Maybe you had braces as a child, or you are thinking of having your own (it's never too late) or your child's teeth straightened through orthodontia. But how much do you really know about this branch of dentistry? Here are six questions people often ask about orthodontia.

Q. How did the word “orthodontia” originate?
A. From Latin roots meaning “straight” and “teeth”

Q. Teeth are anchored in bone. How is it possible to move them?
A. Living bone is not unchanging. The bone, ligament, and the outer layer of a tooth's root (called cementum) react to the stresses of biting and chewing. Due to this stimulation the bone is constantly being resorbed (broken down) and rebuilt as it is pushed from one side of a tooth and pulled from the other. Under normal conditions, there is a balance resulting in a steady state. Orthodontia takes advantage of this process to slowly change the teeth's position in the desired way.

Q. My dentist talks about the periodontal ligament. What does this mean?
A. The ligament is a fibrous tissue that connects the teeth to their bone and takes part in the dynamic process of resorption and rebuilding of the bone.

Q. What kinds of conditions can orthodontia correct?
A. Treatment can improve the teeth's position and relations to each other (being too crowded or badly spaced) and the way the upper and lower jaws relate. It can enhance the appearance of a person's teeth and face, and can also improve the teeth's function in biting and chewing.

Q. What is the best first step to orthodontic treatment?
A. Talk to your general dentist about your concerns. If you are referred to an orthodontist, the next step is to assess your situation using molds of your teeth that show the way the upper and lower teeth meet (your bite). Special x-rays will be taken to show the locations of your teeth and relation of your upper and lower jaw. Your dental team may also use photographs of your smile and computer imaging to get a clear view of how your teeth are now and how they may be moved.

Q. What are some of the methods of treatment?
A. In the traditional method, small metal brackets are attached to the crowns of the teeth. Thin wires, called arch wires, are strung through attachments on the brackets. These wires are used to apply controlled force to direct the teeth in the desired direction. Another method is to use removable clear plastic aligners. A series of aligners is designed by a computer, to be changed from one to the next as the positions of the teeth slowly change.

Contact us today to schedule an appointment to discuss your questions about braces and orthodontia. You can also learn more by reading the Dear Doctor magazine articles “Moving Teeth with Orthodontics” and “The Magic of Orthodontics.”

You may have heard the term “veneer” with reference to woodworking, where it means a thin layer of attractive wood that covers and enhances the surface of a piece of furniture. Exactly the same principle applies to porcelain veneers used in dentistry: A thin layer of ceramic material is used to cover parts of a tooth in order to improve its structure and appearance.

Porcelain is a non-metallic ceramic material that is fired in an oven at a high temperature to make it hard and durable. Dental porcelain veneers are thin layers of ceramic that can be applied to the outside of the tooth so that the end result mimics the natural color and translucency of tooth enamel. The underlying tooth structure has to be prepared by removing a small amount of the enamel, about 1 mm, which the veneer replaces. The veneer is then bonded to the prepared surface using a light-sensitive resin.

In woodworking, a veneer may be used to match the grain between the left and right sides of a piece of furniture, creating a beautiful effect on a curve, or simply to bring the appearance of expensive wood to a backing that is less expensive.

Just as a wood veneer improves the appearance of a dresser or table, porcelain laminate veneers may be used to improve teeth that have a number of cosmetic and functional problems. These include staining that cannot be removed by tooth whitening, teeth that are too small, misshapen, chipped or spaced too far apart. After an assessment of your teeth and your smile, we can create a mock-up using temporary tooth-colored materials so you can decide whether the suggested changes will work for you, or you can make suggestions for further improvements.

Porcelain laminate veneers may not be the best solution for you if your teeth are severely stained or damaged. In cases where a large proportion of the original tooth must be replaced, porcelain crowns may be the best solution. The crown is the part of the tooth that is visible above the gum line, and it can be covered with a porcelain crown that looks exactly like a tooth in shape and color. After studying your needs, together we can decide on the most satisfactory method to restore your most attractive smile.

Contact us today to schedule an appointment to discuss your questions about porcelain veneers. You can also learn more by reading the Dear Doctor magazine article “Porcelain Crowns and Veneers.”

We'd like to take a moment to clarify why it is so important to wear the retainer(s) given to you after your orthodontic treatment. These devices, which literally “retain” your teeth in their new and improved positions, are not just for kids. Anyone who has recently had their teeth moved through orthodontics needs to wear them for the prescribed length of time. Here's why:

Though your teeth may now look perfectly aligned, research has shown that there is no “right” position for your teeth to be in that can assure they don't move again — no matter what age you are when treated for malocclusion (“mal” – bad; “occlusion” – bite). In fact, most people will see changes to their bite and tooth alignment as they get older, with or without orthodontic treatment.

For one thing, there is a natural tendency for bottom front teeth to undergo a gradual “uprighting” with age. This can cause them to crowd as they move toward the tongue. And it happens regardless of whether wisdom teeth are present.

In the case of teeth that have been straightened recently, a type of “memory” of their original position may cause them to drift back to it. This tendency gradually lessens, but it may be a problem for up to 18 months.

That's why it's crucial to follow our instructions for wearing retainers. Keep in mind that the plan we have given you is designed to achieve the best possible results in your individual case. Some people will need to wear retainers 24 hours per day, some just at night, and still others on an as-needed basis. You may have received a removable retainer or one that is secured to the back of your teeth. The important thing is to secure the results you've worked so hard to achieve.

If you have any questions about orthodontic retainers, please contact us, or schedule an appointment for an orthodontic consultation.

You can read more about this topic in the Dear Doctor magazine article “The Importance of Orthodontic Retainers.”

A veneer is a cosmetic dental procedure that we use in some situations to correct discolored teeth, small spaces or gaps between teeth, small chips or oddly shaped teeth, and teeth that are slightly misaligned by placing a thin shell covering over the teeth. They are artistically hand-crafted by lab technicians out of tooth-colored porcelain using precise molds that we have made in our office. We attach veneers to the tooth's surface using a special adhesive that creates a chemical bond. Veneers are often a key component in a smile makeover.

Traditional veneers will require some tooth preparation, a process where we reduce or file down some of the facial (front, visible) portion of your tooth by 0.3 to 0.7 millimeters. For this reason this cosmetic procedure is not reversible.

How Long Do They Last?

Veneers can last from 7 to 20+ years depending on how you care for them. This may include sleeping in a protective, professionally made mouthguard. And while porcelain is a durable material that can withstand a great deal of pressure, you must remember that they are a type of glass. You could possibly shatter a veneer if you bite into anything that requires a hefty amount of twisting movement and biting pressure.

By using the latest technologies and procedures, we will create the naturally beautiful smile of your dreams and we will restore your mouth to full functionality and optimal health. Contact us today to discuss your questions or to schedule a consultation.

Want To Learn More?

Learn more about veneers when you continue reading the exclusive article from Dear Doctor, “Smile Design Enhanced With Porcelain Veneers.”

On the day when braces come off, most people feel that their orthodontic treatment is over. When they are then asked to wear retainers, they may wonder what this additional requirement will accomplish. Wasn't the work of moving their teeth to desired positions already completed? To understand the answer to this question, you need to understand how orthodontics works.

How does orthodontic treatment remodel your smile?

Although they give the appearance of being stable and unmoving, teeth and their surrounding structures (gums, jawbones, and ligaments) are living tissues and are actually in a constant state of change.

Teeth are rooted in bone and are attached by a fibrous tissue called the periodontal ligament (from peri meaning around and odont meaning tooth). One side of the ligament attaches to the cementum (part of the tooth's root) and the other side is attached to the bone, with the tooth suspended in between.

These tissues are constantly remodeling themselves, but pressure from the lips and cheeks on one side and from the tongue on the other create a balance that keeps the teeth suspended in the same location. When mild forces are placed on the teeth, such as the forces from the wires used in orthodontic treatment, the tissues slowly adapt and rebuild, resulting in a new position for the teeth.

What are retainers?

Orthodontic retainers are devices usually made of a clear plastic section that is fitted to the roof of the mouth, with thin wires that fit over the teeth.

What is the purpose of retainers?

The remodeling process keeps going after the orthodontic treatment stops, so time is needed for the teeth to reach a new balanced state. The retainer stabilizes them in their new position so that bone and ligament can reform around the teeth and hold them there. This works well for adolescents, whose jaws are in a state of growth, but adults may need outside assistance to stabilize their teeth for a longer time. They may be asked to wear retainers indefinitely to make sure their teeth do not move from their new positions.

What happens if you don't wear your retainers?

If you don't wear your retainers, your teeth are likely to return to the positions they had prior to your orthodontic treatment. This can happen fairly rapidly, underscoring the importance of wearing retainers as instructed.

What are the different types of retainers?

Most retainers are removable devices as described above. For people who require long-term use of retainers, thin retainer wires can be bonded to the inside surfaces of their front teeth. Such wires are usually left in place for several years, relieving them of the need to remove and replace their retainers.

Contact us today to schedule an appointment to discuss your questions about orthodontics and retainers. You can also learn more by reading the Dear Doctor magazine article “Why Orthodontic Retainers?”