Sometimes it seems that appearances count for everything—especially in Hollywood. But just recently, Lonnie Chaviz, the 10-year-old actor who plays young Randall on the hit TV show This Is Us, delivered a powerful message about accepting differences in body image. And the whole issue was triggered by negative social media comments about his smile.
Lonnie has a noticeable diastema—that is, a gap between his two front teeth; this condition is commonly seen in children, but is less common in adults. There are plenty of celebrities who aren’t bothered by the excess space between their front teeth, such as Michael Strahan, Lauren Hutton and Vanessa Paradis. However, there are also many people who choose to close the gap for cosmetic or functional reasons.
Unfortunately, Lonnie had been on the receiving end of unkind comments about the appearance of his smile. But instead of getting angry, the young actor posted a thoughtful reply via Instagram video, in which he said: “I could get my gap fixed. Braces can fix this, but like, can you fix your heart, though?”
Lonnie is raising an important point: Making fun of how someone looks shows a terrible lack of compassion. Besides, each person’s smile is uniquely their own, and getting it “fixed” is a matter of personal choice. It’s true that in most circumstances, if the gap between the front teeth doesn’t shrink as you age and you decide you want to close it, orthodontic appliances like braces can do the job. Sometimes, a too-big gap can make it more difficult to eat and to pronounce some words. In other situations, it’s simply a question of aesthetics—some like it; others would prefer to live without it.
There’s a flip side to this issue as well. When teeth need to be replaced, many people opt to have their smile restored just the way it was, rather than in some “ideal” manner. That could mean that their dentures are specially fabricated with a space between the front teeth, or the crowns of their dental implants are spaced farther apart than they normally would be. For these folks, the “imperfection” is so much a part of their unique identity that changing it just seems wrong.
So if you’re satisfied with the way your smile looks, all you need to do is keep up with daily brushing and flossing, and come in for regular checkups and cleanings to keep it healthy and bright. If you’re unsatisfied, ask us how we could help make it better. And if you need tooth replacement, be sure to talk to us about all of your options—teeth that are regular and “Hollywood white;” teeth that are natural-looking, with minor variations in color and spacing; and teeth that look just like the smile you’ve always had.
Because when it comes to your smile, we couldn’t agree more with what Lonnie Chaviz said at the end of his video: “Be who you want to be. Do what you want to do. Do you. Be you. Believe in yourself.”
If you have questions about cosmetic dentistry, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Magic of Orthodontics.”
Most of us are quite familiar with what traditional braces look like. But occasionally we see more complex-looking devices being worn by young orthodontic patients: thicker wires that extend outside the mouth, with straps that may go behind the neck or over the chin. What are these devices, and why are they sometimes needed?
In general, orthodontic appliances with external parts braced by the head, neck or chin are referred to as “headgear.” These devices may be used to handle a number of particular orthodontic situations, but they all have one thing in common: They provide the additional anchorage needed to move teeth into better positions.
It may come as a surprise that teeth, which seem so solid, can actually be moved fairly easily over time. This is because teeth are not fixed directly into bone, but are instead held in place by a hammock-like structure called the periodontal ligament. Using a light, controlled force — such as the force of springy wires and elastics in traditional braces — teeth can be moved slowly through the jaw bone, like a stick being pulled through sand.
Of course, to pull a stick through sand, you need a firm anchorage — your legs, for example, bracing against a rock. Most of the time, the back teeth, with their large, multiple roots, provide plenty of support. But sometimes, the back teeth alone aren’t enough to do the job.
If a very large space between teeth is being closed, for example, the back teeth might be pulled forward as the front teeth are pulled back; this could result in poor alignment and bite problems. In other cases, the front teeth may need to be pulled forward instead of back. The back teeth can’t help here; this is a job for headgear.
Some types of headgear have a strap that goes behind the head or neck; they use the entire head as an anchorage. Other types, called “reverse pull” headgear, have a strap that comes over the chin or the forehead; they can pull teeth forward. Headgear can even influence the proper growth of facial structures — that’s why it is usually seen on preteens, whose growth isn’t yet complete.
Headgear is usually worn for 12 hours per day, for a limited period of time. In some cases, rather than headgear, appliances called “temporary anchorage devices” (TADS) may be recommended. These are tiny screws that are implanted into the jawbone in a minimally invasive procedure, and serve a similar function.
While it may not look pretty, orthodontic headgear is capable of moving teeth into their proper positions in a relatively short period of time — and ending up with a great-looking smile is what orthodontics is all about.
It’s something you think about often—especially when you look in a mirror or at a photo of yourself. You wish something could have been done about it a long time ago. But now you think you’re too old to correct your misaligned teeth—your “crooked” smile.
Actually, you can transform your smile through orthodontics, whatever your age. Millions of your peers have done just that—currently, an estimated one in five orthodontic patients is an adult.
If orthodontics isn’t right for you it won’t be because of age, but most likely the condition of your gums and underlying bone or your overall health. That first factor is extremely important: if you’ve lost a significant amount of bone due to periodontal (gum) disease, there may not be enough to support the force of moving the teeth during orthodontics.
Health conditions like severe heart-valve disease, uncontrolled diabetes or drugs to treat arthritis or osteoporosis can also make tooth movement difficult. And, if you have restricted saliva flow (dry mouth), wearing orthodontic devices could be uncomfortable and increase your risk of tooth decay.
If, however, your mouth and body are reasonably healthy (and you don’t have a difficult bite problem to correct), there’s no reason why you can’t undergo orthodontic treatment. The only other thing that might hold you back is concern over your appearance during treatment. Many adults balk at the possible embarrassment of wearing metal braces “at their age.”
If this is a concern, you may have an alternative: clear aligners. These are a series of computer-generated clear plastic trays that conform to the individual contours of your teeth. Each tray is slightly different—you wear one for a short period of time (usually two weeks) before moving on to the next tray to successively and gradually move your teeth. They’re nearly invisible to others and, unlike fixed metal braces, you can take them out for a rare special occasion.
The only way you’ll know whether correcting your misaligned teeth is a viable option is to undergo a full orthodontic evaluation. From there we can help you decide if and how you want to gain a straighter, more attractive smile.
If you would like more information on adult 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.”
If you're currently undergoing orthodontic treatment, you're no doubt looking forward to the day your braces come off. But that won't end your treatment just yet — you'll need to wear a retainer.
Teeth are held secure in the bone of the jaw by an elastic tissue known as the periodontal ligament. As the braces “pull” the teeth to their new position, the ligament stretches and the bone remodels around the teeth. But the ligament also has a tendency to rebound as the tension eases when the braces are removed. The teeth could then return to their original position, especially during the first few months.
To prevent this patients wear an orthodontic appliance known as a retainer. It maintains some of the tension once supplied by the braces to help keep or “retain” the teeth in their new position. Depending on your age and other factors, you'll have to wear one for at least eighteen months; some patients, especially adults, may have to wear one indefinitely.
You may be familiar with a removable retainer, one you can take in and out of your mouth. But there's another type called a bonded retainer that's fixed to the teeth and can only be removed by a dentist. With this retainer a dentist bonds a thin piece of wire to the back of the teeth where it can't be seen. You can feel it, though, with the tongue: an unusual sensation at first, but one easily grown accustomed to.
Unlike their removable counterparts, bonded retainers aren't noticeable, either to others or the wearer. They're especially appropriate for patients who may not be as diligent in wearing a removable retainer.
It does, though, have some disadvantages. The position of the wire running horizontally across several teeth can make flossing difficult. And as with any retainer, removing it could increase the risk of the teeth moving out of alignment.
There are a number of factors to discuss with your orthodontist about which type of retainer is best for your situation. If you do choose a bonded retainer, be sure you work with the dental hygienist on how best to floss the affected teeth. And if you do have it removed, have a removable retainer prepared so you can preserve that smile you've invested so much into obtaining.
Think you're too old to have your teeth straightened? While we automatically pair “teenager” with “braces,” at least one in five orthodontic patients are adults. And there's many more that could benefit, as many as three-quarters of adults with a correctable bite problem.
But although orthodontics can be performed at any age, it's not a minor undertaking. It will require time, patience and expense. So, before you decide to undergo orthodontics, here are 3 simple questions to ask first.
Why? Like children and teenagers, adults can benefit cosmetically from correcting a poor bite. But there's another great reason besides a more attractive smile: misaligned teeth are more difficult to care for than normal teeth. Orthodontic treatment is an investment and potential cost-saver in your future dental health.
Why not? Even senior adults can successfully undergo treatment. But braces might be ill-advised if you have either poor oral or general health. Periodontal (gum) disease, for example, can cause bone loss, which makes it difficult to safely and successfully move teeth (and the effort could worsen current disease activity in the gums). Medical conditions like bleeding disorders, leukemia or uncontrollable diabetes could interfere as well. You'll need both a dental and medical examination beforehand.
How? We can use braces — or we might be able to use a newer, more popular option with adults called clear aligners. These are a series of computer-designed clear, plastic trays you wear in sequence until you finish the series. Each tray is slightly smaller than the previous tray, moving the teeth in much the same manner as braces. But unlike braces, you can remove aligners for cleaning or a rare special occasion — and they're much less noticeable than metal braces. Although in some cases braces may still be the best option, it's also possible clear aligners could be the option you've been looking for.
So, are you ready for a new smile and a more maintainable mouth? Visit us for the answers to your questions and see if braces (or clear aligners) can transform your life and health.
If you would like more information on orthodontic treatment for adults, 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.”