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Congratulations! You’ve done the hard work necessary to create your beautiful smile! You’ve carefully completed all the steps needed to reach the end of your orthodontic journey. Well, nearly all the steps. We can’t forget that last step which will ensure that all your hard work is rewarded.

When you first began orthodontic treatment, Dr. Joseph Brogan decided on the best plan for straightening your teeth and perfecting your bite, whether you wore traditional braces, lingual braces, aligners, or other orthodontic appliances. And now that you’re finishing treatment, there’s one more option to consider—your retainer.

Why do I need a retainer?

While you’ve spent time in treatment, more has changed than just the position of your teeth. The periodontal ligament, the connective tissue that connects the teeth to the jawbone, is stretched as the teeth shift. The bone in your jaw changes, too, reforming and rebuilding around the roots of your teeth as they move to their ideal locations.

These changes happen because your braces or aligners apply gentle, constant pressure to move your teeth. When you’ve finished wearing these appliances, the pressure stops. Ligaments will try to return to their original shape, which can shift teeth back toward their old positions. And the rebuilding bone isn’t dense enough yet to stop teeth from shifting due to the normal, everyday pressures of eating, chewing, and smiling.

A retainer prevents your teeth from moving back, or “relapsing,” by giving your bones and ligaments time to stabilize and rebuild. The process takes months, so keeping your teeth in place as bones rebuild and grow denser is crucial. This is especially important for patients with more serious misalignments. Dr. Joseph Brogan will let you know which kind of retainer will be best for you and just how long you’ll need to wear your retainer.

Are there different kinds of retainers?

There are! Retainers can be removable or fixed, visible or nearly invisible, metal, plastic, or metal and plastic. Three of the most popular retainer options include:

• Hawley Retainers—the traditional removable retainer, which uses a molded acrylic plate with wires attached to keep your teeth properly aligned and to hold your retainer in place.
• Clear Plastic Retainers—a removable retainer made of custom vacuum-formed plastic, which fits over the teeth like a clear aligner.
• Fixed Retainers—a small single wire bonded to the back of specific teeth, which holds them in place and prevents any movement.

Dr. Joseph Brogan will let you know whether a removable or fixed retainer is best for making sure your teeth don’t start to relapse, and fill you in on the benefits and care of each type of retainer.

How long do I need to wear a retainer?

There’s no standard answer to this question. Just like your retainer is custom-built to fit your individual teeth, the amount of time you’ll spend in that retainer depends on your individual needs. Retainers might be worn fulltime for months or years, be worn only at night after several months of daily wear, or be worn long-term to make sure your orthodontic work lasts.

Because you’ve done the hard work already, and your beautiful, healthy smile is the result. Talk to a member of our Philadelphia, PA team about which retainer option will be best for making sure that this smile lasts a lifetime.

Modern dentistry has made the most of today’s technological innovations. And we’ve come a long way from the fraying sticks our ancestors used as toothbrushes.

On the other hand, while it’s a lot better than a fraying stick, the manual toothbrush model you’ve used for years might be ready for an upgrade. Should you take this opportunity to try out some new technology offering all the bells and whistles? Let’s answer that question by asking a few more questions.

Happy with your manual brush?

If you like your manual toothbrush and it’s doing the job, by all means, stick with it. But even your old familiar brush can evolve:

• There are lots of bristle options, but soft bristles are almost always the way to go. Medium and hard bristles can be too abrasive for your enamel.
• Heads come in a variety of sizes, so make sure the head size is comfortable. You want to be able to maneuver to reach every tooth surface, which a too-large brush head just can’t do.
• Try a different handle shape if you’re having trouble maneuvering and keeping a firm grip.
• Change your brush regularly. Brushes are effective for about three months before the bristles start to fray and breakdown. This is a good opportunity to experiment with different brands and styles.

Does your old brush suit your current needs?

Different types of manual toothbrushes are available for effective and comfortable brushing when you need options that a typical brush doesn’t provide:

• Special orthodontic toothbrushes are designed with bristles trimmed to fit around brackets and wires and smaller heads to reach into tight places.
• For those with mobility issues, brushes with larger or easy-grip handles make cleaning more comfortable.
• Brushes with extra-soft bristles are available if you have enamel erosion or sensitive gums.
• Because many women find their gums become especially sensitive during pregnancy, there are brushes designed especially for moms-to-be.

Is it time to go electric?

If you haven’t tried an electric toothbrush before, you might find that getting braces is a great reason to give one a spin.

• Electric toothbrushes can outperform manual models. A dedicated brusher might manage hundreds of brushstrokes for each minute of brushing, while an electric brush can provide thousands. If, despite your regular brushing, you have plaque build-up, an electric brush might be a good alternative to your manual brush.
• Models are available which can alert you when you’re brushing too hard—which is important for your enamel if you’re a heavy-handed brusher.
• If you tend to *think* you’ve brushed for the recommended two minutes, but have *actually* brushed 32 seconds, some electric brushes come with timers!
• There are tapered electric orthodontic brush heads designed just for people with braces.
• Electric brushes have bigger handles and can be easier to grip.

Is your current brush doing the job?

So, should you stick with the familiar toothbrush that’s worked for you all these years, or take this opportunity to try out some new technology that offers all the bells and whistles? The answer is clear: the right brush for you is the one that works!

If your regular checkups show that plaque is under control, you’re doing just fine with the brush in hand. If you or Dr. Joseph Brogan notice plaque buildup, it’s time to consider making some changes. Whether it’s a question of tools, techniques, or time spent brushing, your Philadelphia, PA dental team has the answers you need for state-of-the-art dental hygiene.

There are many great reasons to see an orthodontist. For a healthier bite. For straighter teeth. For a more confident smile. So why are you hesitating? If the visibility of traditional braces is what’s holding you back, ask Dr. Joseph Brogan about lingual braces.

With regular braces, brackets are bonded to the front of each tooth with a special adhesive. Ligatures around each bracket or bracket clips grip an archwire, which does the work of moving the teeth. The gentle pressure from the wire guides the teeth into alignment in gradual stages. Every adjustment moves the teeth to their perfect positions. These braces are quite effective—and they are usually quite visible.

Lingual braces, on the other hand, are virtually invisible. Lingual means “toward the tongue,” and this placement is the difference between lingual braces and more traditional types of orthodontic braces.

Lingual braces are custom designed to be applied to the inside of your teeth. Specially designed brackets are attached to the backs of the teeth. Individually crafted archwires are used to guide your teeth to their best alignment.

Lingual braces can be the solution to many orthodontic concerns:

• If you need or want invisible braces for personal or professional reasons, lingual braces are a great option. Because they are behind your teeth, they are even less noticeable than clear aligners—and you don’t need to keep track of your hours wearing them.
• Lingual braces keep the front of your teeth braces-free for playing a brass or reed instrument, or for participating in sports. (Just remember, a mouthguard is always a good idea for athletic activities, and especially when you wear braces.)
• Both brackets and wires can be customized to fit your teeth perfectly, and new lingual brackets and wires are more comfortable than ever.

You might be a good candidate for lingual braces if:

• You have a large enough tooth surface to place a bracket. Adults with small teeth—or children—might not be have enough room on the back of each tooth to hold a bracket.
• You don’t have a major malocclusion (bite problem) which would make lingual braces impractical. A deep overbite, for example, could cause the wires and brackets behind the upper teeth to come loose or detach as they come in contact with lower teeth.
• You are dedicated to keeping up with your oral hygiene. Because wires and brackets are behind the teeth, it can be harder to keep them free from food particles and plaque.

Finally, even if lingual braces aren’t the perfect match for your orthodontic needs, there are other options that can work for you. Smaller metal brackets, ceramic brackets that blend in with your enamel, and clear aligners mean today’s orthodontic work is more subtle and discreet than ever before.

For a healthier bite, for straighter teeth, for a more confident smile—don’t hesitate. Contact our Philadelphia, PA office to discuss the many great options you have available to give you the smile you’ve always wanted—front and center.

When we think orthodontics, we commonly think teeth. Naturally! Straight teeth and a beaming smile are everyone’s orthodontic goal. But orthodontics is a field which specializes in more than misaligned teeth. While your beautifully aligned teeth are the visible outcome of your orthodontic work, a properly aligned bite is the foundation for your healthy smile.

A malocclusion occurs when the teeth and jaws aren’t properly aligned—they don’t fit together the way they should when the mouth is closed. A malocclusion, or bad bite, affects many people to some degree, but not always in exactly the same way. Some of the different types of malocclusion include:

• Crossbite

A crossbite occurs when upper teeth fit inside lower teeth. An anterior crossbite refers to the front teeth, with one or more upper front teeth, or incisors, fitting behind lower front teeth. A posterior crossbite affects the back teeth, with upper teeth fitting inside the lower teeth on one or both sides of the jaw.

• Crowding

When the jaw is small and/or the teeth are large, lack of space can result in crowded, twisted, or crooked teeth.

• Open bite

An anterior open bite means that the front teeth don’t close when biting down, leaving an open space between the upper and lower teeth. A posterior open bite occurs when the back teeth don’t make contact when the front teeth close.

• Overbite

Our upper front teeth naturally overlap the lower ones a small bit when the teeth are closed. An overbite occurs when the upper teeth significantly overlap the lower teeth.

• Overjet

When the upper front teeth protrude too far forward over the bottom teeth, it’s called an overjet, or, sometimes, buck teeth. Where an overbite causes a vertical overlap, an overjet takes into account the horizontal relationship of the teeth.

• Spacing

A jaw that is large, teeth that are small, missing teeth—these conditions can lead to gaps between the teeth.

• Underbite

An underbite results when the lower teeth and jaw extend further forward than the upper teeth and jaw, causing the bottom teeth to overlap the top teeth.

If you have a malocclusion, what comes next? This depends.

Some malocclusions are so minor that no treatment is necessary. Some are the result of misaligned teeth. Some occur because the upper and lower jaws are growing at different rates. Some are a combination of teeth and jaw misalignments. Some are caused by genetics, while others are caused by injuries or habits like prolonged thumb sucking or tongue thrusting.

Because malocclusions are so varied, your treatment plan will be designed for your specific needs. Braces, aligners, appliances like the Herbst® appliance or the palatal expander, surgery for severe malocclusions—there is a larger variety of treatment options than ever before to help you achieve a healthy bite.

When teeth and jaws don’t fit together as they should, the consequences can be damaged teeth and enamel, problems with the temporomandibular joint, headaches and facial pain, and difficulty chewing, eating, and speaking.

The good news is that early intervention for children can help correct teeth and jaw problems before they become more serious, leading to easier orthodontic care in the teen years, and helping to avoid the possibility of surgery or extractions. This is why Dr. Joseph Brogan and our team recommend an orthodontic assessment at our Philadelphia, PA office for children around the age of seven.

If you’re an adult with concerns about your teeth or bite, there’s good news for you, too. Dr. Joseph Brogan can devise a treatment plan to improve your bite and your smile no matter what your age.

Of course, despite our title, there’s really no such thing as a “common malocclusion” when we’re talking about your dental health. Each person—and each smile—is unique. Dr. Joseph Brogan will diagnose your malocclusion and create a personalized plan carefully tailored to your exact needs, for an uncommonly attractive, confident, and healthy smile.