Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Does My Orthodontist Have to Pull My Teeth?

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My orthodontist wants to pull a couple of my teeth. He says it’s the only way he can make all my teeth straight and keep them that way. I disagree. I’ve never heard of this and I don’t understand why he would want to remove good teeth. Aren’t dentists supposed to be in the business of saving teeth, not pulling them? What should I do? Is this normal and something I have to go along with or is the guy a little off his rocker?

Jeremiah

Dear Jeremiah,

Yes, orthodontists commonly remove teeth as part of treatment. There are a number of reasons why they do, but a lot of time it comes down to not having enough space. If you have a narrow arch and a full set of teeth, there may not be enough room for them to be straightened out and fit properly. This likely is the cause of you having less than straight teeth to begin with. When an orthodontist catches cases like this early on, before the top of a child’s mouth is fused, a metal expander can be used to gradually widen the arch. At a certain age, usually around age 12 or so, the palate becomes hard and can’t adjust, so the only way to make room for everything is to remove some teeth.

There are other reasons why it might be necessary as well, such as to correct an overbite or to prevent the roots of the teeth from becoming exposed during treatment in some cases, but a lot of the time it simply comes down to making room.

Having straight teeth makes it much easier to keep them clean and to clean between them, which in turn helps prevent decay. So, although those teeth are healthy now, keeping them could indirectly affect the health of all your other teeth in the long run. When an orthodontist considers your treatment plan, he takes time to weigh the value of performing extractions. They’re not the easy way out, but they can help produce the results you need.

Should you go along with it? Only you can decide that. However, If you’re on the fence about it, find another orthodontist and have him provide an assessment. You don’t even need to mention your concerns about the extractions- just ask him what the best way to get the results you want is. If he suggests extractions, then you know it’s probably a solid choice. If he doesn’t, then you can see how he feels about it. Best of luck to you.

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

Metal or Ceramic Braces

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I need to get braces and am having a hard time deciding between metal or ceramic braces.  Can you help? I’ve heard they’re less visible, but can have some other problems.

Dave H. – Montana

Dave,

You’re right that the ceramic brackets are less visible than the metal brackets. However, they will still have the metal wire going through them, so I’m not sure how beneficial that is. Here are some of the downsides to ceramics and you can decide what you feel has more weight to it.

  • Ceramics are stronger than the enamel on your teeth, so if you bite down and hit one of the brackets, you risk chipping a tooth.
  • Some orthodontists charge more for ceramic brackets.
  • Ceramics are harder to remove.

There is an alternative if your goal is to have less visibility on your orthodontic treatment. Have you spoken with your dentist about Invisalign? These are completely invisible, even at a conversational distance.

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

I Need Dental Implants and Braces

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Can you advise me? I need some dental implants on two teeth I lost in an accident. I also wanted to get my teeth straightened. which procedure is it important to do first?

Jeannie L. – Portland

Jeannie,

You’ll need to have your teeth straightened before you get your dental implants. Dental Implants are surgically implanted directly into your jawbone. They don’t have the ligaments that allow them to be moved, like your natural teeth can.

One exception would be if you need the implants in your molar. In some cases those need to be placed first.

Either way, I would meet with your orthodontist and your implant dentist and make sure they’re communicating.

If you have a dentist who does both orthodontics and dental implants, that would be ideal.

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

Will braces really cost more if I leave my son’s baby teeth alone?

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My son has teeth erupting behind his baby teeth. My dentist thinks I need to have his baby teeth extracted. He says if I don’t it will make the braces harder and more expensive later. To be frank, I think he’s being melodramatic in order to get some more money out of me. I mean, if he’s going to need braces, he’s going to need braces. Why would it be harder if the adult teeth stayed where they are? They’re there now anyway.

Lisa – Delaware

Lisa,

I don’t think your dentist is trying to squeeze extra money out of you. The fact of the matter is, the longer your child’s adult teeth are in the wrong position, the harder it is to move them into the correct position with orthodontics. The more difficult the orthodontic case, the more expensive it is.

If the baby teeth are loose and about to come out, then sure, you may let nature takes its course. But, if they’re holding firm, then I would agree with your dentist. The teeth need to be extracted.

I hope this helps put your mind at ease.

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

Does Invisalign hurt as much as braces?

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When my first daughter had braces they hurt her all the time. The inside of her mouth was constantly cut, no matter how much “wax” was put on the brackets. My youngest child now needs braces. I keep hearing about invisalign. Are they more comfortable than braces?

Irene F. – Nevada

Irene,

Your youngest daughter is lucky. Orthodontics have changed a lot. Invisalign is much more comfortable than traditional braces, as long if she is a good candidate. There are some things to take into consideration.

First, they are slightly more expensive than traditional braces. But, given your first child’s experience, I doubt you’d mind.

The second one is your youngest child’s responsibility level. Unlike braces, Invisalign is removable. So, if your child won’t keep them in, that could be a problem. The treatment only works if they’re kept in the prescribed amount of time.  There is an Invisalign Teen which has a few replacement aligners, but only you know your child.

I hope this helps.

This blog is brought to you by Tulsa Dentist 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.

Can’t get a date. Is it my teeth?

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Everyone says I am beautiful. I can see where my face is pretty, but I have a huge gap in my front teeth. Could that be why I can’t get a date? If so, what can I do about it at 37? I’m not wearing braces.

Jenna S. – Maine

Jenna,

I would be ridiculously unfair of me to say your teeth are the reason you can’t get a date. It could be you just haven’t met the right guy. It could be you’re beautiful AND wicked smart, so men are intimidated.  I won’t convince you to get a procedure based on something emotional and personal.

What I can do is tell you how to discreetly fix your teeth at 37. You have a few options.

  1.  Fill in the gap.  That can be done wtih dental bonding. I have a hesitation with this, simply because you said the gap was huge. You don’t want to do this if filling it in will make your smile look unnatural.
  2. Invisalign.  If all that is worrying you about your smile is the gap, Invisalign can close it without you having to wear traditional metal braces.  This uses clear aligners to gently shift your teeth into proper alignment. No one will even know you’re doing it.
  3. Porcelain Veneers. I’d only suggest this if you needed a complete smile makeover. It can change the shape, size, and color of your teeth.

I’d pick one of these only if YOU are unhappy with your smile.  Otherwise, go about your life. The right man will come along.

This blog is brought to you by Tulsa Dentist 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.

SmileCareClub

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What can you tell me about the Smile Care Club?

Jessica B. – Flagstaff, AZ

Jessica,

The SmileCareClub is, in essence, a do it yourself Invisalign treatment. There are some differences.

  1. Your treatment is not monitered by a dentist, so if something goes wrong, you’re on your own.
  2. A dentist looks at pictures of your teeth, to see if you’re a good candidate. That might work to tell if there is a crowding issue. Unfortunately, he or she is not likely to be able to tell if you have gum disease. That could be a serious issue, because if you have gum disease, the shifting of your teeth could cause them to come loose.
  3. With Invisalign you switch aligners every two weeks, with SmileCareClub every four.

It possible this will work. I would just be concerned about the possibilities of things going wrong and not having an orthodontist or dentist who does orthodontic work to keep his or her eye on things.

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

Does invisalign teen work the same way as invisalign for adults?

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I was thinking of getting my daughter Invisalign because I was so happy with mine.  She’s 14. I know they have invisalign teen. Do they work the same?

Jenna K. – Orlando, FL

Jenna,

I’m glad to know how much you enjoyed your Invisalign treatment. It has a very high patient satisfaction rate.  Invisalign teen works very much like the adult version.  There are two big differences.

The first is that unlike the adult version,  Invisalign teen can work on studentst that have erupting or erupted permanent dentition. An orthodontist can tell you if she is a good candidate. The second big difference is extra aligners. Because invisalign realizes that teenagers aren’t always as responsible as adults. Because of that, they do offer a few extra aligners in case your darling misplaces one or two.

It is still very important that they wear the aligners for the prescribed amount of time. Otherwise the treatment won’t work. If you think she’ll cooperate with that, then Invisalign Teen is a great option.

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