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Orthodontics have become a new tool to recreate our smiles. For the longest time, orthodontic braces was a treatment only for children. Advances in orthodontic materials have led to changes in the appearance of orthodontic appliances, and increased speed of movement of our teeth. Orthodontics have become a treatment of choice for many teens and adults. There are multiple options for orthodontic treatment today to make them as aesthetic as possible with shorter treatment lengths along with more cosmetic appearance. While teeth are being moved, changes occur to the mouth, lips, chin, and cheeks. The million dollar question is…..Can Orthodontic treatment change a person’s facial appearance?

Once orthodontic treatment is completed, many patients will look in the mirror and notice changes in their facial appearance. The bigger change happen when exhibiting a full smile, as this will show off the new found symmetry of your smile. The change will be even more noticeable if there are major corrections during your orthodontic treatment.

 Orthodontic Corrections = Changing Facial Appearance

-Correction Of Overbite.  An overbite can cause the upper lip to protrude otward. In very extreme cases the upper lip is so far advanced that the lips are not able to completely cover and close the mouth at rest. In side profile the upper lip flares and the convexity of the mid face is pronounced. After completion of orthodontic movement, the facial area from nose down to chin flattens and the appearance can soften.

-Correction Of Underbite. An underbite causes the chin to protrude and lower lip to retrude, giving you a “Moon Shape” profile. After orthodontic movement, the face loses much of this concavity. This again helps to flatten and soften the features, bringing the lips together in a more natural look. Underbite correction may in some cases require surgery.

-Open Bite Correction. Prior to correction, the mouth and lips may seem a bit overstretched. In more severe cases the lips do not touch at rest. After movement, The mid face appears more relaxed and the lips come together at rest. Severe open bite may require surgery to be fully corrected.

-Upper Or Lower Jaw Expansion. There are times when a patient has too little space in one or both of their arches.  The middle of the face may be narrow, and cheeks a bit hollow. If space needs to be opened, a device is custom fabricated called an orthodontic expander. If it is used on top jaw it is referred to as a palatal expander and if used on lower jaw it is called a mandibular expander. Expanders are used more often on children but they can also be used on adults in coordination with surgery. The expansion is usually done in very small increments and usually will go unnoticed by many. A more symmetrical smile and wider mid face will be the end result.

Conclusion

Orthodontic treatment can change a person in multiple ways. These changes can include a bigger smile, straighter teeth, and balancing of one’s facial appearance. The changes to a person’s face are usually more pronounced when surgery is involved.  A person’s side profile is what changes most dramatically. When teeth are in proper alignment, the profile of a person will be more in line with the rest of their facial features creating a more symmetrical balanced appearance.

The facial changes can usually be predicted prior to treatment. Ask your dentist what changes you can expect based on your individual smile

As we age many changes occur in our bodies including our teeth. Our teeth shift and move over time due to many forces that we control and ones we do not. These forces include tongue movements, lips pushing against our teeth, and how our teeth come together. Below we will review some of these forces in greater detail.

Forces Attempting To Move Our Teeth

-Tongue Habits. The most common is an abnormal tongue thrust. Our tongue places pressure on our teeth through eating, swallowing, and talking. We do not even realize how often our tongue presses against our teeth. If you swallow, you will realize that your tongue presses against your upper teeth. For most of us, this is not an issue but for others with a powerful tongue thrust, this can cause tooth movement over time.

-Lip Habits. The forces that your lips apply to your teeth can actually cause your teeth to move.  A good example is tucking your lower lip behind your upper teeth.  This is especially common in younger children and people who bite their lips when they get nervous. The forces over time can cause those teeth to shift outward.

-Frenum Issues. The frena is the attachment between your lips and tongue to the gum tissues attached to the teeth. The one on the inside by your tongue is called a lingual frenum. The other two are on the inside of your lips and called a labial frenum. The lingual frenum generally does not affect the teeth but can affect eating, speech, and swallowing as it can constrict tongue movement. The labial frenum can play a part in moving the front two teeth apart. To alleviate this your dentist or oral surgeon can remove the labial frenum surgically.

-Forces From Our Teeth. Our teeth are in a constant state of pressure from each other.  Normally when you bite together, your teeth touch and rest in a certain position.  This position is known as centric occlusion.  Normally, the top teeth oppose the bottom teeth and keep them in line. However, if you lose a tooth or a tooth becomes badly damaged from trauma or tooth decay space opens up. The teeth on either side of the lost tooth move, as will the tooth that opposes it. For example, if you lost a lower tooth, the tooth on the upper jaw that normally hits it would start to grow down slightly to fill in the space and the adjacent teeth to the lost tooth would start to lean in towards the empty gap.

-Genetics. Our body is hardwired with a set of instructions and our genetics determine if our teeth will be straight or not.

-Tooth Decay. If left untreated, your tooth will eventually break down changing its shape and size. This will open space up causing our teeth to shift into that space. Also, a tooth restored improperly can also change the tooth’s relationship to the other teeth causing changes as well.

-Age. As we age, the area between the teeth starts to wear away. When this happens, the enamel begins to thin out. And, because the lower teeth are inherently thinner, they wear out faster. The more wear and tear on the lower teeth, the less able they are to withstand the force of the top teeth when biting down, resulting in shifting.

-Teeth Grinding (Bruxism). Teeth grinding forces the lower jaw forward and puts tension on the upper teeth. The continual thrusting affects the position of the upper arch, pushing it out of alignment.

Conclusion

As you can see, there are many different forces that are constantly acting on your teeth that could cause them to move. It is important to treat those forces that you can control. See your dentist if you feel your teeth are shifting to avoid future issues.

Undergoing orthodontic treatment can be a trying time for maintaining good dental hygiene, but the end result makes it all worth it. Creating a straight, attractive smile that one can be proud of is the goal of most orthodontic treatment.  However, orthodontic treatment can disrupt your daily routine. The orthodontic brackets and wires, and chewy, sticky foods can make dental hygiene more challenging and difficult. Poor hygiene, while wearing braces, can put your teeth and gums at risk for periodontal disease and decay. Luckily, there are ways to maintain great hygiene even with orthodontic brackets and wires attached to your teeth.

Tooth Decay Prevention Tips

Even without braces, maintaining dental hygiene can be very challenging. The main task in any dental hygiene program is to control the buildup of dental plaque and tartar. This dental plaque contains oral bacteria that releases acid that can destroy the out layers (enamel) of your tooth. Tartar is an irritant that can cause swollen or receded gums, and bone loss. The following are some key tips to help keep your teeth and gums in top shape while wearing orthodontic braces (or even without them!):

Flossing And Brushing Tips - To floss teeth if you have braces, feed the end of the floss threader or all in one floss through the space between the main arch wire and the upper portion of the tooth closest to the gum. Use a gentle sawing motion to work the floss on each side of the two teeth the floss is between. Be careful not to pull with too much force around the arch wire. Brush teeth by using a rotary toothbrush or a regular soft toothbrush. Brush down from the top and then up from the bottom on each tooth with braces. Next, brush your teeth with a proxabrush or “Christmas tree” brush. This brush is specially designed for cleaning between two braces. Insert the brush down from the top and then up from the bottom between two braces. Use several strokes in each direction before moving on to the next space between two braces. A Waterpik with Periogen and purple listerine works very well to flush out plaque, tartar, and stain to keep your brackets and elastics clean. Continue with cleaning until all metal surfaces shine and there is no plaque left behind.

Dental hygiene appointments should occur more frequently (every 3-4 months). Fluoride treatments and dental sealants are also helpful to keep teeth strong and decay free.

Foods to Avoid While Wearing Braces – While going through orthodontic treatment there are several types of foods that shouldn’t be eaten. It helps if the pieces are smaller so they can be easily chewed and lessen risk of breaking any brackets or wires. Items and habits that should be avoided include:

-Hard or difficult to bite foods. These include apples, bagels, pizza crust, beef jerky.

-Chewy and sticky foods. This includes taffy, bubble gum, or caramels.

-Corn on the cob. Remove the kernels and eat them individually vs biting them off the cob.

-Hard pretzels, popcorn, nuts, and carrots.

-Do not chew ice, fingernails, or pencils.

-Do not open things (bottles, chip bags, etc.) with your teeth.

Conclusion

The last thing anyone wants, is to complete orthodontic treatment with beautifully straight teeth loaded with cavities and bleeding gums. Luckily, with diligent work in maintaining dental hygiene tooth issues can be prevented. This should also include regular dental visits for examinations and professional cleanings.

Crooked teeth (also called malocclusion) can affect almost 75% of all American adults. Malocclusion can significantly affect oral health over the course of a lifetime, leaving you with increased chances of developing periodontal disease and increased wear and trauma to teeth.

Types Of Malocclusion

-Crossbite – A crossbite is when the lower teeth overlap or come out even with the upper teeth. In a normal occlusion the upper teeth overlap the lower ones but when a crossbite (can occur on either side or both) is present, the opposite is true. This can lead to premature wear, increased risk of chipping or fracturing your teeth, development of abfraction (small notch in tooth at the gumline), and periodontal disease.

-Excessive Overjet – This occurs when the upper front teeth are too far out in front of the lower teeth. This can lead to increased trauma as well as an increase to chipping or fracturing of teeth (especially the front ones).

-Edge To Edge Bite – This occurs when the teeth touch one another edge to edge (or cusp to cusp). The teeth do not fit together propely allowing the biting surfaces to touch. This will lead to increased risk of chipping and fracturing, Temperomandibular Joint (TMJ) pain, as well as short, worn down teeth.

-Open Bite – This is a common occurence from thumb sucking or can be genetic. It is when there is a space between the front upper teeth and the front lower teeth upon closing. Not only is this an unesthetic option but it can lead to abfraction, is difficult to bite and tear food ,and causes excessive, premature wear of the back teeth.

-Over Bite- This is when the upper front teeth completely cover the lower front teeth. Often, the lower teeth hit into the backs of the upper teeth and sometimes into the roof of the mouth.

-Under Bite- This occurs when the lower jaw has grown more quickly than the upper jaw. The lower front teeth and jaw have grown in front of the upper teeth.

-Tooth Size Arch Length Discrepency- When your teeth are too large for your jaw space and cause extreme crowding or when your teeth are too small for your mouth. Crowding can lead to decay, fracture, and periodontal disease. Small teeth are generally a major cosmetic issue.

The General Health Danger

Gum disease is commonly found along with malocclusion, due to difficulty in maintaining good oral hygiene when teeth are not in proper position.

Periodontal disease has been linked to many systemic diseases through various studies. Some of these diseases include heart disease, diabetes, and alzheimer’s. Periodontal disease generally takes years of neglect to develop. There are various stages of periodontal disease progression, they include:

-Gingivitis – The earliest stage. The only stage that is reversible with proper dental care. This stage is characterized by swollen, red gum tissues, bleeding upon brushing, as well as bad breath (halitosis). If treated before it progresses, it can be reversed back to a normal, healthy, gingival state.

-Periodontitis – This is the stage that develops following ginigvitis. It is not reversible but can be controlled. Damage to teeth, bone, and gums can be limited with proper dental care. During this stage, the supporting tissues around the teeth may break down leading to gum recession and bone loss around the teeth.

-Advanced Periodontitis – This stage increases the bone loss and gum recession leading to loosening of teeth with the real possibility of losing one or more teeth.

How Do Crooked Teeth Affect Our Mouths?

When teeth are crowded and not aligned properly, the plaque and bacteria that forms on our teeth during everyday food consumption  becomes much more difficult to remove. This makes it difficult to  maintain a good state of health. Many times, flossing and brushing areas of overcrowded teeth will become very difficult. These areas are generally called a “plaque trap” for their ability to constantly trap food and debris.  As mentioned earlier, without proper care, plaque traps can lead to bone loss, gum recession, and even tooth loss.

Another cause for concern is wear and trauma to the teeth. Poorly aligned teeth can create unnatural stresses on the teeth and the jaws. Teeth subjected to excessive pressures can develop chipping, fracturing, and abfractions. Premature wear can also lead to lost teeth, loose teeth and even root canal therapy.

Finally, crowded teeth affect your systemic health by allowing bacteria to grow and flourish unabated in these crowded areas. Over time, this can lead to devastating life threatening effects like heart disease and stroke.

What Can Be Done To Combat Crooked Teeth?

Fortunately, in many cases the simple solution is increased visits to the dentist for professional cleanings as well as diligent  home care.  When there is undue stress placed on the teeth that can cause trauma and wear over time, Orthodontics is the answer in most cases. Orthodontics is a type of dentistry dealing with crowded or misaligned teeth. Proper orthodontic treatment can, in many cases, restore your smile and make it easier to maintain it.

Orthodontics Conclusion

Orthodontics is not just for cosmetic reasons. We are not all born with perfectly straight teeth and sometimes we need a little help to get there. The bottom line is to have beautiful teeth and gums that make you feel confident and healthy. Your smile should  last you a lifetime!