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Orthodontists do everything they can to save teeth, but sometimes, a tooth is so damaged by accident, injury, infection, or decay that extraction is the only option. Or perhaps your child’s wisdom teeth are starting to come in—and starting to cause problems. Or, when this is the healthiest alternative, an extraction might be necessary for orthodontic reasons.

While there are several possible reasons an extraction might be necessary, one thing is true for any extraction: you want to make sure that your child is as comfortable as possible and heals as quickly as possible after the procedure.

Aftercare and recovery time isn’t exactly the same for every extraction. Whether your child’s tooth is a baby tooth or a permanent one, whether it’s a single tooth or several, whether it’s erupted or impacted, whether a local anesthetic or sedation is recommended—these factors and more can make a difference in recovery time.

Dr. Daniel Ma will provide you with clear, specific instructions for helping your child to a speedy recovery after an extraction. We’d also like to offer you some general aftercare ideas to make sure your child is as comfortable as possible while recovering.

• Bleeding

Some bleeding is normal after an extraction. Follow your dentist or oral surgeon’s instructions carefully to minimize bleeding at the extraction site. Your child will probably need to keep a gauze pack in place for as long as directed to reduce bleeding and to help a clot form. If bleeding is heavier than expected or goes on longer than expected, call our Vancouver, BC office.

• Swelling

Swelling is a normal response to extractions. Your dentist might suggest cold compresses to help reduce swelling immediately after the extraction. If you don’t have an ice pack, ask whether a bag of frozen peas or corn can substitute.

With any cold compress, it’s important to protect your child’s skin from injury. Follow your dentist’s suggestions for application and be sure not to exceed the time limits recommended. And don’t apply a compress directly to your child’s face—wrap a towel or cloth around the bag or pack to protect the skin.

• Careful Cleaning

The area around the extraction shouldn’t be disturbed or touched. The blood clot that forms after an extraction protects the area from irritation and infection caused by food particles and bacteria. If a clot is dislodged accidentally, it can lead to a condition called dry socket, which can be very painful.

This means no brushing near the extraction site, and no heavy rinsing or spitting for as long as directed. If your child is younger, you might need to help with brushing over the days following to make sure those sturdy bristles don’t get close to the extraction site before it’s healed.

• Soothing Foods

Have a supply of your child’s favorite comfort foods handy while healing, such as cream soups, mashed potatoes, scrambled eggs, gelatin, yogurt, and smoothies. Hot and cold foods can be irritating, so stick to cool or lukewarm foods for the first few days. Encourage your child to drink lots of liquids, but nothing carbonated. And do wait until any numbness wears off before giving your child chewable foods to avoid biting tongue or cheeks.

Remove spicy favorites from the menu, which can be irritating, as well as chewy, crunchy, or jagged foods like crackers, since tiny, sharp bits of food can make their way inside the site. Remind your child to chew on the side of the mouth opposite from the extraction site. And, since suction is an all-too-easy way to dislodge the clot over the extraction site, no straws!

• Schedule Recovery Time

Make sure your child rests and takes it easy after the procedure. Exercise, lifting, even bending over can dislodge a protective clot, so re-schedule any physically demanding sports and activities until your child is given the dental all clear.

• Medication

If your child has been given a prescription for pain medication or antibiotics, follow the instructions as directed. Dr. Daniel Ma might recommend age-appropriate over the counter pain relievers to have on hand. For severe or continuing pain, call your orthodontist or oral surgeon right away.

• Coordinate Dental Schedules

Orthodontic extractions, if needed, will be scheduled into your child’s orthodontic treatment plan. Treatment can begin or resume when the extraction site has healed.

If an emergency extraction is necessary, call our Vancouver, BC office so we can be aware of the situation and can coordinate with your child’s dentist or oral surgeon to keep treatment on track as much as possible.

An extraction can be worrying for both patient and parent, so talk to your orthodontist for the best ways to make this experience a positive one for your child before, during, and after treatment.

You have a lot going on. School. Sports. Activities. Family. Friends. Teens lead busy lives and have busy schedules, so you need to budget your time and energy. One thing you don’t want to spend any of your time and energy on? Dealing with gum disease.

Gum disease most often begins as a reaction to plaque and tartar. The bacteria in plaque produce acids which irritate gum tissue, causing inflammation, swelling, and bleeding. This is gingivitis, the early stage of gum disease.

Left untreated, early gum disease can become periodontitis. Periodontitis is a serious gum infection which can cause receding gums, loose teeth, and even tooth and bone loss.

We usually think about gum disease as something that only older adults worry about. But the unfortunate fact is that children and teens are also at risk for gum disease—and the teen years bring special risks. Why?

• Braces

The teen years are the most common years for orthodontic treatment. Wearing traditional or lingual braces can make removing plaque from around brackets and wires, between the teeth, and near the gum line more challenging, and gum disease can be the result. When you’ve been working so hard to create a healthy attractive smile, you don’t want to delay your orthodontic progress to treat gum disease.

• Less-than-Nutritious Snacking

When you have after school commitments like sports practices, play rehearsals, or work, you probably carry a snack to give you the energy you need until dinner. Popular snacks like energy drinks, chips, or candy bars are common go-to choices, but they contain acids, simple carbs, and sugars which are bad for both gums and tooth enamel.

• Hormones

Increased hormone levels during puberty can make the gums more sensitive and more easily irritated.

• Your Busy Life

Maybe you’re not getting enough sleep. Or eating as well as you could. Or you’re feeling anxious. Lack of sleep, poor nutrition, and stress can affect your body’s immune system and your ability to fight off infection. And if you’re also not brushing and flossing regularly, your gum health can really suffer.

How do you know if you have gum disease? Good question! Sometimes the early stages of gum disease aren’t obvious. Perhaps you’ve noticed changes in your gums, such as:

• Redness
• Swelling
• Soreness
• Bleeding
• Bad breath even after brushing

Any of these changes can be symptoms of gum disease and are a good reason to give our Vancouver, BC office a call, since time is important when treating gum disease.

Caught early, gingivitis is usually very treatable—in fact, you can often reverse early gingivitis by paying more attention to your daily dental hygiene. If gingivitis is more advanced, or if periodontitis develops, you need professional dental care to prevent serious damage to your gums, teeth, and bone.

Preventing gum disease from ever developing is always best, though, so let’s look at what you can do to keep gum disease from becoming a problem.

• Keep Up with Healthy Dental Habits

Even though you’re leading a busy life, take time for your dental care. Brushing twice a day for at least two minutes per session and flossing once a day take just a bit of your time and are the best way to keep your gums healthy. If you wear braces or have a tendency toward cavities and gum disease, Dr. Daniel Ma might recommend brushing or flossing more often.

• Use the Right Tools

Using the right tools makes a big difference. You should always choose a toothbrush with soft bristles to protect your delicate gum tissue—especially if it’s extra sensitive. Too-harsh brushing can damage even your super-hard tooth enamel, so you can imagine what it can do to your gums! Change out your brush every three to four months when it starts to get frayed and worn.

If you wear braces, ask Dr. Daniel Ma to recommend the best kind of floss to clean between your teeth and around your brackets and wires. The right tools will make flossing a lot easier, and will help you keep your gums healthy and your orthodontic treatment on track.

• No Matter How Busy You Are, Treat Yourself Well

Watch your diet. Drinking water to hydrate is a healthy (and inexpensive) alternative to sugary and acidic drinks. When you know you have after-school commitments, pack yourself a healthy snack. After snacking, it’s a good idea to rinse with water when you can’t brush to remove any food particles sticking around your teeth and gums.

And even though your schedule is demanding, caring for your mind and body should be a priority. If you have difficulties with sleep or stress, or questions about a nutritious diet, talk to your doctor for some valuable tips to make your daily life healthier and more enjoyable.

With so much going on in your active life, gum problems are problems you really don’t need. Make room in your schedule now for careful daily brushing and flossing, a healthy lifestyle, and regular visits to our office, and you’ll be living that active life with a beautiful, healthy smile!

Not many people look forward to going to the dentist, especially if you already know that you need dental work done. A small amount of anxiety is one thing, but dental phobia, or odontophobia, is something else entirely. It is an irrational fear of going to the dentist. If you have it, you might be unable to force yourself to go to the dentist, even if you are suffering from bad tooth pain. The effects of dental phobia can be serious, but there are ways to overcome your fear of the dentist to help you achieve and maintain good oral health.

Causes of Dental Phobia

You can develop dental phobia for a variety of reasons, including the following.

• Fear of pain, which you might acquire based on others’ horror stories of their trips to the dentist.
• Fear of needles, such as those used to provide anesthesia.
• A previous bad experience, when something went wrong and pain was intolerable.
• Lack of control from not knowing what is happening or how uncomfortable a procedure might be.

Consequences of Dental Phobia

Avoiding the dentist can have long-term consequences. When caught early, tooth decay is easily stopped with a minor filling. If you let the decay go, you can end up losing your tooth and have chronic pain. A dentist can also check for early signs of gum disease, which, if left untreated, could lead to losing one or more teeth.

Even if you do not have a particular problem, going to a dentist for regular cleanings is a good idea because the hygienist can point out where you need to brush better and remove the plaque from your teeth.

Getting Over Fear of the Dentist

Most patients with dental phobia can get over their condition. These are some approaches that Dr. Daniel Ma and our team recommend:

• Explain each step of the process
• Let you know that you can stop the procedure at any time
• Encourage you to come with a family member or friend
• Help you with deep breathing techniques

Maybe you’ve known people with braces and aligners—maybe you’ve worn them yourself!—so if braces or aligners are in your teen’s future, you have some idea what to expect and when to expect it.

But quite often, orthodontic issues require more treatment than braces alone can provide. When misalignment affects not only the teeth but the jaw as well, treatment can be more effective when it begins earlier and makes use of a different kind of appliance—the “functional appliance.”

During the years your child’s bones are still rapidly growing and forming, around the ages of eight to 14, functional appliances can help guide tooth movement and encourage jaw growth and development. One of the most widely used of these devices is the Herbst® appliance.

What does the Herbst appliance do?

There are several types of malocclusions, or “bad bites” treated by Dr. Daniel Ma. A common condition called a Class II malocclusion occurs when the upper jaw and teeth project too far forward over the lower jaw and teeth. Signs of a Class II malocclusion might include an overjet (protruding upper teeth), and/or a small or recessive lower jaw.

While correcting this malocclusion often enhances facial symmetry, which can be very important for a child’s confidence, correcting a Class II malocclusion also promotes jaw and dental health. Misaligned teeth are more difficult to clean, which can lead to decay and gum disease. Bite problems can cause persistent jaw pain and damage to the teeth. And, with an overjet, a child’s upper teeth are more at risk for injury.

The Herbst appliance was developed to treat this kind of malocclusion. It moves the lower jaw and teeth forward to create a balanced, healthy smile.

How does the Herbst appliance work?

The Herbst appliance is fixed in place with stainless steel bands or crowns that are secured to four teeth in the rear of the mouth, often the first molars on each side of the upper and lower jaws. The band or crown on each lower tooth is equipped with a small bar that extends toward the front of the mouth.

An arm on each side links the bands or crowns on the upper teeth to the front of the bar assemblies on the lower teeth. Each arm consists of a rod that fits smoothly into a tube. The telescoping action of the rod and tube allows the mouth to open and close normally. When the mouth is closed, the arms on both sides telescope shut, forming compact cylinders that hold the jaw forward.

While a child’s bones are still growing, the lower jaw’s new forward position can stimulate further bone growth and remodeling to maintain the jaw in that forward position. The Herbst appliance also has a restraining effect on the forward movement of the upper jaw. The result is a steady, noticeable improvement in the relationship between the upper teeth and jaw and the lower teeth and jaw.

Is the Herbst appliance hard to take care of?

The Herbst appliance is fairly low maintenance, but, like any orthodontic gear, it should be treated with care.

• It’s important to watch your child’s diet, because sticky, crunchy, and chewy foods can damage the appliance. Save the caramels for a post-treatment celebration!
• Carefully cleaning around the appliance is necessary, because a buildup of bacteria and plaque leads to consequences like bad breath, gum disease, and tooth decay. A water flosser can make reaching and cleaning tight spots easier if a brush alone isn’t effective.
• If the Herbst appliance is damaged, some minor fixes might be doable at home with instructions from your treatment team. But if a band or crown comes loose, or if there’s a problem you’re unfamiliar with, call our Vancouver, BC office right away.
• To help avoid the need for minor (or major) fixes, playing with the appliance with fingers or tongue, nibbling on pens and pencils, chewing on ice, or any other risky habits should be strictly off limits.

When it comes to your child’s health, you always have high expectations. Dr. Daniel Ma and our team have all the answers you’ll need about what to expect from this phase of your child’s orthodontic treatment, and just why the Herbst appliance is the very best option to create a future of attractive, healthy smiles.