6 month Braces

If you are an adult, you have likely heard of this term called "6 month braces" or "6 month smiles."
As an orthodontist, let me assure you that this is not an appropriate modality of treatment when you are trying to get your teeth fixed.
I am posting this blog because of the amount of patients I have recently seen who have completed 6 month braces with their dentist and are now in FULL BRACES to not only finish up, but also correct a wide array of problems that were caused by the treatment.

The "6 month braces" is done by a general dentist who has taken a few courses on tooth movement.  While many general dentists are extremely skilled in their profession, there are SPECIALISTS for a reason.  Would you go to your primary care physician for heart surgery?  I think not, you would choose the specialist who has gone through a rigorous residency program in which they learn the "ins and outs" of the specialty.  While choosing a dentist vs orthodontist is not as serious, just understand that an orthodontist has gone to 3 MORE YEARS OF SCHOOL with specialized training in physiology of bone movement, growth and development, proper timing of treatment, minimizing risks such as root resorption, excess removal of tooth enamel, and many more things!

Here is why many adults find 6 month braces appealing:
1.  QUICK (in & out of braces in 6 months)
2.  Cheaper than traditional braces
3.  If you are getting a smile makeover, such as crowns/veneers, or implants, it is a quick way to get the teeth aligned to be in better positions for your crowns or veneers, which maximizes esthetics

Unfortunately, while these 3 items SOUND good, these are the exact same reasons that the 6 month braces fail:
1.  QUICK treatment does NOT lead to stability (stability means teeth are in a good position and will likely stay long-term).  While no tooth movement will stay long term without retention, you can be sure the teeth that have been quickly moved into 1 position will quickly move back to their original position (even while wearing retainers).  Anyone who has knowledge of tooth movement realizes that 6 months is INSUFFICIENT TIME to move and stabilize teeth

2.  Cheaper than full braces?  Here is some math- most dentists charge $2500-3500 for 6 months of time in braces.  Most orthodontists charge $4,000-6,000 for 18 months-2 yrs worth of braces.  It is really not that much more for a better, more predictable, more STABLE result.

3.  If you are getting a smile makeover, do things right the first time so you don;t have to do it again!  6 month braces works by removing a good amount of enamel from the sides of your teeth.  While some of this is normal, too much enamel removal will cause food to become impacted between teeth, cause periodontal (gum) problems, and can be bothersome to a patient who is used to having tight contacts between the teeth (ie, have to really "snap" floss to get in- that is a good tight contact).

 SO, are these risks really worth not going though full braces (OR INVISALIGN)?  Talk to your orthodontist- there are MANY options you have to choose from instead of going the "fast" route with 6 month braces.  I have many adults who are doing lingual (braces on the inside of the teeth) who can a beautiful stable result because they complete their full treatment and DON'T SHOW BRACES AT ALL!  If that is your concern, then please re-evaluate and see what all of your options are.

Are you concerned about your child's thumb sucking habit?

Thumb habits and Impact on the development of the jaws

Thumb sucking is a very normal process for babies and toddlers.  It is soothing and calming, and there is no reason to worry if your child is under  5 years of age.  In most cases, if the thumb habit is ceased around age 4-5, the permanent teeth will come in (around age 6) just fine.  However, if the habit persists beyond the time the permanent teeth begin to erupt (age 6), the bite becomes affected.  As a child sucks his or her thumb, a tremendous negative pressure is created inside the mouth, while outside, the cheeks are being contracted at the same time.  The characteristic bite of thumb sucking is “protruding” or flared upper front teeth, spacing between the upper front teeth, open bite (see picture below-where front teeth don’t touch), and a narrowed upper jaw (due to the negative pressure inside the mouth and the positive pressure from the cheeks “pushing” on the back.  These characteristics can do many things to affect the eruption of the other permanent teeth.  For example, too narrow of a palate means insufficient space to accommodate all the remaining permanent teeth.  Also, the pressures created can also impact the formation of the jaws, where the lower jaw remains much further back than the upper jaw.

The cheeks push the UPPER back teeth IN, causing a narrowed palate, while the tongue posture is LOW, so no balance of forces occurs on the upper teeth (as seen in the lower teeth)

                                                    THUMB SUCKING- Before                                                                

 

 After a Thumb crib

What are the treatments to stop a thumb habit in a 6-7 year old?

If treated early, right as the permanent teeth are erupting, treatment will be a short 8-10 month duration and will consist of only 1 appliance to prevent the thumb from sneaking in the mouth (especially at night which is the hardest to control!)

Your child will receive either a thumb crib with an expander, or just a regular thumb crib.

                                         Thumb crib + expander                                                                                

                                                
                                                                              Thumb crib only

How will I know if I need and expander with a thumb crib?  Dr. Bauer will explain all of this to you- if your child has a crossbite, he or she will need the expander as well.

(example of a crossbite)- Upper back teeth are located behind Lower back teeth







I know how thumb habits are difficult to stop, but we are here to help you!!
Please call us with any questions!  Don't hesitate to bring in a child even at the age of 4-5 to get some ideas for getting that thumb out of there!  We want you and your child to succeed!!

Danielle Bauer DDS, MS

630-665-5495

Bauer Orthodontics
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Orthodontist v. dentist

The difference between a Dentist and an Orthodontist

Why is it so important to see an orthodontic specialist for braces as opposed to your general dentist?

1.        A qualified orthodontic specialist must first receive his/her doctorate in general dentistry – the same as the general dentist. Then, they must complete an additional  three years of graduate training in orthodontics at an American Dental Association approved, university affiliated program. As a specialist, the orthodontist limits his/her practice exclusively to orthodontic treatments. If a dental practitioner is practicing general dentistry and providing orthodontic services, he/she is not an approved specialist in orthodontics.

2.       An orthodontist received extensive training in growth and development of the bones and teeth, and is better equipped to properly diagnose and treat problems with the jaws and teeth!

3.       While many people consider orthodontics as just “straightening crooked teeth,” there is really so much more.  As an orthodontist, I look at the developing bones of the upper and lower jaws, the bones and gums surrounding the teeth, the specialized x-rays we take (the panoramic x-ray and the cephalometric x-ray) to further evaluate the harmony of all these things together.  Lastly, we are treating FACES, not teeth-so therefore I must look at how the lips relate to the teeth and how to best treat each person based upon their FACIAL NEEDS!!  For example, this patient wanted straighter teeth and to fix her smile: 

Please look at how much of her gums she shows when smiling-this is something that needs to be addressed and diagnosed properly from day 1 or the results will not be optimal.  A general dentist may not catch this or evaluate this because they do not have the specialty training to realize the complexity of this case.  This patient came to me after being treated by her general dentist because she was unhappy with the outcome because all he did was align her teeth.

4.        I have been asked several times about early treatment at a young age (age 7-9 years old) and how this works and who gets it.  Thanks to our wonderful organization AAO (American Association of Orthodontists, I was able to get this particular brochure that really explains it well.  Please take a moment to read this!

http://www.aaomembers.org/Resources/upload/Two_Phase_Treatment-l.pdf

Your family dentist is excellent at achieving your needs for  esthetic concerns such as fillings in the front teeth, crowns, veneers, replacement of missing teeth )such as implants), but a specialist in ORTHODONTICS is best equipped to handle the growth and development of the jaws and facial harmony required for a successful orthodontic case.

 

*****WHAT ABOUT 6 MONTH BRACES?

This is a big issue I deal with a lot.  6 months is too short of a time to complete braces in children or adults.  Part of having braces is not only aligning your teeth, but achieving a good functional bite.  Placement of braces for 6 months cannot accomplish all these things; in fact, the bite gets altered significantly in the first few months of treatment, thus leaving you with fairly straight teeth, but an uncomfortable bite that you may not accept.  As an orthodontist, I see this a lot and patients have to come to me to have things fixed.  So, you end up paying twice and going through braces twice.  Beware of these “quick fixes,” as many times they turn out to be longer than a regular 18 months worth of braces!

If you have any questions on any of these topics, we would love to discuss this with you!  Please call our office at (630) 665-5495 to set up your complimentary consultation!!

Check out our website at www.bauerbraces.com

Danielle Bauer DDS, MS                                                               
630-665-5495                                                                  

Bauer Orthodontics
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Can you skip phase 1 orthodontics?

 SOMETIMES, YES!!!

This is another article showing there really is no huge advantage to EARLY treatment (around age 8-9 prior to all the permanent teeth being in) in patients who present with a class II (aka- large overjet).   Shown here in the picture

 Unless there are pressing bite issues (like a crossbite or severe crowding), it may just be best to wait for the phase 2 (full braces/appliance treatment).

Intrarater agreement about the etiology of Class II malocclusion and treatment approach

Of course, it is a case-by-case basis so an evaluation should still be done by an orthodontist to determine if early treatment would be beneficial.

When should I take my child to the orthodontist?

Great article on when to see an orthodontist

Many people wonder when is the best time to take their children to see the orthodontist. While the American Association of Orthodontists recommends age 7, that does not mean it is time to start anything at that time. An orthodontist does not just straighten teeth, but we also harmonize the lips and soft tissue, as well as the bones that the teeth grow in. If there are early problems with bones, these can be addressed at this time. By addressing problems early on, braces are less expensive and take less time (14-18 months as opposed to 2-3 years). Young patients do really well with treatment and Dr. Danielle is awesome with kids! As a mom herself, Dr. Danielle understands how to reach the young kids in a tell-show-do method. This decreases anxiety and creates a positive environment for everyone!
So check out this article from the NY Times!

Call our office with any questions or concerns! 630-665-5495

http://www.webmd.com/oral-health/features/when-to-see-orthodontist

Braces are for adults too!

So you think because you are a mother or father that you are too old to get braces? Or you are in college and don't want them because of your active social life? Well, no one is too old for braces!
The truth is that teeth move through bone, so the fallacy of teeth not moving when you stop growing needs to be removed. Growth does not matter if you just want to move teeth (yes, growth is helpful when we want to use it in our ortho treatment!).

There are many ways high schoolers, college students, and adults of all ages can get braces:
1. Damon clear braces are a great alternative to the traditional braces because they are made of ceramic, which blends into the tooth. You can still see the wire, but it is pretty nice and not very obvious. My atients love how clear they are. They DO NOT yellow or stain, even in smokers.

2. Invisalign is a clear alternative to braces. There are no braces involved; it is merely a series of clear trays that are worn for 2-3 weeks at a time. They are removed to eat and brush the teeth, which results in excellent hygiene. It is an excellent product and gives a great result. Not everyone is a candidate for invisalign; however. I do a full examination to let you know if you would be a good candidate. There are instances where the teeth are too severe that Invisalign will only give mediocre results and can better be handled with braces.

3. Incognito, or lingual braces are braces located behind the teeth, so NO ONE can see your braces! It still offers the same advantages of braces, where tooth movement is very controlled, but also offers the wonderful advantage of no one seeing the braces (and not having to remove them to eat). These are 100% customized to YOUR teeth by CAD-CAM technology, along with robotically bent wires to accurately move your teeth. It is also a very efficient form of treatment.

I personally love doing all 3 of these types of braces and would love to show you and explain all the options to you!

Invisalign - Common Questions about Invisalign

Invisalign is a modern approach to moving teeth-it uses a set of clear plastic aligners that can be removed to eat and brush. This is a luxury for many adults who are very meticulous with their hygiene and don’t want the hassle of trying to clean around the braces. Each tray is worn for 21 hours per day for a total of 2 weeks, then the next tray is started. Wearing the aligners will gradually move your teeth into the desired position based on the exact movements planned out by the orthodontist.

There are some advantages and disadvantages of Invisalign that should be discussed so we are all on the same page!

Advantages of Invisalign:

They are removable, clear, can be removed for excellent hygiene, NO POKEY WIRES or BROKEN BRACKETS (which means less trips you have to make), and they move the teeth at the same rate as braces do.

Disadvantages of Invisalign:

The fact that they are removable is ALSO a disadvantage-they can be thrown away/misplaced after they are removed, you may forget to put them back in, therefore teeth are not moving (which slows treatment down), and Invisalign is NOT FOR EVERYONE.

Candidates for Invisalign are determined on a case-by-case basis by Dr. Danielle Bauer. Sometimes, a more in-depth case will just be treated better with braces. There are times where Dr. Danielle has done Invisalign and the results are not where we wanted them to be and traditional braces have been placed after Invisalign is completed. This MAY add to the cost of treatment, and also makes treatment longer to get a satisfactory result. This will need to be discussed with Dr. Danielle. If we decide Invisalign is not right for you, we will explain why, and don’t worry-there are other alternatives, such as LINGUAL/HIDDEN BRACES, and also DAMON CLEAR BRACES, which are extremely esthetic alternatives to metal braces!

WHAT TO EXPECT during Invisalign:

1. Teeth are moving, so discomfort is to be expected. Depending on your pain tolerance, you may or may not need to take Ibuprofen or Tylenol.

2. When the aligners are removed to eat and brush, the teeth may feel as though they are loose – this is totally normal. It is due to the tooth movement.

3. If you have ANY dental work that needs to be done (other than cleanings), such as fillings, crowns, bridges, etc, this must be done prior to beginning Invisalign so that the trays fit perfectly.

4. If any dental work needs to be done during Invisalign, we will speak to your dentist about when to take care of this, as it may be able to wait until completion of Invisalign.

5. When you are finished with a tray after wearing it for 2 weeks, always KEEP THE TRAYS!!! Sometimes, we need to backtrack to a previous tray and will need your old ones. We will give you baggies to put them in to keep them safe.

6. When going out to eat, remove your aligners BEFORE entering the restaurant and place them in their case. If not, you run the risk of wrapping them up in a napkin and throwing them away. Trust me, it happens all the time. This slows down treatment because we have to wait a few days for a replacement to come in.

7. When treatment is over, you will wear retainers, just like with regular braces. Please see my blog on retainers to have a better understanding for this.

Please visit the our website for more information on Invisalign. You may also visit the Invisalign website for videos and testimonials.

Thanks for reading!!!

Trauma to front teeth? What can orthodontics do?

I am sure many of you have heard of or seen firsthand the stress of a child getting hit in the face in a sport and the front tooth either completely comes out (in dental terms-AVULSION), or the tooth significantly moves due to a fracture in the tooth.  While these teeth can be saved, there are chances that the tooth can become fused to the bone (ankylosis) and will eventually need to be taken out.  There are also chances that the tooth just cannot be saved if it was out of the mouth for too long.  Here is a great article on how new technology can  "replace" these teeth with another tooth. 
This process is called AUTOTRANSPLANTATION.  What does this mean???

Well, read the article, but in a nutshell, it means taking another tooth in the mouth (like a wisdom tooth or a premolar) that is still forming and removing it and replacing it in the front tooth that was lost.  I had the pleasure of doing this procedure during my orthodontic residency program and the outcome was amazing. 
I will share those photos as well in this post.

http://www.ajodo.org/article/S0889-5406(12)00448-9/fulltext

Here is my case:  9 year old boy with his upper left front tooth still not in his mouth

So, you just finished braces, NOW WHAT? (ALL ABOUT RETAINERS)!!!

Most of you have heard that when your braces come off, you will wear a retainer. This is intended to help you understand the importance of retainers and what they are.

Retainers are custom-made devices, made usually of wires or clear plastic, that hold teeth in position after any method of straightening teeth. They are most often used after braces to hold teeth in position while allowing the gums and bone to remodel itself around the newly positioned teeth. Most patients are required to wear their retainer(s) 24 hours a day at first until further instructed, then you may wear the retainers at night only to hold the teeth. There are three types of retainers typically prescribed by orthodontists and dentists: Hawley, Essix, and Bonded (Fixed) retainers.

A Hawley is a retainer with acrylic on the palate (roof of the mouth) and a wire going across the front of the teeth. Kids love these retainers, as they can pick their favorite color for the acrylic (shown in white here). It is removable only to eat and brush (until instructed to wear at night only)

An Essix retainer looks just like an Invisalign tray or a bleaching tray. It is made of a hard plastic that will hold the teeth in place just as the Hawley retainer does. It is also removable with the same instructions as the Hawley retainer.

A Fixed retainer, or permanent retainer is a different type of retainer than the 2 above. A fixed retainer typically consists of a passive wire bonded to the tongue-side of the teeth (usually on the Lower teeth only, depending on the bite). Unlike the previously-mentioned retainer types, fixed retainers cannot be removed by the patient. Some doctors prescribe fixed retainers regularly, especially where active orthodontic treatments have effected great changes in the bite and there is a high risk for reversal of these changes. This retainer is often kept in place for life. Fixed retainers may lead to tartar build-up or gingivitis due to the difficulty of flossing while wearing these retainers. As with dental braces, patients often must use floss threaders to pass dental floss through the small space between the retainer and the teeth. We will help you understand how to take care of this retainer!!

OK, now I know you have questions:

How long do I wear these retainers? Well, the answer is NOT simple. Truthfully, retainers are for LIFETIME, because our teeth continue to shift throughout life (whether we have had braces or not), and when you have had braces, you do risk relapse even several years after braces come off. So, to make it easy for you, my plan for retainers is to do a fixed retainer on the bottom teeth (since those are always first to relapse), and the clear Essix retainer on the top. After about 4-6 months, you will only be required to wear the essix at night, so it is not too bad having to wear the retainers.

So my answer to the question is: You wear your retainers AS LONG AS YOU WANT YOUR TEETH TO STAY STRAIGHT!!!!

If I have braces, when should I wear a mouthguard?

Many patients and parents ask me when it is appropriate to wear a mouthguard.
First of all, here is my favorite mouthguard for braces.  It is designed to fit over the braces, so no need to boil it and bite into it.  It is very comfortable and also adjustable.  They also come with football straps for the football players.  You can buy these online or at Dick's Sporting goods.

Now for the question "How do I know if  I need to wear a mouthguard?"
Basically, everyone in sports should be wearing them.  You need to PROTECT YOUR TEETH AND SOFT TISSUES (lips, cheeks, etc)!!!

What sports?
1.  Hockey
2.  Football
3.  Basketball
4.  Soccer


These are the more obvious sports and are required in order to play football or hockey.  For basketball and soccer, there are chances you can get elbowed in the face, hot with a ball, so best be safe than sorry!!!


In addition, I would recommend wearing a mouthguard for:
1.  Baseball/softball
2.  Gymnastics
3.  Rigorous cheerleading (practices only)
4.  Any other sport/hobby in which there is a danger to your face


I cannot stress enough that it is not worth NOT being safe and risking a potentially serious injury.  The mouthguards are nice and breathable, adjustable, and they feel very comfortable, so getting used to it is the only tough part.


Let us know if you have any questions!

Danielle Bauer DDS, MS

630-665-5495

Bauer Orthodontics
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Orthodontic jaw surgery - ALL THE INFO!!!

All you need to know about Jaw Surgery and Orthodontics

Sometimes you head to the orthodontist with thoughts of getting braces to fix your "crooked teeth" or your "bad bite."  Well, sometimes people leave the orthodontist full of information they have NEVER heard of, like JAW SURGERY.
You think to yourself "I only came here for braces and she is telling me I need surgery."  In order for teeth to properly align, the jaws must properly align, which is no easy task in a non-growing adult.
The jaw misalignment you have probably seen is the "Underbite" where the lower jaw jets out in front of the upper jaw.  That is just one of many misalignments that may warrant a surgical correction.












Another one is if the lower jaw is much further BEHIND the upper jaw.  Sometimes the upper jaw is too far forward or too long.  These are all things that make it difficult for us to correct the teeth when we don't have a proper bony base to place the teeth.
 

If you are a candidate for Jaw surgery, there is a great deal of planning involved with the orthodontist, oral surgeon and general dentist.  We all work as a team to achieve the best result!
You will get braces IN CONJUNCTION WITH SURGERY.  Why?  Because teeth want to touch each other, so they do whatever they can to get to one another.  For example, in the more familiar underbite case, the upper teeth will lean as far forward as they can, and the lower teeth will lean as far backwards as they can in attempts to touch.  This is unhealthy for the underlying bone and gum tissue, so to set up for surgery, we must decompensate these effects, and it ends up making the bite look worse prior to surgery.  Here is an example of what I am talking about:














So you can see the upper teeth and lower teeth TRYING to meet and touch.  The angle of the lower teeth is too far backward.  The teeth need to be put back in the correct place in the bone so we can achieve the best surgical results!

Here, I am going to give you the typical process/sequence of treatment on how braces set up for jaw surgery

1.  Consultation/x-rays, photos, models of the teeth with orthodontist and oral surgeon to finalize the treatment plan whether it will be a 1 jaw or 2 jaw surgery
2.  Braces will be placed (approximately 1 year time to prepare for surgery)
3.  You will take a trip or 2 back to the oral surgeon to determine whether you are ready for surgery yet (again-we must all work together for optimal results)
4.  Once ready for surgery, the orthodontist and surgeon take more records (impressions, photos, etc) and get you set up for the surgery
5.  Surgery happens (can either be in the hospital or in the surgeon's office, depending on what the surgeon tells you)
6.  Follow-ups with surgeon
7.  4 weeks after surgery, back to the orthodontist to check the bite and continue with adjustment appointments and finishing up for about another year
8.  The process takes 2-3 years total time (it depends on the severity of the case)
9.  Once braces come off, there will be RETAINERS!!

Please read this INFORMATIVE ARTICLE by a very experienced orthodontist who really explains thins and shows pictures, steps, and much more!
 
Visit our website for more information on orthognathic surgery as well!  If you have any questions, call us today!!!

Danielle Bauer DDS, MS

630-665-5495

Bauer Orthodontics
Rate us here!