Our Blog

By and large, the human body is a marvel of symmetry. But, of course, no one is perfect. You might have noticed one ear is a bit higher than the other. That you wear a shoe a half-size bigger on your left foot. That one shirtsleeve always looks longer.

Or that your smile looks off-center. This dental asymmetry could be caused by a condition known as “midline misalignment,” and, unlike that left foot, you can do something about it!

The dividing line between our center teeth, upper and lower, is called the midline. If we draw an imaginary line down the middle of a face, from the forehead to the nose to the midpoint of the chin, that line should go right between the front teeth. When it doesn’t, because the teeth have shifted past the midpoint, it’s often due to a condition called midline misalignment.

This kind of misalignment, also known as a deviated midline, can have several causes:

• Baby teeth that are lost too early

Baby teeth do more than promote healthy eating and speech development. They also reserve space for permanent teeth. If a primary tooth is lost too early, permanent teeth might “drift” to fill the empty space, causing the midline to move as well.

• Thumb sucking that goes on too long

As a child gets older, and certainly when by the time permanent teeth start to arrive, aggressive thumb sucking can lead to numerous orthodontic problems, including a deviated midline, as the teeth shift in response to that continuous pressure.

• Missing adult teeth

When you lose a tooth through decay or trauma, or when an adult tooth simply never develops, the remaining teeth can shift over to fill the open spot.

• Spacing issues

Crowded teeth, teeth with significant gaps between them, very large teeth, very small teeth—all of these issues can affect spacing and midline alignment.

• Crossbite

A crossbite is a kind of malocclusion, or bite problem. When you have a crossbite, the teeth don’t fit together properly, with upper teeth fitting inside lower teeth, instead of aligning on the outside where they belong. A deviated midline can indicate a posterior crossbite, where the top back teeth slant inwards or fit inside the bottom back teeth.

A tiny bit of midline shift one way or the other might be nothing to worry about, but if one front tooth is literally the center of attention, or if your teeth are noticeably out of alignment, it’s a good idea to talk to our Vienna, VA & Great Falls VA orthodontic team.

Because there are several potential causes for midline misalignment, Dr. Allen Garai & Dr. Karen Tratensek will carefully analyze your individual situation to determine where the problem lies: with the teeth, the bite, or, rarely, the jaw itself.

Dr. Allen Garai & Dr. Karen Tratensek will also offer you your best dental treatment options. A shift of a few millimeters might be treated with clear aligners or traditional braces. A crossbite could require braces or aligners coupled with elastics (rubber bands) to bring your bite into alignment. A palatal expander can help correct a serious crossbite.

Why visit Garai Orthodontic Specialist because of a little asymmetry? Because a deviated midline is more than a cosmetic concern. If you have a malocclusion to begin with, or if your misalignment leads to changes in chewing habits, which cause new bite problems, you might be facing jaw pain, chipped and cracked teeth, headaches, and all the other unpleasant consequences of malocclusion.

By and large, perfect symmetry in life is unattainable. But if you want a smile that is well-balanced and healthy, talk to us about all the treatments available to make sure your smile—and not a single tooth—is the center of attention.

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. Allen Garai & Dr. Karen Tratensek 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. Allen Garai & Dr. Karen Tratensek 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 Vienna, VA & Great Falls VA 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.

Wearing braces during your treatment at Garai Orthodontic Specialist presents some unique challenges in the types of food you can safely eat. The wrong items can be difficult to remove from between your teeth and the appliance. Other foods may even break or loosen your braces.

Dinner recipe ideas

Lasagna is a great dinner choice because it provides you with several food groups in one easy dish.

• 1 ½ pounds ground hamburger
• 1 garlic clove
• 1 tsp. basil
• 1 pound diced tomatoes — canned is fine
• 12 oz. tomato paste
• 1 package of dry spaghetti sauce mix for seasoning
• 10 oz. box dry lasagna
• 3 cups ricotta or cottage cheese or 1 ½ cups each mixed
• ½-cup Parmesan cheese
• 2 eggs
• 1 pound sliced or shredded Mozzarella cheese

Brown and drain your hamburger meat. Dice the garlic and simmer the hamburger, garlic, basil, diced tomatoes, tomato paste and powdered sauce mix for ½ hour.

Cook the lasagna noodles as directed on the package and drain.

Beat the eggs and combine them with your ricotta or cottage cheese.

Layer ½ of the noodles in a 13 x 9 pan. Spread ½ of your cottage cheese mix on top of the noodles, then layer ½ of the mozzarella on top. Finish this layer with ½ of your hamburger mix. Repeat the layering with the other half of your ingredients. Bake at 350 F for 30 minutes.

Meats

You can enjoy ribs and chicken wings as long as you cut the meat from the bone before you eat. The same rule applies to turkey legs; do not gnaw on bones, because this can damage your braces.

Vegetables and fruits

You still need to include fruits and vegetables in your daily meals. Skip corn on the bob, whole apples, and raw carrots. Broccoli is soft but particles can become stuck in your braces, so be sure to brush and floss after your meal.

Desserts

Avoid caramel, taffy, and hard candies for dessert. Pudding and ice cream are fine, but low-sugar versions are best.

Remember that your mouth will be sore after adjustments with Dr. Allen Garai & Dr. Karen Tratensek. Stick to softer foods until the sensitivity is reduced. Please do not hesitate to ask our team for recipe and meal ideas. We will be happy to take the time to explain which foods items are the best choices and why.

If you have any questions about these recipes, or if you have any questions about eating with braces, please give us a call at our Vienna, VA & Great Falls VA office!

The month of May has the unique distinction of being National Teen Self-Esteem Month. What does that mean?

National Teen Self-Esteem Month was created to raise public awareness about how low self-esteem can negatively affect teens. Especially during May, parents and guardians of teens are asked to be positive role models. If teens can receive positive re-enforcement and their negative images of themselves are improved, then their self-esteem has a better chance of developing in a positive direction.

Dr. Allen Garai & Dr. Karen Tratensek and our team at Garai Orthodontic Specialist know there are a lot of young adults living in America are struggling with depressed self-images. These can affect all aspects of their everyday lives. Some evidence shows learning abilities and increased risk of eating disorders can originate in a teen’s low self-esteem. It can also lead to abuse of drugs and thoughts of suicide. Dating violence among high school teens is now more common than previously thought.

What can be done to help?

So what can adults do specifically to help their teens? The National Teen Self-Esteem Facebook page offers a variety of suggestions and positive messages for teens and parents alike. Of all the pages your teen “likes” on social media, perhaps he or she should include this page. Some of the tips offered include:

1. When you stumble, get right back up.
2. Don’t compare yourself to anyone else.
3. Do things that make you feel good about yourself.
4. Open yourself up to compliments.

Another great way to build self-esteem is to have a beautiful, health smile, and that’s where our team at Garai Orthodontic Specialist come in! Whether your teen is due for a simple cleaning, could benefit from cosmetic treatments, or needs orthodontic care, we can help bestow a confident smile he or she will be proud to show off.

Overall, a more positive approach to life will help us all. It is a very important trait to instill in our teens. As parents, a big part of our responsibility is to show our children there is always another day and bumps in the road are just that. We need to help guide their self-esteem and reinforce their positive traits. We can help them recognize the value of who they are.

We should make our children’s self esteem a priority — not just in May, but throughout the year. Let National Teen Self-Esteem Month serve as the impetus for new levels of self-esteem.

For more information on this topic, or to schedule an appointment with Dr. Allen Garai & Dr. Karen Tratensek, please give us a call at our convenient Vienna, VA & Great Falls VA office!