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We’ll give it to you straight: it can be harder to keep your teeth their cleanest while you’re wearing braces. Food particles play hide-and-seek, plaque builds up around brackets, flossing is harder when you need to maneuver around wires. But keeping your teeth and gums healthy is even more important now that you’re wearing braces.

Why? Because when your braces come off, you want to enjoy the beautiful smile you’ve worked so hard for without worrying about discolored enamel, cavities, or swollen gums. Let’s look at some of the possible consequences when brushing and flossing are more challenging.

Decalcification

If you’ve noticed white spots around your brackets, you’re seeing the signs of decalcification, a common problem for those who wear braces.

Decalcification begins when plaque collects on the enamel around your brackets. The bacteria in plaque produce acids. These acids eat away at the minerals which keep your enamel strong, minerals like calcium and phosphorous. Places on the enamel where erosion takes place are left weakened and discolored.  Eventually, these weak spots can lead to . . .

Cavities

When plaque sticks around, whether near your brackets or anywhere on your teeth, it provides the perfect conditions for decay to develop. Left untreated, bacterial acids continue working away at decalcified spots in your enamel. This continuing erosion causes these surface spots to expand, grow deeper, and become cavities.

If you’re having trouble with built up plaque, and brushing isn’t doing the job for you, your dentist can remove it with a professional cleaning. Getting rid of plaque is healthy not only for your enamel, but your gums as well.

Gum disease

When plaque and tartar collect around the gumline, they irritate delicate gum tissue. This irritation causes gingivitis, or early gum disease. And, while young people rarely suffer from serious gum disease, the pain, redness, bleeding, swelling, and bad breath caused by gingivitis are not anyone’s life goals!

Brushing and flossing are essential to keeping your enamel and gums plaque-free. But even if you brush more often, it’s not as easy as it once was now that you have to work around and between brackets and wires. Luckily, there are lots of tools out there to help you get your teeth, gums, and braces their cleanest.

• Orthodontic toothbrushes

Special brushes designed just for braces can help you work around brackets and wires. V- or U-shaped bristle formations let you brush around and over your braces. Curved bristles can fit under wires. Smaller brush heads let you reach those hard-to-reach places.

• Electric toothbrushes

Many people find these brushes can clean more easily and effectively, especially when wearing braces. Tapered orthodontic brush heads are available, and, if you’re a heavy-handed brusher, there are models which alert you if you’re brushing too hard—protecting your braces and your enamel.

• Orthodontic floss

Special orthodontic flosses can help you do the tricky job of fitting floss behind your wires and between your teeth, or use a floss threader, which helps guide uncooperative floss into tight spaces.

• Water flossers

With their pulsing streams of water, water flossers can reach spots where regular brushes and flosses just can’t comfortably fit. There are even flossers available with special orthodontic tips.

Straight teeth are great. Straight and healthy teeth? Even better! You, Dr. Quas, Dr. Wiater and Dr. Kang, and our Bend, Redmond, Prineville, La Pine or Sisters OR orthodontic staff make a great team. Take advantage of our advice and tips for the best tools and techniques to make sure your smile is both perfectly aligned and perfectly healthy once those braces come off!

You’ve worked hard for your attractive, healthy smile, and now you’re making sure it stays attractive and healthy by wearing your retainer. Since wearing a retainer is usually a matter of years, not months, it’s natural to wonder just how long you can count on that retainer to help you maintain your smile.

That answer depends on the type of retainer you get at our Bend, Redmond, Prineville, La Pine or Sisters OR office. A Hawley retainer, a clear retainer, and a fixed wire retainer have different lifespans. Because they each have their own advantages, Dr. Quas, Dr. Wiater and Dr. Kang will recommend the retainer that’s right for protecting your individual smile.

So let’s look at the average lifespan for different retainers, and, equally important, some of the common mishaps that can shorten that working life.

The Hawley Retainer

This is the retainer most people picture when they think “retainer.” Made of wire securely attached to an acrylic base, the Hawley retainer keeps the teeth in place, and can even be adjusted, if needed, to improve alignment. They generally last anywhere from three to ten years.

How can you make sure your Hawley retainer keeps working for you as long as possible?

• Keep it in its case. While some damages to these retainers can be repaired, why take a chance? And it’s much harder to lose a retainer if it’s in its case as opposed to, say, a cafeteria napkin.
• Keep it away from your pet. Dogs, especially, are tempted by the taste and smell of saliva, but there are safer, less expensive chew toys out there.
• Keep wearing it. Without your retainer, your teeth can shift. Over time, not only will your retainer fail to fit anymore, but you might need to return for further orthodontic treatment. If you notice your retainer is starting to feel uncomfortable, give your orthodontist a call.

The Clear Retainer

Clear retainers look like clear aligners, and, like clear aligners, are almost invisible. Made of vacuum-formed plastic, they’re designed for a close, comfortable fit, often around the entire arch of your teeth. Also like clear aligners, these retainers aren’t made to last forever. If they become loose, warped, or cracked, they should be replaced. With care, they can last from six months to several years. How to protect them?

• Protect your retainer from damage. Keep it in its case when you’re not wearing it. You’ll avoid losing it, and you’ll avoid damaging it.
• Protect it from teeth. And we don’t just mean pets, although they find clear retainers yummy, too. If you grind your teeth, your retainer can suffer. Clear retainers are not the same thing as night guards, so talk to your orthodontist for recommendations.
• Protect it from heat. Hot surfaces like ovens or heaters, hot dashboards, washers and dryers, even very hot drinks can be a problem. (You should only be drinking water while you wear your clear retainer, so that particular issue shouldn’t arise!)

The Fixed Retainer

A fixed retainer is a small piece of wire that is custom-fit and bonded to the back of specific teeth to prevent any movement from occurring. Because it’s bonded to the inside of the teeth, a fixed retainer is completely invisible when you speak or smile. It can last five years, ten years, and in some cases, even longer. Even though you won’t be exposing this retainer to external dangers like hungry pups or the wash-and-rinse cycle, there are still some situations to watch for:

• Watch your diet. The same sticky, crunchy, or hard foods that can damage brackets and wires can also loosen a fixed retainer.
• Watch your dental hygiene. While cleaning around a bonded retainer can be a bit challenging, not cleaning around it can result in plaque and tartar buildup—and your retainer might have to be removed to clean your teeth.
• Watch for changes. If your teeth start to shift, it could mean your retainer has detached from one or more teeth. Ask your dentist to check the retainer’s bond whenever you have a checkup.

So, how long will that retainer last? Depending on the kind of retainer you have, if you don’t keep it in its case, or if you don’t watch your diet, or if you expose it to heat, the answer is—not nearly long enough. Dr. Quas, Dr. Wiater and Dr. Kang will give you the very best tips to keep your retainer clean, safe, and working for as long as possible. Now, it’s up to you!

It’s a new year, and it couldn’t come fast enough for many of us! Let’s do our part to make this a better year in every way—and you can start by making this the year you quit smoking once and for all.

You know that smoking is very damaging to your body. Smokers are more likely to suffer from lung disease, heart attacks, and strokes. You’re at greater risk for cancer, high blood pressure, blood clots, and blood vessel disorders. With far-reaching consequences like this, it’s no surprise that your oral health suffers when you smoke as well.

How does smoking affect your teeth and mouth?

• Appearance

While this is possibly the least harmful side effect of smoking, it’s a very visible one. Tar and nicotine start staining teeth right away. After months and years of smoking, your teeth can take on an unappealing dark yellow, orange, or brown color. Tobacco staining might require professional whitening treatments because it penetrates the enamel over time.

• Plaque and Tartar

Bacterial plaque and tartar cause cavities and gum disease, and smokers suffer from plaque and tartar buildup more than non-smokers. Tartar, hardened plaque which can only be removed by a dental professional, is especially hard on delicate gum tissue.

• Bad Breath

The chemicals in cigarettes linger on the surfaces of your mouth causing an unpleasant odor, but that’s not the only source of smoker’s breath. Smoking also dries out the mouth, and, without the normal flow of saliva to wash away food particles and bacteria, bad breath results. Another common cause of bad breath? Gum disease—which is also found more frequently among smokers.

• Gum Disease

Smoking has been linked to greater numbers of harmful oral bacteria in the mouth and a greater risk of gingivitis (early gum disease). Periodontitis, or severe gum disease, is much more common among smokers, and can lead to bone and tooth loss. Unsurprisingly, tooth loss is also more common among smokers.  

• Implant Failure

Tooth implants look and function like our original teeth, and are one of the best solutions for tooth loss. While implant failure isn’t common, it does occur significantly more often among smokers. Studies suggest that there are multiple factors at work, which may include a smoker’s bone quality and density, gum tissue affected by constricted blood vessels, and compromised healing.

• Healing Ability

Smoking has been linked to weakened immune systems, so it’s harder to fight off an infection and to heal after injury. Because smoking affects the immune system’s response to inflammation and infection, smokers suffering from gum disease don’t respond as well to treatment. Smokers experience a higher rate of root infections, and smoking also slows the healing process after oral surgeries or trauma.

• Dry Socket

Smoking following a tooth extraction can cause a painful condition called “dry socket.” After extraction, a clot forms to protect the tooth socket. Just as this clot can be dislodged by sucking through a straw or spitting, it can also be dislodged by the force of inhaling and exhaling while smoking.

• Oral Cancer

Research has shown again and again that smoking is the single most serious risk factor for oral cancer. Studies have also shown that you reduce your risk of oral cancer significantly when you quit smoking.

• Consequences for Orthodontic Treatment

Finally, if this is the year that you’re investing the time and effort needed to create an attractive, healthy smile with orthodontic treatment, don’t sabotage yourself by smoking!

Cosmetically, smoking doesn’t just discolor your tooth enamel—tar and nicotine discolor your aligners and braces as well. If one of the reasons you chose clear aligners or ceramic brackets is for their invisible appearance, the last thing you want is yellow aligners and brackets.

More important, smoking, it’s been suggested, can interfere with your orthodontic progress. When blood vessels are constricted, your gums, periodontal ligaments, and bones can’t function at their healthy best, moving your teeth where they need to be steadily and efficiently. This means that your treatment could take longer. And if your smoking has caused gum disease, you might have to put any orthodontic treatment on hold completely until it’s under control.

Quitting smoking is a major accomplishment that will improve your life on every level. It’s always a good idea to talk to Dr. Quas, Dr. Wiater and Dr. Kang for strategies to help you achieve your wellness goals for the new year. Make this the year you stop smoking, and the year your health improves in countless ways because you did.

Maybe you’ve known people with braces and aligners—maybe you’ve worn them yourself!—so if braces or aligners are in your teen’s future, you have some idea what to expect and when to expect it.

But quite often, orthodontic issues require more treatment than braces alone can provide. When misalignment affects not only the teeth but the jaw as well, treatment can be more effective when it begins earlier and makes use of a different kind of appliance—the “functional appliance.”

During the years your child’s bones are still rapidly growing and forming, around the ages of eight to 14, functional appliances can help guide tooth movement and encourage jaw growth and development. One of the most widely used of these devices is the Herbst® appliance.

What does the Herbst appliance do?

There are several types of malocclusions, or “bad bites” treated by Dr. Quas, Dr. Wiater and Dr. Kang. A common condition called a Class II malocclusion occurs when the upper jaw and teeth project too far forward over the lower jaw and teeth. Signs of a Class II malocclusion might include an overjet (protruding upper teeth), and/or a small or recessive lower jaw.

While correcting this malocclusion often enhances facial symmetry, which can be very important for a child’s confidence, correcting a Class II malocclusion also promotes jaw and dental health. Misaligned teeth are more difficult to clean, which can lead to decay and gum disease. Bite problems can cause persistent jaw pain and damage to the teeth. And, with an overjet, a child’s upper teeth are more at risk for injury.

The Herbst appliance was developed to treat this kind of malocclusion. It moves the lower jaw and teeth forward to create a balanced, healthy smile.

How does the Herbst appliance work?

The Herbst appliance is fixed in place with stainless steel bands or crowns that are secured to four teeth in the rear of the mouth, often the first molars on each side of the upper and lower jaws. The band or crown on each lower tooth is equipped with a small bar that extends toward the front of the mouth.

An arm on each side links the bands or crowns on the upper teeth to the front of the bar assemblies on the lower teeth. Each arm consists of a rod that fits smoothly into a tube. The telescoping action of the rod and tube allows the mouth to open and close normally. When the mouth is closed, the arms on both sides telescope shut, forming compact cylinders that hold the jaw forward.

While a child’s bones are still growing, the lower jaw’s new forward position can stimulate further bone growth and remodeling to maintain the jaw in that forward position. The Herbst appliance also has a restraining effect on the forward movement of the upper jaw. The result is a steady, noticeable improvement in the relationship between the upper teeth and jaw and the lower teeth and jaw.

Is the Herbst appliance hard to take care of?

The Herbst appliance is fairly low maintenance, but, like any orthodontic gear, it should be treated with care.

• It’s important to watch your child’s diet, because sticky, crunchy, and chewy foods can damage the appliance. Save the caramels for a post-treatment celebration!
• Carefully cleaning around the appliance is necessary, because a buildup of bacteria and plaque leads to consequences like bad breath, gum disease, and tooth decay. A water flosser can make reaching and cleaning tight spots easier if a brush alone isn’t effective.
• If the Herbst appliance is damaged, some minor fixes might be doable at home with instructions from your treatment team. But if a band or crown comes loose, or if there’s a problem you’re unfamiliar with, call our Bend, Redmond, Prineville, La Pine or Sisters OR office right away.
• To help avoid the need for minor (or major) fixes, playing with the appliance with fingers or tongue, nibbling on pens and pencils, chewing on ice, or any other risky habits should be strictly off limits.

When it comes to your child’s health, you always have high expectations. Dr. Quas, Dr. Wiater and Dr. Kang and our team have all the answers you’ll need about what to expect from this phase of your child’s orthodontic treatment, and just why the Herbst appliance is the very best option to create a future of attractive, healthy smiles.