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What is a palatal expander?

December 28th, 2022

If Dr. Allen Garai & Dr. Karen Tratensek and our team at Garai Orthodontic Specialist have recommended a palatal expander, you might be wondering what it is and how it will help you. A palatal expander is a small appliance fitted in your mouth to create a wider space in the upper jaw. It is often used when there is a problem with overcrowding of the teeth or when the upper and lower molars don’t fit together correctly. While it is most commonly used in children, some teens and adults may also need a palatal expander.

Reasons to get a palatal expander

There are several reasons you might need to get a palatal expander:

  • Insufficient room for permanent teeth currently erupting
  • Insufficient space for permanent teeth still developing which might need extraction in the future
  • A back crossbite with a narrow upper arch
  • A front crossbite with a narrow upper arch

How long will you need the palatal expander?

On average, patients have the palatal expander for four to seven months, although this is based on the individual and the amount of correction needed. Several months are needed to allow the bone to form and move to the desired width. It is not removable and must remain in the mouth for the entire time.

Does it prevent the necessity for braces?

The palatal expander doesn’t necessarily remove the need for braces in the future, but it can in some cases. Some people only need braces because of a crossbite or overcrowding of the teeth, which a palatal expander can help correct during childhood, when teeth are just beginning to erupt. However, others may eventually need braces if, once all their permanent teeth come in, they have grown in crookedly or with additional spaces between.

If you think your child could benefit from a palatal expander, or want to learn about your own orthodontic treatment options, please feel free to contact our Vienna, VA & Great Falls VA office!

Eating and Invisalign®

December 21st, 2022

One of the greatest advantages to using Invisalign is that it provides maximum results with minimal impact on your everyday life. Invisalign is comfortable, easy to insert, and simple to remove. Because you can remove Invisalign aligners, you can enjoy all your favorite foods and beverages without worries about getting food stuck in the wires and brackets of traditional braces.

Eating and Invisalign

While the aligner is durable and strong, you should remove it before you eat or drink beverages, as the chewing action inside your mouth can break, crack, or distort the aligner. Even minute damage to the Invisalign tray will prevent it from aligning your teeth properly. Furthermore, eating with Invisalign in your mouth can be quite messy.

Beverages and Invisalign

Repeated exposure to hot liquids may also cause the Invisalign aligner to distort. This distortion changes the shape of your aligner in a way that will affect how it straightens your teeth. Contact our Vienna, VA & Great Falls VA office if your Invisalign aligner has distorted after consuming a hot beverage.

Fluids can settle inside the aligner to “bathe” the teeth. Bathing teeth in acidic fluids can be especially problematic, as the acids can wear away tooth enamel. Exposure to acidic fluids is not normally a problem, as saliva neutralizes and buffers the acid then washes it away. Wearing an aligner, however, prevents the saliva from doing those jobs, increasing your risk for tooth decay.

Colored drinks may also change the color of your teeth. Most discoloration is temporary but stubborn stains may occur.

To prevent discoloration and tooth decay, brush your teeth after every meal or beverage before putting in your Invisalign aligners. If you do not have access to clean water, chew sugar-free gum to remove bacteria, acid, and food particles from your teeth. As a last resort, you may leave your aligners out for an hour or two until you can brush and floss properly. Before inserting Invisalign, rinse the aligner in lukewarm water or use the Invisalign cleaning kit.

Contact our Vienna, VA & Great Falls VA office for more information about eating and Invisalign.

Overbite or Overjet?

December 21st, 2022

The words “overbite” and “overjet” certainly sound similar. Both conditions concern your front teeth. Both conditions fall under the same category of bite problems—Class II malocclusions, if you want to be technical. So it’s not surprising that they’re often used interchangeably. But while there are similarities, overbite and overjet are also distinctly different.

  • Overbite/Overjet Geometry

In a healthy bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth. The key word here is “slightly.” With a Class II malocclusion, the upper front teeth project further beyond the lower teeth than they should.

Of course, teeth and bites are as individual as we are, so there are variations in just how and just how much the overlap occurs. In diagnosing an overbite vs. an overjet, the difference comes down to a matter of vertical vs. horizontal.

An overbite, or deep bite, occurs when the top teeth vertically overlap the bottom teeth more than they should for a healthy bite. Generally, when a person’s top teeth cover more than a quarter of the bottom teeth when biting down, or more than two to three millimeters, that person is said to have an overbite.

An overjet, commonly known as protruding or buck teeth, is the result of a horizontal overlap that is broader than normal. This causes the top teeth to project outward toward the lips more than they do in a typical bite. An overjet is usually diagnosed when the horizontal distance between the top and bottom teeth exceeds two to three millimeters.

  • Overbite/Overjet Causes

The causes for both an overbite and an overjet might be dental (caused by tooth alignment), or skeletal (caused by bone development), or a combination of both. These bite problems can run in families. They are also affected by the size and position of the jaws and the shape and position of the teeth.

Early oral habits, such as prolonged and vigorous thumb-sucking or pacifier use, can also contribute to the development of a Class II malocclusion, particularly an overjet. Consistent pressure from thump or pacifier pushes the teeth outward as they erupt, which encourages them to protrude. These oral habits can affect the shape of the palate and jaw, too.

  • Overbite/Overjet Treatments

There are many types of treatment available to correct teeth and bite misalignments. Dr. Allen Garai & Dr. Karen Tratensek will tailor your treatment to your specific malocclusion for the best orthodontic outcome.

If you have a mild malocclusion, and minor dental issues are the main cause of that malocclusion, either braces or clear aligners can be effective for an overjet or an overbite. Elastics (rubber bands) are often used as part of this treatment.

If the malocclusion is due to bite problems caused by uneven upper and lower jaw development, devices called functional appliances can be used with braces to help guide the growth of the jawbones while young patients’ bones are still forming. These include appliances that work inside the mouth to help the upper and lower jaws grow proportionally, and external appliances such as headgear.

In some cases, where the malocclusion is skeletal in nature as well as dental, surgical treatment might be necessary to reshape the jawbone itself. Orthodontic treatment is usually needed as well both before and after surgery.

  • Overbite/Overjet Consequences

Over time, a deep overbite can cause damaged gum tissue, worn enamel, and fractured teeth. When teeth protrude because of an overjet, they can lead to self-consciousness and are more at risk for injury. Both malocclusions share dental and medical consequences, including concerns about facial and jaw appearance, problems speaking or chewing, headaches, and face and jaw pain.

Class II malocclusions aren’t all the same, and orthodontic patients aren’t all the same either. You may have a minor malocclusion or a significant one. You may have an overbite, or an overjet, or a combination of different bite and alignment concerns. Your malocclusion may not bother you at all, or it may cause pain, discomfort, or self-consciousness.

That’s why every overbite or overjet should be evaluated by an orthodontist. When you visit our Vienna, VA & Great Falls VA orthodontic office, Dr. Allen Garai & Dr. Karen Tratensek will be able to diagnose the exact nature of your malocclusion, the reason for it, and your best individualized treatment plan. An overbite and an overjet are different malocclusions, but you and your orthodontist want the same outcome for each: a healthy, attractive, and confident smile!

Forget Something? It’s on the Tip of Your Tongue!

December 14th, 2022

Let’s see…

Toothbrush? Check.

Fluoride toothpaste? Check.

Floss? Check.

Two minutes of thorough brushing? Check.

Careful cleaning around your brackets and wires? Check.

Wait… there’s something else… it’s right on the tip of your…

Ah! Your tongue! Whenever you brush, morning, evening, or any time in between, if you want the freshest breath and cleanest teeth, don’t forget your tongue.

Why your tongue? Because the tongue is one of the most common sources of bad breath. Let’s examine just why this occurs.

The tongue is made up of a group of muscles that help us speak and chew and swallow. But there’s more to this remarkable organ than mere muscle. The surface of the tongue is covered with mucous membrane, like the smooth tissue which lines our mouths. But the tongue isn’t completely smooth—it’s textured with thousands of tiny bumps called papillae.

These little elevated surfaces have several shapes and functions. Some make the tongue’s surface a bit rough, which helps move food through your mouth. Some are temperature sensitive, letting you know that your slice of pizza is much too hot. And some are covered with thousands of the taste buds, which make eating that pizza so enjoyable.

All of these papillae with their various functions combine to create a textured surface, filled with miniscule nooks and crannies. And if there’s a nook or a cranny where bacteria can collect, no matter how miniscule, it’s a good bet that they will, and the surface of the tongue is no exception. But bacteria aren’t alone—the tongue’s surface can also hide food particles and dead cells.

How does this unappealing accumulation affect you? These elements work together to cause bad breath, especially the bacteria that break down food particles and cell debris to produce volatile sulfur compounds—compounds which create a particularly unpleasant odor. Including your tongue in your brushing routine helps remove one of the main causes of bad breath.

And that’s not the only benefit! Cleaning the tongue helps eliminate the white coating caused by bacterial film, and might even improve the sense of taste. Most important, studies show that regular cleaning noticeably lowers the levels of decay-causing plaque throughout the mouth.

So, how to get rid of that unwanted, unpleasant, and unhealthy debris?

  • When you’re done brushing your teeth, use your toothbrush to brush your tongue.

Clean your tongue by brushing gently front to back and then side to side. Rinse your mouth when you’re through. Simple as that! And just like a soft-bristled toothbrush helps protect tooth enamel and gum tissue, we also recommend soft bristles when you brush your tongue. Firm bristles can be too hard on tongue tissue.

  • Use a tongue scraper.

Some people find tongue scrapers more effective than brushing. Available in different shapes and materials, these tools are used to gently scrape the surface of the tongue clean of bacteria and debris. Always apply this tool from back to front, and rinse the scraper clean after every stroke. Wash and dry it when you’re through.

  • Add a mouthwash or rinse.

As part of your oral hygiene routine, antibacterial mouthwashes and rinses can assist in preventing bad breath. Ask Dr. Allen Garai & Dr. Karen Tratensek for a recommendation.

  • Don’t brush or scrape too vigorously.

Your tongue is a sturdy, hard-working organ, but tongue tissue is still delicate enough to be injured with over-vigorous cleaning.

Taking a few extra seconds to clean your tongue helps eliminate the bacteria and food particles which contribute to bad breath and plaque formation. Make this practice part of your daily brushing routine—it’s a healthy habit well worth remembering!

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