Dr. Sheen recently completed the LSU Esthetic Continuum. This hands-on workshop, spanning 10 months, concentrates on achieving the beautiful, healthy, and longlasting smile we all desire. The LSU Esthetic Continuum is recognized by the American Academy of Cosmetic Dentistry as one of the foremost programs in the country.

Whether to seek orthodontic care is a personal decision. Many people live with crowding, overbites or other types of bite problems and do not seek treatment. However, many people feel more comfortable and self-confident with properly aligned, attractive teeth. Orthodontic care can help improve appearance and build self-confidence. It also may help you to chew better or speak more clearly.
 
Orthodontic care is not just cosmetic in nature. It also can benefit long-term dental health. Straight, properly aligned teeth are easier to brush and floss. This can help reduce the risk of tooth decay. It also can help prevent gingivitis, an inflammation that damages gums. Gingivitis may lead to infection, which occurs when bacteria cluster around the area where the teeth meet the gums. Untreated gingivitis can lead to periodontitis. This type of gum disease can destroy bone that surrounds the teeth and lead to tooth loss.

People with bad bites also may chew less efficiently. Some people with a severe bite problem may even have problems getting enough nutrition. This especially may occur when the jaws are not aligned correctly. Fixing bite problems can make it easier to chew and digest foods.

When the upper and lower front teeth don’t align right, people also can have speech difficulties. These can be corrected through orthodontic treatment, often combined with speech therapy.

Finally, orthodontic treatment can help to prevent premature wear of back tooth surfaces. As you bite down, your teeth withstand a tremendous amount of force. If your front teeth don’t meet properly, it can cause your back teeth to wear more.

Many people’s teeth are irregular in some way. For example, teeth may be slightly crowded or unevenly spaced. In fact, experts say many adults have an irregular bite. Sometimes the main problem with a “bad” bite is appearance. In other cases, it can cause difficulty in chewing or talking.

 You may have inherited an irregular bite, but not all bite problems are genetic. Other causes include:
o Trauma &— When teeth are broken or knocked out and then replaced, they may fuse with the bone that surrounds them. This is called ankylosis or abnormal root fusion to the bone. If this happens in a growing child, the teeth will not be able to line up properly in the jaw. An irregular bite will result.
o Prolonged thumb sucking or pacifier use &— These habits can cause bite problems. For example, it may cause your upper teeth to protrude (stick out) in front of your lower teeth. A tongue-thrusting habit when you swallow can cause a similar problem.
o Premature loss of primary (baby) teeth &— If a primary (baby) tooth is lost too early, the permanent tooth loses its guide. It can drift or come into the mouth (erupt) incorrectly. In some cases, the permanent teeth may be crowded, or they may come in only partially. Sometimes the teeth next to the lost primary tooth can move or tilt into the space left by the missing tooth. This may prevent the permanent tooth from coming in.

Orthodontics is a specialty field of dentistry that diagnoses, prevents and treats irregularities of the teeth and face. Treatment can correct an irregular or “bad” bite, also known as a malocclusion.
Orthodontic care involves the use of appliances. There are two main types. Braces are attached to the teeth. Removable appliances are put in and taken out by the patient. These devices can be used to: 

 -Straighten teeth 
- Correct an irregular bite 
- Close unsightly gaps 
- Bring teeth and lips into proper alignment

They also can help with procedures in other areas of dentistry. Examples include cosmetic and implant dentistry.
In young children, orthodontic treatment also may guide proper jaw growth and permanent tooth eruption.

After your orthodontist has determined that your braces can be removed, it is very important that a retainer (a plastic appliance) be worn during the day or night as recommended by them. The retainer can be cleaned with warm water or toothpaste and a toothbrush after you wear it and placed in a plastic container when not in use.

See your dental professional for a twice a year professional cleaning and the orthodontist for regular maintenance appointments.

Your orthodontist, dentist or dental hygienist will provide you with thorough instruction of how to properly clean your braces. There are many toothbrushes you can use both manual (specifically designed for orthodontic patients), power, electric or sonic. Ask your dental professional which is be best for you. Brushing should be conducted at least 2-3 times per day at a 45 degree angle in a back and forth motion. Be sure to remove plaque at the gum line to prevent gingivitis (inflammation of the gum tissue). Be sure to angle the toothbrush at the gum line and then gently brush around the brackets to remove plaque and food debris.

It is very important to clean in between your teeth with a floss threader and floss, a stimudent (tooth pick cleaner) or a proxabrush (interproximal cleaning brush) may be used if there is space between the teeth. Oral irrigators may be recommended to remove food debris and irrigate the gum tissue to remove disease and odor-causing bacteria that may be there if you have gingivitis. An antibacterial toothpaste and over-the-counter antimicrobial mouth rinses could also be used with the oral irrigator or alone.

The American Association of Orthodontists reports that in the United States 4.5 million people are wearing braces or other dental appliances to straighten teeth and provide a healthy, beautiful smile1.
As many of us know, an orthodontist is a dentist with additional clinical training to treat malocclusions (improper bites), which may result from tooth irregularity and jaw issues.

Why Do Teeth Become Crooked?

Terry Pracht, DDS, past president of the American Association of Orthodontics says that both heredity and environmental factors can create crooked teeth and bite problems. Dr. Pracht mentions that hereditary factors include crowded teeth, teeth where there is too much space and malocclusions. He also mentions that crooked teeth can be caused by thumb sucking and tongue thrusting as well as accidents occurring to the jaw(1).
What are Treatment Options to Straighten Teeth or Malocclusions?

There are three stages of orthodontic treatment. The first is when appliances are used to gain space in the mouth. For example, palatal expanders are used to expand the width of the palate and lingual bars are used to expand the lower jaw. The active corrective stage is next when the braces are placed on the teeth. The teeth are then adjusted and then straightened and malocclusions are corrected over a period of time based upon the severity of the irregularity of the teeth and jaw issues. The third stage is the retention stage after braces are removed and when the teeth are monitored through the use of a retainer (removable or fixed) and semi-annual orthodontic visits are conducted to maintain the straightened smile.
Types of Braces

Braces from over 30 or so years ago included large metal bands that were enclosed and cemented around each tooth. Braces can be attached to the cheek side of the teeth as well as the tongue side of the teeth depending on what your orthodontist recommends to you for treatment. Braces, arch wires and bands can be colorful and a lot of fun for children, adolescents and teenagers to choose from.

Today, tiny brackets are placed onto the front surface of the tooth and are made of metal or ceramic. The brackets are bonded to the front tooth surface with a glue-like material and metal bands can be used on the back teeth. Arch wires are placed inside the brackets and are made of a heat-activated nickel-titanium source that can become warm due to the temperature in the mouth, which will allow it to apply constant pressure on the teeth as well as when the arch wires are adjusted at the orthodontist’s office.

Another newer alternative to braces is the Invisalign system which uses a series of clear removable aligners that are worn during the day and night to help in moving teeth into the correct alignment. When eating or brushing and flossing, the aligners may be removed.

Many medications have side effects, and some can even affect oral health.
In most cases, the oral side effects of medications resolve shortly after you stop taking the medication. However, the American Dental Association encourages patients to talk to their dentists about prescription and over-the-counter medications to learn more about how to limit the side effects on oral health.
Some common oral side effects include:
Dry mouth — antihistamines and other drugs can cause a decrease in saliva, leaving your mouth prone to soft tissue inflammation, pain and infection. Tooth decay can also develop, and chronic dry mouth can create problems for people who wear dentures. Alleviate dry mouth by drinking more water or using sugarless lozenges or gum to stimulate the flow of saliva. Artificial saliva or, in some cases, medication may be recommended by your dentist or physician.
Gum tissue overgrowth — also referred to as “gingival hyperplasia,” gum tissue overgrowth is associated with anti-seizure medications, immunosupressant drugs such as those taken by organ transplant patients and calcium channel blockers taken by heart patients. Studies suggest that gum tissue overgrowth can be controlled if meticulous oral hygiene is started at the same time or before medication is taken. Tissue overgrowth can complicate oral hygiene. Sometimes, a gingivectomy (a procedure used to remove excess tissue) may be necessary.
Soft-tissue reactions — oral sores, inflammation or discoloration of the soft tissue can result from taking medications prescribed for blood pressure control, immunosuppressive agents, oral contraceptives and some chemotherapeutic agents. Your dentist may recommend an oral hygiene program to limit the discomfort associated with such side effects.
Abnormal bleeding — reduced blood clotting is a result of aspirin and prescribed anticoagulants, like heparin or warfarin. These medications are prescribed to treat strokes or heart disease, but can cause bleeding problems during oral surgery or periodontal treatment. If you’re having dental treatment, talk to your dentist about these medications, especially if the dental procedure involves bleeding.
Tooth discoloration — intake of tetracycline products when teeth are developing can cause permanent staining in those teeth. Cosmetic dentistry techniques like veneers, crowns, bonding procedures, or, in some cases, bleaching may be used to lighten teeth with tetracycline stains.
© 2003 American Dental Association. All rights reserved. Reproduction or republication is strictly prohibited without the prior written permission from the American Dental Association.

You may have heard of the mind-body connection, but what about the mouth-body connection? To many people, a dental visit is about getting their teeth cleaned, having a tooth pulled, or getting a filling. However, a dental visit is not just about teeth. It is also about your overall health. What goes on in your mouth can affect the rest of your body. What goes on in your body also can have an effect on your mouth. Many diseases and conditions can affect your oral health. For example, people may get more infections in the mouth if their immune system is weak. The immune system protects your body from illness and infection. It can be weakened by disease, by drugs taken to prevent the rejection of transplanted organs, or as a side effect of cancer chemotherapy drugs.

Medicine for other conditions also can affect the health of your mouth. For example, many drugs cause dry mouth. This can increase your risk of dental decay and yeast infections. It also can affect taste. While examining your mouth, your dentist might see a sign or symptom of an illness or disease that you might not even know you have. The dentist may perform tests and/or refer you to a specialist for treatment.

If you have certain medical conditions, you may need specialized oral and dental care. If necessary, your dentist can refer you to an expert in oral medicine. Your oral health also can affect other medical conditions. For example, if you are diabetic, a mouth infection can disrupt your blood-sugar levels and make your diabetes harder to control. Researchers also are exploring whether periodontal (gum) disease may increase the risk of various medical problems. These may include heart disease, stroke, kidney disease and premature births. About 35% of U.S. adults have some form of periodontitis. Another 50% have gingivitis, the mildest form of gum disease. Because gum disease is so common, its treatment and management can have important implications for overall public health.     
 
The “Mouth-Body Connection” was reviewed by the faculty at Columbia University College of Dental Medicine.

The term “bruxism” refers to tooth grinding and tooth clenching that many children and adults experience throughout their lifetime. Bruxism occurs when the teeth contact each other in a forceful fashion, this can be silent or cause a loud sound especially when sleeping.

Why Does it Occur?
Many medical and dental professionals may not always know the exact cause,but bruxism can occur due to psychological stress that people may be dealing with during the week. Stress can be categorized in two ways — by internal and external factors.
Internal factors could be the foods you consume, your level of fitness, your emotional stability, overall health and well-being, and the amount of sleep you get each evening. External factors of psychological stress include the environment you are in each day, interaction with others, when you are at home and how you deal with challenges on a daily basis.

Bruxism’s Impact on the Mouth-

There are several elements that can occur in the mouth when people are experiencing bruxism:
o Wearing away the tooth enamel and possibly the dentin
o Cracking or chipping teeth, bridgework or implants
o Tooth sensitivity can occur
o Teeth can become painful or loose
o Facial pain due to clenching of jaw muscles
o Headaches
o Overall facial fatigue
o Pain in the temporomandibular joint (jaw bone on either side of the mouth)

Most individuals suffering from bruxism should see their dental professional/specialist to determine why they are experiencing this problem. Your dental professional may recommend that you wear a mouth guard or a night guard to cushion the clenching or tooth grinding during sleeping. Additionally, your dental professional may suggest ways to reduce stress so you can decrease the level of bruxism. You should consider avoiding foods such as chocolate and drinks that contain caffeine and alcohol. Avoid chewing forcefully and your dentist or oral maxillofacial surgeon may suggest conducting exercises to relax your jaw muscles during the day. If your bruxism is more severe, an occlusal splint may be recommended as well as medication prescribed to help relax you or make you sleep more soundly. Your dental professional will be able to work with you to find the cause and the solution to alleviate this problem.
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