The Myths about “Tongue Thrust”, and the Tongue’s Influence on the Teeth

I see many patients that have been informed that they have what is called a “tongue thrust”, and that it is causing issue with their teeth and bite. Specifically, tongue thrust has been claimed to be the cause of open bites (front teeth that are separated from one another), and front teeth that are excessively proclined (tipped forward). I would like to present the key points from an article by Robert M. Mason, D.M.D, Ph.D. from the International Journal of Orofacial Myology, titled, “Myths that Persist about Orofacial Myology”. The key question is- can tongue thrusts move teeth?

  • speech10A tongue thrust is different than the resting posture of the tongue. Tongue thrusting is an opportunistic behavior, that finds and fills spaces available in the dentition (such as existing open bites), sometimes when swallowing. There is no proof that tongue trusting causes malocclusions, or misaligned teeth. However, there is much data to support the relationship between abnormal resting posture of the tongue with misaligned teeth and malocclusions.
  • A tongue thrust when swallowing does not move teeth! Moving teeth in humans requires a minimum of approximately six hours of continuous pressure. Even if you were to swallow thousands of times a day where the tongue pressed forward against (or between) the teeth, this is not nearly enough to make teeth start to move. Biochemical studies of Davidovich and colleagues demonstrated that hours of continuous forces against the teeth are required for significant amounts of specific enzymes to built up, which activate sequences of periodontal activities that result in tooth movement. Intermittent pressing motions of the tongue, no matter how strong, do not move teeth or cause open bites.
  • If the tongue rests in a forward position between the teeth for long periods of time, this continuous position can absolutely cause open bites and protrusion of the front teeth. The key is that the force is continuous, even if the pressure exerted is very light (this is how braces work!). The same can be said for thumb sucking – hours of constant pressure can move teeth dramatically.

If you have any questions about your child and the position of their tongue, please feel free to contact me. Often this is something that can be addressed very successfully. More persistent cases may require the help of an orofacial myologist.

Dr. Dan Rejman is a Board Certified orthodontist, and is the owner of Meadows Orthodontics in Castle Rock, Colorado. There are two locations to serve the residents of the Castle Rock area, one in the Meadows, and one near Founders/Terrain. 

Image source: healthline24x7.com

Which Type of Braces or Aligners Should I Use to Straighten My Teeth?

Getting your teeth aligned can change your life in so many positive ways. At Meadows Orthodontics we talk with new patients every day who are both excited and nervous about which type of braces (or invisalign) they should choose. We work with each patient individually to help decide what will be best for their bite, and what will fit best into their lifestyle. The most important thing to remember is that braces, invisalign, and orthodontic devices of any type are only as good as the orthodontist using them. We all have different preferences-in general it is the decisions we make and mechanics we use that determine the quality of your outcome, not the braces themselves! Here is a guide to the orthodontic choices that are currently available.

braces 22Metal Braces:  These are the “traditional” braces that most of us think of when we picture braces. Metal braces are very popular because of their small size and low profile, and the fact that kids (and some adults) love choosing the color ties that hold the wire part of the braces in. At every appointment with us, these color ties are changed, and there is an opportunity to “refresh” the look of the braces.

  • Effectiveness:  Braces of all types (metal, ceramic, and self-ligating) are usually the gold standard in getting the best results for most types of bite and misalignment problems.
  • Esthetics:  Metal braces bring the bold fun factor, as kids really look forward to the thousands of color combinations that can be used with the ties. Silver and clear ties can be used if you want a less colorful look. They are very noticeable though, and adults and older teens often will often opt for a less noticeable option.
  • Relative cost: Metal braces offer a great value as far the unbeatable result you will get for the relatively lower investment in the actual braces.

downloadCeramic Braces: Often called “clear braces”, these braces are made of ceramic, composite or crystal materials. They are usually clear or tooth colored, and look amazing.

  • Effectiveness: For the majority of patients, ceramic braces are usually just as effective as metal braces and the same great results are expected. There are some exceptions: For patients with deep bites (lower teeth that are largely hidden behind the upper teeth) or with patients that grind their teeth heavily we have to decide individually if ceramics can be worn on the lower teeth. The goal is to prevent wear on the biting edges of the upper teeth in these cases. Even these patients can usually wear ceramics on their upper teeth though.
  • Esthetics: Ceramic braces are know for their discreet, sophisticated look that adults and older teens often gravitate towards. These braces are the best option for a highly esthetic look, with all the mechanical advantages of traditional braces. Because they are clear or tooth colored, we have patients that often go for months before co-workers notice they are wearing them!
  • Relative cost: Ceramics braces usually cost more to manufacture than metal braces, and depending on the case may cost slightly more than traditional braces (although usually not as much as invisalign).

images (1)Self-ligating braces: Common brands of self-ligating braces include Smart-clip, Damon, Harmony, and Speed, among many others. Self-ligating braces use various types of sliding doors or clips to hold the archwire into the braces instead of the color ties, and can be made of metal, ceramics, or a combination of the two. Although these braces work just as well as traditional or ceramic braces, patients must be very wary of marketing claims made by the manufacturers and dental providers regarding the “advantages” of these braces. Most credible, peer-reviewed research (summarized by a recent article by the American Association of Orthodontists’ Council of Scientific Affairs in the American Journal of Orthodontics and Dentofacial Orthopedics), is showing that there is no statistical difference between traditional braces and self-ligating braces in overall treatment time, faster alignment, reduced forces, patient comfort, or improved hygiene- basically, all the important reasons these brackets have been marketed. However, these are all great brackets, and I offer these brackets in my practice- I am just very up front with my patients that they only differ by the way the braces hold onto the archwire, they cost more, and results are the same as traditional or ceramic braces (the vast majority of my patients choose traditional or ceramic after learning this!).

  • Effectiveness: Self ligating brackets are just as effective as traditional braces, and the same treatment time and results can be expected.
  • Esthetics: These braces can be metal, ceramic, or a mixture of the two, and the size varies depending on the manufacturer.
  • Relative cost: The moving parts within these braces make manufacturing them more costly, and this may be passed on to the consumer. Like always , this varies case by case.

imagesInvisalign:  Invisalign is a series of clear plastic trays that are changed at a prescribed period of time in order to make many incremental movements to your teeth. There are many things that invisalign does as well as braces, and some things that it struggles with in comparison. For the things that invisalign tends to have a harder time correcting, orthodontists must use adjuncts that would normally be used with braces: elastics, bite planes, in addition to what are called “attachments”, or composite bumps that are bonded to the surface of the teeth in order for the trays to “grip” onto. Also, patients and parents must consider that the ability to remove the trays at any time is both invisalign’s greatest advantage (for eating, brushing, special events such as playing an instrument in concert, etc…), and its greatest disadvantage (if they are not worn consistantly, they do not work!).

  • Effectiveness: After years of using invisalign and braces, I have a good sense which bites are corrected really well with invisalign, and which ones are not. Of all the treatment types described here, Invisalign is the most important for this early case selection and identification of limitations of treatment. I actually prefer to use invisalign on some cases, and on others would not attempt to use it. I will discuss the pros and cons at your initial appointment!
  • Esthetics: One of the advantages of invisalign is the clear nature of the trays, and often it is close to being undetectable to the public. However, it is very common to need the bonded attachments to your teeth. Some patients would rather have ceramic braces than these attachments, while others do not mind them at all. It is important to be comfortable with what they will look like before we get started, and I will review with you where each attachment will be, and if rubber bands will needed.
  • Relative cost: On the average, invisalign tends to cost more than the other options, and this reflects the relatively large fee we pay in order to use invisalign’s technology. Again, there is a large variation in cost due to case complexity and expected treatment time.

Alignment with retainers:  Minor movements are possible within retainers that are made by our office. The key word is “minor”, as retainers are designed to retain, or hold the teeth in place. Small areas of pressure, or even a spring-loaded wire  can be added within a retainer that can push an area of a tooth a small distance.

  • Effectiveness: Only for very minor movements, and the retainer must be worn steadily for the desired movements to occur.
  • Esthetics: It appears that you are wearing your retainer, whether it be a clear vacuum formed tray, or a Hawley type retainer with acrylic and wire across the front teeth.
  • Relative cost: The cost is usually proportionate to the minor movement that we are trying to achieve.

Call me at any time at Meadows Orthodontics, and we can discuss which option is best for you or your child!

Dr. Dan Rejman is a board certified orthodontic specialist, with two Castle Rock locations. Our original location in the Meadows right next to Einstein’s/Caribou, and our new location near Founders and Terrain, in the Founders marketplace.

Thinking About Becoming an Orthodontist?

This week we we were happy to welcome a local high school student who will be working part time in our office. She has shown interest in becoming an orthodontist in the future, and wants to jump right in and see first hand what my day to day life is like at Meadows Orthodontics. I worked as a dental assistant when I was curious about the dental profession, so I think it is really neat that she wants to work with us at such a young age (much younger than when I started thinking about my long term career!) I thought I would write a bit about my profession and experiences as an orthodontist, and hopefully it may help kids who are considering a career as an orthodontist.

I think whatIMG_3643 our new friend is doing is the best way to see if orthodontics is a good fit. A question I am asked frequently is, “How can you work in people’s mouths all day long?” I explain to kids that the majority of health care professions deal with the human body, whether it be the mouth, feet, growths on skin, backs/spines, etc… I think it is important to work part time or as an intern in the field that you are considering, because yes, you may not be comfortable working in these situations. Nothing worse than going to more than 8-12 years of college before finding out that mouths, eyeballs, or rashes skeeve you out! My brother in-law is an ER doc, and although it is a really interesting job, it is not something that I would be comfortable with day in and day out. For me, working with peoples teeth is just the opposite- it is just a natural fit for me.

Another thing to consider is how involved and visible you want to be within your community. When I go to the grocery store, out to eat, or run an errand in Castle Rock, I almost always run into and end up talking with a number of patients or their parents. As an orthodontist you get to know thousands of people- it is not the best job for introverted personalities! I personally like seeing people I know all over town, but if you prefer to be more “anonymous”, this profession may not be a good fit, or you may consider living in another community from where you work.

During the workday itself, I there is rarely a moment when I am not talking to patients, kids, parents, or my staff. It is a job where you are “on” nearly all the time, as far as being in front of people (my wife was a teacher and she says it is similar in this regard). Again, I really like this about my career, while others may find it exhausting. Really think about your personality and if this seems like a fit for you.

Other components of my profession include:

Creativity- there is rarely a day that I am not challenged to figure out a mechanical, physical, aesthetic, or administrative issue that presents itself.

Working with your hands/artistry: I gravitated to orthodontics largely due to the artistic component that is involved with aligning peoples teeth and creating an optimal aesthetic appearance. This is a passion for me personally, and is what makes me love going to work each day!

Entrepreneurship: Most orthodontists own their own businesses, and there is no preparation or training for this part of my job in all the schooling I have done. It is learn as you go, and luckily I have my wife who has helped tremendously with the day -to -day adventures of running a practice. This includes hiring, training and managing a staff of assistants and administrators, doing payroll, taxes, filing and checking insurance claims, advertising, paying bills, keeping up with and enforcing HIPPA and OSHA regulations, maintaining professional and business insurances, licences….it goes on and on! Running a business is hard work (but also rewarding) and having the right people around you to help has been the key for me. If this is really unappealing to you, there are options to become an orthodontist and work for larger, corporate dental chains that allow you to largely not be involved with the administrative or business aspects of dental care.

As always, I welcome anybody young or old who is interested in a career in orthodontics to come in and speak with me. I did not start dental school until I was 29, so it is never too late!

Dr. Dan Rejman is a board certified orthodontist who is the owner of Meadows Orthodontics in Castle Rock, Colorado. He has two offices located within Castle Rock, and is a specialist in braces and invisalign for children, teens and adults.

 

Our New Broncos Mural Room, and Congratulations Denver for Winning Super Bowl 50!

Meadows Orthodontics second location in Castle Rock is now officially open in the Founders, Terrain, Pradera, and Crystal Valley area of Castle Rock, in the Founders Marketplace! I will post pictures soon of the new office (it is amazing!), but after the Broncos’ Super Bowl win this past Sunday, I wanted to get a picture up of the Mural I have been painting in our new treatment room, as well as some additional pictures of Broncos Spirit from around town. It has been quite an amazing week, and our staff is proud to be from Castle Rock and the Denver area!

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This is the new treatment room where we will be placing and removing braces, seeing new patients, and celebrating Denver’s win in Super Bowl 50! What a nice coincidence that I got this far painting the mural just before the big game. I still have a ways to go, but the scene from inside Sports Authority Field is looking better and better!

 

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Broncos orange, blue and white were VERY popular the last two weeks as color choices for ties on braces. This is my son showing off his colors (I think he needs to get brushing!).

 

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This is the sculpture heading east on 5th in downtown Castle Rock. I’m not one for messing with sculptures and art, but this orange shirt placed on the cowboy was playful, fun, and showed the spirit we all had this past week!

 

 

 

 

I’ve been wearing that tie way too much this past week.

 

 

 

My boxer, Stanley, with his Bronco jersey!

 

 

 

 

 

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Amazingly, we had what is known as a “Broncos Sky” Saturday night before the game, and this proved to be a good omen. Well, it has been a fun several weeks at Meadows Orthodontics and in Broncos Country. I will get pictures up of the new office soon.

 

 

 

Dr. Dan Rejman is one of the few orthodontists that are Board Certified in Douglas County and the Castle Rock, CO area. For a list of orthodontists in your area that are Board Certified, go to AmericanBoardOrtho.com

 

We are Opening Our Second Location in Founders Marketplace Soon!

IMG_3396We are excited to be opening our second office in Castle Rock! In addition to our office in the Meadows, Meadows Orthodontics will be open the first week of February in the Founders Marketplace on Ridge Road (near King Soopers). Why are we opening two locations in Castle Rock? Convenience! Starting orthodontic treatment usually means seeing us every month or two for a year and a half  for adjustment visits for braces and Invisalign. Most all Castle Rock area residents have noticed how increasingly challenging and time consuming it can be to cross I-25 with all the new construction (and soon to be Mall!). We decided to make our offices super convenient for residents of both sides of I-25. Our original West office in the Meadows near Einsteins/Carribou  is really close for residents of the Meadows, Red Hawk, etc…, while the new East office in Founders Marketplace will be close to Terrain, the Founders, Crystal Valley Ranch, Plum Creek, and downtown areas. the East office will also be much closer for our FullSizeRenderIMG_3406patients from Elizabeth, Franktown and Parker.

Construction started several months ago, and is nearing completion (I am
posting several pictures of the progress that is being made). The new office is very similar in size to the Meadows location, but has a slightly different layout and feel. One nice thing about opening this location is that it has inspired me to start painting like crazy again. I am trying to get 4-6 new oil paintings completed and on the walls before the grand opening the first week of February. Here are a couple pictures of the progress of the paintings (the one with the plants is 36″x 36″ and is taking a IMG_3432while- I am having dreams about swiss chard!).

We hope you will enjoy the new location and the convenience it will provide busy families who have kids in braces! I will follow up with more pictures when the office is complete.

 

Dr. Dan Rejman is a Board Certified Orthodontic specialist who lives and practices in Castle Rock, Colorado. Meadows Orthodontics specializes in Braces, Clear Braces, and Invisalign.

Motivating Your Child to Wear Their Elastics (Rubber Bands) for Braces

Colorful-inter-arch-rubber-band-on-bracesOne of the challenges that parents of of children or teens in braces deal with on a daily basis is getting the child to wear their elastics, or rubber bands, consistently. I commonly hear, “We know they should be wearing their rubber bands all day and night, but when they go to school or to bed, they take them off or don’t remember to put them on.” The situation can get very frustrating for parents, as they feel powerless as their child’s orthodontic treatment extends much longer than was originally planned.  Not wearing rubber bands consistently and as asked by your orthodontist WILL make treatment take longer, which in turn increases the risk of permanent staining of the teeth around the braces (called decalcification), and increases the risk of root shortening and gum disease. What can you do if your child is just not showing interest in cooperating with elastic wear? Here are some tips.

  • Remind them of the biggest benefit of wearing elastics as asked.  The biggest benefit is usually what kids want about half way through their treatment- to get them taken off! I constantly remind kids that wearing the rubber bands is usually the only way to move teeth as we want, and wearing them close to all day and night makes things go really fast. Parents, remind them of this often.
  • Go to google images, download and print out a picture of “braces decalcification”. Tape it to the childs bathroom mirror as a reminder of what may happen if braces are on too long.
  • Similarly, tape a paper saying ‘Remember your elastics” to their mirror, refrigerator, or computer so they are constantly reminded.
  • Try positive reinforcement- bribery works well for encouraging consistent wear (I know- three of my own children are currently in braces!  Reward great elastic wear weekly with a treat from their favorite restaurant, pizzeria, or ice cream. Movies, I tunes points and video games are great rewards to work towards. Every child or teen has specific wants and interests that can be used to your advantage!
  • Keep a calendar that you fill out together every day, coloring the day in with blue for great wear (20-24 hours a day), yellow for so-so wear (14-20), and red to indicate insufficient wear (under 14 hours). Make it clear every red day means an entire extra day in braces!
  • From my own experience, sometimes taking something away may work well if the above ideas do not work. My oldest daughter responds well to several days without her cell phone. Taking away video game or computer time may work well, as could assigning chores or not being able to attend an event (although offering to take them to a movie or an event for great wear usually works better).

Try these tips, and remember that most parents feel similarly and go through some struggles with motivating their children. It is important to remember that most children and teens do not have a fully developed sense of long term consequences and responsibility as most adults do. Give us a call at any time if you feel you need additional help.

 

Dr. Dan Rejman is an orthodontist in Castle Rock, CO, and currently has three children of his own in braces!

Common Misconceptions about Braces and Invisalign, Part 2.

This is the second part of my article explaining some common misconceptions or myths about braces and Invisalign. These are things that I hear and see on a daily /weekly basis and that patient often misunderstand.

  1. images When patients come to see me for a consult and are interested in Invisalign treatment, there are differences that braces that they need to be aware of. First, there are some tooth movements that Invisalign just is not good at. Often times to approach the same quality that you receive from braces, elastics (rubber bands) must be worn, bumps called attachments may need to be bonded to the face of your teeth, and “ramps” on the back of your upper trays may prevent you from closing your back teeth together. I like patients to be aware if these adjuncts are needed before deciding between braces and Invisalign. The relative advantages of Invisalign (aesthetics, the ability to remove them) can then be weighed against the disadvantages (also the ability to remove them, sometimes  limitations in correcting the bite, and usually an increase in cost). I will be glad to help you decide which option is the best for your smile and your lifestyle.
  2. images (1)“I would like clear braces, but I heard that they can discolor or stain.”  For years now, the clear ceramic braces that I use at Meadows Orthodontics do not stain or discolor! The small clear ties that hold in your arch wire can discolor (especially from coffee, tea, red wine and curry), but these are changed to brand new ties at each visit, so they never really get the chance to be noticeably discolored. It is really nice that the clear ceramic braces have advanced to the point that this is no longer an issue!
  3. “If I double up on the elastics that I was asked to wear, I will get my braces removed faster”  Kids- do not do this! Wearing double the rubber bands will not speed up your treatment, and could likely break the brackets off your teeth, cause pain, and slow down tooth movement! There are many sizes and strengths of elastics, and I choose the most efficient ones for you to wear (if needed) at every visit.
  4. “I heard that Damon (or self-ligating) Braces will speed up my treatment, or are more comfortable.” Damon braces are one of MANY brands of braces, and each manufacturer touts the merits of the product that they are selling. The fact is teeth do not know what brand of braces is on them, and it is mainly the decisions of the orthodontist that determines the quality and length of your treatment. Damon is a really nice system of braces and I offer self-ligating braces as an option to my patients, but I am honest with them and explain that the latest research (and my own clinical experience) do not support the above claims from the manufacturers. Please see my blog article from August 21st, 2014 for more detailed information on this topic.
  5. “Phase 1 (or early) treatment will eliminate the need for braces later on, or reduce the total time in orthodontic treatment.”  In general this is not the case. The majority of children do not need early intervention, but it is very important to identify the children that do.  If I have informed you that your child needs early or Phase 1 treatment, it is because of one of the following: 1). If not treated now, there is a window that will be missed that will negatively affect his/her future outcome,  2). If two phases are done a better or more stable outcome will be attained, or 3). The appearance, function or health of the patient will be improved as an adult if treated in two phases versus one phase.  Because the need for early treatment is very specific, you should have a full understanding of WHY early treatment is needed and why it is not advised to wait until one complete set of braces (which I prefer if possible). Phase 1 treatment is limited treatment before all the permanent teeth have erupted, is very specific in its focus, and the limited braces are are usually removed after 9-12 months.  Because there are so many baby teeth present during phase 1 treatment, full alignment of the teeth is not the intention of this early phase. The term “Phase 1” implies that there will be another second phase of treatment, when a full set of braces is placed  to align the permanent teeth when they have erupted. Usually the time in treatment of Phase 1 and Phase 2 added together is longer than most one phase comprehensive cases, so this should be made clear also.

Dr. Dan Rejman is an Board Certified orthodontic specialist, and exclusively treats  patients with braces and Invisalign in his Castle Rock Colorado practice. Meadows Orthodontics is located in the Meadows community, and will soon open a second Castle Rock location in the Founders Marketplace (in February 2016)!

Common Misconceptions about Braces and Invisalign (Part 1)

Everyday at Meadows Orthodontics, we explain to our patients how braces and Invisalign work. There are a number of common misconceptions that keep coming up, so I thought I would write an article with a list that addresses these issues.

  1. “As an adult, I am too old to get my teeth straight, or my bite fixed”.  This is not the case! There are a number of skeletal issues that are best treated as child, but most tooth alignment issues can be treated fully, or significantly improved as an adult. In fact, over 20% of our new patients are over 30 years old!
  2. abo logo“All orthodontists are Board Certified, right?”  Absolutely not! In fact, just over one in three are Board Certified by the American Board of Orthodontics (ABO). Dr Rejman is one of the few Orthodontists that are board certified in Douglas County. Finding a board certified orthodontist helps to ensure they are committed to the very highest standards of the profession. To learn more, visit AmericanBoardOrtho.com, which includes a list of board certified orthodontists when you enter your zip code.
  3. “Braces are so expensive that I cannot afford them”. We understand the that this may be the thought when considering braces or Invisalign, but we offer fantastic, interest free, in house financing to get that smile you have been wanting. We also participate with most insurances, which combined with flex and HSA plans can reduce fees by over half!
  4. “I had braces, then when my wisdom teeth erupted, they caused misalignment of my front teeth”.  This is one that I hear all the time.  Research has shown that wisdom teeth DO NOT push the teeth in front of them forward and cause crowding. In fact, even if you never had braces, teeth tend to crowd as you age (especially the lower teeth).  Teens also tend to stop wearing retainers around college age as they get out of site from their parents- this coincides with the age that wisdom teeth normally try to erupt. It is the lack of retention that is to blame, not the wisdom teeth erupting! Which leads us to…
  5. ©Blue Moon Studio, Inc.“After several years of retainer wear, my teeth will stay straight and stable“.  Every day we let our patents know that to maintain straight teeth, retainers must be worn for life! The good news is that do not need to be worn during the day, and as you get older several nights a week of routine wear is usually adequate.
  6. “I described to my child what braces felt like when I was a kid/teen. Sorry mom or dad… your child’s treatment will be a much more comfortable and fun experience than when you has orthodontic treatment! Advanced in braces, wires, digital technology that replaces the goopy impressions of old, many fun color choices…the improvements since we were kids goes on and on. The orthodontic version of “When I was a kid, I walked uphill to school both ways!”.

Dr. Dan Rejman and his wonderful staff are setting the standard in quality and fun in Castle Rock and the surrounding areas when it comes to Braces and Invisalign. Please contact us if you have any questions.

A Guide for Halloween Candy and Braces

jack-o-lanternHalloween is such a fun time for children, with costumes and candy. For kids with braces, it can be tough to judge what candy may harm their braces. I tell my patients that for this night, it is OK to enjoy some treats, but to follow some guidelines. Here is a list of common candies that are acceptable and not recommended.

Absolute No- No’s:     Candies on this list are either really hard, extremely chewy, or have a consistency that will likely damage your braces.

  • Jolly Ranchers or hard candy
  • Taffy or hard caramels
  • Starburst
  • Now and Laters
  • Tootsie rolls
  • Sugar Daddies
  • Pay Days (or anything with full nuts)

Acceptable as Treats:     These candies are acceptable (as limited treats only!), especially if they are broken into smaller pieces.

  • Chocolate, Hershey’s Kisses
  • Most soft candy bars (Milky Ways, Three Musketeers, and Snickers and Twix in small pieces)
  • Fun dips
  • Lolly Pops- just don’t bite into them!
  • Reese’s Peanut Butter Cups

In general, break things into small pieces, chew lightly, and consume sugar in moderation!

 

Dr. Dan Rejman is a Board Certified Orthodontic specialist, and is the owner of meadows Orthodontics in castle Rock, CO.

Deciding what Type of Retainer to Wear

When the time has come to where you have almost completed treatment with  braces (or Invisalign), Dr. Dan will help you decide which retainers will be best for you and your bite. There are three main types of retainers that we offer (four including Invisilign Vivera retainers), and each has distinct advantages that different people prefer. Her is a description of each type to help you decide which retainer is best for you!

  • essix-header1Vacuum formed retainers:  Vacuum formed retainers are what is referred to as  “essix”clear retainers”, or “clear trays” by most patients. This retainer is made by vacuum forming clear plastic over a stone model of your teeth. Besides being comfortable, the advantage of this type of retainer is its clear appearance. Both upper and lower trays can be worn without them being seen (unless people are REALLY up close!). Kids and teens seem to really like wearing this type of retainer because of the way they look, and how easy they are placed. A relative downside compared to other retainer types is that longevity is usually less than the ones listed below.
  • A subset of vacuum formed retainers are Vivera Retainers, which are made by the Invisalign company. These are clear vacuum formed trays, but they come in a package with 4 sets of retainers, which addresses the longevity issue. When one set wears out, you move right to the next one. Vivera can be a nice option for people that grind their teeth at night, as there is full coverage over the biting surface.
  • Hawley retainers:  This type of retainer is the traditional type that usually comes to mind when picturing a retainer. Hawley retainers are Hawleymade of acrylic that is custom formed to the palate and inside of the upper teeth, and along the inside surface of the lower teeth. There is usually a metal “bow” that is formed to the outside surface of the upper and lower teeth. Hawley retainers have several advantages. They can be modified to stay in your mouth really well if this is an issue with the vacuum formed retainers, and they are very durable (they should last for years id well cared for). Depending on personal preference, some people like the feeling of their teeth being more “free”, as Hawley retainers do not fully cover the teeth like vacuum formed retainers. The acrylic can also be customized in any color, design, with glitter… the choices are endless! Relative downsides of this retainers is the visible metal bar across the front of the teeth, and a fuller feeling on the tongue side of the teeth.
  • BLR Intra oralBonded retainers:  Bonded lingual (which means tongue side of the tooth) retainers are tiny wires that bond permanently to the inside surface of the front teeth. Bonded retainers can almost always be used on the lower teeth, but due to the way teeth fit together, often they cannot be used on the upper teeth (Dr Dan will let you know where they will work for you). The main advantage of this type of retainer is that it is always on, and stays for years. Lower front teeth are notorious for crowding as people age whether they have had orthodontics or not, and bonded retainers will prevent this from happening. The disadvantage to bonded retainers is also that they are permanent and bonded to the back of the teeth- and this makes it more difficult to clean and floss around them. Because of this, I only recommend them for teens and adults who have great oral hygiene.

I hope this helps with the decision of choosing a retainer!

 

Dr. Dan Rejman is one of the few orthodontists that are Board Certified in Douglas County, Colorado. Meadows Orthodontics is located in the Meadows in Castle Rock, and will soon be opening another location in the Founders Marketplace in East Castle Rock.