Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Orthodontist Shaved My Son’s Teeth

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I’m fuming after a visit to the orthodontist. I took my 12-year-old son in to get started with orthodontic treatment. The doctor said it would be a longer visit because they were getting everything set up, but didn’t really elaborate on everything they’d be doing. It may be on me, but I didn’t clarify. I just thought he was getting braces put on. Come to find out, AFTER the appointment no less, that the dentist shaved his teeth. I had to hear about the procedure from my son. I thought he was mistaken when he came out and told me what they’d done, so I corrected him, and the assistant then told me what my son was saying was accurate. She said it was normal for treatment and that they do it with all their patients. Now, on top of everything else, I’m worried about the long-term damage the orthodontist may have caused. Why did he do this and can it be fixed?

Signed,

Not Ok in OK

Dear Not Ok,

Smiling young woman with braces

Why Did the Orthodontist “Shave Teeth?”

This is done to make space. Once the dentist measures out how much space is there and how much space is necessary for all the teeth once they’re in alignment, it becomes apparent if more space needs to be made. There are several ways to make space, such as palatal expanders and tooth extractions, but reducing the width of teeth is common as well. In short, if the dentist removes just the tiniest amount of structure on the sides of each tooth, it adds up to a fair amount of space overall. This may have been the easiest and least invasive method for your son. It’s referred to as “interproximal reduction.”

Interproximal Reduction is Safe

Although each dentist has his own toolkit he draws upon for various cases, interproximal reduction often earns a place in the toolkit because it is a safe and fast choice. True, some of your son’s enamel is gone now. Nothing will bring it back. However, if the reduction was such that your son would be at an increased risk for decay now, the dentist would have protected the surface with dental bonding. You can confirm if this was necessary with the dentist.

The Dentist Should Have Spoken with You

Despite the fact that this is a safe and trusted procedure, the dentist should have explained it to you in advance. He’s required to get “informed consent” before procedures are carried out, and if he didn’t fully inform you, then you didn’t give consent. That’s not ok. It’s possible he glossed over it or the detail was lost amid all the new information you were being given at the time, but if you’re 100% certain he didn’t discuss it, or even think he should have been more direct about it, then you should mention it to him. Again, it doesn’t sound like his practice was off, but if he’s missing the mark in communication, he needs to address that.

This post was sponsored by Dr. Ryan Noah, a Tulsa orthodontic treatment provider.

Invisalign for Spacing Problems

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I had braces as a young teenager, but over the years I’ve had some spacing develop between some of my teeth. I don’t feel like I’d be comfortable with traditional braces at my age. In that case, would I be able to get Invisalign for this type of issue?

Andrea

Dear Andrea,

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

It’s normal for our teeth to move some over the years. If your teeth and gums are healthy, you would be a fantastic candidate for Invisalign. This is a lovely way to straighten your smile without anyone even knowing you’re wearing anything. In your case, you can probably get Invisalign Express which works in even faster.

Aside from enabling you to repair your smile without anyone knowing and without a mouth full of metal, the Invisalign aligners can double as teeth whitening trays. This will give you a sort of mini smile makeover.

Orthodontist Versus Dentist

It used to be that you’d have to see an orthodontist anytime you needed to straighten teeth. Now, it’s not necessary in most cases. Dentists can do Invisalign. Some even do braces. There are still times you would have to see an orthodontist when you have a very complicated case.

That’s not you, so you shouldn’t have any problems. You just need to find a dentist who provides Invisalign. I think you’ll find it a wonderful way to get the smile you had and loved.

One Word of Caution

While some movement of teeth is natural as the years go by, you want to make sure there isn’t another reason for your shifting. Specifically, you’ll want to make sure you don’t have any gum disease. If you see a dentist regularly and have good oral hygiene at home that shouldn’t be an issue.

Your dentist will do an exam ahead of time to make sure you’re gums are healthy enough. If not, you’ll just have to treat the gum disease and then you can get the Invisalign treatment.

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

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

If My Teeth Shift, Do I Re-do Invisalign Treatment?

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I had an Invisalign treatment when I was in my late teens. I’m in my mid-20s now and my teeth seemed to have shifted. Do I need to re-do the Invisalign treatment?

Missy L. – Pennsylvania

Missy,

First, I’d like to assure you it is normal for people’s teeth to shift. If they didn’t, orthodontics would never work. However, genetics plays a large factor in how much shifting people experience.

It’s likely your dentist provided you with a retainer to wear temporarily after you completed your Invisalign treatment for a specific period of time. If your teeth are shifting you may want to wear that retainer again.

The only reason I would re-do the Invisalign treatment is if your teeth shifted into a position you don’t like. Otherwise, a retainer should do the trick.  Some people have teeth which constantly shift. For those patients, I often recommend a permanent retainer. This is permanently fixed to the back of your teeth. You’ll be able to keep your teeth in proper alignment without worrying about people seeing your retainer.

Talk to your dentist or orthodontist. When they look at your bite, they’ll be able to tell you which treatment is preferable in your case. It’s likely, because your Invisalign treatment was completed in your teens, you’re going to a new dentist. Your old dentist should be able to easily provide any records or information your new dentist need about your Invisalign treatment.

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

I’ve Developed a Space after Braces

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I had my braces taken off just over two weeks ago and I’m already seeing a space developing between my two bottom front teeth. I haven’t worn my retainer 24/7 but I didn’t expect this to happen so fast. What should I do?

–  Anne in Oklahoma

Dear Anne,

It is extremely important that you wear your retainers religiously after the removal of braces until otherwise suggested by your orthodontist. The reason for this is that your teeth will automatically want to move back to their original position they were in before the braces were placed on them. You might not notice any change in tooth position but this will become more noticeable over time. The main reason you need to wear retainers is to keep your teeth in the position they were in after the removal of your braces. Teeth can easily shift in a day or two after the removal of braces. Elastic fibers in your gums that hold teeth in place become stretched with orthodontic treatment and it generally takes approximately a year for new elastic fibers to form and keep your teeth in their corrected position. This is why it’s so vital to wear your retainer as directed by your orthodontist.

We recommend that you visit your orthodontist as soon as possible. They may be able to tweak your lower retainer and close the space that’s developing. If this is not successful, you may need to have a new retainer made.

This blog brought to you by Dr. Noah of Region Dental.

Do I Need to Keep Wearing My Retainer?

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When I was a teenager, I had to get braces and was told to wear a retainer for a month all day and then later, only at night. My upper front teeth relapsed a bit, so I spoke with a new orthodontist who said new braces would fix this problem. He also suggested I could use my old retainer to get the teeth pretty straight and then have a new retainer made. He mentioned six months of daily full time wear and then at night would do the job.
I’ve worn the new retainer fulltime for nearly three years and notice one tooth seems to shift after a few hours of not wearing the retainer. So now, I feel like I can’t go more than a few hours without the retainer. Am I imagining this or does this occur sometimes? And if it happens, what are the repercussions? What should I do?
– Justin in Oklahoma

Justin,
You’re probably not imagining that your teeth are moving. Clearly, one tooth in particular, seems to be changing position a bit. You should continue to wear the retainer all the time, day and night. If you don’t want to wear it during the day, you have a couple choices.
Your first choice is to get a permanent retainer bonded to the insides of your teeth. This could be done on the upper or lower teeth. The only issue is cleaning your teeth – you’d need to use a floss threader to adequately clean your teeth. If you’re okay with this, this may be a good solution.
If you’re not keen on this, your other option is to have a tooth bleaching splint created. This clear bleaching tray holds your teeth in position and isn’t as noticeable as the basic orthodontic retainer.
A dentist should see you to determine why your teeth haven’t stabilized. It isn’t good for your teeth to change position so you need to keep using the retainer to avoid this issue. Hopefully, over time, the movement will stop.

This blog brought to you by Tulsa dentist, Dr. Noah.

What should I get done – dental implants or braces?

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I am looking to have some orthodontic work done and I’m trying to find out if it makes sense or not. Soon, my wisdom teeth will be extracted along with tooth #5 and tooth #12. These two additional teeth need to come out due to severe decay and a period of time where I drank too much soda without dental coverage. To be honest, I never really trusted my last dentist. So I was wondering if it is possible to still get braces with these teeth missing? Or do you think I need to get dental implants on each side where the teeth will be removed? Also, I had to have two crowns several years ago, one due to an injury and the other because the filling was large. Will that complicate the possibility of braces as well?

– Robert in Arizona

Robert,

The answer is yes, braces are still a possibility even if you do have crowns.

Although, you need to make sure your tooth decay problem is taken care of before having braces put on. Drinking soda and frequent snacking is harmful to your teeth, especially if you get braces. This is because the braces catch food which leads to more tooth decay. It is important to keep your braces pretty clean.

The tooth numbers you referenced, #5 and #12, are premolars so you don’t want to leave empty spaces there. Dental implants are an excellent solution to replace missing teeth. Or dental bridges may be another option that could work. If the teeth that surround those two teeth have suffered significant decay, bridges may be the better of the two options.

Hopefully that answers your questions.

This post is sponsored by Tulsa dentist Region Dental.

Related link: Invisalign

No crowns unless I get braces?

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Have you ever heard of a dentist refusing to place crowns without having braces done? Here’s what is going on. I went into my dentist today to to talk to him about replacing my old crowns that are on my front teeth. It has been about 15 years or so since they were originally put on and he told me that I need to have full orthodontic braces first. Pretty much I was told that I won’t be able to get new crowns if I don’t do the braces first. The problem is that I cannot afford to have braces and all I really want is to have the crowns replaced. I would consider his other recommendations at a later time, just not right now. I really don’t think my front teeth are that crooked, so I don’t know what to do. Can you provide any insight?

– Tom from Missouri

Tom,

It is not a good sign when a dentist gives you an ultimatum or places restrictions on what treatment they will provide. It sounds like he is only willing to do the perfect scenario and doesn’t seem to understand your budget concerns. Although a treatment may not always be ideal, doing something is most likely better than nothing if you can afford it.

It is possible to have the crowns fixed without having to do the braces. You could wait until you can afford the orthodontics or you could bypass it altogether if you choose.

Take a look around to see if you can find a dentist that is a bit more understanding about your budgetary constraints and will work with you.

For your front teeth it would be best to have all-porcelain crowns done. This is because if you have porcelain fused to metal crowns, then you run the risk of them ending up looking fake. Also, you may have a dark line that is visible along your gum line. But make sure that the dentist you choose is experienced and seems comfortable doing porcelain crowns. You don’t want to push a dentist out of their comfort zone because you may not end up with the results you want.

I hope this information is helpful to you.

This post is sponsored by Tulsa dentist Region Dental.

Related link: Invisalign

Crooked teeth from thumb sucking

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I sucked my thumb until I was 13 years old and my teeth are misaligned. My top teeth are curved upward but it’s not the typical overbite that you would expect. Do you know what I can do to have my teeth corrected? I’m ready to stop hiding my smile.

– Janie in Virginia

Janie,

Misalignment of your teeth is not too surprising having sucked your thumb for such a long period of time. An orthodontist will be able to help you straighten your teeth. Based on how you described the shape of your teeth, it sounds like they are not only out of position but they have an inaccurate inclination. Braces will correct both of your problems.

If you are the parent of a thumb sucker, the best advice is to not make too big of a deal out of the behavior. If you put too much pressure on your child and make too big of an issue of things, it may create a complex in your child and reinforce it. I really wouldn’t worry too much about it until your child is school age. There is no long-term, permanent damage that is done before the age of seven. This is because that is when a child typically loses their baby teeth. If you play it cool, when your child begins going to school they may experience peer pressure from their classmates and friends to stop the behavior.

The reason Janice’s teeth suffered from thumb sucking is due to the fact that she sucked her thumb until she was 13 years old. This means her permanent teeth had fully come in. If your child is over the age of seven and not showing signs of quitting, then you may need to step in. Be sure to use positive reinforcement versus causing shame or embarrassment. Again, you don’t want to create an emotional complex in your child or your plan could backfire. You will have the most success if the child wants to quit. Although, there are aids that you can find at the drug store to help break the habit. The products are bitter to the taste and can be painted on the thumb causing an unpleasant reminder of the habit. Again, be encouraging in your approach.

This post is sponsored by Tulsa dentist Region Dental.

Related links: Invisalign