Dr. John Ballrick, D.D.S., M.S.D.

Hello,

This is a great question! Retainers are a crucial part of any orthodontic treatment. It is imperative that there is proper time for the bone and gums to remodel around the teeth. Permanent retainers are not always required as orthodontic retainers, but often recommended after orthodontic treatment. The teeth are anchored in bone and are under stress as we chew and clench our teeth. This can cause minor movements of the teeth over time. Certain movements over time are to be expected, but can be minimized with proper retainers. Fixed retainers have the advantage of minimizing any changes over long periods of time. Long-term follow-up studies have shown excellent alignment of the teeth when fixed retainers are used. Removable retainers are the alternative approach. When properly worn, removable retainers are an effective orthodontic retainer. The issue with removable retainers is that if they are not worn properly, teeth will move over time. This is the main reason orthodontists like fixed retainers, especially by the lower front teeth.
Good luck with getting your braces off and remember the importance of your retainers!

Hello,

I am happy that you have decided to improve your teeth! I would suggest that you plan a visit to your dentist for a full check up. This will ensure excellent health of the teeth and gums prior to starting orthodontic treatment. You do not want to start any orthodontic treatment if there are any problems with cavities in the teeth or problems with the gums. Schedule a visit with an orthodontist as well so you can learn about your individual situation and if any additional work needs to be done before starting treatment to improve your smile.
I wish you luck on your journey to an improved smile!

Hello, this is a great question! Both braces and Invisalign work by applying forces to the teeth to achieve tooth movements. Braces are glued.

Hello, I have had more patients ask these questions lately! I would highly recommend that you do not try to tighten your retainer at home. If you inadvertently put too much pressure in the wrong spot, your teeth will move. All teeth move in response to pressure. Orthodontists are trained to manage this pressure to guide teeth in to proper positions. If you adjust your own retainer in the wrong way, you may open spaces, cause rotations, or change your bite. All of which would require additional work to correct. I recommend that you call your orthodontist to schedule an appointment for a quick check. Good luck! Sincerely, John Ballrick

Hello,

Teeth will try to move after any orthodontic treatment. Our teeth are designed to move slightly to compensate for wear or changes in function. This means that even the most ideally positioned teeth will have a tendency to move throughout life. In addition, the bones of the face and jaws change slightly and remodel with age which can also contribute to the teeth moving. Orthodontists will make retainers after treatment to maintain the positions of the teeth and prevent this movement. Retainers are commonly worn during sleep to prevent changes and the wear is a long-term commitment.
Thank you for a great question.

Sincerely,

John

Hello,

Yes, this is very normal. Invisalign requires 22 hours per day for proper movement. Anything less and your teeth will not track properly.
Good luck to you with your Invisalign treatment!

Sincerely,

John

Hello,

This has been a common question lately. In some states, all "non-essential and non-emergency procedures" have been postponed, but in many states the orders have been lifted and you may be able to get braces placed. If your state has the order to postpone care, then you will have to wait until it is lifted and your orthodontist can resume safely seeing patients. I can assure you that in the vast majority of cases, a delay in starting treatment will have no effects on your teeth and in no way be detrimental to your dental health. I would suggest you discuss this with your orthodontist to determine if you will still be able to schedule starting treatment. The journey to a healthy and beautiful smile can be a long one, so a temporary delay at the start will be annoying, but it will be worth it!

Sincerely,

John

Hello, this is a fairly common issue. There are usually 2 reasons we see this. The first is that there is plaque accumulating between the braces and the gums. This can lead to some gum swelling which then traps more plaque. It is a vicious cycle that then continues to allow for more gum swelling. It takes vigorous cleaning and brushing to help it resolve. I tell my patients that the swelling comes on quickly but takes weeks to resolve, so any skipped brushing can allow more swelling. It takes 3-4 times per day of brushing above and below the braces with flossing and an oral rinse (I like traditional Listerine) foe this to start to clear up. A good cleaning from your dentist will help as well. The second reason we can see this is an allergy or sensitivity to something in the braces. This is much more rare and would be something your dentist or orthodontist would be able to give more guidance on alternative materials to try. I highly recommend you discuss this with your orthodontist and your dentist. Keep the teeth as clean as possible in the meantime! I hope this helps! -John Ballrick

Yes, crowns can be moved with braces or clear aligners as long as the crown is on a natural root and not on an implant. An implant is designed to be fused to the bone, so it will not move. A crown on a natural root will move just like any other tooth, even if it has a root canal. Great question.

John Ballrick

Yes, overbites can be addressed in a non-growing adult patient. There are many ways to address overbites and each way depends heavily on the cause of the overbite. Sometimes it is as simple as tooth movement to correct the overbite which can be completed with braces or clear aligners. Other cases of overbite have jaw-size discrepancies which may require additional treatments such as tooth removal or jaw surgery. Those cases are more challenging, but very commonly completed. I recommend a complete exam with an orthodontist so you can learn about your overbite and the best available options for correction.
I wish you well in correction of your problem.

Yes, this would not be a problem. The biggest concerns would be eating with the trays in place. We worry about sugar and foods getting under the trays and sitting on the teeth.
I wish you well on straightening your teeth!

John

Hello,

It is very difficult to say that one treatment is better than another. Both braces and clear aligners have the ability to straighten teeth. A great treatment result will depend heavily on the diagnosis and skill of the doctor. Braces are very good with complex movements, but clear aligners have really advanced in the past few years. I would highly suggest you meet an orthodontist and discuss the benefits and limitations of both options.
I hope this helps.

John Ballrick

Today's ceramic braces are much more durable than ever before. They are prone to breaking parts off with heavy contact or hard foods, but this is not very common. Most patients complete treatment without breakage. The biggest concern is that the ceramic braces are harder than tooth enamel. Sometimes in cases of a deep overbite, an orthodontist will use ceramic braces on the upper teeth and metal braces on the lower teeth (which are barely visible during a smile). Other times, the orthodontist will build up the bite with special material to prevent you from biting on the lower braces if ceramic lower braces are used. Your orthodontist will be able to provide guidance on the best way to work with ceramic braces in your case.
I wish you the best in your smile journey.

John Ballrick

Hello,

This is an extremely common question. There are many ways to correct crowded or flared teeth, but oftentimes in non-growing patients (which is what you would be at 23) or in cases of significant crowding or flaring, removing teeth provides the necessary space for proper alignment of the teeth. The teeth must not only just be straight, they must be straight in a good position within your smile and over the supporting bone and gum tissues. In addition, the teeth must fit properly to the teeth on the opposite arch. Many cases do require extraction of teeth in order to gain sufficient space for this alignment. Usually the orthodontist will make this decision after a clinical examination, review of your bite, and study of your X-rays. You will then be referred to a dentist or oral surgeon to have the teeth removed and then braces will be placed to start moving the teeth. At the completion of treatment, the spaces where teeth were extracted will be fully closed. I recommend you discuss with the orthodontist the proposed treatment plan for you if you have any questions. As treating doctors, orthodontists want to ensure that you fully understand the reasons for our treatments.
I hope this helps you!

Sincerely,

John Ballrick

Hello,

I am a fan of electric toothbrushes (almost any manufacturer) compared to a manual toothbrush. Studies have shown that when used properly, there is minimal difference between manual and electric toothbrushes, but it is very difficult to brush teeth properly during treatment with braces or clear aligners. This is where electric toothbrushes are easier for patients to use properly. Keeping the teeth and gums clean is critical to successful treatment, so proper brushing is essential. In my practice, I recommend SonicCare. I like the timers and the simplicity of this brush.
I hope this helps!

John Ballrick

Hello, depending on the adjustment made pain is very normal. Orthodontic treatment causes inflammation around the tooth - in fact this is why teeth are able to move through bone. The process of adjusting the teeth leads to a few days of pain and discomfort which dissipates. This is very normal with treatment and we normally recommend that whatever over-the-counter pain reliever you would normally take be used with orthodontic pain. If the pain persists or doesn't seem to improve after a few days, then I recommend you call the orthodontist to have it evaluated for any other problems. Also, look for any gum swelling or bleeding as it is not uncommon to get food stuck by the gums which can lead to significant pain.

I hope this helps! -John Ballrick

Hello, braces can have some mild effects on the lower part of the face. Teeth are the primary support for the lips, so in some cases moving the teeth can change the lip support. There are cases where orthodontists extract teeth to move them back for improved lip esthetics and alternatively sometimes the teeth are advanced to improve lip support. If larger changes are desired then sometimes braces are used in combination with surgery to move the teeth and jaws. This can lead to significant changes in the lips and chin for a patient. Most surgical cases are situations where there is a significantly small chin or overly strong chin. If you are considering orthodontic treatment, I highly recommend that you meet with an orthodontist to discuss a treatment plan for you and your teeth. An orthodontist could easily explain which changes you might expect depending on your treatment needs. I wish you luck! -John

Yes, braces will make your teeth feel tight. Braces work by applying pressure to the teeth which causes the bones that hold the teeth to remodel. This process will initially have a feeling of pressure followed by some mild pain for a few days. As the bone remodels the teeth will continue to move until the orthodontist adjusts the braces again. I hope this helps! -John Ballrick

Hello, there has been some good research in to shortening treatment times. A co-resident or mine did a large study to predict cases that would treat in faster times and found that excellent oral hygiene, not missing appointments, and having less overbite at the start of treatment was associated with faster treatments. My experience has been that patients with excellent brushing, fewer broken braces and wires, and excellent wear of rubber bands when needed treat the fastest. I would highly recommend that you focus on excellent brushing and flossing especially keeping your gums clean. Try to avoid any hard or excessively sticky foods that could break or bend the braces. Be sure that you follow any instructions about rubber bands if asked to wear them. Beyond that, most other aspects of treatment time are out of your control.

There has been a strong push for devices that vibrate to accelerate treatment times. The research on these devices shows minimal changes in treatment time. Many patients are paying extra for these devices. I do not recommend them since they have minimal changes in overall treatment times. I hope this helps! -John

Hello, you can absolutely drink through a straw with braces. In fact, it is better to drink sugary or acidic foods with a straw because it moves the liquid behind the teeth and braces while you drink. When you drink without a straw, the sugary or acidic drinks bathe the teeth and braces which can lead to decalcification or cavities forming. Thank you for a great question!