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How Do You Treat White Spots After Braces?

How Do You Treat White Spots After Braces?
by DR. JOSEPH THOMPSON

What are these white spots on my teeth?

A very common problem that can occur while a patient has braces is the formation of white spots during treatment. When the braces are removed, some patients will have unsightly white spots and they  wonder why they are there.

Some patients are surprised and they shouldn’t be. Your orthodontist watches and warns when white spots are forming. The white spots are the decalcified areas of the teeth where plaque was allowed to stay for long periods of time. You will hear your orthodontist say over and over again to keep your teeth clean, brush and floss.

How did the white spots develop?

Heavy Plaque on Patient with Braces

There are many types of bacteria that live in our mouth. They show up after you were born and stay with you your whole life. You can’t get rid of them completely. You can only reduce the amount of bacteria in your mouth. We reduce the bacteria by brushing, flossing and rinsing with mouthwash that kills bacteria.

The bacteria streptococcus mutans and lactobacillus are the main germs in dental plaque. Dental plaque is sticky and likes to attach to smooth surfaces of the tooth. These bacteria eat sugars that you eat everyday. When you eat your food, it will contain sugar that the bacteria eats. After the bacteria ingests the sugar, they produce more of themselves and they give off acid for 20 minutes. Since, the plaque is right up against your teeth, the acid dissolves the enamel causing a white decalcification spot to form and eventually it will cause a cavity

A cavity is just a hole in your tooth. These white spots are the beginnings of a cavity. Since the outside layer of the enamel is very hard due to it being enriched with fluoride from our tooth paste, food and water, the decalcification starts below this layer deeper in the enamel. When you look at the surface of the tooth, the outside layer is intact but you can see the white decalcification spot. Once the decalcification weakens the outside layer of enamel enough, it will break through resulting in a hole in the tooth, a cavity.

Once the cavity forms, it will not go away. The bacteria will lay in it and continue the decalcification making the hole larger. As the cavity grows, it can cause pain and it may cause the pulp to die. A cavity has to be repaired by a dentist before it gets too large and the tooth has to be extracted.

Primary or baby teeth have very thin enamel and cavities grow deep quickly. Whereas, with the permanent teeth, the enamel is very thick and a cavity grows slowly.

If you think you have a cavity forming, see your dentist quickly for restoration. Seeing your dentist in a timely manner may prevent tooth loss and cost less.

 

 

What can be done to prevent white spots from developing?

Very simple, brush your teeth. Keep the plaque to a minimum. Dig with the bristles of your brush underneath the wire. The plaque will accumulate mainly between the wire and the gums and underneath the wires. Be aggressive.

Do a good inspection after you brush. Look at your teeth. If you see anything on your teeth, it is either plaque or food. Take your toothbrush that you just used and remove it.

Besides using a regular toothbrush, you can also use an electrical tooth brush like an Oral B or Sonicare toothbrush. Electric toothbrushes work very well in reducing plaque and are better than a waterpik. Waterpiks are not good at removing plaque as well as an electric toothbrush. Also waterpiks can push bacteria into the gum tissue if you have gum disease. Don’t use waterpiks to clean your teeth and braces.

What can be done about the white spots?

Ask your orthodontist for a prescription for GC MI Paste. GC MI Paste is a specially formulated paste that remineralizes the enamel. It replenishes the calcium and phosphate lost during acid production by the plaque. Another product that does not require a prescription is Tooth Mousse GC.

Another item that can be prescribed from your orthodontist or family dentist is Colgate’s PreviDent 5000 Plus (Rx only) or Colgate PreviDent 5000 Sensitive (Rx only) tooth paste. Both deliver 5000 ppm of fluoride in a professional strength 1.1% Sodium Fluoride paste. Directions state they you should brush once a day, preferable before bed, for two minutes. In three to six months, caries remineralized by 57% in most patients. These products are not recommended for children under 6 years old.

DMG ICON Infiltrating Resin for White Spot Decalcifications

After the CG MI paste is used for a period of time, and there are still some white spots, an infiltrating resin like DMG ICON can be applied by your family dentist or orthodontist to reduce the appearance of the white spots. This procedure takes just one office visit. After the teeth are cleaned, they are prepared for the resin. The resin infiltrates the enamel and changes the color of the white spot to a more tooth colored enamel. ICON may not completely get rid of all the white spots but it does accomplish a better appearance.

So it’s up to you. If you keep your teeth free from plaque, the chances of a white spot developing will be very minimal.

SLEEP APNEA AND ORTHODONTICS

An Interdisciplinary Approach to Treating a Chronic Sleep Condition Author- Jim Duffy

Interdisciplinary treatment planning is a concept that’s gaining relevance among oral health professionals. It’s one of the chief tenets of the popular Seattle Study Club, and many finding it extremely rewarding to work with a group of like-minded professionals when treating their patients. This evolving holistic approach to oral health is exemplified in the evolving role that the orthodontist can play in addressing sleep apnea.

The notion that people should see an orthodontist about the sleeping problems they or their children endure might come as a surprise to the general public, but more and more medical and orthodontic experts are pointing toward a future that heads in that direction.

Consider, for example, the most common type of sleep-disordered breathing, obsessive sleep apnea syndrome (OSAS). It’s quite common among both children and adults, though precisely how common can be difficult to say because the condition is significantly under-diagnosed.

A 2012 paper in the journal Pediatrics placed sleep apnea numbers among children within the broad range of 1 to 5 percent of the population. The nonprofit Sleep Foundation estimates that at least 18 million adults have OSAS.

The syndrome can affect patients in a range from mild to severe, with the more serious cases being quite dangerous to long-term health. Among children, OSAS has been linked with poor school performance, learning disabilities, behavior problems, and even some cardiac abnormalities. In adults, it can boost the risk of hypertension, cardiovascular disease, coronary artery disease, and insulin-dependent diabetes.

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Pediatric Sleep Disordered Breathing/Obstructive Sleep Apnea

Pediatric Sleep Disordered Breathing/Obstructive Sleep Apnea

Sleep-disordered breathing (SDB) is a general term for breathing difficulties occurring during sleep. SDB can range from frequent loud snoring to Obstructive Sleep Apnea (OSA) a condition involving repeated episodes of partial or complete blockage of the airway during sleep. When a child’s breathing is disrupted during sleep, the body perceives this as a choking phenomenon. The heart rate slows, blood pressure rises, the brain is aroused, and sleep is disrupted. Oxygen levels in the blood can also drop.

Approximately 10 percent of children snore regularly and about 2-4 % of the pediatric population has OSA.   Recent studies indicate that mild SDB or snoring may cause many of the same problems as OSA in children.

COULD MY CHILD HAVE OBSTRUCTIVE SLEEP APNEA?

The most obvious symptom of sleep disordered breathing is loud snoring that is present on most nights. The snoring can be interrupted by complete blockage of breathing with gasping and snorting noises and associated with awakenings from sleep. Due to a lack of good quality sleep, a child with sleep disordered breathing may be irritable, sleepy during the day, or have difficulty concentrating in school. Busy or hyperactive behavior may also be observed. Bed-wetting is also frequently seen in children with sleep apnea.

A common physical cause of airway narrowing contributing to SDB is enlarged tonsils and adenoids.  Overweight children are at increased risk for SDB because fat deposits around the neck and throat can also narrow the airway. Children with abnormalities involving the lower jaw or tongue or neuromuscular deficits such or cerebral palsy have a higher risk of developing sleep disordered breathing.

Potential consequences of untreated pediatric sleep disordered breathing

  • •Social: Loud snoring can become a significant social problem if a child shares a room with siblings or at sleepovers and summer camp.
  • •Behavior and learning:  Children with SDB may become moody, inattentive, and disruptive both at home and at school.   Sleep disordered breathing can also be a contributing factor to attention deficit disorders in some children.
  • •Enuresis: SDB can cause increased nighttime urine production, which may lead to bedwetting.
  • •Growth:  Children with SDB may not produce enough growth hormone, resulting in abnormally slow growth and development.
  • •Obesity: SBD may cause the body to have increased resistance to insulin or daytime fatigue with decreases in physical activity.  These factors can contribute to obesity.
  • •Cardiovascular:   OSA can be associated with an increased risk of high blood pressure or other heart and lung problems.
 

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Dental Phobia-Treatment and Coping Methods

Communicating With Your Dentist

Talking with your dentist is the key to beating dental distress. Modern dentistry can be almost painless. Therefore, it’s worth taking the time to discuss your fears — and the potential treatment options — with your dentist.

You can feel more in control if you take part in decisions about your treatment. And that can help you to feel less anxious. Your dentist should discuss with you all the procedures you may need. You may be able to have several procedures done at one time or have a series of shorter appointments. Ask your dentist to describe the types of pain control available. Then decide which you feel will work best for you.

During the appointment, ask your dentist to explain what’s happening at every stage of the procedure. This may help to lower your anxiety. When you know what the dentist is about to do next, you can prepare yourself. You won’t be taken by surprise.

On the other hand, some people may feel less anxious if they don’t know what’s happening. If this is true for you, explain this to your dentist. He or she should be willing to adapt to your wishes whenever possible.

Another helpful technique is to agree on a hand signal you can use if you want everything to stop right away. This will give you a sense of control. It can help to lessen your anxiety. You don’t have to wait until you’re having pain to give the signal. You may ask the dentist to stop because you’d like to rinse your mouth or simply catch your breath, or just take a break for a few seconds.

You may feel embarrassed to discuss your fears. Remember that you are not alone. Fears are not uncommon. Once your dentist knows what the issues are, he or she will be better able to find workable solutions.

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Drowsy Driving ~ Raising awareness among health care communities and the public about the costs and dangers of obstructive sleep apnea when left untreated

Drowsy driving can be as dangerous as drunk driving. Drivers are 15 times more likely to be involved in a deadly motor vehicle accident when they have excessive daytime sleepiness, a common symptom of sleep apnea. Motor vehicle accidents due to drowsy driving account for $48 billion in medical costs each year. Current legislation recommends that commercial drivers get screened and treated for sleep apnea. However, many drivers do not know that they have sleep apnea. The American Academy of Sleep Medicine estimates that 18 million Americans have sleep apnea. 80 to 90 percent of cases remain undiagnosed and untreated. The Institute of Medicine reports 50 to 70 million Americans suffer from chronic sleep disorders, including sleep apnea. Help protect yourself, your loved ones and your fellow travelers.

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Mouthguards

Mouthguards

Imagine what it would be like if you suddenly lost one or two of your front teeth. Smiling, talking, eating—everything would suddenly be affected.

Mouthguards, also called mouth protectors, help cushion a blow to the face, minimizing the risk of broken teeth and injuries to your lips, tongue, face or jaw. They typically cover the upper teeth and are a great way to protect the soft tissues of your tongue, lips and cheek lining. Knowing how to prevent injuries like these is especially important if you participate in organized sports or other recreational activities.

When it comes to protecting your mouth, a mouthguard is an essential piece of athletic gear that should be part of your standard equipment from an early age. In fact, studies show that athletes are 60 times more likely to suffer harm to the teeth if they’re not wearing a mouthguard. While collision and contact sports, such as boxing, are higher-risk sports for the mouth, you can experience a dental injury in non-contact activities too, such as gymnastics and skating.

 

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Mouth care during chemotherapy

Some people having chemotherapy treatment find that their mouth gets very sore. This information gives some ideas about how you can look after your mouth before and during your chemotherapy treatment.

Chemotherapy drugs interfere with the way that cells of the body divide and reproduce. Both healthy cells and cancer cells are affected by chemotherapy drugs. Healthy cells can generally repair the damage caused by the chemotherapy, but cancer cells can’t and so they eventually die. When the healthy cells in the lining of the mouth are affected, this can lead to a number of side effects.

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Sleep Treatment Options For Those Who Can’t Tolerate CPAP

AccuFit-Dorsal

An acrylic oral devise can effectively treat obstructive sleep apnea without the discomfort or claustrophobic effects of the CPAP machine.

An estimated 18 million Americans suffer from obstructive sleep apnea (OSA), with many of those cases undiagnosed. OSA can come with serious side effects and consequences including fatigue, obesity, and an increased risk of heart attack, stroke and diabetes.

Continuous positive airway pressure, or CPAP, has been clinically proven to help. With CPAP, OSA sufferers wear a mask that delivers continuous air that keeps a patient’s throat muscles and air passages from collapsing, thus preventing the snoring and pauses in breathing associated with apnea. CPAP is one of the most effective sleep treatment options available. There’s just one problem however—some people can’t stand it.

One study estimates 30-50 percent of CPAP users don’t like the treatment; another survey discovered that about half of patients stop using the device within 1-3 weeks of it being prescribed. However, discomfort shouldn’t be a reason an OSA suffer doesn’t get help for his or her condition—the consequences are just too great. Other sleep treatment options are available for patients who dislike CPAP and should be explored.

 

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Tooth Decay in Baby teeth

America’s Pediatric Dentists Bite Into Problem of Rampant Tooth Decay In Little Teeth and Encourage Parents to Join the Monster-Free Mouths Movement

Approximately 60 Percent of Kids Have Tooth Decay By Age 5; New Report Shows Significant Gaps In Knowledge About Children’s Oral Health

CHICAGO, January 28, 2014 / PRNewswire / — The American Academy of Pediatric Dentistry’s (AAPD) first-ever “State of Little Teeth Report” underscores the significant threat that tooth decay has to the health, welfare and future of children in the U.S. And while studies show that delaying the first dental exam until the age of 2 or 3 can have an adverse impact on a child’s oral health, the “State of Little Teeth Report” reveals that 40 percent of parents and caregivers surveyed wait to take their child to the dentist until after age 2. To address this nation-wide threat to children’s health, the AAPD is launching the Monster-Free Mouths Movement, an educational campaign to arm parents and caregivers with important tools and information to help fight tooth decay, also known as the Mouth Monsters.
According to the Centers for Disease Control and Prevention, tooth decay is the number one chronic infectious disease among children in the U.S., posing an immediate and long-term threat to the teeth of young children and to their overall health and development.

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Sleep Apnea and the Obese Patient

 

Sleep Apnea and the Obese Patient
by Randal S. Baker, MD, FACS

Loud snoring is a common sign of a breathing problem that can lead to other issues. According to the American Academy of Sleep Medicine, approximately 10 to 30 percent of adults snore. Loud snoring, however, is a sign of a serious disorder and affects about five in every 100 people.

When a person snores, it is because the breathing passages in the back of the throat are narrowed and not fully open, thus restricting the amount of air taken in while sleeping. It is like trying to breathe through a wet, sloppy noodle. When the body cannot get enough air, it signals the brain to breathe harder and force the air in (that terrible snoring sound), or if it cannot get any air in (and you stop breathing); it wakes the body up in order to correct the problem.

This can happen hundreds of times a night, and the cumulative effect can lead to chronic sleepiness, trouble concentrating and even depression. The body’s repeated lack of restorative sleep over an extended period can also lead to more serious problems as well, including high blood pressure, heart attack and stroke.

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Digital Radiography: An Improvement?

Despite the many advantages of digital radiography, many practitioners in North America still have not made the switch from conventional, film-based radiography. From our observations and discussions with thousands of dentists, the reasons for not transitioning to digital radiography include high cost, no other forms of digital in the office (ie, computers in the operatories, practice management software, etc), unwillingness to endure the hassle of conversion and staff training, and for some, the complete disbelief that digital radiography is an improvement over conventional forms. Many of the objections are valid; however, the overall benefits of digital radiography far surpass the limitations.
This article includes a discussion of the advantages and limitations of digital radiography, the diagnostic quality of digital radiography versus conventional film-based, the various types of digital radiography available based on image size, the types of digital radiography best suited for specific clinical indications, and anticipated future advances in digital radiography.

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Treating completely blocked canines and full step Class II malocclusion


Dr. Todd Bovenizer presents a full step Class II malocclusion with blocked-out canines utilizing light open coil springs and elastics with the Damon™ System’s Damon™ Q brackets

Evaluation and treatment of Class II malocclusion can present a challenge to the practitioner. One must consider the facial ramifications, as well as skeletal and dental characteristics. This particular case presented with severe crowding that further complicated the diagnosis and treatment planning. This case exemplifies a challenge in multiple planes of space, A-P, transverse, and vertical.

The following case will illustrate how I implemented the combination of variable torques of Damon™ Q, with NiTi coil spring, and early elastic therapy to avoid extraction of maxillary premolars. The ending result was a well-developed transverse arch with ideal incisal inclination.

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Doctors Explore Connection Between Sleep Apnea and Heart Failure

-Tyrone Conner’s heart was in such bad shape that he could barely walk up a flight of steps.

“I felt like I was 80 years old,” said Conner, 50, of Norristown.

He also suffered from sleep apnea, snoring heavily and gasping for breath every night.

What he did not initially realize was that the two problems were linked.

Conner’s physicians, at Thomas Jefferson University Hospital, made the connection, but many do not. Sleep apnea afflicts as many as 60 percent of patients with heart failure — the term for a weakened heart muscle that cannot keep up with the body’s demands. Yet only 2 percent of them nationwide are treated for the nocturnal breathing problem, said Sunil Sharma, associate director of the Jefferson Sleep Disorders Center.

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Kodak Cosmetic Imaging Software

The Kodak Cosmetic Imaging Software enables us to take digital photographs of the patient’s mouth and simulate his or her smile with different cosmetic restorations, such as bleachings, bondings, diastema closures, veneers, and porcelain crowns. Being able to visualize the recommended treatment makes the case more exciting and gives the patient a better idea of what the end results will be.

Logicon Caries Detector Software

This software is a technological tool available to dentists to help detect cavities between teeth, called interproximal cavities. The software compares a digital X-Ray of the patient’s teeth with a database of known problems. It then highlights any areas of concern, indicating the depth of the cavity. This alerts the dentist to check the area more closely for further evaluation. Results are then permanently saved digitally in the patients chart. Early detection of cavities leads to less invasive procedures, reducing the need for more involved treatment in the future.