What is Orthodontics Wax and What is it used for?

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After braces or Invisalign have been placed, it will take some time to get used to them in the mouth. This is when you will most require wax. The braces or the edges of the aligners might irritate causing some discomfort on the inside of the mouth. Wax helps to create a barrier between the bracket and the inside of your cheeks, lips. Over time as you get used to the braces and your mouth “toughens up” you may require less wax.

Orthodontic Wax is usually made of paraffin, bees wax or carnauba and is generally given to you in your goodies bag when you first get your braces on. The wax is not toxic and so there is no need to worry if you happen to swallow it accidentally.

Alternatives to Orthodontic Wax

If you are not a fan of wax or you have run out of orthodontic wax, there are some clever substitutes you can use for the time being until you can get your hands on some orthodontic wax.

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Sugar Free Chewing Gum 
The title itself specifies that the gum you choose MUST be sugar free. Take a small piece of sugar free gum and roll it into pea sized ball. The constant rolling would make the piece of gum soft enough to be placed on the sharp edge of the braces. If the gum remains dry or hard even after rolling it, chew on it for a few minutes until it becomes soft and mushy. Then tear it into small pieces and stick it onto the sharp edges.

This is however only a short term fix for protecting your lips and cheeks from the braces and should not be used as a long term solution. Using sugar free chewing gum should get you through until you are able to get back in to see us and get some orthodontic wax.

Even if you are still struggling with mouth irritation despite using wax or other methods – don’t give up. The mouth will normally adjust over time and the irritation will settle down. You will have your new smile sooner than you know it.

Why did that bracket fell off?

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We understand it can be frustrating when after getting your braces on, one of the brackets come loose. What causes this and how can it be avoided? There are at least three reasons why this happens:  

1) The tooth

2) The placement technique

 3) The patient (yes YOU!)

Ideal bond strength is most easily achieved between normal ivory colored enamel and a new orthodontic bracket. Although there are different orthodontic adhesives on the market, most have at least enough strength to hold a bracket on a normal tooth under regular conditions. When an orthodontic bracket is attached to any other surface besides normal enamel, there is a loss of bond strength that results in more frequent debonding. Examples of other surfaces include porcelain, hyper-calcified enamel (usually have a white, chalky appearance), hypo-calcified enamel (usually yellow or brown staining visible), or any number of dental restorations including tooth-colored composite and silver fillings. If a bracket must be attached to any of these surfaces, there will be a loss of bond strength. Another tooth-related cause of loose brackets is a bad bite. If a tooth in the opposing arch hits on a bracket when the patient bites down, or even if a cusp tip in the opposing arch is directly across from a bracket, it is more likely that bracket will become dislodged during chewing. After placing brackets in our office, we have our patients bite together to see if any are in occlusion. If they are, we place some temporary composite between the teeth to keep things from hitting.

The second variable that determines if a bracket stays on is the clinical technique used by the orthodontist. Modern bonding techniques require that teeth are clean, isolated, and dry before they are sealed. Although there are some cements (like glass ionomer) and some conditioning systems (like self-etching primer) that are more forgiving of contamination by water and saliva, both of these techniques produce bonds that are clinically weaker than regular etching and sealing. A second step in the procedure that can affect bond strength is how well the adhesive is forced into the mesh pad on the back of the bracket. If the cement is not thoroughly incorporated into the mesh, weaker bond strength will result. Finally, there is also a direct correlation between the amount of time that the doctor takes “fiddling” with a bracket before curing it and the strength of the bond. The more times the bracket is moved, the thinner and less uniform the cement on the back of it and therefore the weaker the resulting bond.

The patient is the third cause of bracket failure. Although all patients receive instructions about what they can and cannot eat with their braces on, changing eating habits is challenging. Hard and sticky foods must be avoided. This includes ice! Some patients forget that even some healthy foods (like raw carrots) are not good for their braces and must be avoided during treatment. Sports mouthguards are essential, but they can also dislodge brackets and should be reported to the orthodontist. Last but not least, any habit that involves foreign objects going into the mouth (like pens, fingernails, etc.) must be identified and stopped.

It is important that you check your braces every night when you brush to make sure that none of the brackets have come loose during the day. Although patients commonly tell me a bracket came off during brushing, in reality it was probably already loose but was merely discovered at that time. You can tell if a bracket is loose by gently pushing on it with your finger. If you notice that it moves but the tooth does not, it is probably no longer attached. 

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Why aren't my child permanent teeth coming in?

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Did your son or daughter lose a baby tooth months ago and there is still no sign of a replacement tooth? Here are two common reasons (and three rare ones) why this sometimes happens.

First, for a permanent tooth to erupt into place, there must be sufficient space. The permanent teeth in the front of the mouth are much wider than the baby teeth they replace. Ideally, by the time a baby tooth is lost, there should be extra space on either side of it so that the permanent tooth will have plenty of room. If there is not enough space however, the permanent one won’t come in. This is surprising to parents whose child’s teeth “looked perfect” before the baby one fell out. But baby teeth shouldn’t look perfect by age six; there should be spaces between all the front ones. If there is insufficient space when the baby teeth are lost, your child may need orthodontic treatment to help the permanent teeth erupt.

Second, when a permanent tooth does not come in after a baby tooth has been lost, it may be because the tooth underneath is heading in the wrong direction. There are times when a permanent tooth just doesn’t follow its baby tooth and erupt correctly. This is very common with upper canines and lower second bicuspids. Even when there is enough space (which is almost always the case in the lower arch), the permanent teeth can veer off course and end up in the wrong place. In many cases, removing a baby tooth as soon as the problem is identified may help correct the path of eruption. If the path doesn’t change however, orthodontic treatment is usually required to rescue the wandering tooth and guide it into the right position.

While crowding and crooked eruption paths are the most common reasons why permanent teeth don’t come in on time, there are three rare conditions that must also be considered. First, it is possible that the permanent tooth that corresponds to the lost one just never developed. In cases of missing permanent teeth, most baby teeth do not get loose on their own. Sometimes however, they are lost and there is nothing to replace them. Second, there is a rare condition called primary failure of eruption in which the permanent teeth are present, they just don’t come in on their own. In these cases, braces and oral surgery are required to rescue them. This condition usually affects multiple teeth and treatment times may be three or more years. Lastly, there is a condition called ankylosis where the teeth are fused to the bone and won’t erupt. Although it is sometimes possible to “wiggle” them loose during a surgical procedure, there are many times when these teeth just cannot be moved and must either be left where they are or removed.

If your child lost a baby tooth and no replacement one has come in, you should have him or her evaluated by an orthodontist. An orthodontist is a dental specialist who has two to three additional years of training after dental school in diagnosing and treating problems related to development. Even if there is nothing wrong, it is good to have the peace of mind that comes with knowing that everything is normal.