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If you ask the average person on the street what an orthodontist does, she or he will say that orthodontists straighten teeth. Which is partially true, but they do more than that. What is often overlooked are the actual goals of orthodontic treatment, meaning what are they actually trying to accomplish when they move teeth around.
The real goals of orthodontic treatment are two-fold.
Goal number one is to align the teeth and jaws in a way that enhances facial esthetics. This is important because 80 percent of feeling good is looking good, and a pleasing smile definitely makes us look good. Looking and feeling good translates to enhanced self-esteem and confidence, which gives us an advantage in social interactions. That advantage can mean better outcomes in life like higher paying jobs, better grades, more friends and better relationships.
Goal number two is to enhance overall oral health and in my opinion is equally important. Well-aligned teeth are easier to keep clean which translates to a reduced risk for decay and gum disease. The better the upper and lower teeth fit together (the occlusion or bite), the less likely will be the occurrence of excessive and uneven wear. Better alignment and bites also contributes to the overall oral health by fostering a balance between the jaw muscles, joints, bone, and roots of the teeth as well.
According to the article below posted on the Mayo Clinic website, we can go further with our discussion of the importance of well aligned teeth and jaws, and overall oral health. This interesting article discusses the relationship of oral health to our overall health—I don’t know about you, but after reading this article I immediately went looking for my floss.
Wishing you Health and Happiness,
Oral Health: A window to your overall health
Your oral health is more important than you may realize. Get the facts about how the health of your mouth, teeth and gums may affect your general health. By Mayo Clinic staff
Did you know that your oral health can offer clues about your overall health? Or that problems in your mouth can affect the rest of your body? Understand the intimate connection between oral health and overall health and what you can do to protect yourself.
What’s the connection between oral health and overall health?
Your mouth is teeming with bacteria — most of them harmless. Normally the body’s natural defenses and good oral health care, such as daily brushing and flossing, can keep these bacteria under control. However, harmful bacteria can sometimes grow out of control and cause oral infections, such as tooth decay and gum disease. In addition, dental procedures, medications, or treatments that reduce saliva flow, disrupt the normal balance of bacteria in your mouth or breach the mouth’s normal protective barriers may make it easier for bacteria to enter your bloodstream.
What conditions may be linked to oral health?
Your oral health may affect, be affected by or contribute to various diseases and conditions, including:
- Endocarditis. Gum disease and dental procedures that cut your gums may allow bacteria to enter your bloodstream. If you have a weak immune system or a damaged heart valve, this can cause infection in other parts of the body — such as an infection of the inner lining of the heart (endocarditis).
- Cardiovascular disease. Some research suggests that heart disease, clogged arteries and stroke may be linked to oral bacteria, possibly due to chronic inflammation from periodontitis — a severe form of gum disease.
- Pregnancy and birth. Gum disease has been linked to premature birth and low birth weight.
- Diabetes. Diabetes reduces the body’s resistance to infection — putting the gums at risk. In addition, people who have inadequate blood sugar control may develop more-frequent and severe infections of the gums and the bone that holds teeth in place, and they may lose more teeth than do people who have good blood sugar control.
- HIV/AIDS. Oral problems, such as painful mucosal lesions, are common in people who have HIV/AIDS.
- Osteoporosis. Osteoporosis — which causes bones to become weak and brittle — may be associated with periodontal bone loss and tooth loss.
- Alzheimer’s disease. Tooth loss before age 35 may be a risk factor for Alzheimer’s disease.
- Other conditions. Other conditions that may be linked to oral health include Sjogren’s syndrome — an immune system disorder — and eating disorders.
Be sure to tell your dentist if you’re taking any medications or have had any changes in your overall health — especially if you’ve had any recent illnesses or you have a chronic condition.
How can I protect my oral health?
To protect your oral health, resolve to practice good oral hygiene every day. For example:
- Brush your teeth at least twice a day.
- Replace your toothbrush every three to four months.
- Floss daily.
- Eat a healthy diet and limit between-meal snacks.
- Schedule regular dental checkups.
Also, watch for signs and symptoms of oral disease and contact your dentist as soon as a problem arises. Remember, taking care of your oral health is an investment in your overall health.
The Worth of a Smile
The thing that goes the farthest
Towards making life worth while,
Which costs the least and counts the most,
Is just a pleasant smile.
The smile that bubbles from a heart
That loves its fellow men,
Will drive away the clouds of gloom
And coax the sun again,
It is full of worth, and goodness too,
With many kindness blent;
It is worth a million dollars
And it doesn’t cost a cent.
There is no room for sadness
When we see a cheery smile,
It always has the same good looks,
It’s never out of style.
It nerves us on to try again
When failure makes us blue,
The dimples of encouragement
Are good for me and you.
It pays a higher interest
For it is sincerely lent;
It is worth a million dollars
And doesn’t cost a cent.
A smile comes very easy,
You can wrinkle up with cheer
A hundred times before you
Can squeeze out a soggy tear.
It ripples out moreover
To the heart-strings that will tug,
And always leaves an echo
That is very like a hug;
So smile away, folks understand
What by a smile is meant;
It is worth a million dollars
And doesn’t cost a cent.
Are Braces Worth It?
Here are some blog comments to consider…
“Good luck, and I recommend braces!!” (Samantha)
“Yes it’s worth it!!! Because the older you get the more your teeth start to shift. and it makes your teeth completely straight. I’ve had my braces for about 9 months and I still have 9 more to go, but my teeth are already pretty straight and they were really bad before. And about the retainer for the rest of your life… you really only wear it at night, as my friend does, so don’t worry about that and wouldn’t you want perfect straight teeth? So go for it!” (Anonymous)
“It’s deffs worth it! Your smile is the first thing people notice about you lol! There’s a lot of people that have done it and they don’t mind the retainer or anything. So if you can afford it do it. Take my word for it! You will be way more attractive so hurry and do them while you are still young!” (Meh:)
“I had braces for 2 years and was told I had to wear the retainer forever. It was worth it and I only wore the retainer for 1 year and then on occasion after that. I think you should because you’re still in high school and it’s still socially acceptable to have braces.” (Dave)
“Yeah they are worth it! I have crooked teeth and regret not getting them.” (asban)
“Absolutely since your teeth might look fine but the overbite is a problem that should be fixed. You will love the band behind your teeth once you get your braces off compared to a plastic retainer since you do absolutely nothing with it. You don’t feel it, don’t notice, and most of all will not care about it. The band is simply a tiny metal retainer that goes behind your bottom 4 teeth to prevent it from moving.” (Anonymous)
“A smile costs nothing but gives much. It enriches those who receive without making poorer those who give. It takes but a moment, but the memory of it sometimes lasts forever. None is so rich or mighty that he cannot get along without it and none is so poor that he cannot be made rich by it. Yet a smile cannot be bought, begged, borrowed, or stolen, for it is something that is of no value to anyone until it is given away. Some people are too tired to give you a smile. Give them one of yours, as no one needs a smile so much as he who has no more to give.” (Anonymous)
Single phase orthodontics means we wait until nearly all of the permanent teeth are in place prior to starting treatment. Phased orthodontic treatment means a first phase of treatment is started earlier — commonly at age 7 to 9, when all permanent incisors (front teeth) and permanent first molars are in place but permanent canines and premolars have not yet erupted. There are indications for both approaches and the option selected should be individually based.
If you select the phased treatment option, it is important to realize that there is a greater than 50-50 chance that you will need to do both phases – i.e. even if you start early you will not finish early, and there may be additional cost and time involved.
In our practice, we have a comprehensive approach to the first phase, a rigid retention program, and, in fact, 1 out of 3 patients will not need to go on to a second phase. Furthermore, for the 2 out of 3 patients that still require phase II treatment, the second phase of treatment is often simpler and faster than if we had done single phase treatment. That being said, we do not do phased treatment on everyone, preferring to wait when problems are mild to moderate.
On the other hand, the benefit of a phased approach to young patients may be worth much more than the extra time or cost. For example, many female patients finish most or all of their jaw growth prior to the time their full permanent dentition is in place. Teeth that erupt into the wrong place or are impacted (‘stuck’ or blocked out of place) often require extractions or surgical intervention and this is often circumvented with earlier treatment.
The literature lists the following as benefits of phased treatment:
1. Takes advantage of growth
2. Requires fewer extractions of permanent teeth
3. Involves less orthognathic (jaw) surgery
4. Addresses harmful habits
5. Causes less tooth trauma and enamel wear
6. Improves self-esteem and social comfort
7. Assures greater compliance with the course of treatment than in the challenging teenage years
Most important is the improvement in self-esteem and confidence that occurs when a child is given a beautiful smile during the socially challenging middle school years. With a list of clear long-term medical benefits, the ultimate decision is still based most often on the consideration of that more intangible factor:
How much is your child’s self-esteem worth?
A question that comes up often in orthodontic consultation, diagnosis, and treatment planning is: Will it be necessary to remove premolar teeth to straighten your teeth or to correct your malocclusion (bite)?
The answer is that it depends. There are several factors to consider, including the degree of crowding; flaring; thick versus thin gum tissue; missing, fractured, diseased, or impacted teeth; and the severity of the overbite or jaw imbalance.
A general observation is that about 25 percent of the time extractions are clearly not indicated. These are situations where crowding is mild to moderate, the front teeth are not flared forward, and bite and jaw discrepancies are mild to moderate.
10-25 per cent of the time (percentage varies according to the local prevalent genetic make-up) extractions are definitely indicated. These are situations where the orthodontic patient has either extreme crowding, flaring of teeth, or a significant overbite.
The 50 to 65 percent of patients in the middle of the spectrum are considered to be border line and usually started on a non extraction trial. These days, most folks in this group complete their treatment without removing teeth.
The good news is that, looking at all patients combined, premolar extractions can be avoided about 70 to 90 percent of the time!
Here at Kineret Orthodontics, most extraction cases are started non-extraction. The rationale being that once premolars are removed, you can’t put them back. So if there is a small but reasonable chance of substantial response to wires and rubber bands, it is best to defer extraction decisions until mid-treatment.
Even when it is certain at the outset of treatment that extractions are indicated, I prefer to defer extractions until mid-course. The reason being that by mid-treatment we are in large arch wires, have started rubber bands and can more strategically and efficiently close extraction sites.
First of all, choose the right doctor
In this state, it is legal for general dentists to offer and provide orthodontic treatment to their patients (irrespective of the intensity of their orthodontic education). So, in my opinion, you should be clear on the differences between the levels of training, experience, and expertise that exist between a general dentist with a special interest in orthodontics and a university trained board eligible or certified orthodontic specialist. Short answer: the orthodontic specialist made the commitment of a full time 2 or 3 year postgraduate residency in our specialty, earned a clinical certificate (and a masters degree –credentials: DDS, MS if they did a research project and thesis).
In comparison, the level of training for a general dentist with a special interest in orthodontics is based on the minimal dental school curriculum exposure to basic orthodontics and the weekend courses they have attended.
The orthodontic specialist has limited his practice to orthodontics alone, whereas the general dentist also provides other services. In my mind, the compounding of limited specialty practice with a 2 or 3 year post graduate residency experience distills down to a substantial difference in levels of experience and expertise.
Here is another way to look at this. If you needed a quadruple bypass, who would you choose to do it—an experienced, well-trained cardiac surgeon or the family doctor?
Secondly, follow these guidelines:
Do not base your decision on price but on value.
I believe the general erroneous assumption made by the public is that most doctors’ training, philosophy and results should be the same because our profession is regulated by the state. Remember appearances sometimes can deceive. And guess what? In our community, fees don’t deviate all that much! So the question is: Do you want to be in a great practice and have a very positive experience for you or your child or do you want to save a few dollars a month? May I suggest a checklist to help you choose?
If the conditions on the following checklist have been met, congratulations; odds are that you have made a great investment in your oral health. You have found your new orthodontic home.
You have been referred by another patient(s) who had a very positive experience in that office
The doctor can show you similar cases with pleasing results (there are before and after examples on our blog and website)
You feel that there is very good communication and direct and frequent interaction with the doctor
The staff is very friendly and caring
The office is conveniently located and offers office hours throughout the week and runs on time
The office implements contemporary technologies and infection controls
The office helps you maximize your insurance benefits and offers flexible no interest and no down payment options, and cash discounts
Choose the right office based on the above checklist/criteria–do not get bogged down in terminology or types of appliances used.
There are fads in orthodontics, just like in other professions and industries. Decisions should be based on good diagnosis and treatment planning not on marketing fads, or using the latest, greatest widget. I frequently see this kind of thing happen when the general dentist gives the patient/parent several referral cards; the patient dutifully gathers multiple diverse opinions and then becomes very confused. Instead, use my checklist. It will help, I promise.
Make sure your child is on board and encourage them to cooperate and follow directions to maximize results
I always tell my patients that a great patient and an average orthodontist can often get better results than the reverse. Meaning, this is all about team work folks! If you really want to get a great return on your investment, keep your kids on task with doing their part in treatment—compliance is paramount! Treatment always turns out better and usually moves along faster, if patients keep their appointments, keep the teeth, gums and braces clean, wear their rubber bands consistently, and are careful not to loosen the non-permanent adhesive that attaches the braces to the teeth.
In our office we have many incentives and rewards in place to encourage compliance and responsibility. However, if you can maintain tandem reward systems at home, the gains are more than doubled! The side benefit of this is the maturation and personal growth that occurs when patients take responsibility and become active participants in their treatment.
By Dr. Stephen Kineret