Elastics – what are they and why do I have to wear them?

  Elastics with braces; if you haven’t had them yourself, you’ve probably seen friends or colleagues wearing these small rubber bands connecting several teeth. But what are they, what do they do, and why do I have to wear them? When we refer to elastics, we are referring to the larger colourless, elastic rubber bands that run between the upper and lower jaws. These are different to modules – the tiny, often coloured, O-rings that sit around each bracket and hold the wire in. Almost all our patients will have to wear elastics at some stage during treatment. Generally speaking, we commence the use of elastics about 6 months into treatment once in suitable wires, but depending on what we are trying to achieve we may start on your first appointment. But don’t fret – we will always let you know when, where, how and why you are wearing them, all of which may change over time during the various stages of treatment. The burning question here is why? We understand they can be fiddly, annoying or sore at times, and we don’t just have you wear them for our enjoyment, so why do we include this experience in treatment? Essentially, elastics do things the braces can’t. The elastics are designed to place a small, but constant force on the teeth in order to correct the bite. Initially (like braces), the teeth they attach to may be a little tender, but (like braces) this will dissipate after a couple of days. Like all rubber products, they do tend to age and lose their stretch over time, so for this reason we advise changing the bands at least once (ideally twice) per day to maintain that small but constant force. The most challenging issue for us is compliance – patients either not wearing elastics at all, or only wearing them a percentage of the prescribed time. Rather obviously, not wearing elastics is not going to allow any improvement in the bite. No improvement means extended treatment time. But what about partial wear? Unfortunately, wearing elastics for half the time is equivalent to not wearing them at all. Why? Well without getting too bogged down in the detail, say we asked elastics to be worn for 24 hours per day, but were only being worn 12. For those twelve hours they were being worn, there’s force on the tooth and subsequent movement. Great! One step forward! But then then following twelve hours there’s no force on the tooth and the tooth relapses in the direction it came from. One step back. So a net result of zero movement, bummer. And before the myth about wearing twice as many for half the time arises, there’s unfortunately no truth in that either. The take home message here is that we want your teeth to look great, but also function well. The way we improve function is through occlusion. One of the ways we improve occlusion is with elastics. Hopefully this has provided some valuable insight into why those pesky little elastics which seem to find their way around the entire house are so valuable to us, but more importantly, to you.   Written by Campbell Watson

Living with braces

As a child, I remember braces not being the trendy addition they are now. I often heard stories around the schoolyard about how ‘painful’ or ‘big’ they were and so I was slightly apprehensive about finally getting my own set in 2016. However I did, and to be honest, it hasn’t been anywhere near as bad as I expected. I’ve decided to share my experience with others to unravel some of the rumours surrounding my new fancy, but functional, dental bling. Having been with the team at Sable and Pepicelli Orthodontists for several years now, I have collected a wealth of handy tips and forewarnings about the initial experience. However, a lot of these were not necessarily gained from my colleagues as you’d expect, but rather from the many patients I see as I accompany them through their orthodontic journey. It has been four weeks since I had my braces placed and so far, I’ve found them to be a lot easier than I had imagined. The feeling of having little things stuck to all of my teeth has proved to be more of a challenge than the suggested ‘pain’ associated with them (I found it to be more of a low-level background ache or tenderness that lasted a couple of days). Initially my lips and cheeks did get caught on them (which caused a few ulcers) and I found I needed to be a lot more rigorous with my cleaning routine to get out all the little bits stuck between the brackets. After roughly two weeks, they just felt like any other part of my mouth. There were a few unexpected challenges too. It turns out we really are right when we stay ‘stick to soft foods for the first few days’ (although this may have been exacerbated by the visit to Mr. Nastri’s rooms to have four premolars extracted). All I can say is thank goodness for EasyMac and pumpkin soup! The other surprise was the increased saliva flow from something foreign being in my mouth – it felt like I was dribbling constantly! Although the saving grace is that with all the extra saliva, the braces felt smoother to my lips and cheeks! Granted I’ve only had my braces on a few short weeks, but it’s been incredible to see how quickly my teeth have moved and the difference it has made – already the spaces where my teeth were taken out seem to be closing and I’ve really embraced them! I’ll keep everyone posted! Written by Tracy Nguyen.

What to expect at your initial orthodontic consultation

Your first visit to our orthodontic clinic is nothing to be nervous about! The initial appointment provides an opportunity for you and your family to meet our team, learn about the different types of orthodontic treatment and find out what treatment may be suitable for you. Your first visit will include the following: Assessment and measurements of your teeth, bite and jaw position Record taking (photographs, x-rays and study models as required) A customised treatment plan explaining what treatment (if any) is recommended and why You will then spend time with one of our knowledgeable Treatment Coordinators. Your Treatment Coordinator will show you videos on the recommended treatment, explain what appointments are needed, give you a summary of the payment options and item numbers for your health fund, and answer any questions that you may have. If there are multiple treatment options available to you, we may require a second treatment planning consultation to discuss your options in more detail. If you are ready to schedule an initial consultation for you or your child to be assessed by Dr Pepicelli, Dr Sable or Dr Newby, please contact our practice. Written by Becc Withers.

Why are mouthguards so important?

We are frequently asked if it is important to wear a mouthguard whilst playing sport. The simple answer to that question is- yes!  It is estimated from the American Dental Association that one third of all dental related injuries are sports related. Mouthguards are often mandatory in contact sports such as football, wrestling and rugby and should also be considered in other incidental sports such as basketball and netball. Mouthguards are typically soft plastics or laminates that prevent oral injuries to the teeth, mouth, cheeks, tongue and jaw.  They can ‘cushion’ a blow that may otherwise result in a broken jaw or tooth injury. Another common question we are asked is what is the best type of mouthguard whilst you have braces. There are two main types of mouthguards on the market: boil-and-bite and custom made mouthguards by your dentist. Custom made mouthguards offer a premium fit, however can be quite costly whilst braces are on as the teeth are constantly moving causing constant issues with fit. For this reason, boil-and-bite mouthguards are often recommended during orthodontic treatment as they can be frequently remoulded to fit around a changing mouth. It is vital to wear mouthguards if you have braces as they can prevent damage to the brackets and they provide a barrier between the braces at soft tissues, therefore reducing the risk of injury. Written by Ashleigh Robinson

Types of Retainers

So, what happens after your braces come off?  After braces are removed, your orthodontists will issue retainers to hold and maintain teeth in their final positions.  It takes time for teeth to settle into their new positions, as the gums and bone around the teeth need to adapt to the new changes.  If retainers are not worn, teeth can shift, a little, or back to their original positions.  Therefore, it is really important to follow your orthodontists’ instructions on retainer wear to maintain your beautiful straight teeth. There are different types of retainers, removable and fixed.   Hawley Retainers  This is one of the most commonly used types of removable retainers. It is made out of acrylic which is moulded to the mouth and a wire at the front to hold the teeth in place. There is now a newer type of Hawley retainer available whereby the metal wire at the front is replaced by clear plastic.  This is called a ClearBow retainer.  ClearBow retainer provides great aesthetics, especially for times when retainer wear is required during the day. Both Hawley and ClearBow retainers are available in a variety of colours and designs.     Essix Retainers This is made out of clear plastic moulded around the teeth and is a removable type of retainer.  This type of retainer wraps around the teeth, including the biting surfaces.   Again, this provides great aesthetics.     Bonded Retainer A bonded or permanent retainer is a wire glued to the back of the lower front six teeth, and occasionally on the upper teeth.  If the orthodontist feels that the front teeth are at risk of moving back following orthodontic treatment, they may recommend a bonded retainer to prevent this from happening.  This type of retainer can be great if compliance with removable retainer wear may be an issue.   Whatever type of retainer you may have, be sure to wear it according to your orthodontist’s instructions to maintain your beautiful straight teeth! Written by Jen Wu – Oral Health Therapist at Sable & Pepicelli Orthodontists  

What is the difference between an orthodontist and dentist?

The quality of our smile can have a big impact on our lives. Research shows that adults and children with straight teeth demonstrate higher self-esteem and confidence. Orthodontists and dentists work in different ways to help improve your overall oral health. A misconception in dentistry is that dentists and orthodontists are the same. In reality, they are actually very different. So, what is the difference between a specialist orthodontist and a dentist? Dentists complete a general dental degree and treat a broad range of dental issues. They diagnose and treat dental problems and diseases that affect the teeth, mouth and gums. They do not have specialised training in aligning teeth and correcting your bite. Orthodontists are qualified dentists who have undertaken an additional three years of full time University training, exclusively in orthodontics. Orthodontists are dental specialists that are trained in the diagnosis, prevention and correction of facial and dental irregularities. Orthodontists are specialists in creating aesthetic, functional and harmonious smiles for patients of all ages. When it comes to improving your smile, trust your smile to a specialist orthodontist! Author – Sher Fong

Recipe of the Month

Loaded Baked Potato During the first week or so of braces your teeth will be tender but don’t worry this will disappear. But in the meantime here is a yummy soft food recipe to help get you through! Ingredients 6 medium baking potatoes 500g of lean mince beef 1 jar (500g) of Macro Organic Pasta Sauce Chunky Bolognese 250g of Tomato Paste 3/4 cup shredded Cheddar cheese 6 tablespoons reduced fat sour cream 1/3 cup sliced green onions Preparation Wrap each potato in microwaveable plastic wrap; place on microwave-safe plate.  Microwave on HIGH 6 minutes; turn over. Microwave 5 minutes more or until soft. Heat a large pan over medium-high heat. Add beef; cook 5 minutes or until crumbled and no longer pink, stirring occasionally. Drain. Add Macro Organic Pasta Sauce Chunky Bolognese and tomato paste. Reduce heat to low; simmer 5 minutes or until hot. Cut slit in top of each potato; squeeze each open and fluff with fork. Top each potato with 1/2 cup meat mixture, 2 tablespoons cheese and 1 tablespoon sour cream. Sprinkle evenly with green onions.

Rapid Maxillary Expander

A Rapid Maxillary Expander (RME) is a custom-made orthodontic appliance which is bonded to the upper back teeth and is used to widen the upper jaw. The Maxilla (upper jaw bone) has a midline suture (a joint between the bones) in the palate which will usually close at around the age of 16 years  in females and 18 years in males. Before this time, maxillary expansion can be simply achieved with an expander appliance alone. After the suture has closed (eg in non growing patients) a surgical procedure may be required to re-open the suture to allow expansion. Maxillary expansion is used for patients with a narrow upper jaw. When indicated, widening the upper jaw will achieve a better relationship between the upper and lower jaws for normal function and wear, allow for ideal dental and skeletal development and can also create space for crowded teeth. (more…)