Dental Questions: How can I clean around braces?

Braces can make cleaning any mouth very difficult. The wires, bulky brackets and food trapping ledges all contribute to problems with home care. Fortunately, there are many great products and techniques for keeping your orthodontic appliances clean. Take a look!

A typical example of floss threaders.

One of the most obvious difficulties in cleaning around braces is the inability to floss between teeth. The orthodontic wire prevents regular dental floss from reaching the critical areas at/beneath the gum line. A typical solution to this problem is using a floss threader or dental floss with a built in threader tip. These products allow you to push the floss underneath the wire and reach all areas of the teeth. Newer devices like GumChucks ORTHOgami achieve the same outcome, but with a different form factor. For younger patients, dental picks and floss brushes should be used carefully, as they have the potential to damage the gum tissue and cause bleeding. They are, however, useful for cleaning sticky food out from between the wire and tooth. 

GumChucks ORTHOgami

Brushing around the wires and brackets relies more on careful technique than a special product. You will probably need to make a conscious effort to get the toothbrush positioned underneath the wire and into the various angels of the brackets. Some companies sell special orthodontic brushes with smaller heads for manuvering around the appliances. Still, a standard toothbrush and good technique should be sufficient for most patients. Keeping the gums and tooth surfaces around the brackets healthy is a priority for any patient in braces. You don't want to finish your orthodontic treatment only to have cavities in your beautiful smile!

At Thousand Oaks Family Dentistry, we know that braces can turn dental hygiene into even more of a chore. We are here to make the process as easy as possible. If you would like to know more about braces, orthodontics, toothbrushes or dental cleanings, please give our office a call!

Dental Questions: Can I eat with my Invisalign trays on?

One of the most unexpected (but often appreciated) side effects of Invisalign treatment is weight loss. Because the trays have to be worn 22+ hours a day and can only be used on clean teeth, many patients forgo snacks and extra sugary drinks in the name of convenience. But, if you really need that afternoon pastry pick-me-up, do you actually have to take your trays out, then eat, then brush before putting them back in? The answer is yes, absolutely!

Anytime we eat or drink anything other than water, the pH balance in the mouth turns acidic. Usually, this is slowly buffered back to normal by the compounds in our saliva. However, Invisalign trays can trap food and liquids around the teeth and keep the protective saliva out. This effectively allows the teeth to soak in acid, leading to decay and decalcification spots. You don't want to finish your Invisalign treatment only to find out you need fillings! Furthermore, extreme temperatures and unexpected forces can deform the thin plastic trays. Clear aligners are designed with extreme precision, and even the smallest changes can negate their orthodontic abilities. 

Invisalign is a great treatment option for many patients, but it is not without it's limitations. If you cannot leave the trays in for nearly 24 hours every day, you may need to consider other options. To learn more about Invisalign trays, braces or other cosmetic dental procedures, please give our office a call!

Options for Straighter Teeth

Orthodontics represent one of the most commonly performed dental procedures outside of cleaning and fillings. Every year, thousands of children, teens and adults begin treatment towards straighter teeth. Take a look at some of the considerations you will want to make in obtaining that perfect smile!

First and foremost, orthodontics should only be attempted under the supervision of a licensed dentist/orthodontist. No online guide or mail order kit will be able to bring the expertise of a professional in creating a perfect smile. Even something as simple as closing the gap between your two front teeth can cause irreparable damage. At the very least, you will be wasting time and money on "procedures" that get you nowhere. At the worst, you could end up losing a tooth (particularly true for the rubber band gap closers available online). 

Many younger patients will be best suited for traditional metal band and bracket braces. This treatment is predictable, easy to adjust and can straighten many different types of crooked teeth. Braces are usually worn for about 24 months and are overseen by an orthodontist. The hallmark of this treatment are the non-removable wire and brackets. Children (who typically have poor compliance) do not have the option of "not wearing" their appliance. Conversely, flossing and brushing around the wires can be difficult, making good oral hygiene a must while in braces. 

On the opposite end of the spectrum are clear aligners, like the always popular Invisalign appliance. This treatment is performed by general dentists and orthodontists alike to correct most types of spacing problems. Our office uses Invisalign to correct many mild to moderate orthodontic concerns. Because aligners are clear plastic and can be removed, they are often the choice for individuals with cosmetic requirements. Unfortunately, since the aligners are not physically attached to the teeth, some movements are simply not possible. Furthermore, this treatment relies on patient compliance- the retainers must be worn for 20+ hours a day!

In some specific circumstances, crowns and veneers can also fix gaps and crowding between the teeth. A common application would be placing crowns on the two front teeth to fix a gap by creating a more cosmetic contour. That said, orthodontics are usually the first choice if the only problem is spacing between teeth. If you would like to know more about your options to a straighter smile, please give our office a call!

Case Presentation: Invisalign Orthodontics

Invisalign has made straight teeth a reality for a new generation of adult patients. While traditional braces may not be an option due to esthetic concerns or professional requirements, clear aligners can provide similar results with no visible hardware. In today's patient, Invisalign trays were used to correct minor crowding and spacing issues in the anterior teeth. Notice how the maxillary and mandibular incisors now follow even paths with minimal overlap.

At Thousand Oaks Family Dentistry, we provide Invisalign treatment for long time patients of record with mild orthodontic needs. Severe crowding, cross-bites and complicated spacing issues deserve the attention of an orthodontist. Additionally, it is important to note that Invisalign cannot achieve all the results of traditional braces. Some tooth movements are simply impossible without traditional wires and brackets. To get the whole picture, please visit our office for an exam and consultation!

Braces for Adults

With more nearly 1.5 million patients last year, adult orthodontics are certainly on the rise. Adulthood can certainly be a time where finances and resources align to make the dream of straighter teeth a reality. Wether used on their own or in combination with other cosmetic dental procedures, braces can create a dramatic change in almost any smile. 

Many adult patients will opt for traditional wire-and-bracket braces. These orthodontic appliances are the most versatile option, achieving most tooth movements with ease. The entire procedure is overseen by an orthodontist, who directs and refines treatment on the fly.  The most obvious drawbacks to this type of orthodontics is the esthetics of the exposed appliance. In fixing this, some specialists place tooth colored brackets that better blend in with the surrounding tooth enamel. A second drawback is the increased time devoted to oral hygiene. Brushing and (particularly) flossing become more difficult with a metal bar running across the teeth. However, there are many readily available products that make keeping your braces clean a no brainer. 

For those wishing to avoid the appearance of traditional orthodontics, removable Invisalign trays might be an ideal choice. Here, a series of trays are custom fitted to your teeth to gently push them to their desired positions. Since nothing is truly anchored to the teeth/mouth, tooth movements take a longer time. Additionally, some types of adjustments are difficult/impossible without traditional braces. Invisalign works great for minor corrections, crowding, or correcting orthodontic relapse (for those who have reoccurring tooth movement after finishing childhood orthodontic treatment). 

There are always a number of great options for perfecting and maximizing your smile. Braces and trays represent the ideal solution for those looking for straighter and more evenly spaced teeth. If you would like to know more about your cosmetic options, please call our office to schedule an exam!

Dental Questions: Why do we put braces on baby teeth?

You may have heard of a relatively new orthodontic technique that involves putting braces on baby teeth. This treatment probably sounds absurd- trying to create a perfect and straight smile only to have the teeth fall out within a few years. On the contrary, this routine (known as interceptive orthodontics) is  a very effective method for developing a life-long beautiful smile. 

Interceptive orthodontics take advantage of the fact that toddlers and young children still have developing bones in their face and jaws. Here, braces and orthodontic appliances tend to have a more drastic effect and can correct defects and malocclusions (conditions where the teeth are misaligned) more robustly. They are almost always used as part of a two stage treatment plan- where earlier braces help create symmetrical and properly sized jaws and later phases create the straight and cosmetically pleasing smile. Overall, this combined approach leads to less time in orthodontics versus single phase treatment. 

Not every child needs interceptive orthodontics or will be a good candidate. If your orthodontist recommends early braces, it is part of a long term plan towards your child's best dental health. If you have any more questions about interceptive orthodontics or how they are used, give our office a call! 

Specialist Spotlight- Dr. Hang and Face Focused Orthodontics

At Thousand Oaks Family Dentistry, we are proud of the network of skilled dental specialists we have created. Whether you are in our office or one of our associates’ offices, know that you will be treated with respect, kindness and experience. Today, we would like to highlight orthodontist Dr. William Hang and his program of Face Focused Orthodontics.

Like every orthodontics practice, Dr. Hang offers a variety of services and appliances geared towards straightening teeth and improving the dimensions and mechanics of your mouth. However, his office goes much further with his Face Focused program. Here, he takes an examined approach towards orthodontics to address a variety of problems with breathing and facial esthetics.

Face Focused Orthodontics is the culmination of Dr. Hang’s decades of research, education and practice. He dedicated his career towards developing orthodontic programs that do not retract the teeth as the patient grows older. His ultimate goal is maintaining good rest oral posture, or the relationship of the jaw, face position and airway when you breathe. Poor rest oral posture can lead to a whole host of problems, ranging from headaches to migraines and even sleep apnea.

For young patients entering orthodontics, Dr. Hang focuses on straightening teeth and improving oral esthetics while respecting jaw mechanics and maintaining airways. He strives to create a smile that both looks and functions great for an entire lifetime. In adults, he often treats patients suffering from headaches, snoring problems and sleep apnea in addition to crooked or crowded teeth. Here, his Face Focused program hopes to address poor facial mechanics and establish great jaw and breathing function. No matter what your ultimate orthodontic goal, Dr. Hang and his staff are attentive, communicative and thorough. His consultation appointments alone often take and hour and a half, including X-rays and Cone Beam CT technology.

We love working with Dr. Hang and his office because they offer a unique and powerful service. Patients travel from all around the world to receive treatment from Dr. Hang, while he is conveniently located minutes away from our office. While he is not treating patients, he can be found lecturing or researching ways to perfect his Face Focused treatment. If you would like to know more about Dr. Hang or any other of our fantastic specialists, please give us a call.  We want our patients to know they are in good hands, whether with us or one of our specialists.

To find out more about Dr. Hang, visit his website www.facefocused.com

Specialist Spotlight- Nagel Orthodontics

At Thousand Oaks Family Dentistry, we are proud of the network of skilled dental specialists we have created. Whether you are in our office or one of our associates’ offices, know that you will be treated with respect, kindness and experience. Today, we would like to highlight the services offered by Doctors Norman and Jeffrey Nagel at Nagel Orthodontics.

As an orthodontic practice, Nagel Orthodontics addresses the functional and esthetic needs of many patients in almost every age group. Beyond simply “straightening teeth,” they service a number of problems relating to tooth spacing, biting patterns and jaw position. Orthodontists have a deep understanding of dental mechanics and how your mouth could function at its best. Orthodontic treatment can be appropriate or necessary for many ages, ranging from early intervention for severe crowding to mild readjustments for adult patients.

As a father and son team, Doctors Nagel and Nagel bring over 40 years of experience to treating the Thousand Oaks and Simi Valley areas. Between the two of them, they typically work 60 hours a week, making scheduling an appointment convenient and flexible. They pride themselves in treating patients of all ages- occasionally treating three generations of the same family. At their office, the staff members are caring, friendly and happy to accommodate you or your loved one’s needs. You will probably also notice that the door to their back office is never closed- a true sign of their transparency and welcoming atmosphere!

Nagel Orthodontics utilizes electronic charting, digital impression and even cone beam CT scans to better visualise and manage your orthodontic needs. This information can be made available to either of their offices in seconds, allowing you and your family flexibility between their locations. However, they still take the time to address every case by hand, using plaster and metal articulators (a time consuming step typically reserved only for difficult cases). This combination of new and timeless techniques assures that your case is properly understood and treated with expertise.   

We love working with Nagel orthodontics because we know that your case will be handled with utmost attention. They understand the importance of your overall oral health, and work closely with our office to ensure continuous dental care. If you would like to know more about their office, or any of the other specialists we work with, please give us a call. We want our patients to know they are in good hands, whether with us or our one of our specialists.

Retainers and Space Maintainers

When most patients think of a “retainer,” they imagine a plastic and metal device that snaps across the upper or lower teeth. In reality, there are a whole array of products that assist in the retention and maintenance of tooth position. At our office, we offer a number of retainer solutions to keep your teeth beautiful and straight.

No matter what type of retainer, the general process for fabricating and delivering the appliance is the same. We typically need to take three types of impressions; one of the teeth that the appliance will fit on, one of the “opposing” set of teeth, and a final impression of how your teeth fit together when you bite down. The last two impressions help guarantee that the appliance doesn’t interfere with the occlusal surfaces (where the bottom and top teeth touch each other). Plastic and metal clasps covering these areas can potentially lead to an uneven bite, headaches and even jaw pain. After taking impressions, we need about two weeks for our lab to fabricate your appliance and send it back to us. When you return to our office, we will do some minor adjustments, check the fit and send you off with your brand new retainer!

At Thousand Oaks Family Dentistry, we frequently deliver three types of retainers. The first is the Hawley Retainer. This is the most recognizable “plastic and metal” type appliance. It is removable, easy to clean and usually very comfortable to wear. This type of retainer typically best fits the needs of our adult and teen patients. We also offer clear plastic retainers, known as Essix Retainers. While these appliances are not as noticeable while wearing (the entire device is made from thin clear plastic), the nature of their constructions requires material to cover the biting surfaces of the teeth. This can lead to a whole host of painful problems, particularly in patients who grind or clench.

Finally, we offer a specialized individual tooth retainer called a Space Maintainer for young children who lose a primary tooth prematurely. Decay, cracks and infection can all indicate that a primary tooth needs to be extracted before the adult tooth is ready to erupt. Once removed, the adjacent teeth will typically “move in” and try to fill in the leftover gap. Since the primary teeth serve as placeholders for their adult counterparts, this shift can result in uneven or improper eruption of the adult dentition. A Space Maintainer counteracts this by holding the space of the lost primary tooth. It is physically cemented to the more rearward tooth and butts up against the more forward one, bridging the gap. We recommend space maintainers to almost all of our young patients having primary teeth extracted. This small device can save time, money and headaches by preventing the need for extensive orthodontic work or surgery to correct the adult tooth’s position.

Hawley Retainer

Essix Retainer

Space Maintainer

On top of the retainers offered specifically at our office, there are a number of more complex devices aimed at maintaining tooth position. These appliances can be more discreet, maintain difficult cases or even provide mild repositioning or realignment. For our patients needing these devices, we will typically refer out to our network of wonderful orthodontists. They all have countless hours studying and fabricating these retainers, and can bring years of experience to your needs. After a consultation, we will gladly refer you out to a specialist to best suit your specific case.

As with any of the services offered at our office, a consultation and exam are necessary to determine the best type of retainer for your personal needs. If you are interested in having an appliance made, or have more questions about the process, please give us a call. We are happy to assist you with every step towards optimal oral health!

Invisalign Invisible Braces

One of our very satisfied Invisalign patients. Crowding was addressed on both the upper and lower arches, along with bleaching using the Invisalign trays. The total treatment took 17 aligners and 8.5 months. 

Your smile is one of your most noticeable and forthcoming facial features. Naturally, you take great care of your teeth, brush and floss daily and possibly use whitening products. Still, there is one feature of smile and facial esthetics that cannot be addressed by home care: Orthodontics. If you are interested in having a straighter smile with minimal dental appointments, excellent predictability and discreet treatment, you may be a good candidate for Invisalign.

Invisalign is a system that uses dental impressions, advanced computer programs and clear plastic trays to provide virtually invisible orthodontics. The process is very simple. On your first appointment, we will take a series of impressions and pictures and send them to Invisalign’s headquarters. After that, a representative will send Dr. Kari a digital mockup of your smile, including the movements each tooth is predicted to make. After she approves and adjusts Invisalign’s plan, a set of aligner trays are shipped to our office.

You then return for your second appointment, where we use composites (same kind used in tooth colored fillings) and a special template tray to construct a series of tiny “buttons” on your teeth. These buttons allow the trays to latch and move teeth with extra torque, when necessary. This appointment lasts about 45 minutes and you leave with your very first set of trays!

From left to right: We use the blue trays to take a quick impression of your teeth, followed by a "bite impression" using the purple material in the applicator gun (called Regisil). After invisalign receives and processes your impressions, we receive your custom trays (pictured far right). 

Most Invisalign treatment plans last around 9 months to 2 years, with about 15-30 included trays. You will be expected to periodically return to our office to ensure your treatment is going as planned. While this timeframe may seem lengthy, remember that the trays are invisible, comfortable in the mouth and removable. Any time you need to eat, brush or whiten your teeth, you can remove your appliance in a matter of seconds.

While Invisalign is an extremely predictable and effective process, not everyone is a good candidate. Those who cannot devote the majority of their day (awake and asleep) to wearing trays will encounter a delayed or entirely ineffective orthodontic treatment. For this reason, we do not recommend Invisalign for children, as “patient compliance” is especially difficult to obtain. Furthermore, certain tooth movements are impossible without traditional wire-and-bracket braces. Being a removable piece of plastic, there are limitations to the directions that Invisalign can precisely realign teeth. To determine if you are a good candidate, or address your questions and concerns, please schedule a consultation with our office.