Vancouver is an increasingly multi-cultural place. As more people from other countries come to Vancouver and the demographics become more and more varied, you can be sure that the number of languages you hear spoken rises and our city will benefit from the variety of cultural traditions that are shared and in evidence. Why does it matter when it comes to visiting an orthodontist? If English isn’t your first language and you’re not sure about what your they are talking about, you aren’t getting the best care possible.
Dental Language is Also a Foreign Language
While individuals who have grown up going to English speaking dentists will understand the terminology, it’s not automatically easy to understand what dentists and orthodontists are talking about. And when you learn English as a foreign language, you don’t necessarily get a lesson in how to talk to the orthodontist. If you’re not sure what the orthodontist is talking about, you may not be able to best care for your oral health or get the right care.
In addition to language considerations, there are also cultural considerations to take into account. Not everyone wants to have their mouth examined and for some refugees or newly arrived immigrants, having a dentist poke around in their mouth can be embarrassing and confusing. Women may not want a male orthodontist to look in their mouths. There are things that not everyone will consider, unless they understand the cultural background of their patients.
If you’re new to Vancouver and looking for an orthodontist, it’s a great idea to find someone who can cater to your cultural needs and can even speak your language. That way you’ll know that you’re getting the right dental care and you’ll understand what’s going on at all times. At PacificWest Dental Group we are pleased to offer that kind of personalized and insightful care for our patients.
Good Oral Hygiene is the foundation to Straightening your teeth
I have been treating myself with both lingual(tongue side) and labial(lip side) braces for almost a year now. Initially, the biggest adjustment was to the braces poking or rubbing against my lips or my tongue. The constant irritation gave me raw spots on the mucosa of my mouth. This skin irritation was an annoyance that was minor and lasted only for the first month.
Further to that, I had to learn to eat with the braces, since if I chewed hard on foods, I would hit some of the braces too hard, and broke them off. It is amazing how your body adapts to these needs, since you cannot remove the braces, I was able to adjust the pressure to which I applied with each bite, so that I would not bite too hard to break my braces, but hard enough to chew my food. The proprioceptive(pressure sensing) receptors built into my teeth gave instant feedback to my bite pressure, and by training, my muscles developed the proper muscle memory so that during each subsequent bite, the pressure is just right.
The next adjustment I went through was the fact that I frequently bit on my lip when I chewed. This was a much more painful experience and one that took me longer to get over. During your chewing cycle, your lips, cheeks and tongue have been trained to move the bolus of food that is in your mouth around and on to the biting surface of your teeth. Your lips have to provide an additional function, that is they also have to keep your food, and especially the liquids in your mouth from being squeezed out of your mouth, on to your chin and your clothes. Your eating partners especially appreciate this function, since seeing your food coming out of your mouth is hardly neither appealing nor appetizing. My problem with my lips is that they frequently got caught on my lower braces during chewing and made cuts on my lips that are very painful. Luckily, wounds in your mouth heal much faster than on your skin, and after a few months, my lip muscles also adapted to their new functional parameters.
The last and most lasting difficulty is one that is probably most important and has long term ramifications; that is my ability to keep my teeth clean. With braces on, there are much more nooks and crannies for food to get stuck in. Normal cleaning regimen does not do a thorough job. Even with proper tools and good dexterity, the cleaning process is tedious and took a long time. That is why in our clinic, we stress good oral hygiene practice from day one of your orthodontic treatment. On the day of getting your braces, we spend time teaching you how to clean your teeth properly. We also provide tools that will help speed up the cleaning time. One of those tools is an electric tooth brush. I have always told my patients that if brushing is done properly, a manual tooth brush is as good as an electric tooth brush. However, it does take better coordination and more diligence to achieve a proper cleaning with manual tooth brush. So we provide an electric tooth brush with your orthodontic treatment help you with this important task. The following is a scientific study that demonstrates the advantage of using an electric tooth brush in most people.
Good oral hygiene is a challenge for orthodontic patients because food readily becomes trapped around the brackets and under the archwires, and appliances are an obstruction to mechanical brushing. The purpose of this study was to compare plaque removal efficacy of 3 toothbrush treatments in orthodontic subjects.
This was a replicate-use, single-brushing, 3-treatment, examiner-blind, randomized, 6-period crossover study with washout periods of approximately 24 hours between visits. Forty-six adolescent and young adult patients with fixed orthodontics from a university clinic in Germany were randomized, based on computer-generated randomization, to 1 of 3 treatments: (1) oscillating-rotating electric toothbrush with a specially designed orthodontic brush head (Oral-B Triumph, OD17; Procter & Gamble, Cincinnati, Ohio); (2) the same electric toothbrush handle with a regular brush head (EB25; Procter & Gamble); and (3) a regular manual toothbrush (American Dental Association, Chicago, Ill). The primary outcome was the plaque score change from baseline, which we determined using digital plaque image analysis.
Forty-five subjects completed the study. The differences in mean plaque removal (95% confidence interval) between the electric toothbrush with an orthodontic brush head (6% [4.4%-7.6%]) or a regular brush head (3.8% [2.2%-5.3%]) and the manual toothbrush were significant (P <0.001). Plaque removal with the electric toothbrush with the orthodontic brush head was superior (2.2%; P = 0.007) to the regular brush head. No adverse events were seen.
The electric toothbrush, with either brush head, demonstrated significantly greater plaque removal over the manual brush. The orthodontic brush head was superior to the regular head.
This study and other similar helpful articles can be found on the American Association of Orthodontists’ website. Proper care for you teeth will not only help you with good healthy teeth and gums during your orthodontic treatment, but will also promote good oral hygiene habits that will last a life time. After all, with your orthodontic treatment, you will be rewarded with straight teeth and a great smile, why not keep that picture perfect smile for a life time? Every time you visit your orthodontist, they will check your teeth for proper cleaning, but you will still need to visit your family dentist regularly for professional cleaning and check up to avoid unwanted decay or disease to your teeth and gums.
Because orthodontists can spot subtle problems with jaw growth or teeth while a child still has primary or “baby” teeth present, the American Association of Orthodontists (AAO) recommends all children get a check-up with an orthodontic specialist no later than age seven.
Some problems are not so subtle, and you may notice them early on. If you see any of the following signs in your child, please make an appointment immediately. (If your child is younger than seven, it is not necessary to wait till his or her seventh birthday to visit our office.) We want to identify any problems as early as possible so that we can implement the appropriate treatment at the appropriate time for your child’s individual needs.
- Early or late loss of baby teeth
- Difficulty in chewing or biting
- Mouth breathing
- Finger sucking or other oral habits
- Crowding, misplaced, or blocked-out teeth
- Speech difficulty
- Jaws that shift or make sounds
- Biting the cheek or biting into the roof of the mouth
- Teeth that stick out too far
- Teeth that meet in an abnormal way or don’t meet at all
- Upper and lower jaws that don’t line up
- Grinding or clenching of teeth
Your family dentist may already have found some of these problems and may be monitoring the changes. They may also refer you to an orthodontist to have these problems looked at. An orthodontist is trained specifically in the diagnosis, prevention, and treatment of crooked teeth and jaws, as well as problems of the jaw joints; they will definitely be able to tell you when is the best time to have any of these problems fixed. The key to successful treatment in young patients is delivering the right treatment at the right time.
Since the teeth and bite of children with baby teeth are dynamic and transitional, this means that there are changes going on all the time. The first baby teeth to exfoliate should be the lower central incisors, or the ones in the center teeth. They should become loose and fall out between the ages of 5 ½ and 6 ½. The last baby teeth to fall out should be the upper cuspids or “canine teeth”, at around age 11 to 13. Therefore, between the ages of 6 and 12, there will be a constant changing of baby teeth to permanent teeth. The goal of early orthodontic intervention is to eliminate any interference to the normal eruption of teeth and the development of the jaw and face.
Who is an Orthodontist?
All the orthodontists in British Columbia must first obtain a license to practice dentistry in Canada. They must then successfully complete at least two years of advanced training in the specialized field of orthodontics from an accredited university. Finally, they must pass all provincial dental licensing exams in the field of orthodontics. Only dentists with such advanced specialty education can present themselves as orthodontists. Dr. Wang is one of the most experienced orthodontists in the Province.
Esthetic Orthodontic Appliances
Orthodontic treatment is no longer viewed as a treatment for children and teenagers. On average, one in five patients is an adult in an orthodontic practice. Reasons for adults to seek for treatment are:
- Esthetics – they have never liked the way their teeth looked but never gotten the opportunity to have orthodontic treatment when they were young.
- Dental health – overlapped and crooked teeth have caused them much trouble to maintain good oral hygiene over the years. They notice that their dental health has deteriorated over the years due to difficulty in brushing and flossing.
- Bad bite – the way of eating and speaking are altered because the bite is not proper.
- Dentist’s recommendation – the dentist has recommended them to have a consultation with a certified orthodontist because dental restorations cannot be done properly due to misaligned teeth and/or poor bite. This is a common situation where bridges or implants cannot be made properly to replace missing teeth because neighboring teeth have shifted.
Although the idea of getting a beautiful smile with proper oral function is great, the thought of having metal braces on their teeth for an extended period of time is off-putting. Thanks to recent technological advances in orthodontics, metal braces is only one of the many options that the patients can have in terms of orthodontic appliances.
Ceramic bracket appliance, also known as “clear braces”, has become a very popular choice among adults and teenagers. Even though they are placed on the front surfaces of the teeth, the quality of the brackets is high so that they blend with many shades of teeth and they do not stain. The comfort level and the adjustment period are very close to metal brackets.
For those patients who do not want braces to be attached to their teeth, clear aligner appliances, such as Invisalign, can be an option. These aligners are clear and easy to use. They give the patients some flexibility in their daily lives since they are removable.
Lingual appliance is a truly invisible system because the brackets are mounted on the back of the teeth (lingual = tongue side). The teeth will move as they do with traditional labial braces (labial = lip side) but no one will see the braces. The adjustment period is longer because the brackets are closer to the tongue, which will affect speech and eating, but it is a great option for those individuals who would like highly esthetic orthodontic treatment.
Lastly, a combination of these appliances can be used to customize your needs. For more information or to see if you are a good candidate for treatment, please connect with us today.
Did you know that one in five orthodontic patients is an adult?
Dr. Wang with one of our new Adult patients
It is never too late to have a healthy and beautiful smile! On average, 20% of patients in our orthodontic practice are adults. It’s not something that is just for kids and teenagers and here is why – Many adults now realize the value of a great smile! It’s not vanity – it’s all tied in with self-esteem, first impressions and lasting impressions. Let alone the many health benefits of having a healthy and manageable smile.
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?
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 are 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?
You 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.
One of our former patients is local Realtor Robbie Johal – Robbie knows just how important it is to have a great smile!
Former patient and successful Realtor Robbie Johal
To find out whether braces are for you, contact us today for a free consultation with Dr. Wang
I got my upper lingual “invisible” braces on back in October last year. It took a while for me to get use to eating and cleaning them. In this blog I will describe what I experienced with eating with lingual braces, trying to keep them clean, as well as what I had to do when I encountered “emergencies” with my braces.
Like many active male adults, I love my food! All you can eat sushi buffets was welcomed on a weekly basis. I would tell anyone who is willing to listen that I was on a diet, a “seafood” diet I would say; which really meant that I would only eat food that I can “see”! After I got my braces on, three things kept me from my “seefood” diet;
1. My bite changes all the time, such that I did not have a comfortable place to chew, more importantly, I frequently bit my cheek if I tried to eat too fast. This really made me slow down my eating. I started to chew slower and much more deliberately, so that I did not end up chewing my cheeks and lips every time I ate. The solution is to use the wax that your orthodontic office provide for you, or if you run out, you can get some at the local drug store. You take a small piece of wax, kneed it in you fingers to soften it and form it into a ball, then you can press it to the bracket or wire that is irritating your lip or cheek. This will soften any sharp edges on the bracket or wire that is bothering you, until you skin forms a “callus” that can withstand the constant rubbing of the the new metal in your mouth. The irritation usually goes away in less than 2 weeks. If this does not work, you should return to your orthodontist to get it look at and taken care of.
2. Food tended to get stuck in my braces easily, especially sticky and fibrous foods. I tried to keep a balance diet, and since I do not have any food allergies, and I enjoyed food from many different nationalities, I ate a large variety of different foods. What I found was that vegetables with long strands of fiber was a particular challenge, the fibers tend to wrap themselves around the brackets. I find that I would have to really learn what foods I can eat, and how to clean my braces properly after each meal. Your orthodontic office will be able to provide you with some of the tools and techniques that will keep your teeth and braces clean. Of course, you will need to continue to visit your family dentist for regular check up and cleaning. Some patients find that due to the extra time it takes to chew their food, they have reduced their food intake, and thus have lost weight. This may be a benefit in some cases, however, you should really watch what you eat. Since many of the foods that are easier to eat are highly processed, and may contain high levels of sugar and fats, you will need to be careful not to take in too much of these foods that are not good for you.
3. Until you get used to having something glued onto your teeth, you may try to eat foods that are too hard for your brackets. In those cases, you may break your brackets off. When that happens, your brackets may become loose on the wire, or come completely off the teeth and wire and fall into your mouth while you are chewing. The brackets are there to move your teeth, so if it comes off your teeth, your teeth will not move as they should, and your treatment will be delayed. Also, with no bracket there to hold the wire in place, the wire may start to poke your cheek and gums. It those cases, you should keep the bracket if you can, and return to your orthodontist to get them fixed in a timely fashion.
In the beginning of my own treatment, I experienced all these inconveniences. I broke some brackets off eating thing that I used to eat, with excess vigor; I bit my cheek due to all the excess hardware, and I had trouble keeping them clean. However, after a month or so, I learned how to deal with most of these discomforts, and I believe all of you will too. It is still bothersome at times, however, I have noticed significant improvements to my teeth that are very encouraging. I look forward to further improvements and the day that my braces finally come of and I will be able to enjoy all the benefits of a healthy bite and great looking smile.