Invisible braces - Only your dentist knows for sure

Posted by Dr. Edward Magida | Filed under , ,

The Invisalign system is a series of totally clear, very thin mouthguard-like devices that are custom made for every patient. They fit over your teeth. "Does she or doesn't she... only your hairdresser knows for sure." That was a line in a popular commercial for hair coloring.

Now, it could be a line a dentist uses to promote a new system of invisible braces. That's because nobody can tell you are wearing them.

The Invisalign system is a series of totally clear, very thin mouthguard-like devices that are custom made for every patient. They fit over your teeth.

Used instead of metal braces, they are an alternate way to straighten teeth. To be considered for this type of treatment, you must have only mild to moderate crowding or overlapping.

Since the mouthguards are so clear, you can go through the day and no one will know you are straightening your teeth

Oral hygiene is much improved over conventional braces, which trap food, because you take the appliances out whenever you eat. You also take them out to brush and floss. Another plus is that you do not have to alter your diet the way you have to with metal braces.

One drawback is the cost.

Invisalign costs about 30 to 40 percent more than metal braces, and if you forget to wear the appliances, your results will get delayed.

To get started, you must schedule a consultation with a dentist who does this procedure. If you are a good candidate, impressions are taken and a very sophisticated lad uses a special computer program to fabricate your appliances, which are called "aligners."

Each appliance is worn for two weeks. During that time, the teeth out of alignment are moved ever so slightly. Depending upon the situation, upwards of 40 or more appliances are made for each patient. A new one is used every two weeks to continue the gradual process of moving the teeth into their proper spaces. Occasionally, the dentist might need to slightly recontour some of the teeth to keep the alignment process going smoothly.

In this day and age, with people getting all kinds of cosmetic procedures done so they will look and feel better about themselves, add this to the list of possibilities. If you do decide to have this done, don't worry, I'll never tell. Even if I did, no one would believe me.

Geriatric Dental Patients

Posted by Dr. Edward Magida | Filed under , , , ,

Since 1988 I have been the staff dentist at numerous nursing, convalescent and adult care facilities. While at times, most people would find it a difficult, if not eye opening experience, I personally find it very rewarding to be able to help these patients with their dental needs and help with their problems. While most patients do not pose too much of a problem, there are some, due to their mental and/or physical ailments, that can be a true challenge to treat.

Dentists, at least most of us, are perfectionists. While in my office I strive for this all the time, I have had to learn that for some elderly patients, due to the limitations they present to dental treatment, this is not always possible. Sometimes I can only offer the best I can do given the circumstances. I know that there is no one else many times who would even attempt to help so I feel that at least I am trying my best.

Nursing home patients' needs are somewhat different than the rest of us. Many of them wear full or partial dentures. These are many times in need of repair or replacement. Teeth that have been removed should be added to the person's dentures to maintain a full compliment of teeth. I can't tell you how many people are wearing partial dentures that were made for them years ago. In the interim, someone took out one or more teeth but never bothered to replace the now missing teeth on the person’s denture. I don’t know how some people eat. Not being able to eat properly and nourish yourself, is a major downfall of patients in these types of settings. You wouldn’t think of buying one set of tires for your car and expecting to have them last your lifetime. You shouldn’t expect Uncle Bob’s denture to be a perfect fit forever either. The denture teeth wear down over the years and this makes it hard to chew, as well as causing the person’s face to "sink in" so to speak. Properly sized teeth give a person a more youthful look as well as increased chewing ability.

Sometimes the denture is fine but the patient has lost a lot of weight so the denture now "kind of swims" in the person’s mouth. In this case a reline of the teeth will allow it to fit properly to the shrunken gums. The biggest complaint I come across is the pain related to sore spots caused by pressure of the dentures on the gums. Sometimes all that is needed is some minor adjustment to the denture to make it a winner. Sometimes the reline procedure is needed to make a more intimate fit with the gums.

The biggest problem I see is the lack of basic oral hygiene. Either the person does not brush their teeth, or has it done for them on a daily basis, or it is done but is not very effective. This can easily lead to major cavity formation as well as periodontal disease. Both of these will ultimately lead to tooth loss. Many medications the elderly take will tend to adversely affect the teeth and gums. Many meds will dry out the person’s mouth which makes it easy for cavities to form. Someone with a dry mouth needs to pay extra attention to their oral hygiene.

If you know of someone in a nursing or convalescent type facility, please insist that the staff pay good attention to the oral hygiene of the person. This advice even goes to someone homebound or bedridden at home. I have on many occasions attended to people in these situations. The relative or personal aid must make sure the patient keeps his or her teeth as clean as possible. I know it sounds like common sense, but many times it just doesn't happen.

Getting back to why I do this. It is a great thrill to have the ability to help someone in need, and to help them in a way that no one else can or will. Just seeing a person’s new smile when all is said and done, goes a long way.

Consider Changing Your Toothbrush

Posted by Dr. Edward Magida | Filed under , , , ,

Does your toothbrush look like you’ve been cleaning all the statues in New York City?

Do the bristles go in every direction, like a cartoon depicting someone’s hair while they get shocked by electricity?

Does the receipt for your toothbrush show it actually was purchased many years ago at a 5 and 10 cent store for only a dime?

Maybe it’s time to consider starting fresh and tossing your old friend and replacing it with a new toothbrush.  Studies have shown that the germs in your mouth easily contaminate the bristles, and get spread around as you brush your teeth.

It is wise to rinse the brush after using, and allow the brush to dry out first before using it again, since this will help control the spread of these germs. The use of two brushes, alternating between them, will help this process.  In a healthy person, you should replace the brush every three-four months.

Patients who have colds (or flu virus) should replace the toothbrush when the cold is over.  People with chronic conditions as well as those with oral inflammatory conditions, i.e. gum disease, should replace their toothbrushes more frequently as well as immersing their brushes into an antimicrobial mouthwash for 15-20 seconds when done using them.

Toothpastes containing triclosan appear to significantly reduce the microbial contamination on the brush.  Do not store toothbrushes in a room that has a toilet as it has been shown that flushing sends up a large amount of tiny droplets, which could contaminate the brush.

Electric toothbrush heads should be changed just as often.  If the person has braces on, then change the head every two-three months.

Toothbrushes are a vital element in maintaining good oral hygiene but they do need to be cleaned and replaced on a timely basis to be as effective as possible.