If you are dissatisfied with the way your smile looks, and your dentist is unhappy with the way your teeth fit together — but you don't like the idea of wearing braces — clear aligners may be your best solution. How much do you know about this teeth-straightening alternative? Below are some FAQs on the subject.

What do we mean by clear aligners? Clear aligners are a system for straightening teeth that uses clear plastic removable “trays” that fit over your teeth. As the teeth move to fit the trays, new trays are substituted that are designed to continue to move your teeth into the desired position. This system is an alternative to the traditional system of brackets and wires known as braces.

How can teeth be moved to new positions? The connection that holds a tooth in place in your jaws — the periodontal ligament — is not immobile. It constantly changes its position based on the normal forces of your bite. As the ligament is pushed on one side and pulled on the other, the living cells of your mouth respond by depositing bone and cementum (the protective covering of the tooth's root) on one side and dissolving it on the other. Normally this happens in a balance, maintaining your teeth in their position. We can manage these slight changes by applying constant light forces to move teeth in a predictable way.

How long does it take to move teeth to their optimum position using clear aligners? As with braces, the process is gradual. Total treatment time can range from six months to two years.

Do the trays have to be worn all the time? As you move through the sequence of trays, each is worn for 20 hours per day for two weeks. They may occasionally be removed for important social occasions.

How does an orthodontist design the sequential trays that are used? The trays are designed using a computer, based on an assessment and images of your mouth, teeth and jaws.

What kinds of problems can clear aligners correct? This method works well to correct mild to moderate crowding or spacing. If your back teeth already fit together as they should, the system may be ideal. If you have an extreme overbite or underbite, braces might work better.

Are clear aligners an alternative for everyone? Clear aligners are recommended for adults and recently, teenagers. They are not usually recommended for young children.

Why is it important to have your teeth straightened? Besides the obvious benefit of feeling better about yourself and your appearance, straight and well-aligned teeth work better. You will experience a better-functioning bite and can improve your oral health.

Contact us today to schedule an appointment to discuss your questions about orthodontics and clear aligners. You can also learn more by reading the Dear Doctor magazine articles “Clear Orthodontic Aligners” and “Moving Teeth With Orthodontics.”

Your self-image has a lot to do with how you feel about your appearance — and particularly your smile. If you are unhappy with the way you look, cosmetic dentistry may be the answer to your problems.

1. What do we mean by cosmetic dentistry? The word “cosmetic” refers to beneficial changes in appearance. Thus cosmetic dentistry is all dental work that restores or improves a person's appearance.
2. What is a cosmetic dentist? Every dentist learns to do procedures in a way that conserves or improves a patient's appearance. Some dentists continue to study and specialize in procedures that are done specifically for the purpose of enhancing a person's appearance.
3. What is a smile analysis? The first step to improving your smile, this analysis involves a study of all the elements of your smile — teeth appearance and alignment, gums, jaws — and also your facial features and how they all fit together.
4. How can I choose the right cosmetic dentist? Ask your dentist about his or her training and experience. Ask for photos of previous work. You may need to select more than one person, working as a team to take best advantage of each one's experience, skills, and training.
5. What can be done to improve a smile using 21st century techniques? We are fortunate to live in times in which numerous options are available. These include making teeth whiter; altering their size, shape, balance, color, and alignment; filling in parts of teeth that are missing because of decay or injury; and even replacing teeth that are missing entirely.
6. How can chipped or discolored front teeth be restored? This can often be done by bonding with composite resin.
7. How can damaged back teeth be restored? Back teeth with cavities or traumatic injuries can now be repaired with non-metallic tooth-colored material that bonds to the tooth substance.
8. What techniques can be used to correct more severe problems? Porcelain veneers, thin layers of porcelain material, can be used to change the appearance of misshapen or undersized teeth. Porcelain crowns can be used to replace the part of the tooth that rises above the gums.
9. How can we change the position of teeth that do not meet together well? Orthodontists are dentists who specialize in correcting malocclusions (bad bites). They use traditional braces or clear aligners to move teeth into more attractive and functional positions.
10. What if some teeth are missing? A dental implant replaces the root of a missing tooth. A porcelain crown that looks just like a natural tooth can then be connected to the implant.

Contact us today to schedule an appointment to discuss your questions about cosmetic dentistry. You can also learn more by reading the Dear Doctor magazine article “Cosmetic Dentistry: A time for change.”

Modern dental implants not only help you maintain your normal chewing ability and speech patterns after you have lost a tooth or teeth — they also keep you looking younger. How do they do this? Read on.

Do lost teeth cause tooth-supporting bone to “melt” away? Yes. Of course, the bone does not actually melt. Bone is a living tissue, and under normal conditions it constantly dissolves and rebuilds. Stimulation by the small stresses from the contact of upper and lower teeth — something that normally happens hundreds of times each day — keeps these two forces in balance. When a tooth is missing, the bone that normally surrounds and supports the tooth (called alveolar bone) no longer receives the stimulation that causes it to rebuild, and it begins to diminish over time.

What happens if you don't replace missing teeth? The first year after a tooth is lost, the width of the bone that once surrounded the tooth decreases by 25 percent. Over the years, gradually increasing bone loss results in sunken cheeks and lips, making you look older. Gum tissue also decreases, affecting your ability to chew and speak.

What happens if you lose all your teeth? For people who have lost all their teeth, called edentulous, the effects are severe. After the alveolar bone is lost, the bone beneath it, called basal bone, also begins to be resorbed, eventually causing the lower part of the face to partially collapse.

Do partial or full dentures prevent bone loss? Unfortunately, just the contrary is true. A removable denture pressing on a person's gum increases bone loss because the pressures from biting are not transferred into the internal structure of the bone but instead are compressive, which damages the bone over time. This is why dentures begin to fit poorly after they have been worn for a while. This problem can be reduced by anchoring dentures with strategically placed dental implants.

What is a dental implant? A dental implant is a tooth-root replacement that is made of titanium. This metal is able to osseointegrate, or fuse with the bone. For a single tooth replacement, a crown that looks and functions like natural tooth is attached to the titanium implant. As mentioned above, implants can also be used to anchor dentures.

Does an implant prevent bone loss? Yes. When dental implants fuse to the jaw bone, they stabilize the bone. They also provide tooth-to-tooth stimulation that was formerly supplied by the natural tooth.

How long do dental implants last? Dental implants have been shown to last at least 10 years. For most people, implants will last the rest of their lives.

Contact us today to schedule an appointment to discuss your questions about tooth loss and dental implants. You can also learn more by reading the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”

While the long-term success rate for a dental implant is well over 95%, there are factors that can compromise their success. For this reason, our office has put together this list so that you can be prepared should you ever need a dental implant. We feel that by providing our patients with this type of easy-to-understand information, we can educate, address any concerns and help produce the best results.

The three most common categories for classifying factors that influence dental implant success are: general health concerns, local factors and maintenance issues. As you may suspect, general health concerns include factors such as:

• Whether or not you smoke or use tobacco products.
• Certain prescription and over-the-counter medications you are currently taking or have recently taken.
• If you have or have a family history of osteoporosis (“osteo” – bone; “porosis” – sponge-like).
• If your medical history includes any cancer or radiation treatment to the jaws.
• Or if you have a compromised immune (resistance) system.

The second category is “local factors” and includes bone quantity and quality — there must be sufficient bone to anchor implants. Other considerations that fall into this category include whether or not you clench or grind your teeth or have additional bite concerns, as all of these can have negative impacts on both the short and long-term success of an implant.

The last category concerns maintenance. While dental implants are superior works of technology that can last a lifetime and produce results that are nearly identical to natural teeth in looks and durability, they do require routine maintenance. This includes daily cleaning (brushing and flossing) and routine visits to our office for evaluation and professional care to make sure they are functioning properly.

To learn more on this subject, continue reading the Dear Doctor magazine article “Factors which can influence implant success.” You can also contact us today to schedule an appointment to discuss your questions about dental implants.

Oral sedation can be an ideal and safe solution for someone who suffers from fear and anxiety regarding dental appointments — the very reason we offer it to our patients. However, there are some things you need to do prior to and following your treatment for optimal oral sedation benefits and treatment results.

• Being completely honest about your health history and any medication you are taking is a critical aspect, as it lets us know that oral sedation medication is safe and will work for you. We also ask you to let us know about any over-the-counter (OTC) medications, remedies, or vitamins and/or supplements you are taking. The reason this is so vital is that some can negatively impact your treatment, recovery, and the effectiveness of the oral sedation medications.
• You should not eat or drink anything six hours prior to your appointment unless we instruct you otherwise.
• You should make arrangements to have someone drive you to and from your appointment, as it may not be safe for you to drive or operate any heavy machinery until the effects of oral sedation have worn off. It is important to note that this will vary depending on what medication is used, so do not assume your reaction/response will always be the same.
• Drink plenty of fluids (especially water) to stay hydrated after your appointment.

To learn more ways you can prepare, read the article “Oral Sedation Dentistry.” Or you can contact us today to discuss your questions or to schedule an appointment.