Posts for: January, 2019
As a basic orthodontic appliance, braces are what allows us to move teeth into better positions to improve a person’s bite. In certain cases, though, this treatment application gets a little assistance from Temporary Anchorage Devices (TADs) to improve accuracy and reduce treatment time.
Braces take advantage of our teeth’s natural ability to move. Teeth are held in place within the bone by the periodontal ligament, an elastic tissue that attaches to the teeth with microscopic fibers secured by a hardened substance called cementum. The periodontal ligament is constantly remodeling in response to changes in the mouth. As pressure is placed on a tooth, new bone, ligament and cementum are formed on the “pulling” side of the tooth; on the other side, the bone and ligament dissolve (resorb), allowing the tooth to move in that direction.
Braces allow this natural process to occur with controlled forces applied by thin flexible wires threaded through the small brackets attached to the front of the teeth and then affixed or “anchored” to other teeth. By attaching the teeth to the other teeth by wires running through all the brackets, “anchorage” is created to allow teeth to be moved where the dentist wants them to go. By adjusting the tension on the wires, we can apply light but constant pressure on the “unanchored” teeth to move them into a new desired position.
Teeth we do not want to move are referred to as the anchorage for teeth we do want to move. If, however, the situation calls for more precise isolation of teeth to be moved, TADs can be very useful. TADs are mini-implants imbedded in the bone to serve as anchorage at strategic locations in the mouth. In this way, the group of teeth to be moved receives forces that are applied through the additional anchorage provided by the TADs. That “tension” or “pressure” is applied only to them and not to adjacent teeth that should not move. This increases efficiency for tooth movement and helps reduce the treatment time.
TADs can be placed using local anesthesia and with little discomfort, and are removed when orthodontic treatment is completed. Although the procedure is pretty straightforward, it does require collaboration between orthodontist and surgeon to ensure correct positioning.
In the end, TADs increase our ability to control the forces that move teeth during orthodontic treatment. This lessens discomfort for the patient and helps ensure the end result — a more functional bite and a transformed smile.
If you would like more information on the use of TADs and other orthodontic appliances, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “What are TADs?”
Since boxers first began using them a century ago, athletic mouthguards are now standard safety equipment for most contact sports. Without them, dental injuries would skyrocket.
But a recent study in the peer-reviewed journal, General Dentistry, indicates there’s another important reason to wear a mouthguard for contact sports or exercise: you may be able to significantly reduce your risk for a mild traumatic brain injury (MTBI), better known as a concussion. It’s believed the mouthguard absorbs some of the force generated during contact, resulting in less pressure to the brain. That reduction is even more significant if your mouth-guard has been custom-made by a dentist.
That last finding is important, because not all mouthguards on the market are equal. There are three basic categories of mouthguards — stock, “boil and bite,” and custom. Stock mouthguards come in limited sizes; they’re relatively inexpensive, but they provide the least level of protection. “Boil and bite” can be customized after purchase to the wearer’s bite, but they don’t always provide complete coverage of back teeth. Custom mouthguards are designed and fashioned by a dentist; they’re relatively expensive (running in the hundreds of dollars), but there’s ample evidence they provide the highest level of protection from mouth injuries.
The General Dentistry study also corroborates custom mouthguards’ effectiveness in preventing concussions. The study followed approximately 400 football players from six different high school teams. While all the players wore the same type of helmet, half of them wore custom-made mouthguards and the other half wore stock guards. 8.3% of the athletes wearing stock guards experienced a concussion injury; by contrast only 3.6% of those with custom guards sustained an injury — greater than half fewer occurrences.
The study also highlights the need not to rely solely on helmets or other protective headgear for concussion prevention. It’s important to include mouthguards along with other athletic protective gear to lower injury risk as much as possible.
So when considering how you can provide the optimum injury protection for you or your child, be sure to include an athletic mouthguard, preferably one that’s custom-made. We’ll be happy to advise you further on what you need to know to prevent traumatic dental injuries, as well as concussions.
If you would like more information on custom-fit mouthguards, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Mouthguards.”
When he isn’t among the ten players vying for position on the basketball court, Cole Aldrich of the New York Knicks sometimes lets his dangle behind one ear. Mason Plumlee, who plays for the Brooklyn Nets, slips his snugly inside one of his socks during off times. Other players can be seen at timeouts gnawing on them nervously, or tucking them into spandex waistbands. But when the whistle blows, they go into the mouth before the players get on the court.
We’re talking about protective mouthguards, of course. According to a recent story in the New York Times, only a handful of basketball players wore them regularly a few years ago. Today, more and more are wearing them, both in practice and during games. What’s the reason for the change?
Partly, it’s the result of better design and improved construction; today’s mouthguards are more comfortable and better-fitting than ever. Part of it comes from mounting evidence that they work: Research studies have consistently demonstrated the benefits of wearing a mouthguard — not only to protect the teeth, but also to reduce the risk of concussion. And partly, it stems from the growing acceptance that safety is an important aspect of all athletic activity.
If the pros are doing it — shouldn’t you be too? While you may think that only contact sports (such as football) are risky, the fact is that “non-contact” sports like baseball and basketball account for the majority of dental injuries. In fact, the American Dental Association recommends you wear a mouthguard when you participate in activities like handball, soccer, surfing and weight lifting — as well as boxing, skydiving, martial arts and “extreme sports” — whatever that may mean to you.
What’s the best kind of mouthguard? It’s the one that you actually wear, of course! And the most comfortable and best-fitting mouthguard is the one that’s custom-made for you by your dentist. Sure, you can pick up an off-the-shelf mouthguard at a big box store; but it can’t offer you the same level of protection and comfort you’ll get from a mouthguard that is made from a model of your own teeth. Custom-made mouthguards from your dentist are reasonably priced — and by preventing dental trauma, they can save an untold amount of hurt… both to your body and to your pocketbook.
So take a tip from the pros: Get a custom-made mouthguard, and wear it every time you play. But when you’re done playing… how about putting it away in a case?
If you would like more information about custom-made athletic mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “An Introduction to Sports Injuries & Dentistry” and “Athletic Mouthguards.”