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Orthodontists and dentists use advanced procedures to treat and save teeth. But sometimes, a tooth just can’t be saved and needs to be extracted. Sometimes it’s due to extensive decay, or infection, or serious injury. Or sometimes, to create a healthy bite, an extraction is necessary during orthodontic treatment.

When does an orthodontist recommend an extraction? Conditions which call for extraction include:

• Incoming Wisdom Teeth

Not many people have enough space in their mouths for four wisdom teeth! And when there’s no room to erupt properly, wisdom teeth can become decayed or infected, push your other teeth out of place, and damage the roots of nearby molars. Extracting wisdom teeth protects your teeth and your bite alignment.

Usually, orthodontic treatment takes place before the wisdom teeth begin to erupt. But if yours start to make an appearance during treatment, your orthodontist and dentist will work together to schedule extraction without interfering too much with your orthodontic treatment plan.

• Tooth and Jaw Structure

Dr. Iwei Huang and the team at Gold Coast Orthodontics carefully plan your treatment based on examinations, X-rays, and/or 3D imaging. The goal is to align your teeth and jaws for an attractive smile and a healthy, functional bite. When overcrowding is severe, or if there is a serious malocclusion (bite problem), or if a particular tooth is unusually large or misshapen, your orthodontist might recommend an extraction.

Sometimes more room can be made for teeth with appliances such as palatal expanders or, in other cases, with the help of oral surgery. Extractions are only recommended when they are absolutely necessary.

• Baby Teeth Which Aren’t Coming Out 

Baby teeth normally fall out in a predictable pattern. Front teeth first, canines and molars last. Baby teeth have small roots, and these roots begin to break down when the adult teeth underneath put pressure on them as they start to erupt. As the root gets smaller and smaller, the baby tooth gets looser and looser—until it falls out. 

Sometimes, though, the roots of primary teeth don’t break down, and the baby teeth stay right where they are. This means that the permanent teeth have to erupt someplace else—usually behind those baby teeth. This creates a double row of teeth, and your permanent teeth can become crooked or overlap as they try to fit in. Extracting stubborn baby teeth allows your adult teeth to come in just where they’re supposed to. Because of their small roots, extracting primary teeth is usually simple and straightforward, and can be done in your dentist’s office. 

• Too Many Teeth

Most of us have 32 adult teeth, including wisdom teeth. It’s rare, but sometimes an extra, or supernumerary, tooth develops. Your jaw is most probably not equipped to accommodate any extras, so, in this case, the extra tooth or teeth are removed to give the rest of the teeth the space they need to avoid overlapping or crowding.

When your orthodontist recommends an extraction, it’s because it’s important for your dental health. Dr. Iwei Huang will refer you to a dentist or a specialist like a periodontist or oral surgeon, who will: 

• discuss the extraction procedure with you, including sedation options
• numb the area 
• gently loosen and then extract the tooth
• provide options for pain management after the procedure
• give you detailed instructions for aftercare
• work with your orthodontist to keep your treatment on schedule

Extraction is never your first choice, or your orthodontist’s! But when an extraction is necessary for tooth and bite alignment, everyone at Gold Coast Orthodontics in Chicago will coordinate a treatment plan to create your best—and healthiest—smile.

It’s the littlest month of the year, so what better time to think about the dental health of our littlest family members? February is National Children’s Dental Health Month, and we’re here to suggest some of the best dental habits for healthy childhood smiles.

Babies 

• Even before your baby cuts her first adorable tooth, you can start proactive dental care by gently wiping little gums with a clean, moist gauze pad or soft cloth twice a day. This removes bacteria and food particles and helps prepare your baby for brushing.
• When that first tooth does appear, or by age one if it hasn’t yet erupted, it’s time to schedule a visit to the dentist. At this first visit, your child’s dentist will check jaw and tooth development and can give expert guidance on teething, brushing, how much and which kind of toothpaste to use, and topics like thumb-sucking and pacifier use.
• When baby teeth arrive, use a small soft-bristled toothbrush designed to fit comfortably in tiny mouths.
• Use toothpaste as recommended. Children under the age of three who use paste should use a very small amount, no larger than a grain of rice.
• Prevent “baby bottle tooth decay”—don’t put your baby to bed with a bottle. This allows the sugars in formula or, when your child is 12 months or older, milk, to bathe the teeth throughout the night. And babies and toddlers never need sugary juices or sodas in those bottles!

Toddlers 

• Help your child develop a positive relationship with his dental team. Read books or watch videos to help your child learn what to expect. Practice with him by having him open his mouth while you count his teeth. Plan visits when your child isn’t hungry or tired. Be positive yourself—your child will take his cues from you!
• Schedule regular appointments for exams and cleanings. Your child’s dentist will check tooth and jaw development, look for any signs of decay, and evaluate potential problems such as prolonged thumb sucking or pacifier use. 
• By age three, children have most or all of their baby teeth. Use a soft bristled brush to clean your child’s teeth twice each day. As she grows, demonstrate how to brush properly. Your dentist and hygienist will have some great ideas on technique!
• Daily flossing should begin as soon as your child has two teeth which touch. 
• Around age six, your child may be transitioning to solo brushing and flossing—but your oversight is still needed. Make sure all the surfaces of the teeth, including the tops of new molars, are brushed thoroughly. You might provide a timer or a two-minute song or video to make sure your child spends enough time brushing. Flossing can be tricky for young hands, so you’ll need to help with that task for a few years more.

School-Aged Children

• Orthodontists and dentists recommend a first visit to the orthodontist by age seven, or earlier if you notice your child has trouble chewing or biting, if the teeth don’t seem to fit together properly, or if you have any concerns about bite and alignment. When potential problems are discovered right away, early intervention can prevent more serious orthodontic issues from developing later. The team at Gold Coast Orthodontics in Chicago is happy to answer any questions you might have about early interventions!
• If your child is beginning orthodontic treatment, you can help make the journey easier: 
  • Keep up with appointments and adjustments—missed appointments can delay your child’s progress. 
  • Braces can make brushing and flossing more difficult, so try special brushes and floss designed just for braces. 
  • If needed, remind your child to wear bands or aligners for the recommended number of hours each day. 
  • Be encouraging! Remind your child that these months in braces or aligners will lead to years of healthy, attractive smiles.
• Talk to your dentist about sealants. Permanent molars usually erupt between the ages of six and 12. Sealants are thin coatings which protect the chewing surfaces of these molars from food particles and cavity-causing bacteria which would otherwise collect inside grooves in the enamel.
• Children who play sports and engage in activities with a chance of physical contact should have a well-fitted mouthguard to protect their teeth. Be ready to replace it as often as recommended by Dr. Iwei Huang or if it’s damaged.
• Increases in hormones during puberty can lead to puberty gingivitis, and swollen, red, and bleeding gums can be the result. Proactive dental hygiene will prevent gum disease from developing. Make sure your child brushes two minutes, twice a day, and flosses once per day. If symptoms persist, it’s time to see the dentist.
• A nutritious diet is essential for healthy teeth and gums. Give your child solid nutritional building blocks with a diet rich in proteins, vitamins, and minerals. If your child wears braces, have a variety of appealing, braces-friendly foods on hand. 

Help your child enjoy a future of healthy, confident smiles by working in partnership with your child’s dentist and the orthodontic team at Gold Coast Orthodontics. They are ready every month of the year with advice and expertise to make that healthy dental future a reality!

We probably all remember sitting through history lessons during our schooling years. Revolutionary war heroes, English royals, and pop-culture icons filled the pages of our textbooks. Although you may recall a detail or two about their historical significance, how much do you know about their teeth?

Picture England in the mid 1500s. People wore frilly clothes as they hustled along the street, and talked about the latest import from the Indies: sugar. Wealthy Brits did not hesitate to indulge their sweet tooth, and it was no different for the monarch, Queen Elizabeth I.

The queen was especially fond of sweets, but not so fond of the dentist. Her teeth rotted; they turned black and gave off a foul odor. Eventually, Elizabeth lost so many teeth that people found it difficult to understand her when she spoke.

Flash forward to the Revolutionary-era colonies in the 1770s and we encounter the famous dentures of George Washington. They were not made of wood, but rather a combination of ivory and human teeth, some of which were his own pulled teeth and some he purchased from slaves.

Washington did not practice proper dental hygiene throughout his life. He began to suffer dental problems as early as age 24, when he had his first tooth pulled. By the time he was inaugurated in as the first president in 1789, he had only one tooth remaining in his mouth, which was pulled in 1796.

Washington’s dentures were made too wide and never quite fit his mouth properly. He complained that they were painful to wear and caused his jaw to protrude visibly outward.

If you’ve heard of Doc Holliday, you know him as the gun-toting, mustached criminal that ran the Wild West in the late 1800s. You might be surprised to learn that John Henry “Doc” Holliday actually had a career as a dentist.

He graduated from dental school in 1872 and began to practice in Griffin, Georgia. Holliday was later diagnosed with tuberculosis and his violent coughing fits during exams drove patients away. Jobless, he packed his bags for Texas and spent the rest of his days running from town to town as a criminal.

The Beatles brought pop music and British culture to their fans, as well as … teeth? In the mid-1960s, John Lennon had a molar removed that he presented as a gift to his housekeeper, Dorothy. Dorothy’s daughter was a huge fan of the Beatles and he thought she might like to a keepsake. Her family held onto the tooth until 2011, when they auctioned it off to a Canadian dentist for $31,000.

These historical figures had very different experiences with their teeth, but it’s safe to say a bit of extra brushing and flossing could’ve saved them a lot of trouble. Whether you’re queen, president, or an average citizen, it’s up to you to practice good dental hygiene!

Ask a member of our team at our Chicago office if you have any questions about how to keep your teeth in top shape!

Brackets and wires, clear aligners, lingual braces, regular brackets, self-ligating braces, elastics, spacers—you and your orthodontist have had to narrow down a lot of choices to discover the best treatment for your orthodontic needs. Now that the end of treatment is in sight, there’s one more important choice left—your retainer!

Do I Need a Retainer?

No retainer at all is probably the one option that’s off the table from the start. It’s not just your teeth that have changed position; it’s the bone and ligaments holding them that have changed as well.

A retainer prevents your teeth from moving away from their new, ideal location while your bones and ligaments are stabilizing. This process takes months, so keeping your teeth in place as your bone rebuilds and regains density is crucial.

What Are Your Retainer Options?

Three of the most popular retainer options available at our Chicago office include:

• Hawley Retainers

This is the traditional retainer, with wires to hold your retainer in place and to keep the teeth properly aligned. The wires are attached to an acrylic plate molded to fit the roof of your mouth or around your bottom teeth. You can customize the acrylic base with colors and patterns for a one-of-a-kind look.

Hawley retainers are adjustable, so minor realignments can take place if necessary. The wire in front of your teeth makes these retainers visible, but, after several months of wearing them all day long, you may end up wearing them only at night.

Hawley retainers are removable, so you need to make sure they are safely in a case when you’re not wearing them. Minor damage can often be repaired, but it’s better to be proactive.

• Clear Plastic Retainers

These retainers look like clear aligners. They are formed by heating a thin piece of plastic and vacuum-forming it around a model of your teeth to create a custom, comfortable fit.

Clear retainers are almost invisible when worn, and can be removed when you eat or drink—which they should be, because food particles and liquids can be trapped inside them.

When you’re not wearing it, a clear retainer should always be in its case, because it must be replaced if the plastic is warped, cracked, or broken.

• Fixed Retainers

A fixed retainer is a small single wire bonded to the back of specific teeth, commonly the six bottom front teeth. Because fixed retainers don’t allow the teeth to move at all, they are often recommended for patients who had serious misalignments, extremely crowded teeth, or teeth with large gaps between them.

Many patients like fixed retainers because they keep teeth in perfect alignment, they won’t be seen, they’re comfortably small, and they can’t end up in the cafeteria recycling bin because you forget to replace them after lunch!

Fixed retainers are usually quite durable, but you’ll need to pay attention to your diet, because crunchy and chewy foods can put pressure on the retainer and damage it. These retainers also require special care with brushing and flossing, to make sure the teeth bonded to the wire stay clean and plaque-free.

The Right Retainer

The process of stabilizing your teeth in the jaw takes time. Choosing your retainer will depend in part on how long and how often you need to wear it: fulltime for months or for years, at night after several months of day-and-night wear, or long-term to make sure your orthodontic work lasts.

And there are other variables, as well. Your retainer might need to be removable. It might need to be adjustable. You might need a retainer for just your upper teeth, just your lower teeth, or both. All these factors and more need to be taken into consideration before deciding on your ideal retainer.

Fixed, removable, wire, plastic, colorful, clear—which retainer is right for you? The one that helps you retain the beautiful smile you’ve worked for all these months. Talk to Dr. Iwei Huang to discover the retainer that will protect that smile for years to come.