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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. Joseph Brogan and the team at Brogan 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. Joseph Brogan 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 Brogan Orthodontics in Philadelphia, PA will coordinate a treatment plan to create your best—and healthiest—smile.

We get it. You’re working out and could use a boost. It’s 2 a.m. and that essay won’t write itself (darn it). You’re in the middle of a rehearsal that goes on and on and . . . 

It’s easy to reach for an energy drink when you’re feeling a bit low on, well, energy. These drinks are loaded with caffeine, and, like coffee or tea, can help you feel more alert. But before you pop that top, let’s look at how energy drinks affect your dental health.

• Energy drinks are very acidic.

Acid levels are measured using the pH scale, which ranges from 0 (most acidic) to 14 (most alkaline). Saliva has a normal pH somewhere between 6.2 and 7.6, which helps neutralize any acidic conditions in the mouth and promotes a healthy oral environment. But saliva’s neutralizing effect can be overwhelmed by highly acidic foods and drinks.

Why are higher levels of acids bad for our teeth? Acids strip away minerals like calcium from tooth enamel, minerals which make enamel the strongest substance in the body. This demineralization weakens the enamel’s protective outer structure and can lead to enamel loss, sensitivity, tooth discoloration, and decay.

Many energy drinks are among the most acidic beverages on the market. Mineral loss in your enamel starts to occur when the pH balance in the mouth falls to 5.5 or less. Lemon juice has a pH between 2 and 3. White vinegar has a pH of 2.5. Energy drinks can range from 1.5 to 3.5 on the pH scale! Studies show that regular consumption of energy drinks greatly increases the risk and severity of dental erosion.

• Most energy drinks are full of sugar.

Sugar is easily metabolized, or broken down, by the body. When our bodies break down food, energy is released. That’s why companies add sugar as well as caffeine to their energy drinks. 

The plaque bacteria which create cavities also use sugars in these drinks as an energy source, converting sugars into acids. Just like acidic foods and drinks, bacterial acids break down the mineral structure in tooth enamel. You might notice small white spots when the enamel starts to erode—and a cavity starts to develop. 

• Energy drinks aren’t just bad for your dental health. 

The temporary burst of energy you get from all the sugar in energy drinks is followed by a sugar crash when blood sugar levels go down again, and you can feel tired, weak, or shaky. 

Even worse, one energy drink might contain three to four times the amount of caffeine found in a cup of coffee. Excess caffeine interferes with healthy sleep. It can cause changes in heart rate, blood pressure, and anxiety levels. 

Children and teens are especially vulnerable to the effects of large amounts of caffeine while their brains and bodies are still developing. That’s why the American Academy of Pediatrics recommend no energy drinks at all for children and teenagers. The FDA suggests that adults should not take in more than 400 milligrams per day of caffeine, while energy drinks can range from around 80 to 400 mg per can. 

If you do have the occasional energy drink, what’s the best way to protect your teeth and gums?

• Don’t linger over your drink. Sipping slowly over time just bathes your teeth and gums in sugar and acids over a longer period. 
• Drink water when you’re done. Water helps wash away sugars and acids, hydrates, and promotes healthy saliva production.
• If the team at Brogan Orthodontics gives gum a thumbs up, chew a piece of sugarless gum after downing an energy drink to increase saliva flow and help neutralize acids in the mouth. 
• Wait at least 30-60 minutes to brush after finishing an energy drink. Acids in the drink weaken enamel, and brushing immediately can be abrasive to the tooth surface.
• Eat a healthy diet rich in proteins, complex carbs, vitamins, and minerals to feel more energetic.
• Keep up with good dental hygiene. Brush twice each day for two minutes and floss daily, or more often as recommended by Dr. Joseph Brogan.

If you notice signs of enamel erosion—sensitivity, front teeth which are becoming transparent or rough around the edges, yellowish discoloration, or white or brown spots on your enamel—it’s time for a talk with your dentist. When caught early enough, treatment is available which can stop further erosion from harming your teeth.

It can be harder to brush and floss as effectively when you wear braces, so it’s more important than ever to make healthy choices in your diet and to keep up with your dental hygiene. The team at Brogan Orthodontics in Philadelphia, PA is always happy to give hygiene tips! Talk to your dentist or doctor to discover healthy ways to stay focused and energetic. Your workout, your essay, your rehearsal, and, above all, your healthy body and healthy smile will thank you!

Now that you’re entering the working world, or heading off to college, or pursuing any of the many adventures awaiting you in adult life, you’re ready to take on more adult responsibilities. And one of those responsibilities is making sure you maintain your dental health.  

Luckily, it’s not that hard! Successful adulting often means simply making small proactive choices which add up to big long-term benefits. So, let’s look at a few of the everyday habits of dentally successful adults.

Choose a Healthy Lifestyle

• Eat well.

Just like the rest of our bodies, our teeth and gums need a healthy diet to thrive. Sugar-fueled study sessions and energy drink-filled work hours should be the rare exception, not the norm. A diet rich in vitamins and minerals keeps gums healthy and enamel strong.

• Don’t use tobacco products. 

Cigarettes, cigars, pipe smoking, chewing tobacco—any form of tobacco products, especially combined with alcohol use, can greatly increase your chances of developing mouth and throat cancers.

• Talk to your doctor about the HPV vaccine.

HPV (human papillomavirus) can also cause mouth and throat cancers. The American Academy of Pediatrics recommends the HPV vaccine for kids ages 9 through 12. If you haven’t been vaccinated yet, talk to Dr. Joseph Brogan about the potential benefits of the HPV vaccine. 

Practice Good Oral Hygiene

• Brush at least twice a day, for two minutes each time. 

Plaque begins to build up within hours after your last brushing. Removing plaque morning and evening also removes the cavity-causing bacteria which live in plaque. These bacteria erode enamel and lead to cavities.

• Floss at least once a day. 

Flossing helps remove plaque from your gumline. When plaque accumulates over time, it becomes tartar, a substance so hard that you’ll need a dental professional to remove it. The bacteria in plaque and tartar irritate your gums, and this irritation is the beginning of gum disease. Early stage gum disease (gingivitis) can often be reversed with better brushing and flossing habits—but, even better, help stop gum disease before it starts with daily flossing.

• See your dentist regularly. 

If you’ve had the same dentist since childhood, you’ve probably developed a great partnership, typically visiting your dentist twice each year for an exam and a professional cleaning. 

Make sure you make space in your busy adult life to keep your smile its healthy, sparkling best by continuing to schedule regular cleanings and exams. This is the best way to clean away any plaque or tartar you may have missed, and, most important, to catch any small problems before they become bigger ones. 

Keep Up with Your Orthodontic Care

If you’ve spent several of your teen years in braces or aligners creating a beautiful, healthy smile, you don’t want to see all your hard work go to waste. Retainers are designed to make sure your teeth stay just where they belong for a lifetime. 

When retainers aren’t worn as directed, especially when braces or aligners first come off, the teeth can shift back to their old positions. Sometimes going back to your regular retainer schedule can fix any minor movement, but sometimes patients need to go back for repeat orthodontic treatment.

How to avoid orthodontic do-overs?

• If you have a retainer, wear it as scheduled to maintain your alignment and healthy bite. 
• Put your retainer in a case when you’re not wearing it. A bent or broken retainer won’t keep your teeth aligned properly and can damage delicate oral tissues!
• If your retainer is damaged, see the dental team at Brogan Orthodontics in Philadelphia, PA ASAP for repair or replacement.

Not so difficult, right? In fact, you’ve probably adopted most of these healthy habits already. Take charge of your dental health now, make good habits a part of your daily routine, and you’ll be prepared to enjoy a lifetime of healthy, attractive, adult smiles!

You pay attention to what you eat. After all, your oral health depends on it. Without the necessary proteins, vitamins, and minerals in your diet, your teeth and gums will suffer. But did you know it’s a two-way street? Without healthy teeth and a healthy bite, your digestive system can suffer as well.

Because digestion doesn’t start in your stomach—it starts in your mouth! Let’s take a quick look at how the digestive system operates.

• Teeth

The first step in digesting is breaking down foods so your body can extract their nutrients more easily. Healthy teeth are essential here. Incisors and canines tear food into smaller pieces while molars grind these pieces into an easy-to-swallow, paste-like consistency. While we chew, the surface area of the food increases, allowing the digestive enzymes in saliva, the stomach, and the small intestine to work more efficiently.

• Salivary Glands

Saliva production increases when we eat. Digestive enzymes in saliva begin breaking down carbs into sugars, and separating fat molecules. Saliva also contains antimicrobial peptides which are important for oral and gut health.  

• Esophagus

This muscular tube connects the back of the throat to the stomach. As we swallow, muscles in the esophagus contract and relax, an involuntary movement called peristalsis. These contractions push food down into the stomach. Peristalsis also occurs in the stomach and intestines, efficiently moving food through the rest of the digestive system. 

• Stomach

Inside the stomach are gastric acids and enzymes which break food down further to help the small intestine make use of these nutrients in the next stage of digestion.

• Small Intestine

This organ works to reap the benefits of our healthy diets. The small intestine absorbs about 95% of the nutrients from our digested food—carbohydrates, proteins, fat, vitamins, and minerals—and transfers these nutrients to the circulatory system to be used throughout the body. Any remaining food particles travel to the colon, or large intestine.

• Large Intestine

Bacteria in the large intestine help process soluble fiber, which we can’t digest on our own. The large intestine is also where insoluble fiber and anything else undigested are converted to solid waste. 

Now, let’s look at how a malocclusion, or bad bite, can disrupt the digestive process.

In some cases, malocclusions are mild, and require little or no treatment. A more serious malocclusion, though, can impact the way the jaws fit together, making it difficult or impossible for the jaws and teeth to align correctly for efficient and comfortable chewing. What are some possible consequences?

• Uneven bite pressure

With a healthy bite, your teeth and jaws fit together properly to let you get the most out of your meal. When teeth and jaws don’t meet properly, it’s hard to chew food into the paste-like consistency necessary for rest of our system to process it smoothly.

• Reduction in digestive enzymes and peptides

Difficulty chewing means less chewing. Less chewing means less saliva, and your system won’t benefit from the digestive prep work and gut protection which saliva typically provides. 

• Uncomfortable swallowing

Insufficiently chewed food makes peristalsis in the throat and other digestive organs more difficult. Larger pieces of food can become stuck in the esophagus, causing painful swallowing or even choking.

• Higher risk of stomach problems

When food isn’t chewed thoroughly, the stomach has to work harder, and the risk of gastroesophageal reflux increases. Highly acidic gastric juices can back up into the esophagus and mouth, causing heartburn, chest pain, sore throat, and vomiting. 

• Bowel irritation

When food particles are too large, the small intestine must work harder to break them down and to absorb their nutrients. Insufficiently digested food can also upset the bacterial balance in the large intestine. These problems can cause indigestion, constipation, gas, and bloating.

• Changes in nutrition 

Orthodontic problems can also lead to nutritional imbalances even before we start to digest. Soft foods and liquids are often chosen over proteins, fruits, and vegetables when chewing pain is a regular occurrence. While a soft diet is fine for a few days if your mouth is a bit sore following an orthodontic or dental treatment, it can be difficult to get the all the nutrients your body needs when you only eat soft foods.

Orthodontic treatment has many well-known benefits. Straighter teeth. A comfortable, functional bite. Increased self-confidence. Let’s add one more benefit to that list—making sure your digestive system gets off to a great start!

The team at Brogan Orthodontics in Philadelphia, PA recommends an orthodontic evaluation for children around the age of seven, because finding malocclusions early makes it easier to correct them. But if you’re an adult, don’t settle for painful chewing and an increased risk of digestive problems. Talk to Dr. Joseph Brogan to learn how orthodontic treatment can give you an attractive, functional smile. Your healthy smile—and your healthy body—will thank you!