Post-Orthodontic Care

It seems today that every dentist is a cosmetic dentist. This represents a fairly recent phenomenon. Since cosmetic dentistry is not a specialty recognized by the American Dental Association, how does one determine who's good, and who's not?

Below are four criteria that I would recommend using in your selection of a cosmetic dentist:


  • EDUCATION: There are many continuing education courses offered in cosmetic dentistry, and most of them are quite good. A cosmetic dentist must be dedicated to expanding his learning and increasing his knowledge through regular participation in these courses. This is a critical component of a cosmetic dentist's development of his or her own philosophy and technical expertise.

  • EXPERIENCE: While education is extremely important, it is of little relevance if not used in practice. The more cases a cosmetic dentist completes, the more capable that professional becomes in visualizing results, anticipating challenges, and knowing which techniques will produce the optimum result for the client. Cosmetic dentistry is extremely technical, and a clinician's skill set develops over time.

  • LAB SUPPORT: Most cosmetic dental cases involve the fabrication of a porcelain crown and/ or veneer. These items are made in a dental laboratory by specially trained personnel. This dental laboratory technician, or ceramist, is responsible for translating the cosmetic dentist's specific information on your case into a well-crafted and natural-looking product. In this sense, the ceramist is a true artist. In order to achieve a high level of proficiency, this individual must have benefited from the experiences of completing many cases. Ideally, the cosmetic dentist should have the same highly skilled ceramist complete all of his or her cases. This scenario would result in consistently beautiful results. In order to achieve this, the cosmetic dentist must have an established relationship with a high-quality dental laboratory.

  • REFERENCES: A cosmetic dentist should be able to provide a list of clients on whom he or she has completed cosmetic procedures. This is the best way for a potential client to gauge the patient's experience with their cosmetic dentist and their degree of satisfaction with the final product.

Hopefully, these guidelines will help in the process of selecting the cosmetic dentist who is right for you

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One day in the not-too-distant future, your braces will come off. In a few moments, you'll be free of bands and brackets, able to eat what you want and run your tongue over smooth, clean teeth. But, even on this happy occasion, please remember that you're not quite done with orthodontic treatment yet: The next phase, called retention, is just beginning.

Family.

Retention is a critical follow-through stage that typically involves wearing an orthodontic appliance called a retainer. Several different kinds of retainers are available, all of which are custom-made.

But if your teeth are straight now, why do you need a retainer at all? Simply put, it's because if you don't wear one, your teeth will start moving right back to where they were!

Teeth aren't set rigidly in the jawbone — instead, they're held in place by a network of fibers called the periodontal ligaments. After they have being moved, it takes several months for the periodontal ligament to adjust to the new position. So if you want to keep that new smile — and not waste all the time, effort, and money it took to get it — it's essential to wear your retainer as directed.

Being fitted for a retainer usually happens on the same day your braces are removed. After your teeth are thoroughly cleaned, another set of X-rays and/or bite impressions may be taken to check how well your braces worked and to see how much your wisdom teeth have developed. Then, a retainer will be prepared for you.

Three Types of Retainers

Types of orthodontic retainers.

There are three basic types of retainers available today; each works best in particular situations. The most common is the so-called “Hawley” retainer — a thin, tongue-shaped piece of acrylic molded to fit your mouth, with a wire that holds your teeth in position. The Hawley retainer is simple, durable and easily removed. It's even possible to personalize it by choosing different colors and designs for the plastic arch.

Another popular style of retainer is the clear aligner-type, which looks similar to the Invisalign® tray system. These retainers are custom-made of thin, transparent plastic designed to fit precisely over your teeth. Their main advantage is that they're invisible, with no wire to show. These retainers are also easy to remove, but they may be somewhat less durable than the Hawleys. They aren't recommended for patients with certain conditions, like teeth grinding.

Finally, fixed retainers may be an option for some people, especially on the lower front teeth. As their name implies, they aren't removable by the wearer — but they aren't visible either. Like lingual braces, this system uses a wire which is bonded to the tongue side of the teeth. It may remain in place for months, or longer. This type of retainer is sometimes recommended when there's a high risk that teeth could revert to their former position.

A Period of Adjustment

After a short time, most people adjust quite well to wearing a retainer. Some may find that they produce more saliva than usual for a day or so after first wearing any type of retainer — a normal reaction to a foreign object in the mouth. You may also find it a little harder to talk normally at first, but that problem will soon disappear. Of course, removable retainers should always be taken out when you eat or brush your teeth — a big change from braces!

At first, you will probably be told to wear your removable retainer all day, every day. This period of 24/7 retainer use generally lasts from several months to a year. Later, it may be OK to wear it only at night. Finally, you'll probably need to put it on just a few nights a week.

Maintaining — and Retaining — Your Retainer

How to Clean Removable Retainers

To stay fresh and germ-free, all retainers need proper cleaning. A Hawley-type retainer can be brushed gently with a regular toothbrush — but a brush may scratch the clear aligner types. Denture cleaners, in powder or tablet form, as well as special retainer cleaners, can be used to clean most removable retainers. Fixed retainers are cleaned by brushing and flossing; a floss threader or interproximal brush can also be a helpful cleaning tool when needed.

Finally, remember to always carry — and use — a retainer case. You'd be surprised how many retainers end up folded in a napkin and accidentally discarded! Also, don't expose your retainer to excess heat by washing it in very hot water or leaving it on a heater: That can cause the retainer to warp and make it unusable. With proper care and conscientious use, a retainer can help you transition from braces to a permanent, healthy smile.

Related Articles

Orthodontic Retainers - Dear Doctor Magazine

The Importance of Orthodontic Retainers Decades ago, orthodontists used to think that once teeth were moved into the “right” positions, they would stay there forever. Research over the past thirty years has shown that this is not true — there is no “right” position that can assure a permanent, unchanging result. The only way to be sure the alignment of your teeth and your bite remains stable after orthodontic treatment is to wear retainers as needed and as directed by your orthodontist or dentist... Read Article

Orthodontic Retainers - Dear Doctor Magazine

Why Orthodontic Retainers? It is common to wear retainers following orthodontic treatment or what people commonly refer to as braces, for good reason. Teeth must be “retained” or stabilized in their new position long enough for the gum tissue, bone and ligament to reform and mature around them, which can take several months. The teeth will tend to relapse into their old position quite rapidly if the retainers are not worn... Read Article