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Orthodontics and Implants

May 4th, 2022

Maybe you’ve wanted braces since childhood. Maybe you had them, but your teeth have shifted over time. Maybe you’re tired of living with an uncomfortable bite. Good news! If you’re not happy with your adult smile, that doesn’t mean you’ve missed the opportunity to have the healthy, attractive smile you’ve always dreamed of.

While there are many benefits to having orthodontic work done as a child, there’s a lot to be said for orthodontic treatment as an adult. After all, you know exactly what you want. You’re dedicated to following your treatment plan. You have plenty of discreet orthodontic options available now, from clear aligners to lingual braces, to make your treatment as inconspicuous as possible.

But, on occasion, adult treatment does come with some adult baggage. Worried about your crowns, fillings, or veneers? If these restorations are part of your dental history, we can generally work with them. Dental implants? Those might fall into a slightly different category.

Implants are a great way to restore your smile because they function like your natural teeth. They are designed to look just like natural teeth, and they allow you to speak, chew, and bite with confidence. Implants even stimulate the jawbone when we chew just as natural teeth do, helping to prevent bone loss in the jaw as we age.

But there is one important difference between implants and natural teeth: implants are firmly anchored in the jaw, while your natural teeth can change position.

Why is this a concern? Because tooth movement is one of the basics of orthodontic treatment. Unlike implants, our teeth aren’t firmly anchored in our jaws. They are held in their sockets by a ligament which cushions them and connects the tooth to the bone.

When braces or aligners gently apply consistent pressure to the teeth, the ligaments and eventually the bones holding the teeth reshape themselves in response to this pressure, and then become stable again during the retainer phase of treatment.

Implants, on the other hand, are crowns attached to a metal cylinder or screw that is surgically implanted into the jawbone. After several months, osseointegration takes place—which is a technical way of saying that the metal base fuses with the bone. This means that there won’t be any movement taking place—good when you’re chewing, but not helpful for realignment!

If you haven’t yet replaced a missing tooth with an implant, it’s often best to wait before starting orthodontic work. We can design treatment around a missing tooth, leaving room to accommodate an implant in just the right spot when your orthodontic treatment is finished.

If you have an implant already, the placement of your implant will help determine your treatment:

  • If your implant is already perfectly placed for your future alignment, braces or aligners can be designed to work with and around your implant.
  • If the placement is almost ideal, you might find a very small degree of misalignment acceptable, and we can plan your treatment around your existing implant.
  • If it’s not possible to work with your implant where it’s presently located, it is possible to remove an implant. You would then have the implant procedure redone after your orthodontic work is complete.

Talk to Dr. Todd Hamilton and Dr. Bryan Whitecotton about your treatment possibilities. By analyzing your orthodontic goals and working with your dental history, we can let you know exactly what can be done for your teeth and bite—even if you have an implant.

True, there are many benefits to having orthodontic work done in your childhood, but there’s a lot to be said for orthodontic treatment as an adult. And the greatest benefit of all? You’ll finally have the healthy, self-confident smile you’ve always dreamed of. Talk to our Denver, NC team about making that smile a reality.

Talking Over Your Underbite

April 27th, 2022

You’ve been told that you have a malocclusion called an “underbite.” Let’s look at just what this diagnosis means, and what it means for you.

Just what is an “underbite”?

A malocclusion is another way of saying that you have a problem with your bite, which is the way your jaws and teeth fit together when you bite down. In a typical bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth.

An underbite, on the other hand, results when the lower teeth and jaw extend further forward than the upper teeth and jaw, causing the bottom teeth to overlap the top teeth.

What causes an underbite?

Underbites tend to be genetic, and run in families, so, most often, an underbite is something you’re born with. The size of your jaws, the shape of your teeth, or both will affect your bite.

A smaller number of underbites develop because of injuries or early oral habits, such as prolonged and vigorous thumb sucking or tongue thrusting.

How do we treat an underbite?

Your treatment will depend on the type and severity of your underbite, and your age when treatment occurs.

  • Braces and Aligners

If your underbite is a slight one, caused, for example, by crowded or overly large teeth, braces or clear aligners can help move the teeth into proper alignment.

  • Functional Appliances

If the underbite is caused by a problem with upper and lower jaw development, devices called functional appliances can be used to help guide the growth of the jawbones while a child’s bones are still growing and forming.

If you’re a young patient, two appliances commonly used to help correct an underbite are palatal expanders, which gradually widen the upper jaw if it’s too narrow, and reverse pull headgear, which fits both inside the mouth and outside on the face, and provides a steady, gentle pull to encourage the forward growth of the upper jaw.

  • Surgical treatment

In some severe cases, surgical treatment can correct an underbite by reshaping the jawbone itself and positioning it further back to align properly with the upper jaw.

Why treat your underbite?

A serious underbite can cause damaged teeth and enamel, painful problems with the temporomandibular joint, headaches and facial pain, sleep apnea, difficulty chewing, eating, and speaking, and can affect confidence and self-esteem.

By following your treatment plan, you’ll not only prevent these consequences, but you’ll achieve major benefits—a healthy, comfortable bite, and an attractive, confident smile. Want to know more? Talk it over with Dr. Todd Hamilton and Dr. Bryan Whitecotton at our Denver, NC office for all the information you’ll need!

Retainer Hacks

April 20th, 2022

Even with the best of care, accidents can happen, and your retainer, unfortunately, is not immune. Of course, you need to visit our Denver, NC office ASAP if your retainer is damaged, but, in the meantime, there are some strategies you can use to help your teeth—and your retainer—stay as healthy as possible while you wait.

For Removable Retainers

  • When you notice any damage to your removable retainer—remove it.

Don’t wear a damaged retainer, especially overnight. You don’t want to damage it further, and you do want to avoid the possibility of choking if a retainer breaks while you’re sleeping. Dr. Todd Hamilton and Dr. Bryan Whitecotton and our orthodontic team are experts when it comes to deciding if your retainer is wearable, so always consult an expert before putting a suspect retainer back in your mouth.

  • Damaged Hawley retainer?

If you have a Hawley retainer—the traditional wire retainer—here’s some good news: a Hawley retainer can often be repaired if it’s not damaged too badly. Don’t try to fix your retainer yourself, and bring it into our office as soon as possible to see if it’s fixable.

  • Damaged clear retainer?

If you have a clear retainer, let’s start with the bad news: A clear retainer is not a repairable retainer. Cracks, breaks, warping—these injuries mean that a new retainer is in your future.

The good news is that materials for plastic retainers are available that are more durable than ever. This might be a good option for you to check out, especially if you suffer from bruxism, or tooth grinding, which can be very hard on clear retainers.

  • When you’ve just finished treatment with clear aligners . . .

It’s worth asking if your last tray can sub for your retainer until you have it repaired or replaced.

  • Ask us about over-the-counter mouthguards.

While you wait for a retainer repair/replacement, your teeth are at risk of shifting out of alignment. A customizable OTC mouthguard might reduce the chance of shifting, although it’s definitely not a long-term solution! We can let you know if this temporary fix is worth it.

For Fixed Retainers

If the wire retainer bonded to your teeth becomes loose, or if you notice your teeth shifting, you might need a repair or a replacement. This is a job for us. In the meantime,

  • When you have a broken wire . . .

If a broken wire is causing discomfort, check to see if you should flatten it or cover the wire tip with dental wax to protect soft tissues. Warm water rinses can ease irritation.

  • When your wire is broken or loose . . .

Stay away from chewy, sticky, and crunchy foods. You should be doing this anyway with a fixed retainer to keep it from becoming detached—and if it’s already loose, no need to make it more so!

  • Ask us about over-the-counter mouthguards.

Check to see if an OTC, customizable mouthguard is a good idea to keep your teeth from shifting if you can’t visit Hamilton and Whitecotton Orthodontics right away.

We started off by saying that accidents can happen even with the best of care. So you can imagine what can happen without the best of care. Keep your retainer in its case, keep it away from heat, don’t eat foods that can harm your retainer—all the precautions that make accidents unlikely to happen.

But if something awful befalls your retainer, call our Denver, NC office right away. Why aren’t we suggesting ways to fix your broken retainer with the supplies you have in your home toolbox? Because the best life hack of all for someone with a damaged retainer is to leave the fixing to a dental professional.

Which Retainer is Right for You?

April 6th, 2022

Brackets and wires, clear aligners, lingual braces, regular brackets, self-ligating braces, elastics, spacers—you and your orthodontist have had to narrow down a lot of choices to discover the best treatment for your orthodontic needs. Now that the end of treatment is in sight, there’s one more important choice left—your retainer!

Do I Need a Retainer?

No retainer at all is probably the one option that’s off the table from the start. It’s not just your teeth that have changed position; it’s the bone and ligaments holding them that have changed as well.

A retainer prevents your teeth from moving away from their new, ideal location while your bones and ligaments are stabilizing. This process takes months, so keeping your teeth in place as your bone rebuilds and regains density is crucial.

What Are Your Retainer Options?

Three of the most popular retainer options available at our Denver, NC office include:

  • Hawley Retainers

This is the traditional retainer, with wires to hold your retainer in place and to keep the teeth properly aligned. The wires are attached to an acrylic plate molded to fit the roof of your mouth or around your bottom teeth. You can customize the acrylic base with colors and patterns for a one-of-a-kind look.

Hawley retainers are adjustable, so minor realignments can take place if necessary. The wire in front of your teeth makes these retainers visible, but, after several months of wearing them all day long, you may end up wearing them only at night.

Hawley retainers are removable, so you need to make sure they are safely in a case when you’re not wearing them. Minor damage can often be repaired, but it’s better to be proactive.

  • Clear Plastic Retainers

These retainers look like clear aligners. They are formed by heating a thin piece of plastic and vacuum-forming it around a model of your teeth to create a custom, comfortable fit.

Clear retainers are almost invisible when worn, and can be removed when you eat or drink—which they should be, because food particles and liquids can be trapped inside them.

When you’re not wearing it, a clear retainer should always be in its case, because it must be replaced if the plastic is warped, cracked, or broken.

  • Fixed Retainers

A fixed retainer is a small single wire bonded to the back of specific teeth, commonly the six bottom front teeth. Because fixed retainers don’t allow the teeth to move at all, they are often recommended for patients who had serious misalignments, extremely crowded teeth, or teeth with large gaps between them.

Many patients like fixed retainers because they keep teeth in perfect alignment, they won’t be seen, they’re comfortably small, and they can’t end up in the cafeteria recycling bin because you forget to replace them after lunch!

Fixed retainers are usually quite durable, but you’ll need to pay attention to your diet, because crunchy and chewy foods can put pressure on the retainer and damage it. These retainers also require special care with brushing and flossing, to make sure the teeth bonded to the wire stay clean and plaque-free.

The Right Retainer

The process of stabilizing your teeth in the jaw takes time. Choosing your retainer will depend in part on how long and how often you need to wear it: fulltime for months or for years, at night after several months of day-and-night wear, or long-term to make sure your orthodontic work lasts.

And there are other variables, as well. Your retainer might need to be removable. It might need to be adjustable. You might need a retainer for just your upper teeth, just your lower teeth, or both. All these factors and more need to be taken into consideration before deciding on your ideal retainer.

Fixed, removable, wire, plastic, colorful, clear—which retainer is right for you? The one that helps you retain the beautiful smile you’ve worked for all these months. Talk to Dr. Todd Hamilton and Dr. Bryan Whitecotton to discover the retainer that will protect that smile for years to come.

(704) 822-0320