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You’ve decided—now’s the time to talk to Dr. Allen Garai & Dr. Karen Tratensek about straighter teeth and a better bite. So what’s holding you back? If you are concerned because you have a missing tooth, don’t let that stop you from making that first appointment. Orthodontists today have many options to help you achieve the benefits of a more attractive, and even healthier, smile.

How can we accommodate a patient with a missing tooth or teeth? Because each patient is different, our approach will be tailored to your specific needs.

A Lost or Missing Permanent Tooth

There are a number of treatment options available, depending on the position of your other teeth.

• If your teeth are already crowded, it might be possible to close a small gap left by a missing tooth with braces.
• If the space between your teeth is the perfect size for a replacement tooth, your orthodontic appliance will keep that spot open as your braces move the rest of the teeth into alignment.
• If you need more space for a replacement tooth, braces can help widen the space between your surrounding teeth for an ideal fit.

Tooth loss can occur for a number of reasons. Accidents, decay, and gum disease can lead to tooth loss.  Congenitally missing teeth, teeth that simple never developed, are also a fairly common condition. But missing teeth are not merely a cosmetic issue, and should not be ignored. A gap in your smile can lead to shifting of the teeth around it, bite problems, difficulty chewing, and gradual loss of bone tissue beneath the missing tooth.

Today’s implants are a permanent, natural-looking replacement for a lost tooth. If you decide that an implant is your best option for tooth replacement, you are still a candidate for orthodontic treatment. Dr. Allen Garai & Dr. Karen Tratensek and your oral surgeon can decide on a schedule that will provide the best timing for each phase of your treatment.

A Lost Baby Tooth

Finally, let’s not forget younger patients. Sometimes children benefit from orthodontic care before all of their adult teeth have erupted. If your child has lost a baby tooth too early, a space maintainer can be used to prevent shifting and misalignment of the remaining baby teeth and leave room for the adult tooth to erupt in its proper spot.

We recommend that your child have a first orthodontic assessment around age seven, but if your child has lost a primary tooth before its time, give our Vienna, VA & Great Falls VA office a call. We can let you know if a space maintainer is the best way to prevent future dental and orthodontic problems.

If you have concerns about a missing tooth or teeth, talk to us! Orthodontic treatment is always custom-designed to fit the needs of each individual patient. We can discuss your specific goals, and how orthodontic treatment can help you achieve them. There is no reason to let a missing tooth keep you from a more attractive, healthier smile!

If there’s one meal that can claim the title of “Sweetest Meal of the Day,” it’s almost certainly breakfast. Sugary cereals, syrup-covered waffles, oatmeal with honey, cinnamon toast (which is literally sugar poured on toast)—it’s hard to imagine another menu even coming close. But you’re trying to keep your diet as healthy as possible. What to do?

First, no need to deprive yourself of the occasional pastry or stack of pancakes. The real problem with breakfast isn’t so much sugar as it is added sugar.

• Just a Spoonful of Sugar? What’s So Bad About That?

Nothing! Many healthy foods have natural sugars. Milk contains lactose sugar, and it also contains calcium and is enriched with vitamin D—both of which are essential for strong bones and teeth. Fruits get their sweetness from a sugar called fructose, and deliciously provide vitamins, minerals, antioxidants, and fiber to our diets.

Even processed sugar is surprisingly low in calories. In fact, a teaspoon of white sugar has only about 15 calories. But this teaspoon is also rich in nutrients for cavity-causing bacteria. The oral bacteria in plaque use sugars and carbohydrates from food particles as a fuel source to produce acids. These acids erode enamel and lead to cavities.

Choosing breakfast foods without additional sugars, then, is an easy way to reduce the number of empty calories in your diet while safeguarding the health of your teeth. We have a few suggestions.

• Be Selective with Cereals

If the word “sugar” or “honey” or appears on the box, that’s a hint that your favorite cereal is heavy on the sugar. But there’s a more scientific way to tell just how much sugar is in that spoonful.

While the colorful packaging and playful mascots are eye-catching, check the black-and-white panel with nutritional facts found on every box. If one serving equals 27 grams, and the sugar in that serving equals 15 grams, you know you have a problem. And cereals marketed to children are especially “rich” in added sugar.

But luckily, you don’t need to give up your morning bowl. Many cold cereals are available that offer whole grains, protein, and fiber without a lot of added sugar. Spend some time in the cereal aisle comparing, or, to make life easier, there are many online sites which recommend the best (and worst) cereals in terms of sugar content.

• Use Your Judgment with Juices

Fruits are packed with important nutrients. Not only do they provide essential vitamins and minerals, they’re a great source of water and fiber. If you drink 100% fruit juice, you are getting the benefit of most of the vitamins and minerals found in fruit. (You’re also getting less of the fruit’s natural fiber, and more of the fruit’s natural sugar, so consider fresh fruit as an option occasionally.)

But when fruit juice comes with “cocktail,” or “punch,” or “ade” attached to the end of it, there’s often something else attached—added sugar. For natural fruit flavor and the least amount of sugar, stay with 100% unsweetened fruit juice.

• Search Out “Surprise” Sugars

Remember the childhood excitement of searching through your cereal box for the prize inside? Fun! What’s not so much fun? The surprises you might find when you search through the labels on your favorite breakfast items—because added sugars make their stealthy way into many of our morning favorites.

When you compare plain, Greek, and low-fat yogurts, for example, the low-fat options are often higher in added sugar. A container of low-fat yogurt can provide 19 grams of sugar—that’s a tablespoon and a half!

And while you’re at it, be sure to compare the sugar content in granola bars. Some are full of nuts and grains, and some are full of added sugar.

Going out for a breakfast smoothie? Those can contain 70 grams of sugar and more. Making your own at home might be a little more time-consuming, but if you use fresh fruit as your sweetener, you can make sure that what you’re not consuming is added sugar. If you’re on the go, check out all-fruit options at your favorite smoothie shop.

Dr. Allen Garai & Dr. Karen Tratensek and our team aren’t asking you to eliminate sugar from your breakfast diet altogether. (Everyone loves a doughnut now and again.) But substituting some alternatives for your regular menu choices can reduce the amount of added sugars by tablespoons every meal. That’s another great reason to greet the morning with a smile!

If this is your first winter with braces, you might be wondering how to make the best of the holiday season. Dr. Allen Garai & Dr. Karen Tratensek and our team have some suggestions for happy and healthy holiday smiles.

Treat Yourself

Winter means tasty holiday treats, and just because you wear braces doesn’t mean you need to step away from the holiday table! You can enjoy your favorites if you remember to check your list for the usual problem foods. Hard, crunchy, chewy, and sticky items? Naughty list.

• Crunchy vegetables on the appetizer plate
• Nuts
• Hard rolls
• Candy canes and other hard sugar treats
• Caramels, Toffee and other sticky candies
• Pecan pie
• Fruit cake

Luckily, there are plenty of nice alternatives.

• Turkey and ham—remember, small pieces are best
• Dressing and stuffing
• Mashed potatoes
• Soft breads and rolls
• Pumpkin pie—but skip a tough crust!
• Cheesecake
• Soft cookies and cakes
• Soft chocolates

We’re happy to provide recommendations for braces-friendly holiday foods. And we don’t expect you to turn down every sweet treat this season.  Just be sure that if you enjoy something sugary, brush carefully after indulging.

Express Yourself

While you’re decking the halls, or pinning up the New Year’s balloons and streamers, or even choosing a great holiday outfit, don't forget that your ligatures can be decorative as well as functional.

• Celebrating Christmas? Red and green bands around your brackets are jolly and traditional.
• How about Hanukkah? Try blue and white!
• Love the season? Icy silvers and pale blues are a frosty statement—and can have the benefit of making your teeth look whiter, as well. Snowy white? The arctic idea is great, but white bands can sometimes make teeth look more yellow, or become stained themselves.
• Glam New Year? Gold adds sparkle to your smile, but can bring out any yellow tones in your teeth. Silver might be the perfect choice, because it is generally neutral with enamel shades.

Check out our ligature colors for the best possible choices for your teeth and coloring. Take advantage of these options to create a fresh, confident look for the season. Give others the gift of your smile!

Look After Yourself

Winter comes with some special reminders about your dental health.

• Winter sports are a great way to celebrate the snow and ice, but be sure to protect your teeth and braces. If you enjoy skiing, snowboarding, ice skating, hockey, or any other winter activities, talk to us about why a mouth guard is so important.
• While you enjoy your winter break, don’t forget to keep up with your dental routine. And because ‘tis the season for holiday treats, be especially careful to clean your teeth and braces after sweet desserts and snacks. Don’t forget to floss!
• What do cold breezes and hot chocolate have in common? They can both trigger tooth sensitivity! While some sensitivity is normal after an adjustment, if you find you are experiencing tooth sensitivity more often or more strongly than you usually do, give us a call. It might be something as simple as brushing habits, or you might need to see your dentist.

If you have any questions about your braces, in this season or any other, just ask when you visit our Vienna, VA & Great Falls VA office. Your beautiful, healthy, and confident smile can make this the most wonderful time of the year!

One of the many benefits of your clear aligners is that you can remove them to eat. You should brush after every meal, just like you would with traditional braces, but cleaning your teeth is much easier without having to work around and between brackets and wires.

But when you wear your aligners 22 hours a day, you might be tempted to leave them in when you’re just having a sip of something when you’re thirsty. Unless you’re drinking water, please don’t.

What’s the problem with a can of cola or a cup of coffee?

• Staining

The virtue of your clear aligners is that they are, well, clear! Probably one of the reasons you decided on this method of treatment was because you liked the idea of an inconspicuous appliance.  Unfortunately, dark beverages such as colas, coffee, tea, and red wine can stain your aligner, making it more visible.

• Warping

Very hot beverages might actually affect the shape of your aligners. Since they are formed using heat, it makes sense that heat can also de-form them. If hot teas and coffee drinks cause a change in the shape of your aligners, they will not move your teeth the way they were meant to.

• Affecting Tooth Health

Even though our enamel is very strong, sugary and acidic drinks can damage it. Acidic foods can erode enamel, and the sugars in our diet provide food for cavity-causing bacteria, which then produce acids that erode enamel.

Normally, saliva provides some protection from acids and sugars by diluting them and washing them away from the teeth. When you drink a cola or an orange juice with your aligners on, some of the liquid will get in them, and can stay in them until the aligners are removed. You will actually give these problem beverages the opportunity to bathe your teeth in sugar and acid over a longer period of time, without exposure to saliva to help offset potential harm. And after all your work to create a beautiful smile, you certainly don’t want new cavities!

How to protect your aligners and keep them their cleanest—and most invisible?

• Take your aligners out before drinking beverages that can stain them, or, if you can’t, try using a straw. Clean your aligners according to Dr. Allen Garai & Dr. Karen Tratensek and our team’s instructions to keep them as clear as possible.
• Don’t drink very hot beverages with your aligners in place. Try icing your coffee and tea if you can’t remove your aligners. And if you think your aligners have changed shape, please give us a call.
• Drink water! Water hydrates you, doesn’t damage enamel, and keeps your aligners clean. Tap water is your best option, as even bottled waters can be acidic.

If your aligners should become stained, remember that you change them frequently, so the staining can be a temporary problem. If you do have a drink of something hot and your aligners feel “off,” give our Vienna, VA & Great Falls VA office a call. We’ll let you know if you need to replace them.

But prevention is always best! Avoid staining from the start by removing your aligners before you drink dark beverages. Don’t expose your aligners to heat. Think about replacing unhealthy drinks with water. And certainly brush right away, or rinse with water if that’s not possible, if you drink a sugary or acidic beverage. These simple precautions will help keep your aligners, and, most important, your teeth, looking their best.