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Orthodontists and dentists use advanced procedures to treat and save teeth. But sometimes, a tooth just can’t be saved and needs to be extracted. Sometimes it’s due to extensive decay, or infection, or serious injury. Or sometimes, to create a healthy bite, an extraction is necessary during orthodontic treatment.

When does an orthodontist recommend an extraction? Conditions which call for extraction include:

• Incoming Wisdom Teeth

Not many people have enough space in their mouths for four wisdom teeth! And when there’s no room to erupt properly, wisdom teeth can become decayed or infected, push your other teeth out of place, and damage the roots of nearby molars. Extracting wisdom teeth protects your teeth and your bite alignment.

Usually, orthodontic treatment takes place before the wisdom teeth begin to erupt. But if yours start to make an appearance during treatment, your orthodontist and dentist will work together to schedule extraction without interfering too much with your orthodontic treatment plan.

• Tooth and Jaw Structure

Dr. Groisser and the team at Village Orthodontics carefully plan your treatment based on examinations, X-rays, and/or 3D imaging. The goal is to align your teeth and jaws for an attractive smile and a healthy, functional bite. When overcrowding is severe, or if there is a serious malocclusion (bite problem), or if a particular tooth is unusually large or misshapen, your orthodontist might recommend an extraction.

Sometimes more room can be made for teeth with appliances such as palatal expanders or, in other cases, with the help of oral surgery. Extractions are only recommended when they are absolutely necessary.

• Baby Teeth Which Aren’t Coming Out 

Baby teeth normally fall out in a predictable pattern. Front teeth first, canines and molars last. Baby teeth have small roots, and these roots begin to break down when the adult teeth underneath put pressure on them as they start to erupt. As the root gets smaller and smaller, the baby tooth gets looser and looser—until it falls out. 

Sometimes, though, the roots of primary teeth don’t break down, and the baby teeth stay right where they are. This means that the permanent teeth have to erupt someplace else—usually behind those baby teeth. This creates a double row of teeth, and your permanent teeth can become crooked or overlap as they try to fit in. Extracting stubborn baby teeth allows your adult teeth to come in just where they’re supposed to. Because of their small roots, extracting primary teeth is usually simple and straightforward, and can be done in your dentist’s office. 

• Too Many Teeth

Most of us have 32 adult teeth, including wisdom teeth. It’s rare, but sometimes an extra, or supernumerary, tooth develops. Your jaw is most probably not equipped to accommodate any extras, so, in this case, the extra tooth or teeth are removed to give the rest of the teeth the space they need to avoid overlapping or crowding.

When your orthodontist recommends an extraction, it’s because it’s important for your dental health. Dr. Groisser will refer you to a dentist or a specialist like a periodontist or oral surgeon, who will: 

• discuss the extraction procedure with you, including sedation options
• numb the area 
• gently loosen and then extract the tooth
• provide options for pain management after the procedure
• give you detailed instructions for aftercare
• work with your orthodontist to keep your treatment on schedule

Extraction is never your first choice, or your orthodontist’s! But when an extraction is necessary for tooth and bite alignment, everyone at Village Orthodontics in Clarksburg, Gaithersburg, and Hagerstown will coordinate a treatment plan to create your best—and healthiest—smile.

Great question! Tooth movement is your body’s natural response to light pressure applied by braces over a period of time (usually two years). Braces work by using brackets that are glued onto your teeth; these brackets have small slots, and that is where Dr. Groisser and our team insert orthodontic wires. These wires are held in place by small elastic ties that fit around the brackets. As time passes during your treatment, these wires apply pressure on your teeth, which sets in motion the movement of your teeth into their desired positions. Each of your teeth has a different size and shape to them, as do the brackets. Each bracket is custom-made for the particular tooth on which it’s supposed to fit.

Not long ago, orthodontists had stainless steel wires and that was about it. Today, however, we have a number of different high-tech wires at our disposal to move your teeth faster and more comfortably.

When you first get your braces on, the first wire or two will typically be very flexible, but still strong enough to apply a constant force on your teeth. As your teeth straighten out over time, however, Dr. Groisser will use progressively thicker and firmer wires to help move your teeth in place for an ideal bite.

Every time you visit our office for an adjustment, we will swap out the wires in order to keep putting pressure on your teeth, which is why it’s so important for you to keep your adjustment visits during your treatment. Most adjustment appointments are scheduled four to eight weeks apart to give your teeth time to move.

As for rubber bands and elastics, most of our patients will need to wear elastics or rubber bands at some point during their treatments. These elastics typically go from one or more of the upper braces to one or more of the lower braces, and pull on your teeth to move them in the direction they need to move in order to achieve an optimal bite.

If you have any questions about wires, brackets, or elastics, or have any general questions about your treatment, please give us a call at our Clarksburg, Gaithersburg, and Hagerstown office.

Orthodontic treatment should begin earlier than most parents are apt to assume. According to the American Association of Orthodontists, orthodontic treatment should start at around seven years of age.

Dr. Groisser can evaluate your child’s existing and incoming teeth early on to determine whether treatment might be necessary or not.

What is early orthodontic treatment?

Early orthodontic treatment usually begins when a child is eight or nine years old. In stage one, bite problems such as underbites and the jaw’s growth pattern are corrected. It can also help to make room in the mouth for the permanent teeth to take their proper places as they come in, which reduces the chance that the patient will require extractions later, due to overcrowding.

Does your child need early orthodontic treatment?

If you notice any of the following characteristics in your son or daughter, you may want to have a chat with Dr. Groisser.

• Early loss of baby teeth (before age five)
• Late loss of baby teeth (after age five or six)
• Your child’s teeth do not meet properly or at all
• Your child is a mouth breather
• Front teeth are crowded (you probably wouldn’t see this until your child is about seven or eight)
• Protruding teeth, typically in the front
• Biting or chewing difficulties
• A speech impediment
• Your child’s jaw shifts when he or she opens or closes the mouth
• Your child is older than five years and still sucks a thumb

What are the benefits of seeking orthodontic treatment early?

There are many benefits to early orthodontic treatment. One of the biggest is that, because a child’s jaw and bones are soft and pliable, corrective procedures such as braces can work much faster than they do for adults.

Treatment at our Clarksburg, Gaithersburg, and Hagerstown office can enable your child to avoid lengthy procedures, extraction, or surgery in adulthood. Early orthodontic care will give your son or daughter a healthy, stable smile.

On the last Wednesday in September, we celebrate “Women’s Health and Fitness Day.” Because your oral health plays such a large role in your general health and well-being, let’s look at a few of the ways you can treat yourself with the care you need and deserve at different stages of your life.

Puberty 

Puberty begins around the ages of 8 to 13, and typically lasts from 2-5 years. During this time, our bodies begin to produce the hormones estrogen and progesterone, which affect not just the reproductive organs, but our brains, hearts, skin, hair, bones, and more. These hormones can also affect our oral health.

• Gingivitis

Hormonal fluctuations make gum tissue more sensitive to irritants like plaque and bacteria. You might find that your gums are swollen, tender, red, or bleed easily. 

What you can do:

Keeping up with your dental hygiene is the best defense against gingivitis. Even if your gums feel a bit tender, it’s important to keep up with your brushing and flossing because proactive dental hygiene can reverse gingivitis before the condition becomes more serious. If symptoms persist, a visit to the dentist is in order.

Menstruation

• Menstruation gingivitis

Elevated hormone levels can also cause gingivitis during the menstrual cycle, usually beginning a few days before the start of your period and ending soon after your period begins. Some women also experience canker sores and swollen salivary glands during this window.

What you can do:

Be mindful of any oral changes during your menstrual cycle. Pay special attention to dental hygiene, and, if you develop canker sores, talk to your dentist or doctor about the best way to care for yourself while they heal.

Pregnancy

Pregnancy brings about many physical changes, including potential changes in your oral health.

• Pregnancy Gingivitis

Pregnancy hormones cause an increase in the blood supply to your gums while at the same time making them more vulnerable to irritation from bacteria and plaque. You may find that your gums are redder, more swollen, and more likely to bleed when brushing. 

• Loose Teeth

During pregnancy, increased hormone production helps relax and loosen ligaments and joints in preparation for birth. Teeth are held in place by ligaments, and you might be alarmed to discover your teeth are looser as well. Typically, this situation resolves when the baby is born.

• Pregnancy Granulomas

Some pregnant women may also experience pregnancy granulomas. These dark red swellings are benign tumors which appear along the gumline. These generally shrink on their own, but, if a granuloma is causing you pain or discomfort, your dentist can remove it surgically.

What you can do:

Let your dental team at Village Orthodontics know right away when you learn that you’re pregnant. You’ll get helpful advice about brushing and flossing techniques, pregnancy-related oral conditions to look out for, when to schedule dental treatment and cleanings, a tooth-healthy diet, and more.

Menopause and Later Years

As we age, there’s an increased risk of oral health issues.

• Osteoporosis

Osteoporosis causes loss of density in the bones—including the bones and bone tissue which hold our teeth in place. Studies indicate that women with osteoporosis suffer significantly higher tooth loss than women who don’t have the disease.

• Dry Mouth

Saliva helps protect the teeth from cavities by washing away bacteria and food particles and by neutralizing acids in the mouth. Reduced estrogen production, medications, and medical conditions such as diabetes can all cause dry mouth. 

• Gum Disease

About 2/3 of older Americans have gum disease, which is one of the leading causes of tooth loss in adults. Lower hormone levels have been linked to increases in periodontal diseases.

• Oral Cancer

Oral cancer is more common as we age, and, while men are affected almost three times as often as women, we should be aware of the common symptoms of oral cancer, including a sore in the mouth which doesn’t heal, a lump or thickening in the mouth, red or white patches on the tongue, gums, and other oral tissues, loose teeth, or persistent earaches or discomfort when eating or swallowing.

What you can do:

Visit your dentist and doctor for preventative care and whenever you are concerned about your oral health! Whether it’s helping you prevent osteoporosis and dry mouth or discovering dental and medical conditions early, when they are more likely to be treated successfully, regular visits to your dentist and doctor can help ensure that you have years of happy smiles ahead.

At Any Time of Life

Let’s talk a moment about something which isn’t limited to any one phase of your life—orthodontic treatment!

Straighter teeth and a healthier bite aren’t gender-related. Women and girls don’t have different orthodontic needs from men and boys. They don’t require different types of braces or appliances. But there is one difference in the sexes—women and girls choose orthodontic treatment more often. Good for us! And let’s encourage the men in our lives to do the same.

Why? Because orthodontic treatment does more than give you an attractive smile. You and Dr. Groisser work to create an attractive, healthy smile. A well-aligned bite can lead to healthier teeth and gums, more comfortable jaw movement, and even improved facial symmetry. And, while it helps to begin treatment early, while the bones are still forming, as long as our teeth and gums are healthy, we adults can reap the benefits of a beautifully aligned smile as well.

What you can do:

Today’s orthodontic treatment is more comfortable and effective than ever before. Women of all ages are benefitting from the latest treatment options, including smaller and lighter traditional braces, discreet aligners, and lingual braces attached to the back of the teeth. If you’ve always wanted straighter teeth, or if you have bite discomfort, or if your teeth have shifted with age, make an appointment with Village Orthodontics in Clarksburg, Gaithersburg, and Hagerstown for an evaluation. 

Missed the date this year? No worries! Women’s Health and Fitness Day is one day in September, but every day in the calendar is a good day to think about your oral health. Partner with your dentist, your doctor, and Dr. Groisser to help make your healthy smile something to celebrate all year long!