How to tighten braces

Straight wire braces are pre angled and individualized for each piece, the position the crown and root will get will be determined by the brace base and gap’s angulations, that’ why braces must be placed in a determined position each dental piece. For this, the dentist uses an instrument called “star” that will allow him/her to find a geometric center to place the brace.

The center, where the brace will be out, is determined by the intersection of the horizontal line given by the star with the vertical one, which divides the tooth’s face in two. The tooth is cleaned up with a rotator brush, it’s also very effective the use of pumice stone. The acid engraving is done and the vestibular tooth face becomes white matte when it dries. The adhesive is placed of the brace’s base and on the tooth’s face; the brace is put with special tweezers of the determined center, the dentist corrects the position with an explorer until it is well aligned.

Wires

Wires used in orthodontics can be active or passive if they exert strength or not onto the teeth. They are used wires of steel, nickel, titanium or titanium nickel with copper. Steel wires are used to make removable and fixed appliances, to make different types of arcs that are unable to make with nickel titanium. They are used wires of 0.5 to 1.25 mm of diameter; they can be welded to other bands and wires.

For the straight arc they use wires of nickel and titanium, and even copper, these wires exert continuous strengths, have an extreme resistance to deformation, but with a prolonged use they get worn out, they can be folded anymore.

The NITINOL® wire used in orthodontics was a military discovery in the navy laboratories in the U.S.; it’s an alloy that has the capacity of getting back its original shape –it has a great memory- and that’s why it is used for braces placement. It moves the dental pieces until the wire gets straight –let’s keep in mind it doesn’t fold- for their reason is basic to place each brace on its normal position and one each tooth, since the gaps’ angulations are different.
There are braided, round and rectangular wires. The orthodontic treatment usually starts with a braided wire, which actually is formed with three folded wires that has an extreme flexibility, once they are placed they liberate the teeth and the alignment begins. For this, dentists use wires of 0.015 mm of diameter.

After this, the dentist place the round wire, which go from 0,012, 0,014, 0,016, 0,018 y 0,020 mm of diameter.

The rectangular wire is the last one to be placed; it’s used to twist the dental pieces. There are many seizes but the most used are the ones from 0,022 to 0,016.

Wires Ni-Ti

The wire is placed on the braces gaps and dentist use bands to hold them, whether metallic or elastic. The metallic bands are soft wires of 0.2 5mm. nowadays the elastic bands are the most used and come in different colors.

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Braces

They are metallic or ceramic pieces that are welded to the bands or stuck directly to the teeth, used to support the active element: the arc. The molar bands already have their braces. The conventional braces are formed by a base with a covering that allows the adhesion to the tooth, a gap for the arc and some clips to fix the elastics.

Each dental house as its identifying methods for braces: arrows, numbers, colors, etc. there are esthetic braces, ceramic, (the classical ones are metallic) and there are laminated ones that get easily dyed. The ceramic braces get broken more easily though; they are hard and they may cause damage the enamel.

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Fixed Orthodontic

In Orthodontia they use fixed pieces in the oral cavity, so the patient can not take them off. They are combined with other types of orthodontics and any movement can be done with them. They sue continuous forces, thus more dangerous for the teeth, and therefore there must be a careful patient control.

There are many techniques of fixed orthodontia, the most used techniques since a few years ago and still used till these days are the Begg technique and the arch on its side apparatus, but due to the new materials, especially the nickel titanium wires, and the treatment system of most specialists has changed. The technique that is now taking the lead for its simplicity is the “straight wire”.

Elements used in fixed orthodontic:

– Space maintainers
– Bands
– Braces
– Wires
– Metallic and elastic bonds
– Elastics and elastomer chains
– Bonding and bottoms
– Extra oral apparatus

The ones that will support the wires and other elements fixed in the mouth are the bands and braces.

The Straight wire was created by Dr. Larry Andrews. The treatment can be started with movable or functional orthodontia, but we’ll always be rotating pieces, radial torque, extrusion, intrusion, leveling and aligning with fixed orthodontic.

Space maintainers

To place bands, we must defeat the contact point of the dental pieces that’s why dentists use metallic bonds or plastic mainteiners. After 24 hours we get the maximum separation, which is the double of the band’s size.

Bands

They are arc-shaped metallic elements that are pasted over the molars. Formerly, they used to be placed on each dental piece, but nowadays they only paste over the molars with glass ionomers. The bands are made from laminated steel and come in different shapes and numbers (1-32), so they are no longer made at dental laboratories.

Superior and inferiors bands

The inner side of the bands is matte and the external one is plain. The superior bands use to have three holes and the inferiors ones, two, they are aimed at supporting active and passive wires. Wires are placed inside the central hole of the superior band and inside the superiors’ hole of the inferior band. They may have tubes to join together dental devices.

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What other oral diseases we may have?

Fever blisters: Infections of the herpes simplex virus type 1 (HSV-1). If you ever had a fever blister, herpes labialis or cold sore let me tell you, you are not the only one. Half a million people suffer from it every year. Once you’ve been exposed to this virus, this may hide inside your system for years. Taking to much sunlight, having slight temperature with a cold, stress may wake up the virus, causing tiredness, muscular pain, sore throat, inflamed and sensible and lymphatic glands and fever blisters.

These blisters are quite contagious and are usually formed on the lips, or sometimes underneath the nose or the chin. The blisters take from 7-10 days to heal without leaving any scars.

There are medicines available at any drug store or supermarket to apply over the cold sore to anaesthetize and ease the pain. If the fever blisters persist, consult your doctor or your dentist to prescribe you an antivirus medication to help you diminish the chances of having these types of viral infections.

Aphthous ulcers or aphthosis: Common blisters, mostly innocuous, appear inside your mouth like ulcers of white or gray base and red border; they are more frequently in women than in men, usually during the menstrual period.

Their causes are unknown so far, but specialists relieve they are related to problems of the immunological system, which protect us from diseases, bacteria and viruses. Fatigue, stress or allergies may increase the probabilities of acquiring an aphthous ulcer. You may also get one if you have a cut in the interior part of your cheek or on your tongue. Aphtae may be small and are usually healed in one or three weeks. However, if you have a big aphtae (more than 1 centimeter); it might be treated with medication. Avoiding spicy meals can ease the pain. It may help as well using smooth mouth washers or salad water, of cleaning the aphtae with milk of magnesia or a mix or water and oxygenated water. There is no proven way to prevent aphtae, but if you get them constantly, take into account what may be irritating your mouth and tell your dental or dental hygienist.

Candidiasis or oral infections by fungi: These infections appear like red or white lesions in the mouth, plains or slightly up. They are common the people who use dentures, especially to old people, young people who have had extractions, or people who have problems in their immunological system. People with dry mouth syndrome have high probabilities of acquiring oral infections by fungi, which may be prevented with a good oral hygiene. If you use fake teeth, wash them and take them out when going to sleep. Ask your dentist or dental hygienist about medicines for these infections.

Dry Mouth Syndrome: Quite common in many adults, especially as they grow old. This may difficult eating, swallowing, tasting and talking. It happens when the salivary glands stop functioning correctly, usually as a secondary effect of medicines or any other health problems. If it is not treated it may produce cavities, since saliva helps the mouth to stay free from pieces of food and also helps to avoid acid form plaque onto your teeth.

Oral cancer: This type of cancer happens more frequently in people over their 40’s. It is discovered at its most advanced stage, when it is harder to treat. This happens because oral cancer is not painful, so the person who bears it may not find out she has it. Besides, many people don’t visit the dentist often enough to discover the cancer at an early stage. The most places where this cancer is developed are the tongue, lips and the mouth’s base. The use of tobacco, especially combined with alcohol is the main cause if this cancer. Oral cancer may show as a spot or a small blister, red or white in any place of the mouth. Among other signals there are:

– An easily bleeding blister or a blister that never heals.

– Change of color of the oral tissues.

– A scab, sensibility, numbness or a corrupted area by pain in any part of the mouth or lips.

– Problems for chewing, swallowing, speaking or moving the jaw or tongue

– Change in the teeth adjustment.

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How are oral problems related to other parts of your body?

Oral health may be an indicator or your general health. Many serious diseases, such as diabetes, HIV or some eating disorders show their first signals through symptoms in the mouth. For this reason, it is important to regularly have complete oral exams.

Most of us think of oral problems in terms of cavities, tooth aches, twisted or spotted teeth. The lack of healthy teeth and gums affects our appearance, but also affects the health of our system. For instance:

If you suffer from periodontal diseases, you have more probabilities of having cardiac diseases.

If you have no teeth, this may affect your mental health, since it can make you feel bad about yourself.

If you are diabetic, this may increase you probabilities of having periodontal diseases.

If you have diabetes and periodontal disease, you may have more trouble for controlling your sugar levels in the bloodstream.

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Baby’s oral health

If you’ve just given birth you must be wondering what to do for your baby’s oral health. Here we tell some facts you should know:

The same germens that affect your teeth may be transmitted to your baby if you put in your mouth your baby’s stuff, such as toys, spoons, etc.

If you clean the teeth and gums of your baby with a soft cloth or a special toothbrush for babies after breastfeeding or giving him/her meals, this helps to remove the sugar contained on milk and that may cause dental detriment.

If you give bottle to your baby, you‘d better stop doing it before he/she turns one year old. Never put your baby to sleep with a bottle of milk or juice. Never put a pacifier or lollypop on his mouth either. Sucking a bottle being lying on his/her cradle may destroy your baby’s teeth, causing great pain and difficulties for feeding him/her.

Pediatricians and pediatric dentists suggest baby should have an oral exam between the first and the second year of age. This is to evaluate possible problems in your child’s mouth, and this also will teach you how to take care correctly of the mouth and teeth of your baby.

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Women and oral health

Why as a woman I should worry about my oral health? Actually you should have a proper oral health care in every stage of your life. As a woman the changes in you hormonal levels during puberty, menstruation and menopause produce changes in your mouth. These hormonal changes may produce:

• Blisters and thrushes
• Gingivitis during puberty
• Mouth dryness (often related to the use of certain medication)
• Changes in the sense of taste
• High risk of having periodontal diseases
• Bone weakness by menopause

If I’m pregnant, should I take a special oral health care?

If you are pregnant you require special oral care:
Try to have a complete oral exam before or at the early beginning of your pregnancy, all the dental arrangements needed should be made before pregnancy or between the fourth or sixth month of it.

It is possible to receive emergency treatment during pregnancy, but this could be risky for your baby. Oral treatments are more dangerous during the first three months. If you are in the last three months of pregnancy you can receive oral treatment, but the dentist chair can be uncomfortable for you.

If you haven’t received oral assistance it is now time for practicing oral hygiene and having a healthy diet. Brush your teeth and use dental floss carefully everyday. Doing this you can control your risk of having an inflammation or periodontal diseases.

Some pregnant women have periodontal diseases, like pregnancy gingivitis, which increases the possibilities of having more serious periodontal diseases. This condition may be produced by a bad oral cleaning and by the increase of hormonal level during pregnancy as well. Having this problem may cause inconvenience while brushing your teeth or using dental floss, but it is important not to leave these things aside.

Also keep in mind that women with periodontal disease are more prone to have premature babies and low-weight babies.

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