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

Hello, invisible braces usually refer to clear aligners such as Invisalign or the more recent clear aligners that have come along. They are a series of trays designed to move teeth using almost invisible bonded attachments on the teeth. A doctor will meet with you and design your smile digitally and then fabricate a series of trays to move the teeth. The trays are usually worn 2 weeks at a time for 20-22 hours per day. A typical treatment can have anywhere from 10-40 aligners. There are clear braces available as well which are very close to typical metal braces but made out of tooth colored ceramic braces. This type of braces offers excellent control of individual teeth but is more noticeable than clear aligners. I highly suggest you meet with an orthodontist to learn more about what might work best for you. The costs can vary based on your individual treatment needs and difficulty of your case. Longer and more difficult cases generally cost more. Be aware that most orthodontists fees will include all of your treatment as well as all of your retainers which will be important to maintain the results. Most orthodontists do not charge a fee for an initial consult so search for local orthodontists and reach out for a consultation appointment. Best of luck with your smile!

Hello, we have many options available for our adult patients. Many adults choose to use Invisalign or comparable aligners. This will help to gain improved alignment. Another choice is clear or ceramic braces for alignment. This offers a tremendous amount of control over the teeth and bite. Finally there are some doctors who use lingual (inside by the tongue) braces. This option is not as popular since it costs more and can be more irritating to the tongue. I recommend that you meet with an orthodontist to discuss your options. Many doctors will offer you a complimentary exam to discuss your options. I wish you well in your journey to a perfect smile! -John

Hello, this is a common question. Sometimes the teeth can be straight with bite problems present and the first time it is noticed is when the incisor teeth erupt. Treatment is often done as part of an interceptive or phase 1 treatment to correct problems with growth and development of the jaws. Appliances are commonly used as teeth erupt to help improve the bite and guide eruption of teeth. There are many instances though where an overbite may be present and the treatment can wait until the adult teeth grow in to the mouth. Most orthodontists will meet with you at a complimentary appointment and discuss if treatment should be done early or if this problem can wait until your daughter is older and has all of her adult teeth. I recommend you search the American Association of Orthodontists for a local orthodontist and set up an appointment. Sincerely, John

Hello, this is a great question. Braces offer a tremendous amount of control of teeth for orthodontic purposes. This is why many orthodontists prefer braces to align teeth and correct bite problems. Braces are now available in ceramic materials which do blend much better with teeth than metal. Clear aligner therapy with Invisalign or some of the new aligners on the market offer esthetic options for tooth movements as well. Many cases require attachments to be bonded on the surfaces of the teeth to allow the aligners to engage the teeth to mimic the forces that are applied with braces. These attachments are made out of tooth colored composite materials that are usually used to repair chipped teeth. They are designed specifically for certain tooth movements. In addition, orthodontic rubber bands can also be used for certain bite corrections. I would encourage you to have a consultation with an orthodontist. You will learn a lot about your smile and have any of your questions answered. You will also learn about the different esthetic options including clear braces and clear aligners. When you begin your treatment, your orthodontist will be able to closely monitor your care and ensure that you get the smile you are looking for. I wish you the best of luck on your perfect smile! -John

Hello, this is a great question. Thumb sucking can cause significant changes to the developing teeth and bite. The habit can cause the teeth to develop an open bite. This is when a patient bites down and touches only the back teeth. Patients with an open bite will not be able to touch the front teeth together. In addition, patients with thumb sucking habits will
have an increased overjet commonly called "bucked teeth." This occurs because the thumb acts to push the upper front teeth forward and the lower front teeth back toward the tongue. Finally, patients with a strong thumb habit will suck the cheeks in which can lead to a narrow upper jaw. The longer the thumb habit persists, the higher the risk of these problems developing. I would recommend you work with your daughter to remind her to stop this habit. Thumb paint solutions such as Mavala or Thumb Stop can serve as a reminder to not put the tongue in the mouth. There are thumb guards which go over the thumb which can also help some children to stop this habit. Rewards charts are a great way to encourage positive
reinforcement if she can fall asleep without her thumb going in the mouth. Trying at home remedies to see if you can get this to stop is a good first step. If you cannot get it to stop at home soon, I would suggest you review this with your dentist, a pediatric dentist, or an orthodontist. Many times they can provide you with things to try to help stop the habit and let you know if any tooth or jaw problems are developing. If simple remedies fail, you can have custom appliances made to block the thumb from shifting the teeth or changing the jaw growth. You are addressing this at a great time since age 6 is when many of the permanent teeth erupt. Please don't hesitate to reach out to a dental professional if you feel you need more help - we love to help avoid problems from developing in the first place.
I wish you the best of luck with your daughter!

Sincerely,

John

Hello, this is a common problem for everyone. We have learned over the years that everyone gets changes in the positions of the teeth over time. The most common change is crowding of the lower teeth. In a lot of cases this can be realigned with clear aligners and then held with a fixed retainer. This type of retainer is a wire behind the lower front teeth. Based off research, most orthodontists recommend a lifetime retention to prevent continued tooth movement. Do not be surprised if your orthodontist discusses some interproximal reduction. This means they will create some space by lightly reducing the widths of the lower front teeth. I hope this helps!

Hello,

This is a common question that many people have. The American Association of Orthodontists recommends the first consult with an orthodontist at age 7. We do this so we can evaluate things such as jaw size and the development of the teeth. Many first exams include an X-ray which will allow us to evaluate all the teeth that have not fully erupted. Many times patients are placed in a recall system to monitor the eruption of the teeth and will start with braces when all the teeth have erupted. Other children with jaw-size concerns may start treatment early to fix problems that are easily addressed while growth is occurring. I would suggest an exam with an orthodontist just to have the discussion about your concerns with crowding. Most orthodontists do not charge for a first exam and it can help to establish a relationship with a doctor your son will be seeing someday.
I hope this helps!

Hello,

You are correct that your teeth can be damaged and change from clenching. There is a relationship between clenching and stress, so this is not uncommon to see. The clenching can lead to wear of the teeth, fractures, changes at the gum lines, changes in the positions of the teeth, changes to the shape of the dental arches, and sometimes even lead to problems with the TMJ. I would suggest that you discuss this with your dentist and discuss possibly using a night guard to reduce the damage from the clenching. There are other medical therapies that can be used as well.
I wish you well in dealing with this.

Hello, a lower jaw that is too large compared to the upper jaw is a complex problem that may require multiple treatments depending on the severity. There are a few options ranging from modifying growth of the upper jaw with expanders, extraction of teeth the camouflage the jaw size discrepancy, or surgical treatments to make the jaw size more appropriate. I would recommend a full work up with an orthodontist including X-rays. I wish you the best of luck on your orthodontic journey, your daughter will surely thank you in the end!

Hello, correction of tooth and jaw problems often involves using braces or clear aligners to reposition the teeth. Even if you use clear aligners instead of braces you will feel some discomfort as the teeth move. The biological process of tooth movement is similar whether you select braces or clear aligners. As for the jawline, if this is a cosmetic concern of yours then there are orthognathic surgical procedures the can correct jaw-size imbalances. I highly suggest you meet with an orthodontist to discuss your concerns in person. Most orthodontists will offer a complimentary consult to help answer your questions and discuss all of your treatment options. I wish you the best of luck and hope this helps.

Hello, I would suggest that you see an orthodontist. You will not require a referral to an orthodontic specialist, so feel free to call and schedule an appointment on your own. Most orthodontists will see patients for an exam to determine if any problems are developing and if any treatment is necessary. The American Association of Orthodontists recommends a first screening at age 7. This is the time when most of the permanent teeth are erupting. If any treatment is necessary you will be told what is needed and why. If not, most doctors will inform you what follow up is needed. I wish you the best with your son and wish you a happy, and healthy smile!

Hello, stopping a thumb habit is very important to improving dental alignment. Thumb habits can change tooth positions, jaw growth, tongue posture, and arch width. Stopping the habit sooner vs later is important and making sure it is stopped prior to growth of the adult teeth is critical. You can work with your dentist for ideas to stop the habit. Frequently rewards and positive reinforcement work well. Encouraging your daughter and helping remind her to stop the habit can help. If all else fails, many denstists frequently recommend a topical application of a reminding solution (Mavala or Stop Thumb). If that fails and the habit continues to adult teeth many doctors recommend habit appliances. Good luck working with your daughter and don’t forget to ask your dentist or pediatric dentist for more help and advice.

Hello, Zirconia is a type of ceramic. When used for braces, they are clear and very difficult to see on the tooth. There is minimal difference between clear braces and traditional metal other than the appearance. Both allow the doctor to apply appropriate forces to move the teeth. Metal or sometimes white coated wires are used with either type of braces. I hope this helps!

Hello,

This is a very common treatment for protrusive or crowded maxillary teeth. It has been used for many years without problems and has been thoroughly researched. In most cases when it is suggested there is not a good alternative treatment that will allow for proper alignment and retraction of the teeth. I am confident that your orthodontist has your best interests in mind and is not suggesting a treatment that is out of the ordinary. As with any treatment, do not hesitate to contact your dentist or orthodontist if you have concerns, but maxillary premolar extractions are a frequent treatment option.

Hello, while it is very difficult to predict an exact time for alignment of teeth, I can give you some averages for alignment. The average orthodontic case in the USA is just over 24 months. There is a wide variation of length based on the difficulty of alignment and the bite. Some cases are 6-12 months and some are 36 months. Excellent oral hygiene and outstanding cooperation during treatment has been shown to lead to decreased treatment times. I am sorry I can’t give a more accurate number for you. I encourage you to discuss treatment length and treatment options with your orthodontist.

This is very normal when first getting braces. It will take some time for the cheeks and tissues to acclimate to the new appliances. We recommend dental wax to cover any sharp areas and definitely keep your mouth clean. Use a salt water rinse or Peroxyl to keep the areas clean. Finally, there are small braces covers that can snap over the wires if you really can’t get comfortable. The vast majority of patients do well after a few days. I hope this helps!

Hello, first I would make sure you aren’t using any whitening products. A classic sign is sensitivity and most patients will whiten the teeth after treatment. I would strongly recommend that you have the doctor check your teeth and retainers for any problems and make sure everything looks good clinically. I personally have seen times where a minor distortion in a retainer can put pressure on teeth where we don’t want it which can lead to discomfort. I hope this helps!

Hello,

It is not uncommon to have the teeth appear to change in height or size relative to the gum tissues during orthodontic treatment. The most common cause is inflammation of the gum tissues which can cause the tissues to swell slightly. This happens frequently and makes the tooth appear to be covered by more gum tissues. This is almost always reversible with excellent hygiene. Outstanding tooth brushing, flossing, and adding an oral rinse (Listerine works best) helps tremendously. If the tooth appears longer out of the gum tissue, this can be from movement to move the tooth in to proper occlusion with the opposing teeth. Also, teeth that appear longer during treatment can happen when there is some gum recession. Usually, it is mild and of minimal concern, but occasionally it can progress.

The main reasons for swollen cheeks are usually infection or allergy. Both would be exceedingly rare following braces removal. Perhaps having the mouth open for a longer procedure triggered some minor muscle swelling. Usually if that happens, it resolves on its own. I would suggest that you call the doctor for a follow up if this does not resolve. If it should get worse or lead to any other symptoms I would suggest you get seen sooner to rule out any infections or allergies.
I hope this helps!

In order to move teeth, orthodontists have to apply pressure to the teeth with braces or appliances. The braces or appliances stimulate an inflammatory process that allows the teeth to move. This will cause some discomfort and pain for a few days. Patients can handle this with over the counter pain medications and a softer diet. After the first few days, the teeth will continue to move with minimal discomfort.
I hope this helps!

-John