Role of Speech Therapy in Your Orthodontic Treatment

Role of Speech Therapy in Orthodontic Treatment

patient before treatment

patient before treatment

After treatment

After treatment

As a practicing orthodontist, we treat all kinds of malocclusions in children and adults.  Most of our patients come to our office seeking treatment because their teeth looks crooked or, less commonly, because their teeth do not function properly.  Rarely do they come complaining of poor swallowing or tongue thrusting, or of a speech impediment. However, the root cause of some unsightly bites and speech impediments is the fact that they do not swallow properly.

Tongue-thrust diagrams

Tongue-thrust diagrams

 

Swallowing is a more complicated activity than most people realize.  It involves muscles and nerves of the tongue, cheeks and throat.  In some people, these muscles and nerves retain an “infantile” or protrusive position during swallowing.  Swallowing in babies with no teeth is programmed to provide suction to the breast, facilitate “suckling”, the act of stimulating lactation and provide ingestion of milk without breaking the seal to the breast.

 

Open bite example

Open bite example

The action of this “infantile” swallowing is very different from normal chewing and swallowing of an older person who is not breast feeding. The transition from infantile swallowing to normal swallowing occurs usually before the age of 6; thus before the development of adult dentition.  The swallow may also be modified later as the child grows, by thumb or finger sucking habits or other “mouth habits”.  Due to the close proximity of the teeth to the muscles affecting swallowing, normal growth and development of the dentition may be affected by abnormal swallowing pattern.

Example of tongue-thrust

Example of tongue-thrust

tonguethrustpatient

Tongue-thrust patient

Proper mature swallowing pattern places the tongue up against the roof of the mouth, or hard palate, with the tip of the tongue resting slightly behind the upper front teeth.  The shape of the hard palate is influenced by this muscular and “suctional” pressure. A person who swallows incorrectly, such as in the case of infantile swallow, will place the tongue against the teeth.  The pressure from the tongue, which can be a few ounces to several pounds with each swallow, will now displace and misalign teeth,.  This misplaced action is a significant force, since we swallow about 2000 times a day, even when we sleep. Depending on the pressures of the tongue, cheeks, lips, and throat, malocclusions created by abnormal swallowing pattern can be manifested in ways such as upper protruded teeth or “buck teeth”; anterior open bite,  posterior open bite, or constricted upper arch.

Such malocclusions or faulty bites are not only unsightly, but can also cause serious problems that may affect one’s dental health, nutritional balance, or speech problems. We help provide solutions for patients each and everyday at our Surrey and Vancouver Offices.

Getting Use To My Braces

I now have just the upper “lingual” braces on.  Because they are on the inside of my upper teeth, when I bite down, my lower front teeth  which are behind my upper front teeth, are now biting on these new braces.

Dr C Lun WangThis is very common for  lingual braces wearers.  This will occur with all patients unless their front teeth do not touch at all when they bite down.  In some ways, this contact of the lower front teeth with the upper front braces, prevent the patient from closing all the way down in the back, creating an open bite in the back.  When this happens, the back teeth will react  and come together slowly by “passive eruption”.  This side effect may be beneficial in cases where patient present with a deep bite; the contact of lower front teeth with the upper front braces actually will speed up the correction of the deepbite.

I will tell patients to be careful when they first get their Lingual Braces because they are not used to having the braces there when they bite down, and when eating, they may bite down too hard or too fast, and end up breaking the braces off.  This is exactly what I did during the first week I had the upper lingual braces on.  I constantly bit down too fast and hard, resulting in breaking 3 braces off in the first 3 days!  Something I am always on my patients about.  I found that I really had to slow down on my chewing, and be very careful and deliberate in my jaw movement as to not hit the braces too hard.

I did notice that there were changes to my teeth and my bite that were occurring quite rapidly.  My  back teeth were quite far apart when I first got my braces on, however, 2 weeks later the back teeth were already coming together by passive eruption.

I had 2 major hurdles that I had to get over in the first 2 weeks.  The first had to do with hygiene.  After each meal or snack, I had to really clean between my braces because of all the food that would get stuck in my braces.  Any sticky or fibrous food, they would wrap themselves around the brackets when I chewed.  Of course this is something I had expected, but I did not know how much it would bother me to have that food stuck to my braces.  I became obsessive in cleaning my braces, and started to carry around a special tooth pick that I can use to get between the wires and braces.

2099Composite-Progress 1

The second problem I was having was the irritation to my tongue by the constant rubbing of the sides of my tongue against the wire.  Because the first wire that was put in was a very thin and flexible wire, my tongue could not avoid it when I am eating, swallowing, or talking.  I found it most irritating when I talked.  The sides of my tongue rubbed against the back braces, and created cuts on my tongue.  As you know, the tongue is a very sensitive organ, and any cuts on the tongue is very painful.  The good thing is that any skin in your mouth heals very quickly, and any cuts on the lips or tongue will heal very fast, within a couple of days.  It still took over 2 weeks for my tongue to get use to rubbing against the braces.

The journey continues!

 

One In Five Orthodontic Patients is an Adult

dr.wangIt is never too late to have a healthy and beautiful smile!  On average, 20% of patients in an orthodontic practice are adults.  It’s not something that is just for kids and teenagers and here is why:

  • Desire to Look Good

Many adults have thought about getting braces themselves because they are self-conscious about their smile.  Orthodontic treatment can help correct crooked teeth or spaces that they have been uncomfortable with all their lives.  Straight teeth and a great smile can boost confidence and pride.

  • Maintaining Dental Health

Because misaligned teeth can make brushing and flossing more difficult, other dental problems, such as tooth decay and gum disease, may arise if oral hygiene is not satisfactory. Also, poor bite can lead to abnormal wearing of tooth surfaces and cause difficulty in chewing.  Orthodontic treatment can help maintaining good dental health easier so that teeth can last for a lifetime.

Many adults may have many concerns about getting braces at an older age.  Here are answers to some of the more commonly asked questions regarding adult orthodontic treatment:

  • Is orthodontic treatment effective for adults?

Win your smile for free!Orthodontic treatment is equally effective for adults as for kids and teenagers as long as teeth and gums are healthy.  Orthodontic forces move teeth the same way in patients of any age.

  • Are there any other options than metal braces?

Metal braces is just one of many options when it comes to orthodontics appliances.  Ceramic brackets, also known as “clear braces”, are a popular choice for most adults due to their high esthetic and comfort level.  For the patients who would rather get orthodontic treatment without being seen with braces, lingual braces is a good option because they are mounted behind your teeth.  Lastly, the ever-so-popular Invisalign is also a good option for patients who don’t want actual braces cemented on their teeth

  • Will orthodontic treatment fit my lifestyle?

invisalignYou can do almost anything during orthodontic treatment!  After the initial adjustment period, you will find braces become a natural part of life.  There have been great advances in orthodontic technology in the recent years so the brackets are now smaller and the wires are gentler on teeth but are even more effective than before.  Therefore, the initial adjustment period has been shortened to a couple of days to weeks.  However, the biggest challenge is to be able to maintain a high standard of home oral care so that your teeth and gum can remain healthy throughout treatment.  It is something that will become second nature once you get used to the routine.

  •  Can I get orthodontic treatment if I have some missing teeth?

Yes.  Usually, the teeth next to the spaces have drifted into the space, making any type of dental restorations difficult to be fabricated perfectly.  Orthodontic treatment can create or hold space, align teeth and correct the bite so that the restorative dentist can achieve the best result with your new restorations.

  • Can I get orthodontic treatment if I have been treated for gum disease?

As long as the gum disease is not active and is under control, orthodontic treatment can still be rendered.  Your orthodontist will consult with your dentist and/or periodontist about the health of your gums before treatment. If you are a candidate for orthodontic treatment, you will continue be under regular supervision by your dentist and periodontist while you have braces.

To find out whether braces are for you, contact our office to schedule your personal and complimentary consultation with Dr.Wang himself!

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What is better for me…. Crowns or braces?

pacific west dental smileHaving straight teeth and a beautiful smile is something that you want.  The question is “what is better for me…crowns or braces”?  To know which type of treatment is better for you, it is important to know what their advantages and disadvantages are before you decide.

Advantages of Dental Crowns or Veneers

  • Good esthetics – Dental crowns or veneers are made of porcelain, a material that can mimic the color and the appearance of a real tooth.   They are great and are needed in cases where teeth are discolored due to internal stains, are chipped or fractured, are badly broken down by cavity, have large fillings or are worn down.
  • Fast Results – They can mask some minor imperfections of your smile in a matter of a couple of appointments.  It can be a quick solution to your problems.

Disadvantages of Dental Crowns or Veneers

  • Removal of Tooth Structure – Each tooth that needs a crown or veneer has to be “prepared” or shaved down before they are cemented on your teeth. Because these teeth will never be the same as before, preparing healthy teeth that are in perfect condition purely for the purpose of esthetics may be too invasive.
  • High Maintenance – Maintenance of crowns and veneers is even more important because any gum disease or cavity can create a lot of problems and oftentimes they will need to be replaced when these problems occur.
  • Inability to correct bite problems - Crowns and veneers can only mask very minor problems.  Crowns and veneers will not be able to solve problems like overbite, deep bite, underbite, narrow arches and/or crossbite.
  • Cost – Depending on the area and the amount of insurance coverage, each dental crown or veneer can cost $1000 or more.
  • Longevity – Usually crowns or veneers last 10-15 years, even with great home care. They may need to be replaced from time to time. Improper bite or grinding/clenching habits may cause cracks or chipping of the porcelain.

first-visitAdvantages of Orthodontic Treatment

  • Comprehensive Care – Orthodontic treatment is a comprehensive treatment that addresses all the issues so that you will have straight and properly functioning teeth at the end of treatment.
  • Longevity – Braces are temporarily glued onto your teeth, leaving your teeth are just the way they were before orthodontic treatment at the end.  Your very own natural teeth can last forever if they are well taken care of.  No need to worry about replacement of restorations.
  • You have options! – There are many different types of braces that you can choose to cater your lifestyle.  There are traditional metal (with or without colors) and clear braces as well as clear aligner systems (such as Invisalign).  Also, lingual braces (braces that are mounted on the back of your teeth so they are truly invisible) are ideal for those adult patients who highly value esthetics.
  • Cost – Although the cost of orthodontic treatment can be high initially, it is usually a one-time cost.  When retainers are worn properly, patients who had braces before rarely need to have braces again.  Think of it as spreading the cost of braces treatment over a lifetime.  This cost is much less than crowns and veneers, which usually need replacements from time to time.

Disadvantages of Orthodontic Treatment

  • No Instant Gratification – Depending on the severity of the problem, orthodontic treatment usually takes approximately 18-24 months, on average.
  • Multiple Visits – Each patient needs to have their routine orthodontic adjustments every 4-8 weeks.
  • Temporary Discomfort - Every orthodontic patient will experience an adjustment period when braces are first put on.  Discomfort of teeth and the change of eating and speaking habits are the common complaints but these problems usually go away in 1-2 weeks after initial placement of braces.

When considering what approach is the best for you, it is important to know the advantages and disadvantages of the options that you have.  It is also important to have the long term health and stability of your teeth in mind.  Dental crowns and veneers are a good option for those that have very minor problems or have problems that cannot be resolved with orthodontic treatment, such as chipped or discolored teeth. However, when the problems are more than just mild rotations or spaces, comprehensive orthodontic treatment is the more appropriate option.  Empower yourself with a complete understanding of all the possibilities-contact our office and schedule your complimentary consultation today at our Surrey or Vancouver location.

A Healthy, Beautiful Smile At Any Age

slider-smilesIt’s Never too late to be your best. You’re never too old to benefit from orthodontic treatment.  Today, adults make up about one in every five orthodontic patients.

Here’s why:

Looking  Good.

Orthodontic treatment can help correct crooked teeth or spaces that you’ve been self-conscious about for years.  It can give you the confidence and pride that come with straight teeth and a great smile.

Maintaining Dental Health.

Leaving misaligned teeth untreated may lead to other dental problems such as tooth decay and gum disease, as well as abnormal wearing of tooth surfaces and difficulty in chewing.  Orthodontic treatment can help you keep good dental health.  Advances in orthodontics have made treatment more comfortable and more successful than ever for people of all pages.  Orthodontists work with other dental practitioners- general dentist, periodontists, prosthodontist , oral surgeons- to provide a comprehensive approach to your dental health.

Can Braces Work for Adults?

People of all ages can benefit from orthodontic treatment.  The physical process for moving teeth is the same, young or old, which means it’s never too late to address issues such as an overbite or underbite, crooked or crowded teeth, or jaw disorders.

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How Do I Get Started?

If you’re considering orthodontic treatment, we can set up a consultation appointment for you.  During this meeting we will perform a general assessment of your oral health, discuss options for treatment and answer any questions you may have.  We will also discuss matters of cost and insurance.  The next step is an orthodontic records appointment in which we take x rays, photos, and an impression or a scan of your teeth.  This information drives your unique treatment plan.

 

dr.w1[1]Who is an Orthodontist?

To be recognized as a certified orthodontists in British Columbia, as well as in Canada, a dentist needs to obtain an additional 2-3 years of advanced training in the specialized field of orthodontics after dental school from an accredited university.  An orthodontist is trained specifically in the diagnosis, prevention, an treatment of crooked teeth and jaws as well as problems of the jaw joints.  Only dentist with such advanced specialty education can present themselves as orthodontists.

Getting my Lingual Braces

drwangchariThe day has come to put on my new lingual braces.

I received the large box containing my lingual braces set up, which took 8 weeks to be manufactured (see my previous blog regarding the virtual set up and manufacturing process), and then it took another 3 weeks to schedule an “appointment” for myself in my own clinic!  I guess my staff didn’t want to take me away from “real” patients, since if I was in the chair, then I couldn’t be working on all the paying patients.

The braces came in a tray that is custom fitted to my teeth, when I fit the tray to my teeth, the braces are held tight against my teeth, exactly where they should be positioned.  This way of placing braces on to the teeth is called “indirect bonding”, since the braces are placed onto the teeth with help of a transfer tray, indirectly. There are several advantages to using the “indirect bonding” technique, the main ones are that it should require less chair time for the doctor and the patient, and the positioning of the brackets should be more accurate, since they are initially set up in the lab, with better vision to its placement.

Once I have tried the tray in my mouth, to ensure that the fit is good, it is only a matter of cleaning my teeth,  putting some special glue on the back of the braces, and then insert it back onto my teeth.  The glue sets in about two and half minutes, at which time, the tray can be removed, and the braces are now glued to my teeth.  I can’t say that the whole process went according to plan, because some of the braces came off when we removed the tray.  We had to clean up the teeth again, and try to re-glue the braces again.  We have been using this technique for very successfully for all our lingual braces patients, so it was not something new.  The slight glitch of some of the bonding failure we had to chalk them up to working with a new system.  I will up date you on future bonding experiences when I get to work with this system a few more times.

Once the brackets are securely placed on my teeth, we just had to insert a wire into the braces to begin the process of moving my teeth.  The wires, as previously explained, are also very special.  They are robotically bent to fit exactly to the final position of where we want the teeth to move to.  Therefore, they are also custom made to work with me and my set of problems.

After about an hour of being in my own dental chair, now I am officially a braces wearing, metal mouth!  However, because the braces are placed on the back of my teeth, they are completely invisible.  Invisible does not mean, trouble or pain free, I will update you on my struggles with this new experience in my next blog.

My before picture

My before picture

My lingual "tongue side" braces

My lingual “tongue side” braces

The time has come to have my braces bonded!

The time has come to have my braces bonded!

The Latest in Customized Invisible Braces

Dr. C Lun WangI have been working with lingual braces (lingual=tongue side) or “Invisible braces” for the past 20 years.

The main advantage of this system is that they are virtually invisible to people around you, and the main disadvantage is that they are much harder for the orthodontist to work with, and in some people, they can adversely affect their speech.

The one big technological advancement in the braces world which allowed for the experimentation of lingual braces is the development of a glue that is strong enough to hold the braces on to the surface of the teeth.

In the 1970′s, such a glue was developed, previous to that, braces were held on to teeth with bands that went around the teeth, and give the patients the classic “Rail road tracks” appearance when wearing braces.  It took another 20 years of technological and technique development for lingual braces reach reliability in treatment as traditional braces.

In the last 20 years, further improvement in technology has improved the ease of treatment, thus reducing the amount of time the patient is required to spend at the orthodontic office.  The second thing that is making rapid advancement is the use of computers in planning and making of braces treatment, improving the precision in which braces are used in individual patient.

The system I am working with is the Harmony Lingual System.  There are a few reasons that I believe make this the most ideal system at this time;.

1. Lingual (tongue side) System.   The HARMONY System attaches to the interior side of your teeth, so no one knows you are wearing braces but you.  Not everyone need to have “invisible braces”, some people need to have straighter teeth but cannot show their braces because of work, however, many people ask for an aesthetic alternative to the traditional braces for personal reasons.  Lingual braces offer the ultimate in aesthetics with all the treatment advantages of traditional braces and none of the compromises that removable aligner appliances experience.

A made-to-measure smile

2.  Computer aided treatment planning.  Your orthodontist is able to take advantage of the latest, state of the art technology in designing your smile. The process begins with a digital scan of your teeth, which is used by computer aided technology to ideally aligned your teeth on a virtual model, following your orthodontist’s treatment plan.

3.  A fully customized hardware solution.  The virtual treatment plan can then be translated into braces and wires that are robotically produced, customized for each patient and their unique situation.  This process is extremely technique and technology sensitive, and up until recently, extremely expensive to produce.

A faster treatment

Each HARMONY System is uniquely customized to achieve your perfect smile quickly and efficiently.

An improved comfort

4.  The ideal hardware design.  The HARMONY System is engineered to be small and smooth, which helps you adapt quickly and comfortably to your orthodontic treatment.  The self ligating technology that is built into the HARMONY System offers more control in the hands of your orthodontist to achieve precise tooth alignment. Self ligating technology does away with elastic O-rings, so friction in the system is reduced which leads to a more comfortable experience throughout treatment. This technology also improve clinical efficiency, reducing operator error and difficulties, thus reducing the amount of time you spend in the dentist office.

Presently, there are no other system that take advantage of all these innovations.  I therefore, have chosen to use this system for myself and my patients that require the most aesthetic, comprehensive orthodontic treatment.

Pacificwest team smiles

My Road to Straighter teeth

The day that I received my set of lingual (tongue side) braces, I was like a kid in the candy store.  I was really excited.  Not only will I begin on my own road of straightening my own teeth, but I will also be experiencing first hand the effects of using the latest technology in braces!

Dr C Lun WangEver since I began my career in orthodontics over 20 years ago, I embraced the idea that every person is unique, with a particular set of circumstance that required individualized, custom solution.  We received training in diagnosis and treatment planning that analyzed every aspect of the persons tooth size, shape, position, as well as their jaw position and facial appearance.  We looked at each persons anatomical needs as well as their practical, everyday habits and esthetic requirements.  I believed that my treatment planning included the desires of the patients.

Over the years, I honed my skills at coaxing the essence of the person’s functional and esthetic needs out of the patient’s x-rays, models, and clinical exam, and coming up with the best solution for that patient.  However, when it comes to executing those desires in their actual treatment, we are still using prefabricated set of braces on each person.  Mind you, braces have come a long way in the use of technology; new materials in the construction of braces and wires have made our jobs much accurate and with greater comfort and reduced treatment time.  However, the braces themselves are still not “customized” for each person.  To get the most out of braces we are using, we still had to make adjustments to the braces clinically to achieve desired movements that we wanted.

To reduce the uncertainty of individual variation, I believe that braces that we use should be customized for each person, ones that will fit each tooth exactly, and then be able to place them on those teeth exactly where they should be placed.  Before we place them in our patient, we should test it out on a computer simulation, to see how the teeth should be moved, and look at the final result, to see if the treatment is what we want to achieve.  After years of clinical trials, and the advancement in computer technology, we are finally at a point where all this may be possible!

braces banded all teeth6/29/00 Hand Out photo FEATURES

The traditional “rail-road” tracks of braces in the past

2003Upper Occlusal-Progress 1

Today, you can have braces from the inside of your teeth with your very own customized bracket!

Inspiring Confidence – One smile at a time

Pacificwest team smiles

PacificWest Dental Team

Knowing that you have a winning smile will give you the confidence to face challenging situations in life, and at PacificWest Dental Group we are here to Inspire Confidence through a beautiful smile.  Our team of specialists are expertly trained to give you that smile.

“My Passion for Orthodontic care comes from the privilege of being involved in a very significant, personally transformative process”,

Dr.  Lun Wang, a Certified Specialist in Orthodontics and 20 year practitioner and teacher of “invisible” braces.

Dr C Lun WangWith over 25 years of experience in the dental profession, and 17 years as an orthodontists in the Surrey, Langley, Delta and Vancouver areas. Dr. Wang, the humble and soft- spoken expert, has thousands of smiling patients who happily thank PacificWest Orthodontics for their great results.  Straightening teeth, correcting bite and jaw are expertise that Dr. Wang has learned and practiced in a wide range of institutions across Canada.

Dr. Wang attended the University of Toronto for his undergraduate studies, and in 1985 he started his training towards a dental degree at the University of Western Ontario.  He also took 3 extra years to earned his specialty degree in Orthodontics and Dentofacial Orthopedics, as well as a Masters of Science from the University of Manitoba.  In the time between earning his many degrees, Dr. Wang learned and contributed much during his appointment at the Hospital for Children Toronto, Ontario and on staff at the IWK Children’s hospital in Halifax, Nova Scotia.

At Dr. Wang’s two offices, he has personally selected and trained highly qualified teams that are able to provide all the latest orthodontic treatments available.  They can certainly answer any questions you may have regarding available treatments options, at the same time, ensuring each patient experience is enjoyable and top-rated.

Both Surrey and Vancouver locations are popular with people from all different backgrounds and languages.  The multi-lingual nature of our staff is coveted by our patients with different ethnicity;  we now offer services in English, Mandarin, Cantonese, Punjabi, Hindi,  Vietnamese and Chaozhou among others.

Your smile is one of the most important aspects of your appearance, no matter what age.  It’s the first thing people notice about you, and we want to help you get a smile you’ll be proud to show off!  At PacificWest Dental Group, we provide orthodontic care, including Invisalign and lingual braces, in a family- friendly, welcoming environment.

Good treatment begins with proper diagnosis; with extensive experience and a heart that cares, Dr. Wang will provide you with a complimentary consultation that is your best path to a beautiful smile.

 

 

New Year – new smile?

Welcome to our new website!

We’re constantly improving the way we communicate. Using Social Media, this new Blog and many other improvements within our offices.

It is our commitment to help you get the best smile possible to help inspire your confidence!

We’re starting 2013 with a brand new contest – win your smile for free!

contest-banner-2For all new visitors to our practice – all you need to do is come visit with Dr. Wang. He’ll assess your need for braces. If you’re eligible, we’ll write you up a full plan of what we can do to help you get the best smile possible. We’ll let you know how much it would cost and how you can pay for it – we have lots of options! And that’s it, your name will be entered into our latest draw, and on February 28th 2013 one of our new patients will win their entire braces treatment for free!!

Image having a wonderful smile for your Graduation! Or a winning smile to help you get that dream job. These are stories we help make happen everyday.

Call us today, don’t delay! It can take 24 months + to achieve that perfect smile.

604 501 0993 if you’re in the Surrey area, or 604 558 0993 for our Vancouver office.

We so look forward to meeting you soon!

Dr C. Lun Wang & all the team at PacificWest Dental Group