After Braces

Dr. McHenry and Dr. Adams have the experience and skills necessary to provide beautiful results to all their patients, whether it involves correcting an improper bite or perfecting a smile. We offer a variety of cutting-edge methods for correcting your smile. The technology to align teeth – either with traditional metal braces, clear braces, or invisible aligners - has changed dramatically over the years and Dr McHenry has combined the latest techniques, technology and education to provide our patients with the best care available. Below are a few of the options we currently offer our patients.

Metal Braces
Metal braces are the most widely used system of straitening teeth. Our new mini metal brackets are a more aesthetic solution to larger metal brackets but offer all the versatility of traditional metal brackets. These braces are bonded to the teeth with a wire passing through them. The wire is usually held tightly to the brackets with small elastic o-shaped rubber bands and it is the wire which actually moves the teeth. The rubber bands can be metal colored (the most discreet) or colorful, depending on what you like. Metal brackets are very strong and can withstand most types of treatment. They tend to be the most inexpensive treatment and can treat the most severe cases.

Clear Braces
Radiance clear braces are a great method of inconspicuous orthodontics without compromising results. Radiance brackets use sapphire crystal instead of traditional ceramic giving us a crystal clear bracket which will not stain. The treatment time and functionality of the clear braces are generally the same as metal braces and can also treat more severe cases.

Invisalign
Invisalign is another alternative to traditional metal braces. Instead of moving your teeth with wires, as is done with braces, your teeth are moved with a series of clear plastic trays called aligners. They are virtually invisible, which means that most people won’t even notice that you are in treatment! This is a great option for teens and adults who are concerned with their esthetics while in treatment. Invisalign can be used to treat crowded teeth, widely spaced teeth, overbites, under bites and cross bites; the more severe the case, the less likely that it will be successfully treated by invisalign. Dr. McHenry offers free consultations to see if this option will successfully treat your case to give you the smile you deserve. Dr. McHenry does not recommend Invisalign for more severe cases where major tooth movement or bone movement is needed. Invisalign is more expensive than traditional metal braces or clear braces because the cost of the lab work is much higher.

Early Treatment
Many parents wonder what age is appropriate to bring their child to the orthodontist. While most children to not need to have braces until all of their baby teeth have been replaced at age 11 or 12 some children do require early treatment. The American Association of Orthodontists recommends that all children 7 years of age or older should be evaluated by an orthodontist to determine if treatment is necessary. Early treatment is designed to correct a specific identifiable problem and should generally take less than one year. It is used to intervene only when not doing so will cause the problem to worsen or severely complicate later treatment. This is generally seen when teeth do not come in on schedule, the top teeth are biting inside the bottom teeth, or there is a severe overbite. Other reasons for early treatment can include thumb-sucking or teasing at school which can affect psychological well-being.

Followup Treatments
Orthodontics can give you that beautiful smile you've always wanted. It can make your teeth straight and give you a healthy and favorable bite. Once your braces are off, your treatment is not necessarily over. You will need to wear retainers for at least two years following your braces.

Retainers
Retainers are required after braces to stabilize the teeth. Our teeth are held in place by ligaments. These ligaments are like bungee cords and are stretched during treatment. When the braces are removed these ligaments attempt to pull the teeth back to their previous position, retainers prevent this from happening and allow the mouth to adapt to the new position of the teeth. All retainers are not the same and each type has advantages and disadvantages. In order to better serve our patients we offers three different types of retainers.

Essix Retainers
The first type is a clear plastic tray that holds your teeth in its ideal position. They can be worn all day and all night without getting in the way of normal activity. They are taken off for eating and you will need to brush your teeth before wearing them. Many patients love these retainers because they are almost invisible. A few patients find them uncomfortable or simply prefer traditional retainers.

Traditional Retainers
Traditional retainers use metal wires and an acrylic base to hold your teeth in their ideal position. They are worn during most of the day and while you are sleeping for the first six to twelve months in order to allow the bone to solidify around the tooth.

Fixed Retainers
Fixed retainers are often referred to as “permanent retainers” because they are cemented to the teeth. It consists of a small wire adapted to the inside surface of the teeth and cemented in place to avoid unwanted movement of the teeth. These retainers are not removed to eat but can require more maintenance than other retainers since it can be broken off if certain foods are not avoided and will have to be replaced. For all types of retainer, they must be worn nearly all day long for at least six months and up to one year following active treatment. After this time, they should be worn every night until the teeth are stable, this can take several years. The retainers should be worn through your twenties because it is during this time that the jaw-bones do their final growing and many people notice that their front teeth start to crowd.

Contouring
Once your teeth are moved into their ideal alignment, you might notice that there are slight adjustments needed to take your smile to the next level in beauty. When teeth are not aligned properly the will often wear abnormally resulting in a non-ideal shape, Dr. McHenry can contour your teeth by removing very small amounts of enamel to restore their original shape. This is often done to correct 'black triangles' caused by the gums not filling in spaces between teeth. Dental contouring can also be done to remove mamelons. Human teeth naturally have ridges on the edge called mamelons. They are thought to help with biting food and are more clearly seen in kids. For most people these ridges will wear away over time giving the teeth a straighter appearance. However, if your teeth did not bite in the proper way, the mamelons may still be there longer than is normal and will need to be polished away to provide optimal aesthetics.

Teeth Whitening
When your teeth are correctly aligned and shaped they are much easier to clean and keep white. But what if your teeth are not naturally as white as you would like? When your braces are finished is a perfect time to get your teeth whitened. Dr. McHenry can fabricate custom whitening trays for you to take home and use at your convenience. Each day after placing the whitening material in your tray, simply wear the tray for an hour, and clean the material out after. Continue treatment until you are satisfied. For faster results, you can do two 1-hour treatments in one day. For all at-home teeth whitening systems out there, it takes 2 weeks for the shade to stabilize. Results vary depending on the starting shade and structure of your enamel.

MI Paste
Many patients find it difficult to maintain proper oral hygiene during orthodontic treatment. While we encourage patients to brush two to three times a day and to floss every night before brushing, we know that it is still difficult to clean around the brackets. Unfortunately, if your teeth are not kept clean they can demineralize in very esthetic areas- typically on the front of the front teeth between the braces and the gums. When teeth demineralize, they first show up as a very white spot, then a brown spot, and then the spot can cavitate (hence the term 'cavity'). Before the spot cavitates, the demineralization can be treated minimally with MI paste. MI paste is also good for patients who have decreased salivary flow (typically older patients or people undergoing chemo-therapy or radiation-therapy) or for patients with high risk of cavities. The white spots, or areas of hypo-mineralization, need to be nourished with calcium and phosphate to strengthen the teeth. MI paste contains bio-available calcium and phosphate and increases fluoride absorption by the tooth. Using MI Paste nightly for several weeks can get rid of or minimize these spots by creating an environment where re-mineralization can occur. However, this treatment is not always successful and prevention is always the best solution.

Appliances

Rapid Palatal Expander
Attached to the upper molars through bonding or by cemented bands, the Rapid Palatal Expander is an orthodontic device used to create a wider space in the upper jaw. It is typically used when the upper jaw is too narrow for the lower jaw or when the upper teeth are crowded or blocked out of the dental arch. When patients are still growing, their connective tissue between the left and right halves of their upper jaw is very responsive to expansion. By simply activating the expander through turning a screw in the center of the palatal expander, gradual outward pressure is placed on the left and right halves of the upper jaw. This pressure causes an increased amount of bone to grow between the right and left halves of the jaw, ultimately resulting in an increased width. This expansion should be performed before age 16 when the two halves of the upper jaw begin to fuse together. In adult patients significant widening of the upper jaw can only be accomplished through surgery.

Bite Plate
A Bite Plate is designed to fit the upper teeth and open a deep bite (when the top teeth come down too far over the lower front teeth). This prevents the top teeth from biting off the lower braces and allows us space to apply the braces. In addition, it creates a space between the molars. The space created gives the upper molars room to come down as the lower molars come up until they meet. Once the back teeth are biting together they will hold the front teeth apart and the Bite Plate can be removed. Every time you brush your teeth you should also brush the Bite Plate with your tooth paste and toothbrush. There is an adjustment period where speech may be affected for a short period of time. It may take a few weeks to completely adjust to your new Bite Plate.

Head Gear
Though rarely used today Headgear is used primarily when the upper and lower jaws are not growing at the same rate. It applies pressure to the growth-sites in the jaws and either increases or decreases growth depending on the type and location of pressure. Dr McHenry believes that this appliance is cumbersome and should only be worn at home and during sleep to avoid intrusion into daily activities.

Thumb Appliance
Prolonged thumb sucking exposes the teeth to unnatural pressures which can permanently distort both the jaws and teeth. As such it should be stopped before such damage can occur. There are many less invasive devices and methods used to control thumb habits but for children who are non-responsive a thumb appliance may be necessary. This appliance is cemented in place and prevents children from easily sucking their fingers. It is not painful but often causes difficulties with speech and does require a period of adaptation. It is generally left in place for six months after the child stops sucking their finger to ensure the habit does not return.

Tongue Crib
When children develop the habit of pushing their tongue between their teeth it often results in an open bite where the top and bottom teeth to not touch. This causes both speech and chewing problems as well as aesthetic concerns. The tongue is a powerful muscle and can easily displace the teeth. This appliance will prevent the tongue from resting in this position and allow us to close the space between the teeth.