Post-Orthodontic Care

Your child won't keep his or her first teeth forever, but that doesn't mean those tiny pearly whites don't need conscientious care. Maintaining your child's dental health now will provide health benefits well into adulthood, as primary (baby) teeth serve some extremely important functions.

Kids developing jaws and teeth.

For one thing, primary teeth serve as guides for the eruption of permanent (adult) teeth, holding the space into which these new teeth will erupt. The crowns (tops) of the permanent teeth actually push against the roots of the baby teeth, causing them to resorb, or melt away. In this way, the adult teeth can take their proper place.

What's more, your child's primary teeth will be there for most of childhood, helping your child to bite, chew and speak. For the first six or so years, he or she will be relying on primary teeth exclusively to perform these important functions. Until around age 12, your child will have a mix of primary and permanent teeth. You will want to make sure those teeth stay healthy and are lost naturally — when it's time.

Your Child's First Teeth

Kids mouth anatomy.

Your child's 20 baby teeth will begin to appear usually between six and nine months, though in some cases it may start as early as three months or as late as twelve months. The two lower front teeth tend to erupt first, followed by the two upper ones, these teeth are called the central incisors. Then the neighboring teeth called lateral incisors will erupt too. The first molars come in next, followed by the canines (eyeteeth). And finally, the last teeth to erupt are the two-year molars. Sometimes your baby can experience teething discomfort during this process. If so, there are courses of action to help make your child more comfortable.

Your infant's gums should be gently wiped after each feeding with a water-soaked gauze pad or damp washcloth. As soon as the first tooth erupts, establish a daily brushing routine with a small, soft-bristled toothbrush and no more than a thin smear of fluoridated toothpaste. Your child may need your help with this important task until about the age of 6.

Your Child's First Dental Appointment

Age one dental visit

The American Academy of Pediatric Dentistry recommends that your child see a dentist by his/her first birthday, or as early as the first tooth erupts. Though this may sound early, learning proper pediatric oral hygiene techniques, checking for cavities, and watching for developmental problems is extremely important.

There are a number of forms of tooth decay that can affect babies and small children. Early Childhood Caries (tooth decay) can develop rapidly, progressing from the hard, outer enamel layer of a tooth into the softer, inner dentin in six months or less.

Most of all, it's important for your child to have a positive experience at the dental office as he/she will be a regular visitor for years to come.

Pediatric Dental Treatments

There are a variety of dental treatments offered to prevent tooth decay in children, or to save or repair teeth when necessary. They include:

Topical Fluoride — Fluoride incorporates into the enamel of teeth, making it harder and more resistant to decay. Although there is a small amount of fluoride in toothpastes and in some drinking water supplies, a higher concentration can be applied professionally to your child's teeth for maximum protection.

Dental Sealants — A plastic coating can be applied at the dental office to prevent cavities by sealing the little grooves on the chewing surfaces of back teeth known as “pits and fissures.” These little crevices become the perfect environments for decay-causing bacteria. Immature tooth enamel is more permeable and therefore less resistant to tooth decay. Dental sealants are easy to apply and provide years of protection (Watch Dental Sealant Video).

Root Canal Treatment — Perhaps you have had a root canal treatment yourself, to save an injured or severely decayed tooth. Well, sometimes children need root canals, too. In children these are called pulpotomies or pulpectomies. As mentioned above, baby teeth are important guides to the permanent teeth that are already forming beneath your child's gums. Therefore, saving them from premature loss can help prevent a malocclusion (“mal” – bad; “occlusion” – bite) that requires orthodontic treatment.

Bonding — Chips and minor fractures to front teeth — common childhood occurrences — can be repaired with tooth-colored bonding materials. These lifelike resins made of plastic and glass can be used on baby teeth as well as permanent teeth and last until the youngster has completed facial growth (Watch Bonding Video).

Orthodontic Concerns

Orthodontic Problems.

By around age 7, most malocclusions have become evident. Interceptive orthodontic treatment around this time can help direct proper tooth positioning and/or jaw growth, eliminating or simplifying the need for later treatment. There are many orthodontic problems that can be detected early and are examples of why a trained professional should evaluate your child during his/her growth and development.

Sports & Your Child's Teeth

If your child is active in sports, a custom-made mouthguard is a highly recommended safeguard. According to the American Dental Association, an athlete is 60 times more likely to suffer dental harm when not wearing one of these protective devices. A custom mouthguard is made specifically for your child using a model of his or her teeth. This will offer greater protection than an off-the-shelf model. It's an investment that pays off highly in the form of reduced pain, suffering — and dental expenses down the road!

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One day in the not-too-distant future, your braces will come off. In a few moments, you'll be free of bands and brackets, able to eat what you want and run your tongue over smooth, clean teeth. But, even on this happy occasion, please remember that you're not quite done with orthodontic treatment yet: The next phase, called retention, is just beginning.

Family.

Retention is a critical follow-through stage that typically involves wearing an orthodontic appliance called a retainer. Several different kinds of retainers are available, all of which are custom-made.

But if your teeth are straight now, why do you need a retainer at all? Simply put, it's because if you don't wear one, your teeth will start moving right back to where they were!

Teeth aren't set rigidly in the jawbone — instead, they're held in place by a network of fibers called the periodontal ligaments. After they have being moved, it takes several months for the periodontal ligament to adjust to the new position. So if you want to keep that new smile — and not waste all the time, effort, and money it took to get it — it's essential to wear your retainer as directed.

Being fitted for a retainer usually happens on the same day your braces are removed. After your teeth are thoroughly cleaned, another set of X-rays and/or bite impressions may be taken to check how well your braces worked and to see how much your wisdom teeth have developed. Then, a retainer will be prepared for you.

Three Types of Retainers

Types of orthodontic retainers.

There are three basic types of retainers available today; each works best in particular situations. The most common is the so-called “Hawley” retainer — a thin, tongue-shaped piece of acrylic molded to fit your mouth, with a wire that holds your teeth in position. The Hawley retainer is simple, durable and easily removed. It's even possible to personalize it by choosing different colors and designs for the plastic arch.

Another popular style of retainer is the clear aligner-type, which looks similar to the Invisalign® tray system. These retainers are custom-made of thin, transparent plastic designed to fit precisely over your teeth. Their main advantage is that they're invisible, with no wire to show. These retainers are also easy to remove, but they may be somewhat less durable than the Hawleys. They aren't recommended for patients with certain conditions, like teeth grinding.

Finally, fixed retainers may be an option for some people, especially on the lower front teeth. As their name implies, they aren't removable by the wearer — but they aren't visible either. Like lingual braces, this system uses a wire which is bonded to the tongue side of the teeth. It may remain in place for months, or longer. This type of retainer is sometimes recommended when there's a high risk that teeth could revert to their former position.

A Period of Adjustment

After a short time, most people adjust quite well to wearing a retainer. Some may find that they produce more saliva than usual for a day or so after first wearing any type of retainer — a normal reaction to a foreign object in the mouth. You may also find it a little harder to talk normally at first, but that problem will soon disappear. Of course, removable retainers should always be taken out when you eat or brush your teeth — a big change from braces!

At first, you will probably be told to wear your removable retainer all day, every day. This period of 24/7 retainer use generally lasts from several months to a year. Later, it may be OK to wear it only at night. Finally, you'll probably need to put it on just a few nights a week.

Maintaining — and Retaining — Your Retainer

How to Clean Removable Retainers

To stay fresh and germ-free, all retainers need proper cleaning. A Hawley-type retainer can be brushed gently with a regular toothbrush — but a brush may scratch the clear aligner types. Denture cleaners, in powder or tablet form, as well as special retainer cleaners, can be used to clean most removable retainers. Fixed retainers are cleaned by brushing and flossing; a floss threader or interproximal brush can also be a helpful cleaning tool when needed.

Finally, remember to always carry — and use — a retainer case. You'd be surprised how many retainers end up folded in a napkin and accidentally discarded! Also, don't expose your retainer to excess heat by washing it in very hot water or leaving it on a heater: That can cause the retainer to warp and make it unusable. With proper care and conscientious use, a retainer can help you transition from braces to a permanent, healthy smile.

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