It’s something you think about often—especially when you look in a mirror or at a photo of yourself. You wish something could have been done about it a long time ago. But now you think you’re too old to correct your misaligned teeth—your “crooked” smile.

Actually, you can transform your smile through orthodontics, whatever your age. Millions of your peers have done just that—currently, an estimated one in five orthodontic patients is an adult.

If orthodontics isn’t right for you it won’t be because of age, but most likely the condition of your gums and underlying bone or your overall health. That first factor is extremely important: if you’ve lost a significant amount of bone due to periodontal (gum) disease, there may not be enough to support the force of moving the teeth during orthodontics.

Health conditions like severe heart-valve disease, uncontrolled diabetes or drugs to treat arthritis or osteoporosis can also make tooth movement difficult. And, if you have restricted saliva flow (dry mouth), wearing orthodontic devices could be uncomfortable and increase your risk of tooth decay.

If, however, your mouth and body are reasonably healthy (and you don’t have a difficult bite problem to correct), there’s no reason why you can’t undergo orthodontic treatment. The only other thing that might hold you back is concern over your appearance during treatment. Many adults balk at the possible embarrassment of wearing metal braces “at their age.”

If this is a concern, you may have an alternative: clear aligners. These are a series of computer-generated clear plastic trays that conform to the individual contours of your teeth. Each tray is slightly different—you wear one for a short period of time (usually two weeks) before moving on to the next tray to successively and gradually move your teeth. They’re nearly invisible to others and, unlike fixed metal braces, you can take them out for a rare special occasion.

The only way you’ll know whether correcting your misaligned teeth is a viable option is to undergo a full orthodontic evaluation. From there we can help you decide if and how you want to gain a straighter, more attractive smile.

If you would like more information on adult orthodontics, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Orthodontics for the Older Adult.”

The human body’s immune system has amazing defensive capabilities. Without it a common cold or small wound could turn deadly.

One of the more important processes of the immune system is inflammation, the body’s ability to isolate diseased or injured tissue from unaffected tissue. Ironically, though, this vital component of the healing process could actually cause harm if it becomes chronic.

This often happens with periodontal (gum) disease, an infection of the gums caused by bacterial plaque built up on teeth due to inadequate hygiene, which in turn triggers inflammation. The infection is often fueled by plaque, however, and can become difficult for the body to overcome on its own. A kind of trench warfare sets in between the body and the infection, resulting in continuing inflammation that can damage gum tissues. Untreated, the damage may eventually lead to tooth and bone loss.

In treating gum disease, our main goal is to stop the infection (and hence the inflammation) by aggressively removing plaque and calculus (tartar). Without plaque the infection diminishes, the inflammation subsides and the gums can begin to heal. This reduces the danger to teeth and bone and hopefully averts their loss.

But there’s another benefit of this treatment that could impact other inflammatory conditions in the body. Because all the body’s organic systems are interrelated, what occurs in one part affects another especially if it involves inflammation.

It’s now theorized that reducing gum inflammation could lessen inflammation in other parts of the body. Likewise, treating other conditions like high blood pressure and other risk factors for inflammatory diseases could lower your risk of gum disease and boost the effectiveness of treatment.

The real key is to improve and maintain your overall health, including your teeth and gums. Practice daily brushing and flossing to remove plaque, and visit your dentist regularly for more thorough cleanings. And see your dentist at the first sign of possible gum problems like bleeding, redness or swelling. You’ll not only be helping your mouth you could also be helping the rest of your body enjoy better health.

If you would like more information on the relationship between gum disease and other systemic conditions, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “The Link between Heart & Gum Diseases.”

What do a teenager with a poor bite, a senior citizen with multiple missing teeth or a middle-aged person with a teeth grinding habit all have in common? They may all depend on a dental appliance for better function or appearance.

There’s a wide variety of removable dental appliances like clear aligners or retainers for orthodontic treatment, dentures for tooth loss or night guards to minimize teeth grinding, just to name a few. But while different, they all share a common need: regular cleaning and maintenance to prevent them from triggering dental disease and to keep them functioning properly.

The first thing to remember about appliance cleaning is that it’s not the same as regular oral hygiene, especially if you have dentures. While they look like real teeth, they’re not. Toothpaste is a no-no because the abrasives in toothpaste designed for tooth enamel can scratch appliance surfaces. These microscopic scratches can develop havens for disease-causing bacteria.

Instead, use liquid dish detergent, hand soap or a specific cleaner for your appliance with a different brush from your regular toothbrush or a specialized tool for your particular appliance. Use warm but not very hot or boiling water: while heat indeed kills bacteria, the hot temperatures can warp the plastic in the appliance and distort its fit. You should also avoid bleach—while also a bacteria killer, it can fade out the gum color of appliance bases.

Be sure you exercise caution while cleaning your appliance. For example, place a towel in the sink basin so if the appliance slips from your hands it’s less likely to break hitting the soft towel rather than the hard sink. And while out of your mouth, be sure you store your appliance out of reach of small children and pets to avoid the chance of damage.

Cleaning and caring for your appliance reduces the risk of disease that might affect your gums or other natural teeth. It will also help keep your appliance working as it was designed for some time to come.

If you would like more information on care and maintenance for oral appliances, please contact us or schedule an appointment for a consultation.

Those unattractive teeth you see in the mirror are what are standing between you and a truly beautiful smile. If only you could make them go away.

In a way, you can do just that—with dental veneers. For the past three decades dentists have been covering the imperfections of problem teeth with these thin layers of porcelain. What's more, they're usually less involved and expensive than other restorations.

Veneers work best on teeth with moderate flaws like chipping, heavy staining or wearing, or slight misalignments like crookedness or gaps. The dental porcelain used is a ceramic material that so closely mimics the color and translucence of natural teeth it often takes a trained eye to notice any difference.

The first step to getting veneers is to plan your new look with a full examination and a diagnostic mock-up, a temporary application of tooth-colored filling materials applied directly to the teeth. This gives you and your dentist a better visual idea of how veneers will look on your teeth, and to make any adjustments ahead of time. A dental lab will use these findings to create your custom veneers.

In the meantime we'll prepare your teeth to accommodate your veneers. Although they're usually only 0.3 to 0.7 millimeters thick, veneers can still appear bulky when placed straight on the teeth. To adjust for their width we usually must remove some of the teeth's surface enamel so the veneers look more natural. Because enamel can't be replaced, the removal permanently alters the teeth and will require some form of restoration from then on.

When the veneers are ready we'll attach them with special cement so they'll form an almost seamless bond with the teeth. You'll then be able to use them just as before—but with a little caution. Although quite durable, veneers can break under too much force, so avoid biting on hard objects like ice, hard candy or nuts. And be sure you practice good dental care on your veneered teeth with daily brushing and regular dental cleanings and checkups.

The end result, though, is well worth the upkeep. Porcelain veneers can rejuvenate your smile and provide you a new level of confidence for years to come.

If you would like more information on porcelain veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Porcelain Veneers: Your Smile—Better than Ever.”

Porcelain veneers are a great way to enhance an unattractive smile. But are they appropriate for teenagers? The answer usually depends on a patient’s current development stage and the type of veneer used.

Veneers are thin layers of porcelain bonded to the front of teeth. But even though quite thin, they can appear bulky if we don’t first remove some of the tooth’s enamel surface. This is irreversible, so the tooth may require a restoration from then on.

This could be a major issue for teens whose permanent teeth are still developing. During this period the tooth’s central pulp is relatively large and the dentin layer not fully developed. As a result, the pulp’s nerves are often closer to the surface than in an adult tooth. This increases risk of nerve damage during veneer preparation; if nerve damage occurs, the tooth could ultimately require a root canal treatment to save it.

On the other hand, some types of veneers don’t require tooth alteration (or only very little) beforehand. These “no-prep” or “minimal prep” veneers are best for certain situations like abnormally small teeth, so we must first determine if using such a veneer would be appropriate for your teen.

In effect, we’ll need to weigh these and other factors before determining if veneers are a safe choice for your teen. That being the case, it may be more advisable to consider more conservative cosmetic techniques first. For example, if enamel staining is the main issue, you could consider teeth whitening. Although the often amazing results eventually fade, whitening could still buy some time until the teeth have matured to safely apply veneers.

Slight deformities like chipping can often be corrected by bonding tooth-colored composite material to the tooth. In artistic hands it’s even possible to create a full veneer effect with very little if any tooth preparation. How much we can apply, though, depends on tooth size, and it won’t be as durable as a porcelain veneer.

With that said, veneers could be the right solution to enhance your teen’s smile. But, we’ll need to carefully consider their dental situation to ensure their new smile remains a healthy one.

If you would like more information on cosmetic solutions for smile appearance problems, please contact us or schedule an appointment for a consultation.