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Posts for: July, 2018

WhiteSpotsonYourTeethAfterBracesMayBeAnEarlySignofEnamelLoss

After months of treatment we’ve removed your braces and your new smile emerges. Upon closer view, however, you notice a number of chalky white spots on your teeth.

These pale areas are white spot lesions (WSLs), the result of mineral breakdown from the long-term contact of acid with the enamel surface. The underlying cause is built-up bacterial plaque due to inadequate oral hygiene, and as such WSLs are the beginning stages of tooth decay.

While anyone can develop WSLs, brace wearers are highly susceptible because of the extra care required to clean around orthodontic hardware. Poor dietary habits such as frequent snacking on sugary or acidic foods and beverages also increase the risk of WSLs.

To reduce the risk of developing this condition, brace wearers must give extra attention and effort to daily oral hygiene, including brushing and flossing. The extra effort required in brushing can be aided by specialized toothbrushes designed to clean around brackets and wires, along with prescription-level fluoride toothpastes for added enamel strength. Floss threaders or a water flosser, a device that uses pulsating water under high pressure, may help you maneuver around hardware to remove plaque between teeth. It's also important to maintain a healthy mouth environment by limiting intake of sugary or acidic snacks and beverages, avoiding tobacco or excessive alcohol or caffeine, and drinking plenty of water to keep your mouth from drying out.

If you’ve already developed lesions, it’s important to stop the decay process before it causes more damage. One way is to assist your body’s natural mechanism for re-mineralizing tooth enamel with fluoride pastes or gels or re-mineralizing agents, or undergoing micro-abrasion to repair a tooth’s surface.

To improve a tooth’s appearance a procedure known as “caries infiltration” involves injecting a liquid tooth-colored resin into the lesion, which is then hardened with a curing light. The spot becomes less noticeable and appears more like normal enamel. For extensive defects, conventional bonding with composite resins or porcelain veneers can be used to cosmetically cover the tooth.

Getting ahead of the problem with effective oral hygiene and good dietary and lifestyle practices will keep WSLs at bay while you undergo orthodontic treatment. If they do develop, however, there are ways to minimize their effect and restore the look of your teeth.

If you would like more information on dental care during orthodontic treatment, please contact us or schedule an appointment for a consultation.


By Legacy Dental Care
July 21, 2018
Category: Dental Procedures
ThinkYoureTooOldforOrthodonticsReadThis

You’ve lived most of your life with crooked teeth and an imperfect smile. You feel you should have done something about it years ago, but now you’re approaching your golden years — what would be the point?

Here’s the point: there’s a growing trend of older adults undergoing orthodontic treatment. People are discovering the life-changing benefits of straightening their teeth — even if they’re no longer teenagers.

So, what’s really holding you back?

I’m too old to have my teeth straightened. Not true — teeth can be straightened at any age, not just during childhood or adolescence. If anything would prevent orthodontic treatment it would be the state of your oral and general health, not your age. Your teeth’s supporting bone must be reasonably sound and healthy; likewise, systemic problems like bleeding disorders, leukemia and uncontrolled diabetes can make orthodontics difficult. But if you and your mouth are reasonably healthy, you can have your teeth straightened.

It’s too much to spend just to look better. Yes, orthodontic treatment can transform your smile — but it can also improve your oral health. Misaligned teeth are harder to keep clean, increasing the risks for tooth decay and periodontal (gum) disease; they also don’t work well together so chewing is more difficult. By correcting your bite, you can reduce your chances of dental disease and improve overall mouth function.

I’d look silly at my age in braces. Self-consciousness about wearing these traditional appliances is common at any age. It’s understandable — the glint of metal is the first thing people see when you smile. But there’s a good chance you may be able to wear an alternative appliance that’s barely noticeable: clear aligners. These are a series of removable, clear plastic trays that you wear in sequence to gradually move your teeth. Not only are they less noticeable than braces, you can take them out for special occasions.

Don’t let these or other excuses keep you from a more attractive smile and healthy mouth. Visit your dentist for an examination to see if orthodontics can work for you.

If you would like more information on transforming your smile through orthodontics, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Orthodontics for the Older Adult.”


JulianneHoughSharesaVideo-andaSong-AfterWisdomTeethComeOut

Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.

That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!

Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.

Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”

One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.

Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.

Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”  Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.

If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”


AvoidBoneLossaroundToothRootsthroughRegularDentalCare

Periodontal (gum) disease is a serious matter. Not only can it wreak havoc with your gums, it could also cause bone loss in the jaw that supports your teeth.

Gum disease is a bacterial infection that originates from a thin film of food particles on tooth surfaces called plaque. If you're not diligent about removing plaque through daily brushing and flossing, it can become a feeding ground for certain strains of bacteria that trigger gum infections. Left untreated, the disease can advance deeply into the teeth's supporting structures.

We're particularly concerned about furcations, the specific locations where multiple roots of a tooth fork or separate. When these locations become infected we call it a furcation involvement or invasion. The bone along the furcation will begin to deteriorate and dissolve, following a progression of stages (or classes) we can measure by probing the gum tissue or through x-ray evaluation:

  • Class I: the furcation feels like a groove, but without any noticeable bone loss;
  • Class II: a depression of about two or more millimeters develops indicating definite bone loss;
  • Class III:  bone loss now extends from one side of the root to the other, also known as “through and through.”

Treating furcation involvements can prove challenging because the infection is usually well below the gum line (sub-gingival). As with all gum disease treatment, our primary approach is to remove all plaque and calculus (hardened plaque deposits) where we find it, including around the roots. We typically use specially shaped instruments to clean the root surfaces. We can also employ an ultrasonic device that loosens plaque and calculus with high-frequency vibrations and flushed away with water.

Sometimes, we may need to surgically access involved furcations to clean them and stimulate bone growth with grafting. We can also use surgery to make the areas easier to clean — both for you and for us during your regular office cleanings — to prevent reoccurrences of infection.

Of course, preventing gum disease in the first place is your best defense against oral problems like furcation bone loss. Be sure you brush and floss every day, and visit us for thorough cleanings at least twice a year (unless we recommend more). This will help make sure not only your gums, but the bone that supports your teeth stays healthy.

If you would like more information on treating periodontal (gum) disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “What are Furcations?


By Legacy Dental Care
July 10, 2018
Category: Dental Procedures
Tags: invisalign  

InvisalignAs an adult, you've made many important decisions--college, career, marriage, a home. However, you postponed your orthodontic treatment. You dislike the idea of wearing traditional braces. Is there a way to straighten your smile discreetly? At Legacy Dental Care in Woodbridge, VA, Dr. Sownya Punaji and her staff invite you to explore treatment with clear and comfortable Invisalign aligners.

Amazing Invisalign

One out of every five people undergoing orthodontic treatment is an adult. That's right...not the middle school or high school student, but someone well over 21 who never had the time, desire or resources to address problems such as:

  • Overbite
  • Crossbite
  • Openbite
  • Underbite
  • Tooth rotation or tipping
  • Gaps
  • Crowding
  • Protruding front teeth

Yes, adults find conventional braces unsightly, expensive, time-consuming and lifestyle-limiting (there are many dietary restrictions and hygiene rules). While metal or ceramic braces are unavoidable for complex orthodontic problems. many older teens and adults with moderate issues can use comfortable, clear Invisalign aligners. There a great alternative to traditional appliances.

These ultra-thin aligners are crafted individually by Invisalign technicians. SmartTrack material, an innovative kind of BPA-free acrylic, guarantees durability and wearability, too. In other words, your aligners will move your teeth gradually and precisely into better positions while you enjoy your usual diet and brush and floss as you always have.

In all, you'll wear 18 to 30 Invisalign appliance pairs 20 to 22 hours a day. You'll visit Legacy Dental Care in Woodbridge, VA, every six weeks to receive the next sets of aligners in your personalized treatment plan and for a simple check on your progress.

Throughout the short nine to 18 month treatment, only you and your dentist will know you're an orthodontic patient. That's how discreet Invisalign aligners are.

How can you qualify for Invisalign?

Dr. Punaji will inspect your teeth and gums and take a special three-dimensional scan. With this information, she can tell if Invisalign will work for your smile and exactly how your case should proceed. After the lab fabricates your aligners, treatment begins.

Find out more

Invisalign aligners provide straight, healthy smiles for thousands of patients across the world every year. You could be one of them. To arrange a consultation with Dr. Punaji, please contact Legacy Dental Care for an orthodontic consultation: (703) 494-4490.