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Braces and Band? Play On!

March 12th, 2019

You’re in the band and you’re getting braces. Now what? If you are a member of the string or percussion sections, you can go back to rehearsal. You’re good to go. When your talents have seated you in the reed or brass sections, though, a little adjustment might be necessary to keep your instrument and your braces working in harmony.

If you play a wind instrument, you know the term embouchure—the way you position and use your lips, tongue, facial muscles, and teeth to produce the sound you want. Depending on the instrument you play, you might be completely unaffected when you get your braces, or you might need to develop a more comfortable embouchure to accommodate them.

Wires and Woodwinds?

If you play a wind instrument such as the flute or piccolo, you might find that your normal lip positioning or blowing angle is affected by your braces, but usually the adjustment time is fairly short. Reed instruments such as the saxophone, clarinet, oboe, and bassoon are considered some of the easiest to adjust to when you have braces, but even though the single and double reed mouthpieces don’t require as much pressure as brass instruments, there can still be an adjustment period. One thing you should look out for is more condensation in your mouthpiece or instrument—be sure to keep your instrument clean to keep your sound pure.

Brackets and Brass?

Brass instruments require mouthpiece pressure. This leaves your lips pressed between the mouthpiece and your braces. For this reason, many brass players have a more challenging adjustment when wearing braces. Smaller mouthpieces (trumpet, French horn) usually require more pressure than larger ones (tuba, trombone). It’s important to learn how to use technique to avoid cuts, irritation, and other injuries caused by the pressure of your braces against your lips. Learning to play with less pressure on the lips and more air control and breath support will help you to recover your tone and range of notes while protecting your lips and mouth.

How Can We Help?

Let Dr. Douglas and Larry Harte know if you play, or plan to play, a wind instrument. We might be able to offer some suggestions. For regular metal and ceramic braces, some musicians find extra wax is helpful in preventing lip and cheek injuries. There are brace guards available that can be applied over the braces to protect your lips and mouth if wax doesn’t do the trick.

There are also alternatives to regular bracket-and-wire braces, depending on your orthodontic needs, cost factors, and length of treatment. Invisalign® devices fit smoothly over your teeth and can even be removed when it is time to practice or play, as long as you get the necessary hours of wear in per day. In some cases, lingual braces, where the brackets and wires are placed behind the teeth, might be the best choice for you.

Finally, don’t forget to talk to your music instructor. Don’t be dismayed if you find the quality of your playing has been affected. Your teacher might have valuable suggestions for adjusting your embouchure, playing with less pressure on the lips, and developing better air and breath support. You might need to shorten your practice time at first, and there might be another period of adjustment after your braces come off.

Above all, take care of yourself! If something is poking your lip or cheek, call our Sparta or Livingston, NJ office immediately before it causes injury. It might be difficult at first, but finding an embouchure that works for your comfort and technique is worth it. And remember, these temporary fine-tunings will lead to a wonderful coda: skilled musicianship and a beautiful, healthy smile. Bravo!

 

Does my child need two-phase treatment?

March 5th, 2019

You might be surprised to see one of your second grader’s friends with a dental appliance. Isn’t orthodontic work just for teenagers? And, if not, should your seven-year-old be sporting braces right now? The answer to both of those questions is “Not necessarily.” Two-phase treatment is a process designed to correct issues that arise during different times in your child’s life.

First Phase Treatment

We recommend that every child have an orthodontic evaluation around the age of seven to determine if there is a problem that would benefit from early treatment. First phase orthodontics is not the same as orthodontics for older patients. The focus here is on the developing bone and muscle structures which form your child’s bite and provide space for the permanent teeth when they arrive.

There are some clear-cut orthodontic goals that are much easier to attain when children’s bones are still growing.

  • Reducing Crowding

If your child’s mouth is small, the permanent teeth will have little room to fit in when they arrive. We may recommend gently enlarging the upper dental arch with the use of a palatal expander. This device will provide room for the adult teeth, and could potentially shorten second phase treatment time. Sometimes the extractions necessary to create more room for permanent teeth in later years can be avoided, as well as the possibility of an impacted tooth—one which doesn’t erupt because it is blocked by other teeth.

  • Dealing with Jaw and Bite Concerns

Bones and muscles do not always develop properly, leading to problems with jaw and facial structure. Your younger child still has growing bones, so this is a great time to gently re-form the jaw into a healthy shape. Problems caused by crossbites, underbites, open bites, and other malocclusions can be reduced with early treatment.  

  • Protecting Teeth

If your child has protruding front teeth, these teeth are more likely to be damaged in falls, at play, or while participating in sports. We can gently reposition them.

Second Phase Treatment

Second phase treatment is designed for your older child. After a resting period, when the permanent teeth finish erupting, we should see your child to evaluate any further orthodontic needs. This is the time to finish the process of straightening the teeth and making sure that each tooth fits together properly for a comfortable and healthy bite. This phase usually makes use of braces or aligners, and can take approximately 12-24 months.

Two-phase treatment is not necessary for every child. But there are some unique reasons that early orthodontics might be recommended for your child, even if it’s clear that more orthodontic work will be needed later. Make an appointment with Dr. Douglas and Larry Harte at our Sparta or Livingston, NJ office, and let’s evaluate your child’s orthodontic needs, whether now or in the future, for a lifetime of beautiful smiles.

What is a palatal expander?

February 26th, 2019

Orthodontists like Dr. Douglas and Larry Harte recommend a first orthodontic visit and evaluation for your child around the age of seven. We will evaluate your child’s jaw and facial development and make sure that there is enough room in the mouth for the permanent teeth when they arrive. One of the recommendations we might make for early treatment is the use of a palatal expander. If you are unfamiliar with this device, let’s take a closer look at why it’s necessary and what exactly it does.

Why do we recommend the palatal expander?

There are two dental arches, composed of the upper and the lower teeth, in your child’s mouth. This arch-shaped design is meant to accommodate all the permanent teeth. Further, when the upper and lower teeth meet, they should result in a healthy occlusion, or bite.

Sometimes, the upper dental arch is simply too small to accommodate all of your child’s permanent teeth, leading to crowding, extractions, and impacted teeth. Also, a too-narrow arch can result in a crossbite, where some of the upper teeth bite inside the lower ones. An improper bite can lead to problems such as TMJ (temporomandibular joint) disorder, improper wear and stress on teeth, certain speech difficulties, and other potential complications. The palatal expander was designed to prevent these problems from occurring.

What is a palatal expander and how does it work?

The expander itself is a device that increases the size of the upper dental arch. Before your child’s bones are finished growing, the space between the two bones of the upper palate is filled with cartilage. This tissue is flexible when children are young, but gradually fuses solidly into place by the time they are finished growing (usually in the early to mid-teens). If the arch can be widened to accommodate the emerging permanent teeth, or to reduce malocclusions, this improvement can also affect the need for, and length of, future dental work.

There are several types of expanders available at our Sparta or Livingston, NJ office. These are custom-made appliances, commonly attached between the upper teeth on each side of the jaw. The two halves of the device are connected with a screw-type mechanism that can be adjusted to widen the upper palate and dental arch with gentle pressure. This is a gradual process, with small adjustments usually made once or twice a day to slowly move the bones further apart. As weeks go by, you will notice a successful change in the spacing of the teeth. Your child might even develop a gap in the front teeth, which is normal and will generally close on its own.

If you would like more detailed information, talk to Dr. Douglas and Larry Harte about the palate expander. We can tell you what to expect from this treatment if we think it is best for your child’s unique needs, and how to make it as easy as possible for your child. Our goal is to provide your child with the healthiest teeth and bite possible, always making use of treatments that are both gentle and effective.

Ceramic Braces

February 19th, 2019

Congratulations! You have made the decision to get orthodontic treatment at our Sparta or Livingston, NJ office. Now it’s time to choose among your various appliance options. Traditional metal brackets and wires, lingual braces, a series of aligners—they all have positives to recommend them. And for some people, ceramic braces are the clear favorite.

Ceramic braces work like regular metal braces. Brackets are bonded to the front of each tooth, and rubber bands surrounding the brackets hold the arch wire that gradually moves the teeth into alignment.

Ceramic braces, however, use brackets made of clear or tooth-colored ceramic or porcelain which blend beautifully with the color of your tooth. The elastic ligatures, or rubber bands, can be chosen to match the brackets or your enamel. There are self-ligating ceramic brackets which don’t use bands at all. Technology is even working on ways to make the arch wire less visible! The end result is braces that are almost undetectable.

If you want a less obvious appliance for professional or personal reasons, talk to us about ceramic braces. As always, there are other factors to consider before you decide, which we will be happy to discuss with you.

  • Ceramic brackets are very strong, but they are still more brittle than the metal model. If you play a contact sport, these might not be for you. (But whatever braces you choose, please wear a mouthguard when playing sports.)
  • Ceramic braces might not be ideal depending on the amount of alignment and bite correction that is needed. They might also take a bit more time to bring your teeth into alignment. We will be able to tell you if ceramic braces will work for you and if they might require a longer period to move your teeth to their perfect position.
  • Brackets can sometimes be somewhat larger (though this isn’t always the case), and, because they can be abrasive, are often recommended for upper teeth only. This way, the lower teeth will not impact, or be impacted by, contact with the upper teeth.
  • Oral hygiene can trickier with ceramic braces. Although today’s brackets aren’t as prone to staining, you still need to be careful to brush away the plaque that can accumulate around the brackets. And the bands are susceptible to staining by the usual suspects—coffee, tea, colas, blueberries, or any strongly colored food or beverage.
  • Costs will differ depending on the treatment method you choose. Talk to us about cost comparisons with other orthodontic treatments.

Ceramic braces, because they are so much less visible, are a popular orthodontic option, especially for older teenagers and adults. If you are interested, talk to Dr. Douglas and Larry Harte about this effective way to straighten your teeth—discreetly. Ceramic might be the clear solution for creating your lasting, beautiful smile.

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