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Midline Misalignment

February 15th, 2023

By and large, the human body is a marvel of symmetry. But, of course, no one is perfect. You might have noticed one ear is a bit higher than the other. That you wear a shoe a half-size bigger on your left foot. That one shirtsleeve always looks longer.

Or that your smile looks off-center. This dental asymmetry could be caused by a condition known as “midline misalignment,” and, unlike that left foot, you can do something about it!

The dividing line between our center teeth, upper and lower, is called the midline. If we draw an imaginary line down the middle of a face, from the forehead to the nose to the midpoint of the chin, that line should go right between the front teeth. When it doesn’t, because the teeth have shifted past the midpoint, it’s often due to a condition called midline misalignment.

This kind of misalignment, also known as a deviated midline, can have several causes:

  • Baby teeth that are lost too early

Baby teeth do more than promote healthy eating and speech development. They also reserve space for permanent teeth. If a primary tooth is lost too early, permanent teeth might “drift” to fill the empty space, causing the midline to move as well.

  • Thumb sucking that goes on too long

As a child gets older, and certainly when by the time permanent teeth start to arrive, aggressive thumb sucking can lead to numerous orthodontic problems, including a deviated midline, as the teeth shift in response to that continuous pressure.

  • Missing adult teeth

When you lose a tooth through decay or trauma, or when an adult tooth simply never develops, the remaining teeth can shift over to fill the open spot.

  • Spacing issues

Crowded teeth, teeth with significant gaps between them, very large teeth, very small teeth—all of these issues can affect spacing and midline alignment.

  • Crossbite

A crossbite is a kind of malocclusion, or bite problem. When you have a crossbite, the teeth don’t fit together properly, with upper teeth fitting inside lower teeth, instead of aligning on the outside where they belong. A deviated midline can indicate a posterior crossbite, where the top back teeth slant inwards or fit inside the bottom back teeth.

A tiny bit of midline shift one way or the other might be nothing to worry about, but if one front tooth is literally the center of attention, or if your teeth are noticeably out of alignment, it’s a good idea to talk to our Vancouver, BC orthodontic team.

Because there are several potential causes for midline misalignment, Dr. Daniel Ma will carefully analyze your individual situation to determine where the problem lies: with the teeth, the bite, or, rarely, the jaw itself.

Dr. Daniel Ma will also offer you your best dental treatment options. A shift of a few millimeters might be treated with clear aligners or traditional braces. A crossbite could require braces or aligners coupled with elastics (rubber bands) to bring your bite into alignment. A palatal expander can help correct a serious crossbite.

Why visit our office because of a little asymmetry? Because a deviated midline is more than a cosmetic concern. If you have a malocclusion to begin with, or if your misalignment leads to changes in chewing habits, which cause new bite problems, you might be facing jaw pain, chipped and cracked teeth, headaches, and all the other unpleasant consequences of malocclusion.

By and large, perfect symmetry in life is unattainable. But if you want a smile that is well-balanced and healthy, talk to us about all the treatments available to make sure your smile—and not a single tooth—is the center of attention.

Valentine Candy: Is It 4 U?

February 8th, 2023

It’s Valentine’s Day. Love and friendship are in the air, and candy is on the gift list. Are there tasty Valentine treats that are safe to eat even with your braces? We have some sweet news for you!

Safe Valentine candy, like the rest of your braces-friendly diet, won’t stick to your braces (potentially causing cavities) or damage them (potentially causing emergency visits to the orthodontist). In other words, foods that aren’t sticky, chewy, hard, or crunchy.

So, which candy treats are on the “Loves Me Not” list?

  • Chewy Candies

Love heart-shaped gummies? Or spicy cinnamon jellies? Or Valentine-pink taffy? These sweet confections might be delicious, but, no matter how delicious, all that sugar sticking to your brackets and wires is not healthy for your teeth and it’s especially hard to brush off. And the chewy nature of these treats can break wires and pull brackets loose from your enamel.

  • Hard Valentine Candies

Do U luv these? R they UR favorites? Whether or not they come in the shape of colorful hearts with clever stamped messages, as crunchy nuts surrounded by chocolate, or as gleaming red hearts on a lollipop stick, hard candies R not 4 U when you wear braces. Biting down on hard foods can damage wires and loosen brackets.

  • Boxes of Assorted Chocolates

The beauty of a heart-shaped box filled with chocolates is its variety. The problem with a heart-shaped box filled with chocolates is its variety. Any pieces with nuts, toffee, or caramel should be left in their little paper cups. Sticky, chewy, and crunchy foods are some of the worst offenders when it comes to damaging your braces. If your candy doesn’t come with descriptions, break open the piece before you indulge to see just what you’re biting into.

Is this list a bit depressing? Take heart! There are several Valentine’s options that are safe for your braces.

  • Soft Chocolates

Any kind of soft chocolate should leave your braces intact—and if you choose dark chocolate, you’ll be enjoying less sugar and more minerals and antioxidants.

  • Chocolate-Covered Peanut Butter Candies

These treats are also soft enough to be harmless to your brackets and wires. And if they’re molded into hearts? Bonus!

  • Boxes of Assorted Candies

The problem with a heart-shaped box filled with chocolates is its variety. The beauty of a heart-shaped box filled with chocolates is its variety. Nestled among all the sticky, chewy, and crunchy chocolates are the safer soft cream centers. Choose the braces-friendly options and share the rest.

Whether you’re buying a candy gift for someone in braces, or you’re the lucky giftee, choose candies that will make Valentine’s Day memorable for all the right reasons! Don’t be afraid to think out of the (heart-shaped) box—pink milkshakes or smoothies, sweetly decorated cupcakes, and creamy pastel ice creams and frozen yogurts are soft, smooth, and safe holiday treats.

Of course, after indulging in any Valentine treat, be sure to clean your teeth and braces carefully. Cavities are never fun, and especially not when you’re in braces. Brush and floss after eating, and make sure your brackets and wires are clear of any sticky, sugary souvenirs. If you do have a problem with damaged wires or brackets, be sure to call our Vancouver, BC office right away to keep your treatment plan on track. Valentine’s Day comes once a year, but your beautiful, healthy smile? You want it to last 4ever!

Double Duty

January 25th, 2023

If you play a contact sport, you know about mouthguards. You know about the cushioning protection they provide for your teeth. And not just your teeth—mouthguards also help protect your lips, tongue, and jaw, helping you avoid or minimize many of the injuries caused by collisions.

But you don’t have to be part of the defensive line or face off on center ice to wear a mouthguard. It pays to be proactive with your oral health in any activity where impact is a possibility. Whether you play a team sport, practice gymnastics, ride a bike, ski, skateboard, or participate in other athletic pastimes, there’s almost always the risk of impact—with a ball, with the mat, with the sidewalk, with another person.

So, how do mouthguards protect your teeth and mouth? It’s a combination of materials and design. Mouthguards are made of a strong, cushioning material such as plastic or silicone which helps absorb and distribute the force of impact, usually in the form of a horseshoe-shaped piece which fits over your upper teeth. The specific design can be tailored to the sport or activity you’ll be using it for.

And now that you’re wearing braces? Working toward an attractive, healthy smile doesn’t mean you can’t be active or find a mouthguard which will work for you. In fact, when you wear braces, mouthguards do double duty—they protect your mouth and teeth, and they protect your braces, too!

Even minor impacts can damage wires and brackets, and damaged braces means more time at the orthodontist and lost treatment time. More important, your guard not only helps protect your brackets and wires from impact injury, it protects your delicate mouth tissue from trauma caused by impact with your brackets and wires.

Because you probably have braces on both upper and lower teeth, the usual mouthguard design might not work for you. To make sure you’re completely protected, you may need a guard which covers both upper and lower arches.

There are over-the-counter mouth guards designed for braces, and even for covering both your upper and lower teeth. These might be one-size-fits-all or fit-it-yourself guards, or models which should be used only after a fitting at our Vancouver, BC orthodontic office. While some of these guards are better than others, the best option for your teeth—and your braces—might be a custom mouthguard.

What are the benefits of a custom guard for orthodontic patients? They:

  • Provide a perfect fit around teeth and braces
  • Protect better because they fit better
  • Are designed for easy breathing and speaking
  • Are less bulky
  • Are more durable
  • Fit more comfortably
  • Can accommodate orthodontic adjustments
  • Can be tailored to your specific sport or activity.

Custom mouthguards are more expensive, because they are individually crafted for your teeth and braces, but in terms of effectiveness, they are the best guards out there—because they are individually crafted for your teeth and braces. If cost is an issue, Dr. Daniel Ma can let you know whether an over-the-counter option might work for you.

An active life should mean proactive dental care. Wearing a mouthguard when you’re wearing braces protects both your body and your orthodontics. Whichever guard option you choose, it’s a good idea to check out the fit with Dr. Daniel Ma to make sure you’re getting all the protection you need for both when your mouthguard is doing double duty.

Overbite or Overjet?

January 18th, 2023

The words “overbite” and “overjet” certainly sound similar. Both conditions concern your front teeth. Both conditions fall under the same category of bite problems—Class II malocclusions, if you want to be technical. So it’s not surprising that they’re often used interchangeably. But while there are similarities, overbite and overjet are also distinctly different.

  • Overbite/Overjet Geometry

In a healthy bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth. The key word here is “slightly.” With a Class II malocclusion, the upper front teeth project further beyond the lower teeth than they should.

Of course, teeth and bites are as individual as we are, so there are variations in just how and just how much the overlap occurs. In diagnosing an overbite vs. an overjet, the difference comes down to a matter of vertical vs. horizontal.

An overbite, or deep bite, occurs when the top teeth vertically overlap the bottom teeth more than they should for a healthy bite. Generally, when a person’s top teeth cover more than a quarter of the bottom teeth when biting down, or more than two to three millimeters, that person is said to have an overbite.

An overjet, commonly known as protruding or buck teeth, is the result of a horizontal overlap that is broader than normal. This causes the top teeth to project outward toward the lips more than they do in a typical bite. An overjet is usually diagnosed when the horizontal distance between the top and bottom teeth exceeds two to three millimeters.

  • Overbite/Overjet Causes

The causes for both an overbite and an overjet might be dental (caused by tooth alignment), or skeletal (caused by bone development), or a combination of both. These bite problems can run in families. They are also affected by the size and position of the jaws and the shape and position of the teeth.

Early oral habits, such as prolonged and vigorous thumb-sucking or pacifier use, can also contribute to the development of a Class II malocclusion, particularly an overjet. Consistent pressure from thump or pacifier pushes the teeth outward as they erupt, which encourages them to protrude. These oral habits can affect the shape of the palate and jaw, too.

  • Overbite/Overjet Treatments

There are many types of treatment available to correct teeth and bite misalignments. Dr. Daniel Ma will tailor your treatment to your specific malocclusion for the best orthodontic outcome.

If you have a mild malocclusion, and minor dental issues are the main cause of that malocclusion, either braces or clear aligners can be effective for an overjet or an overbite. Elastics (rubber bands) are often used as part of this treatment.

If the malocclusion is due to bite problems caused by uneven upper and lower jaw development, devices called functional appliances can be used with braces to help guide the growth of the jawbones while young patients’ bones are still forming. These include appliances that work inside the mouth to help the upper and lower jaws grow proportionally, and external appliances such as headgear.

In some cases, where the malocclusion is skeletal in nature as well as dental, surgical treatment might be necessary to reshape the jawbone itself. Orthodontic treatment is usually needed as well both before and after surgery.

  • Overbite/Overjet Consequences

Over time, a deep overbite can cause damaged gum tissue, worn enamel, and fractured teeth. When teeth protrude because of an overjet, they can lead to self-consciousness and are more at risk for injury. Both malocclusions share dental and medical consequences, including concerns about facial and jaw appearance, problems speaking or chewing, headaches, and face and jaw pain.

Class II malocclusions aren’t all the same, and orthodontic patients aren’t all the same either. You may have a minor malocclusion or a significant one. You may have an overbite, or an overjet, or a combination of different bite and alignment concerns. Your malocclusion may not bother you at all, or it may cause pain, discomfort, or self-consciousness.

That’s why every overbite or overjet should be evaluated by an orthodontist. When you visit our Vancouver, BC orthodontic office, Dr. Daniel Ma will be able to diagnose the exact nature of your malocclusion, the reason for it, and your best individualized treatment plan. An overbite and an overjet are different malocclusions, but you and your orthodontist want the same outcome for each: a healthy, attractive, and confident smile!

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