Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

How Long Will I Need this Retainer?

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I had braces in my teens. My teeth have done fine in past years but then started to shift again. I went to see a new orthodontist as an adult. He said I had a couple of options. I could re-do braces or wear my retainer again for a while and see if that helps. I opted for the retainer. It does move my teeth back into position. He suggested six months of wearing it full-time, then switching to nighttime wear for an equal amount of time. I followed through on that, but when I “graduated” from the retainer, I noticed that by the next day two of the teeth had shifted again. I’ll put the retainer back in and the cycle repeats. Is there anything I can do about this?

Morgan

Dear Morgan,

While this isn’t considered “normal” it does happen. For some reason, your teeth aren’t ready to stay in place on their own yet. I have a couple of suggestions for you.

When Teeth Won’t Stay in Place After Braces

You will need to wear a retainer full time for an indefinite period of time. One thing you can do in this case is have a lingual retainer made. This is a retainer which will be bonded to the back of your teeth. This is invisible to everyone else. The downside to this procedure is it is very difficult to get the teeth clean. You will need a floss threader to get in there.

Teeth whitening trays in a blue case
Teeth Whitening Trays Can Double as a Retainer

Another option is to use teeth bleaching trays as retainers. These are completely clear so no one will know you are wearing them. They do have the additional benefit of allowing you to whiten your teeth at the same time. Giving you both a straight and white smile simultaneously.

While many cosmetic procedures do require some expertise and post-doctoral training, teeth whitening does not. Any family dentist can do this for you.

My advice is to speak with your orthodontist and discuss these options in depth and decide which you think is best for your situation. It would also be good for him to investigate what is going on with the shifting.

This blog is brought to you by Glenpool Dentist Dr. Ryan Noah.

Orthodontics before Crowns?

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I’m hoping you can help me. I have had two crowns on my front teeth for a long time. They’ve always looked a little pastier than my other teeth, but now they have this unsightly gray line and they are discolored. I need to get them replaced, but my dentist is insisting I get braces first. I really can’t afford that. Isn’t there any way they can do the crowns without my teeth being perfectly straight?

Martha

Dear Martha,

Tulsa braces for othodontic dental treatment

What your dentist is doing is unfair to you. He is insisting on the ideal treatment. Well, not everyone can afford the ideal. He should be able to do these crowns regardless of whether or not you have orthodontics done. How else would they have been placed on your teeth originally? I’m assuming the needed orthodontics isn’t a new thing.

You may have to see another dentist to work within your budget, but that’s okay. there are affordable dentists who take into consideration that sometimes a patient can’t get everything done at once. This is called phased treatment.

You can either get the crowns done now and put off the ortho until later. You can even skip braces altogether. It is completely up to you.

Orthodontics for Adults

If you decide later on you do want to straighten your teeth, you no longer have to get a mouth full of metal wires and brackets. There are better options for adults these days. Most prefer a brand of invisible braces called Invisalign.

These use clear aligners which allow you to straighten your teeth without anyone even knowing. They truly are invisible, even at a conversational distance.

Crowns for Front Teeth

There was a reason your dental crowns looked pasty when you first had them placed. Your dentist placed porcelain fused to metal crowns. While these are perfectly fine for back teeth, they are way too opaque looking for front teeth.

Plus, as you’ve experienced, they also eventually develop a gray line at the gumline. For front teeth, we recommend all-porcelain crowns. These look much more natural and will never develop that unsightly gray line.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.



Choosing the Right Orthodontist

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I’ve had three consultations with orthodontists. I’m looking for clear or invisible braces to straighten my teeth and give me more confidence at work. The first two orthodontists gave me similar treatment options for braces. The treatment period would be about two years and would correct my bite and straighten my teeth. The cost was about the same, too. The third consultation costs less and treatment time is shorter. This is strange to me that there is such a difference in time and cost. Are the first two orthos prolonging treatment or is the third one rushing it and trying to get my business with an offer that sounds better but isn’t really going to give me good results? I am on a budget, but I don’t want to waste time on treatment that doesn’t really work. Thanks. Lorna

Lorna,

Your first two consultations with orthodontists propose aligning your bite and your teeth, which can be done with traditional braces or clear aligners. An estimate of two years for orthodontic treatment is in line with the average time, but a thorough examination and digital x-rays are the only way to get a true estimate.

Two images: one of a woman placing her Invisalign aligner. The other, she's smling with it in.
Invisalign works faster than traditional braces

It seems that your third consultation didn’t include bite correction in the treatment. If the estimated treatment time is one year, it seems that a shortcut will be taken somewhere. Tooth movement takes time, and if you’ve never received orthodontic treatment, accurate alignment often takes longer than a year.

It’s reasonable that the cost for the third option is less expensive than the others because your treatment time is shorter. It’s unclear whether the third option is for full orthodontic treatment or for cosmetic treatment that corrects only the teeth that are seen when you smile.

Orthodontic Treatment with Traditional Braces vs. Invisalign

Although you didn’t mention it as a factor, the type of orthodontic appliance used has an effect on your treatment time. For example, Invisalign invisible braces move your teeth with greater precision than traditional braces. And treatment with Invisalign is often shorter—often half the time of traditional braces?

What’s Next?

You can consider calling the third orthodontist and asking what is included in the cost, the type of braces you would receive, and the results you can expect. Weigh your decision carefully, and don’t base your choice of treatment on time and cost alone.

This post is sponsored by Ryan Noah, DDS of Region Dental in Tulsa.

Gum Recession During Braces

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I had a problem with gum recession during my braces. This created a black triangle at my gums. Is there a solution for this?

Dave

Dear Dave,

images of teeth with black triangles

Unfortunately, quite a few patients develop this problem with traditional braces. Many patients find it harder to keep up with their oral hygiene as well. Yes, gum recession can lead to black triangles. I’m sorry you’re dealing with this. The first thing I’d do is find out the cause of the gum recession, making sure it’s not a result of gum disease. If gum disease is the cause, that will need to be dealt with first.

There are orthodontic treatments that make it easier to brush and floss properly. For instance, with Invisalign, you simply remove your aligners then brush and floss as you normally would.

Treating Black Triangle After Orthodontics

Sometimes orthodontics can correctly repair a black triangle, but if this happened during your treatment that’s not going to happen. Instead, you’ll need a cosmetic solution.

I’ll be honest with you, not many dentists can do this repair. It’s treated with dental bonding, but because of the placement of the spaces, it requires some real expertise in cosmetics to make this look natural.

Unless your dentist is among the top cosmetic dentists in the country, I’d have him recommend someone for you.

This blog is brought to you by Glenpool Dentist Dr. Ryan Noah

Solutions for a Wonky Tooth

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I have a tooth slightly rotated. My dentist wants me to get braces, but that is a minimum of two years treatment. I’m a senior. I don’t want to look ugly my last year of high school and first year of college. Tell me what my options are.

Caitlin D. – Boston

Caitlin,

You have a couple of great options aside from traditional orthodontics. The first is Invisalign. If you are a candidate, which not everyone is, it can straighten your smile in about half the time as braces. The best part is it truly is invisible. No one will know you’re wearing them.

If you’re not a candidate for Invisalign, or if you have other things you’d like to change about your smile, then I’d suggest porcelain veneers. It’s a strictly cosmetic procedure that can completely remake your smile. It can change the shape, size, and color of your teeth. It’s the type of makeover celebrities get on their teeth.

Invisalign is the more affordable of the two options. I don’t know if budgeting is a factor in your decision. But, if it is you’ll want to consider the cost difference.

Also, if you’re getting porcelain veneers in order to re-make your smile, you won’t just get a veneer for the wonky tooth. You’ll get a minimum of six on your upper arch.

This blog is brought to you by Dr. Ryan Noah.

 

Are Retainers Even Necessary?

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I wore braces for three years.  I got them off six months ago.  I know I am supposed to wear my retainer but I just hate it.  Are they really going to move back if I don’t wear it?

Thanks, Angie

Dear Angie,

I know you probably hate it, but your teeth absolutely will move if you don’t wear it.  They may not move completely back to where they were when you first got your braces on but they WILL move.

More than likely, if you had severe crowding, your lower front teeth will start to overlap.  Teeth that were the most difficult to move, like turned teeth, will begin to turn again ever so slightly.  Before you know it you will not be able to wear your retainer because it will no longer fit.  Then you will be too embarrassed to go back to the orthodontist because you think he may say, “I told you so!”  Meanwhile, your teeth will continue to move.

In order to stop the movement, you will need to spend a couple of hundred dollars for a new retainer.  Don’t forget, you will also need to get new impressions and you know how much people love those!  So, wear the retainer….even if you only wear it at night.  It is a small price to pay to keep that beautiful smile.

This blog is brought to you by Dr. Ryan Noah.

Orthodontist vs. General Dentist: Who’s Right?

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I’m having trouble figuring out what’s going on with my son’s teeth. We have a great orthodontist and what I thought was a good dentist, but now I’m not so sure. My son is missing a tooth on the upper right, near the front. We planned to have an implant done for him when he’s older, so the orthodontist straightened everything out and left a space for the implant. He said we could either get a retainer to keep everything in place or have the family dentist make something else. Well, that something else wound up being a “Maryland bridge,” to put a false tooth in place for the next few years. On the first round, the dentist created something with clasps and it fell out right away. He said it was the cement, so he put it back in with something stronger. It fell out again within a few days. Now he wants to have the whole thing remade with metal clasps and I’m a little worried that the same thing will happen. I mentioned it to the orthodontist and he said he wasn’t sure why the family dentist was going this route and suggested we get a flipper instead. I’m really torn. Was the orthodontist saying the dentist did something wrong? Should we switch gears and get a flipper? Do we need a new dentist?

Thanks,

Jocelyn

Dear Jocelyn,

The problem probably wasn’t the cement. It was the way that the teeth were prepared. The adjacent teeth needed notches cut in them to hold the bridge in place, but in an effort to be conservative, the dentist probably made them too shallow. For this reason, the replacement bridge will probably do the exact same thing. The only real fix is to make those grooves deeper, but that will permanently alter the structure of those teeth. Since they’re healthy, that would not be the best form of treatment.

It’s unclear why your dentist chose this route over a flipper to begin with, unless it’s because you passed on the retainer and they’re similar in build. Your best bet is to request the flipper, instead of going forward with a new bridge. This is something that your family dentist should be able to create for you, but if you have trouble, you may want to find out who the orthodontist prefers for general dentistry and get an opinion from that office.

I hope this helps you make a decision.

This blog is brought to you by Dr. Ryan Noah.

Do it yourself braces

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Will you help me?  My daughter saw a video on youtube by a teen who is doing her braces herself because her parents can’t afford braces.  We’ve been saving up to get our daughter invisalign teen, but just don’t have all the funds….yet.  I expect we will by next summer.  But, my daughter is impatient and I saw her watching the video and trying to do it herself.  I’m not dentist, but I think this is dangerous.  Will you tell me what I can say to her?

Worried Mom

Dear Worried Mom,

You’re right to be concerned.  I’ve seen the video you’re referring to (if we’re thinking of the same one). There are a couple of pretty serious things that can go wrong with this:

  • Dentists move teeth in two stages. This is true whether you use traditional braces or Invisalign. First we move the teeth and then we have a rest period for the bone to reform over the newly positioned tooth root.  With the do it yourself method, you’re tipping the teeth which doesn’t take the root into consideration.  Eventually, your teeth can come loose and even fall out.
  • The bands that the teens are using can actually cut off the blood supply in their gums. Even just a minor blood supply cut-off can change the color of her teeth. Fully cutting it off can lead to painful inflamation and infection.

I know it seems like forever to your daughter now, but waiting will not only give her a more beautiful smile, but do it in a safe way that doesn’t put her teeth or health at risk.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Do you have to go to an orthodontist for invisalign?

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I was thinking of getting invisalign, but wondered if I’d have to see an orthodontist?

Jennifer R. – Mississippi

Jennifer,

No, you do not have to see an orthodontist for invisalign.  Many general dentists are qualified to handle your orthodontic needs, including not just invisalign, but braces as well.

Each dentist is a little different with how they handle it.  Some do it themselves. Others, share their practice with an orthodontist who comes in once a week.

I’d start with talking to your family dentist. If he doesn’t place invisalign, he can certainly recommend you to someone who does.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Braces and fainting spells

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I have very low blood pressure. As a result I get fainting spells. My mother has never let me get braces as a result.  She’s worried I’ll cut my mouth on the metal.  Is there anything you can say to make her worry less and let me get braces? All my other friends have straight teeth or are getting them straightened. I’m worried I’m going to end up as the ugly friend.

Dena M. – Mississippi

Dena,

Parents worry. Sometimes their worries are well founded and sometimes they’re not. But, at least you can know that they love you. Otherwise they’d just let you do what you want.

In this case we can put your mother’s mind at ease. There are more than one type of orthodontic. If she’s worried about tissue damage from a fall, you could wear Invisalign aligners.  Even if you fell directly onto your mouth, these will not cut you. There are no metals, wires, or brackets.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.