Our Blog

One of the most common reasons for getting braces is because there’s just not enough room for all your teeth to fit next to each other evenly. The result is overlapping and crooked teeth. What’s the first step in creating the space you need? Well, that depends on just how much room you need to align your teeth and bite properly.

When there is going to be a serious need for space, there are orthodontic solutions that can help, including palatal expanders, surgical options, and extractions. But if you only need a tiny bit of room so that regular braces will fit properly, we have a tiny solution—orthodontic spacers!

Why do you need to make space before you get braces? Because Dr. Allen Garai & Dr. Karen Tratensek might need to make some room around crowded molars so your braces can be installed properly.

For example, you might need orthodontic bands to anchor your braces. An orthodontic band is a slim, custom-fitted ring of metal which fits snugly around a molar. It is durable, provides a place to attach bands and springs to help correct malocclusions (bite problems), and can securely surround a tooth that might be weak because of a large filling. Spacers can separate crowded teeth just enough to allow a band to be fitted around a molar.

Even if you don’t need bands, sometimes separators are necessary to provide enough space between the teeth for your braces to work effectively. The back teeth tend to move even closer together with braces, and, without adequate space, bite problems, risk of decay, and other difficulties can arise.

And while you might think that some serious equipment is in order to make room between those sturdy molars, the typical spacer, or separator, is actually extremely simple--usually a tiny, round elastic band, often made of rubber. Spacers can be placed between tight teeth in a matter of minutes. Each ring is stretched and positioned between your teeth with a special tool. As it returns to its original shape, the spacer’s width provides just enough pressure on the teeth it touches to make a bit of space between them. And a bit of space is usually all you’ll need.

What do spacers feel like? For some people, they can be uncomfortable. You might feel soreness, some pressure, or as though a piece of food is stuck between your teeth. Ask us for suggestions on making you more comfortable, whether it’s dining on ice cream and cold drinks, eating soft foods, or taking over-the-counter pain relief. Separators are only designed to be in place for a very short period (usually under two weeks), but if they are causing you pain, give us a call.

What do you need to do to help the process along? Actually, it’s more what you need not to do. Don’t use dental picks or floss on your separators, avoid chewing gum, and take chewy and sticky foods off the menu. And don’t be tempted to touch or play with your spacers!

Spacers can create space between the teeth so quickly and efficiently that they often fall out on their own after a few days. If your separators fall out, give our Vienna, VA & Great Falls VA office a call. It could mean that you are ready for your braces, and on the way to a lifetime of healthy, beautiful smiles. And it’s a journey that begins with a tiny, springy step.

“Yes,” you’re thinking, “I shouldn’t be chewing sugary, sticky gum while I’m wearing my braces.” Or perhaps, “I should check with my orthodontist to see if this sugar-free gum is safe for my braces.” And these are both great thoughts—but today, we’re thinking about gums of a different sort!

While you’ve been taking care of your teeth with regular brushing and flossing, you’ve also been taking care of your gums. And now that you’re wearing braces, your gums need a bit of special attention to keep them their healthiest.

We tend to think of gum disease as an adult problem. In fact, periodontitis, or serious gum disease, is one of the most common chronic infections in the adult population. But young gums need care, too! Gingivitis, a milder form of gum disease, is unfortunately a common problem for both children and adults.

Gingivitis is an inflammation of the gums caused by the build-up of plaque and tartar. When plaque builds up, it irritates delicate gum tissue. And while gingivitis is not as serious as periodontitis, the symptoms caused by this disease are nothing to smile about:

• Redness
• Tenderness and soreness
• Swelling
• Bleeding
• Bad Breath

If you’re already feeling a little tender or swollen after an adjustment, the added discomfort caused by gingivitis is the last thing you want. But even worse, neglected gingivitis can lead to more serious infections of gum and even bone tissue. Luckily, gingivitis is both preventable and treatable with proper dental care.

So, how to protect your gums? We have some suggestions.

• Brushing Better with Braces

It can be hard to brush around your brackets and wires, but keeping these areas free of food particles and plaque makes for healthy gums—and fewer cavities! There are specially designed manual toothbrushes made for braces wearers, and tiny interproximal brushes that can reach tight spaces. Or, perhaps an electric toothbrush will do a better job for you. Just be sure to brush after each meal for the most complete removal of bacteria and plaque.

• Learn New Flossing Techniques

You might wonder how on earth you’ll get in between your teeth with your wires and brackets in the way. We have the answers! We know the best techniques for flossing your specific braces, and we’ll recommend specially designed flossing tools to make the job easier. Water flossers can also be a great help for cleaning in tight spots. Be sure to make flossing part of your daily routine—you’ll be able to remove plaque from places brushing just can’t reach.

• Rinsing? Recommended.

Talk to Dr. Allen Garai & Dr. Karen Tratensek about the best dental rinses for reducing plaque and tartar, or how gargling can help prevent irritation. And drink water! Water helps wash away plaque and bacteria, and is a great way to rinse teeth and braces if you absolutely can’t brush after eating.

• Keep up with Professional Cleanings

Be sure to keep up with your regular dental exams and cleanings. Your dentist or hygienist will be able to remove any plaque or tartar build up that home brushing can’t handle.

We want your time in braces to be as healthy—and comfortable—as possible. If you have any gum discomfort, swelling, or sensitivity, give our Vienna, VA & Great Falls VA office a call. With prompt action, gingivitis can be treated, and with careful attention to your cleaning routine, gingivitis can be prevented altogether. Something to think about!

From the time you were small, you’ve been warned about the dangers of plaque. Why? Because:

• It’s an unpleasant film that sticks to your teeth
• It causes cavities
• It causes gum disease
• It can cause extra problems when you wear braces

And really, do we need to know much more than this to motivate us to brush? But if you’re in a curious mood, you might be wondering just how this soft, fuzzy film accomplishes all that damage. Let’s take a closer look at the sticky problem of plaque.

How does plaque form?

We live with hundreds of species of oral bacteria, most of which are harmless, and some of which are actually beneficial. But when our oral ecosystem gets out of balance, problems can occur. For example, without regular and thorough brushing and flossing, we start to build up plaque.

Plaque starts forming within hours of your last brushing. And even though plaque fits the very definition of “seems to appear overnight,” this biofilm is actually a complex microbial community with several different stages of development.

• It starts with saliva.

Saliva is vital to our oral health, because it keeps us hydrated, washes away food particles, neutralizes acids in the mouth, and provides minerals which keep our enamel strong. Saliva also contains proteins, which help form a healthy, protective film on the tooth surface. This film is called a pellicle.

• Bacteria attach to the pellicle.

There are species of oral bacteria that are able to attach themselves to the pellicle film within hours of its formation. As they become more firmly attached, they begin to grow and divide to form colonies, and are known as the early colonizers of the plaque biofilm.

• A complex biofilm forms.

If you’ve skipped brushing for a few days (please don’t!), you’ll notice a fuzzy, sometimes discolored film on your enamel—that’s a thriving plaque community, and it only takes a matter of days to go from invisible to unpleasant.

If you’re not removing plaque regularly, it can harden further and become tartar. And once you have tartar buildup, you’ll need the care of a dental professional to remove it.

• What happens if we ignore plaque and tartar?

We get cavities and gum disease.

How does plaque cause cavities?

• The bacteria in plaque, like all organisms, need nutrients.

Our normal oral environment and the food in our everyday diets provide the nutrients plaque needs. And, as we mentioned above, certain types of oral bacteria convert these nutrients into acids. Foods such as carbohydrates, starches, and sugars are most easily converted into acids, which is why we recommend that you enjoy them in moderation.

• The biofilm promotes acid production.

Within the plaque film, anaerobic bacteria (bacteria which don’t use oxygen) convert sugars and starches into acids. As the plaque film becomes denser, it blocks acid-neutralizing saliva and oxygen from reaching these bacteria close to the tooth’s surface, creating an ideal environment for the bacteria to produce their acid waste products.

• Acids attack enamel.

The sticky nature of plaque keeps these acids in contact with tooth enamel, where, over time, acids dissolve minerals in enamel, weakening the mineral structure of the tooth.

How does plaque cause gum disease?

• Bacteria cause inflammation and gingivitis.

The bacteria in plaque irritate the delicate tissue of the gums, which causes an inflammation response which can leave your gums swollen, red, bleeding, or tender. This early form of gum disease is gingivitis. Fortunately, good dental care and careful brushing and flossing can usually prevent and even eliminate gingivitis.

• Plaque and tartar can lead to periodontitis.

When plaque and tartar build up around and below the gumline, the gums pull away from the teeth, leaving pockets where bacteria collect, leading to infection as well as inflammation. Infections and constant inflammation not only harm gum tissue, they can destroy the bone supporting the teeth. This serious gum condition is periodontitis, and should be treated immediately to avoid further infection and even tooth loss.

How does plaque affect orthodontic patients?

• Plaque collects around your braces.

Braces provide plenty of spots for plaque to hide from your brush. If you aren’t extremely diligent with your brushing and flossing, plaque collects near brackets, wires, and bands—all those spots that a brush and floss find difficult to reach.

• Plaque promotes demineralization

The demineralization process we mentioned above can cause white spots on teeth (decalcification), where minerals have dissolved. Sometimes these spots can be treated, and sometimes they are permanent. They can become quite sensitive, and may lead to cavities.

Careful brushing and flossing around your braces will help eliminate the plaque that can cause demineralization near brackets. Ask Dr. Allen Garai & Dr. Karen Tratensek about the tools and the brushing and flossing techniques which will give you the best results.

How do we fight plaque?

From the time you were small, you’ve learned how to fight plaque:

• Brush at least twice a day for two minutes, and be sure to brush all of your tooth surfaces and around the gumline.
• Floss to remove plaque from between the teeth and near the gumline.
• See your dentist as recommended for a thorough professional cleaning.

Be proactive. If you have any questions, talk to us at our Vienna, VA & Great Falls VA office about the best way to keep plaque at bay. We can show you the most effective ways to brush and floss, recommend anti-plaque toothpastes and rinses, even suggest plaque-revealing tablets if you’re missing some trouble spots.

We’ve only brushed up on some plaque basics, because there is a lot more to discover about this complex biofilm. Happily, even with all there is to learn about plaque’s growth and development, it’s reassuring to know that getting rid of it is quite simple—with just a soft-bristled brush, some dental floss, and a few minutes of your time each day, you’re on the way to a healthy, happy, plaque-free smile.

If you are a student of Speech or Drama, you know how important it is to be clear and articulate. You’ve worked on pronunciation and projection, and the audience in the back row can understand every word.

And now you’ve gotten braces, and, suddenly, you don’t sound quite like yourself. Why? And, more important, what can you do?

• Don’t Panic!

Many patients see no change at all in their speech after getting braces. With some orthodontic conditions or appliances, you might have problems pronouncing certain sounds, but these changes in articulation are usually quite temporary. 

• Why Are You Sounding Off?

Every consonant is formed in a precise way as tongue, lips, and teeth work together. If you have brackets and wires in the way, or just got a new retainer, or have a set of aligners, you might find that your articulation is a little off, especially for sibilant sounds such as S’s and Z’s. Luckily, we humans are a flexible bunch, and it usually takes a very short time for our tongues and mouths to adapt to orthodontic appliances and return to normal pronunciation.

If your speech is affected at first because your lips and cheeks are sore or sensitive after getting braces, take time to take care of yourself! Use wax as often as needed to cover irritating brackets and wires, eat foods that are low in salt, spice, and acids, and follow your orthodontist’s instructions for taking care of your mouth. You should start feeling better within a few days, and should be fine after a week or two. If pain or discomfort persists, call your orthodontist.

• Practice Makes Perfect

If you want to speed along the process of getting back to your normal pronunciation habits, practice! Read aloud, sing along to your favorite songs, recite lists of words with the specific sounds you want to work on. Oddly enough, to get back to your normal speech more quickly, slow down. Thinking before you speak is never a bad idea, and, in this case, thinking while you speak can help you position your tongue and mouth to verbalize tricky sounds more easily.

You don’t have to be a national debate champion or the world’s most blood-curdling Lady Macbeth to be concerned about clear speech. Talk to Dr. Allen Garai & Dr. Karen Tratensek during your next appointment at our Vienna, VA & Great Falls VA office if you find you are having problems with pronunciation. Whether your appliance needs an adjustment, or you need a few suggestions for speech exercises, or it’s simply a matter of time, soon you’ll be back on the road to perfect pronunciation—and on the way to your perfect smile.