Ten New Year’s Resolutions To Improve The Brain

In order to stay healthy and vital, the mind needs regular attention like all parts of the body. Follow these suggested resolutions for improved brain function.

Improve Your Diet

The brain thrives on a healthy diet. Incorporate an abundance of fresh fruits and vegetables into your daily meals to ensure your brain receives the nutrients it requires to function at its best.

Eat Less Sugar

Sugar contributes significantly to the condition we refer to as “brain fog.” Avoid high carbohydrate foods when you need your brain to function at its highest level.

Read Two Books A Month

Reading engages the brain in physical activity. Look up new words and memorize them. Read a mix of fiction and non-fiction titles for a blend of entertainment and education.

Keep A Journal Or Diary

Keeping a daily journal lets the brain know the things that are important to you. By writing them you are reinforcing their place of importance in the brain. These events will be easier to recall at a later time.

Write About Your Family

Record the fun and exciting events of family life in notebooks. From a baby’s first tooth to the six year old riding a bike with no training wheels, you will remember details better if you have written them down. Your children and grandchildren will appreciate the stories too.

Learn A Language

The world is as close as the Internet, and knowing a second or third language is a definite asset in both your business and personal pursuits. Learning a new language is an excellent brain exercise.

Quality Sleep

Get good quality sleep every night to enhance brain function. Quality sleep refreshes and recharges the brain for the next day’s challenges.

Take Walks

Walking is good exercise and improves circulation, which is critical for a healthy brain. A good walk “clears the brain” and strengthens the memory. Daily walking can help improve the memory of senior citizens.

 

Play Word And Number Games

Crossword puzzles, Scrabble, Sudoku, and other word and number puzzle games create mind-stimulating challenges for the brain. Playing “thinking” types of games on a consistent basis keeps the brain functioning at a healthy level.

Never Stop Learning

When the brain is called upon to learn new things, the challenge stimulates and improves overall brain function.

Making healthy New Year’s resolutions for your brain results in improved memory and increased brain function.   

Urban Legends of the Orthodontic World

There are a lot of urban legends and myths about orthodontists and their services. Some of these have become so commonplace that they are now inseparable from the actual facts. As an orthodontist, I feel it is my responsibility to educate both my patients and the public so that they can have a clear understanding of what I do and how I can help them. With that in mind, I’d like to take a few minutes to debunk some of the common orthodontic urban legends and myths.

Myth One: I don’t need an orthodontist because my general dentist can take care of the problem.

 While your general dentist is undoubtedly a talented and educated professional, when you have a dental issue that falls into the realm of orthodontics you should see a specialist (orthodontist). Why? Orthodontists receive more specialized formal education than a general dentist. Not only do orthodontists complete four years of dental school, they also receive 2-3 additional years of intensive clinical and didactic training. This greater knowledge base allows for more efficient treatment times with more consistent treatment results.

Myth Two: Only children or teens need to visit an orthodontist. 

Some people believe that braces are only for children or teens. They are often surprised to find that orthodontists treat adults on a regular basis. In fact, the number of adult patients is on the rise. According to the New York Times, between 1994 and 2010, the number of Americans over 18 getting either braces or some type of teeth-straightening treatment from an orthodontist went from 680,000 per year to 1.1. million per year (Newman, 2012). Adult patients now make up approximately 22% of orthodontic patients in the US. No matter your age, dental health and a dazzling smile can be achieved and often times, orthodontics is a key component in reaching that goal.

Myth Three: Braces are just for cosmetic purposes and aren’t necessary for my dental health.

While braces can definitely help you get that beautiful smile, they aren’t just for cosmetic improvement. Well aligned teeth can facilitate good oral hygiene making it easier to prevent tooth decay and gum disease. In addition, resolving certiain orthodontic problms with the use of braces can improve your ability to speak, chew, and even breathe.

Myth Four: Getting braces is extremely painful. 

Adults and children alike often associate braces with pain. This may stem from a painful dental experience in the past. Fortunately, there is no pain involved in putting on braces or adjusting the wires. Only several hours after the proceduere do the teeth become sensitive to pressure. This pain is not a toothache. The teeth only hurt when they are biting into solid foods. If the teeth are apart, no pain is felt. This sensitivity to pressure gradually diminishes over the coure of 2-4 days. If you ever feel a sharp or stabbing pain that is persistent consult with your orthodontist to make sure there aren't any problems.

Myth Five: My braces will set off metal detectors (like those in airports) and cause me to be struck by lightning.

 No, none of the above. Braces can be made of a variety of materials; however, metal alloys are the most common material. Because the metal used is so light weight, they will not trigger any security systems in the airport or anywhere else. As for lightning, with or without braces your chances of gettting struck by lightning are the same. 1 out of 775,000 (Dr. Cooper, n.d.).

These are just a few of the urban legends and myths associated with orthodontics. If you have additional concerns or questions about orthodontics and orthodontists feel free to set up an initial consultation with me. I’ll be happy to provide you with all the information you are looking for.

Resources

Cooper, M. A. (n.d.). Medical Aspects of Lightning. Retrieved from http://www.lightningsafety.noaa.gov/medical.htm

Newman, A. A. (2012). Orthodontists Market to Adults Seeking Prettier Smiles. Retrieved from http://www.nytimes.com/2012/02/02/business/media/orthodontists-market-to-adults-seeking-prettier-smiles.html

Celebrating the Holidays with Braces

What foods to eat and what foods to avoid this holiday season

With Thanksgiving already here and December clearly in site, the holiday season is really getting underway. It’s an exciting time of the year because there’s so much to look forward to including time off from school and work, family gatherings, gift giving and receiving, decorations, and let’s not forget the food! The holiday season brings with it fabulous foods that you probably don’t get to indulge in the rest of the year. Unfortunately, a lot of these delicious, mouth watering dishes pose a real problem to individuals with braces. To help, I’ve created two lists to guide individuals with braces safely through any holiday feast.

The Naughty List
If you have braces beware of the foods I’ve placed on the naughty list this year. Indulging in these foods could result in damage to your braces including loose bands, broken wires, or detached brackets. Damage can be costly, painful, and prolong treatment time.

Here are some of the foods to avoid this holiday season:

Carmel Candy
Candy Canes
Hard Breads
Peanut Brittle
Pecan Pie
Popcorn (Kernels)
Cranberries and Cranberry Sauce - may stain clear ties.
Snack Mix - typically contains nuts and hard pretzels which should be avoided.
Vegetable Trays - raw, hard vegetables like carrots need to be cut up.
Hard Cookies - go for soft cookies or soak hard cookies in milk. Watch out for nuts!

In general, you should limit your intake of foods and beverages (such as soda) that contain high amounts of sugar. Sugar is eaten by the bacteria that live in the mouth; in turn, the bacteria excrete acids which lead to tooth decay and cavities.

The Nice List
This holiday season, try to pick foods that I’ve placed on the nice list whenever possible. Play it safe! I’m sure no one wants to be spending the day after Thanksgiving at the orthodontist’s office. Here are some foods to enjoy this holiday season:

Turkey
Ham
Cooked Vegetables
Soft Breads
Stuffing
Mashed Potatoes
Deviled Eggs
Pumpkin Pie
Sweet Potato Pie
Chocolate Pie

Enjoy your holiday season; spend it with your friends, family and colleagues - not your orthodontist! The best way to do that, if you wear braces, is to follow the naughty and nice lists I’ve created. If you see a dish on your dinning room table that isn’t on my lists the best way to evaluate it is to ask yourself these two questions:

1. Is it sticky and/or chewy?
2. Is it hard - if I bit into it, would it go crunch?

If the answer is yes to either of the above questions than avoid that food! Move on to other, friendlier dishes. I know this means giving up some of your favorite foods but in the long run, it’ll be worth it because you’re going to have a beautiful smile, and isn’t that one of the best holiday gifts you could give yourself?

Narrow Smile

This patient came to me because she did not like how narrow her smile looked.



Because the back teeth do not fill out the full width of the smiling lips and mouth, in most lighting there are shadows that cast in the sides of the mouth when she smiles leaving a darkness in the corners of the mouth.  In orthodontic language, these dark shadows are called "buccal corridors."

The narrowness of the upper portion of her upper jaw resulted also in a protrusion of the upper teeth.

This is the most dramatic view of the narrowness of her jaw. 

  

This is the same picture of her upper teeth after braces.  She elected to wear a permanent retainer which is what you see bonded to the back of her front teeth.

You can see the improvement in the width of the jaws.  I also manicured the edges of her incisors so they have the correct shape and contours.

The overbite was corrected.



You can see the dramatic improvement in her smile! 

Teenager With Dental Crowding and Overbite

This young lady came in to my office when she was almost 12 years old. She and her mother were concerned with the crowding of her teeth.
   

When she smiled it was evident that she had "crooked teeth."  This was a result of a crowding problem.  The teeth that had grown in were too large for the current size of her jaws. 

One common presentation of crowding seen here is that the front two teeth (central incisors) are more forward than the teeth adjacent to them (lateral incisors).  Also, the canine teeth or "eye teeth" are out too far toward the lips and cheeks. 

 

This patient also had an overbite.  This means that the top teeth are more anteriorly positioned in the face than the bottom teeth.  Also, there will often be a forward angulation to the top front teeth as you can see here particularly of the central incisors.  This forward angulation is often referred to in orthodontic terms as flaring or dental protrusion. 

This is a view of the crowding of the upper teeth looking up into the mouth.

The bottom teeth also had some crowding but it was mild compared with the upper teeth.

This is a cephalometric x-ray that shows the teeth from the side.  This image helps the orthodontist to see more clearly the angulation of the front teeth, the amount of overbite, as well as how the jaws are developing.  The field of orthodntics has developed hundreds of ways to analyze these x-rays to help understand current jaw positions, identify facial growth patterns, and evaluate tooth angulations.  Average, normative values have been suggested which can help the orthodontist to quantify the severity of the problems as they relate to treatment goals. 

This is the final x-ray after the overbite has been corrected.  You can see that the tongue-facing surfaces of the top front teeth are resting on the lip-facing surfaces of the bottom front teeth.  This is the correct position of the teeth.  

Her jaws were expanded to accommodate the crowded teeth leaving her with a beautiful, broad smile.

Tooth alignment has been achieved using braces.

Overbite correction has been achieved using orthodontic elastics.  Elastics work by moving groups of teeth.  Specifically in this case, the top teeth were pulled back and the bottom teeth were pulled forward.  The elastics are attached to certain braces that have "hooks" designed to hold the elastics in place.  Consistency with elastic wear is very important to the success of this type of treatment.  Optimal tooth movement occurs with 20 or more hours of elastic wear per day.  Since patients are able to put the elastics in and take them out by themselves, they must be committed to keeping them in.  Parental reminders don't hurt either :)  Usually, elastics are removed while eating and brushing and flossing.  Otherwise, they are worn full time.     

You can see the broadness of the dental arches which contributes to her beautiful smile.

Happy Mother and Daughter!!!

Orthognathic Surgery

     Not all bite problems are a result of improper tooth alignment. There are certain individuals who have bite problems because of misaligned jaws. In other words, the upper and lower teeth don’t fit together properly because the bony bases that support the teeth are not properly positioned relative to one another. In orthodontics, we call this type of problem a “skeletal dispcrepancy.” This simply means that the upper and lower jaws have not developed in harmony with each other. Typical presentations of these jaw problems include underbite, overbite, crossbite, or jaw asymmetry.

     People who have severe skeletal discrepancies also have poor facial balance which negatively affects their appearance. When severe, surgical correction of the jaw positions is necessary to achieve proper facial balance. This type of surgical procedure is called “orthognathic surgery.” In our day and age, all orthognathic surgery must be done in conjunction with orthodontic treatment. Orthodontics is a crucial part of the process because the teeth must fit together perfectly when the jaw bones are reset. Therefore, every patient that needs jaw surgery will also have at least some movement of the teeth prior to the surgery being performed. This allows for a proper bite at the time of surgery. In addition, the attachments on the braces and wires allow the oral surgeon to use miniature elastics to hold the jaws closed during healing. The patient can then recover without having the mouth wired closed.
    
     The patient below is a professional singer who is in the public eye every day.  She had braces as a child but was unhappy with the way that her teeth looked.  She came to my office for a consultation hoping to resolve her concerns by wearing braces.  In every case, and especially in a situation like this, it is very important as an orthodontist to really understand the chief concern that each patient would like addressed.  As I looked in her mouth, I did see that she had some bite problems but they were not severe.  If my goal was only to fix the bite, I could have done that easily with braces alone. 

As we talked, however, it became clear to me that she was more unhappy with the structure of her jaws and lower face than the position of her teeth. 

In this picture you can see that in order for her to close her lips together, she has to flex the muscle of her chin. If the lips do not come together comfortably when all of the facial muscles are relaxed, it requires the chin muscle or "mentalis" muscle to flex in order to get the lips closed.  This is called mentalis strain or lip strain.  It can result from two skeletal problems.  First, the height of the lower face is too large requiring the lips to "reach" further to keep the mouth close. Second, when the lower jaw is behind the upper jaw, the lower lip can get "trapped" below the upper teeth requiring the chin muscle to flex and force the lower lip forward and up to get the lips together. In her case, both of these problems were present causing significant mentalis strain on lip closure.   

You can see from this picture that when she smiles, she shows an excessive amount of gum tissue. In orthodontics this is known as a "gummy smile." It can be the result of a very mobile upper lip that lifts higher than normal but more commonly is it a result of the upper jaw being positioned too far below the nose and cheeks. That is the case with this patient and it is a problem with structure of the craniofacial bones, not the position of the teeth.

In the profile view, the retruded position of the mandible is apparent.  The mentalis strain mentioned above is also evident.  A more forward position of the lower jaw and chin would go a long way to achieving proper facial balance.

A view of the occlusion shows that the lower front teeth are positioned behind the upper front teeth.  In orthodontics, this is called overjet but "overbite" is the term used in the general populations.  If facial structure were not an issue, the bite could be corrected using braces alone.





 

These views show that the jaws were somewhat narrow along with mild irregularities in the positions of several teeth.

This x-ray is called a panoramic x-ray and it shows that the wisdom teeth have been extracted.  Also, four premolar or "bicuspid" teeth were removed prior to her first set of braces when she was a child.  The orthodontics used the spaces gained from those extractions to align the teeth.

This x-ray is called a cephalometric x-ray and is very useful to the orthodontist and the oral surgeon in determining the position of the jaws and in planning the jaw movements that need to be made.

You can see the facial changes that were made using combined orthodontic treatment and orthognathic surgery.  The lower facial height decreased allowing for more relaxed lip closure.

The jaws were expanded resulting in a broader smile.  The upper jaw was also lifted resulting in less gum display when smiling.

The lower jaw and chin projection increased dramatically taking away the lip strain that pre-surgically was needed to close her mouth.  This procedure was done without any implanted chin material so the results will last a lifetime.

After removal of the braces, the teeth are well aligned

The overbite is no longer present

The width of the jaws has increased as well

The oral surgeon uses many plates and screws during surgery that stabilize the jaws while they are healing.  This "hardware" does not need to be removed.

This is the final cephlometric x-ray after the braces have been removed. 

The braces are removed several months after the surgery once the bones are totally healed and the bite has completely stabilized. Successful treatment of severe skeletal deformities of the lower face requires a team approach and precise planning on the part of the orthodontist and the oral surgeon. Those who undergo this treatment experience possibly the most dramatic improvements in facial appearance that exist in medicine today. While surgery is an amazing tool to restore harmony in jaw relationships, some bites that appear to be far off can be corrected using orthodontic treatment alone….especially in young people. We can help you determine if orthognathic surgery is right for you.

When Should I Bring My Child In For An Orthodontic Consultation? By trumanorthodontics on 2/20/2012 11:21 AM

One of the most common questions that people ask me is: When should my son or daughter get braces?

One of the most common questions that people ask me is:  When should my son or daughter get braces?  This question has several variations which include:  Why are people getting braces so young now days? or Didn't people used to get braces when they were in middle school?

No matter how it is phrased, what parents really want to know is why some people are getting braces in 2nd or 3rd grade and others are getting their braces in 7th or 8th grade.  Naturally, they also want to know in which of these groups their child belongs.

In order to understand the answer to that question, it is first important to understand something about dental development.  Most children begin losing their front teeth at about 6 years of age.  By 8 or 9 years old, eight permanent front (incisor) teeth have replaced the front baby teeth.  At the same time, four new permanent molars are growing in behind the back baby molars.  So at about 8 or 9 years old, a child usually has twelve permanent teeth and twelve baby teeth in the mouth at the same time.  In dentistry this is called "the mixed dentition" because there is a mix of permanent and baby teeth.

This x-ray shows permanent teeth (which have no tooth buds underneath) as well as baby teeth (which have the buds of permanent teeth underneath them)

At this point, there is typically a window of 2-3 years before the child will lose anymore baby teeth.

It is also at this time that problems of crowding and misalignment of the front teeth become apparent because the size of the permanent teeth is so much larger than the teeth that they replace.  Children who did not have spaces between their baby teeth will develop crowding of the front teeth simply because the permanent teeth are so much bigger.  Because of the development of these and other problems as the new teeth grow in, it is the time when "early intervention" or "phase I treatment"  is usually performed.  Because only half of the permanent teeth have grown in, only partial orthodontic treatment can be rendered at this stage.  It therefore becomes necessary to complete the treatment with a second stage of braces that is worn after the growth of the remaining teeth at approximately the age of 12 or 13. 

While certain children benefit from early intervention as described above, the majority can wait for the eruption of all of the permanent teeth before beginning orthodontic treatment which can be accomplished in a single stage. I recommend two-phase orthodontics for two reasons:

     1.     A better end result can be achieved by intervening early

     2.    Patients and their parents have cosmetic concerns that are affecting the self-esteem of the child. (For example: an 8-year old child is being made fun of at school and does not want to wait 4 more years to begin correcting the problem)

Those children who come to the office in the mixed dentition stage of development who do not meet the criteria above are placed in our observation program. Their parents are re-assured that everything will work out fine and treatment will be more efficient if it is done at a later time. Parents really appreciate the opportunity to discuss their child’s specific situation and understand the course for the future. That is why we like to see children for the first time when the top front teeth start to grow in. Periodic imaging of the developing teeth will be done at follow-up appointments so that treatment can begin at the most efficient time.

Happy New Year!

We are excited to announce our new VIP Rewards Card.

When you come to your next appointment you will be given your VIP Rewards Card!  All you have to do is bring your card to each appointment and watch the points pile up! Earn more points at each appointment for things like; having excellent oral hygiene, getting great grades, referring a friend or seeing your dentist for a dental cleaning.

The great thing about our new program is that you can swipe the card at each visit and earn points.  You can redeem those points on-line at countless stores.  Your hard-earned prizes will then be sent directly to your home!

This new program will take the place of our wooden nickels. Bring your wooden nickels in to redeem for points on your new VIP Rewards Card. We just ask that you try to redeem your old nickels by March 31, 2012.

We look forward to seeing you soon and showing you how fun and easy it is to use your new VIP Rewards Card.

Underbite

Underbite is when the lower front teeth are in front of the upper front teeth.

Often, it is not so much a problem with the teeth as it is with the jaw structure.  Underbite patients usually have either an under-developed upper jaw, an over-developed lower jaw or some combination of the two. In orthodontic terms, this jaw growth discrepancy is called a skeletal class III malocclusion and it usually runs in families.  Precise measurements of cephalometric x-rays of the patient's face and skull like the one shown above can help the orthodontist understand the growth pattern and predict the effectiveness of treatment.

Early treatment is aimed at orthopedically enhancing jaw growth of the upper jaw and retarding growth of the lower jaw.  This is typically accomplished using a reverse pull headgear that the child wears at night while sleeping.

An underdeveloped upper jaw that is not growing forward in harmony with the lower jaw will also often be under-developed in a transverse dimension as well.  In other words, the upper jaw is too narrow. This can be seen as a crossbite of the posterior teeth with the upper back teeth biting on the wrong side of the bottom back teeth.  In the image above, this can be seen on the right side (which is the patient's left side).

The narrowness if the upper jaw can also lead to crowding of the top teeth.  In this case, there is not enough room for the new incisors to grow in correctly.

The panoramic x-ray shows the crowding of the lateral incisors that want to come in but are not because of the crowding.

After expansion of the upper jaw and braces on the top teeth, space was created for the teeth to be aligned.

Night-time wear of a reverse headgear allowed for the jaw growth to be modified and returned to normal.

Now he can't stop smiling....