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. Sung Lee and the team at Sung Lee 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. Sung Lee 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 Sung Lee Orthodontics in Puyallup, WA will coordinate a treatment plan to create your best—and healthiest—smile.

Long days in the sun’s rays offer you lots of options for outdoor activities. Beach time? Vacation? Open-air concerts? Baseball, biking, board sports? No matter what plans you have for these sunny days in Puyallup, WA, we have some tips to keep your smile beaming.

Use Sunscreen

Sunscreen is good for all ages and skin tones, and it’s also designed to protect your smile. Lip tissue is thin and delicate, and can easily be damaged by the ultraviolet rays which cause skin cancer and premature aging. 

If your regular sunscreen isn’t suitable for your lips, there are many protective lip balms designed especially for your smile.

• Make sure you get the proper level of protection. Dermatologists recommend lip balms with a minimum SPF (Sun Protection Factor) of 30.
• Reapply at least every two hours, and sooner if your lips get wet or if you’re eating or drinking.

Protect Your Smile with a Mouthguard

Mouthguards help protect your teeth from damage caused by impact, whether from hard surfaces or hard elbows! Any time there’s a chance of a fall or a collision, a mouthguard is a good idea. Use your guard for:

• Biking, in-line skating, skateboarding, or any activity where an unexpected fall is possible 
• Contact or low-contact sports like baseball, basketball, and soccer, where bodies collide with equipment or other bodies

If you play organized sports, you might already own a mouthguard. If not, talk to Dr. Sung Lee about over-the-counter options or a custom-fitted model. And if you wear braces, no need to stay indoors! There are mouthguards designed to protect your teeth, cheeks, lips, and braces. Ask the team at Sung Lee Orthodontics for recommendations.

Hydrate

On hot days, our brains help regulate our body temperature. How? By sending the signal to start sweating! Some heat is transferred from our bodies to evaporate perspiration, which helps cool the skin. But that cooling perspiration comes at a cost—the water we lose through sweat can lead to dehydration. 

Water is essential for our health, and especially when it’s scorching outside. Drinking water throughout the day is healthier than drinking lots of water at one time, and your doctor can let you know the right amount of water for your body, since we’re not all built the same. A bottle of water doesn’t contain artificial ingredients, caffeine, or sugars, so it’s a great, healthy outdoor companion. 

More? Water is also great for your smile!

• Water washes food particles and bacteria away from teeth and gums for fresher breath and a healthier mouth.
• Most communities add fluoride to their water, and fluoride strengthens tooth enamel to help you fight cavities. If your local water supply isn’t fluoridated, talk to your dentist about other treatments which can provide fluoride’s cavity protection.
• Hydrating helps prevent dry mouth. Normal saliva production doesn’t just keep the mouth moist for eating and speaking—it also protects our teeth and gums as it washes away food particles and helps counteract excess acidity in the mouth.

Summer’s a Great Time for Dental Care

It’s easy to get distracted with summer activities and vacations—after all, they’re designed to be distracting! But don’t let your well-deserved fun in the sun distract you from your regular dental care. 

• If you haven’t started orthodontic treatment, summer is a terrific time to begin. You’ll have several weeks to get used to your braces or aligners before school starts in the fall.
• If you’re going on vacation, let Dr. Sung Lee know. It’s necessary to keep adjustments to your braces or aligners on schedule so you can enjoy your beautiful smile as soon as you possibly can. Don’t delay your progress by missing appointments.
• Wear your appliances or bands as directed. If you don’t put in the hours with your aligners or your bands, you’ll be spending more time in treatment than you need to.
• Regular dental exams catch small problems before they become larger ones, and cleanings make sure your smile is bright all summer long. If you’re overdue for a visit to your dentist, make room in your schedule for a checkup.

Summer can be a time to relax, renew, and recharge. While you’re enjoying those extra hours of sun, take care of your oral health for a beaming smile which will look great on you any time of year!

February is Gum Disease Awareness month, a timely reminder that preventing gum disease is one of the best ways to protect our oral health. 

Gum disease is easily treated in its earliest stages. Left untreated, the progressive nature of gum disease makes it one of the leading causes of tooth loss in adults. 

And while we often think of gum disease as an older person’s disease, the fact is that teens and young adults can suffer from gum disease, too. Irregular brushing and flossing habits, hormone fluctuations, family history, and even orthodontic treatment can make people of any age more vulnerable to gum disease.

Let’s take a moment in this shortest month of the year to discuss how understanding, treating, and, above all, preventing gum disease can help us enjoy long-lasting healthy smiles.

How Gum Disease Develops

Gingivitis is the first, mild stage of gum disease. 

• Gingivitis begins with plaque. 
• Plaque irritates gum tissue, causing inflammation, which is the body’s reaction to injury or infection. 
• Typical symptoms include gums which are swollen or red. The gums might feel tender or bleed easily when you brush or floss. You could develop persistent bad breath. 

With proper care, gingivitis is reversible. Because gingivitis symptoms can be very mild, they’re sometimes overlooked. That’s why it’s important to keep up with regular checkups to discover and treat the disease in its earliest stages. 

Periodontitis is a serious gum disease which is destructive to the structures which support our teeth: gums, connective tissue, and bone. 

• Plaque, when it’s not removed, hardens into tartar, which can form on the tooth above and below the gumline. 
• The gums pull away from plaque and tartar deposits, creating a space between the gum tissue and tooth roots. 
• As the gums continue to recede, pockets form between the teeth and gums.
• Infection-causing oral bacteria thrive in these pockets. Gum infections can lead to painful abscesses—but gum disease is not just an infection.
• The body normally responds to bacterial infection with inflammation. With periodontitis, this inflammation becomes destructive chronic inflammation. 
• Over time, chronic inflammation and infection break down the gum tissue, bone, and connective tissue holding teeth in place. Teeth become loose or shift out of alignment.

The tooth’s support structure eventually becomes so compromised that extraction is the only option. That’s why prompt treatment is essential.

Treating Gum Disease

Several options are available to treat gum disease, depending on its severity.

Treatment for gingivitis can be as simple as paying more careful attention to your brushing and flossing and, if necessary, seeing your dentist for a professional cleaning. In some cases, your dentist might recommend an antimicrobial mouthwash or rinse.

Periodontitis requires specialized treatment from your dentist or periodontist, and this treatment will be based on how advanced the condition is:

• Topical, oral, or time-release medications treat infection.
• Non-surgical deep cleaning procedures called scaling and root planing remove plaque and tartar above and below the gumline, allowing gum tissue to reattach to the tooth. 
• Flap surgery treats more advanced gum infection by reducing pocket depth and re-securing the gums snugly around the teeth.
• If needed, bone grafts, gum grafts, and other regenerative procedures are available which help repair and restore damaged tissue.

Preventing Gum Disease

What many people aren’t aware of is just how preventable gum disease is! Because wearing braces can make brushing and flossing more challenging, it’s especially important during these months to stay on top of your dental hygiene and be on the lookout for signs of gingivitis.

• Brush twice a day for two minutes each time, after every meal, or more often if your orthodontist recommends it. 
  • Use proper brushing technique, angling your brush toward the gums to gently clean around and below the gum line. Be sure to brush around your brackets and under your wires. Use a soft-bristled brush to protect both gum tissue and tooth enamel.
• Floss once each day, after every meal, or as directed by Dr. Sung Lee. 
• There are specialized brushes and flossers available to make cleaning around brackets and wires much easier. Electric toothbrushes and water flossers can also be helpful in removing hard-to-reach plaque. Ask Dr. Sung Lee to recommend the flossing tools and techniques which will work best for you.
• See your dentist regularly. Gum disease can be invisible in its beginning stages. Discovered early, treatment is simple and effective. 
• Having your teeth cleaned every six months, or as recommended, will remove tartar buildup which brushing alone can’t handle. 

Your dental hygienist is experienced in cleaning teeth when patients wear braces. And you can get tips for better brushing and flossing techniques from the team at Sung Lee Orthodontics in Puyallup, WA, too!

Even when it seems like there aren’t enough days in the month or hours in the day, it takes just a few minutes daily to care for your gums and teeth. And when you’re aware of just how much those few minutes mean to a healthy smile, it’s time well spent!

Many patients underestimate the importance of wearing their retainers after their braces come off, but it is one of the most critical post care practices to keep your teeth in alignment. Why spend all that time, energy, and money to straighten your teeth when you don't plan to keep them straightened after treatment?

What is a retainer?

As the name implies, a retainer keeps teeth from moving back to the positions in which they started before treatment was administered; they "retain" your smile and bite. There are many different types of retainers—some are removable and some are permanent. Some retainers are made of plastic and metal (known as Hawley retainers) and others are all plastic or all metal. Some retainers can even be bonded to the back of your teeth!

How long do I need to wear it?

If you've been given a removable retainer by Dr. Sung Lee, you may be wondering how long you need to wear it. It takes time for the tissues and bones around your teeth to reorganize and set into place after braces treatment.

The amount of time you’ll need to wear your retainer depends on your unique situation, but typically, retainers should be worn at least as long as the time you spent in braces. You might need to wear them full-time for a while, and then transition to wearing them only at night. Dr. Sung Lee will have a treatment plan especially for you, and if you stick to it, you'll always have a straight smile.

Nothing is forever (at least without retainers!)

Research has shown that there is no “permanent” position for your teeth to remain in. In fact, some studies say upward of 70% of patients will see a change to their bite and tooth alignment as they get older. This applies to people who have had orthodontic treatment and those who have not. Of course, some people's teeth never seem to shift—you can consider them the lucky ones, as most people's teeth do.

And this is precisely where retainers come in. The only way to ensure your teeth stay in alignment long-term is by wearing your retainers. If you have any questions about retainers or your treatment plan, please ask any member of our Puyallup, WA staff.