, toxins from bacteria irritate gum tissue. This irritation can cause red, swollen, or bleeding gums, as well as persistent bad breath.
• Dry mouth: Saliva plays an essential part in your oral health. It not only helps you speak and eat, but it also disposes of any food debris. Dry mouth creates a shortage of saliva. Without the proper amount, your mouth can’t clean away dangerous pathogens. This creates unpleasant breath and results in other dental conditions.
• Oral infections: When you have an infection in the throat, mouth, or nose, bacteria spreads to your mouth through a post-nasal drip. The bacteria feed off your mucus while your body fights off the infection. These biological processes create bad breath.
• Tobacco use: Tobacco products leave a bad taste in your mouth, which creates halitosis. Smoking also dries out the mouth, leading to further complications that result in bad breath.

Treating Halitosis

Improving your dental hygiene is the best way to treat your halitosis. Take a step back and evaluate your daily routines. It’s important that you always brush your teeth at least twice a day for two minutes. Make sure that your toothpaste contains minerals such as fluoride, which helps to naturally eliminate bacteria. Another important activity is flossing, at least once a day. It’s even better to floss after every meal.

There are a few other lifestyle changes that can help, such as cutting back on caffeinated beverages, drinking more water, seeing your dentist twice a year, and chewing sugarless gum to help your bad breath while stimulating saliva production.

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Pediatric dentistry is the study, practice, teaching, and research of oral care treatments and preventions in children. It is recommended that children visit their pediatric dentist twice a year. Parents should schedule the first visit within six months of their child’s first baby tooth coming in, or by 12 months of age. Regular checkups thereafter will help prevent oral health complications as your little one grows up.

Pediatric Dental Procedures

Brushing and flossing every day is the best way to prevent cavities and gum disease. However, if your child has aggressive signs of an oral disease, home hygiene will not do the job on its own and restorative treatments will be necessary. Such pediatric dental treatments include:

• Tooth fillings: Cavities and irreversible tooth enamel erosion will need to be treated with fillings. These complications usually occur from a poor diet of excessive acidic liquids and foods, as well as inadequate home hygiene. Baby teeth are more likely to be affected than permanent teeth because the enamel is thinner and less mineralized. The filling will help prevent the cavity from progressing.
• Pediatric pulp therapy: A baby root canal is similar to its root canal counterpart in the way that the pulp inside a tooth will be treated in an effort to save or restore it.
• Crowns: Made of stainless steel, crowns are placed on a child’s baby molars in an effort to protect them. This could be because the teeth have not formed properly or are already very decayed.
• Tooth extractions: Removing a tooth might be necessary if your child is experiencing trauma, disease, overcrowding, or decay.
• Space maintainers: After a tooth is extracted, a space maintainer is placed at the extraction site to ensure that your child’s tooth erupts properly.

Preventive Pediatric Dental Treatments

To ensure that your child has all possible defenses to fight tooth decay, plaque, and tooth loss, there are two preventive dental treatments available. These treatments include:

• Sealants: A thin coating is placed on the deep pits and grooves of baby and permanent teeth to help prevent tooth decay.
• Fluoride treatment: A mineral that has been proven to decrease the progression of cavities. Since its introduction to the water supply in 1945, dental cavities in children and adults have significantly decreased. Your child can get fluoride in two other ways:
  • Dietary fluoride supplements: Offered in tablet or liquid form, this supplement is only recommended for those who drink water low in fluoride or have a higher risk of developing cavities.
  • Topical fluoride therapy: This treatment is best used for children between three and six years old. It comes in a variety of forms, such as over-the-counter fluoridated toothpaste, gels, pastes, or varnishes. The applied treatments are done only in a professional dental office.

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Knowing what to expect after your first orthodontic appointment will help alleviate any anxiety or concerns you may have about treatment. Your orthodontic team will do what they can to help you feel at ease, such as answering all your questions and discussing possible financing options.

What happens at the initial appointment?

• Introductions: Getting braces for the first time can be daunting, so it’s important that proper introductions are made to help ease anxiety. You will meet with your orthodontic team; they will do everything they can to make sure you’re comfortable.
• Paperwork and health history: A team member will ask you to fill out paperwork regarding your relevant health history. It also informs your orthodontic team if you’ve had X-rays in the past or any previous oral issues you may have experienced.
• Exam and X-rays: During a thorough examination of your teeth, an orthodontic team member will use advanced 3D scanning, X-rays, and visual inspection. This helps them understand the unique needs of your teeth to build an effective treatment plan.
• Treatment plan: Generally, there may be a few orthodontic treatment options available to you. Together with your team, you will decide which plan works best for you. This can even be based on budget, predicted results, and treatment length.
• Patient questions: Once a treatment plan has been chosen, you will be given the floor to ask any and all questions. Your orthodontic team wants to make sure you have a solid understanding of what to expect in the next coming months, so questions are highly encouraged in order to address concerns and alleviate anxiety.
• Finances: A team member will review your insurance and discuss the payment options for your treatment. Some orthodontic offices offer flexible financing options or payment plans to help make costs more manageable.
• Your next appointment: Once your first appointment is completed, a team member will schedule your following appointment to put your treatment plan into action.

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Your child’s first tooth is a big developmental milestone, so it’s important for you to know what to expect and how to maintain your child’s teeth when they start coming in. It’s just as vital to take care of baby teeth as it is permanent teeth, even though the baby teeth eventually fall out. Improper dental hygiene can set your child up for oral complications early on, as well as poor dental hygiene habits down the road, including more severe oral issues. Be sure to look for the signs that their baby teeth are coming in and take the proper steps to keeping them healthy.

Eruption of Baby Teeth

Baby teeth typically erupt in the lower front teeth region, with most children obtaining all their baby teeth by three years old. For some children, this timeline varies. Some may not experience their first erupted baby tooth until their first birthday.

Teething

Teething is an indicator that your child’s baby teeth are coming in, and is usually accompanied by slight discomfort, excessive drooling, and swollen or tender gums. Some tips to remember when teething begins include:

• Massage your child’s gums with a clean finger to ease some discomfort.
• Offer a solid, not liquid-filled, teething ring (can be frozen).
• Offer a clean, frozen, or wet washcloth.
• Offer a teething biscuit, but be sure to monitor your child while they eat it.
• If discomfort persists, talk to your child’s pediatrician about a safe dose of liquid acetaminophen.
• Avoid teething tablets that contain belladonna and benzocaine gel, as these substances can be potentially toxic to your child.
• Never use a teething necklace, as your child will be at risk for strangulation or choking.

Proper Oral Hygiene

Once your child’s first tooth comes in, you will need to begin an oral hygiene routine with them. The process slightly changes as they grow, so some helpful tips include:

• Brushing twice a day with a grain-of-rice-sized dollop of fluoride toothpaste, especially after consuming foods or beverages.
• Refrain from letting your child go to bed with a bottle since this can lead to tooth decay.
• When your child turns three years old, you may increase fluoride toothpaste to a pea-sized amount when brushing.
• When your child is at the developmental stage where they can spit, teach them to spit out the excess toothpaste after brushing.
• It’s recommended that the parent place the toothpaste on their child’s toothbrush until they reach six years of age.
• Parents should monitor and assist their child while brushing until they reach seven or eight years old.

Importance of Fluoride

Fluoride is an essential mineral for preventing tooth decay, as it works to harden the enamel of the teeth. Fluoride is often found in tap water, rarely ever bottled, so it’s a good idea to give your child tap water when they begin eating solid foods. If you feel that your child is not consuming enough fluoride, talk to your pediatric dentist about fluoride supplements.

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