What is Decalcification?

Decalcification

The white marks sometimes found on teeth after orthodontics treatment

            There are two types of white discolorations that are found on teeth.  In one case there is a defect in the enamel formation when the tooth is being formed under the gums, causing internal white marks that can be found at any position on the tooth, even up around the biting edges.  Teeth just erupt this way and it is not a sign of decay, but they may not look very aesthetic.  Most of the time we do not know why this occurs although infections during early childhood may be a cause.

In the other case, the white marks are caused by acids that have begun to eat away the enamel of the tooth (decalcification).  This is the first stage of tooth decay.  As the enamel starts to dissolve it begins to appear white and chalky.  Eventually the enamel starts to turn brown or black and disintegrates.  At this time it is considered a “cavity”.

Typically these white marks are around the gum line where the patient has not done a good job of brushing and flossing.  As food particles collect in this area they are colonized by bacteria forming plaque.  The bacteria then eats the sugar and excrete acids which then eat away the enamel.  Any additional acids added to the mouth like citrus fruits, soft drinks, sports drinks, sour candy, etc. just make the situation even worse.  Of course sugary things just give the bacteria more to eat, so sugary acidic foods are doubly bad.  Some of the worst things are sports drinks and soft drinks.

          In the “old days” before orthodontist learned to “glue” the brackets directly to the tooth they used metal bands that were cemented around the tooth to which the brackets were welded.  Sometimes the cement would wash out from under a band, even though the band would stay around the tooth.  In those cases plaque would cause decalcification under the band that would not be discovered until the bands were removed and a white “belt” was seen across the middle of the tooth where the band was positioned.  Those were unfortunate discoveries that we just don’t see anymore.

So how do you prevent decalcification in patients with braces?

·       Brush or at lease rinse out your mouth after every meal or soft drink.

·       Make sure you do one GREAT brushing every day to remove all the plaque (it takes days for plaque to form to the point where it produces acid)

·       Avoid stick, sugary, acidic foods as much as possible.

·       Use the fluoride rinse we prescribe to lessen the risk of decay.

What Can I Eat with Braces?

Now that you have braces, what can you eat?

The first days in braces are more difficult to eat than normal.  We tell our patients that soft foods are easier to eat and chew than foods that are tough.  There will be a slight discomfort when you first get your braces on, so the action of chewing just makes it more painful.  Here are some GREAT IDEAS for the first three days in braces:
Breakfast foods

Scrambled Eggs

• Scrambled eggs                    
• Pancakes
• Oatmeal
• Cream of wheat
• Bananas
• Toast

Banana Recipe 

Lunch Foods

• Pudding
• Jello
• Spaghetti O's
• Ravioli's
• Cheese
• Grapes
• Brownies
• Hummus and Pita Bread
• Bananas, Sliced Apples, Raisins
• Breads 
• Soups

Dinner Foods

Veggie Soup

• Breakfast for Dinner
• Pastas
• Rice
• Hamburger Helper
• Soups
• Grilled Cheese
• Hamburgers & Fries
• Chili
• Cooked Veggies
• Softer Meats

Desserts & Snacks

• Pudding
• Jello
• Smoothies
• Milk Shakes 
• Ice Cream
• Brownies
• M&M's (Non-Frozen)
• Chocolate
• Popsicle
• Cinnamon rolls

The first days in braces are always the hardest.  At first some patients have a hard time eating their favorite foods.  We ask patients to chew softly and to remember that they have braces on before they aimlessly bite into anything.  To help keep the brackets on patients need to cut foods into smaller pieces about 1 inch squares.  This helps allow you to get the food to the back teeth so the patient is less likely to break brackets.  After the about 2-3 weeks patients find it easier and easier to eat more foods that they like.
We tell our patients that they can have anything that they want as long as it is not Sticky, Chewy, or Hard!  This means that there are quite a few foods our patients won't be allowed to eat while they are having fixed orthodontic care.

Are you on Pinterest? Here is a link to our Braces friendly foods board on Pinterest.

Things to AVOID:
          Sticky:

• Jolly Ranchers
• Taffys
• Caramel
• Bubble Gum

        Chewy:

• Airheads
• Now & Laters
• Skittles
• Starburst

        Hard:

• Uncut Apples and Fruit with hard centers
• Chicken Wings, Ribs and Meat with Bones  
• All of the above items need to be cut into pieces
• Pens, Pencils and fingernails should be kept out of your mouth and away from brackets
• Nuts, Hard Pretzels, Some Chips & other Crunchy foods
• Frozen candies in Ice Cream

Things that you didn't thing you could eat but CAN:

• You MAY chew SUGAR-FREE gum (We actually encourage it!)
• Popcorn (Try to limit popcorn to special occations due to the extra Oral Hygiene needed to remove from braces, teeth and gums)
• Chips ( You have to break them into smaller pieces)
• Soda (We ask that you limit soda to mealtimes and always rinse with water after consumption)

Here are just a few ideas to help get you started on the first few days in fixed orthodontic treatment.

How Much Do I Wear My Invisalign

How much do I wear my Invisalign aligners?

           Patients that are moving teeth and are wearing Invisalign appliances should wear their aligners anywhere from 23-22 hours everyday to get the best optimal wear. 

           This amounts to taking them out only to eat or to brush.  One nice thing about Invisalign though is if you have a special occasion or a meeting or even photo shoot you can take them out and just make up the time you lost at the end of your two week process.  

           Certain days you may not want to risk losing them so you can just keep them in a safe place and just add a day at the end.  The one thing that you must always do is wear them for the full two weeks.  Each aligner is only designed to do 100% of its job it can not do anymore than that so if you aren't wearing your aligners enough you will build an in correction into your future aligners.  

How do I know if I have a type of gum disease?

Gum Disease-

You may not have pain or any “problems,” but there are a few ways to tell if you need to go see your dental professional.  

            Some ways to know are your gums bleed when you are brushing or flossing, your gums are red and swollen, and/ or  you have mouth sores or bumps that will not go away.  
         
         When you are at the dental professional’s office, it is important that you ask what steps to take to improve your oral hygiene.  Even though you maybe brushing you may be doing it incorrectly or not brushing or flossing long enough.

Clean teeth & Gums, What's the point?

Keeping your mouth healthy and clean is an important part of your overall health. When teeth are not being taken care of, they tend to build up plaque and tartar. This build up creates bacteria that causes irritation to the gums causing bleeding and a low grade infection. This infection is called gingivitis. People who have gingivitis are more likely to have heart problems, suffer a stroke, or heart attack. You are also more likely to have a hard time controlling blood sugar and blood pressure problems.

How long do I need to wear my retainers?

How long do I need to wear my retainers?

This is a question that is asked almost everyday in our office. The answer is an easy one, you need to wear them as long as you would like to keep your teeth straight. If you would like your teeth to be straight until you are 90 then wear your retainers until you are 90. We can only ensure that your teeth stay straight as long as you wear your retainers and they fit properly. Dr. Waxler always says "Our bodies are ever changing no matter how long you've held your teeth straight they can still move as you get older. Even people who had "perfect" teeth when they were young, often find their teeth moving slightly as they age."

So what good were braces?

The secret of a good orthodontic result is to put the teeth in the most stable position that is possible considering the person's facial structure and dental problems. After a few years in retainers, the tooth arrangement should be reasonably stable; although corrected dental and skeletal problems all have varying tendencies to "rebound". This is like people who always have to be on a diet or wear glasses to correct a problem, some teeth need to be retained forever.

If I decide not to wear my retainer...., should I still see my Orthodontist?

After approximately two years of retainer wear we enter into a post-retention period. We require appointments on a "as needed" basis. Unless you are told that your problem is particularly unstable, you may only need to wear your retainer 2-4 nights a week. If you lose, break or your retainer no longer fits please call our office to make an appointment so we can advise you on what options will fit your situation best. If you have graduated from our office there may be an office visit charge or a replacement fee.

What about my bonded (or glued in) retainer?

You may come back to see us anytime to have our office check your bonded retainer, but your regular dentist can evaluate this retainer for you at your dental check ups. If anything appears to be wrong please call us immediately to have it checked. If we need to remove this retainer we suggest getting a removable retainer to ensure that your teeth will stay straight. You may have this retainer removed at anytime and take an impression for a removable retainer to be made (at the current fee). This removable retainer will be asked to wear at night time for as long as you would like to hold those teeth straight.