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Interproximal Cavities: The Inside Story

February 1st, 2023

Time to brush! So, you make sure you gently brush the plaque off the outside surfaces of your teeth. You want to present a gleaming smile to the world, after all. And you make sure to brush the inside surfaces as well, because who wants to feel a fuzzy patch of plaque every time their tongue hits their teeth? And, naturally, you remember to clean the tops of your molars, because those crevices make them more cavity-prone than any other surface.

Done? Not quite!

You might be surprised to learn that no matter how well you’ve brushed all the visible surfaces of your teeth, you’ve left quite a bit of enamel untouched—the adjoining, or touching, surfaces of the teeth that sit next to each other.

You’ve probably noticed that your bristles can’t . . . quite . . . reach all the enamel between your teeth (especially between your molars!) when you’re brushing. This means that food particles and plaque have an easier time sticking around. And when the bacteria in plaque are left undisturbed, especially with a banquet of food particles available, they produce acids which gradually eat away at the enamel covering our teeth, creating a cavity.

Here’s where we work in some specific dental vocabulary. “Interproximal” means between the adjoining, or touching, surfaces of the teeth. And an interproximal cavity is a cavity that develops on one of those side surfaces of your teeth.

  • Preventing Interproximal Cavities

Fortunately, prevention is about as basic as it can be—brushing and flossing effectively. Dentists recommend brushing for two minutes at least twice a day and flossing once each day. While most of us are good about keeping up with brushing, sometimes that daily flossing is more a goal than a reality.

But it’s flossing which really does the trick when it comes to interproximal cleaning. If you floss correctly, food particles and plaque are removed from between the teeth and around the gum line—places where bristles just can’t reach.

When you wear braces, though, flossing isn’t quite so basic. Getting that floss just where it needs to be in between brackets and wires and in between teeth can be a challenge!

The good news is there are many products designed just to make flossing easier while you’re in orthodontic treatment:

  • Floss threaders are flexible hoops that help you thread floss behind your wires easily.
  • Precut floss strands use a stiff tip at one end for threading floss through wires.
  • Interproximal brushes are tiny, cone-shaped brushes which can fit between your teeth and braces for precise cleaning.
  • Water flossers eliminate floss altogether, using a pulsing stream of water to clean between and around teeth and braces.

During your next visit to our Springfield, MA office, Dr. Scott Smith can give you tips on how to use any of these tools effectively for cleaner teeth and cleaner braces.

Preventing cavities on the exterior surfaces of your teeth is probably pretty much automatic by now, but don’t forget the potential for stealth decay! If we find signs of erosion on the sides of your teeth, or if your hygienist lets you know that you’ve got a lot of interproximal plaque buildup, work with your dental team to make sure “interproximal cavity” doesn’t become a working part of your dental vocabulary.

Orthodontics and Oral Piercings

January 25th, 2023

Traditional braces and oral piercings—does the inevitable meeting of metals pose any risks? Let’s look at some of the potential problems with oral piercings, and you and Dr. Scott Smith can decide if you should take a break from jewelry while you’re in treatment.

  • Tooth Damage

Enamel is the strongest substance in our bodies, but when up against constant contact with metal? It’s not a fair fight.

Tongue piercings, especially, cause problems for your teeth. Whenever you speak or eat—even while you’re sleeping!—your tongue is making contact with your teeth. This continual tapping of metal on enamel can chip and crack teeth and damage fillings. A serious fracture could mean a root canal.

You’re getting braces to create a more attractive, healthy smile, so keeping your teeth intact is a priority.

  • Gum Problems

Your gums are affected by orthodontic treatment. As the teeth move, the gums, ligaments, and bone around them adapt and even reshape over time. You might notice when you first get your braces, or when you go in for an adjustment, that you have a few days of swollen, sensitive gums afterward. You might also find that you are at greater risk of gingivitis, because it can be harder to keep plaque away from your gumline until you perfect your brushing and flossing skills.

Oral piercings bring their own gingival dangers. Jewelry in the tongue or lip can rub against gum tissue, especially around your lower front teeth. As the gum tissue continues to be irritated and inflamed, it pulls away from the teeth. This process is called gum recession.

Receding gums expose the tops of your roots to cavity-causing bacteria. They make you more sensitive to hot or cold foods. Pockets between gums and teeth can harbor infections that threaten the tooth itself.

Caring for your gums during braces is important for your dental health. Since people with oral piercings have a much higher rate of gum recession that those without, why add one more risk factor to your oral health?

  • Metal vs Metal

Lip and tongue piercings can make contact with traditional brackets and wires, especially if you have a habit of playing with them. And let’s not forget lingual braces! Lingual braces are almost invisible because their brackets and wires are custom fitted to the back of your teeth. Whenever you speak or eat, you’ll be taking the chance that a tongue piercing will damage these custom-made appliances.

Dr. Scott Smith can tell you if your piercings are in any danger of interfering with your braces, but even if you’re planning on aligners, there are additional reasons to consider retiring your oral jewelry. Dental associations and medical associations discourage oral piercings because they can damage teeth and gums. And there’s more. Oral piercings can lead to swelling, bleeding, allergic reactions, infection, and nerve damage.

The reason you’re considering braces is because you want a healthy, attractive smile. Don’t let a tiny piece of jewelry make your life and your treatment more difficult! Do some research and talk to our Springfield, MA team about your oral piercings, and come up with a solution that’s best for your health and best for your smile.

Courting Disaster

January 18th, 2023

When we think of sports and dental damage, we naturally think of hockey and football. But when it comes to the actual number of dental injuries suffered each year, vying for top seed is the game of basketball.

How is this possible? After all, football and hockey are categorized as “collision sports”! But along with the helmets, shin guards, and padding, these teams quite often require mouthguards—and this makes all the difference. Studies have shown that an increase in the number of players wearing mouthguards means a decrease in the number of oral traumas.

And while basketball isn’t considered a collision sport, it is a contact sport. Basketball is a combination of running, jumping, hard surfaces, and solid bodies. And elbows. We can’t forget elbows. So a broken or even a knocked out tooth isn’t, unfortunately, all that unusual when bodies in motion meet hard surfaces—or other players. But there are other dental dangers as well. Besides tooth injuries, oral injuries can involve:

  • The ligaments and bone structures holding teeth in place
  • Bones in the upper and lower jaw
  • Delicate gum, tongue, and mouth tissue.

You need a solid defensive strategy to reduce the severity of oral injuries or to prevent them from happening altogether, especially when you wear braces. The best play in your playbook? Wearing a mouthguard!

Choosing the right guard is key. There are three common options, and you can choose the model which works best for you:

  • Stock guards, which are ready-made guards in pre-formed shapes and sizes. You can buy them over the counter in drug stores and sporting goods stores. Because these guards aren’t shaped to fit your teeth and mouth specifically, they can be less protective (and harder to speak around).
  • “Boil-and-bite” guards can also be purchased, and can provide a closer fit. After warming the guard in hot water as directed, you place it in your mouth and bite down firmly to mold it to your teeth.
  • Dr. Scott Smith can make you a mouthguard that is designed and crafted specifically for your use. Because this guard is custom-fitted, it provides better protection for your teeth and mouth. Patients often find custom guards much more comfortable and more durable as well.

Mouthguards are most effective when you wear them on the court and care for them off the court. This means avoiding a few flagrant fouls.

  • Dirty play

All those moist nooks and crannies inside your mouthguard are a perfect environment for bacteria, mold, and plaque buildup. You should clean your mouthguard carefully every time you wear it, and let it air dry before popping it back in the case. Ask Dr. Scott Smith for advice on getting your guard and its case their cleanest.

  • Failure to sub out in a timely fashion

Mouthguards don’t work if they’re damaged. If you notice any warping, breakage, or jagged or sharp edges, contact our Springfield, MA office for a replacement. If a guard doesn’t fit you properly, it doesn’t protect you, and sharp edges can irritate or injure delicate mouth tissue.

  • Unnecessary roughness

Your mouthguard protects you, so don’t forget to protect it! Keep your guard in its case when you’re not wearing it to save it from dirt, damage, and disappearance.

If you know your basketball, you know your guard game can make all the difference. Even though a mouthguard might not be mandatory on your team, that doesn’t mean it’s not essential. Remember that basketball is a contact sport, and protect your teeth, your mouth, and your braces with a mouthguard whenever you play.

Positioned for Success

January 11th, 2023

As you near the end of your orthodontic treatment, you’re probably already imagining the day when your brackets and wires finally come off. Or the moment you’ve finished with your last set of aligners. That day might come just a bit sooner if Dr. Scott Smith and our team recommend a positioner.

While not as well-known as other orthodontic treatments, a positioner is an appliance that can shorten your time in traditional braces and aligners by weeks or even months. Curious? Read on!

  • What Exactly Is a Positioner?

A positioner resembles a clear mouthguard. Its arched shape is designed to fit snugly over your teeth. It’s sometimes called a finishing appliance, because it’s designed to make those last small adjustments to your alignment and bite. If you’re a good candidate for a positioner, it can replace your braces or aligners for your last several weeks or months of treatment.

  • How Are Positioners Made?

This appliance is custom fabricated to fit your very specific orthodontic needs. Commonly, a mold is made of your teeth. A model of your teeth is made from this mold. Precision instruments are used to move the model teeth into your ideal alignment.

Once this model of your future finished smile is complete, it is used to create the positioner. When the thermoplastic material is molded to the model, it creates an appliance with an indentation for each individual tooth in its desired final location.

Available in a variety of materials, a positioner is most often designed as a clear single piece, covering both your upper and lower teeth. This makes sure that your teeth are not only aligned properly, but that your upper and lower teeth are working together for a healthy bite. Openings in the positioner provide airways which allow you to breathe easily.

  • How Do Positioners Work?

Because your teeth haven’t settled firmly into place yet (this will happen as you wear your retainer), they’re still able to move. That’s why your positioner is shaped to fit your teeth in their future ideal placement, not where they are at present.

Positioners require your active participation. Your teeth move to the ideal spots molded into the positioner through “exercise”—biting down on your appliance for 15-20 seconds before relaxing your bite, usually every 10-15 minutes during your daily wear. The gentle force provided by your jaw muscles helps guide your teeth into position more quickly. Dr. Scott Smith will give you instructions on just how to—and how often to—do these exercises.

  • How Long Are They Worn?

Positioners are commonly worn at least four hours a day to start with and all night long, or Dr. Scott Smith might recommend 24 hour a day wear for the first week. As you progress, you’ll wear them for shorter periods during the day, gradually tapering off until your treatment is complete.

Depending on the amount of correction that’s still needed, positioner use ranges from several weeks to several months. One thing that will ensure that your time in a positioner is as short as it can be is your willingness to follow our instructions. The speed and effectiveness of your final tooth movements is largely up to you!

  • Caring for a Positioner

Gentle treatment is best. Clean your positioner before and after wearing it using a toothbrush and mild toothpaste. Never boil it or expose it to heat. We will give you instructions for how to clean it more thoroughly, if needed.

Like retainers, clear aligners, and mouthguards, a positioner needs to be protected when it’s not in your mouth. Your positioner will come with a case, so be sure to use it!

Positioners aren’t recommended for every orthodontic patient. But if you feel this might be an option worth pursuing, talk to us when you visit our Springfield, MA office. A positioner could be an effective, time-saving step on your path to a lifetime of healthy smiles.

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