Invisalign Braces and Justin Bieber

Teen sensation, Justin Bieber used clear removable aligners called “Invisalign Teen” to straighten his teeth. Invisalign aligners are worn for 20-22 hours per day and each aligner moves teeth about 0.25 mm. Since the movement is so subtle, the amount of discomfort is minimal. The movements are prescribed by your doctor and the aligners are manufactured by Align Technology. These aligners are only removed when eating or brushing your teeth providing Teens with an alternative to unsightly metal braces.

Unlike the traditional metal braces, you can eat relaxed without the worries of breaking brackets or wires. That means that you do not have any dietary restrictions. Cleaning your teeth also is less challenging since you can simply remove aligners to brush your teeth normally.

Another huge benefit is that with no wires there is also is no chance of poking cheeks or irritating lips. This usually leads to fewer visits to the orthodontist since emergency appointments are rare.

If you play contact sports, you can wear your aligners under a properly fitted mouthguard to protect your teeth from being injured during practices or games.

Like Justin Bieber, many teens want to have straight beautiful teeth, but do not want to have the nickname “metal mouth”! Teen Invisalign delivers results as good as or even better than traditional braces. The good news is that you do not have to be a “Teen Idol” to have Invisalign. The cost of Invisalign is about the same as metal braces and if you have orthodontic insurance, it will cover Teen Invisalign.

Tongue Piercing: What you need to know!

Certain types of body piercing have existed continuously since ancient times. Today, in most cultures, body piercing has become more acceptable in the general population than ever before in history.

Tongue piercing is especially popular with teens and young adults. Tongues are typically pierced by running a needle through the front third of the tongue, from top to bottom. Mouth jewelry, in the form of a removable stud, hoop or barbell-shaped device is inserted through the hole. No systematic research has been done on the after effects of tongue art, so it's impossible to say how likely it is that there will be complications from a tongue piercing, however, the American Dental Association officially does not support piercing in or around the mouth because of the potential for serious side effects. Negative effects from the piercing process or from wearing the jewelry can include pain, post-placement swelling, prolonged bleeding, gum injury, permanent numbness, loss of taste and oral hygiene problems. More serious side effects include speech impediments, injury or shrinkage of gums, damage to teeth, fillings, and other dental work, difficulty chewing or swallowing, cysts and prolonged blood loss immediately after the procedure. Infection is always a possibility - after all, you're creating an open wound in your mouth! - and includes the risk of contracting hepatitis, HIV and AIDS.

Tongue piercing also can result in an allergic reaction if the metals used in the jewelry are not of the highest quality. And even if the highest quality metal is used, all metal jewelry can injure the one thing that cannot easily be replaced, the beautiful enamel of your teeth. In a study done by a prominent university, of young adults who had worn a barbell through their tongue for at least 4 years, 47% had chipped teeth. Some studies show that the repeated bumping of the jewelry against teeth and gums causes gums to recede, setting the stage for periodontal (gum) disease.

However, if despite the warnings, you're still planning on having your tongue pierced, make sure it is done as hygienically as possible. Make sure your piercer is experienced and licensed and works in a sterile environment with sterile, disposable instruments. Ask your dentist for advice on oral hygiene while the piercing is healing, including advice on brushing to avoid inflaming the tongue, and use of mouthwash to clean areas that your toothbrush cannot reach. If you have a heart defect or a health condition that requires that you take preventive antibiotics before dental work, DO NOT under any circumstances, have a piercing done without seeing your doctor or dentist first. The needle inserted through your tongue during the piercing process opens your bloodstream to bacteria, which can lead to a life-threatening infection in your heart. Also, be sure to get regular dental check-ups. Whether you have a tongue piercing or not, a thorough examination of your gums and teeth are needed to identify problem areas or potential long term dental health concerns.

Bruxism: The Grinding Truth

Most people refer to bruxism as "grinding" the teeth. When you "brux", you tightly clamp your top and bottom teeth together, especially your back teeth. Many people who clench also grind their teeth at the same time. Grinding is when you slide your teeth over each other, generally in a sideways, back-and-forth movement. Many people clench and grind their teeth during the day, but the nighttime bruxing is of most concern, because it is harder to control and can lead to eventual jaw, tooth and gum damage.

Experts don't agree on what causes bruxism. Some researchers believe that it's caused by a bite that is not correctly aligned, while others believe it is a central nervous system disorder. Children frequently exhibit bruxism behaviors in response to pain and discomfort of illnesses such as colds, ear infections or allergies. An additional concern with children is their increased intake of acidic and carbonated drinks which can accelerate the damage caused on teeth.  In adults, excess intake of alcoholic beverages may affect their level of grinding and clenching, and stress is also a huge factor in bruxing.  Many experts believe it's a combination of these and other problems and that different people brux for different reasons.

Almost everyone "grinds their teeth." The problem is the degree of bruxing. Some people only grind their teeth a bit and show few symptoms, but for those who brux frequently and over a period of many years, the effects on teeth and the surrounding structures of gums and bone can be severe.

The pressure that you can apply to your teeth can range from 100 to 600 pounds per square inch! Severe bruxism can result in wearing or breaking of teeth, sensitive or loose teeth, receding gums, loss of supporting bone around the teeth, bony ridges in the gums, cheek irritation, sore muscles, headaches, earaches and TMJ (temporomandibular jaw) dysfunction.

If you or a family member shows signs or sounds of bruxism, ask us for an evaluation. An examination will rule out other disorders, that could be causing the symptoms. Once a diagnosis is made, the goals of treatment are to ease pain, prevent damage to teeth and surrounding areas, and reduce bruxism behavior as much as possible.

To prevent damage, we may recommend undergoing orthodontic treatment (braces). Aligning the teeth and placing them in their correct positions allow occlusal forces to be directed down the long axis of the teeth and distributed to surrounding tissues. This tends to relieve or reduce bruxism. Although this will reduce occlusal trauma, the reduction in bruxing may be temporary and may re-appear after treatment is finished.  Alternatively, we may prescribe an appliance, such as a splint, for you to wear at night. Appliances may protect teeth from the pressure of clenching and may even reduce clenching, however some patients find that it does not make their bruxism better and may even make it worse. There is no one cure-all for bruxism, so it may take a team effort between you, Dr. Luis and your dentist to find the cure for your problem.

Just remember that bruxism is not a dangerous disorder and that with conscious effort and professional help, you can prevent damage to your oral and overall health.

Waterloo Orthodontist on Invisalign G4

Invisalign is proud to introduce Invisalign G4, the next generation of SmartForce clinical innovations engineered to deliver even better clinical results. Nothing is more important to Dr. Luis than delivering great results for his patients. That is why this weekend Dr. Luis attended the 1st Annual Canadian Invisalign Summit held in Toronto.  

 

Present at the Summit was John Morton, Align Technology’s Director of Research and Technology, who provided an inside look at the new features of Invisalign G4. This presentation covered how the principles of biomechanics have been applied to deliver the clinical innovations in Invisalign G4.  These new features include applying two force systems to one tooth or creation of moments. This is accomplished by attachments and/or pressure points, where one feature will counteract the negative forces caused by the first. They are supposed to allow for simultaneous movements such as extrusion and rotation, as well as translations.

This next-generation SmartForce clinical innovation, Invisalign G4 is expected to provide the much-needed solution to some significant treatment challenges faced by the doctors.  Invisalign G4 will help enhance open bite treatments, more predictable movement of upper laterals and improved root control for canines and central incisors.

In recent times, Align has undertaken several strategies to improve adoption of Invisalign. These include acceleration of product and technology development and extension of clinical effectiveness. Several orthodontists are now able to treat almost any orthodontic problem with clear aligners. This is becoming a great alternative for moving teeth, not just for patients not willing to wear braces, but for all orthodontic patients.

Which Toothpaste is Best for You?

Thanks to better care and technological advances, more people than ever before are keeping their teeth throughout their lives. The most important thing you can do to make sure you're one of those who keep their natural teeth is to brush and floss regularly, especially if you have braces!

Most dental decay is caused by plaque, a sticky, colorless bacteria that is constantly forming on your teeth. Saliva, food (especially sugar) and fluids combine to produce plaque, which collects on teeth and where teeth and gums meet. Plaque that is not removed by regular brushing and flossing can harden into tartar, a crusty deposit that can only be removed by a dentist. Plaque also leads to gum disease, a potentially serious infection that can erode bone and destroy the tissues surrounding teeth. Flossing removes plaque between teeth, and brushing removes plaque from the large surfaces of the teeth and, if done correctly, from just under the gums.

With brushing being such an important factor in your oral health, you can see why your choice of a toothpaste is important, but with so many brands and types - plaque control, tartar control, whitening, gum care, sensitive teeth, polish, smoker's - from which to choose, picking the right toothpaste can be a daunting task. Your dental professional can help narrow the field by discussing what your special brushing needs are.

If you tend to build up plaque or tartar quickly, you'll want a plaque or tartar-control toothpaste. Anti-plaque/tartar toothpastes will have ingredients such as fluoride and/or antibacterial agents to limit plaque and tartar formation. Ask Dr. Luis or your dentist before choosing fluoride toothpaste for your young children. Excessive fluoride ingestion by pre-school age children can lead to discoloration of the permanent teeth. If your child uses fluoride toothpaste, make sure she/he does not swallow toothpaste while brushing.

If you smoke or drink tea or coffee, a whitening toothpaste may help with stains. However, whitening toothpastes only remove adherent stain. The ingredients necessary to actually bleach your teeth are not chemically stable enough to be included in toothpaste. Use caution with those toothpastes made to remove heavy stains, frequently referred to as "smoker's toothpaste" or "tooth polish". These toothpastes may be excessively abrasive and may cause progressive wearing away of the tooth and supporting tissues. (Also, if you smoke, be sure to see your dentist regularly, as smokers are at increased risk of gum disease, early tooth loss and also soft tissue conditions including oral cancer.)

Temperature sensitive teeth will benefit from a toothpaste made to desensitize your teeth. Your needs may change as you age, so don't be surprised if your dental professional recommends a type of toothpaste you haven't used before.

Once you've determined which type of toothpaste is best, choose the one that tastes and feels best and doesn't cause irritation or sensitivity problems. If you like the flavor and texture of your toothpaste, you'll brush more and longer. And brushing well and regularly means you'll be smiling with your natural teeth well into your mature years.

Adult Braces: It's Never Too Late To Improve Your Smile!

Braces aren’t just for kids anymore. Tooth alignment can be changed at any age if your gums and bone structure are healthy. We offer a variety of treatments that are designed for different age groups – including adults. A new smile can begin today.

Orthodontic treatment at later stages in life can dramatically improve your personal appearance and self-esteem. Improving the health of your teeth and gums is equally important. Crooked teeth and a bad bite can contribute to gum and bone loss, tooth decay, abnormal wear of the tooth enamel and surfaces, headaches and jaw joint (TMJ/TMD) pain.

Good news! The new techniques and appliances we use greatly reduce discomfort levels, decrease the frequency of visits, shorten treatment time and may allow you to choose from several options. Your options may include metal braces, translucent braces or transparent aligners that can be worn to improve mild cases of misaligned teeth.

During the initial examination, Dr. Luis will be able to determine the best possible treatment for your individual needs. During this initial examination, we can outline the treatment plan, time of treatment expected and the approximate cost.

A large percentage of our patients are adults, and they agree that it’s never too late to improve their greatest asset – their smile.

Indirect Bonding: Improving the Braces Experience

RiteBite Orthodontics uses an indirect method of positioning your braces properly on your teeth, ultimately creating an ideal smile for you. Indirect bonding results in an increased level of precision, leading to ideal results much faster than you would with traditional methods. Traditional application of braces involved a long appointment, placing the braces on the teeth one at a time, directly in the mouth. The old method of placing braces directly on the teeth, one at a time, while the patient is in the dental chair is prone to inaccuracy and errors due to the inability to directly view the teeth properly and patient movement.

How does it work?

Once you have decided to proceed with orthodontic treatment, an appointment is arranged to take very accurate impressions of your teeth. The impressions are then poured and a model representation of your teeth is produced. The model of your teeth, allows Dr. Luis to examine your teeth from every angle imaginable, for precision positioning of your braces. Dr. Luis then positions your braces on your tooth model.


What does treatment with indirect bonding mean to you?

With the indirect bonding system, the top and bottom braces are placed as a single unit, rather than tooth-by-tooth, resulting in a much shorter and pleasant appointment the day you receive your braces. The treatment results generated by this method enable exceptional accuracy when positioning braces, because Dr. Luis is able to fine tune bracket placement with unmatched precision. Because of increased accuracy, patient cases using indirect bonding progress much faster than usual, meaning less time in braces and patients also have to undergo fewer adjustment appointments. This means less disruption to your everyday life.

Imagine No More Dental Impressions!

Millions of impressions are taken each year for the fabrication of orthodontic models and appliances. Orthodontic offices take a number of these “patient hating” procedures on a daily basis. A new system is now available that creates digital free impressions of a patient’s teeth.

The iOC Scanner, a digital orthodontic impression system powered by iTero, ensures a more accurate impression from the start, which results in improved orthodontic treatment.

The iOC scanner will eliminate the need to take physical impressions of a patient’s mouth. Instead of taking oral impressions which is one of the most anxiety producing procedures for patients undergoing orthodontic care, we will soon be able to use the iOC scanner which employs laser technology to capture accurate images of the mouth, doing away with the traditional messy impression. Imagine no goop, gagging or discomfort!

The iOC Scanner is the product of Cadent, now a part of Align Technology. It scans the mouth with a radiation-free laser and in six to eight minutes renders a digitally perfect, 3-D impression of the teeth and soft tissue structures. The iOC Scanner can be used for any orthodontic treatment including traditional metal braces and clear aligner-based orthodontic systems and it is the only product that can be used with Invisalign.

RiteBite Orthodontics, one of the top invisalign providers in the Waterloo Region with practices in Cambridge, Waterloo and Listowel, continues to embrace cutting edge orthodontic technology. If these scanners prove to be as accurate as they claim, you can rest assured that we will be one of the first offices to bring this technology to the Waterloo Region.

Essix versus Hawley Retainers

Both Hawley and Essix type retainers are commonly used by orthodontists. The traditional type is the Hawley retainer, which includes a metal wire that surrounds the teeth and keeps them in place. Named for its inventor, Dr. Charles Hawley, the wire is anchored in an acrylic arch that sits in the palate (roof of the mouth). The advantage of this type of retainer is that the metal wires can be adjusted to finish treatment and continue moving teeth as needed.  The Essix retainer is a vacuum formed retainer. This is a polypropylene or polyvinylchloride material, typically .020" or .030" thick. Essix is a brand name many dental offices are familiar with. This clear or transparent retainer fits over the entire arch of teeth and is produced from a dental mold. Is there any difference between these two type of retainers related to stability and patient acceptance?

A recent prospective study by Kumar and Bansal (2011) compared the effectiveness and acceptability of Essix and Hawley retainers.  The study consisted of 224 patients who had undergone comprehensive orthodontic treatment. The results showed that there was, no clinically significant differences in stability and irregularity, when the two types of retainers were compared. They also found that Hawley retainers were more acceptable for biting and Essix retainers were more acceptable for appearance and comfort.

So what can we take away from this? Basically, that your Essix retainers work just as well as traditional retainers but they are more comfortable and you will probably be more pleased with your appearance as well!


Kumar AG, Bansal A. Effectiveness and Acceptability of Essix and Begg Retainers: A Prospective Study. Aust Orthod J 2011; 27 (May):52-56.

Setting your Child up for Success: Parent's Involvement in the Beginning of Orthodontic Treatment

Parents want the best for their children. The best education, the best career, being successful, happy, and of course, having a healthy and beautiful smile.. When your child gets braces, this can be a very exciting experience for the child, the parent, and in some cases, the entire family.

Parents think back to the way that dentistry used to be when they were kids, which was not that enjoyable in some cases. Dentistry and Orthodontics are constantly changing.  We want our patients to LOVE coming to see us, and we are proud to say that most of them do!

Some children need their parents to accompany them into the clinical area, but in most cases, the child is a lot more comfortable during the visit if their parents are not present. There are a number of factors to consider when preparing for the first visit or what is more commonly known as the “braces on” visit:

1.     Most children adapt very well to new surroundings and new things. Children are often at ease immediately upon entering the clinic because the staff at Orthodontic offices all love children and do an excellent job of highlighting the fun parts of the appointment and explaining the procedure in a kid-friendly and fun way. Parents try their best to prepare their children for the first visit, and although they mean well, parents can often dishearten their children based on the way they describe braces to their children. Parents often don't know the particulars of the appointment and end up unintentionally highlighting the wrong things when describing the “braces-on” visit. For example “Don't worry, it won't hurt.” Children immediately think “Should I worry, is this going to hurt? Why would he/she say that?”

2.     Parents are very interested in the braces-on procedure. They often don't intend to ask questions, but sometimes they can't help themselves and what ends up happening is if the parent comes in for the first appointment, the clinician's energy is divided between answering the parent's questions and the child. It is very important that your child is the clinician's number one priority during this time. At the end of the visit, there is time set aside for all questions and discussions about the new braces. It is in the best interest of your child that all questions are held until the end of the appointment in order to be as attentive as possible to the child, and focus on him/her as the number one priority throughout the appointment.

3.     When parents are in the operatory during the braces-on visit, this can also have a negative effect on the child's experience for one very important reason. Parents think that when they come in for their child's visit, they are being supportive. What they don't realize is that when their child is lying back in the chair, they can't see what is going on around them. As soon as the parent attempts to be soothing to the child (i.e. Holding the child's hand or touching their leg), the child interprets this as a situation where they should be afraid, like something scary is going to happen next that they can't see yet, so they can start reacting to this with things like crying, etc, that perhaps would have not happened if the parent was out in the sitting area.

4.     Many contemporary dental offices have open-concept operatories. This has been proven to ease the nerves of patients, especially children because they can see other patients around them at ease during their visits. With the open-concept set up, it is great when the parent comes back with them to watch them get started, then after a few minutes, wander back to the sitting room. The parent is more than welcome to come and check on their child every once in awhile.

In summary, the braces-on visit can be really fun and exciting for your child. After reading this information, try acting and speaking in ways that will positively affect them. During the visit, try leaving the room for most of the visit while “checking back” every once in awhile. This way, your child is at ease because they know you are around if needed, but the clinician is able to focus their energy solely on your child. When explaining braces to your children, try to use really positive and fun descriptions.  Tell them what the braces will do and if you do feel the need to inform your child about the braces-on visit, use descriptions like “It's like crafts, they have to use a special glue to stick on the braces, I hear it's really fun!”

Kids love braces these days, and with your help, all aspects of Orthodontic treatment can be fun and exciting for your child!

Jennifer Stretch, RDH
RiteBite Orthodontics

Tips on Removing your Invisalign Aligners

Are you breaking your nails taking off your invisalign trays? Or, are you getting so frustrated that you don’t even want to take them off? If you answered yes to any of these questions, don’t panic! We are going to share a few tricks that we have shared with our patients and even some that our patients have shared with us that will make removing your Invisalign trays a lot easier. Here we go…

Start at the back. We always recommend starting to remove your aligners from the back and usually on the tongue side of the dental arch. First, lift the aligners off the molars on each side of the mouth, then gradually work towards the front. Some patients prefer to remove from one side of the mouth to the other. If you choose to use this approach be careful to not use too much force since it can lead to aligner breakage.

Start away from attachments.  Lift off easier sections of the tray and leave tougher areas for last such as, crowded areas and areas with several attachments. So if a specific area is too difficult try another area until gradually the whole aligner is off. When you reach those areas, lift tray out and over the attachment

Use a paper towel. Several of our patients have sworn that using paper towels increase the grip on the aligner allowing them to grasp the aligner firmly thereby allowing them to pull the trays off the molars. This might not work for every patient especially if they have several attachments. However, if you try this approach, it is helpful to keep your mouth as dry as possible.

Use an Outie. An outie is an invisalign removal tool although it is not provided by Align Technology.  It looks similar to a crochet hook and is designed specifically for removing clear braces by hooking under the edge of the aligner and lifting it away from the tooth. They are especially helpful for people with attachments. If your orthodontist does not provide you with them you can find them online (http://www.shop.outietool.com/). 

Try changing aligners at night: Similar to wire changes during braces, new aligners are going to feel tighter (if they didn’t then your teeth would not move!). For this reason, some patients prefer to insert new aligners prior to going to sleep. The rationale is that your teeth will get adjusted over the course of the night making them easier to remove in the morning.  Additionally, the discomfort is more tolerable if you are sleeping and not thinking about it. However, if they keep you up at night, you may want to reconsider this approach or take a mild painkiller to get your through the night.

Removing aligners gets easier with time: Initially, if you try to remove your new aligners, you will find that it is quite challenging. Be patient as your teeth adjust and you will notice that the aligner becomes much easier to remove the longer you wear it. So wherever possible, try to hold off removing your trays.

Hopefully you will find success with one of the above tips. However, if all else fails, do not forget to stay calm. Take a deep breath and relax. Removing your aligners gets more difficult when you panic and become frustrated. Good Luck!

How to keep your Invisalign aligners clean

A quick rinse and gentle scrub with a soft bristle toothbrush is a good idea after eating.  This is a good habit to get into and will prevent unpleasant odours from developing. Although a toothbrush is recommended, we suggest staying away from using toothpaste since it tends to be abrasive.  Such abrasion results in tiny scratches providing a breeding ground for bacteria. We recommend using a mild dishwashing soap such as Dawn instead. If brushing and rinsing alone is not effective in removing unpleasant odours, soak your trays in mouthwash for a few minutes while you brush and floss your teeth. This will help your trays and mouth stay fresh and clean!  Failure to clean your trays on a regular basis will result in your aligners looking foggy and murky. It is this build up that is responsible for these unpleasant smells and if left long enough, it becomes very difficult to remove.

A more thorough cleaning once a week with a retainer (Retainer Brite) is also recommended. Leaving trays in a bath for 10 minutes usually allows for a thorough cleaning and neutralizes any offensive smells. Remember to rinse under water and give trays a quick scrub with a soft bristle toothbrush after removal from bath. If you are looking for an effective but more economical home-made option, you can soak your aligners in diluted vinegar or hydrogen peroxide solution which is mixed with 50% water.

Lastly, your Invisalign cases need cleaning too. When you remove your aligners they often have excess saliva that can easily be transferred to your case. After a few days, these cases can turn into a science project! Giving them a good rinse daily can solve this problem. As with the Invisalign aligners a gentle scrub with a soft toothbrush can help them stay hygienic.

It is also a good idea to sterilize your Invisalign aligners before storing them. As you finish with each set of trays, sterilize them using a denture cleaner and place them back in the re-sealable bag in which they arrived. If you need to reuse them for any reason at a later date they will be clean and ready for use.

When is the best time to begin orthodontics?

This is a question we are asked often and it is a good one!  Although seeing an orthodontist can enhance a smile at any age, there is an optimal time period to begin treatment. Beginning treatment at an early age ensures the greatest result and the least amount of time and expense. The American Association of Orthodontists recommends that the initial orthodontic evaluation should occur at the first sign of orthodontic problems or no later than age 7. 

By the age of 7, the first adult molars erupt, establishing the back bite. During this time, Dr. Luis can evaluate front-to-back and side-to-side tooth relationships. For example, the presence of erupting incisors can indicate possible overbite, open bite, crowding or gummy smiles. Timely screening increases the chances for an incredible smile. 

Early evaluation provides both timely detection of problems and greater opportunity for more effective treatment. Prudent intervention guides growth and development, preventing serious problems later. When orthodontic intervention is not necessary, Dr. Luis can carefully monitor growth and development and begin treatment when it is ideal.

You can request a complimentary consultation with Dr. Luis and he can answer all your questions about your child’s orthodontic treatment.

Invisalign: Are You Getting Your Money's Worth?

When seeking Invisalign treatment, price should not be the deciding factor.  Considering who is going to do your Invisalign treatment should be a key consideration.  As with any procedure, it's essential to find an experienced doctor that you can trust. 

 

An orthodontic specialist will typically charge slightly more for an Invisalign case than a general dentist will  because orthodontists specialize in straightening teeth and correcting bites. Furthermore, orthodontists undergo three additional years of training after the required four years of dental school.  This fact is important when comparing fees for Invisalign treatment in the Waterloo Region, since fees can range anywhere from $4,000 to $7,000. Therefore, if you are comparing Invisalign prices, it is important to factor in whether it is a dentist or an orthodontist who will be doing your Invisalign treatment.

If you decide to have an orthodontist help you with treatment, something else to be aware of is that not all orthodontists are equal, especially when it comes to Invisalign. Many orthodontists decide against treating patients with Invisalign because they are not familiar with this technique and are more comfortable treating patients with braces. Before making your decision, ask your provider if they are Premier or Elite providers.  Alternatively, visit www.invisalign.com to locate the right provider.  
You want to make sure that you select an Invisalign provider that has achieved a significant level of experience in treating patients with the Invisalign system.

Treatment price will also be affected by the complexity and the duration of your treatment. If your case requires more than just straightening your teeth, it is worth the extra cost to get those problems also resolved. These could include functional issues like how your teeth come together or if they are in their proper positions.  Many of these issues can be resolved with Invisalign treatment by an experienced provider as well, although it may be more involved and of course, more expensive. So, if you are told that you cannot be treated with invisible aligners, always seek a second opinion.

Finally, after you select a dental professional, you might then wonder why the cost of Invisalign, even if it is by the same doctor, will frequently be $500-$1000 more expensive than braces treatment.  The higher cost reflects the lab fee that the dentist or orthodontist must pay for the Invisalign trays. This may not be necessarily the case at all offices but if it is at the office you attend for a consult, you will now know why there is a difference in cost.

In the end, we recommend you take your time to search for an experienced Invisalign provider if you are seriously considering being treated with invisible aligners. As with any investment, always remember that if it sounds too good to be true, it usually is.

The Flip Side of "Experience"

Being a younger professional, it is not uncommon to have a patient ask your staff “how much experience does the doctor have?” or “how long has he been in practice?”  One would think that after twelve years of post-secondary education, not only would you have the knowledge and experience necessary to treat patients but more importantly, you would have earned the respect and trust from patients as it relates to your skills and ability. However, when you step back, you begin to understand that asking about experience is not an unusual question and that perhaps, you would ask the very same question if it were you or your own child seeking treatment. It makes sense that doctors practicing for a number of years, have in all likelihood seen it all and know it all. However, can too much experience be a bad thing? Is 15 years really better than 5 years?

One of the dangers of having too much experience is getting caught up in one school of thought or following a particular ideology. This is quite common when it comes to the medical and dental profession. Often we hear, “I’ve been doing it this way for years, and that’s the way it is supposed to be done!” Most professionals undergo extensive training which is great. The problem arises when the training becomes outdated and in a way, not practical. If you consider that most textbooks are several years old by the time they go into print, and that most professors are older veterans, you quickly realize that many of the techniques learned during a professional’s training, although proven, are usually outdated and may not be the most practical by today’s standards or expectations. 

The advantage of “not having as much experience” means that you are not set in your ways and that you most likely have not developed strong opinions or old ways of doing things just because “that’s how they’ve always been done”.  I guess the point is that it requires a certain kind of naivety to think outside the box and a certain amount of confidence to try taking risks to better our patient’s treatment and experience when under our care.

So the next time someone tries to sell you on experience...think twice or better yet, make sure to get a second opinion! 

What are Invisalign Attachments?

When our patients are treated with Invisalign, Dr. Luis always reviews the need for using attachments. Attachments are small tooth-colored bumps of dental bonding material that are bonded to surfaces of selected teeth. The idea is that the placement of the attachments provides an anchor point on teeth around which an aligner can firmly grasp. This allows the aligner to direct its forces to the tooth more effectively than it would otherwise be able to do. Imagine trying to pull a door open without a handle or a door knob. 

Does this mean that all your teeth will have attachments? No. An attachment might be needed in those instances where a particularly difficult type of tooth movement is required (such as tooth rotation or pulling a tooth up/down). An attachment might also be needed in other situations but Dr. Luis will best determine this on a case by case basis. 

Placing of attachments is similar and as easy as bonding brackets (braces). This procedure is painless and does not require any needles. We receive a plastic template from Invisalign that essentially looks like any other Invisalign tray but has small bulges on it that we can fill with bonding material. The template is then seated over the teeth and after the bonding material is set, the tray is removed leaving behind the attachments on specific locations of selected teeth.

Attachments, in most cases, are not visible to others.  However, their visibility will depend on where they are placed, if you consume large amounts of food or drink that have staining properties (e.g. wine, coffee, tea) and how well the color of the bonding material actually matches the color of your teeth. Even in cases that require attachments on patient’s front teeth, these are not as noticeable when wearing trays which patients are encouraged to wear 20-22 hours per day. In instances where attachments do become heavily stained, you can always request to have them replaced.

Removal of attachments occurs at the end of your Invisalign treatment and it is easily removed with a dental drill that only removes bonding material (i.e. does not scar enamel) and the surface of the teeth is then polished so that the glue on the teeth is completely buffed off. 

So don’t panic when it comes time to get your attachments on or off. It is a simple and painless procedure that is a beneficial part of your treatment and makes your final orthodontic outcome that much better!

Choosing a Mouthguard

Mouthguards vary in terms of cost, comfort, and effectiveness. The ideal mouthguard is durable, resilient, and comfortable. It should fit properly, be easy to clean, and should not affect your ability to breathe or speak. Here are some facts to consider when choosing a mouthguard:

• Stock mouthguards are typically the least expensive. They offer some protection, but they do not grip the teeth, and it can be difficult to keep them in place unless you bite down on them constantly.
• Boil-and-bite models fit more closely around the teeth and this makes it easier to keep them in place. However, when you bite into the hot mouthguard to give it the right shape, you reduce the thickness of the device. This, in turn, may reduce the level of protection.
• Custom-made mouthguards are the most expensive, but they have a better fit, which means better protection and more comfort.

Our mouthguards are pressure laminated custom mouthguards which represent leading-edge technology in custom protection. Each mouthguard is produced by pressure-forming multiple layers, shaped separately over a customized mold of the athlete’s teeth. With controlled thickness offering protection in areas where it is needed most, our mouthguards also offer superb durability with a tight, comfortable fit.

If you or your children wear braces or other fixed orthodontic appliances, it is especially important to have a mouthguard that fits properly. Otherwise, a blow to the mouth can damage the brackets and wires of the braces, and can also cause added damage (cuts and tears) to the soft tissue inside your mouth.  

Mouthguards are a smart investment because they provide valuable insurance against injuries that could cost much more in the long run in - not only in financial terms, but also in terms of time and suffering. Protect your winning smile with a mouthguard when you take part in activities that pose a risk of injury to your mouth.

If you would like to find out more about our mouthguard clinics, please check our website (www.ritebite.ca) or email us at info@ritebite.ca.

Health Canada  (www.hc-sc.gc.ca)

Braces or Invisalign?

When we tell are patients that they can be treated with Invisalign, many are surprised to find out that they don’t need braces to straighten their teeth. Dr. Luis always explains that “teeth do not discriminate between metal or plastic. They just know that they are being moved by forces, that if applied correctly will allow them to move in a certain direction.”  However, Dr. Luis will always evaluate a patient to determine if their orthodontic problem can be best treated with braces or Invisalign. What most people and even many dental professionals are not aware of, is that there are several situations where Invisalign actually provides a better option than braces.

Invisalign can be used to correct many orthodontic problems such as crowding, spacing, deep bites, open bites, crossbites, Class II and Class III malocclusions and even cases that require extractions or surgery.

Invisalign trays are not only more comfortable than braces, they are also removable. This allows patients to brush and floss their teeth without the obstacles of wires and brackets. This also allows you to eat the foods you love that may be forbidden with regular braces.  Additionally, you avoid the discomfort that braces may cause which can include poking wires, mouth sores, and other trauma caused by broken appliances.

Of course, the reason our patients like Invisalign so much is because most people don’t even realize that you are going through treatment since they are practically invisible. And even if a special occasion requires that you remove the trays, go ahead and place them back in when it is over. Can’t get much better than that!  

So if you live in the Waterloo, Cambridge or surrounding areas and are considering straightening your teeth, whether with regular braces or invisible ones, come see us for a complimentary consultation.

What's growing on YOUR retainer?

A study out of UCL Eastman Dental Institute found that insufficient cleaning of your retainer could lead to the growth of potentially pathogenic microbes. Samples from the mouths of people without retainers were compared to those wearing retainers. The study looked for microbes which are not normally found in the oral cavity, with particular interest in Candida (a type of yeast) and Staphylococcus (including MRSA). These researchers found that species of these microorganisms were present on 66.7% and 50% of retainers, respectively, regardless of the retainer type. These microbes were also present on the interior cheeks and tongue of retainer wearers.

Candida and Staphylococcus rarely cause problems in healthy individuals, but are potentially highly problematic in people with a compromised immune system. The bacteria on the retainers live in biofilms, which are communities of bacteria living together covered in a layer of slime. Once these biofilms form, they are very difficult to remove and often have high levels of resistance to antimicrobials.

The researchers advised that retainer hygiene is of the utmost importance in preventing transmission of these microbes. So don’t forget to wash your hands before and after handling your retainers, rinse them every time you remove them, brush them regularly and soak them occasionally in mouthwash or retainer cleaning solution.

 

Newsbites. Orthodontic Products, March 2011

Is Invisalign Teen different from Invisalign?

For the most part, Invisalign has always been considered a method of treating adults. However, with the launch of Invisalign Teen, we now can provide the same advantages of Invisalign treatment to our teenage patients in the Waterloo, Cambridge and surrounding areas. 

Invisalign Teen has several features that are different from Invisalign. One of these features includes its ability to allow for partially erupted teeth (teeth that are not all the way through the gum tissue) to now be included as part of treatment. Previously, teenagers were only considered a candidate for Invisalign if all their permanent teeth were present. This is no longer the case.

A second feature is its compliance indicators. Since Invisalign is a removable appliance, it is different from traditional braces which are used to treat the majority of teenagers, since these are glued to the teeth for the length of treatment. Therefore, Invisalign treatment was considered an unsuitable treatment option in the eyes of most orthodontists for teens.  To work effectively, a patient needs to wear their aligners 20-22 hours a day. Invisalign Teen introduced compliance indicators, which are colored indicators that fade with use, allowing your orthodontist to gauge if the appliance is being worn the required amount of time.

Finally, Invisalign Teen also provides up to six free replacement aligners should they be lost or broken. This was in recognition that teenagers may not be as responsible as adults. However, since the launch of Invisalign Teen, research has shown that there has been no significant difference between teenagers and adults when it comes to losing trays.

If you are a teenager and are considering improving your smile but don’t want a mouth full of metal, contact an orthodontist who is a specific Invisalign Teen designated provider and who specializes in using Invisalign for teens in the Waterloo, Cambridge and surrounding areas.

Braces and Teeth Whitening

Tooth whitening, also known as tooth bleaching, is used to brighten the shade of teeth. Tooth whitening procedures attempt to remove extrinsic stains. Extrinsic stains are found on the surface of the enamel layer and can usually be removed by having a professional cleaning. Stains that are not removed will begin to penetrate deeper layers of enamel and tend to be more difficult to remove. It is these persistent stains that may still be removed by teeth whitening procedures.


If you have braces or are thinking of getting braces, you should consider having your teeth whitened after your orthodontic treatment is complete, that is when your braces are removed. This usually results in a more esthetic result.

If whitening is done prior to having your braces placed, it is difficult to distribute the whitening gel evenly on teeth that are crooked resulting in different shades and overall dissatisfaction. If teeth whitening is done when the braces are still on, not only is it difficult to do, but after your braces are removed, you will notice darker areas where the whitening gel could not penetrate your teeth under the braces.

Regardless of what stage you are at with your orthodontic treatment, before you start whitening your teeth, consider speaking with your orthodontist. It is also recommended that you have your dentist check your teeth and gums. Whitening a cavity or exposed root could penetrate deep into your tooth and cause sensitivity. Patients who already have sensitive teeth may also experience increased sensitivity.

Braces? But I still have baby teeth!

D-Gainer stands for Damon space re-gainer. It is a gentle way of re-gaining space and arch width as the first step of treatment in 9-11 year olds.

The D-Gainer is also known as a limited fixed appliance. Basically, it comprises of Damon orthodontic brackets placed only on permanent front teeth and permanent first molars.  Initially, just the front teeth are aligned during the first couple of visits so that stronger wires can then be placed connecting the front teeth to the back teeth. Light nickel titanium springs are then placed on either side to gently expand the arch. These appliances are used primarily to create additional space to allow for the eruption of the permanent canines (eye) teeth when it is determined early that it won’t be possible for these teeth to fit into the dental arch. 

The D-Gainer also gently widens the dental arch which also generates space. The appliance can be used in both arches or just the upper or lower arch. This system of treatment has been shown to  produce more physiological acceptable forces and, in many cases, has replaced the use of palatal expanders. When deemed necessary, it is used as the first step to placing full Damon braces on the teeth. This approach is usually started in the 6-12 months preceding the eruption of the adult eye-teeth. This is often around 9 1/2 to 11 years of age. However, this has to be assessed in each individual case. D-Gainers would not be used when all of the teeth have already erupted and more commonly a full set of Damon braces would be chosen at that time. 

With this in mind, Dr. Luis will normally plan for D-Gainer treatment if it appears that the ability for the canine teeth to eventually erupt into the arch is questionable and possible impaction of the canines will result. In many cases, it is fairly clear that if nothing is done, extractions will be required at a future time at the least, or worse, the permanent canines may become impacted and need surgical intervention to be brought into the arch with or without extractions of permanent bicuspids. The duration of this type of early treatment is normally 12 months.

Waterloo Cambridge Orthodontist on Invisalign

Invisalign (Align Technology, Inc.) is a series of clear trays that are worn on crooked teeth to gradually straighten them.  When worn, Invisalign trays are practically “invisible,” unlike regular braces.  Not only are they more cosmetically pleasing than traditional orthodontic braces, Invisalign is also a more popular option because they are generally more comfortable than braces.  The trays are smooth and will not irritate your lips and cheeks like traditional braces can. This in turn results in less visits to your orthodontist since you will never have nagging issues like poking wires and broken wires or brackets.
 

Invisalign trays are removable, so you can remove the trays when eating and do not have to worry about walking around with food particles stuck between your braces.  The trays are also removed for brushing and flossing and, if need be, for special occasions.  The best part is that you can enjoy your food! Eating with braces can be challenging, especially early in treatment.

Invisalign trays are required to be worn for 20-22 hours per day.  Each set of trays moves the teeth a small amount (~0.25mm) until they are straight.  Typically there are 10-50 sets of upper and lower trays, and each set is worn for two weeks before proceeding to the next set.  Therefore, treatment can take anywhere from 5 to 24 months, depending on the complexity of the case, and how well the trays are worn.  Invisalign can be used to correct most orthodontic problems.  

Dr. Luis is the only Premier Preferred Provider of Invisalign in the Waterloo-Cambridge Region, which places him in the top 5% of all Invisalign providers in North America. Contact us for a complimentary Invisalign consultation and have Dr. Luis explain why Invisalign is a good choice to straighten your teeth.

Gum disease...try salmon!

An article in the Journal of American Dietetic Association revealed that DHA, an omega-3 fat found largely in fish oil, may lower the risk of periodontitis, a chronic inflammation of the gums that leads to gum and bone loss and eventually tooth loss.

They studied 9,182 adults aged 20 years and older who participated in the National Health and Nutrition Examination Survey between 1999 and 2004. Periodontitis was assessed by dental exam. Intake of n-3 fatty acids was assessed by 24-hour dietary recall. The survey included approximately 9,000 people who were examined for gum disease.

The results revealed that those who consumed some DHA were about 20 percent less likely to have periodontitis, than those who reported consuming none.  The results also showed a weaker link for another major omega-3 fat in fish called EPA and no link between alpha-linolenic acid, which is an omega-3 fat found in soy, canola and flax oil.

These findings only demonstrate an association between periodontitis and DHA. Further experimentation will be required involving people who are at risk or have periodontitis to actually see if DHA is effective at reducing the risk of periodontitis.

For now it is still recommended that you have 2 servings of fatty fish a week for other reasons such as lowering your risk of heart disease.

J. Am. Diet. Assoc. 110(11):1669-1675, 2010.