Recently I was giving a consultation to a young woman who was interested in clear aligner orthodontic therapy. After determining she was a good patient for aligners and the protocol of use, I brought up the fact that once treatment is complete she might need a “refinement”. After all trays are completed the teeth may not be where we expected them to be at the end of treatment. In these cases new impressions are taken and more trays are used to obtain an optimal result. These refinements may need to be done several times to achieve proper results. On rare occasion some brackets may need to be placed to finish treatment. After this explanation she asked me an interesting question, “if they use this sensitive computer technology to produce my trays and you have a computer work up of how my teeth should look at the end of treatment, why would I need a refinement?” Now on the surface this might seem like a simple question with a response like, “well things don’t always work out like they are supposed to.” Instead I found myself saying that even though they use sensitive computer programs to accurately predict the teeth’s final position, “biology doesn’t always follow technology.” The more I thought about that statement I realized this didn’t only apply to aligners but all of orthodontics. There are so many factors that go into one’s individual biology; it is no surprise that a computer would not be able to fully predict how teeth are going to move. When it comes to fixed braces this is exactly why we treat the mouth from visit to visit. Of course we have a general treatment plan with certain goals in mind, but we must constantly adjust to what we did the last visit. This is one of the things I love about orthodontics; the constant problem solving that must be done not only at the start of treatment but every visit. This brings me to my main point, although aligner therapy plays an increasingly important role in orthodontics, it is extremely important for the doctor and patient to understand that they should not be used on all orthodontic cases indiscriminately. Some tooth movements are much more predictable than others and the success rate with clear aligners are not equal for all cases. It is also paramount that you see a dentist who has a lot of experience with aligner therapy and can determine what kind of orthodontic therapy would be best for your individual case.
Thursday, September 15, 2011
Friday, February 11, 2011
We all know that one of the best things about Valentine ’s Day is the candy. Thankfully for the orthodontists out there, the main sweet treat on Valentine's day is chocolate. Chocolate tends to be kinder on the braces than the hard or gummy type candies. However there are some treats that you have to be careful eating while you have braces on. First off, stay away from the chocolate/peanut brittle type sweets . These sugar/chocolate concoctions can wreak havoc on your braces. Generally any hard type chocolate that has peanuts or that you really need to bite hard into is a no-no. If there is any doubt, call your orthodontist and ask. The main problem with breaking your braces is that it delays your treatment. Have a very happy Valentine's day!
Monday, January 10, 2011
The American Association of Orthodontist recommends all children get a check-up with an orthodontist no later than age 7. There are many reasons why this should be done even if the child is not ready for braces. It is important to spot any problems with jaw growth and emerging adult teeth while the baby teeth are still present. This often can be done with a simple x-ray and examination. Sometimes baby teeth will not fall out on their own due to the adult teeth being impacted or limited space available. This is often seen with maxillary canines. Many times this goes undetected and is first see by an orthodontist when the patient is already a teenager. The orthodontic treatment becomes more involved in this case and may have been prevented had the problem been diagnosed at an early age. Although I am not one to rush into placing braces at a young age, there are several problems that should be addressed early on. These problems include: anterior and posterior cross-bites, thumb sucking habits and skeletal growth issues. Also when a child has severely protruded anterior teeth, treatment is often recommended to lower the risk of trauma to these teeth. Also some orthodontic problems can cause severe emotional or psychological distress to a young person. In these cases limited treatment might be recommended to help ease their stress.