General 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.

I was not your typical teen. My mom was a pediatric dentist. I watched as she helped thousands of kids get, and keep, their beautiful smiles. Braces excited me. Even the idea of headgear was appealing. I begged for it!

Like I said: not your typical teen.

One reason for my orthodontic appliance excitement was that, because of the work my mom and her colleagues did, I could easily see a result. I heard endless stories about how patients were more confident after all the hard work was over. As a teen, I associated braces with confidence, not disaster. (Breakouts before the big dance? That was another story.)

Our teens and children could use a confidence boost these days. According to DoSomething.org, an organization that helps young people create social change:

• Three-quarters of girls with low self-esteem reported engaging in negative activities like cutting, bullying, smoking, drinking, or disordered eating.
• More than 40 percent of boys in middle and high school regularly exercise with the expressing goal of increasing muscle mass (not being healthy).
• About 20 percent of teens experience depression before they reach adulthood.

The power and relentlessness of social media makes it even more difficult for teens to feel confident, but there is another issue that worries me. Boys and girls are able to rely on camera filters to hide every flaw. If they can change their appearance with an app, why explore changes that actually would improve their health and wellbeing?

Getting braces, Invisalign, and BRIUS are not just about creating a better selfie — it’s about creating a strong smile that reflects better health. As the American Association of Orthodontists says, “Oral health is a window into your overall health. … A good bite makes it easier for you to bite, chew and speak.” We even know now that routine dental care might protect against severe cases of COVID-19.

My young patients’ glee often is infectious once their orthodontic appliance comes off. But that glee is not confined to the kiddos.

I’ve been welcoming more and more adults into my office who are exploring orthodontia. These men and women either skipped braces as kids, or need a little tune up because they didn’t wear their retainers to keep their teeth in place. Often they are not just looking for a better smile, though. Perhaps a bite that has been off is now causing severe jaw pain.

There are many reasons people pursue orthodontia as an adult. Whatever the reason, they are as happy with the results as teens. I want my patients to walk out of the office feeling like they can do anything.

That is the power of good self-esteem. I love this line from Confidence Code authors Claire Shipman, Katty Kay, and Jillellyn Riley in The Atlantic: “Confidence is an essential ingredient for turning thoughts into action, wishes into reality.”

Having a beautiful smile obviously is not the single ingredient we need to build young peoples’ confidence, but it helps. As a recent article in Shape explained:

“Research suggests that dental disorders such as malocclusion (misaligned teeth) can cause a ‘profound impact’ on self-esteem, thereby negatively affecting the overall quality of life. While studies show this to be more common in adolescents (especially given their age and ‘increased aesthetic desire’ and ‘unique social and physiological needs’), a 2019 poll of 2,000 people emphasizes that adults are also subject to insecurities around their teeth. The study, conducted by OnePull and funded by teeth-whitening company Snow, found that seven in 10 Americans are self-conscious about their teeth, and 50 percent try to smile with their mouths closed (perhaps as a result).”

In addition to improving health and self-confidence, we know that straighter, whiter teeth can impact employment prospects and perceptions of leadership capability.

According to a survey by Kelton and Invisalign, Americans perceive those with straight teeth to be 45 percent more likely than those with crooked teeth to get a job when competing with someone who has a similar skill set and experience. Additionally, 73 percent of Americans would be more likely to trust someone with a straight smile than someone with a good job, outfit, or car.

So, skip the trendy new shoes. Come in for a consult instead so we can discuss how to create lasting confidence.

The idea for Earth Day was the brainchild of Gaylord Nelson, a senator from Wisconsin. He envisioned an Earth Day that would be a kind of environmental teach-in. The first Earth Day celebration took place on April 22, 1970, and a surprising 20 million people participated on that day. Ultimately, it became the largest organized celebration in US history.

Earth Day Over the Years

Over the years, the recognition of the day, and the number of people celebrating it all over the world, turned Earth Day into an international celebration. Because it is celebrated throughout the world, it is not only the largest international environmental observation, but it is also more widely celebrated than any other environmental event in the world. Today, Earth Day is celebrated in 175 countries where over 500 million people participate in celebrations.

The Earth Day Movement

The Earth Day movement is credited with developing the idea that people should “think green”. It encouraged congress to enact laws, including one that resulted in the creation of the Environmental Protection Agency. It also inspired the passage of the Endangered Species Act.

The Five R's and Their Importance

• Reduce – Reduce by avoiding unnecessary purchases. Reduce your use of materials that wind up in landfills. Reduce the use of chemicals around your house. Reduce your use of disposable bags, plates, cups, eating utensils, and batteries.
• Reuse – Instead of using plastic bags for your groceries or purchases, bring your own reusable bags. When you go to buy coffee at Starbucks, take a travel mug so you don't have to get your coffee in a disposable paper cup. Instead of storing food in disposable refrigerator containers, buy containers that can be washed and reused. Don't use regular batteries. Whenever possible, opt for rechargeable batteries that you can reuse.
• Recycle – Most cities offer a recycling program to collect used bottles, cans, and newspapers. Recycling includes collecting recyclable materials that would otherwise be considered waste, sorting and processing recyclables into raw materials such as fibers and manufacturing raw materials into new products.
• Re-buy – Make an effort to purchase things that are made through recycling. When purchasing furniture, look for items that are made from reclaimed wood. When buying paper for kids school work, computer printer paper, holiday cards, or anything else, make a point of purchasing recycled paper products. Instead of buying clothing at full retail price, shop for second hand clothing. You will save a lot of money by doing so!
• Rethink – Rethink the way you do things so that you do them in an eco-conscious way at all times. Instead of driving to work alone, consider taking the bus or going in a carpool. Walk or ride your bike when you're only going a short distance. Plan your shopping trips and errand runs so that you can do everything on one day, and do it in a way where you can save time and gas.

Other ways to "think green" include growing your own food, composting yard waste and food scraps, or by participating in local recycling programs. Join a group like Freecycle so you can share your unneeded and unwanted possessions with people who can use them. Likewise, you'll be able to get things you need or want for free.

Earth Day teaches people that the planet belongs to everyone, so everyone is equally responsible for protecting it. Although Earth Day is an environmental celebration, our team at Spring Valley Orthodontics wants to remind you that you don't have to wait until then to make changes that will allow you and your family to live a greener life.

Happy Earth Day from the team at Spring Valley Orthodontics.

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.

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.

The U.S. Food and Drug Administration (FDA) now has approved not one, but two, vaccines for COVID-19 and we could see final data on a few others later this winter. This news is good … very good … but I do want our patients to know that things still won’t be completely back to normal for some time. If you have questions about what’s coming next, or about the vaccine, I hope you’ll ask our team, or your family practitioner.

In the meantime, let’s going to try to answer a few common questions.

People Are Having Reactions To The Vaccine – Doesn’t That Indicate It’s Unsafe?

In short: no. In fact, if the reaction is a fever or aches and pains those actually are a sign that your body is processing the vaccine correctly. That discomfort means you’re building immunity. Truly adverse reactions to reactions to vaccines are rare. If your pain or fever hasn’t subsided after a day or two, give your doctor a call, but chances are, just like with the regular flu vaccine, you’ll feel better in no time.

Trying to explain how aches and pains mean a vaccine is working? Check out the August 14 episode of But Why? A Podcast for Curious Kids for an engaging, kid-appropriate discussion with your little ones.

When Will I Get The Vaccine?

That question is up to each state to answer. In Maryland, there will be three phases of delivery:

• Phase 1A: health care workers, long-term facility care staff, and first responders;
• Phase 1B: high-risk individuals, including those with underlying conditions, and adults who live in congregate settings (e.g., homeless shelters or long-term care homes);
• Phase 2: individuals who work in “essential industries”; and
• Phase 3: the general population.

Right now, Maryland is in phase 1A, which as WBAL-TV explained, includes hundreds of thousands of individuals.

According to WUSA-9, the District of Columbia’s plan is very similar to Maryland’s except that individuals at long-term care facilities are in the first group of recipients.

Will My Doctor Give Me The Vaccine? How About My Dentist Or Orthodontist?

Perhaps. Each state, each city, and each local health system will determine how, to whom, and where the vaccine will be administered. Because the goal is to get the vaccine as quickly as possible to as many people as possible, it is likely that you’ll see it being administered in places where you wouldn’t usually go for healthcare.

Businesses might be able to offer the vaccine onsite to employees, for example, or schools or even malls and convention centers could become vaccine sites. We certainly are looking into the possibility of offering our patients the vaccine when supplies are more plentiful. Stay tuned, but please also remember that the two current vaccines are not yet approved for use in individuals under the age of 16. Chances are mom and dad will be inoculated well before the kiddos.

How Long Does The Vaccine Provide Protection?

The short answer is: we do not know. We know the individuals who participated in the vaccine trials continue to be evaluated and, so far, it looks like the drugs are working even months after being administered, but it’s impossible to know how long that will last.

We’re watching this question closely, so feel free to discuss it during your next visit!

Can I Take Off My Mask Once I Have The Vaccine?

The short answer is: no. As noted above, because it will take a while for everyone to receive the vaccine, things still will not look “normal” for some time. And while we know that the vaccine does a very good job of protecting you from getting sick, we are not sure yet if it prevents you from spreading the virus.

Dr. Purvi Parikh, an immunologist with the Allergy and Asthma Network who was a co-investigator for the Pfizer vaccine trials, explained why to the data analysis website FiveThirtyEight. She said, “Theoretically, a vaccine should stop both the infection as well as the transmission and spread,” but noted, because the focus of these clinical trials was narrow, scientists only looked at whether the vaccines prevented illness and were safe, not into other questions like whether vaccinated people can still spread the virus.

We wear masks to protect our loved ones, our neighbors, our teachers, and, yes, our orthodontists and dentists. We’ll be asking you to wear masks in our office even if you have received the vaccine.

If you have other questions, please don’t hesitate to raise them during your next visit, or to give us a call. We’re here for you.

We’ve been celebrating the new year for a really, really long time. It goes way back, but it started formally in 1582, when Pope George XIII made January 1^st the official holiday for ushering in the new year. The idea was to yell, cheer, and blow horns to scare away all the evil spirits of the previous year with the hope that the new one would be filled with happiness and opportunity.

While scaring away evil spirits isn’t what’s on our mind these days, we still ring in the New Year by cheering and hollering with friends and family. It’s a time to set new goals, refocus on old ones, and look forward to all the surprises the coming year will bring.

Whether you’re saying hello to the New Year snuggled up at home on your couch in the Washington D.C. area or by gathering your friends for a social celebration, here are some tips to help ensure you welcome this new chapter with a smile.

Tips for a great New Year’s Eve celebration from Spring Valley Orthodontics

• Stay safe. This one’s vital, because nothing puts a damper on your party like an emergency trip to the hospital. Stay responsible and try to plan ahead, whether that means taking a taxi, staying with a friend, or recruiting a designated driver. Do what you have to do to keep yourself and everyone around you safe.
• Spend time with the people you love most. The way we see it, the whole point of the holiday season is to cherish your family and friends. Regardless of what you’re doing, make sure there’s something for everyone. It’s essential to do something the whole group will enjoy!
• Smile! Whether you get all dressed to go out or have a quiet gathering with family and friends, make sure you accessorize with a smile. There’s always something to smile about!

We can all agree that change can be scary sometimes, but ringing in the New Year is an observance we all welcome with open arms. We hope you’ll enjoy this transitional holiday in a fun, healthy, and safe way. You have endless possibilities ahead of you!

Have a fantastic New Year!

“I think I have to cancel my appointment.”

Our office has gotten that call more than once in the last several weeks, sometimes just hours before a scheduled visit. Under normal circumstances, we discourage these last-minute cancellations, but these days? Well, we certainly understand when it comes to COVID. In fact, we want you to act with extreme caution.

It is one way that you can help us keep our offices safe and help prevent community spread of this deadly virus.

As you and your family probably have seen, our offices have increased the amount of personal protective equipment we are wearing – sometimes we even don more than one mask! You’ve seen face shields (which are added protection, but should not be relied on instead of a mask) and certainly more hand sanitizer.

Dentist and orthodontist offices always are always fanatical about infection control, but we are even more so now.

And, the good news: we know it’s working.

According to a study from the American Dental Association (ADA), while dentists and orthodontist offices were shut down at the beginning of the pandemic due to fears about COVID spread, less than one percent of dentists have had the virus. That result is far below the rate of other health professionals in the United States. The ADA also noted that “99 percent of dentists are using enhanced infection control procedures such as screening protocols and enhanced disinfection practices when treating patients.”

If you are feeling well, you should feel confident about keeping your regular dentist and orthodontist appointments.

What can you do to help keep our offices free of COVID?

At home and wherever you go:

• Wash your hands frequently with soap and water for 20 seconds or, if you don’t have access to soap and water, use alcohol-based hand sanitizer;
• Maintain at least six feet of distance between yourself and anyone else, especially if they are coughing or sneezing;
• Limit interaction with individuals outside of your household;
• Avoid touching your eyes, nose, and mouth;
• Cover your mouth and nose when you cough or sneeze – do not use your hands; and
• Wear a mask whenever you are outside of your household.

Obviously, if you have a fever, cough, shortness of breath, headache, or have lost your sense of taste or smell, call our office. We’ll discuss your health status, the dental treatment you require, and whether or not visiting our office will be safe for you, our other patients, and our staff. Please also give us a call if you’ve been exposed to someone that has had a positive COVID-19 test. That’s helpful information and we can always see you after you’ve had time to quarantine.

Third, while we know the early bird gets the worm, it also can cause crowding in our waiting rooms. Please be on time, but if you’re more than five minutes early, wait in your car or call to see if we can safety seat you.

Finally, a note about travel, which my patients know that I love! I have not enjoyed being grounded, but COVID-19 can travel with us wherever we go. If you have been out of the area in the last 14 days – anywhere – or if someone in your household has traveled, please let us know. Again, we can always reschedule!

At the heart of every doctor-patient relationship is trust and good communication. If you’re worried about coming in, or wondering if you should keep your appointment, just give us a call and we’ll talk through it. Remember: our job is to keep you and your family smiling and healthy.

Especially, in these times, we’ll understand if you need to reschedule.

Playing sports? We always recommend always wearing a protective mouthguard to participate in most physical sports. We especially encourage this if you have BRIUS or if you have braces that can potentially cut your mouth or cause damage to your teeth. You have various choices to consider when you’re looking for a protective mouthguard.

One option is a full facial guard, which is often used for contact sports, such as football or hockey. This type offers full protection of the face from external impact. You should also consider an additional mouthguard to protect yourself from cuts inside your mouth, and avoid possible damage to your braces or BRIUS.

Boil-and-bites are another version of mouthguard that can be used for more physical sports. This type is used just the way its name implies: You warm the mouthguard in water to soften the material, then bite down gently once it’s at the correct temperature to form it into the shape of your mouth. These are fine to use temporarily, but they don’t always provide the best protection if they don’t fit properly.

Another option is to have Dr. Sagafi make a custom mouthguard for you. The mouthguard will be designed with built-in layers to protect both your teeth and braces/BRIUS when it’s worn. Having our office create a custom-fitted mouthguard will ensure optimal protection and a comfortable fit whenever you participate in physical activities.

Protecting your teeth and braces (or BRIUS) is essential when you compete in sports. Accidents happen, and having a preventive mouthguard can potentially save you from oral pain and damaged braces/BRIUS. Our Washington D.C. office is happy to assist you in creating a custom-made mouthguard for any sports activities you want to pursue.

If you’ve experienced a mouth injury that has caused damage to your braces or BRIUS, please contact us immediately so we can fix the problem right away. Remember, prevention is key when it comes to your oral health!

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.

Crooked teeth, more correctly called malocclusions, have reached epidemic proportions in the late 20th and early 21st centuries. According to the American Association of Orthodontists, approximately 80 percent of American teenagers are currently undergoing orthodontic treatment. Although advances in orthodontic devices and increased availability of such devices explain part of this increase, it still means there are a lot of crooked teeth in the world.

The theories about what is causing so many crooked teeth range from the ridiculous to the scientific. For years, oral health professionals believed that crooked teeth were an evolutionary result of the change in Western diets from raw, wild foods to soft, processed foods. That theory has since been debunked.

The truth is that crooked teeth can be caused by a number of things. Crooked teeth can be an inherited trait. Parents with crooked teeth and malformed jaws are more likely to have children with malocclusions. Ill-fitting or poorly-executed dental restorations, such as fillings and crowns, can also cause teeth to become crooked. Baby teeth that fall out early, gingivitis, and even a jaw that is too small to accommodate all of a person’s adult teeth are additional causes of crooked teeth. In addition, thumb sucking and the use of a pacifier for too long can contribute to crooked teeth.

What to do about crooked teeth

Fortunately, modern orthodontics offers a number of solutions for crooked teeth. Traditional metal braces are the most popular, though our Washington D.C. office provides a number of clear, aesthetic options as well. If you’re tired of hiding your smile because of crooked teeth, contact our team at Spring Valley Orthodontics and set up an appointment. We’ll have you showing off your straight pearly whites in no time!

By Dr. Negaar Sagafi

As my patients know, I have opinions about Halloween. More specifically, I have opinions about Halloween candy, which is hard on braces and brackets. Orthodontia and Jolly Ranchers simply do not mix. In fact, the results often are terrifying.

This year, Halloween is scarier than usual. Coronavirus threatens to steal more happy moments from our children and while I’d prefer that kiddos stay away from hard candy, I want them to celebrate. I want them to have fun.

How can they do that?

First, let’s remember that some of the most active participants in our Halloween traditions are our elderly neighbors. Who doesn’t get excited to see a sweet little Hermione or Harry Potter at their door? As we have for the last eight months, we must think first of the health and safety of our most vulnerable friends and family. Every piece of advice below is an effort to keep them – and you – safe.

But if you are someone who falls into the “vulnerable” category, there are still ways to celebrate – without even opening your door. Try:

• Putting a spin on the “garden walk.” Establish a list of neighbors that will commit to putting out the spookiest decorations. Create a map, post it on your local listserv, and encourage families to drive the route during an established time on October 31.
• Channeling your inner Willie Wonka. Willie Wonka didn’t just make candy … he made candy an experience. Get creative about delivery. Leaving out a bowl rarely works (teenagers always take it all, right?), so create a scavenger hunt. Leave clues to where you’ve hidden morsels around your yard. Or do what this dad featured in The Washington Post did: create a candy chute.
• Boo’ing your neighbors. This tradition is perfect for our current times. Boo’ing involves placing a basket of goodies on a neighbor’s porch and disappearing. The candy comes with a note instructing your neighbor to “boo” someone else. If your home has been boo’d, put a sign out so as many children as possible receive sweet treats.

The Centers for Disease Control, along with Washington, D.C. and Montgomery County, Md. public officials, also have released guidance on how to celebrate Halloween this year. As a healthcare provider, I agree with it, but I also recognize that families have approached this pandemic differently. While officials do not recommend traditional trick-or-treating, some parents will allow this tradition, so the question is: what are some smart tactics that will keep children safe.

First, remember that costume masks will not protect your child from getting the virus, or spreading it. Adequate face coverings are not optional. The CDC’s advice on choosing masks is here.

Second, do not allow children to pop a piece of candy into their mouths while trick or treating, even if they have used hand sanitizer. Your child should not touch their face until their hands have been thoroughly washed. We still do not know everything there is to know about COVID-19 transmits, but we do know it is a respiratory disease. Keeping masks on and keeping interactions short are two of the best steps a person can take to protect themselves.

Third, travel the neighborhood only as a family. For many children, Halloween will be their first big event in eight months. It will be hard, if not impossible, to contain their considerable excitement, but it will be easier if a group is small. And, of course, it is easier to stay at least six feet away if you’re travelling as a small unit. Remember: the six foot rule applies especially when individuals are talking, eating, and drinking … which we do a lot of on Halloween.

Other steps to take include:

• Carrying a bell or noisemaker instead of ringing the doorbell.
• Sanitizing the candy. I recommend creating your own “candy wipes” using gauze and Cavicide, a safe disinfectant we use in our office that is available on Amazon.
• Keeping interactions as brief as possible. If a friend opens the door, stay six feet away, say thank you, and politely move on.

These steps should mitigate risk, but, they will not eliminate it. To keep Halloween as safe as possible, stay home. While bobbing for apples is a bad idea, there are plenty of ways to celebrate the holiday, including:

• Going on a ghost hunt by downloading an online game like Phasmophobia and playing it virtually with friends or family;
• Holding a family Halloween movie night;
• Decorating your home (inside and out) with Halloween-themed arts and crafts;
• Finding an outdoor restaurant with a Halloween-themed meal, or cooking one at home;
• Using an online meeting platform to host a costume contest or pumpkin carving contest; or
• Dressing up your pups for a Halloween parade around the neighborhood.

One of my favorite ideas? The Switch Witch … with a pandemic twist. Leave candy on the kitchen counter for the good witch Switch. She will swoop in during the night on her mighty broom, grab the sugar, and leave a new toy in its place! (Normally Switch claims the candy trick or treaters amass on October 31, but with this spin anyone can play during COVID.)

Another smart idea is reverse trick or treating, which combines the fun of a Fourth of July parade with Halloween’s creativity. With this option, children dress up, but stay on their own lawns and porches. Adults who parade through the neighborhood on foot or decorated bikes and vehicles while throwing candy. Staying safe this Halloween is all about proper mask-wearing, mitigating contact, and maintaining a safe social distance. Reverse trick-or-treating, when properly supervised by mom and dad, achieves all that.

Just remember to brush those teeth!