Dental Health

By Dr. Negaar Sagafi

After moving to the United States from Iran, my family settled in Massachusetts where Henry David Thoreau was born, raised, and wrote Walden. Thoreau said, “Kindness to children. Love for children. Goodness to children … These are the only investments that never fail.”

Every visit to my office is an investment. Not only because the time I spend with my patients will result in a healthier smile, but because compassionate care will form lifetime opinions about the importance of dental health and my profession.

Taking a few extra seconds to connect with a child matters.

We know an appointment with the dentist is anxiety-producing. A visit with the orthodontist can be even more so. As a result, according to a 2018 DentaVox survey, 61 percent of the Americans say they suffer from dental fear. Four percent said they were so afraid that they have never seen a dentist. These patients will be more likely to suffer from ill health.

As clinicians, it is imperative that we act with empathy.

I find that children’s anxiety disappears quickly when my staff and I connect what we are doing to their teeth to their unique interests.

This task is pretty easy when I’ve got patients who are excited about math, science, or the arts. For one very young patient, I simply talked explicitly about what tooth number I’m referring to and ask them to count along with me. For students interested in physics or technology, I discuss in detail how BRIUS uses artificial intelligence to help move teeth. With one teenage patient, we’ve gotten so deeply into the details that she’s interested in an internship! I hope the time we’ve spent together not only encourages her to pursue a medical degree, but to become an empathetic practitioner.

For my chess-loving patients, we focus on strategy. If I do this on the top row of teeth, how is that going to impact what’s happening on the bottom, or even their bite? And, trust me, if your child loves history, I can go way back! Did you know, for example, that the Etruscans (who lived outside of what we now know as Rome) are responsible for some of the earliest orthodontics?

My staff and I also just ask a lot of questions. I always try to remember what the Spanish cellist Pablo Casals said. He told children, “You are a marvel. … There has never been another child like you. Your legs, your arms, your clever fingers, the way you move. You may become a Shakespeare, a Michelangelo, a Beethoven. You have the capacity for anything.”

Whether it is music, athletics, or academics, our patients have the potential to become anything. Simply asking kids to describe what they’re up to — what makes them smile! — is a great way to make anxiety disappear and to put them on a path toward a lifetime of good dental health.

Dentists and orthodontists also need parents’ help in our efforts to reduce dental fear.

According to a 2015 survey of parents with children 12 and under, 48 percent said they are nervous themselves about going to the dentist. It was no coincidence, then, that roughly the same number of children (47 percent) said they were nervous. As Dr. Bill Kohn, Delta Dental Plans Association’s vice president of dental science and policy, said, “It’s easy for kids to pick up on their parents’ anxieties … so parents should try to stay positive when talking with their children about dental visits.”

Parents must remain relaxed.

Especially since we’re actually seeing increased anxiety lead to dental problems. In an ironic and painful twist, while anxiety can keep people away from the dentist and orthodontist, it also can drive them to us. According to a ADA Health Policy Institute study, in February 2021 more than 70 percent of dentists said they have observed an increase in the number of patients experiencing stress-related teeth grinding and clenching. That number is up from just under 60 percent in the fall of 2020.

Americans are more anxious than ever. For the sake of their long-term health, we need to make a greater effort to connect with kindness.

If you’ve just gotten braces at our Washington D.C. office, you’ve probably also learned a whole new vocabulary. Malocclusion, brackets, archwires, ligatures, elastics—you’ve got the definitions down. But now you’re scheduled for an “adjustment.” What exactly does that mean?

Why Do I Need an Adjustment?

After all, you’ve just gotten braces! But the fact is, moving your teeth to their ideal location is a process that involves many steps. The brackets and wires you have today are only a starting point. Wires, and rubber bands if you need them, put gentle pressure on the teeth, gradually moving them into a better position. Every time we see you, we check the progress you’ve made and adjust your braces to move the teeth into even better alignment. It’s a careful process to make sure your teeth and jaws fit together perfectly for straight teeth and a healthy bite.

What Will Happen at an Adjustment?

Because your braces are made specifically for you, there is no one answer for everyone or even every appointment. Usually, your ligatures (the colorful bands around your brackets) will be removed, and often the orthodontic wire that is attached to your brackets will be removed as well. We’ll check to make sure you are brushing and flossing properly around your wires and brackets, and check on the condition of your braces.

Your wire might be adjusted, or bent, or tightened, or replaced all together. In the beginning, the wire will probably be more flexible. Later in your treatment, you might get a thicker, firmer wire to move your teeth more effectively, or we might bend a wire to move specific teeth.

If you need rubber bands to make sure your bite is in alignment, we’ll show you how to attach and take care of those. We’ll also look for other adjustments that might need to be made to your brackets. If you have any concerns about brackets, wires, or any other part of your braces, let usknow! And once we’re done adjusting your braces, this is your chance to change the color of your ligatures for a new look.

Will It Hurt?

You might suffer some discomfort in the hours after an adjustment, so treat yourself gently! Stick to soft foods for a few days, and treat yourself to something cold and soothing like ice cream, yogurt, or a smoothie. Brush gently if your teeth are sensitive. Usually, over-the-counter pain relievers will take care of any soreness. You can even take a pain reliever 30 minutes to an hour before the adjustment if you are expecting some discomfort. We have more great ideas on how to reduce any tenderness you might feel—let us know if we can suggest some.

Within a day or two, you should be back to normal. If you ever suffer serious discomfort, or if the soreness lasts more than a few days, give us a call.

Remember, each adjustment brings you closer to your goal—straight teeth and a healthy bite. And that’s the definition of a beautiful smile!

Many people undergo orthodontic treatment during childhood, adolescence, and even into adulthood. Wearing orthodontic appliances like braces is sure to produce a beautiful smile. Though orthodontic treatments at Spring Valley Orthodontics are designed to accommodate your lifestyle, chances are you will need to make some dietary modifications to prevent damage to your braces and prolong orthodontic treatment.

The First Few Days with Braces

The first few days wearing braces may be the most restrictive. During this time, the adhesive is still curing, which means you will need to consume only soft foods. This probably will not be a problem, however, as your teeth may be tender or sensitive while adjusting to the appliances.

Orthodontic Dietary Restrictions

You can eat most foods normally the way you did without braces. However, some foods can damage orthodontic appliances or cause them to come loose. Examples of foods you will need to avoid include:

• Chewy foods like taffy, chewing gum, beef jerky, and bagels
• Hard foods like peanuts, ice chips, and hard candy
• Crunchy foods like chips, apples, and carrots

How to Continue to Eat the Foods You Love Most

Keep in mind that you may still be able to enjoy some of the foods you love by making certain modifications to the way you eat them. For example, steaming or roasting carrots makes them softer and easier to consume with braces. Similarly, you can remove corn from the cob, or cut up produce like apples and pears to avoid biting into them. Other tips include grinding nuts into your yogurt or dipping hard cookies into milk to soften them. If you must eat hard candies, simply suck on them instead of biting into them.

If you have any question whether a food is safe to eat during your treatment with Spring Valley Orthodontics, we encourage you to err on the side of caution. Of course, you can always contact our Washington D.C. office with any questions you have about your diet and the foods that should be avoided during treatment. By following our dietary instructions and protecting your orthodontic appliances from damage, you will be back to chewing gum in no time.

The best part of summer vacation is time. Time to hang with friends, time to travel, time to get a summer job, time to catch your breath after a busy school year. And if we have recommended braces, summer is also a great time to start orthodontic treatment!

• Time for Office Visits

It can be easier to get an appointment in the summer because many patients and their families are on vacation. And, because your earliest visits are generally the longest, you won’t have to disrupt your school schedule as much or work around after-school activities.

• Time to Get Used to Your Appliance

There can be some discomfort in the first few days after you get your braces, so you might find it’s more convenient and comfortable to be at home. You’ll have time to get used to choosing and eating braces-friendly foods, to practice speaking clearly with new braces or aligners, to appreciate your new look. And your friends will have time to get used to your braces, too!

• Time to Establish New Dental Routines

Over the years, you’ve gotten used to brushing at least twice a day for two minutes and flossing at least one a day. Now it’s time to add some new moves. Brackets and wires can trap food particles and lead to a greater risk of cavities, so you’ll need some new tools to keep your braces their cleanest.

There are toothbrushes that have heads designed especially for cleaning around brackets. Floss threaders get floss in between wire and brackets, or use a floss specifically designed for braces. Little cone-shaped brushes called interproximal brushes fit around your braces and under your wires to remove hard-to-reach food particles and plaque.

Getting your cleaning routine down during the summer will help you take care of any clinging food particles quickly during your lunch hour or before after-school activities. And, you’ll know exactly what dental supplies you’ll need in your locker.

• Time to Make Adjustments to Your Extra-Curricular Activities

Braces or aligners will provide you with a future filled with beautiful smiles, but they might require some present-day adjustments in your normal activities.

If you play a sport, especially where contact is possible, a custom mouthguard is the best way to protect your teeth, your jaw, and your braces in case of collision or a fall. Let us know what sports you play as soon as you get your braces.

If you play a reed or wind instrument, you might have to adjust the way you use your lips and teeth to produce your sound. Learning to use dental wax to cover brackets and protect your lips and mouth is well worth it. If you take lessons, talk to your instructor about the best way to adapt to your braces if you think your tone has been affected.

If you are in speech or drama, it could take a while to be comfortable with your articulation. Talk to us if you find you are having problems with your regular pronunciation for some great suggestions on getting back to normal as quickly as possible.

Summer certainly offers some advantages in giving you the time you need to get comfortable with your braces or aligners. But, there’s really no bad time to begin your orthodontic treatment. Spring, summer, fall, or winter, we’re here to help make sure your treatment experience at our Washington D.C. office is a positive one. After all, working toward a lifetime of beautiful smiles is always in season.

Sticky, hard, and gooey: these candies fill your dopamine receptors with spasms of sugar-filled joy, but if you’re undergoing orthodontic treatment at Spring Valley Orthodontics to straighten your teeth, then these sweets are not so sweet. While you may have a Willy-Wonka-sized sweet tooth, there are some candies you’re going to have to avoid while wearing braces.

Here are five bracket- and wire-destroying culprits that our team recommends leaving on the candy aisle and not put in your mouth, no matter how tempting they may be.

1. Gum is sticky and stringy. It can get tangled like fishing net in your braces. You don’t want to be that boy or girl trying to pull knots of Wrigley’s out of your braces without being seen.
2. All chewy, gooey candies need to be avoided. When you’re wearing braces, don’t even think about putting a caramel candy in your mouth. Caramel will not only stick to your braces, making it look as if you haven’t brushed your teeth in a week, but the gooey texture can pull apart the wires, and trigger an emergency visit to Spring Valley Orthodontics.
3. Hard candy may seem like a safe choice, but it’s not. What’s the problem? Nobody ever just sucks on hard candy; sooner or later, we bite down on it. Biting a hard candy may cause part of your braces to snap. Furthermore, once the candy is broken into a bunch of little pieces, it’s not uncommon for one of those sugary shards to get wedged between your braces and teeth … and that’s a cavity waiting to happen.
4. The taffy you enjoy getting at a seaside boardwalk is going to have to go on the back burner. Like caramel, taffy can pull apart and damage your braces. You don’t want to have your expensive orthodontic gear replaced.
5. Please, just one lollipop? Nope. A lollipop is nothing more than hard candy on a stick. If you can’t have hard candy during orthodontic treatment, then you shouldn't have hard candy on a stick either.

Have any more questions about what you can and can’t eat when you have braces? Please give us a call at our convenient Washington D.C. office to learn more, or ask us during your next adjustment visit!

It's springtime and it's again time to remind our patients at Spring Valley Orthodontics to protect their faces and pearly whites while out on the field playing sports. According to the National Youth Sports Safety Foundation, children, high-school athletes and adults have more than 5,000,000 teeth knocked out in sporting events annually.

If you are planning on participating in spring sports, it’s imperative to have a proper-fitting mouthguard. Mouthguards can prevent chipped or broken teeth, lip and cheek injuries, jaw fractures, mouth lacerations and even concussions.

Having a mouthguard can make the difference between losing your teeth or not, and because many of our patients who play high school sports have jaws that are still growing, last year’s mouthguard may no longer fit as it should. Our team can fit you for a new guard.

To learn more about mouthguards or for general questions about your treatment at our Washington D.C. office, please give us a call!

If you participate in sports or other physical activities, it’s wise to consider getting a mouthguard. Also known as mouth protectors, mouthguards are a device worn over the teeth to lessen the impact of a blow to the face.

This reduces the chance that you might lose teeth or sustain other serious oral injuries. We recommend that all patients involved in a contact sport such as wrestling, football, or hockey wear a mouthguard because of the high risk of such injuries.

However, anyone involved in a physically demanding sport or activity should wear a mouthguard as well.

Can you imagine what it would be like to lose a few of your front teeth? The way you talk, eat, and smile would all change. Potential injuries when you don’t wear a mouthguard include chipped and broken teeth, fractured jaws, root damage, damage to crowns and bridgework, concussions, and/or injury to the lips, cheeks, or gums.

Types of Mouthguards

There are three different types of mouthguards — typically made of a soft plastic material or laminate. You can decide which works best for you in terms of budget, fit, and comfort.

• Stock mouthguards are prefabricated to a standard size. They offer adequate protection, but you need to make sure you find one that fits properly and comfortably. Stock mouthguards are readily available at department stores, sporting goods stores, and online.
• Boil-and-bite mouthguards are placed in boiling water to soften them, then into the mouth so they can conform to the shape of the teeth. Boil-and-bite mouthguards are more expensive, but offer a more customized fit than stock ones. You can find these in department stores, pharmacies, sporting goods stores, and online.
• Custom-made mouthguards are created just for you by our office. These offer the best fit and comfort of all the options, but they are also the most expensive. Ask a member of our Washington D.C. team for more information.

The American Dental Association says a good mouthguard should be easy to clean, fit properly, be comfortable, and resist tearing or damage. It shouldn’t restrict speech or breathing.

Still not sure if you need a mouthguard or which kind is right for you? Just ask us for more information.

We are about to mark the one-year anniversary of our nation’s collective COVID-19 shutdown. Montgomery County, Md. and Washington, D.C. – where my two practices reside – went into lockdown on March 13, 2020.

Resilience is a word that is sometimes overused, but it was definitely more appropriate than ever in 2020. I am so proud of the schoolchildren who are my patients. They learned to … well … learn in a whole different way over the last 12 months. And parents? They are my superheroes! I cannot imagine working from home while monitoring schoolwork.

I am also proud of my staff and my fellow orthodontists and dentists. Even though we know the care we provide is essential, last spring we were kept for many weeks from doing what we love and what we know is a vital service to our community. We didn’t know when our livelihoods would bounce back … or if they would.

I’m especially proud that, since our practices opened up again last summer, we have proven that our offices are safe places where patients can get routine and emergency care in a COVID-free environment.

According to a new study published in The Journal of Dental Hygiene, the estimated prevalence rate of COVID-19 in U.S. dental hygienists is low. In fact, a survey of nearly 5,000 hygienists revealed only 3.1 percent had ever tested positive or been diagnosed with the virus. Masking up keeps the virus from spreading!

That study came after one published in October 2020 in The Journal of the American Dental Association that indicated fewer than one percent of U.S. dentists had been diagnosed with COVID-19. That result was far below the rate of other U.S. health professionals. The Journal also reported 99 percent of dentists were using enhanced infection control procedures such as screening protocols when treating patients.

We are committed to patient safety.

My practices not only have increased screening protocols and disinfection practices – I am scrubbing and hand sanitizing so much now that I sleep with gloves and moisturizer on my hands! – we have altered our personal behavior outside of the office to ensure our offices stay COVID-free.

I love to travel and have not been on a plane since last February. We are not carpooling with friends and neighbors – and we are not taking car or ride shares either – and we are celebrating birthdays and other family milestones from the safety of our own homes, with only those who live under our roofs. And, of course, we are excited to report that, as frontline healthcare workers, most of us have received our COVID-19 vaccines!

We miss social interaction and vacations just like everyone else, but with so many people still unvaccinated, going on a little weekend jaunt is not worth the risk.

While our practices were deemed non-essential at the beginning of the pandemic, we also know now that dentists, orthodontists, and other oral health experts actually can help diagnose COVID-19. According to Dr. Aravindhan Karunakaran, the virus can cause lesions on the tongue that might be the only symptom of COVID-19.

I hope these measures and this academic research will reassure parents and caregivers. According to a survey by C.S. Mott Children's Hospital National Poll on Children’s Health, 40 percent of parents have avoided seeking dental care for their children during the pandemic, citing concerns about infection, office closures, and cost.

Not only does this set a bad precedent about how children will view dentists and orthodontists long-term (they’re scary or non-essential), it threatens overall health. What happens with your teeth can impact everything from quality of sleep to heart health. And, according to a report in Dentistry Today, patients with COVID-19 and gum disease were 4.5 times more likely to need a ventilator, and almost nine times more likely to die than those without gum disease.

Dental care is essential. And during COVID-19, it is safe.

You might be surprised to see one of your second grader’s friends with a dental appliance. Isn’t orthodontic work just for teenagers? And, if not, should your seven-year-old be sporting braces right now? The answer to both of those questions is “Not necessarily.” Two-phase treatment is a process designed to correct issues that arise during different times in your child’s life.

First Phase Treatment

We recommend that every child have an orthodontic evaluation around the age of seven to determine if there is a problem that would benefit from early treatment. First phase orthodontics is not the same as orthodontics for older patients. The focus here is on the developing bone and muscle structures which form your child’s bite and provide space for the permanent teeth when they arrive.

There are some clear-cut orthodontic goals that are much easier to attain when children’s bones are still growing.

• Reducing Crowding

If your child’s mouth is small, the permanent teeth will have little room to fit in when they arrive. We may recommend gently enlarging the upper dental arch with the use of a palatal expander. This device will provide room for the adult teeth, and could potentially shorten second phase treatment time. Sometimes the extractions necessary to create more room for permanent teeth in later years can be avoided, as well as the possibility of an impacted tooth—one which doesn’t erupt because it is blocked by other teeth.

• Dealing with Jaw and Bite Concerns

Bones and muscles do not always develop properly, leading to problems with jaw and facial structure. Your younger child still has growing bones, so this is a great time to gently re-form the jaw into a healthy shape. Problems caused by crossbites, underbites, open bites, and other malocclusions can be reduced with early treatment.

• Protecting Teeth

If your child has protruding front teeth, these teeth are more likely to be damaged in falls, at play, or while participating in sports. We can gently reposition them.

Second Phase Treatment

Second phase treatment is designed for your older child. After a resting period, when the permanent teeth finish erupting, we should see your child to evaluate any further orthodontic needs. This is the time to finish the process of straightening the teeth and making sure that each tooth fits together properly for a comfortable and healthy bite. This phase usually makes use of braces or aligners, and can take approximately 12-24 months.

Two-phase treatment is not necessary for every child. But there are some unique reasons that early orthodontics might be recommended for your child, even if it’s clear that more orthodontic work will be needed later. Make an appointment at our Washington D.C. office, and let’s evaluate your child’s orthodontic needs, whether now or in the future, for a lifetime of beautiful smiles.

Sports are great for children for a variety of reasons. Children can develop their motor skills, learn how to solve conflicts and work together, and develop their work ethics. As a parent, you may recognize the benefits of sports, but also naturally worry about your child’s health and safety. Your job goes beyond providing a water bottle and making sure your child follows the rules of the game.

Although you may not think of your child’s teeth first when you think about sports, accidents can happen that affect your children’s teeth. A stray hockey stick, an errant basketball, or a misguided dive after a volleyball are examples of ways a child could lose a tooth. In fact, studies show that young athletes lose more than three million teeth each year.

Becoming a Better Athlete to Protect Teeth

Becoming a better athlete involves refining skills, learning the rules of the game, and being a good sport. These components are not just about winning. They are also about safety. Young athletes who are better ball-handlers and who are careful to avoid fouls and penalties are less likely to have harmful contact with the ball, teammates, or opponents. Children who are better roller-bladers are less likely to take a face plant into the blacktop, and more likely to save their teeth. Being a good sport and avoiding unnecessary contact is one way to protect teeth.

Proper Protective Equipment for Teeth

If your child is in a sport that poses a high threat to teeth, it is essential for your child to wear a mouthguard. Mouthguards fit your child’s mouth and consist of soft plastic. We can custom fit a mouthguard if generic ones are uncomfortable. While children may resist wearing a mouthguard initially, your persistence in insisting that they wear it should be enough to convince them. A helmet or face mask provides additional protection.

While prevention is best, rapid treatment can improve the situation if your child does happen to lose a tooth during sports. Rapid implantation can work in about ten percent of cases. To learn about ways to save a lost tooth, contact our office.

Orthodontists and dentists both help patients improve their oral health, but in different ways. Dentistry is a broad medical specialty that deals with the teeth, gum, nerves, and jaw, while orthodontics is a specialty within dentistry that focuses on correcting bites, occlusion, and the straightness of teeth. One important difference is that all orthodontists are dentists, but not all dentists are licensed orthodontists.

How are they similar?

The main similarity between a dentist and orthodontist is that they both focus on oral care. An orthodontist can work in a dental office and provide the same care as a dentist. So in this respect, they are quite similar. They are both considered doctors, and deal with the teeth and gums.

How are they different?

There are more differences than similarities. An orthodontist requires additional schooling as a dental specialty; the situation is similar to a doctor who obtains additional schooling to become a surgeon. Another difference is that orthodontists specialize in helping patients with the alignment of their teeth, improving their bite, or fitting them for corrective braces and devices. If a patient has an overbite, a dentist will refer him or her to an orthodontist.

Dentists typically encourage good oral hygiene and provide services related to:

• Tooth decay
• Root canals
• Gum disease
• Crowns
• Bridges
• Veneers
• Teeth whitening

Orthodontists are dentists that specialize in the alignment of teeth, and provide services related to:

• Misaligned teeth
• Crowded teeth
• Overbite
• Underbite

What an orthodontist can help with

Orthodontists help with crooked teeth, but they assist patients with other issues as well. These include overbites and underbites, crossbites, spaces between teeth, overcrowding of teeth, and the treatment of temporomandibular disorders (TMD). Additional problems with the jaw also need to be treated by an orthodontist.

While a dentist may be trained to provide orthodontic care in addition to extractions, TMJ treatments, and fillings, trusting your smile to an orthodontist can better balance the different procedures you require.

To learn more about the difference between dentists and orthodontists, or to schedule an initial consultation, please give our team at Spring Valley Orthodontics a call at our convenient Washington D.C. office.

February has officially arrived! This is a great time to “brush up” on your child’s dental hygiene in honor of National Children’s Dental Health Month! The tips below won’t only benefit the kiddos, however. Parents should take note too!

Dental care for your child begins in infancy. The bacteria in your mouth is dynamic and changes as kids age. Brushing always is important but becomes even more so with each candle you add to the birthday cake.

Getting your child to brush their teeth every day, twice a day can prove challenging and exhausting at times but don’t give up! Just keep telling them to do it. Building a habit takes time, but it ultimately pays off when you teach your child healthy habits that will last the rest of their life. When your child undergoes orthodontic treatment the diligence of their oral hygiene routine becomes even more important. If you don't brush while having braces, it will leave spots.

When it comes to selecting toothpaste for your child I would choose one with minimal amounts of fluoride. Kids aren't great at swallowing so less fluoride actually is better. No more than a pea-size amount of toothpaste is necessary - that is plenty!

One of the most important parts of maintaining a healthy smile is maintaining a healthy diet! Diet becomes particularly important while undergoing orthodontic treatment. Smoothies and veggie-packed soups are great, especially for kids with sore teeth from braces.

As for when to bring your child in for their first appointment, it can vary. For dental visits, it used to be 3 years old, but the American Association of Pediatrics now recommends younger. For ortho, the recommended age is 7 years old. Sounds early, but that is what the AAO recommends! Here is a link where you can learn more: https://www.bethesdaorthodontics.com/early-orthodontic-treatment

If your child is worried or scared about their oral health visits, be mindful about projecting your own anxiety. Try not to refer to your own difficult dental stories! Preparing your child well before their first appointment is highly encouraged, but talking through their worries is better than falling back on past experiences.

And, when in doubt, go the library! There is a great book called "Smile" that explains orthodontia and its benefits. I've had children tell me that it really prepared them to come in for their first appointment. Like the book (it's a graphic novel), my office is colorful and inviting. And we always smile!

If you have any questions or concerns or want to learn more, our team is always happy to discuss them with you—any time of year! We should celebrate children's dental health every month!

When we think braces, we can’t help but think of the brackets on each tooth and the colorful ligature bands that surround them. But actually, the whole point of those brackets and bands is to hold the archwire in place as it gradually moves your teeth to create a better bite and a straighter smile. Let’s learn more about this talented part of your braces!

• Wire We Wearing These, Anyway?

Archwires use gentle, continuous pressure to move your teeth into alignment. That sounds simple, but there is actually a lot going on. Teeth often need more than realigning. Some teeth need to be turned a bit, some tilted. Your teeth need to be better aligned with those next to them, of course, but also need to fit properly with the teeth above or below them. You might have a malocclusion, or bad bite.

How can one wire handle all that? Well, it can’t. That’s why there are different types of wire. We often use thinner, flexible wires at the beginning of treatment, to put gentle pressure on the teeth as they start their movement. Other wires are firmer, and can be helpful in later phases, when each tooth is carefully moved to its specific, ideal spot. Archwires can be round or rectangular, thicker or thinner, springy or stiff, remember their shape or be bendable—all depending on what they need to do.

Whew! This sounds confusing, but we're archwire experts! At every adjustment appointment, we check on the progress of your alignment and choose the exact wire you need to take you to the next stage of your orthodontic journey.

• Out of the Frying Pan, Into the Wire

Now that you have braces, it’s more challenging to make sure that your teeth are clean after eating. We’ll give you advice on how to get rid of the pesky food particles that sometimes get stuck in your braces. First, that’s absolutely not the look you’re going for. But, more than that, bacteria can use these “leftovers” as fuel to create the acids that damage your enamel and cause cavities.

There’s a whole new world of dental products out there waiting to help get your braces clean. Special toothbrush heads work in the spaces between your teeth and the archwire. There are floss threaders that can get dental floss into tight places, and flosses with one stiff end you can guide under the wire so you can direct the floss to where it’s needed. There are even tiny cone-shaped brushes called “interproximal brushes” that can fit under your wires to clean around your brackets and teeth.

Take a care kit to school or work with you so you can keep the tooth surface under your wires and around your brackets free of plaque. After all the hard work you’ve put in with your braces, the last thing you want is cavities once you’ve achieved your beautiful smile!

• Down to the Wire

We said archwires were awesome, but we didn’t say they were perfect! We couldn’t leave without suggestions for handling any wire-related problems that might come up.

One of the most common problems is the irritation caused by the end of a wire that has somehow come loose. You might be able to use a cotton swab to gently push the wire flat against the tooth. If that doesn’t work, orthodontic wax can be used to cover the end of the problem wire and smoothed into place. We’ll provide you with instructions on how to handle these and other minor wire problems at home.

Other problems should be run past us first. If you feel your wire is coming loose, or if a loose end is causing a lot of pain and irritation, call our Washington D.C. office. We’ll give you instructions on how to help, and make an appointment if necessary for a professional fix.

In fact, call us anytime you have questions about your braces. We’re here to help you understand each phase of the orthodontic process as you move step by step on the path to a healthy bite and a beautiful smile. And what’s more awesome than that?

Time.

There really does not seem to be enough of it these days and, with all due respect to the fathers who come through my office door (and there are a lot of them!), balancing work from home and school from home is taking the harshest toll on mothers.

Consider this telling statistic: in December 2020, the American economy lost a net 140,000 jobs. Men actually gained 16,000 jobs, but women lost 156,000. Last fall, Facebook’s Chief Operating Officer, and founder of the LeanIn.Org, Sheryl Sandberg urged companies to be more flexible – or risk losing their top female talent.

I hear the stress in the voices of the mothers who come into my office, whether they hold jobs outside of being wife and parent or not. This crisis has taken a toll.

The medical community can make things just a tiny bit easier by embracing digital technologies that allow us to check in and follow up with our patients virtually.

Both of my offices use Dental Monitoring by DentalMind, for example. With the app on iOS and Android, patients capture their treatment progress, communicate them to my office, and receive any necessary instructions or changes directly from me. This technology allows me and my patients to maintain consistent contact between appointments in a safe, seamless, and time-saving way.

I also offer virtual consults. Patients take a few snaps of their smiles and, based on these photos alone, I can come up with a preliminary treatment plan. We will meet face to face as a next step, but there is no reason not to use technology to get things started.

Digital technologies also are super convenient in a pinch.

A couple of weeks ago, my front desk fielded a call from a mom in Middleburg, Va. who was supposed to bring her teenage son in that day for an in-person consult. Even under normal circumstances, Middleburg is quite a drive to the Washington, D.C. area and, on this particular day, everyone was just running behind.

I could hear the relief in mom’s voice when I told her the consult could be done digitally. After all, why do we carry around high-resolution cameras and computers in our purses if we can’t use them to save ourselves a few minutes? I hope that mom was reassured, too, that if she chose our office for her son, many of our follow-ups could be completed from her own living room.

Smartphones also can be incredibly helpful when assessing emergency situations with your dentist or orthodontist. A friend of mine who is a pediatric dentist evaluated a young patient on a Friday night who fallen (err, jumped) off a couch and landed on a set of drums. (Ouch!) Teeth were broken, but the dentist also clearly could see that stiches were needed. While mom still was not happy with the stage dive, at least her dentist-by-iPhone gave her a clear path forward and at least some reassurance.

Telehealth not only saves time, it saves money. According to an April 2020 article in U.S. News & World Report, for medical visits, “The national median cost for a video-based virtual visit is $50, compared to $85 for low-severity treatment at a doctor’s office, $130 for an urgent care facility visit, and $740 for an emergency room visit.”

One more benefit?

Telehealth also is good for the environment. When researchers from the University of California at Davis studied the use of telehealth in the Golden State, they found “telemedicine utilization saved the air almost 2,000 metric tons of carbon dioxide, 50 metric tons of carbon monoxide, 3.7 metric tons of nitrogen oxides and 5.5 metric tons of volatile organic compounds.”

Digital health: good for the planet … easy on your schedule.

So, take an easy breath next time you’re worried about making time for your appointment. Give us a call, and we’ll determine if we can do it virtually instead.

Today, we thought we would offer a few tips for our patients currently undergoing orthodontic treatment. For those of you wearing braces, it’s important to be even more dedicated to good oral hygiene than those not currently in treatment.

After getting your braces, it is important to know how to take care of your teeth in order to ensure that your braces stay intact and do their job so that your teeth are in top-notch condition after you complete your orthodontic treatment.

Braces are known to trap food, which contributes to plaque formation. If it is not carefully removed from the teeth and gums, plaque will develop into decay or gum disease, leading to costly delays during your treatment. It is important to practice good oral hygiene by following instructions your treatment.

We are proud to offer supplies to help fight plaque, such as a proxabrush, dental floss, and floss threaders. The use of an electric toothbrush and or a water pick can also be helpful in combating cavities and decay. And, of course, our team at Spring Valley Orthodontics suggests brushing at least twice a day.

We hope that helps! If you have any questions, please give us a call or ask us during your next adjustment appointment!

When a child is born, he or she will have 20 primary teeth and 32 permanent teeth. But sometimes kids are born with additional teeth, and our team at Spring Valley Orthodontics calls this oral condition "hyperdontia." Primary teeth are the first set of teeth that erupt in your child's mouth, typically by the time they are 36 months old, and are shed by the time your child reaches the age of 12. Permanent teeth then take the place of the primary teeth and are usually fully-erupted by the time your son or daughter reaches 21 years of age. Anyone who develops more than 20 primary teeth or more than 32 permanent teeth has hyperdontia, and the additional teeth are referred to as supernumerary teeth.

While the cause of hyperdontia is not entirely clear, it is believed that there may be a genetic factor. Oral professionals have found that patients with extra teeth often have syndromes like cleidocranial dysplasia, Ehler-Danlos syndrome, Gardner syndrome, or cleft lip and palate. The prevalence of hyperdontia affects between one and four percent of the population in the United States, and the majority of cases are limited to a single tooth.

So, what is the best way to deal with hyperdontia? It really depends on the case. The treatment plan your doctor suggests varies according to the potential problem posed by the supernumerary teeth, as well as their type. Orthodontic treatment may certainly may help, but extraction can also be a good option. We recommend that children receive an oral evaluation or checkup no later than the age of seven. In addition to hygiene evaluation, this helps ensure your child does not experience hyperdontia problems.

If you suspect you or your child may be suffering from hyperdontia, please give us a call to schedule an appointment at our convenient Washington D.C. office to be evaluated.

Just because it’s cold out there doesn’t mean you’ll give up keeping fit and active! Winter is the season for some of our favorite team sporting activities, and when you’re donning your protective gear, don’t forget to protect your teeth as well.

• Basketball

This sport actually tallies one of the highest counts of dental injuries. Running, jumping, and diving for the ball on an unforgiving court can lead to tooth and jaw injuries.  And for every ten men on the floor, it seems like there at least 50 flailing elbows in the paint.

• Hockey

Notorious for the toll it takes on teeth, hockey is a game of sticks, ice, and whizzing pucks. And when your sport’s penalties include the terms hooking, slashing, and tripping, the more protection, the better.

• Skiing

When you are flying down the slopes, combining powdery snow and speed, mouth protection is a good idea. This also applies to snowboarding and other snow sports.

• Wrestling

Grappling and pinning in close quarters can lead to unintended injuries after accidental contact with the mat or your opponent.

Different uniforms, different equipment, and different playing fields, but all these sports have one thing in common—the easiest way to protect your teeth while playing them is with a mouth guard.

Mouthguards generally come in three forms:

• Over the counter, ready-made appliances. These are available in drugstores and sporting goods stores, but might not be a comfortable fit as they are pre-formed sizes.
• The “boil-and-bite” option is a mouthguard form placed in hot water. You then bite down to shape it to your mouth and teeth.
• Custom mouthguards can be fabricated just for you through our Washington D.C. office. These appliances are designed to fit your individual mouth and teeth, so provide a better fit and better protection. They are also usually more durable and more comfortable. If you wear braces, you definitely need a custom mouthguard to prevent an injury to your mouth or braces caused by an ill-fitting appliance.

Whether you play on a team or pursue individual athletic activities, keeping safe as you keep fit is your first priority. We would be happy to discuss your mouthguard options for any sport, any time of year.

Nobody likes bad breath, and although it can sometimes be difficult to tell if you have it, it is always better to practice good oral health than risk having a smelly mouth. There are many ways to reduce or eliminate bad breath, some are definitely more effective and longer lasting than others. Check out ways to do so below.

Floss Regularly

As difficult as it can be to remember to floss regularly, when it comes to bad breath, flossing is one of the easiest and most cost effective ways to freshen your mouth. See, flossing reduces the plaque and bacteria found in areas of your mouth that a toothbrush simply can't reach, and in turn, it rids your mouth of the smell associated with that bacteria. While flossing may not eliminate bad breath on its own, if you do it along with other health oral hygiene habits like brushing, then you may just develop a fresher smelling mouth.

Use Mouthwash

Using some sort of mouthwash can really freshen up your breath, especially if you find it still smells after brushing and flossing. There is a wide variety of mouthwash products on the market, however, you can also create your own by simply using baking soda mixed with water.

Always Brush after You Sleep

Whether after taking a nap, or having a full night of sleep, you will want to brush your teeth in order to reduce bad breath. The truth is, bacteria accumulates in your mouth while you are sleeping (even during a short nap) and that is ultimately the source of bad breath. So next time you wake from a good slumber, give your mouth some brushing and you will find it makes a big difference in the freshness of your breath.

There are many ways to freshen your breath beyond just using gum or mints, the above mentioned are just a few for you to try. Test them out and you will likely find your bad breath problem is solved, or at least considerably reduced. Of course, you can always ask us at your next visit.

Your teeth are precious. Once your permanent teeth come in, they need to last you a lifetime. Extensive tooth decay can lead to dental caries and the need for fillings, crowns, bridges, and dentures.

While these fixes can go a long way toward maintaining your quality of life, they cannot compare to your natural teeth. Getting braces is no excuse to let up on your thorough oral health routine: You need to take good care of your teeth before, during, and after braces to benefit completely from the gains you get from newly straightened teeth.

Why You Should Maintain Good Oral Health for Life

Begin a complete oral health regimen as early as possible in life, and maintain this routine throughout your life. Keeping your (or your child’s baby) teeth clean establishes a routine. It preserves healthy baby teeth whose function is to save space for the permanent teeth when they are ready to come in. Care of your permanent teeth helps preserve the enamel and prevent decay.

Take Special Care with Braces

It is important to pay attention to oral health when you have braces. If you do not take special care of your teeth during the months or years that you have braces, you risk irreversible damage to your teeth. Care is more difficult with braces because food can easily get stuck. In addition to brushing twice daily and flossing each day, we suggest avoiding sticky foods.

Most people think braces are all about their teeth. While it is true orthodontics is meant to move your teeth into proper position, there's more to it than that. To safely move your teeth with braces, you're going to need healthy and stable gums (or periodontium—the tissues that support your teeth).

For this reason it's critical to have your periodontal health evaluated prior to getting braces. This applies particularly to adults, since a 2013 study by the Center For Disease Control found that an estimated 47.2% of adults 30 years of age and older had periodontitis (gum disease). If you do have periodontitis, moving your teeth with braces will only make things worse.

Conversely, there is also risk for periodontal disease if you don't get orthodontic treatment. Malocclusion, as well as crooked and spaced teeth, can all contribute to periodontal disease. In these situations your teeth and gums are more difficult to clean and become breeding grounds for disease causing bacteria. Bad oral hygiene combined with these traits can greatly contribute to the development of periodontitis.

So, periodontics and braces have a tricky relationship. On one hand, you shouldn't get braces if you show signs of developing or have periodontitis, while on the other hand, braces can help prevent the possibility of developing periodontitis by correcting the bite and straightening the teeth.

If you are 30 years of age or older and are considering getting braces, it would be wise to first:

• Call our office and let us know about your desire to get braces
• Get an exam to make sure you're in good periodontal health and a good candidate for braces
• If you are a good candidate, keep an eye on your teeth and gums and get regular dental checkups throughout your entire course of treatment.

If you are in any doubt about the status of your teeth and gums, it's always best to get them checked before embarking with braces treatment. For more information or to have your periodontal health assessed for braces treatment, please contact our Washington D.C. office.