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“Yes,” you’re thinking, “I shouldn’t be chewing sugary, sticky gum while I’m wearing my braces.” Or perhaps, “I should check with my orthodontist to see if this sugar-free gum is safe for my braces.” And these are both great thoughts—but today, we’re thinking about gums of a different sort!

While you’ve been taking care of your teeth with regular brushing and flossing, you’ve also been taking care of your gums. And now that you’re wearing braces, your gums need a bit of special attention to keep them their healthiest.

We tend to think of gum disease as an adult problem. In fact, periodontitis, or serious gum disease, is one of the most common chronic infections in the adult population. But young gums need care, too! Gingivitis, a milder form of gum disease, is unfortunately a common problem for both children and adults.

Gingivitis is an inflammation of the gums caused by the build-up of plaque and tartar. When plaque builds up, it irritates delicate gum tissue. And while gingivitis is not as serious as periodontitis, the symptoms caused by this disease are nothing to smile about:

• Redness
• Tenderness and soreness
• Swelling
• Bleeding
• Bad Breath

If you’re already feeling a little tender or swollen after an adjustment, the added discomfort caused by gingivitis is the last thing you want. But even worse, neglected gingivitis can lead to more serious infections of gum and even bone tissue. Luckily, gingivitis is both preventable and treatable with proper dental care.

So, how to protect your gums? We have some suggestions.

• Brushing Better with Braces

It can be hard to brush around your brackets and wires, but keeping these areas free of food particles and plaque makes for healthy gums—and fewer cavities! There are specially designed manual toothbrushes made for braces wearers, and tiny interproximal brushes that can reach tight spaces. Or, perhaps an electric toothbrush will do a better job for you. Just be sure to brush after each meal for the most complete removal of bacteria and plaque.

• Learn New Flossing Techniques

You might wonder how on earth you’ll get in between your teeth with your wires and brackets in the way. We have the answers! We know the best techniques for flossing your specific braces, and we’ll recommend specially designed flossing tools to make the job easier. Water flossers can also be a great help for cleaning in tight spots. Be sure to make flossing part of your daily routine—you’ll be able to remove plaque from places brushing just can’t reach.

• Rinsing? Recommended.

Talk to Dr. Nicola Crichigno about the best dental rinses for reducing plaque and tartar, or how gargling can help prevent irritation. And drink water! Water helps wash away plaque and bacteria, and is a great way to rinse teeth and braces if you absolutely can’t brush after eating.

• Keep up with Professional Cleanings

Be sure to keep up with your regular dental exams and cleanings. Your dentist or hygienist will be able to remove any plaque or tartar build up that home brushing can’t handle.

We want your time in braces to be as healthy—and comfortable—as possible. If you have any gum discomfort, swelling, or sensitivity, give our Stoney Creek office a call. With prompt action, gingivitis can be treated, and with careful attention to your cleaning routine, gingivitis can be prevented altogether. Something to think about!

Temporomandibular joint disorders (TMD) describe a set of conditions that involve trouble with your jaw and face muscles. They result from a problem in the temporomandibular joint (TMJ), which is a hinge that connects the temporal bones, in your skull in front of each ear, to your jaw. The joint enables you to talk, yawn, and chew by letting your mouth move.

TMD can be very painful and interfere with functions such as eating and speaking. This what to watch for and how to try to prevent TMD.

Risk Factors for TMD

You are at higher risk for TMD if you are a women than if you are male. The disorder is most common among adults between the ages of 20 and 40 years. Other risk factors for TMJ disorders include the following.

• Arthritis in the area, making movement more difficult
• Excessive tooth grinding, because it increases stress on the joint
• General stress, which can lead you to clench your teeth and strain facial muscles

Symptoms of TMD

Symptoms of TMD can last for just a short while, or for several years. Seeing Dr. Nicola Crichigno is important if your symptoms make it impossible for you to eat regularly or if you have unbearable pain or discomfort. The following symptoms can occur on both or one side of your face.

• Aching or very tired facial muscles
• Jaws that are fixed open or shut without you being able to unlock them
• Grating or popping sounds when you chew or close or open your mouth
• Pain in the entire area, including the mouth, jaw, neck, or shoulders, that comes on when you chew or yawn

Preventing TMD

You can try to prevent TMD by focusing on reducing risk factors. If you grind your teeth at night, ask Dr. Nicola Crichigno about wearing a mouthguard. If you are overly stressed, look into ways to better manage your stress and relax your muscles. Another strategy for trying to prevent the development of TMD is to avoid chewing gum, since that puts stress on your jaw.

If you have questions about TMD, don’t hesitate to contact our Stoney Creek office.

When the time comes for Dr. Nicola Crichigno to remove your braces, it is very exciting. Unfortunately, it can be somewhat confusing, too, because you are faced with choosing between two kinds of retainers. Should you go with permanent, removable, or a combination of the two? It is always wise to follow Crichigno Orthodontics recommendations, but knowing more about the two types of retainer beforehand can be helpful.

Removable Retainers

Removable retainers offer the advantage of easy use: you will generally put a removable retainer in at night and take it out in the morning. Regardless of your retainer schedule, you'll be able to enjoy some time with no retainer. However, a removable retainer can easily be forgotten at times, and this means you won't be taking full advantage of teeth retention.

Another potential advantage of a removable retainer is that you can take it out and brush and floss your teeth with ease, which is more of a challenge with a permanent retainer. Although removable retainers can be very effective, they don't tend to be as effective as permanent retainers, especially if they are not used as directed.

Permanent Retainers

Permanent retainers are the clear choice for patients who want to “get it and forget it.” Once your permanent retainer is placed in your mouth, you won’t need to worry about daily retainer schedules, since it is permanently affixed to your teeth.

Because teeth begin to shift naturally as we age, a permanent retainer typically offers better long-term results for teeth straightening than a removable one. You can't forget to put it in — it's already there! Temporary retainers get lost or are forgotten on trips, and often fail to get used as often as they should be.

One drawback to permanent retainers is flossing. Some patients find it more difficult to floss with a permanent retainer, but we can show you effective ways to floss fairly quickly with your permanent retainer.

Some orthodontists may recommend a combination of the two; for example, a removable retainer for the top teeth and a permanent one for the lower ones because the lower teeth are smaller and tend to shift more.

Ultimately, the most important thing to remember is that wearing your retainer as directed is extremely important. As long as you follow our orthodontist’s advice, you will get the best results from your retainer, regardless of its type. If you’re still not sure whether the choice you’ve made is truly right for you, get in touch with us at our Stoney Creek location right away!

Maybe you’ve known people with braces and aligners—maybe you’ve worn them yourself!—so if braces or aligners are in your teen’s future, you have some idea what to expect and when to expect it.

But quite often, orthodontic issues require more treatment than braces alone can provide. When misalignment affects not only the teeth but the jaw as well, treatment can be more effective when it begins earlier and makes use of a different kind of appliance—the “functional appliance.”

During the years your child’s bones are still rapidly growing and forming, around the ages of eight to 14, functional appliances can help guide tooth movement and encourage jaw growth and development. One of the most widely used of these devices is the Herbst® appliance.

What does the Herbst appliance do?

There are several types of malocclusions, or “bad bites” treated by Dr. Nicola Crichigno. A common condition called a Class II malocclusion occurs when the upper jaw and teeth project too far forward over the lower jaw and teeth. Signs of a Class II malocclusion might include an overjet (protruding upper teeth), and/or a small or recessive lower jaw.

While correcting this malocclusion often enhances facial symmetry, which can be very important for a child’s confidence, correcting a Class II malocclusion also promotes jaw and dental health. Misaligned teeth are more difficult to clean, which can lead to decay and gum disease. Bite problems can cause persistent jaw pain and damage to the teeth. And, with an overjet, a child’s upper teeth are more at risk for injury.

The Herbst appliance was developed to treat this kind of malocclusion. It moves the lower jaw and teeth forward to create a balanced, healthy smile.

How does the Herbst appliance work?

The Herbst appliance is fixed in place with stainless steel bands or crowns that are secured to four teeth in the rear of the mouth, often the first molars on each side of the upper and lower jaws. The band or crown on each lower tooth is equipped with a small bar that extends toward the front of the mouth.

An arm on each side links the bands or crowns on the upper teeth to the front of the bar assemblies on the lower teeth. Each arm consists of a rod that fits smoothly into a tube. The telescoping action of the rod and tube allows the mouth to open and close normally. When the mouth is closed, the arms on both sides telescope shut, forming compact cylinders that hold the jaw forward.

While a child’s bones are still growing, the lower jaw’s new forward position can stimulate further bone growth and remodeling to maintain the jaw in that forward position. The Herbst appliance also has a restraining effect on the forward movement of the upper jaw. The result is a steady, noticeable improvement in the relationship between the upper teeth and jaw and the lower teeth and jaw.

Is the Herbst appliance hard to take care of?

The Herbst appliance is fairly low maintenance, but, like any orthodontic gear, it should be treated with care.

• It’s important to watch your child’s diet, because sticky, crunchy, and chewy foods can damage the appliance. Save the caramels for a post-treatment celebration!
• Carefully cleaning around the appliance is necessary, because a buildup of bacteria and plaque leads to consequences like bad breath, gum disease, and tooth decay. A water flosser can make reaching and cleaning tight spots easier if a brush alone isn’t effective.
• If the Herbst appliance is damaged, some minor fixes might be doable at home with instructions from your treatment team. But if a band or crown comes loose, or if there’s a problem you’re unfamiliar with, call our Stoney Creek office right away.
• To help avoid the need for minor (or major) fixes, playing with the appliance with fingers or tongue, nibbling on pens and pencils, chewing on ice, or any other risky habits should be strictly off limits.

When it comes to your child’s health, you always have high expectations. Dr. Nicola Crichigno and our team have all the answers you’ll need about what to expect from this phase of your child’s orthodontic treatment, and just why the Herbst appliance is the very best option to create a future of attractive, healthy smiles.