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Posts for: March, 2015

By Jeffery J. Johnson & Jodi B. Johnson DDS
March 23, 2015
Category: Dental Procedures

Early Intervention Some childhood problems are easily recognized by parents and caregivers, such as learning disabilities or hearing impairment. But orthodontic issues, those involving the alignment of the teeth and jaw, often go unnoticed until several of the permanent teeth have already come in. Experts urge parents to take their children to a family dentist for an orthodontic screening no later than age 7. If your child has just recently started losing baby teeth at that age, you may be wondering, "Why so early?" Here are the facts:

Still Growing

As a parent, you're probably amazed at how quickly your kids grow out of clothing and shoes. You're not just imagining it - between the ages of 2 and 12, children grow at an average rate of 2 to 2 1/2 inches per year. The same rapid growth applies to the facial bones that support a child's teeth. This is why seeing your St. Louis dental professional is so important - with the bones still flexible as they grow, their pattern can be monitored and a plan for treatment can be devised if necessary. This doesn't necessarily mean your child WILL need treatment; establishing a baseline and keeping track of the progress is necessary to make that determination.

Certain Conditions

While most modern orthodontic work begins around ages 9 to 14, there are a few growth problems that need to be corrected as early as possible. Some children have a crossbite, a condition where the upper teeth are situated behind the lower teeth. A retainer worn on the upper back molars, called a palatal expander, gradually widens the upper jaw. This is a painless procedure that is carried out over a period of weeks, and patients become accustomed to the feel of the expander in their mouth within a few days.

Children with severe crowding, where the small size of the mouth is not relative to the size of the teeth, may also benefit from early intervention with a palatal expander. Some patients may need one or more teeth extracted to allow more space for the adult set to come in. Braces may be necessary later, but they will likely be worn for a shorter duration.

Bad habits

Thumb sucking is a common habit that sometimes begins prior to birth. Although this reflex is natural, if the habit is carried out beyond age 3, it can result in the teeth shifting and the jaws to change shape. This can cause the orthodontic abnormality known as "open bite," in which the upper and lower teeth do not meet in the front. Mouth breathing can also cause the upper and lower jaws to grow out of sync with each other, resulting in a multitude of potentially severe orthodontic problems.

With adult molars coming in around the age of 6, early detection of problems with growth or mannerisms can mean avoiding expensive, lengthy and often painful treatments later in life. Your dentists in St. Louis encourage you to take advantage of the opportunity they provide with early orthodontic screening.


By Jeffery J. Johnson & Jodi B. Johnson DDS
March 17, 2015
Category: Oral Health
Tags: oral hygiene   orthodontics  
WhiteSpotsonYourTeethAfterBracesMayBeAnEarlySignofEnamelLoss

After months of treatment we’ve removed your braces and your new smile emerges. Upon closer view, however, you notice a number of chalky white spots on your teeth.

These pale areas are white spot lesions (WSLs), the result of mineral breakdown from the long-term contact of acid with the enamel surface. The underlying cause is built-up bacterial plaque due to inadequate oral hygiene, and as such WSLs are the beginning stages of tooth decay.

While anyone can develop WSLs, brace wearers are highly susceptible because of the extra care required to clean around orthodontic hardware. Poor dietary habits such as frequent snacking on sugary or acidic foods and beverages also increase the risk of WSLs.

To reduce the risk of developing this condition, brace wearers must give extra attention and effort to daily oral hygiene, including brushing and flossing. The extra effort required in brushing can be aided by specialized toothbrushes designed to clean around brackets and wires, along with prescription-level fluoride toothpastes for added enamel strength. Floss threaders or a water flosser, a device that uses pulsating water under high pressure, may help you maneuver around hardware to remove plaque between teeth. It's also important to maintain a healthy mouth environment by limiting intake of sugary or acidic snacks and beverages, avoiding tobacco or excessive alcohol or caffeine, and drinking plenty of water to keep your mouth from drying out.

If you’ve already developed lesions, it’s important to stop the decay process before it causes more damage. One way is to assist your body’s natural mechanism for re-mineralizing tooth enamel with fluoride pastes or gels or re-mineralizing agents, or undergoing micro-abrasion to repair a tooth’s surface.

To improve a tooth’s appearance a procedure known as “caries infiltration” involves injecting a liquid tooth-colored resin into the lesion, which is then hardened with a curing light. The spot becomes less noticeable and appears more like normal enamel. For extensive defects, conventional bonding with composite resins or porcelain veneers can be used to cosmetically cover the tooth.

Getting ahead of the problem with effective oral hygiene and good dietary and lifestyle practices will keep WSLs at bay while you undergo orthodontic treatment. If they do develop, however, there are ways to minimize their effect and restore the look of your teeth.

If you would like more information on dental care during orthodontic treatment, please contact us or schedule an appointment for a consultation.


By Jeffery J. Johnson & Jodi B. Johnson DDS
March 06, 2015
Category: Dental Procedures
Tags: celebrity smiles   braces  
DwightHowardABrightNBAStarWithaSmiletoMatch

Have you started orthodontic treatment recently? Are you having a little trouble getting used to your braces? If so, you are not alone: Everybody goes through an adjustment period during which they momentarily wonder if they’ll really ever get used to this. Don’t worry — you will! And we’ve never heard anyone say, on the day their braces come off and their new smile is revealed, that they aren’t glad they went the distance. Just ask Houston Rockets all-star center Dwight Howard, who discussed his own orthodontic treatment in a recent interview.

“I’m sure I was no different than anyone else who has ever had braces,” he told Mediaplanet. “At first I hated them so much… That changed once I got used to them and I actually grew to love them.” What’s Howard’s advice? “Do exactly what your orthodontist says and know that the outcome is well worth it in the end.” We couldn’t agree more! Here are some tips for wearing braces comfortably:

  • Hard & Chewy Foods: If you love fresh fruits and vegetables, that’s great; there’s no reason to give them up, just the really hard ones. You don’t want to bite into an apple or carrot or any other hard foods like bagels and pizza that have any “size” to them. Small pieces may be ok as long as they can’t bend your wires. Chewy, sticky candy should really be avoided completely. Same with soda, sports drinks and so-called energy drinks because they contain acids that promote tooth decay and can cause a lot of damage around the braces.
  • Effective Oral Hygiene: Keeping your teeth clean is more important than ever, but also more challenging than ever. It’s easy for food to get stuck under wires and around brackets, but failing to remove it can cause tooth decay, gum irritation and soreness. Therefore, the cleaner your teeth and your braces are, the healthier you will be. Use interdental cleaning brushes and/or a floss-threader to get behind your wires. A mouthrinse can also help strengthen teeth and keep bacteria in check. If you have any questions about how to clean between your teeth, please ask for a demonstration at your next visit.
  • Pain Relief: Some soreness at the beginning of orthodontic treatment is normal. To relieve it, you can use an over-the-counter pain reliever and/or a warm washcloth or heating pad placed on the outside of the jaw. If brackets or wires are rubbing against the inside of your cheeks or lips, try applying wax to these areas of your braces. If this does not offer enough relief, we may be able to trim the end of a poking wire. Call us if you need help with this.

Our goal is to make your orthodontic treatment as comfortable as possible on the way to achieving your all-star smile. If you have questions about adjusting to braces, contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Caring for Teeth During Orthodontic Treatment.”