Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Can Invisalign Cause TMJ Problems

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I’ve been using Invisalign for about three months now and most of the time it is awesome. One thing that does worry me is that whenever I put in a brand new pair of aligners, it causes my jaw to ache for a few days. Is it possible that this treatment is actually causing me to develop TMJ Disorder? My friend who has that said her first symptom was her jaw aching.

Missy

Dear Missy,

Upper Invisalign Aligner

TMJ Disorder is when there is a problem with the temporomandibular joint in your jaw. It’s the hinge joint. Sometimes, TMJ problems can be caused by having a bite that is out of alignment. However, you are working to straighten your teeth and are getting them in alignment, so that would not be an issue. In fact, sometimes orthodontics is the “cure” for TMJ Disorder.

Of course, it is possible, if you went to a horrible orthodontist who provided you with braces that messed up your bite, you could end up with some TMJ problems. However, Invisalign is designed with sophisticated computer software and is more accurate than what you would normally get.

What is Causing the Ache?

So, if Invisalign is so awesome why is your jaw aching when you first pop in those new aligners? The most likely cause is that your teeth are shifting. In the first couple of days when you place in your newest set of aligners, you will notice that they are a bit snug. That is because they are shifting your teeth into the new position. After two or three days, the aligners will feel looser and the aching will subside. This is because they are now in the next designated position for your treatment plan.

Don’t Try to Speed Up Your Treatment

Some patients, in an effort to speed up their treatment, will put in the next pair of aligners as soon as their new ones loosen up a bit. However, this is a dangerous thing to do. Yes, your teeth are in their new position. However, the remainder of the time you are supposed to wear those aligners is so the bone has time to integrate with the teeth in the newer position.

If you don’t give it that time, there will gradually be an ever widening gap between your teeth roots and the bone, which can cause your teeth to come loose and even fall out. So, make sure you use them as prescribed.

If the achiness of the first few days is getting to you, I have a couple of recommendations that should help. First, you can try changing out your aligners at night, so you can sleep through most of the initial achiness. A second thing you can do is take an over-the-counter anti-inflammatory.

A Secret Benefit to Invisalign

Did you know that your Invisalign aligners can actually double as teeth whitening trays? This means you can straighten and whiten your teeth simultaneously at a fraction of the cost it would normally be. Simply ask your dentist for some professional strength teeth whitening gel and wear it in your aligners at your convenience.

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

Invisalign and Missing Teeth

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If I have missing teeth, can I still get Invisalign? I’ve seen an orthodontist for a consultation and he said Invisalign only works on the most ideal cases, but my dentist thinks I can still get Invisalign if I want to. I’m not sure which is right. They both have “motive” to get my money. Hahaha. As I live in a completely different state from you and you can’t get any of my money, do you think Invisalign is possible for me?

Elinore

Dear Elinore,

Upper Invisalign Aligner

I like your style. It is always a good idea to ask for your advice from someone who cannot benefit from the answer given. While it used to be in its early days that Invisalign only worked on the easiest cases, there have been quite a few advancements in the technology and it is now on the opposite ends of the spectrum where it works on all but the most complicated cases.

Invisalign does fine working around missing teeth, so you shouldn’t have any problems with Invisalign if that is the most complicated thing about your case. So, you may be wondering why your orthodontist was saying it cannot. I don’t think it was a completely financial answer. Orthodontists were trained to work with braces. They have more confidence in working with that procedure. He’s telling you what HE can do the best job with.

If you decide to get Invisalign, you should know there is one other hidden benefit to Invisalign. The clear aligners they use can also double as teeth whitening trays. This means, if you want to, you can straighten and whiten your teeth at the same time. It is like getting a mini smile makeover for a fraction of the cost.

I would consult with the Invisalign dentist you choose about replacing the teeth. In some cases, the teeth can just be shifted, depending on the placement of the teeth, without it having a negative impact on your smile. However, in some cases, your dentist will need to open up space for you to replace those teeth. In that case, you can replace the teeth once your case is done. The best tooth replacement is a dental implant. However, one step at a time.

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

Fixing a Black Triangle

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I’ve just finished my braces and am starting my retainer. My orthodontist ended up shaving off about 2mm of space on the teeth. This ended up creating a black triangle at the gums. Will this go away or will I need to have another procedure done? Would grafting gum tissue to the space fix it?

Emma

Dear Emma,

example of black triangles at bottom teeth

Black Triangles

My guess would be your orthodontist is planning on fixing this by closing the space and just has it this way at the start of your retainer treatment. The first thing I would do is talk to him about it. If he doesn’t plan on doing anything about it and the gums don’t adjust when you’re done wearing a retainer, then you’ll need to take steps.

Gum grafting won’t be a useful procedure for you in this case. Your gums position themselves based on both the positions and shapes of your teeth. Even if you grafted gum tissue there, it would shift to a position based on the teeth in the area.

If your dentist doesn’t close this space and it bothers you, the procedure to fix it would be dental bonding. However, you don’t want to have just any dentist do this. It’s a tricky procedure to get right. You’ll need an expert cosmetic dentist to work on this.

One thing to be aware of with braces is to make sure you’re really getting in there when you brush your teeth. The areas surrounding the brackets gather bacteria. If you aren’t super careful, you’ll end up with white spots on your teeth. You haven’t mentioned this as an issue for you. I’m only bringing it up for the benefit of others who may still be wearing braces.

The Modern Alternative to Braces

These days, there are been tremendous advancements in orthodontics. The best of these advancements is Invisalign. These are sometimes called invisible braces because they use clear aligners to straighten your teeth instead of metal wires and brackets. They are completely invisible even at a conversational distance.

They have another, mostly unknown, benefit as well. The aligners can also double as teeth whitening trays. This will allow you to straighten and whiten your teeth at the same time.

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

Are Orthodontics Required to Replace Crowns?

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I have had two crowns on my front teeth for a while. They are starting to show their age and really need to be replaced. For some reasons, my dentist is insisting that I do orthodontics first before he’ll replace my dental crowns. It’s not that I don’t want straight teeth, but I just can’t afford them. Is this just a preference thing or will I face this with every dentist?

Miranda

Dear Miranda,

A dentist and patient
It is unfair to patients when a dentist insists on the ideal treatment, regardless of circumstances

I have to admit that it annoys me when dentists behave this way. Yes, having straight teeth is the ideal, but if you cannot afford orthodontic work, then you can’t afford it.

Obviously, you can have dental crowns placed when your teeth aren’t straight or you wouldn’t have any now. This is a preference issue on the part of your dentist.

In all honesty, I’m going to suggest you find another dentist. Look for one who is willing to work within the budget of his patients. You could do an internet search for an “affordable dentist” in your area.

Benefits of an Affordable Dentist

If you find an affordable dentist, they’ll be willing to work within your budget. They’re also willing to stage treatments, so you don’t have to do everything at once. Additionally, they will often have payment plans. Some of them have in-house plans and some of them work through Care Credit.

Getting a Crown on Your Front Teeth

One thing you want to be careful of, regardless of where you go to get your crowns done, is that they only give you all-porcelain crowns on your front teeth.

A metal-based crown will not look right on front teeth. They will be too opaque. They will also develop a gray line on the gumline.

If You Ever Decide to Get Orthodontics

When you do decide you are able to get orthodontics (and that should be completely up to you) you no longer have to get metal wires and brackets. These days, you have the option of “invisible braces”.

Invisalign is the most popular brand which utilizes clear aligners. These gently guide your teeth into their correct position.

I hope this helps you. This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Will a Dental Flipper Make My Teeth Look Straight?

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I really don’t want braces. They take forever, hurt, and look horrible. Would a dental flipper work to just make them look straight?

Ben

Dear Ben,

A woman placing her Invisaliagn aligners

Orthodontics no longer has to mean metal braces

I like how you like to think out of the box. That shows a creative mind open to new ideas. Unfortunately, the dental flipper won’t be a viable solution for you. It’s meant as a temporary tooth replacement option. However, I do have two great solutions for you.

The first will do what you were hoping a dental flipper would accomplish. Snap-on Smile will fit snap over your teeth and make them appear straight. However, because they fit over your teeth they tend to make your smile look bulky. You also need to understand their limitations. These aren’t going to be a beautiful smile makeover like porcelain veneers. They’ll look okay. They can even look attractive. But, they won’t be stunning.

Invisalign—The Modern Alternative to Braces

You no longer have to wear traditional braces with their ugly, uncomfortable wires and brackets. Invisalign uses clear, comfortable aligners. You wear them in two-week intervals and switch them out for the next set. They’re nicknamed invisible braces because no one can tell you’re wearing them, even at a conversational distance.

Because they’re removable, you can eat whatever you want. Additionally, it makes it easier to brush and floss. You simply remove your aligners and brush and floss as you normally would.

A little-known side benefit of Invisalign is the aligners can double as teeth whitening trays. This allows you to get two procedures knocked out in one go. It’s like getting a mini smile makeover. You’ll look and feel great. You’ll also be surprised how much more confidence a nice smile brings you.

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

Do Braces Cause Spots on Teeth?

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My mom wants me to get braces. I want to get Invisalign. She says I’d have to give her a good reason to pay the extra for Invisalign. My friend Sydney got braces and when they came off her teeth were spotted white were the braces were and have stayed that way. Is that caused by the braces?

Kaleigh

Dear Kaleigh,

Someone smiling with braces

While those spots wouldn’t have appeared like that without her braces, the braces weren’t the actual cause of the spots. The spots are caused by food being trapped in the braces and not adequately cleaned. After a time the bacteria will start eating away at the enamel on your teeth. When the braces are removed, those spots look whiter or sometimes brown. Often, there is decay underneath the spots which seriously needs to be dealt with.

Benefits for Using Invisalign Orthodontics

Here is what you can tell your mother. Invisalign is superior to braces in the following ways:

  • Invisalign makes it much easier to clean your teeth. You simply remove the aligners, brush, and floss, then put the aligners back in. There is a lot less risk of the problem listed above, which will cost your mother additional money in digging out the decay, then finding a skilled cosmetic dentist to do the cosmetic bonding on top of the spots.
  • She can cook whatever she wants because there are no limitations on what you can eat. Nothing gets stuck in the aligners because you remove them to eat.
  • They’re much more comfortable than braces because there are no metal wires and brackets.
  • They tend to work faster than braces.
  • Students have more confidence wearing them because they truly are like having invisible braces.

What You Need to be Aware of

There are three things you need to be aware of going into this so you’re prepared. First, not everyone is a candidate for Invisalign. It’s always possible your mom could agree to get you Invisalign but when you go to see a dentist or orthodontist, it turns out your case is too advanced for Invisalign and you have to do traditional braces.

Second, it will cost your mother additional money if you misplace your aligners, which has been a problem with teenagers using the procedure.

Third, you must wear the aligners the prescribed time or it won’t work. This is a great treatment, but it’s a treatment which requires patient compliance requiring maturity. Be honest with yourself about your abilities to take this seriously.

Best of luck convincing your mother!
This blog is brought to you by Tulsa dentist Dr. Ryan Noah.

Solution for a Huge Tooth Gap

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I have a tooth gap big enough to almost fit another tooth in. My dentist suggested Lumineers. I can’t imagine that scenario turning out well. What would I have? A center tooth like a cyclops? Eeww! I do want a solution though. What do you recommend? Please don’t say Lumineers. I might cry.

Luna

Dear Luna,

A woman placing her Invisaliagn aligners

Orthodontics no longer has to mean metal braces

I’m glad you have more sense than your dentist. You’re right that Lumineers would end up a disaster. With such a large gap you’d need one of the top cosmetic dentists in the world to make that look natural. I have a much better solution for you.

Commonly, a tooth gap is repaired using dental bonding. This closes the gap with a composite resin. However, again, the size of the gap you’re dealing with would make this challenging.

In your particular case, I’d suggest orthodontics. As an adult, you won’t want a mouth full of metal even if it means closing your tooth gap naturally. Instead, Invisalign will be a fantastic solution, but without being uncomfortable and unsightly. They have one of the highest patient satisfaction rates too.

Getting a Mini Smile Makeover with Invisalign

Many people find that by combining teeth whitening with Invisalign, they get a mini smile makeover of sorts. The Invisalign gives them beautiful straight teeth, while the teeth whitening takes years off their appearance and makes them a brilliant white color.

One thing to be aware of with teeth whitening is it will only whiten natural tooth structure. If you have other dental work, such as crowns or fillings, those won’t whiten from the solution. Instead, they’ll have to be redone in order to get them to match your new white color.

I hope this helps you. Again, I’m glad you sought out advice instead of just listening to your dentist’s disastrously bad suggestion.

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

Is Orthofill a Scam?

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I was looking at the Orthofill website. They seem to have a lot of regular people saying it worked for them. It’s so much more affordable than braces. All I really need to do is close a gap in my front teeth. This seems like a much more reasonable option. However, my dad always says if something seems too good to be true, it probably is. I just want to make sure I’m not getting myself scammed when I just want to close a gap. I’m not opposed to spending money, but I don’t want ugly braces and I kind of wanted something that worked faster than braces.

Mandy P.

Dear Mandy,

I’m glad you wrote. People see their gap closing and think “Problem solved.” What they don’t see is that the gap will eventually open back up. The bands don’t actually work on your teeth the way true orthodontics would. They tip your teeth toward one another. You’d get the same results if you wrapped small rubber bands around your front teeth.

There have been horror stories with these too. Bands have wormed their way underneath people’s gums causing horrific damage to the patient. As the bands are most often worn during sleep, you wouldn’t even know it was happening.

Orthodontics aren’t the only solution for a tooth gap. There are cosmetic solutions, such as dental bonding as well. That will use a composite solution to fill in the gap on your teeth. If there are other things you’d like to change on your teeth, porcelain veneers are a great solution. They can completely remake your smile. You mentioned the only thing you were interested in is the gap, so this probably isn’t your solution. I just wanted you to know it was available.

Also, if you’d like to close the gap, not just cosmetically, but actually. There is a way to do it without bulky metal wires and brackets. Invisalign can do the same things as braces, without anyone knowing you’re wearing anything. Faster too.

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

Orthodontics for adults

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I’m 42 years old with crooked teeth. I’m determined to do something about it in 2016, but don’t want to wear teen aged braces with mouth full of metal.  Tell me there is something else for adults?

Leslie M. – Connecticut

Leslie,

You are in luck!  You can have straight teeth in 2016 and not only do it without metal braces, but do it without anyone ever knowing. There are tons of advances in orthodontics.

Invisalign uses invisible aligners.  Not everyone is a candidate, so you’ll have to be checked to see if they’ll work for you.

If you’re serious about a smile makeover, you’ll want to look into porcelain veneers. These won’t straighten your teeth, but they can make them appear straight. The big benefit about these is they can change the shape, size, and color of you teeth. You can get a completely new smile.

Good luck with your new smile in the new year!

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

My daughter is in tears because she doesn’t want braces

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I have a sixteen year old daughter. We just moved to the states. The children here seem to all have perfect teeth. I know she should get braces, but she is very upset about it.  She said the children with braces are made fun of and she doesn’t want that to happen to her. If she’s happy with out straight teeth, should I make her get braces?

Maggie L. – San Diego, CA

Maggie,

Whether or not your daughter gets braces is a decision you’ll have to make together. It wouldn’t be fair of me to tell you what is the best decision for your daughter, especially since I haven’t examined her.  Maybe her teeth are fine, but just crooked. In that case it wouldn’t matter if she got braces. In other situations, maybe her teeth are out of alignment in a way that can lead to TMJ. That can cause serious problems and pain for her.

My suggestion is you see a dentist who does orthodontic work and they can examine her and see what will be best for her.  I do have some good news for you. If it is determined that she will need braces, she’s not stuck with those metal things that makes her afraid of being made fun of in school There are now “invisible braces”, such as Invisalign. No one will ever know she is wearing them. Her teeth can be straightened in secret.

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