Home   |  Issues  |  The Daily Star Home |Volume 5, Issue 47, Tuesday, November 30, 2010

 

Dental Wise

Braces
Every one craves a Monalisa smile. A smile that accentuates a pleasant face and contributes towards self-confidence, the edge that makes the difference in this fast paced world.

Many will say that an attractive set of teeth contributes to a smile. While some are blessed, others less fortunate often complain to dental health personnel regarding misaligned teeth and other problems.

...to relieve pain
· Braces are annoying, but require mild drugs to deal with the discomfort. Usually a normal dose of Tylenol or Ibuprofen will do the trick. Aspirin is not recommended as it could cause bleeding. Expect that your teeth will hurt for a week or two. After that the pain should subside.
· Your teeth are most likely sensitive to the touch, so don't try to chew anything that is crunchy or challenging, such as sandwiches. Try mashed potatoes, soups, yoghurts, and other soft foods.
· Eat something very cold like ice cream or suck on an ice cube. It will numb your mouth and temporarily relieve the pain.
Alternatively, drink hot soups, such as broths or tomato soup. Heat promotes blood flow, and will ease the swelling.

Photo: Sazzad Ibne Sayed
Model: Mayeesha Mahboob

Using braces can help people who feel they have poorly aligned or misplaced teeth, irregularly spaced teeth or protruded teeth. It is difficult to maintain dental hygiene in such cases as they are difficult to clean.

Abnormal bites caused due to misaligned teeth can cause open bite, cross bite etc., which can cause damage to the supporting structures of the teeth.

Orthodontic treatment can be provided at any age as long as the supporting structures of the teeth are healthy. But it is during the growing age that options for orthodontic treatments are most available. The best results can be achieved if the treatment is completed before 17 years of age.

For teenage patients who are considering braces, the Orthodontist will need to determine if all of the adult teeth are in, or if the patient still has a mixture of baby and permanent adult teeth (transitional dentition). Depending on the case, the options are varied -- traditional metal braces, clear ceramic braces, invisible braces or iBraces, and Invisalign.

Certain options such as Invisalign and invisible braces (metal braces hidden behind the teeth) called "iBraces" are generally not used in children with a mixed dentition, that is, if they still have both baby teeth and adult teeth.

Another consideration with teenage patients is the status of the wisdom teeth, also known as the third molars. The Orthodontist can take a special X-ray called a Panorex, which will show the wisdom teeth and whether these third molars in fact are impacted or poorly oriented in the jaw. The Orthodontist may recommend that the wisdom teeth be extracted if there is a concern that these teeth may push the other neighbouring teeth out of alignment.

If extractions are recommended, the Orthodontist does not personally extract the wisdom teeth, but will generally refer the patient back to the family dentist or an oral surgeon.

It is recommended that children have their first orthodontic screening by age seven. It is not necessary to lose most baby teeth first. In fact, early intervention can be helpful in decreasing the need for complex future treatment. Such potentially complex treatment often requires extraction of adult teeth because the crowding by that point often becomes overwhelming.

Sometimes the Orthodontist may recommend “Phase I Treatment”. This is offered when children who are young and actively growing and face certain problems. Such problems include, but are not limited to, cross-bites, extreme crowding, canine impactions, blocked adult tooth eruption, and more.

The Orthodontist, upon evaluating the growth and orthodontic status of the child determines the proper timing of “Phase II Treatment”. This phase of treatment is usually done in teen age.

Teenagers may also decide on traditional metal braces with a variety of colour options for the elastics. The bright colours you see on braces are actually small coloured elastics that hold the wire in the brackets. They come in rainbow colours, although with time constraints many offices will limit you to two colours per visit.

With Invisalign and "iBraces" there are no coloured elastics. As many children enjoy choosing colours, they often shift to Phase II Treatment using the traditional metal braces.

Clear ceramic braces are placed on the front of the teeth like traditional metal braces, but they are less visible than the metal brackets. The clear brackets can be a good option for those who would be self-conscious with metal brackets.

There are however some disadvantages of clear ceramic braces. They may be stained by certain foods and beverages such as coffee. Discoloured clear braces may look less cosmetic than shiny metal braces. Clear ceramic braces tend to be more fragile than traditional metal braces. They may come off more easily and require additional orthodontic appointments.

If clear ceramic braces are placed on the lower teeth, the upper teeth can sometimes accidentally sheer off the lower braces with the force of biting down, depending on the position of the teeth.

For this reason, sometimes clear braces are used on the upper teeth and traditional metal braces on the lower. Your Orthodontist will need to explain for you whether this is an option after examining your bite.

 

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Retainers
We have come a long way since the 1960s. Nowadays braces come in mini sizes and the small metal bands that wrap all the way around the tooth are usually only on the back teeth. There is a lot less “Heavy Metal”. The wire that sits in the bracket applies pressure to move the teeth and this can sometimes cause some discomfort.

At the end of the active orthodontic treatment, a retainer is needed to make the achieved change stable. An orthodontic retainer is an oral appliance which is used to keep the teeth stable and in alignment. Retainers are usually used after orthodontic treatment is completed and a patient is given two retainers, one for the upper, and a second for the lower teeth.

Retainers are designed to help ensure that your wonderful smile and all the beautifully aligned teeth stay exactly that way and do not shift or change (relapse). Retainers fall into two basic categories, namely, removable and fixed.
Bonded fixed retainers are sometimes the only answer for particular types of retention challenges such as preventing a big space or diastema from re-appearing between the upper two front teeth. In such cases permanent retention is needed to maintain successful closure. Even minor tongue pressures or forces due to chewing can cause a space to re-appear.

A removable retainer may be lost, whereas there is no chance of losing a fixed retainer as it remains in the mouth. If a removable retainer is somehow lost, please call your Orthodontist for an appointment for an impression to make a new retainer as soon as possible.

You don't want your teeth to shift after all the investment in time and effort to achieve your great smile. Always keep your retainer case handy and do not wrap your retainer in a napkin. It is too easy to forget and send your retainer to the great retainer graveyard in the sky.

Special thanks to Dr Saeed Hossain Khan (Consultant Orthodontist, AIKO Dental and Implant Centre #9885426) who contributed in preparing a major portion of this article.


Under a different sky

Metallic menaces

Teenage years, as is widely known, are usually the most fashion-savvy years of a person's life following the latest trends, listening to the 'coolest' music and pretty much doing whatever's 'in'.

Unfortunately, in the stereotypical world that most teenagers live in, kids with braces are usually considered 'dweebs' or 'geeks'.

As a matter of fact, instead of suppressing smiles, teenagers now sport braces by having a mouthful of brightly coloured metal to become the envy of their peers.

However in reality braces are not only difficult to adjust to in the world of fashion and glamour; (think Ugly Betty) they don't make things easier 'teeth-wise' either.

What many people may not know is that braces are quite painful (in some cases) for the first couple of days and sometimes you may have to take painkillers to ease the pain for a couple of hours.

Now, of course there are retainers that you won't have much of a problem with since you can take most of them off during the day. But even that is after the hard part with the actual braces is over.

But since the majority of people who wear braces need it for at least a year or two, and sometimes even longer without any possibility of taking them off, making them look fancy once in a while can help you get comfortable with having them around. Some teenagers even prefer matching them with their clothes.

But for those teenagers who're embarrassed of putting their braces on in front of their friends at school or afraid they might have to face bullying from the more 'popular kids', there are alternatives to traditional metal dental braces.

Instead of the regular ones you can opt for the Invisalign braces which are invisible, removable teeth aligners. These braces are much easier for a teenager to have because they can be taken out when eating, drinking, and cleaning the teeth and there will be no need to clean the teeth after eating something every time. The regular brushing of three times per day is all that is necessary. They also do not irritate the mouth like the other metal braces do.

It's about time kids get out of their shell and wear their braces proudly; and once the treatment is over, they'll have the best set of teeth to show off!

Now the first thing you should think about when you get the appointment from your orthodontist is what colour you're
going to pick!

By Naziba Basher


The cry of a mountain had been roaring inside of me for a while. It wasn't a soft cry, it was loud and had sharp edges which scraped my inside. My heart pumped faster, the cry got louder by the minute and finally gathered up like a ball of cloud and shot out of my mouth like the mightiest sigh. I knew it was time…

The crying mountain dragged me to the east; moist air made me crave tamarind and an ocean lay quietly on one side spreading salt over the entire island of Borneo. I can't say it was a happy place, neither was it a sad one. It was quiet and always in anticipation. As if someone or something was about to arrive. There was a subtle anxiousness, a common syndrome of a place where people come and go and only a few stay back. There were mounts of energy left behind from past visitors, fulfillments of climbers, strength from the dead and inspiration from the new. I didn't fall in love with it but I was eager to see the mountain, so I rested.

Morning comes early in Mt. Kinabalu. It comes with the joyous sounds of those who made the summit, it comes running down the faces of the ones who have conquered the mountain. Mt. Kinabalu, which translates to “a Chinese widow,” tells a story of a local woman of Borneo who fell in love with and married a Chinese emperor. She and the emperor lived happily for a few good years and their family grew each year with a child. After some years the emperor went back to China and never returned. The lovesick wife waited for days and finally started climbing Mt. Kinabalu at sunrise, reaching the summit every night hoping for the sight of her husband's returning ship. After years of following this routine, she passed away at the summit as her eyes searched a last time for a betrayer, a returning ship, a Chinese emperor. Kinabalu told a story of a broken a heart, of left behind spirits, it spoke of forgotten love.

Like the Chinese widow I started at sunrise. The forest changed its shape as I climbed up. The plants looked carnivorous and the little squirrels didn't seem as entertaining as we climbed higher. Every half kilometer I hiked up, there was a rest stop. The guide had eight children, he climbed Kinabalu every week and he was bone thin with bright glowing eyes. He kept a close eye on my toes and knees and I tried to keep my eyes open as the altitude played with my body.

The base camp was a square structure bringing in people from all around the globe. Each room held four in bunk beds. I ate and slept till it was 2 am; there were no lights, only the power of our will took us further. The summit shined brightly at sunrise, the clouds below waited for some unknown order from the above; the spirits of the mountain prayed in harmony with lost living souls.

The way down was rough, brittle red earth had me holding tight and I lost balance a few times and wished for another way down besides the one involving my legs.

The cry inside of me had subsided; I could tell I was leaving it behind me, so that all cries could unite and turn into a giant cloud, pouring over Mt. Kinabalu; showering widows, lovers and those who never found love. The mountain waited for it to rain while we stepped down her chest hoping for an early monsoon.

 

 
 
 

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