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Analyzing strong points, looking for potential problems, making comparisons—it’s bracketology time! Nope, not basketball (although we hear they have something similar), but a brief analysis of your orthodontic options when it comes to choosing a winning bracket.

If you’re getting braces, you’re probably already familiar with how they work—brackets are bonded to the teeth to hold an archwire, which provides gentle, controlled pressure to move the teeth into alignment. But within that basic bracket-and-wire system, there are several different bracket designs available to you at our Youngstown, OH orthodontic office. Let’s see what the scouting report has turned up on our final four, pointing out their distinct advantages as well as some potential mismatches.

Traditional metal brackets

Advantages:

• Traditional braces with metal brackets are effective for more than just straightening teeth. They can be used to correct rotated teeth, differences in tooth height, and bite problems. For severe bite and alignment problems, traditional braces are most often the right choice.
• Metal construction makes these brackets able to handle the controlled pressure needed to treat serious malocclusions.
• Cost-effective. These are usually the least expensive option.

Potential Disadvantage:

Clear/Ceramic Brackets

Advantages:

• Lack of visibility! Whether you go for clear brackets or brackets tinted to match your enamel, you’ll be keeping a low-profile with this choice.
• Stronger and more stain-resistant than ever before, using the latest in ceramic, porcelain, or plastic materials.

Potential Disadvantages:

• Not as durable. Unlike metal, these clear brackets can crack or break. If you play a contact sport, these might not be for you.
• Some ceramic brackets are larger than other choices, so might be recommended only for the top teeth.
• Clear or tinted brackets can be more expensive.

Self-Ligating Brackets

Advantages:

• These brackets use a clip or trapdoor mechanism to hold your archwire without the need of bands. Ceramic options are available if you want an even more discreet appearance.
• Can be more comfortable with less friction between wire and bracket.

Potential Disadvantages:

• Self-ligating braces are generally more expensive.

Lingual Braces

Advantages:

• Lingual braces use metal brackets, but they attach to the back of each tooth for almost invisible bite correction.
• Custom-made. Lingual brackets can be designed and fabricated to fit your individual teeth perfectly.

Potential Disadvantages:

• Trickier to clean because of their placement behind teeth.
• Might not be suitable for a deep bite if there’s not enough clearance between top and bottom teeth.
• Initial discomfort caused by the tongue’s contact with the braces when you speak and eat.
• Custom-made brackets are more expensive.

So that’s a brief rundown of your bracket choices. But, unlike sports bracketology, there are no losers here! Dr. Anthony Bisconti can give you the pros and cons of each bracket design, so you can make an informed decision based on the kind of braces which will work best for you. With coaching like that, no matter which bracket option you choose, the final result is the same—a winning smile!

When does an underbite need surgery? The short answer is: when Dr. Anthony Bisconti and our team recommend surgery as the best way to give you a healthy, functional bite. But let’s take a longer look, and see just why your doctors might come to that conclusion.

• First, what exactly is an underbite?

In a perfect bite, the upper and lower jaws align, well, perfectly. Upper teeth overlap lower teeth very slightly, upper and lower teeth meet comfortably, and jawbones and joints function smoothly. When the alignment is off, it causes a malocclusion, or “bad bite.”

When we talk about an underbite, or Class 3 malocclusion, it means that the lower jaw protrudes further than the upper jaw. This protrusion causes the bottom teeth and jaw to overlap the upper teeth and jaw.

• What causes an underbite?

Sometimes an underbite is caused by childhood behaviors while the teeth and jaw are developing, including tongue thrusting or prolonged thumb-sucking and pacifier use. (Working to stop these behaviors before they affect tooth and jaw formation is one of the many good reasons children should have regular visits with their dentists and pediatricians.)

Most underbites are genetic, however, and tend to run in families. It’s estimated that from five to ten percent of the population has some form of underbite. The lower jawbone (mandible) might be overdeveloped, the upper jawbone (maxilla) might be underdeveloped, both bones could be affected, or, sometimes, tooth size and placement might cause an underbite. These irregularities in jaw shape and size and/or tooth crowding are not something that can be prevented, and require professional treatment.

• Why? What’s the problem with an underbite?

Even a minor underbite can cause difficulties with biting and chewing. A more severe underbite can lead to speech problems, decay and loss of enamel where the teeth overlap, mouth breathing and sleep apnea, persistent jaw and temporomandibular joint pain, and self-confidence issues.

• Can’t my dentist treat my underbite?

Most probably not. A very mild underbite can be camouflaged cosmetically with veneers, but this does not address the cause of the underbite, and will not work for moderate or severe underbites.

• Can my orthodontist treat my underbite?

Dr. Anthony Bisconti will create an underbite treatment plan after a detailed study of each patient’s individual dental and skeletal structure. Treatment options will vary depending on the cause of the underbite, its severity, and even the patient’s age.

Early intervention is especially important for children who show signs of an underbite. That’s why we recommend that children visit our Youngstown, OH office by the age of seven.

If an underbite is caused by tooth misalignment or crowding, braces can reposition the lower teeth. Sometimes extractions are necessary to make room for proper alignment.

If the cause is due to jaw structure, children’s bones are still forming, so treatment can actually help correct bone development. Palatal expanders, headgear, and other appliances are various methods of encouraging and guiding bone development.

But braces and appliances aren’t effective for every patient with an underbite, and especially in patients (usually those in their late teens and older) when the jawbones are already fully formed. In this case, we might suggest coordinating treatment with an oral and maxillofacial surgeon.

• What does an oral and maxillofacial surgeon do?

An oral surgeon has the training, experience, and skill to help correct an underbite by surgically reshaping and repositioning the jawbone. This corrective jaw surgery is called orthognathic surgery.

• What will happen during orthognathic surgery?

Your treatment will be tailored to your specific needs. Two of the common surgical procedures for treating an underbite involve repositioning the upper jaw to lengthen it and/or reshaping the lower jaw to shorten it.

Bone is sometimes removed or added, small bone plates or screws are sometimes used to stabilize the bone after surgery—your surgeon will let you know exactly which procedures will give you a healthy, functional bite. The surgery itself is most often performed under general anesthesia and requires a brief stay in the hospital.

• How will my orthodontist and oral surgeon coordinate my treatment?

Correcting a Class 3 malocclusion can take time. Your oral surgeon will work together with Dr. Anthony Bisconti to analyze the interrelationship of teeth, bones, and joints to determine dental and skeletal problems, and will develop the best treatment plan possible to create a healthy alignment.

• So, when does an underbite need surgery?

Sometimes, a minor underbite can be corrected with braces and appliances alone. A serious underbite, however, will often require the specialized skills of both Dr. Anthony Bisconti and an oral surgeon.

And, while it’s not the primary purpose of surgery, corrective jaw surgery and orthodontics can also make you happier with your appearance and boost your self-confidence. Achieving a lifetime of beautiful, comfortable, and healthy smiles—that’s the answer to your question.

By no stretch is it rare for your gums to hurt during and after flossing. Even some bleeding is to be expected. This is especially true if you have not flossed in a long time. However, if your gums do indeed hurt when you floss, and unbearably so, there are some things you can do.

Be Gentle

Perhaps the most obvious way to combat gum soreness and bleeding is to be gentle. One of the most common occurrences of these gum problems is over-aggressive flossing. In other words, if you are too rough on your gums while flossing, either because you are out of practice or because you are in a hurry, soreness and hurting is to be expected. Instead, try taking your time and be gentle. Also, if you are just starting out, be patient and consistent, your gums will become more conditioned over time.

Use an Alternative Method

If being consistent and gentle does not work, there are other alternative methods of flossing that you can try. You can also try a water floss machine, or what is sometimes called a water pick. The device essentially shoots water into the crevasses between your teeth, and in other areas of your mouth, in order to dislodge food and plaque. These oral instruments also come with different attachments that allow you to reach many of the hard to see and reach areas of your mouth. And lastly, you can always buy floss that is not as abrasive to your gums. There is floss that comes with soft and gentle coatings that will do less harm to your gums while they are adjusting to the good oral hygiene habit you are creating.

Flossing is one of the easiest parts of oral hygiene to overlook. When you first start out, it is common that you may want to stop because of the pain it can initially cause. However, if you try one, or all, of the above mentioned methods, you will give yourself the best chance of being success with your flossing, and it won't hurt as much.

For more flossing tips, schedule an appointment at our Youngstown, OH office and askDr. Anthony Bisconti or a member of our team!

Many developing orthodontic problems can be intercepted and corrected if diagnosed and treated at an early age. Dr. Anthony Bisconti and our team at Bisconti Orthodontics recommend children have their first orthodontic evaluation no later than age seven, or younger if the front four permanent teeth have replaced the baby teeth. Early treatment, also known as interceptive treatment or Phase I treatment, provides both timely detection of problems and greater opportunity for more effective treatment. Early intervention guides growth and development, preventing serious problems later.

If your child is showing these signs, it may be time to think about early orthodontic treatment:

• Early or late loss of baby teeth (your child should typically start losing teeth around age five or six, and will have all their permanent teeth in around age 12 to 13)
• Difficulty chewing and/or biting
• Mouth breathing
• Sucking his or her thumb
• Speech impediment
• Protruding teeth (the top teeth and the bottom teeth extend away from each other)
• Crowded front teeth
• Teeth that don't come together in a normal manner or even at all

Early intervention will greatly reduce the severity of your child’s case, and therefore reduce the length of treatment time and cost for a second phase of treatment when all of his or her permanent teeth have erupted. An evaluation at our Youngstown, OH office will determine if your child’s dental and skeletal growth is proceeding properly or if interceptive treatment is needed. Many times, a more severe problem can be corrected using sophisticated removable appliances instead of traditional orthodontic treatment.

To schedule a consultation for your child to visit with Dr. Anthony Bisconti, please give us a call! We will provide your child with an initial exam, and discuss with you the best steps to take toward caring for your child's smile.