Post-Orthodontic Care

This section is dedicated to the latest information on oral health topics, culled from authoritative sources such as the American Dental Association.

Click here for the latest news from the American Dental Association.


Heart Disease

Poor dental hygiene can cause a host of problems outside your mouth-including your heart. Medical research has uncovered a definitive link between heart disease and certain kinds of oral infections such as periodontal disease. Some have even suggested that gum disease may be as dangerous as or more dangerous than other factors such as tobacco use. A condition called chronic periodontitis, or persistent gum disease, has been linked to cardiovascular problems by medical researchers.

In short, infections and harmful bacteria in your mouth can spread through the bloodstream to your liver, which produces harmful proteins that can lead to systemic cardiac problems. That's why it is critical to practice good oral hygiene to keep infections at bay-this includes a daily regimen of brushing, flossing and rinsing.


Antibiotic Prophylaxis

In some cases, patients with compromised immune systems or who fear an infection from a dental procedure may take antibiotics before visiting the dentist.

It is possible for bacteria from your mouth to enter your bloodstream during a dental procedure in which tissues are cut or bleeding occurs. A healthy immune system will normally fight such bacteria before they result in an infection. However, certain cardiovascular conditions in patients with weakened hearts could be at risk for an infection or heart muscle inflammation (bacterial endocarditis) resulting from a dental procedure.

Patients with heart conditions (including weakened heart valves) are strongly advised to inform our office before undergoing any dental procedure. The proper antibiotic will prevent any unnecessary complications.


Dentistry Health Care That Works: Tobacco

The American Dental Association has long been a leader in the battle against tobacco-related disease, working to educate the public about the dangers inherent in tobacco use and encouraging dentists to help their patients break the cycle of addiction. The Association has continually strengthened and updated its tobacco policies as new scientific information has become available.

Smoking and Implants

Recent studies have shown that there is a direct link between oral tissue and bones loss and smoking. Tooth loss and edentulism are more common in smokers than in non-smokers. In addition, people who smoke are more likely to develop severe periodontal disease.

The formation of deep mucosal pockets with inflammation of the peri-implant mucosa around dental implants is called peri-implantitis. Smokers treated with dental implants have a greater risk of developing peri-implantitis. This condition can lead to increased resorption of peri-implant bone. If left untreated, peri-implantitis can lead to implant failure. In a recent international study, smokers showed a higher score in bleeding index with greater peri-implant pocket depth and radiographically discernible bone resorption around the implant, particularly in the maxilla.

Many studies have shown that smoking can lead to higher rates of dental implant failure. In general, smoking cessation usually leads to improved periodontal health and a patient’s chance for successful implant acceptance.


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One day in the not-too-distant future, your braces will come off. In a few moments, you'll be free of bands and brackets, able to eat what you want and run your tongue over smooth, clean teeth. But, even on this happy occasion, please remember that you're not quite done with orthodontic treatment yet: The next phase, called retention, is just beginning.

Family.

Retention is a critical follow-through stage that typically involves wearing an orthodontic appliance called a retainer. Several different kinds of retainers are available, all of which are custom-made.

But if your teeth are straight now, why do you need a retainer at all? Simply put, it's because if you don't wear one, your teeth will start moving right back to where they were!

Teeth aren't set rigidly in the jawbone — instead, they're held in place by a network of fibers called the periodontal ligaments. After they have being moved, it takes several months for the periodontal ligament to adjust to the new position. So if you want to keep that new smile — and not waste all the time, effort, and money it took to get it — it's essential to wear your retainer as directed.

Being fitted for a retainer usually happens on the same day your braces are removed. After your teeth are thoroughly cleaned, another set of X-rays and/or bite impressions may be taken to check how well your braces worked and to see how much your wisdom teeth have developed. Then, a retainer will be prepared for you.

Three Types of Retainers

Types of orthodontic retainers.

There are three basic types of retainers available today; each works best in particular situations. The most common is the so-called “Hawley” retainer — a thin, tongue-shaped piece of acrylic molded to fit your mouth, with a wire that holds your teeth in position. The Hawley retainer is simple, durable and easily removed. It's even possible to personalize it by choosing different colors and designs for the plastic arch.

Another popular style of retainer is the clear aligner-type, which looks similar to the Invisalign® tray system. These retainers are custom-made of thin, transparent plastic designed to fit precisely over your teeth. Their main advantage is that they're invisible, with no wire to show. These retainers are also easy to remove, but they may be somewhat less durable than the Hawleys. They aren't recommended for patients with certain conditions, like teeth grinding.

Finally, fixed retainers may be an option for some people, especially on the lower front teeth. As their name implies, they aren't removable by the wearer — but they aren't visible either. Like lingual braces, this system uses a wire which is bonded to the tongue side of the teeth. It may remain in place for months, or longer. This type of retainer is sometimes recommended when there's a high risk that teeth could revert to their former position.

A Period of Adjustment

After a short time, most people adjust quite well to wearing a retainer. Some may find that they produce more saliva than usual for a day or so after first wearing any type of retainer — a normal reaction to a foreign object in the mouth. You may also find it a little harder to talk normally at first, but that problem will soon disappear. Of course, removable retainers should always be taken out when you eat or brush your teeth — a big change from braces!

At first, you will probably be told to wear your removable retainer all day, every day. This period of 24/7 retainer use generally lasts from several months to a year. Later, it may be OK to wear it only at night. Finally, you'll probably need to put it on just a few nights a week.

Maintaining — and Retaining — Your Retainer

How to Clean Removable Retainers

To stay fresh and germ-free, all retainers need proper cleaning. A Hawley-type retainer can be brushed gently with a regular toothbrush — but a brush may scratch the clear aligner types. Denture cleaners, in powder or tablet form, as well as special retainer cleaners, can be used to clean most removable retainers. Fixed retainers are cleaned by brushing and flossing; a floss threader or interproximal brush can also be a helpful cleaning tool when needed.

Finally, remember to always carry — and use — a retainer case. You'd be surprised how many retainers end up folded in a napkin and accidentally discarded! Also, don't expose your retainer to excess heat by washing it in very hot water or leaving it on a heater: That can cause the retainer to warp and make it unusable. With proper care and conscientious use, a retainer can help you transition from braces to a permanent, healthy smile.

Related Articles

Orthodontic Retainers - Dear Doctor Magazine

The Importance of Orthodontic Retainers Decades ago, orthodontists used to think that once teeth were moved into the “right” positions, they would stay there forever. Research over the past thirty years has shown that this is not true — there is no “right” position that can assure a permanent, unchanging result. The only way to be sure the alignment of your teeth and your bite remains stable after orthodontic treatment is to wear retainers as needed and as directed by your orthodontist or dentist... Read Article

Orthodontic Retainers - Dear Doctor Magazine

Why Orthodontic Retainers? It is common to wear retainers following orthodontic treatment or what people commonly refer to as braces, for good reason. Teeth must be “retained” or stabilized in their new position long enough for the gum tissue, bone and ligament to reform and mature around them, which can take several months. The teeth will tend to relapse into their old position quite rapidly if the retainers are not worn... Read Article