Orthodontics

Smile Virtual Consult

October 31st, 2018

Smile Virtual Consult

  Orthodontic Consultations From Your Own Couch!

So you have finally decided you are going to do something about those crooked front teeth or debilitating overbite you or your child try to hide in every picture you take.  But the thought of calling the orthodontist and adding one more thing to your already overbooked schedule takes the wind right out from under your wings (no pun intended..well, kind of intended).  All you really want to know is what your options are to improve your smile, how long your treatment would take, and how much it would cost — if only there were a way to get these questions answered in the comfort of your own home, preferably while still wearing your favorite pajamas.

Well…consider us your personal genie, because your wish has been granted.  With Dr. Wing’s revolutionary new Smile Virtual Consult for Orthodontics, you can have all of these questions answered simply by sending Dr. Wing four easy pictures of your teeth.  He will take these pictures and prepare a short slide show that will explain how orthodontic treatment can improve your smile and bite, what treatment options are available to you, and of course…how much each option will cost.

This all sounds incredible, you say, but you’d still like to meet the orthodontist whom you will be entrusting your teeth or your children’s teeth to and seeing every 6-8 weeks in the office.  Well, Dr. Wing isn’t making house calls quite yet for these in-home consultations, but he has come up with something that’s a close second to actual in-person face time.  The email that he sends you will include a link to a video that he will have recorded earlier, and in this video he will be talking to you from a face bubble in the lower left corner of your screen and explaining every part of the slide show that is playing in front of you.  Other than sitting in our office movie theater and smelling the tantalizing scent of freshly baked cookies, you will have just completed the same orthodontic consultation as other patients who still choose the “old fashioned” way of coming to the office.

 

The best part of this in-home video consultation is that there is absolutely no fee or obligation.  After you view your video as many times as you wish, you either tell yourself “sounds amazing…but maybe later,” or “let’s do it!”  If you wish to get started, the next step is simply to call our office and schedule an appointment to get your braces on or get your teeth scanned to begin Invisalign treatment.

If you’d like to give the Smile Virtual Consult a test drive, just click on the link below and follow the simple instructions of how to upload the four pictures of your teeth and send them to Dr. Wing.  In this day and age of online shopping and doorstep delivery of any restaurant food you can imagine, doesn’t this just make sense?

www.smilevirtualconsult.com/dr-jeffrey-wing/

 

Orthodontic Rubber Bands: More Than Just Great Hair Ties!

April 25th, 2018

                    

If you have ever had braces, there’s a good chance that you’ve had the immense pleasure of wearing rubber bands on these braces.  Contrary to popular belief, these little elastic beauties serve a greater purpose than holding pony tails and annoying friends by flicking them in their direction (preferably coated with saliva).  In this blog, you will find out why we use them, how often and how long they have to be worn, and what happens if you opt not to wear them and instead make a fun bracelet out of the piles of rubber bands you have stashed in your bathroom drawer.

While braces and Invisalign can move teeth into perfect alignment and give you that smile that makes you wish Snapchat wouldn’t erase your selfies after 20 seconds, neither one is able to bring your upper and lower teeth into the ideal relationship (a.k.a. the “perfect bite”).  There are several different “accessories” that are used in orthodontics to achieve this perfect bite, but elastics are by far the easiest and most convenient.  By hooking them to certain upper and lower braces, they are able to achieve such movements as bringing a lower jaw forward or back and pulling upper and lower teeth together into ideal contact with each other.

 

As effective as elastics can be in achieving that perfect bite, there is one catch:  they have to be worn!!  Several of my teenage patients have developed some interesting theories regarding their rubber bands, a few of which I have compiled into a fun little True/False Quiz:

True or False:  If I double up on my rubber bands at night, I don’t have to wear any during the day

True or False:  If I wear my rubber bands REALLY well one week before my appointment with Dr. Wing, I don’t have to wear them the rest of the month — he won’t know!

True or False:  I don’t have to wear my elastics on vacation — if I get a break, my teeth get a break, too!


True or False:   If I swallow a rubber band, my stomach won’t digest it for 7 years

If you are really smart, you guessed that the answer to all of these questions is FALSE!  With elastics, consistency is the key.  I like to tell my patients of a legendary 13th century tale of a man who embarked on a quest to push a large boulder up a hill.  On his first few attempts, he grew tired on his ascent and decided to take a break (probably to go hang out with friends).  Upon his return to the boulder, he discovered much to his dismay that instead of being in the place where he last left it, the rock had rolled back down to the bottom of the hill.  He had lost what valuable progress he had previously made, and he had to start completely over on his arduous quest.  He finally discovered that in order to get the boulder to the top of the hill, he had to put his shoulder to it — and just…keep…pushing until his goal was reached.

There is a remarkable similarity with elastics to this captivating boulder story — if frequent breaks are taken or they are only worn 1/2 time, whatever progress that has been made while wearing them is quickly lost and the teeth and/or jaws move back to their original position.  Constant forces are required for teeth/jaws to move where we want them to go in the first place, after which these constant forces are further necessary to allow the bone that supports the teeth to remodel in this new position and provide long term stability.

After 3 round of braces, I am the first to admit that the first few days of wearing elastics are tough!  Leaning over the bathroom counter until your face is 2 inches away from the mirror, with what seems like your whole hand in your mouth and a small stream of saliva dripping down your arm — it can get frustrating!  And very much like braces, rubber bands can make your teeth sore!  Several of my patients take them off because of this soreness, but the best way to help the teeth feel better is to keep the elastics ON and let the teeth get used to the force.  Don’t worry…by day 3 or 4 you’ll be able to put those rubber bands on blindfolded while riding a bike and posting your latest selfie to Instagram.

The good news about elastics is that most patients do not need to wear them for the entire time they are in braces — most bite correction is accomplished during the second half of treatment.  And although full-time wear is encouraged, you can take them out to eat and to brush.  Once again, my clever teenage patients think they have found a loophole to the system by sticking to a strict snacking plan of eating something every 30 minutes.  However, for those avid snackers out there, we recommend that you keep the elastics in for snacks and only take them out for actual meals. 

The moral to this stretchy story is that elastics are a crucial part of your orthodontic treatment.  Without them you may achieve the perfect smile, but your perfect bite will be left on the table.  Although a perfect bite lacks the glitz and glamour of a dazzling smile, it is equally important as straight teeth for the long-term health of your teeth and jaw.  So…when your mom, spouse, or orthodontist asks if you’re wearing your rubber bands, follow the immortal mantra of Nike and JUST DO IT!

Retainers!

January 23rd, 2018

Retainers in Orthodontics:

“How long do I have to wear these things?!”

by Jeff Wing DDS MS

Perhaps the question I get asked most often (other than “when do I get my braces off?” and “why do you ride a hoverboard around your office?”), is…”how long do I have to wear my retainers?”  There is nothing more frustrating than going through 18-24 months of braces, only to wake up one morning and see a lower incisor going rogue and breaking away from the nicely aligned team.  This phenomenon is called “orthodontic relapse,” and it is one of the most common reasons that adults and older teens come into our office seeking treatment.  Before I answer the question of how long retainers need to be worn, let’s first take a look at why teeth want to move after the braces come off in the first place.

 

Reasons for Orthodontic Relapse:

  • Contraction of Periodontal Ligament        As teeth are moved with braces, the fibers of the periodontal ligament are stretched (these ligaments attach the roots of the teeth to the bony tooth sockets…basically they’re what hold the teeth in the jaw).  When braces are removed, these fibers can act like little rubber bands, springing back to their original position and bringing the tooth with them.

 

  • Late Growth of Jaw - As with every other physical feature of the human body, some people are luckier than others when it comes to the genetics of their teeth and jaws.  The unlucky ones have genes that tell the lower jaw to continue to grow well past the normal age of growth completion.  This can gradually turn a perfect bite into…well, a less than perfect bite (such as an underbite).

 

 

  • Newly Remodeled Bone Not Fully Calcified - As the roots of the teeth are moving, the bone surrounding these roots remodels to accommodate for the new position of the root.  If this bone hasn’t had a chance to fully calcify, it can’t stabilize the root well enough to keep the tooth from moving.

 

  • Facial Muscles or Tongue - The forces from facial muscles and any habits with the cheeks or lips can put pressure on the teeth and cause them to move.  The habit I see cause the most unwanted movement of teeth is the dreaded tongue thrust.  Instead of swallowing with the tongue pressing against the roof of the mouth, it pushes forward against the back of the teeth.  This can lead to flared front teeth (“buck teeth”) and the vertical separation of the upper and lower teeth (“open bite”).

 

  • Wisdom teeth - These infamous teeth commonly grow in at a forward angle, which puts pressure on the teeth in front of them and causes the front teeth to shift out of alignment.  Normal 6-year and 12-year molars also have a tendency of drifting forward with time, but this is usually a slower and less drastic effect than wisdom teeth.

 

So…as you can see, retainers after braces are critical!  Now, back to the original question…”how long do I have to endure the shame and embarrassment of taking these things out in a restaurant with a string of saliva hanging from my mouth?” 

Full time wear (22 hours/day) is necessary for a certain amount of time after the braces are removed.  This recommended time varies among orthodontists from 6 weeks to 6 months.  After this initial period of full time wear, it is then recommended that the retainers are worn only while sleeping.  And if you happen to be a major party animal or Netflix binge watcher who only sleeps for 3-4 hours, this doesn’t cut it — we’re looking for more like 7-8 hours each night. 

After a year (give or take) of wearing the retainers each night, patients can then test the tooth stability waters by dropping down to wearing them every other night.  At this point, it is recommended that personal best judgment is used — if the retainers feel unusually tight after not wearing them for 48 hours, it would be wise to stick with the "every night” routine for a while longer.  If they slide right in with minimal pressure, you might be one of the lucky ones who only needs to wear them long term for 1-2 nights per week.

The moral of this slobbery retainer story is that the best answer to the question of “how long do I have to wear my retainers?” is…as long as you want your teeth to stay straight!

Invisalign

August 15th, 2017

Invisalign - The Plastic That Dreams Are Made Of

by Jeffrey D. Wing  DDS MS

Allow me to paint a picture for you today -- there you are seated at the finest table of that famous 5-star restaurant, surrounded by rich leather booths and real mahogany walls.  Across from you sits the love of your life, and as the candle burns down to the bottom of its glass, you realize now is the perfect time to express your love for this special person in your life.  As you utter those three soul-bearing words and you flash that perfect smile you’ve practiced in the mirror for hours, the look you get in return is not exactly what you were expecting.  Instead of a warm smile and a whispered “I love you” in return, you get a look of disgust and ultimate horror aimed at your upper front teeth.  As you watch your soulmate get up and run away from the table and out of your life forever, you look at the reflection of your teeth in the knife and see a large green leaf of parsley and a half kernel of corn stuck between your two front braces.  Game over.

Luckily, this situation can easily be avoided, and instead of a long and lonely life of walking around in a tattered bath robe and soiled slippers mumbling “parsley and corn, corn and parsley,” you can have the future you always dreamed of, and that includes the smile you’ve always dreamed of.  That dream is made possible by Invisalign.  Imagine the same dinner situation above, but instead of having braces to straighten your teeth, you have removed your clear Invisalign trays to enjoy this romantic dinner with 100% confidence.  Suddenly, your solitary future has transformed into a rich full life with a loving family and a white picket fence.

Invisalign has been around for almost 20 years now, and in this time they have made several advancements including the plastic material of the aligners, the software used to design smiles, and the efficiency of moving teeth, just to name a few. Today, Invisalign is capable of treating almost every orthodontic problem that braces can in the same amount of time.

So how exactly does it work?  We start with a quick and easy scan of your teeth (no more goopy, gooey, gaggy impressions!), and within minutes we can show you what your smile could look like after treatment with Invisalign.  After submitting your case to Invisalign, I instruct the technicians how to fine tune your set-up in order to move each and every tooth into the perfect position.  Within a couple of weeks, your set of aligners (anywhere from 5 to 50 of them) arrives in our office and your journey to that perfect smile begins!

At your first aligner delivery appointment, we bond "attachments" to a few of your teeth.  These attachments are small tooth-colored composite build-ups that help certain teeth move more predictably.  The Invisalign software dictates what teeth are going to need a little extra grip from the aligners, and these attachments fit into small notches in each aligner to provide better control.

I will usually give you 3-4 of your aligners at a time, and each set is worn 1-2 weeks, depending on the complexity of the tooth movement.  At each one of your appointments, I will make sure all the teeth are "tracking" well (a.k.a. following the program) and show you the progress of your treatment.  And since the aligners need to be worn about 22 hours each day, I will occasionally provide a little positive reinforcement to keep you at this level :)

A few of the amazing advantages of Invisalign include:

  • Removable! This means you can eat anything you want, as well as brush and floss without braces and wires getting in the way

    • Clear! These aligners are customized and adapted so precisely to your teeth and gums, they are barely noticeable when you're wearing them

      • Comfortable! No need for orthodontic wax normally used to smooth over rough parts of the braces -- nothing but smooth plastic for the ultimate enjoyment of your cheeks and lips

      • Convenient! Instead of long orthodontic appointments where we change wires and repair broken brackets, we simply give you your next few sets and make sure all your teeth are on track
      • Great for Teens! Invisalign allows them to eat whatever they want, which means less time in the office repairing broken braces.  Also, for those involved with sports, it is much easier to wear a mouthguard and less damaging to cheeks and lips if they get hit

      If you have any questions about Invisalign and whether it's the right choice for you, please email me at wingortho@yahoo.com.

      Two Phase (Early) Orthodontics

      May 1st, 2017

      Two-Phase (Early) Orthodontics

      Does My Orthodontist Just Need a New Car?

      By Jeff Wing DDS MS

      So the question that’s on everyone’s mind these days (aside from “when will this flipping water bottle craze ever go away!?"), is “why are all of these 8 and 9 year-old kids walking around with braces on?”  It’s an extremely valid question…after all, most of these kids still have 12 baby teeth in their mouth.  Is it simply a scheme that all orthodontists came up with during their super-secret annual underground meeting so they could all upgrade their daily modes of transportation?  Believe it or not, the short answer is…NO!  Now, here’s the long answer:

      In most cases, children’s mouths are big enough to accommodate all of their adult teeth as they continue to come in until age 12 or 13.  Unfortunately, this doesn’t guarantee that these teeth will come in straight, but that’s OK — the main thing we care about in that 8-12 year age group is that all of the adult teeth do, in fact, come in.  In about 10-15% of children, their mouths are so small that there isn’t enough space for all of the adult teeth to squeeze in, so one or more of them can get “stuck” or “trapped” up in the bone under the gums, or even behind other teeth.  Think of the mouth as a parking lot in this situation — these adult teeth are looking for a place to park when the lot is actually FULL, and no cars/teeth are leaving.

      This is one of the situations when a brief period of early limited orthodontics (usually called Phase 1) is a great idea — we can take advantage of these kids’ developing jaws and create the space needed for these trapped adult teeth to find a parking spot.  By doing so, we can avoid the need to extract permanent teeth down the road…and why settle for 24 teeth when you can have 28?!

      Other situations where an early Phase 1 is recommended include:

      Anterior crossbite (underbite) - where the lower teeth bite in front of the upper teeth. This can wear the enamel down on these teeth and lead to chipping or fractures.  This is also a sign of a skeletal jaw pattern that needs to be corrected early to avoid jaw surgery in the future

      Posterior crossbite - where the upper back teeth bite on the inside of the lower teeth on one side, causing the lower jaw to shift to that side.  This is due to a narrow upper jaw, and expansion or widening of the upper jaw is easily performed at an early age

      Severely protruding upper front teeth - when upper front teeth are angled forward and flared out away from the lower front teeth, these teeth are at an increased risk of trauma from sports, the bottom of swimming pools, and sometimes even walls!

      Anterior Open Bite - when there's an opening between the upper and lower front teeth when biting down, usually caused by a thumb sucking habit or tongue thrust habit

      If your children (or any neighbor kids that don't annoy you) display any of these situations, a visit to an orthodontist is recommended.  A simple x-ray and a quick exam will help the orthodontist determine whether a Phase 1 treatment would be beneficial or if we can wait until all of the permanent teeth are in before considering orthodontic treatment.

      Severe Crowding

      Anterior Open Bite

      Anterior Crossbite

      (underbite)

      Severe Protrusion

      Posterior Crossbite

      Please feel free to email me at wingortho@yahoo.com if you have any questions about Phase 1 orthodontics!

      "We LOVE Wing Orthodontics! I have had 2 children as patients and a 3rd about ready to be a patient. The office is so friendly and organized. They are prompt and always help my children feel at ease."~ Laurie D
      "Dr. Wing and his staff have been taking care of my teeth for the last 16 months. They always treat you like you are their only patient. Dr. Wing is great at spending the extra time with you to answer questions and make sure everything is good."~ Joseph L
      "The staff at Wing is amazingly sweet and helpful, Dr. Wing is a caring and thorough orthodontist, and the way they treat their patients is phenomenal. The movie theater in the office and awesome client parties don't hurt either."~ Sarah G
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