IMPORTANCE OF KEEPING UP WITH ORTHO APPOINTMENTS

Orthodontic treatment can significantly improve the health, function, and appearance of your smile. However, the success of this treatment is not solely dependent on the initial consultation, our orthodontic skills, or the braces themselves. Consistent follow-up visits to your orthodontist are crucial. Unlike regular dental visits where treatment is completed that same day, orthodontic treatment lasts anywhere between one and two years. For this reason, a long-term commitment by the patient and parent must be made to achieve success.

First and most important to a successful orthodontic treatment is maintaining great oral hygiene. As orthodontists, we certainly are focused on aligning teeth, however each appointment is also an opportunity to monitor brushing and flossing. Once braces or any other appliances are placed on the teeth patient enters a high-risk category for cavities since we are adding more places for plaque to hide around the teeth.

Once orthodontic treatment has started, we will see our patients every four to six weeks. It is important to note that these orthodontic appointments DO NOT take the place of regular dental cleanings every six months! In cases where a patient is struggling with oral hygiene while in braces, we will recommend increasing regular dental visits to every three months to prevent cavities or permanent white spots (decalcifications), to form on the teeth around the brackets or attachments.

Besides monitoring oral hygiene, an important reason to keep up with orthodontic appointments is to keep treatment on time! Orthodontic treatment requires regular adjustments to ensure that teeth move into their correct positions. At each appointment, we check the progress of treatment, tighten wires, change elastics, or modify aligners as needed. In addition, skipping appointments can significantly lengthen treatment time. Each visit is part of a carefully planned timeline. Missing appointments or rescheduling frequently can delay progress and extend the time patient spends in treatment.

Regular orthodontic visits also give us the opportunity to check for broken brackets or wires and check compliance with our specific instructions for treatment. This can include evaluating elastics wear, appliance progress with expanders, and aligner wear for our Invisalign patients. All these checks are crucial to finishing treatment in estimated time and providing our patients with the best and most predictable outcomes.

The question we get most often is: “When are these braces coming off?” Staying on track with your orthodontic appointments is vital for the success of your treatment and finishing on time. Regular check-ups help ensure your treatment progresses efficiently, prevent potential problems, and keep patients motivated to reach their goal of a healthy and beautiful smile.

Dr. Lindhorst, Dr. Darsey, Dr. Foss and the Heights Pediatric Dentistry and Orthodontics Team

DESENSITIZATION VISITS

Phobias of the dentist are very real for kids, even adults. These phobias can stem from a prior poor experience, hearing negativity about the dentist from parents, or other extensive history of medical visits, hospitalizations, blood draws, etc. These fears can be especially heightened for children with special needs, Autism spectrum or sensory processing disorders. We know that the dental office has many sights, sounds, smells, and tastes that can be triggering for these sensitive children. With our advanced specialty training in pediatric dentistry, continuing education, years of experience, and love for all kids, we have created a program called our “special needs protocol” that caters to each particular child with a customized approach. These visits are usually frequent, such as every 4 weeks and work with the child at a slower pace. We don’t charge for each of these visits, only when we accomplish a milestone such as a full exam, a cleaning or taking x-rays. For example, if it takes us 5 appointments to complete a dental cleaning, we only charge at that 5th appointment, not each individual visit.

We are taking the extra time to break down big tasks in to small manageable bites. The first visit may be slowly warming up to coming inside the office and playing with toys in the playroom. We also use this time to get a detailed history from the parent on their child’s medical diagnoses, needs, habits, likes, dislikes, behaviors, triggers and previous experiences. During this time, we encourage the child to play and familiarize themselves with anything and everything they’re interested in. They’re welcome to explore the office! At the second visit, they recognize the familiar smiling faces at the check-in desk and the fun toys they played with before. They get to hang out in the same quiet, private operatory again where they will find the dental chair, other fun toys or their favorite characters playing on the tv. With each subsequent visit, and as many as it takes, we build upon the previous one. Slowly but surely, we accomplish the full dental visit. We do this all while forming a trusting and friendly relationship!

A technique we use for most children is the Tell-Show-Do method. We tell the child what we’re going to do like polish their teeth, then show them on a model or their finger, then do the step with them. All while saying imaginative words, singing songs and giving lots of praise for being so brave! We also like to work with a child’s therapy team on ways they can prepare for these visits in advance at home or in their therapy sessions. This may include showing the child videos, pictures or props of things they may see in our office.

Desensitizing is attempting to change those triggering moments with something positive. We want each visit to end on a positive note. Parents help us with recognizing cues that signal the patient has conquered enough that visit. We give lots of praise and rewards for successes. Success can look different for each child, whether they allowed us to complete one small task like putting the lead apron on or completing an entire visit! We give high fives, stickers, tokens for the treasure tower or stuffed animals for the little ones that can’t have tiny trinkets.

Our mission is to create a safe space where children can visit the dentist, have healthy checkups and have fun in the process! We have seen great success with our special needs protocol.

Dr. Lindhorst, Dr. Darsey, Dr. Foss and the Heights Pediatric Dentistry and Orthodontics Team

ECTOPIC ERUPTION OF TEETH

Ectopic eruption is the dental term used when a tooth comes in the mouth at the wrong angle or in a wrong position. This can occur with both baby teeth and adult teeth and can cause long-term problems if left untreated. It occurs in 2 to 6% of the population, with the upper first permanent molar being the most commonly affected.

Ectopic eruption is diagnosed during routine checkups in our office. We are not only checking oral health of the teeth and gums but also tooth positioning. If an ectopically erupting tooth cannot be seen during our visual exam, it can also be identified in an X-ray. And if needed, additional x-rays or scans may be taken.

There are several causes of ectopic eruption. Genetics can play a role. If others in your family had issues with eruption of teeth, you might be more prone to experiencing ectopic eruption. If there is not enough room in the mouth and the teeth are crowded, they might not have space to come in properly. Sometimes people have extra teeth that block the path of normal teeth, causing them to erupt in the wrong place. If a baby tooth falls out too soon, the adult tooth underneath might not come in the right position. Finally, cysts or growths in the mouth can block teeth from coming in as they should.

If a tooth erupts in the wrong position, it might hurt as it tries to push through the gum, especially if it is pressing against other teeth. The gums around the tooth may also be swollen or red. If a tooth comes in a wrong position, it can make other teeth move, causing them to look crooked. And in some cases, the tooth might not come through at all, leaving a gap in the mouth.

The treatment of ectopic eruption depends on how serious the issue is. Here are the most common forms of treatment:

• Watch and Wait: In some cases, the tooth might fix itself over time.

• Braces: If the tooth is out of place, braces or other dental appliances can help align it.

• Tooth Removal: If the tooth is causing too many problems, we might suggest extracting it, especially if it is blocking other teeth from coming in.

• Surgery: If a tooth is stuck under the gum, surgery might be needed to expose it or move it into the right place.

• Space Maintainers: If a baby tooth is lost early, a space maintainer may be used to make sure we save space for the adult tooth to fit in later.

Ectopic eruption is a fairly common problem, but it can lead to serious issues if not addressed. Catching it early with regular dental visits can help prevent pain, crooked teeth, and other problems. If you notice anything unusual about your child’s or your own teeth, please schedule a visit to our office so we can discuss the issues and determine an appropriate treatment.

Dr. Lindhorst, Dr. Darsey, Dr. Foss and the Heights Pediatric Dentistry and Orthodontics Team

IS CHEWING GUM GOOD FOR MY TEETH?

To start with, chewing gum is never a substitute for good oral care. Brushing twice a day for two minutes and flossing nightly are the keys to healthy smiles! Chewing certain types of gum during the day can help maintain proper oral health, but only in combination with regular good habits.

Gum bought at stores comes in two categories, CANDY GUM that is sweetened with sugars and can be more harmful than candy as it stays in the mouth for a long time AND SUGAR-FREE gum sweetened by non-cavity-forming sweeteners. Watch out for gum given out at baseball parks and in concession stands as it often is filled with sugar. However, true SUGARFREE gum can stimulate salivary glands to produce more saliva, which is a protective substance for teeth, without the sugar deposit. It also helps with mechanical removal of small food particles and cleansing teeth after meals. Chewing sugar-free gum for 20 minutes after meals has been reported to have multiple benefits for dental health. There are even certain kinds of medicated gum that are recommended for patients with low salivary flow (xerostomia) to stimulate the glands to produce more helpful saliva. Other types have substantial concentration of xylitol, which helps prevent cavities in patients at high-risk for dental decay.

Is there anything I should be careful about while chewing gum?

Several considerations are important prior to developing a gum chewing habit. First, you need to make sure that gum you chose is truly SUGAR-FREE. Most brands sold at grocery stores are in that category and have the ADA seal of approval. Second, be careful chewing gum while in any orthodontic appliances such as braces, expanders, or retainers. Gum can damage them and cause unwanted dental visits and expense. Gum can get stuck to the brackets and pull them off. It can also get stuck in hard-toreach places between wires, brackets and teeth and trap plaque and food. Most orthodontists advise to stay away from gum while in active orthodontic treatment. Third, limit gum chewing if you experience any TMJ pain or discomfort. The repetitive action of chewing works this joint and surrounding muscles constantly and can aggravate the inflammation making it more difficult to open and close your mouth. Sometimes jaw clicking, popping, or even locking can be a result of too much strain on the temporomandibular joint. At times, gum chewing has been linked to chronic migraines, another common symptom of TMJ disorder.

Choose your gum carefully, take care of your braces, don’t aggravate temporomandibular joints, and brush and floss! If you have any questions, call our office for more information.

Dr. Lindhorst, Dr. Darsey, Dr. Foss and the Heights Pediatric Dentistry and Orthodontics Team