Posts for: October, 2017
Recently, two companies — SmileCareClub and Crystal Braces — launched as mail order orthodontics businesses. The companies sell Invisalign knockoffs. SmileCareClub creates a sequence of plastic aligners from impressions consumers can take at home. For an initial fee, the “patient” receives a kit with instructions on how to take her own dental impressions and upload photos of her teeth from a smartphone (Note: Selfies are for slumber parties not for straightening teeth.) Consumers also are asked to sign a pledge that they have seen a dentist and had X-rays taken. While neither of these companies asks to see the X-ray images, a dentist on staff determines if the case is suitable for treatment, with aligners at additional cost.
Can this kind of treatment work? In simple cases some patients will achieve benefits. Will this type of treatment address important issues regarding the bite relationship or the health of the jaw joints and gums as it relates to the orthodontic problem? No, it cannot. And, while no claims to the contrary are made, it behooves the patient to determine what is right for himself first by seeking a complete diagnosis from an orthodontic specialist. Bypassing the doctor results in the patient making decisions about his care based only on what he perceives as important — not what is medically appropriate. Only a trained and certified orthodontist has the knowledge to determine what is best for a patient.
While SmileCareClub and Crystal Braces do provide email and phone support, no one is there to personally monitor and carefully determine key factors in a patient’s case: how well the patient’s teeth are fitting together; if teeth are getting too loose or colliding traumatically with opposing teeth; or how to remedy any situation that would require more advanced care. The doctor-patient relationship that is so crucial to proper care has been reduced to remote viewing via smartphone.
Another company,promises to close spaces between your teeth with elastic rubber bands. They sell patients packages of elastic rubber bands that are meant to be slipped around and between front teeth which have spaces. Does it work? Yes. Will the teeth stay in place? Not likely. Teeth that are moved quickly need to be maintained for a period of time so that the result will be maintained. Furthermore, elastics tend to cause teeth to tip toward one another rather than moving in a more parallel fashion. This also is a cause of relapse.
The most concerning aspect of GapBands is the danger of losing an elastic under the gum line. If a patient slips an elastic between two teeth and forgets about the elastic, it could slide under the gum line and lead to loss of those teeth. Yes, a forgotten elastic could lead to the loss of healthy teeth. In fact, in dentistry’s earlier days, this was the chosen method for extraction of teeth from patients with bleeding disorders (hemophelia) who couldn’t tolerate tooth removal because of the deadly potential for bleeding.
Just because the consumer can straighten her own teeth doesn’t mean that she should. There is a legitimate reason that orthodontists acquire seven years of post-college education to become experts at the science and art of orthodontics. It is naïve or delusional to think that such qualifications can be matched by an “ortho-by-mail” process. DYI orthodontics risks permanent damage to teeth such as root shortening, bone or tooth loss, tooth decay or other serious problems.
In the never-ending pursuit to reduce health care costs, new solutions are brought to the marketplace. Creativity and innovation fuel technological advances, which brings value to healthcare. Unfortunately, the DYI of orthodontic treatments “dumbs down” a process that requires an expert’s evaluation, in person.
When it comes to DIY treatment decisions, the doctor patient relationship is devalued, or as described here practically eliminated. This could seriously compromise your health. Bottom line: Don’t mail order brides or braces!
Even the sweetest children don’t always have sweet-smelling breath. If your child has persistent bad breath, it may be for one of the following reasons:
POOR ORAL HYGIENE HABITS. Bad breath often results from bacteria on the teeth and tongue that is not effectively removed during brushing and flossing.
- Tip: To encourage thorough cleaning as children are developing their oral hygiene habits, try handheld flossers that are colorful and easy to use, sing or play music to make brushing time fun, or try an electric toothbrush with a timer or a tooth-brushing app that keeps kids brushing for a full two minutes.
PLAQUE BUILDUP, TOOTH DECAY AND GUM DISEASE: Plaque, a sticky bacterial biofilm, can build up on tooth surfaces, between the teeth and under the gum line and can lead to tooth decay and gum disease. These conditions may result in bad breath.
- Tip: Stay on top of your child’s oral hygiene at home, and keep up with regular dental visits for professional cleanings and checkups.
POST-NASAL DRIP: This common cause of foul-smelling breath in children results when excessive mucus is produced and drips down the back of the throat.
- Tip: Schedule an appointment with your child’s pediatrician to determine and treat the cause.
MOUTH BREATHING. Breathing through the mouth instead of the nose can cause a dry mouth. This can lead to increased oral bacteria, which can cause bad breath. If children breathe through the mouth all the time, not just because of a temporary cold or allergies, your child is at greater risk for tooth decay and gum disease.
- Tip: If your child is a chronic mouth breather, schedule a dental visit so we can check for any adverse effects on dental health. Note that over time, habitual mouth breathing may lead to poor alignment of the teeth. An ear, nose and throat (ENT) specialist can treat problems with tonsils, adenoids and sinuses — common causes of mouth breathing.
FOREIGN OBJECT IN THE NOSE. It wouldn’t be the first time a child has stuck a pea or other small object up their nose â?? or their sibling’s nose — only to find that it won’t come back out. A foreign body in the nasal passage can cause infection and lead to bad breath.
- Tip: Don’t try to remove the object at home, as part of it may remain in the nasal passage. A medical professional will have the right equipment to dislodge the object more comfortably.
MEDICATION. Children who take antibiotics for a long time may develop a fungal infection (thrush) in the mouth. Other medications can cause bad breath due to the way they break down in the body.
- Tip: Call your pharmacist if you have a question about medications and bad breath.
MEDICAL CONDITION. Infections of the throat, sinus or tonsils can cause bad breath, as can more serious health conditions.
- Tip: If your child’s breath is unpleasant for an extended period of time, get it checked out by a health professional.
If you are concerned about your child’s breath, schedule a visit. We are happy to remind your child of proper brushing techniques and check for other problems that need to be addressed.
For more on young children’s oral health, read “How to Help Your Child Develop the Best Habits for Oral Health” and “Why See a Pediatric Dentist?”
As if the preteen years didn’t give kids and their parents enough to think about, new oral health concerns loom on the horizon. Along with major changes to the body, brain and emotions, additional risk factors for tooth decay and gum disease appear during adolescence — the period of development starting around age 10 and extending through the teen years that marks the transition from childhood to adulthood.
Even with declining rates of tooth decay across the nation, the cavity rate remains high during adolescence. According to the American Academy of Pediatrics, 1 in every 5 adolescents has untreated tooth decay. What’s more, the onset of puberty — usually beginning around age 10-11 in girls and 11-12 in boys — brings changes in hormone levels that can affect gum health.
We all have millions of microorganisms in our mouth, representing hundreds of different species of mostly helpful, but some harmful, bacteria. Research has shown that total oral bacteria increases between ages 11 and 14, and new types of bacteria are introduced, including some that are not friendly to teeth and gums. Some unfamiliar microbes trigger an exaggerated inflammatory response to dental plaque, so gum bleeding and sensitivity are experienced by many children in this age group. In fact, “puberty gingivitis,” which peaks around age 11-13, is the most common type of gum disease found during childhood.
A combination of hormones, lifestyle changes and poor oral hygiene habits raises the risk of oral health problems among adolescents. A more independent social life may be accompanied by a change in eating habits and easier access to snacks and beverages that are sugary, acidic (like sports drinks and soda) or full of refined carbohydrates — none of which are tooth-healthy choices. And as children move toward greater independence, parents are less likely to micromanage their children’s personal care, including their oral hygiene routines. Good oral hygiene can keep dental plaque at bay, lowering the chance of having gingivitis and cavities. But let’s face it: Adolescents have a lot to think about, and keeping up with their oral health may not be a priority.
To help your preteen stay on top of their oral health, keep healthy snacks at home for your children and their friends and make sure you are well stocked with supplies such as new toothbrushes, floss and toothpaste. In addition, most preteens (and teens) can benefit from gentle reminders about oral hygiene routines.
For optimal oral health through all stages of life, make sure your preteen keeps up with professional teeth cleanings and exams, and talk with us about whether fluoride treatments or sealants may be appropriate for your child.
For more on your child’s oral health, read “How to Help Your Child Develop the Best Habits for Oral Health” and “Dentistry & Oral Health For Children” in Dear Doctor magazine.