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Midline Misalignment

February 1st, 2023

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 Orlando, FL orthodontic team.

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

Dr. Diaz 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 Diaz Orthodontics 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.

Why Do I Need a Retainer?

January 25th, 2023

Congratulations! You’ve done the hard work necessary to create your beautiful smile! You’ve carefully completed all the steps needed to reach the end of your orthodontic journey. Well, nearly all the steps. We can’t forget that last step which will ensure that all your hard work is rewarded.

When you first began orthodontic treatment, Dr. Diaz decided on the best plan for straightening your teeth and perfecting your bite, whether you wore traditional braces, lingual braces, aligners, or other orthodontic appliances. And now that you’re finishing treatment, there’s one more option to consider—your retainer.

Why do I need a retainer?

While you’ve spent time in treatment, more has changed than just the position of your teeth. The periodontal ligament, the connective tissue that connects the teeth to the jawbone, is stretched as the teeth shift. The bone in your jaw changes, too, reforming and rebuilding around the roots of your teeth as they move to their ideal locations.

These changes happen because your braces or aligners apply gentle, constant pressure to move your teeth. When you’ve finished wearing these appliances, the pressure stops. Ligaments will try to return to their original shape, which can shift teeth back toward their old positions. And the rebuilding bone isn’t dense enough yet to stop teeth from shifting due to the normal, everyday pressures of eating, chewing, and smiling.

A retainer prevents your teeth from moving back, or “relapsing,” by giving your bones and ligaments time to stabilize and rebuild. The process takes months, so keeping your teeth in place as bones rebuild and grow denser is crucial. This is especially important for patients with more serious misalignments. Dr. Diaz will let you know which kind of retainer will be best for you and just how long you’ll need to wear your retainer.

Are there different kinds of retainers?

There are! Retainers can be removable or fixed, visible or nearly invisible, metal, plastic, or metal and plastic. Three of the most popular retainer options include:

  • Hawley Retainers—the traditional removable retainer, which uses a molded acrylic plate with wires attached to keep your teeth properly aligned and to hold your retainer in place.
  • Clear Plastic Retainers—a removable retainer made of custom vacuum-formed plastic, which fits over the teeth like a clear aligner.
  • Fixed Retainers—a small single wire bonded to the back of specific teeth, which holds them in place and prevents any movement.

Dr. Diaz will let you know whether a removable or fixed retainer is best for making sure your teeth don’t start to relapse, and fill you in on the benefits and care of each type of retainer.

How long do I need to wear a retainer?

There’s no standard answer to this question. Just like your retainer is custom-built to fit your individual teeth, the amount of time you’ll spend in that retainer depends on your individual needs. Retainers might be worn fulltime for months or years, be worn only at night after several months of daily wear, or be worn long-term to make sure your orthodontic work lasts.

Because you’ve done the hard work already, and your beautiful, healthy smile is the result. Talk to a member of our Orlando, FL team about which retainer option will be best for making sure that this smile lasts a lifetime.

Straight Talk about Braces and Oral Health

January 18th, 2023

We’ll give it to you straight: it can be harder to keep your teeth their cleanest while you’re wearing braces. Food particles play hide-and-seek, plaque builds up around brackets, flossing is harder when you need to maneuver around wires. But keeping your teeth and gums healthy is even more important now that you’re wearing braces.

Why? Because when your braces come off, you want to enjoy the beautiful smile you’ve worked so hard for without worrying about discolored enamel, cavities, or swollen gums. Let’s look at some of the possible consequences when brushing and flossing are more challenging.

Decalcification

If you’ve noticed white spots around your brackets, you’re seeing the signs of decalcification, a common problem for those who wear braces.

Decalcification begins when plaque collects on the enamel around your brackets. The bacteria in plaque produce acids. These acids eat away at the minerals which keep your enamel strong, minerals like calcium and phosphorous. Places on the enamel where erosion takes place are left weakened and discolored.  Eventually, these weak spots can lead to . . .

Cavities

When plaque sticks around, whether near your brackets or anywhere on your teeth, it provides the perfect conditions for decay to develop. Left untreated, bacterial acids continue working away at decalcified spots in your enamel. This continuing erosion causes these surface spots to expand, grow deeper, and become cavities.

If you’re having trouble with built up plaque, and brushing isn’t doing the job for you, your dentist can remove it with a professional cleaning. Getting rid of plaque is healthy not only for your enamel, but your gums as well.

Gum disease

When plaque and tartar collect around the gumline, they irritate delicate gum tissue. This irritation causes gingivitis, or early gum disease. And, while young people rarely suffer from serious gum disease, the pain, redness, bleeding, swelling, and bad breath caused by gingivitis are not anyone’s life goals!

Brushing and flossing are essential to keeping your enamel and gums plaque-free. But even if you brush more often, it’s not as easy as it once was now that you have to work around and between brackets and wires. Luckily, there are lots of tools out there to help you get your teeth, gums, and braces their cleanest.

  • Orthodontic toothbrushes

Special brushes designed just for braces can help you work around brackets and wires. V- or U-shaped bristle formations let you brush around and over your braces. Curved bristles can fit under wires. Smaller brush heads let you reach those hard-to-reach places.

  • Electric toothbrushes

Many people find these brushes can clean more easily and effectively, especially when wearing braces. Tapered orthodontic brush heads are available, and, if you’re a heavy-handed brusher, there are models which alert you if you’re brushing too hard—protecting your braces and your enamel.

  • Orthodontic floss

Special orthodontic flosses can help you do the tricky job of fitting floss behind your wires and between your teeth, or use a floss threader, which helps guide uncooperative floss into tight spaces.

  • Water flossers

With their pulsing streams of water, water flossers can reach spots where regular brushes and flosses just can’t comfortably fit. There are even flossers available with special orthodontic tips.

Straight teeth are great. Straight and healthy teeth? Even better! You, Dr. Diaz, and our Orlando, FL orthodontic staff make a great team. Take advantage of our advice and tips for the best tools and techniques to make sure your smile is both perfectly aligned and perfectly healthy once those braces come off!

The Twin Block Appliance

January 11th, 2023

Orthodontic treatment involves a lot more than just straightening your teeth. For a healthy smile, your bite must be healthy as well! This means that the upper and lower jaws need to fit together properly and comfortably.

If your bite is out of alignment because of jaw misalignment, orthodontic treatment can help correct the shape and position of your jaws with devices called functional appliances. These appliances are most often used for young patients whose bones are still growing, and are designed to treat malocclusions, or bite problems.

Common malocclusions such as overbites and overjets can occur when the upper teeth protrude further than they should, or the lower jaw is positioned too far back, or both. The Twin Block appliance can be used in such cases to help move your lower jaw and teeth into alignment with your upper jaw.

Why “Twin”? Because the Twin Block appliance is two separate pieces, each made of wire and smooth acrylic. Both pieces are crafted to fit precisely over your upper and lower arches and can be adjusted as your treatment progresses. The top plate can also be adjusted, if necessary, to widen the upper palate.

Why “Block”? Acrylic blocks cover the biting surfaces of several of your upper and lower teeth. These blocks fit together like a 3D puzzle. When you bite down, the upper blocks interlock with the lower blocks, pushing the lower blocks forward just a bit before you can bite down completely. Over time, bit by bit (and bite by bite), the Twin Block appliance advances your lower jaw and teeth to create a balanced, comfortable bite.

For the quickest and best results, you should wear your Twin Block appliance as directed. It’s made to be worn comfortably while you sleep, eat, and otherwise go about your day. (It’s a good idea to check with our Orlando, FL orthodontic team to see about removing it when you’re active, especially for swimming and contact sports.) When it’s time to brush, the Twin Block appliance is removable. This means that you can clean your teeth and your appliance easily.

And, while it’s made to work hard for you, it’s not indestructible. Don’t expose your appliance to heat or hot water, as the plastic may warp. Use the cleaning methods we recommend. Finally, when your appliance is out of your mouth, keep it in its case! You don’t want your appliance to end up carefully wrapped in a napkin in the nearby recycling bin. Or, even worse, in your dog’s mouth instead of yours.

The Twin Block appliance might fit together like a puzzle, but there’s nothing puzzling about how to achieve your best and fastest results. Your success really depends on you. Follow Dr. Diaz and our team’s advice, wear your appliance as directed, and you’ll be on your way to a healthy, comfortable bite and an attractive, confident smile!

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