Our Blog

Spacing Out

December 16th, 2020

One of the most common reasons for getting braces is because there’s just not enough room for all your teeth to fit next to each other evenly. The result is overlapping and crooked teeth. What’s the first step in creating the space you need? Well, that depends on just how much room you need to align your teeth and bite properly.

When there is going to be a serious need for space, there are orthodontic solutions that can help, including palatal expanders, surgical options, and extractions. But if you only need a tiny bit of room so that regular braces will fit properly, we have a tiny solution—orthodontic spacers!

Why do you need to make space before you get braces? Because Drs. Cassinelli and Shanker might need to make some room around crowded molars so your braces can be installed properly.

For example, you might need orthodontic bands to anchor your braces. An orthodontic band is a slim, custom-fitted ring of metal which fits snugly around a molar. It is durable, provides a place to attach bands and springs to help correct malocclusions (bite problems), and can securely surround a tooth that might be weak because of a large filling. Spacers can separate crowded teeth just enough to allow a band to be fitted around a molar.

Even if you don’t need bands, sometimes separators are necessary to provide enough space between the teeth for your braces to work effectively. The back teeth tend to move even closer together with braces, and, without adequate space, bite problems, risk of decay, and other difficulties can arise.

And while you might think that some serious equipment is in order to make room between those sturdy molars, the typical spacer, or separator, is actually extremely simple--usually a tiny, round elastic band, often made of rubber. Spacers can be placed between tight teeth in a matter of minutes. Each ring is stretched and positioned between your teeth with a special tool. As it returns to its original shape, the spacer’s width provides just enough pressure on the teeth it touches to make a bit of space between them. And a bit of space is usually all you’ll need.

What do spacers feel like? For some people, they can be uncomfortable. You might feel soreness, some pressure, or as though a piece of food is stuck between your teeth. Ask us for suggestions on making you more comfortable, whether it’s dining on ice cream and cold drinks, eating soft foods, or taking over-the-counter pain relief. Separators are only designed to be in place for a very short period (usually under two weeks), but if they are causing you pain, give us a call.

What do you need to do to help the process along? Actually, it’s more what you need not to do. Don’t use dental picks or floss on your separators, avoid chewing gum, and take chewy and sticky foods off the menu. And don’t be tempted to touch or play with your spacers!

Spacers can create space between the teeth so quickly and efficiently that they often fall out on their own after a few days. If your separators fall out, give our West Chester or Cincinnati, OH office a call. It could mean that you are ready for your braces, and on the way to a lifetime of healthy, beautiful smiles. And it’s a journey that begins with a tiny, springy step.

Start Your Day Off with a (Healthy) Smile!

December 9th, 2020

If there’s one meal that can claim the title of “Sweetest Meal of the Day,” it’s almost certainly breakfast. Sugary cereals, syrup-covered waffles, oatmeal with honey, cinnamon toast (which is literally sugar poured on toast)—it’s hard to imagine another menu even coming close. But you’re trying to keep your diet as healthy as possible. What to do?

First, no need to deprive yourself of the occasional pastry or stack of pancakes. The real problem with breakfast isn’t so much sugar as it is added sugar.

  • Just a Spoonful of Sugar? What’s So Bad About That?

Nothing! Many healthy foods have natural sugars. Milk contains lactose sugar, and it also contains calcium and is enriched with vitamin D—both of which are essential for strong bones and teeth. Fruits get their sweetness from a sugar called fructose, and deliciously provide vitamins, minerals, antioxidants, and fiber to our diets.

Even processed sugar is surprisingly low in calories. In fact, a teaspoon of white sugar has only about 15 calories. But this teaspoon is also rich in nutrients for cavity-causing bacteria. The oral bacteria in plaque use sugars and carbohydrates from food particles as a fuel source to produce acids. These acids erode enamel and lead to cavities.

Choosing breakfast foods without additional sugars, then, is an easy way to reduce the number of empty calories in your diet while safeguarding the health of your teeth. We have a few suggestions.

  • Be Selective with Cereals

If the word “sugar” or “honey” or appears on the box, that’s a hint that your favorite cereal is heavy on the sugar. But there’s a more scientific way to tell just how much sugar is in that spoonful.

While the colorful packaging and playful mascots are eye-catching, check the black-and-white panel with nutritional facts found on every box. If one serving equals 27 grams, and the sugar in that serving equals 15 grams, you know you have a problem. And cereals marketed to children are especially “rich” in added sugar.

But luckily, you don’t need to give up your morning bowl. Many cold cereals are available that offer whole grains, protein, and fiber without a lot of added sugar. Spend some time in the cereal aisle comparing, or, to make life easier, there are many online sites which recommend the best (and worst) cereals in terms of sugar content.

  • Use Your Judgment with Juices

Fruits are packed with important nutrients. Not only do they provide essential vitamins and minerals, they’re a great source of water and fiber. If you drink 100% fruit juice, you are getting the benefit of most of the vitamins and minerals found in fruit. (You’re also getting less of the fruit’s natural fiber, and more of the fruit’s natural sugar, so consider fresh fruit as an option occasionally.)

But when fruit juice comes with “cocktail,” or “punch,” or “ade” attached to the end of it, there’s often something else attached—added sugar. For natural fruit flavor and the least amount of sugar, stay with 100% unsweetened fruit juice.

  • Search Out “Surprise” Sugars

Remember the childhood excitement of searching through your cereal box for the prize inside? Fun! What’s not so much fun? The surprises you might find when you search through the labels on your favorite breakfast items—because added sugars make their stealthy way into many of our morning favorites.

When you compare plain, Greek, and low-fat yogurts, for example, the low-fat options are often higher in added sugar. A container of low-fat yogurt can provide 19 grams of sugar—that’s a tablespoon and a half!

And while you’re at it, be sure to compare the sugar content in granola bars. Some are full of nuts and grains, and some are full of added sugar.

Going out for a breakfast smoothie? Those can contain 70 grams of sugar and more. Making your own at home might be a little more time-consuming, but if you use fresh fruit as your sweetener, you can make sure that what you’re not consuming is added sugar. If you’re on the go, check out all-fruit options at your favorite smoothie shop.

Drs. Cassinelli and Shanker and our team aren’t asking you to eliminate sugar from your breakfast diet altogether. (Everyone loves a doughnut now and again.) But substituting some alternatives for your regular menu choices can reduce the amount of added sugars by tablespoons every meal. That’s another great reason to greet the morning with a smile!

When Does an Underbite Need Surgery?

November 25th, 2020

When does an underbite need surgery? The short answer is: when Drs. Cassinelli and Shanker and our team recommend surgery as the best way to give you a healthy, functional bite. But let’s take a longer look, and see just why your doctors might come to that conclusion.

  • First, what exactly is an underbite?

In a perfect bite, the upper and lower jaws align, well, perfectly. Upper teeth overlap lower teeth very slightly, upper and lower teeth meet comfortably, and jawbones and joints function smoothly. When the alignment is off, it causes a malocclusion, or “bad bite.”

When we talk about an underbite, or Class 3 malocclusion, it means that the lower jaw protrudes further than the upper jaw. This protrusion causes the bottom teeth and jaw to overlap the upper teeth and jaw.

  • What causes an underbite?

Sometimes an underbite is caused by childhood behaviors while the teeth and jaw are developing, including tongue thrusting or prolonged thumb-sucking and pacifier use. (Working to stop these behaviors before they affect tooth and jaw formation is one of the many good reasons children should have regular visits with their dentists and pediatricians.)

Most underbites are genetic, however, and tend to run in families. It’s estimated that from five to ten percent of the population has some form of underbite. The lower jawbone (mandible) might be overdeveloped, the upper jawbone (maxilla) might be underdeveloped, both bones could be affected, or, sometimes, tooth size and placement might cause an underbite. These irregularities in jaw shape and size and/or tooth crowding are not something that can be prevented, and require professional treatment.

  • Why? What’s the problem with an underbite?

Even a minor underbite can cause difficulties with biting and chewing. A more severe underbite can lead to speech problems, decay and loss of enamel where the teeth overlap, mouth breathing and sleep apnea, persistent jaw and temporomandibular joint pain, and self-confidence issues.

  • Can’t my dentist treat my underbite?

Most probably not. A very mild underbite can be camouflaged cosmetically with veneers, but this does not address the cause of the underbite, and will not work for moderate or severe underbites.

  • Can my orthodontist treat my underbite?

Drs. Cassinelli and Shanker will create an underbite treatment plan after a detailed study of each patient’s individual dental and skeletal structure. Treatment options will vary depending on the cause of the underbite, its severity, and even the patient’s age.

Early intervention is especially important for children who show signs of an underbite. That’s why we recommend that children visit our West Chester or Cincinnati, OH office by the age of seven.

If an underbite is caused by tooth misalignment or crowding, braces can reposition the lower teeth. Sometimes extractions are necessary to make room for proper alignment.

If the cause is due to jaw structure, children’s bones are still forming, so treatment can actually help correct bone development. Palatal expanders, headgear, and other appliances are various methods of encouraging and guiding bone development.

But braces and appliances aren’t effective for every patient with an underbite, and especially in patients (usually those in their late teens and older) when the jawbones are already fully formed. In this case, we might suggest coordinating treatment with an oral and maxillofacial surgeon.

  • What does an oral and maxillofacial surgeon do?

An oral surgeon has the training, experience, and skill to help correct an underbite by surgically reshaping and repositioning the jawbone. This corrective jaw surgery is called orthognathic surgery.

  • What will happen during orthognathic surgery?

Your treatment will be tailored to your specific needs. Two of the common surgical procedures for treating an underbite involve repositioning the upper jaw to lengthen it and/or reshaping the lower jaw to shorten it.

Bone is sometimes removed or added, small bone plates or screws are sometimes used to stabilize the bone after surgery—your surgeon will let you know exactly which procedures will give you a healthy, functional bite. The surgery itself is most often performed under general anesthesia and requires a brief stay in the hospital.

  • How will my orthodontist and oral surgeon coordinate my treatment?

Correcting a Class 3 malocclusion can take time. Your oral surgeon will work together with Drs. Cassinelli and Shanker to analyze the interrelationship of teeth, bones, and joints to determine dental and skeletal problems, and will develop the best treatment plan possible to create a healthy alignment.

  • So, when does an underbite need surgery?

Sometimes, a minor underbite can be corrected with braces and appliances alone. A serious underbite, however, will often require the specialized skills of both Drs. Cassinelli and Shanker and an oral surgeon.

And, while it’s not the primary purpose of surgery, corrective jaw surgery and orthodontics can also make you happier with your appearance and boost your self-confidence. Achieving a lifetime of beautiful, comfortable, and healthy smiles—that’s the answer to your question.

Tube Talk

November 18th, 2020

The topic is tubes. No, we’re not talking about TV shows, or sports socks, or British subway systems. We’re talking toothpaste! With so many options out there, which toothpaste should you be looking for to keep your teeth their cleanest and healthiest during orthodontic treatment?

  • Fantastic Fluoride

The last thing you want while you’re wearing braces is a cavity. Cavities develop when plaque sticks to a tooth. The oral bacteria found in plaque produce acids that weaken your enamel. Over time, these acid attacks lead to the breakdown of the enamel and a cavity forms. But you have a way to stop this process. Fluoride provides protection against cavities. Fluoride toothpastes contain minerals that actually strengthen your enamel, and can even repair early damage before a cavity has a chance to form. Whichever toothpaste you choose, fluoride is the most important ingredient.

  • Terrific Tartar-Control

What is tartar, anyway? Tartar, or calculus, is hardened plaque. It’s so hard, it can’t be removed by brushing alone—that’s why your dental hygienist uses special tools to remove it when you have a cleaning. Tartar buildup can lead to receding gums and gum disease, so prevent this buildup before it starts by using a toothpaste especially formulated to remove plaque.

  • Desensitizing Decisions

There are many causes for tooth sensitivity. If painful sensitivity is caused by hot or cold drinks, it could mean a dental issue such as decay or a damaged tooth, and your dentist can help diagnose and treat the problem. Sensitivity be a sign that you’re not cleaning around your braces well enough, leading to sore and inflamed gums. Sometimes sensitivity can actually be caused by over-enthusiastic brushing. Remember, massage, don’t scrub! For some extra-sensitive teeth, a desensitizing toothpaste or even a prescription toothpaste can help. If you find that your teeth are more sensitive only after an adjustment, give us a call. This is usually temporary.

  • What about Whitening?

Whitening toothpastes do a good job of taking care of some surface stains, so why not use them? Because they take care of some surface stains. When your braces are in place, your brackets cover a small portion of your enamel—a portion that won’t be whitened as you brush. Generally, because whitening toothpastes don’t make a huge difference in tooth color, this might not be a problem. Talk to Drs. Cassinelli and Shanker before you decide to whiten, and we’ll have suggestions just for you.

In fact, if you have any questions about the best toothpastes for orthodontic patients, contact our West Chester or Cincinnati, OH office! Getting your braces is a great step forward on your way to a beautiful smile. Let us help you choose the right toothpaste to make sure that beautiful smile is a healthy and lasting one.