Marshfield dentist, Dentist in Marshfield, MA

Stainless Steel

This is the most durable and hygienic appliance material. It does not stain or rust and under normal eating and chewing conditions the material is predictably strong and serviceable. The braces that one sees on most front and side teeth are brackets. These brackets are attached to the teeth usually using a bonding material similar to what your dentist uses for fillings. A wire fits into each bracket on each tooth thereby connecting all the teeth of the upper jaw or lower jaw together. By adding tiny elastics onto the brackets the wire resting in the bracket is made secure so that the teeth can be moved in the desired directions. The tiny elastics can be any of several colors or plain silver to match the stainless steel appearance.

Clear

These aesthetic appliances are often recommended in adult treatment situations. Where appropriate these aesthetic appliances provide predictability, control, convenience and cost benefits. Because their strength is less than stainless steel they cannot be used in some locations of the mouth.

Invisible Aligners

Because of the huge advertising campaign which launched these products several years ago it is not surprising for eager patients to express interest in this service. Patients should be aware that the advertised messages one hears on television stress the benefits of orthodontic care fails to prevent to the consumer an understanding of its limitations. That is to say these aligner devices are not to be used for young children and growing adolescents. They cannot be used where there is excessive crowding or orthodontically challenging malocclusions, in particular where there are skeletal growth imbalances of the jaw.

Often the fees associated with clear aligners are surprisingly high when one realizes the product cannot accomplish for a large number of patients the kinds of growth guidance and tooth movement that so many patients need to have corrected.

Currently most of the clear aligners being used in the United States are being inserted by practitioners who are not trained orthodontists. While many orthodontists are willing to offer the use of aligners in their practices I think it is more important for potential patients to understand what can and cannot be accomplished using these pre-manufactured customized plastic aligners.

For many patients the choice of a clear aesthetic fixed appliance is an excellent option when one compares issues of predictability, detail, control, convenience and cost with the expectations of aligner treatment outcomes.

Elastics

Rubber bands are sometimes worn during part of your orthodontic care. Unless instructed otherwise they must be worn all the time except during meals or when a mouthguard is being worn. Failure to follow these directions will severely limit their effectiveness and this will prolong your orthodontic care needlessly. Replace elastics several times a day and do not allow yourself to run out. We can even mail them to you if you cannot stop by to get what you need. This is important to know and to practice.

Factoid:

Dr. Judge personally designs and shapes every wire that you will need. These are not standard or average sizes and shapes but customized to your mouth for comfort and effectiveness. In all instances the wire is specifically made for each patient and fit in place by Dr. Judge

Pain Control

Although patients new to Orthodontics frequently wonder if treatment is painful the fact is that Dr. Judge will make certain that you are comfortable at every appointment. Note that every single band and bracket intended for your mouth is personally fit and applied by Dr. Judge. There should be nothing that is painful and that is why we do not need to do "shots" or other kinds of anesthesia. However, it is normal that teeth will be moving following your appointments. This movement can be uncomfortable at times so it could be necessary with the approval of an adult that mild analgesics like Ibuprofen or aspirin or Tylenol by used.

A bent or broken piece of your appliance's may rub and irritate the cheek, lip or gums. To get relief and assist healing be sure to use the wax we have given you. Just use a small amount to cover the part of your appliance near the irritated area. The Orabase ointment we have give you may also provide relief and promote healing.

Appliance Problems

If something is loose or broken it may be helpful to cover the wire, band or bracket with wax. This will reduce irritation to your lip, tongue or cheek. Don't forget about using the Orabase ointment in such instances.

Sometimes a tie wire may loosen and move out of position thereby coming in contact with your lip or cheek. You may be able to push it back into position using the eraser end of a pencil.

Headgear or removable appliance problems will require some refitting and/or repair so be sure to promptly call for an appointment.

Spacers

If a spacer comes out it may be necessary to replace it. It depends on a number of factors so it is important to call the office for guidance.

Swallowed Appliance

Usually these items pass through the intestines uneventfully. However, if it results in difficulty breathing you may need medical attention.

Emergencies

True emergencies requiring attention after office

hours are rare. If this occurs please call the office for instructions.

Headgear

For some patients the evening use of headgear is extremely important for completing treatment on time. Not only does it contribute to the movement of teeth but also to re-shaping the manner of one's jaw growth. It makes actual changes in the shape and balance of the growing face.

The metal part of the headgear (face bow) must be slowly but gently inserted so as to avoid bending it or breaking the brace that it slides into. Remove the headgear with care so that there can be no injury to the mouth, face, or eyes.

Always disconnect the metal face bow from the strap before trying to slide it out.

• Never lift the headgear over your face.
• Never wear the headgear outside the house or when other people are around. Wearing the headgear indoors in the presence of close family members who understand the proper care and rules of headgear wearing should be free of any problems.
• Never engage in physical activities when wearing the headgear.
• Never wear your headgear to sleepovers or overnight camps.
  
  

Factoid:

Please bring your headgear to the office at every appointment. This way it can be adjusted or checked frequently as needed.

Retainers

Retainers are necessary once braces are removed. Teeth are by nature able to move in the surrounding bone, even after orthodontic care. To insure the stable positioning of your teeth after active treatment it is necessary to wear retainers as instructed by Dr. Judge.He will tell you how long to wear them so that the teeth may not move unfavorably (relapse).

Your retainers require brushing after meals.The occasional use of denture cleaner may be helpful but the brushing it still necessary. Use a gentle pressure with the manual toothbrush but do not use an electric toothbrush to clean them.

Remember to use your plastic retainer case whenever the retainer is out of your mouth.Then re-insert the appliance promptly after meals have been completed.

Bite Problems and Their Correction

Orthodontic problems affect a substantial percentage of the population both children and adults.These bite problems or malocclusions vary considerably and are the result of unfavorable growth and/or development as it affects the dental and facial features.

Genetics and environmental factors bring about the orthodontic problems. For us to properly diagnose and treat your needs we must follow the procedures discussed earlier under the headings of records appointment and consultation appointment.

Timing for Orthodontic Treatment

At Marshfield Orthodontics Dr. Judge strongly supports the recommendation of the American Association of Orthodontists that at seven years of age is an ideal time for a young patient's first orthodontic evaluation. Even when no treatment may be appropriate it is a great time for Dr. Judge to assess the child's dental development, growth characteristics, facial features and oral hygiene.

For a number of patients orthodontic needs may be uncertain or at any early age. In other situations treatment might best be deferred until a later age. In either situation we routinely schedule periodic recall update appointments on a no charge basis so that the ongoing growth and development for these patients can be monitored regularly. When there is a need for actual treatment Dr. Judge can advise you when is an appropriate time for the treatment to begin. The time for rendering orthodontic care will vary from patient to patient, sometimes quite dramatically due to individual variations. So the advantage of seeing the orthodontist for an initial visit at age seven is entirely appropriate given that so many gradual changes occur from this point on.

We find that a large number of significant aesthetic bite problems can be averted or mitigated for patients during this regularly monitored recall arrangement. Sometimes by age twelve, after following a patient over a series of office visits, we can happily inform the parent(s) that no orthodontic needs remain and no treatment is indicated.

However, you can be assured that all important findings will be explained to you should there be the need to pursue corrective care.

Factoid:

Early treatment will only be recommended for thoes patients with special problems that need to be improved well ahead of the loss of all primary (baby) teeth. These treatments can be expected to be of relatively brief duration. Sometimes early treatments will be the only treatment needed but in some instances it is wise to plan in future years that a second course of orthodontic care should be planned.

Whether an adolescent or an adult with questions Dr. Judge encourages you to call for an initial orthodontic evaluation. Sometimes there are combinations of important bite problems that need to be treated. It may be helpful to ask yourself if any of these factors concern you:

1. limitations of ability to chew properly

2. eating is difficult, jaws experience discomfort

3. a smile that could be more attractive

4. edges of teeth that are flat (because of unusual tooth contacts)

5. bone loss or gum disease

6. protrusive or retrusive front teeth

7. crossbites

8. open bite

9. deep bite

10. spacing or crowding of teeth

11. missing teeth

12. impacted teeth