Protecting Your Healthy Smile While Wearing Braces

Orthodontic treatment is an important investment in your future. We, at OrthoWorks want you to have the best orthodontic results possible. While you are wearing braces, it is essential that you take care of your teeth and gums. This article explains why and how.
More care needed during orthodontics
Have a look in the mirror at your new braces. As you see, the brackets and wires have many nooks and crannies that can trap food and plaque. This means your risk of tooth decay and gum problems may be higher while you are wearing braces or Invisalign.

You need to pay special attention to cleaning your teeth everyday and to your diet. Permanent damage to tooth enamel can occur if the teeth and brackets are not kept clean.

Areas on the enamel surface may begin to lose minerals (the early stage of tooth decay), leaving unsightly white spots. You may also develop inflamed, bleeding gums (gingivitis). Gingivitis and the early stages of tooth decay can be reversed by taking extra care with your cleaning and diet. If left untreated, they can lead to bigger problems that will require treatment and have life-long effects. While you are having orthodontic treatment, you need to continue to have regular check-ups with your family dental professional to ensure little problems don't become big ones.

Tooth-friendly diet
Dental professionals are increasingly concerned about acidic foods and drinks that can damage tooth enamel when consumed frequently or when sipped over extended periods of time.

The chart below shows you how some common food and drinks stack up against one another. While many high acid foods are healthy for your body, low acid foods are better for your teeth. Remember- during orthodontic treatment, it's best to choose low acid foods when you sit down to eat.

Less Tooth-Friendly
Foods & Drinks
(High Acid)
Apples, cherries, oranges, peaches, pears, plums, pineapples, raspberries Tomatoes, pickles
Soft drinks (regular & diet), sports drinks, fruit drinks
Vinaigrette dressings, BBQ sauces, salsas

More Tooth-Friendly
Foods & Drinks
(Low Acid)
Bananas, mangoes, melons
Carrots, cucumbers, lettuce, beets
Milk, water
Meat, poultry, seafood,eggs, crackers, soups, pasta



Most of us are well aware that sugary foods and drinks can lead to tooth decay. Starchy foods, such as potato chips, can also stick to teeth for long periods of time and cause tooth decay.

Soda is especially hard on teeth because it not only contains acidic flavor additives, but it also includes 10–12 teaspoons of sugar, which further increases your chance of developing cavities. Studies show that diet sodas are just as damaging as regular sodas at weakening tooth enamel.1

Saliva is your body's natural defense against tooth decay. You need to give saliva plenty of time to wash away acids that form after eating and drinking. A good rule to follow is to limit eating times each day to 3 meals and 2 snack times. You can drink plenty of water as often as you like! Be aware that bottled water may not contain fluoride.

Braces-friendly diet & habits
There are foods that can loosen, break or bend wires and bands when you are wearing braces.

Avoid hard foods such as nuts and hard cookies. Foods such as apples and carrots should be chopped into small pieces before eating to reduce the stress on your braces. Avoid sticky foods such as caramels, toffees, muesli or fruit bars. No chewing gum! No chewing ice!

Habits such as nail biting, unnatural tongue thrusting, pencil chewing and nervous picking at your wires can also break braces. Be aware of these and make an effort to stop them. Remember that damaged braces mean extra appointments, inconvenience and extended treatment time. If you do break your braces, be sure to make an appointment with your orthodontist immediately. Broken braces are not correcting your teeth!



Care at home
When cleaning your mouth while you are wearing braces, you need to pay special attention not only to your teeth and gums, but also to the brackets and wires.

Here are 10 simple steps for keeping your teeth, gums and braces in great shape:

If your orthodontist has fitted you with elastics, remove them before brushing.
Using a fluoride toothpaste and a soft, compact toothbrush, place your brush at an angle of 45 degrees against the gums. Gently brush along the gum line where the gums and teeth meet, using a small circular motion on each tooth.
Spend about 10 seconds on each tooth before moving onto the next tooth, brushing in a set pattern so that you don't miss any teeth.
Gently brush the braces. Press your toothbrush firmly enough so that the bristles spread into the gaps between the wire and the tooth. Brush in and around all of the brackets and wires. Ensure that you brush under the wires. A battery powered brush may be helpful.
Brush both the inside and the outside surfaces of your teeth using a gentle circular motion on each tooth.

For the chewing surfaces, use a firm back and forth motion.
Spit out excess paste, then closely inspect your teeth and braces in the mirror to check that they are clean and shiny.
Replace your elastics in accordance with your orthodontist's recommendation.
After brushing, rinse with a fluoride mouthwash, such as Colgate® Phos-Flur® , for 1 minute to help prevent cavities and white spots.
Use other oral care products, such as PreviDent® 5000 Booster? (1.1% Sodium Fluoride), as prescribed by your dental professional.
Fluoride and oral care products
Fluoride protection against tooth decay is needed throughout life. However, while you are wearing braces, it is much harder to keep your teeth clean. This can result in higher than normal amounts of plaque accumulation, which can cause cavities.

Using fluoride toothpaste after each meal or at least twice a day is one of the most proven ways to help you stay decay free. Fluoride makes teeth more resistant to the acids produced after eating or drinking and replaces minerals that are lost in the early stages of tooth decay. At OrthoWorks, we encourage our patients to brushing with Fluoride Gel, Gelkam, every night before bed. After brushing with the gel, there should be no rinsing, drinking and eating. Let the fluoride gel work into the enamal while you sleep. This is the best way to make your enamal become stronger and less cavity prone.

If you have further questions about maintaining good oral health during braces, please feel free to call us at the office anytime to discuss with our doctors or our dental assistants.

Thanks.

Dr. David Shen
Tel: 888 BRACES2
www.OrthoWorks.com

Xylitol Chewing Gum Can Prevent Cavities And Gum Disease?

Early childhood caries (ECC), a severe deterioration of infants’ teeth due to bacterial infection, is a major global public health concern and its prevalence is rising, mostly within poor populations. Children with ECC are three times more likely than children without ECC to develop tooth decay in their permanent teeth, and ECC has a negative effect on oral health in general.1

Xylitol Acts as an Antibacterial Agent

Xylitol, a five-carbon sugar alcohol commonly used as a sweetener in foods, gum, and oral health products,2 reduces plaque formation and bacterial adherence by exerting a selective antibacterial action against mutans streptococci, the main bacterial species in human tooth decay.1 However, the concentrations of xylitol in these products are generally too low to have anticariogenic effects.

Efficacy of Xylitol Shown in a Randomized Clinical Trial

A study by Milgrom and colleagues was the first to assess the efficacy of xylitol pediatric topical syrup in the reduction of the incidence of tooth decay.1 Children at high risk for ECC, aged from 15 to 25 months, were followed for 12 months in a double-blind randomized clinical trial. A total of 94 children were randomized to one of three groups, two active groups each receiving oral xylitol (8 g/day) divided into 2 or 3 doses, and a control group receiving a single subtherapeutic dose of 2.67 g xylitol. Dose frequency was controlled by dummy doses of sorbitol, a polyol sweetener which has not demonstrated protective effects against caries.

The number of decayed teeth was evaluated and results are shown in the table. Compared to the control group, significantly fewer decayed teeth were observed in the xylitol-2X group and the xylitol-3X group (51.6% vs. 24.25% vs. 40.6%, respectively). There was no significant difference between xylitol treatment groups (p-value = 0.22).

The results of this trial suggest that exposure to xylitol (8 g/day) in a twice-daily topical syrup during primary tooth eruption prevents up to 70% of tooth decay. Dividing 8 g xylitol into 3 doses daily did not significantly change the efficacy of treatment.3,4 The results confirm the position of the National Institutes of Health and the American Academy of Pediatric Dentistry supporting the importance of xylitol for the prevention of dental carries.1

Adverse Effects and Long-Term Consequences

The most common adverse events of xylitol, such as loose stools and diarrhea, are those most frequently seen after the consumption of polyol sweeteners. There is no published evidence of long-term negative consequences related to the consumption of a specific sweetener during childhood. However, xylitol-based products have been widely available for many years and consumed in several countries with no undesirable effects noted so far.

Xylitol as a Public Health Measure

Xylitol syrup could potentially be a cost-effective measure for the prevention of ECC, especially in high-risk populations. However, further studies are required to establish xylitol effectiveness in real life practice before it can be recommended as a public health measure.5

Have Prolem Breathing at Night? Obstructive Sleep Apnea

It has been estimated that 17% of American adults have obstructive sleep apnea, with 85% being undiagnosed. OSA is the most common chronic disease in developed countries. The person who is suffering from sleep apnea, has brief periods of interrupted breathing during sleep. He is unaware that this is happening, but the quality of sleep suffers greatly.

The symptoms that most likely indicates risk for obstructive sleep apnea are snoring, fatigue, morning headaches, or daytime sleepiness. If you grind your teeth at night, your risk jumps to 80%. If you had four premolar teeth extracted for orthodontics, your risk is 80%.

Why should you be concerned? OSA is a cause of high blood pressure, which leads to risk of death by heart attack. Reggie White, a famous retired football player, died of a heart attack attributed to OSA in his sleep at age 43. OSA would be a much more common cause of death on death certificates, if it were not for the fact that it only causes the heart attack that causes death. Most autopsies list heart attack as the cause of death without commenting on the cause of the heart attack.

OSA also upsets the leptin cycle which causes your body to think it is hungry when it is not. The result is obesity. The weight gain that results then makes the OSA worse, which makes the weight gain worse.


OSA is a cause of ADHD, ADD, depression and sexual dysfunction. OSA is a major cause of heartburn and gastric reflux.

Why is a dentist interested in OSA? We see people every day with symptoms of OSA. Some dentists use a simple screening device which you wear at home for one night. When you return the device, they can get a computer printout of how many times you have had episodes of obstructive breathing problems. If your problems are severe, they make a referral to a sleep disorders doctor. But if your problems are mild or moderate, you can be successfully treated with an oral appliance which holds your chin forward when you sleep (mandibular advancement device).