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Most teens and adults who wear braces cannot wait for the day that they are free from them. They look forward to finally having the straight smile they have desired.

Braces - Marielaina Perrone DDS

Orthodontic Treatment – Braces

Whether treatment takes a few months (in cases of limited orthodontics) or 2-3 years it is still something to look forward to. But now the work begins to continue maintaining proper oral hygiene to keep those teeth straight, white, and free of tooth decay.

Tips to Maintain that Straight Smile

Schedule regular dental examinations and cleanings. Now that the braces are off it is not a time to slack off on maintaining your teeth. Most patients find dental hygiene to be easier after dealing with braces for such a long time. Most patients, especially adult patients, are extra motivated following orthodontic treatment. They want to show off their new smile and keep their teeth shining. Immediately following removal of braces it is very important to schedule an appointment to see your regular dentist to ensure there is no tooth decay, residual cement, chipped enamel or stains. Sometimes there are white spots caused by decalcified enamel under or around the brackets. The gums, and roots of teeth also need to be evaluated. The dentist will also check your orthodontic retainer to assure proper fit and hygiene.

Wear Your Orthodontic Retainer. Following most orthodontic treatment an orthodontic retainer is custom made for patients. This retainer will need to be worn for 9-12 months as your teeth “adjust” to their new positions. If you choose not to wear your orthodontic retainer regularly, your teeth will likely shift. After the first year, many people wear their orthodontic retainers at night, several nights per week, to ensure that their new smiles continue to look great. There are three basic types of orthodontic retainers. These include:

1) Hawley Retainer. This type of orthodontic retainer is made of acrylic that is custom molded to your mouth. These contain a wire to hold your teeth in position. A Hawley retainer is the most common type of retainer. The acrylic can be made available in clear, and in a variety of colors and interesting designs, so you can “personalize” your orthodontic retainer if you so choose.

Las Vegas Orthodontics Marielaina Perrone DDS

Wear Your Orthodontic Retainer To Keep Your Smile Straight!

2) Essix Retainer. These are made of clear plastic. Most people like these as they are fairly lightweight and thin, and do not look anything like traditional retainers.

3) Fixed Retainer. These are just as the name implies, meaning they do not come out. These are usually a thin wire bonded behind a section of teeth using a tooth colored material. This type of orthodontic retainer stays in the mouth 24 hours a day and patients must be extra diligent to maintain proper oral hygiene as food and debris can be trapped along this type of orthodontic retainer. This is most often used on lower teeth, as they have the highest incidence of moving back to their original positions over time. The fixed orthodontic retainer is best for those who would be unlikely to wear a removable retainer as they are instructed to, or would likely lose it.

Never stop wearing your orthodontic retainer unless advised otherwise. Wearing the orthodontic retainer will ensure the teeth do not shift over time.

Maintenance of  Your Orthodontic Retainer

How can you keep your orthodontic retainer clean? You can brush a Hawley retainer with a toothbrush. Brushing is not recommended for Essix orthodontic retainers because brushing can scratch or damage them. You can use denture cleaner such as efferdent, but there are actually several retainer cleaning products custom produced for this task. These include RetainerBrite and SonicBrite. You should also bring your orthodontic retainer to dental appointments, your hygienist can place them in a special tartar and stain removing solution to soak while you are having your teeth cleaned.

-Retainer Brite. This cleaner comes in tablet form and can be used with our without a portable sonic cleaner. The advantage of this cleaner is that the tablets are individually wrapped, which makes it easy for traveling and on the go.

SonicBrite. This cleaner is a powder that comes with a battery operated sonic cleaner bath. It works very well at getting white calculus build up off of many types of Las Vegas Orthodontics Marielaina Perrone DDSorthodontic retainers and dental appliances. Patients with Essix retainers and Invisalign -type aligners tend to like this system.

All of these systems do a very good job at keeping your orthodontic retainer smelling fresh and preventing white build up. They can be used for either plastic and wire Hawley retainers, or Essix (clear plastic) retainers and Invisalign type aligner trays.

What If I lose My Orthodontic Retainer?

Losing retainers especially for teenagers is quite common. A good tip to make sure you do not lose it is to carry a retainer case with you at all times. Get in the habit of placing the orthodontic retainer in its case whenever you need to remove it. This way it is not just left in a napkin on a restaurant table or left for a dog to chew. Be sure to keep your orthodontic retainers in their protective case when out of your mouth.  Dogs love to chew retainers, and they can be easily knocked off counters and stepped on. It is YOUR responsibility to make sure that the retainer is kept in a safe place when not in use.  Backpacks, pockets, and purses are also dangerous, unless the protective case is used.  Heavy books, keys, etc. can bend and break orthodontic retainers.

You have long awaited your new smile. You have been through a lot to get here. Make sure you do all that you need to maintain your investment. Your future should be filled with years of bright smiles. Wear your orthodontic retainer, so that your teeth don’t move out of their new, beautiful positions. Continue with excellent oral hygiene. Be diligent with your dental visits. These tips can help keep that perfect smile straight for many years to come!


Pediatric Dentistry is the area of dentistry treating children from birth through adolescence. Children are special patients and have different needs than adults. So the field of dentistry developed a specialty of pediatric dentistry surrounding their needs. In general, pediatric dentistry takes care of severely broken down teeth requiring sedation. They also are great if your child is too fearful or disabled to handle treatment without sedation. Family dentists are also trained in pediatric dentistry and can treat children of all ages. A pediatric dentistry specialist is not always needed nor required for your children. Most children do quite well in a family dental practice and actually prefer to be with the rest of the family. The earlier a child starts with dental checkups, the easier it is on them and you. Problems are detected early and treatments can be quick and simple. Most children look forward to dental appointments when they have built a trust and confidence in their dentist. This is true for a family dentist or a pediatric dentist.

Whereas adult patients present with one set of teeth and its various issues. Children present to the dentist with three phases of teeth. These phases are called:

1) Deciduous Dentition (teeth) Phase. In this phase all of the child’s teeth are still baby or deciduous teeth. The child has not yet had any permanent teeth erupt.

2) Mixed Dentition Phase. This is where some of the child’s permanent teeth have erupted and replaced some of the primary teeth. So they have a mixture of primary and permanent teeth. This phase has also been coined the “ugly duckling phase”.

3) Permanent Dentition Phase. This is when all the child’s permanent teeth have erupted. This is the point where pediatric dentistry ends and adult dentistry begins.

Pediatric Dentistry Treatments

Oral Prophylaxis. Oral prophylaxis or prophy is another name for a children’s teeth cleaning by hygienist or dentist. The procedure involves some very light use of hand instruments to clean around teeth along with brushing and educational instructions. Education will be reinforced after every visit to ensure patient follows up at home and understands the importance of keeping their teeth clean.

-Application of Fluoride. Fluoride applications can be done in two ways, through the tray method or the paint-on method. Both methods are quite effective at providing the developing teeth with the right amount of fluoride. It is totally a child’s personal preference. The choice is there to make it more comfortable on the child. Pediatric dentistry should always involve choices for the patient so they feel like they are intimately involved in making decisions in their dental care.

-Sealants. These are also called pit and fissure sealants because they are designed to fill in the pits and fissures that are part of a child’s teeth natural anatomy. It is recommended to place sealants on the molar and premolar teeth as soon as they come in. This is because you do not want to risk tooth cavities when you can have protection from the beginning. When properly applied and maintained, they can successfully protect the chewing surfaces of children’s teeth. By forming a thin covering over the pits and fissures, sealants keep out plaque and food, thus decreasing the risk of developing a cavity.  Since the covering is only over the biting surface of the tooth, areas on the side and between teeth are not protected by the sealant.

-Preventive Resin Restoration (also called PRR). This procedure is used in pediatric dentistry for teeth that have already developed very small cavities. This technique is similar to a sealant but the small amount of decay must be removed first. Using a PRR will prevent the progression of the cavity from going any deeper into the tooth.

Dental Bonding. Dentists are able to restore cavities that are larger than a PRR can fix using tooth colored dental materials. This will allow the teeth to remain white and not be noticeable upon smiling. Dental bonding is not as prevalent in pediatric dentistry as in other forms of dentistry.

-Pulp Therapy.The pulp (or nerve) of a tooth is the inner center of the tooth. Nerves, blood vessels, connective tissue and reparative cells are all inside the pulp. In pediatric dentistry the purpose of pulp treatment is to maintain the affected tooth so that the tooth is not completely lost, and can hold the space for the permanent tooth. This can help retain a good bite and makes braces less likely. The main reasons in pediatric dentistry for pulp treatment are dental cavities and trauma. In pulp treatment the dentist removes the diseased pulpal tissue. An antibacterial agent is placed inside the tooth to prevent further bacterial growth and to calm the remaining nerve tissue in the tooth. A stainless steel crown usually follows this procedure.

Stainless Steel Crowns. This type of Crown is used in pediatric dentistry to restore teeth that have been badly damaged due to large cavities, excessive teeth grinding or wear.  They are used when a filling is not possible in a tooth because of the amount of damage present. For front teeth, stainless steel crowns with white facing are used to help with aesthetics.

-Extractions. Tooth removal may be necessary in pediatric dentistry for various reasons, including, infection, risk of infection, preparation for orthodontics, over crowding, teeth growing behind other teeth, or for larger cavities that cannot be restored.

Space Maintainers or early Orthodontic Evaluations. Space Maintainers are used to hold the proper amount of space for permanent teeth. When a primary tooth is lost too early, the teeth beside it may tilt or drift into that empty space. Teeth in the opposing jaw may move up or down to fill the gap.  As teeth beside the gap shift into the empty space, they create a lack of space in the jaw for the permanent teeth.  When this occurs, permanent teeth are over crowded and can come in crooked. If left untreated, the condition may require extensive and costly orthodontic treatment.

Space maintainers are used to in pediatric dentistry to prevent any drifting of teeth and loss of space in your child’s teeth.  They keep the remaining teeth in place until a permanent tooth fills that space. Space maintainers are appliances made out of metal and are custom designed and fitted to your child’s mouth. Using space maintainers is more affordable and easier on your child than having to move those teeth back in place with orthodontic treatment.

Recognizing orthodontic issues early, gives the dentist more options to plan for the future as the rest of the teeth develop.

Pediatric dentistry has its own special challenges but with dedication by dentist, parents, and child it can be a great experience. Education needs to be at the forefront of all pediatric dentistry.