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Does my child need two-phase treatment?

October 17th, 2018

You might be surprised to see one of your second grader’s friends with a dental appliance. Isn’t orthodontic work just for teenagers? And, if not, should your seven-year-old be sporting braces right now? The answer to both of those questions is “Not necessarily.” Two-phase treatment is a process designed to correct issues that arise during different times in your child’s life.

First Phase Treatment

We recommend that every child have an orthodontic evaluation around the age of seven to determine if there is a problem that would benefit from early treatment. First phase orthodontics is not the same as orthodontics for older patients. The focus here is on the developing bone and muscle structures which form your child’s bite and provide space for the permanent teeth when they arrive.

There are some clear-cut orthodontic goals that are much easier to attain when children’s bones are still growing.

  • Reducing Crowding

If your child’s mouth is small, the permanent teeth will have little room to fit in when they arrive. We may recommend gently enlarging the upper dental arch with the use of a palatal expander. This device will provide room for the adult teeth, and could potentially shorten second phase treatment time. Sometimes the extractions necessary to create more room for permanent teeth in later years can be avoided, as well as the possibility of an impacted tooth—one which doesn’t erupt because it is blocked by other teeth.

  • Dealing with Jaw and Bite Concerns

Bones and muscles do not always develop properly, leading to problems with jaw and facial structure. Your younger child still has growing bones, so this is a great time to gently re-form the jaw into a healthy shape. Problems caused by crossbites, underbites, open bites, and other malocclusions can be reduced with early treatment.  

  • Protecting Teeth

If your child has protruding front teeth, these teeth are more likely to be damaged in falls, at play, or while participating in sports. We can gently reposition them.

Second Phase Treatment

Second phase treatment is designed for your older child. After a resting period, when the permanent teeth finish erupting, we should see your child to evaluate any further orthodontic needs. This is the time to finish the process of straightening the teeth and making sure that each tooth fits together properly for a comfortable and healthy bite. This phase usually makes use of braces or aligners, and can take approximately 12-24 months.

Two-phase treatment is not necessary for every child. But there are some unique reasons that early orthodontics might be recommended for your child, even if it’s clear that more orthodontic work will be needed later. Make an appointment with Dr. Harold Fleming at our Falls Church, VA office, and let’s evaluate your child’s orthodontic needs, whether now or in the future, for a lifetime of beautiful smiles.

Generic Clear Aligners vs. Invisalign®

October 10th, 2018

You may have a talent for home repairs. You may be able to rebuild your computer. You may even be able to put together a whole room of furniture armed only with flat-box kits and an Allen wrench. But, please—don’t try do-it-yourself orthodontics!

Now that generic clear aligners are available, you might consider giving them a try to save some money. But is straightening your own teeth really a good idea? Before you are tempted, let’s look more closely at the products and the dental science involved.

Invisalign®

  • Invisalign clear aligners are used by orthodontists and dentists with experience in custom treatment for your smile. A 3D image of your teeth will be captured by the iTero Element® scanner. Using special software, your doctor can map out each projected shift in your teeth, and even show you a projection of your finished smile!
  • Your Invisalign aligners will be tailored to fit your teeth precisely using the 3D scan and 3D printing. They are made from SmartTrack® material, a product specifically engineered for a perfect, comfortable fit. Invisalign aligners are even trimmed to fit your individual gumline to prevent irritation.
  • When your first sets of Invisalign aligners arrive at our Falls Church, VA office, Dr. Harold Fleming will check for fit, answer any questions you might have about use and care, and let you know what to look for and what to expect. Your progress will be monitored with visits every six to eight weeks. (And for parents of teens, Invisalign aligners can offer blue “compliance indicators” to let you know they are being worn the 20-22 hours a day necessary for the best and fastest results.)

Generic Aligners

  • You might be required to make a putty mold of your own upper and lower teeth, which is not the easiest thing to do well, and to take selfies of your teeth.
  • The aligners will be sent to you in the mail. They are generally made of hard plastic with generic gumlines. There will be no one to tell you if the aligners fit properly.
  • They are sometimes less expensive because there is no in-person medical supervision. A dental professional working for the company will look at the model created from molds you submit, and recommend a series of aligners to correct the problems he detects by looking at the model and your selfies. This supervisor will not be able to assess the overall dental health of each patient to make sure teeth and gums are healthy and ready to start treatment, and will not be able to tell if the teeth are moving properly or improperly once the aligners are in use.

Finally, while generic aligners may potentially have some success in minor tooth straightening, they are not created to deal with complex bite issues or malocclusions.  In fact, using generic aligners with no supervision can cause more serious dental problems than a patient started with.

Sure, sometimes a do-it-yourself project turns out well. But your teeth and bones are too important for home improvement. When it comes to creating a beautiful, even smile and balanced, comfortable bite while making sure of your dental health, it’s always best to trust a professional like Dr. Harold Fleming to provide you with gentle, tested, and successful care!

Fall Holiday Guide for Braces

October 3rd, 2018

If this is your child’s first holiday season with braces, here are some tips on how to help children get the most enjoyment from these celebrations without compromising their braces or leaving them feeling left out of the festivities.

Halloween

When you think dental health, “Halloween” is not usually the first thing that comes to mind. Halloween can be tricky, but with some planning and intervention, you can make sure your child doesn’t miss out on the treats that make the holiday a favorite.

Braces present other challenges besides dealing with the scary amount of sugar in every trick-or-treat bag. Certain treats can be a challenge to clean from braces, and can even cause broken brackets and wires. How to avoid these frightful results?

  • Go through your child’s treat bag when you get home after neighborhood trick-or-treating. Anything which can damage braces, such as regular gum, candy with nuts or caramel, or hard or chewy candies should be discarded. Perhaps you and your child can choose a selection of soft candy such as plain chocolate and peanut butter cups to trade for those tricky treats. Your child’s favorite soft fruits, cupcakes, and cookies could also be safe substitutes.
  • Party time? Candy apples, bowls of candy corn, and popcorn balls are favorite treats at Halloween parties, but very bad for braces. Help your child recognize what should be avoided before attending, and suggest safe options like soft cupcakes.
  • Finally, even safe treats will leave more sugar than normal in your child’s mouth and therefore more potential for plaque build-up. Brush and floss more often, if needed, and rinse regularly with water.

Talk candy guidelines over in advance with your child. If you’d like, Dr. Harold Fleming can recommend safe alternatives. With your help, Halloween won’t be a fearsome experience for you or your trick-or-treater.

Thanksgiving

Now, this is a holiday to be thankful for! Almost all of your traditional favorites are perfect for family members with braces.

  • Appetizers: Offer soft food options such as silky cheeses and deviled eggs instead of crunchy vegetables, chips, and nuts.
  • Dinner: Turkey is a required dish on many tables, and no need to miss out! Just make sure pieces are bite-size and off the bone. Creamy mashed potatoes and gravy and jellied cranberry sauce are also braces-friendly traditions. Any cooked vegetable should be fine, but do cut the corn from the cob first. Dressing is a great side dish if your child avoids any crunchy tops and edges, as are soft, nut-free rolls and muffins.
  • Dessert: Pumpkin pie, cheesecake, and apple pie with ice cream are all safe (and delicious) choices. Leave the pecan pie, caramel sauce, and anything nutty or chewy off your child’s menu. And remember to brush and floss carefully after the feast!

If you are concerned that following the usual food guidelines might be a little more difficult during this time of year, talk to us. Dr. Harold Fleming and our team are happy to suggest ways to make your child’s first holidays with braces memorable for all the right reasons. The last thing you’ll want is an emergency visit to our Falls Church, VA office!

Electric Toothbrushes vs. Regular Toothbrushes

September 26th, 2018

Convertible or sedan? Downtown or suburbs? Electric or manual toothbrush? As life decisions go, it’s certainly not choosing your next car, or deciding where you want to live. But, even when you are selecting a toothbrush, it helps to make a list of the pros and cons of the contenders before you make that final selection.

  • Efficiency

The most important factor in choosing a toothbrush is finding out which model works best to eliminate bacteria and plaque. And studies have shown that, used properly, both electric and manual toothbrushes do a great job of removing plaque. Some electric models can reach the backs of teeth and the gumline more easily, some manual head designs work better for your individual mouth and teeth, so your particular needs should dictate which style of toothbrush you use. Talk to us about the best methods to brush with your preferred toothbrush, and we’ll let you know if one type of toothbrush or the other might work better for you.

  • Health Considerations

Brushing too energetically can actually harm teeth and gums, causing sensitivity and damage to the enamel and gum tissue. An electric toothbrush should provide a continuous brushing motion without needing any pressure from the brusher. This might be the model for you if you have a too-vigorous approach to brushing, or sensitive teeth and gums.

An electric toothbrush can also be more efficient for older and younger brushers, those with limited mobility, and those with health conditions or injuries that make brushing with a regular toothbrush more difficult.

  • Cost

An electric toothbrush is not a one-time investment. You should change the removable head as often as you change your manual toothbrush (every three to four months, please). But this cost is offset if an electric toothbrush is more efficient in removing your plaque, easier to use, or even if you just prefer it to manual brushing. If you find that you brush better and more often with an electric toothbrush, the added expense is well worth it.

Whichever brush you decide on, the most important part of the brush is the person holding it! A regular appointment with your toothbrush for two minutes of thorough brushing in the morning and two in the evening, daily flossing, and regular visits to our office for checkups and cleanings will keep your teeth healthy and strong no matter which toothbrush you choose.

Questions about your toothbrush choices? Don’t hesitate to ask Dr. Harold Fleming at our Falls Church, VA office.

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