Category: Braces & Retainers


Help, I lost my removable retainer! What now?

February 13th, 2019 by

Happy New Year! We hope you had a restful and enjoyable Xmas break. For our first post of 2019, we thought it’d be a good idea to address a question many of our patients ask: What happens if I lose my retainer?

Please remind me — why must I wear a retainer?

A retainer is an essential part of your treatment, and your orthodontist should have explained why. But, in case he/she didn’t, here’s the reason: Once your braces come off, like ‘the cat that came back,’ your teeth will tend to try to return to their original crooked positions. A retainer’s job is to ensure those teeth stay put and resist future time or growth-related change.

There are two types of removable retainers: One, which is most common, looks like a plate; the other, which adults usually wear, looks like an Invisalign ©.

Most people wear a retainer full time for six to 12 months and then cut down to wearing it only at night for six to 12 months. Ideally, though, to ensure your teeth remain perfectly straight, wearing a retainer should be a lifetime commitment — although usually just for a couple of nights a week.

Watch out for Fido

At Turner Lim Orthodontists, we hear all kinds of tales about retainers going AWAL. One of our patients, for example, lost a set on the Rangitoto Ferry — probably while having a quick ‘hurley.’ You may be surprised to learn, though, that a common reason for retainer disappearance is the family pooch — dogs love retainers! Why? Well, not because they, too, desire a perfect smile. No, rather they love their owners, and a retainer will have the wearer’s scent all over it. So, to cut a long story short, if you own a dog, keep your retainer beyond its reach.

So, what if I lose my retainer?

Anyway, if you’ve misplaced your retainer — or your dog ate it — it’s not the end of the world. There is a misconception that your teeth will hurriedly return to where they were before you started your orthodontic treatment. This is not the case. However, particularly if your orthodontist removed your braces recently (within two years), it is important to get a new retainer quickly, ideally within a week.

Should you eventually find your retainer, you may discover that it no longer fits that well, depending on for how long it was missing. In this case, your orthodontist can usually make adjustments.

Look after your retainer

If you bend a wire on your retainer, you can push your teeth out of line. So, like with braces, it’s important to take care of your retainer and check that the wire doesn’t become loose or distorted. Eating the wrong kind of food is a sure way to cause problems, so stay away from anything that is hard or sticky, like toffee or corn on the cob.

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3 nearly invisible dental braces that adults love

August 17th, 2018 by

These days, a growing number of adults wish to improve their teeth later in life. There could be a couple of reasons for this: orthodontics is more affordable and available than it once was, and baby boomers feel younger and want a look to match. One thing most adults are not too keen on, though, is visible braces

Yes, wearing braces can feel like being transported back to school. When you’re a teenager, they are a ‘badge of honour’ — a rite of passage. As an adult, though, they’re not so cool. After all, in the ‘grown-up’ world, we are, unfortunately, judged on our appearance. Looks are important — which, of course, is why you might be considering braces in the first place.

Well, we have some good news for you: If you want to get braces, there are less obtrusive options available, including lingual braces.

Lingual braces

Most dental braces fit on the outside of a patient’s teeth and are difficult to hide. Lingual braces, however, sit on the inside and are almost invisible, which makes them ideal for image-conscious adults.

Unfortunately, as many orthodontists are reluctant to fit lingual braces, they are not readily available. You see, compared to other types of braces, there is a bunch of stuff (like there being a smaller arc to work on) that makes fitting and maintaining lingual braces more mechanically tricky.

Anyway, in recent times — thanks to Alla, an old hand in the art, joining the team — Turner Lim has become more involved in lingual orthodontics.

Like many things in life, though, with lingual braces, as well as pros, there are a couple of cons to be aware of:

  • Mind your tongue. Because the braces are on the inside, they can affect tongue movement and take a bit of getting used to.
  • Your budget. Lingual braces are a premium product and, therefore, cost between 30% to 50% more than standard options.

Other discrete dental braces

Apart from lingual braces, there are two alternative non-obtrusive types to consider.

  • Invisalign®: With this system, there are no restrictions on what you can eat and drink. It consists of almost invisible computer simulation-generated templates (aligners), which are changed every 1 to 2 weeks. Your orthodontist will provide a new set at each check-up appointment (usually 8 to 10 weeks). For Invisalign®, the length of time between appointments is longer than many other treatments, which makes it easier to balance other commitments. Invisalign® isn’t effective for some bite issues — although advancements mean the bites types it isn’t suitable for continue to become fewer. In fact, for some bites, Invisalign® is the best option. For tricky work, and to make treatment as efficient, smooth and attractive as possible, we may first use a combination of fixed braces on the back teeth and Invisalign® on the front — there are so many options.”
  • Ceramic braces: Like standard types, ceramic braces have a small gate to hold an archwire in place and are not susceptible to the elastic ring changing colour with your latte or curry. Due to being made of a translucent material — some even come with tooth-coloured wires — ceramic braces are less visible than standard metal braces and even Invisalign®.

Read more about the different types of braces we offer.

We understand that aesthetics are particularly important for our adult patients, which is why we don’t charge adult patients extra for ceramic or Invisalign® braces. Also, with all ceramic and lingual treatments, we routinely use SureSmile on adults to achieve optimum results and treatment times.

So, there you have it: If you’re worried about what braces will look like, there are options available. If you enjoyed this post, please share.

Do you want a smile like Tom Cruise? It’s never too late

August 10th, 2016 by

If I say “Tom Cruise,” what first springs to mind? His flawless white teeth, perhaps? Well, if so, it may surprise you to learn that Thomas Cruise Mapother the Fourth (yes, that’s his real name) wasn’t born with a perfect smile. He saw an orthodontist.

Apparently, Mr Cruise’s teeth used to be pretty bad, and he was spotted wearing braces as recently as 2002. Actually, lots of ‘beautiful people’, including Nicholas Cage, Gwen Stefani and Faith Hill, have seen an orthodontist as adults in pursuit of that ‘perfect smile.’

So, where am I heading with this post? Well, you don’t have to be born with perfect teeth to make significant improvements.

A confident smile

Studies show that people are actually more likely to succeed in their personal and professional lives if they have good teeth. Why? Well, Tom Cruise knows it, you know it, I know it; we are judged by our looks.

As unfair as this may be, people make assumptions. That’s human nature. For example, if your lower teeth protrude, you may be perceived as aggressive; if there’s a gap between your top-front teeth, people may think you’re not too clever.

Of course, when it comes to success (or lack of it) it’s possible that self-perception plays a big part —when we project confidence, people are more likely to have confidence in us.

It’s never too late for braces

These days, if you want to improve your teeth, there’s not much stopping you. As celebrities, like Tom Cruise, show, orthodontic treatment isn’t reserved for teenagers. You’re never too old. At Turner Lim, we’ve treated patients in their 60s!

Teeth move over time

Some adults come to us with crooked teeth, despite having worn braces when they were younger. This may seem strange, but it’s understandable. Teeth move over time, and 20 – 30 years ago, many orthodontists didn’t instruct their patients to wear retainers post treatment — they didn’t think they were necessary. However, we now know that retainers prevent teeth from moving back to their original positions once braces have been removed.

Is treatment expensive?

Orthodontic treatment isn’t as expensive as you might think. Depending on your budget, there are several options available, and most orthodontists offer payment plans.

Braces can be discrete

Of course, as an adult, you’re probably concerned about how you will look with braces. The good news is that you needn’t look like ‘Metal Micky’. Modern braces are not as conspicuous as they used to be. Invisalign®, for example, uses aligners that are almost invisible, and ceramic braces are made of translucent material and use tooth-coloured wires.

In reality, an orthodontist may not be able to make your teeth quite as perfect as Tom Cruise’s. However, they can get pretty close.

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What if I don’t wear a retainer after my braces come off?

April 19th, 2016 by

In the past, once your dental braces were removed, that was it. Your treatment was over. We now know, however, that you still need to wear a retainer after orthodontic treatment.

What is a retainer?

Retainers are designed to hold teeth in place after braces are removed. They are usually made of wire, plastic or a combination of both.

Why do I need a retainer?

If you had orthodontic treatment 15 – 20 years ago, you may find your teeth have become crooked over time. Back then, your orthodontist probably didn’t tell you to wear a retainer.

Orthodontists have tried to figure out why teeth move and whether retainers can be avoided. Studies have looked at whether other things cause teeth to move, such as wisdom teeth and the removal of certain teeth. However, the cause is none of these things. The culprit, it seems, is age. Like our hair and skin, our teeth change over time. They wrinkle in their own way — they get crooked.

Read more about why you need to wear a retainer.

How do retainers work?

Braces straighten teeth by applying pressure. Like a tree bending in the breeze, they usually want to return to their original position once the pressure is gone — especially with young patients who are still growing. Retainers increase muscle memory and keep teeth in place.

How long should I wear a retainer?

The length of time you must wear a retainer depends on your situation. We usually recommend that patients wear retainers every day and night for 6 – 12 months. Afterwards, they can usually wear them at night only for 6 – 12 months. Ideally, a retainer should be worn for a lifetime, usually just one – two nights a week, though.

What if I don’t wear a retainer for a short time?

Research shows there is always a risk of your teeth moving after treatment. If you stop wearing your retainer for a short time soon after your braces are removed (when everything is soft and not settled in) you could experience movement. Also, if your treatment was for a serious condition (like severe crowding or severely crooked teeth) your teeth could also be susceptible to movement.

In summary, once your braces are removed, please wear a retainer — prevention is far better than a cure.

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What to expect during your first visit to an orthodontist

February 4th, 2015 by

So, you’re unhappy with your teeth. Maybe they are crooked or stick out.

The obvious solution, of course, is to see a specialist orthodontist. Despite this, your nervousness about what to expect might be holding you back.

In this post I explain what to expect during your first visit to an orthodontist. If you find this useful please share. I welcome your feedback.

When you arrive at the clinic, you will first meet a treatment coordinator. They are a contact person who will answer any questions you have, during or after your visit.

It is important we know a bit about you before we begin. So, your treatment coordinator will ask you to complete a questionnaire where you’ll be asked about your medical history and why you decided to come and see us.

X-ray

Usually, we’ll take an x-ray using an OPG x-ray machine that rotates around your head. This machine will show all the teeth in your mouth as well as any that are developing. At this point we sometimes take photographs of your face and teeth.

Then either me, Dr. Fiona Turner, or my colleague, Dr. Donna Lim, will examine you. This involves studying your whole face and how your teeth fit within it. Then, we’ll examine your teeth and bite in more detail. We also find out what you want to achieve from having orthodontic treatment. We aim to do our very best to meet your expectations.

Once the examination is complete, we’ll show you what’s happening in your mouth — either using a mirror to show inside your mouth or with photographs taken during your x-ray — and discuss treatment options.

Is the timing right?

Sometimes, even if you want to, we can’t begin treatment immediately — the timing must be right. For example, children sometimes have to wait for their teeth to grow. Or, a patient might have a condition like gum disease, which needs to be treated first. In a situation like this we refer them to a specialist. Everyone is unique in terms of the right timing for their orthodontic treatment.

Affordable orthodontic treatment

Our goal is to make orthodontic treatment achievable. So, if you decide to go ahead with orthodontic treatment, we will take you through a range of flexible, affordable payment options tailored to your situation.

I hope this post has shed some light on what it’s like to visit an orthodontist for the first time.

If you found this useful please share. I welcome your comments.

How does an orthodontist fit dental braces?

October 1st, 2014 by

If you’ve got crooked teeth, braces are an obvious solution. But have you ever wondered how they are fitted?

In this post I explain the steps an orthodontist takes to fit braces. If you find this useful please share and if you have any questions, please leave them in the comments section below.

The fitting of braces usually requires two separate appointments.

The first appointment: Fitting spacers

Your first appointment will be fairly brief and usually takes place about a week before your second appointment. Spacers will be fitted in between your back teeth. These create space for bands to be fitted around your molars during your second appointment. Expect your teeth to feel a little bit uncomfortable and tight with the spacers fitted. This is very normal! You also need to be careful not to dislodge them with your tongue or toothbrush or with sticky foods.

The second appointment: Braces on

At Turner Lim, we usually book the second appointment for late morning — when the clinic isn’t too busy. You will be with us for about an hour and a half, so I recommend you have a good morning tea beforehand and some mild pain relief, like Panadol, to ensure you are comfortable for the rest of the day.

Removing the spacers

The first step is to remove the spacers that were fitted during your first appointment. We will then give your teeth a good polish — even when clean, your teeth have a very thin coating that will prevent glue from setting on your braces.

Fitting the bands

The next step is to fit bands around your back molars. We will select a band that looks like it might fit (we have lots of sizes) and put it on the tooth. A special tool is used to fit the bands and we will ask you to help out by biting on, what’s known as, a “bite stick”. Fitting a band is a bit like fitting a shoe — we’ve got to find the right one.

The removal of the spacers and fitting of the bands is usually carried out by a skilled orthodontic auxiliary. As the orthodontist, I come in to make sure the bands are well fitted and make adjustments if necessary. I’ll then remove the bands from the molars and cement them back on.

Orthodontic bands and spacers

Fitting the brackets

Next, the brackets are fitted. These are the little square-shaped metal or ceramic buttons that are attached to the other teeth in your mouth.

Before they can be fitted, though, your mouth must be very dry. This is very important so that the braces stay on the teeth. So, to absorb saliva, we’ll apply small absorbent pads to the corners of your mouth and use a small vacuum. We’ll also fit a kind of lip guard into your mouth that holds your lips out of the way — you won’t thank us for this; you’ll look a bit like a hapuka fish, but at least your mouth will be nice and dry.

fitting the brackets

We then squirt a jelly onto your teeth. This stays on for about 30 seconds before it’s washed off and a primer is painted onto your teeth, which will ensure the brackets stick.

Next, we work methodically around your mouth applying the brackets. A blue light is used to cure the glue and make sure it sets.

Once we’ve fitted all the brackets, your mouth no longer needs to be kept dry. So, we’ll remove the pads and lip guard.

Fitting the wires

The final stage is to apply a flexible wire, known as an “archwire”, through the tubes on the bands and brackets. The wire is held in place with either coloured o-rings or little gates, depending on the kind of braces you have chosen. We start off with a thin, flexible wire. Later, when your teeth become lined up, it is replaced by a thicker wire. We then make sure the ends of the wires are turned away so they don’t catch on your cheek.

fitting of wires

Caring for your braces

It’s important that you understand how to properly care for your braces. So, once your braces are fitted, we take about 20 minutes to explain how to keep them clean, what foods to avoid and what to expect now your braces are fitted.

What do you think?

If you found this post useful please share. If you have any comments or questions, please leave them in the comments section.

Turner Lim Orthodontists: Luca’s Experience

August 17th, 2014 by

Turner Lim Orthodontists provide a broad range of orthodontic care. This post details the recent treatment of eight-year-old Luca De Biasio.

The problem

Luca visited Turner Lim with his mum, Eloise, after his school dental nurse noticed his six-year-old molars (the first adult molars a child develops at about six years of age) were growing off course.

Dr. Fiona Turner: “Luca’s six-year-old molars should have been growing behind his baby molars; instead, they were growing directly beneath. If left untreated, they would have eventually caused his baby molars to fall out prematurely. Because Luca’s six-year-old molars were too far forward, there would also be no room for his adult pre-molars to grow into his mouth.”

The treatment

To fix the problem, Dr. Turner says that Luca’s six-year-old molars needed to be pushed towards the rear of his mouth. To do this, she used a Halterman Appliance.

“With this appliance, ‘little wings’ are attached to the baby molar. Then an extension arm, much like a fishing rod, is attached to a little button on the six-year-old molar. This provides the necessary pressure to push the six-year-old molar back,” she says.

Halterman appliance

A picture showing how a Halterman Appliance is fitted

Working with kids

Dental or orthodontic treatment can be traumatic for anyone, let alone an eight-year-old boy. This is why Dr. Turner says it’s important to be open with patients. With Luca, she and her staff made a point of explaining to him what was happening as much as possible. “He needed to be comfortable with what was going on,” she says.

Luca’s mum, Eloise: “Luca is a bit of a ‘panicer’ and was quite nervous about the treatment. But they made him feel comfortable — everyone was very friendly and supportive. He was always happy to go to his appointments, even though it might hurt a bit.”

Because Luca was only eight years old, his mouth was small. So, the application of a Halterman Appliance was more complicated than if used on an adult.

Eloise: “There were two appliances fitted on his top and bottom jaw — they were quite massive.”

Eloise says that the appliance caused swelling to Luca’s cheek, so it needed to be adjusted several times.

“Turner Lim was very responsive. Whenever I phoned to make appointment, they were available straight away,” says Eloise. “Despite the extra appointments, the lump sum I paid at the beginning didn’t change.”

The result

Dr. Turner says that Luca’s treatment took about four months and his six-year-old molars are now in the correct position.
“Luca’s baby molars will now stay in his mouth for the appropriate amount of time, which is 11 to 12 years, and his adult teeth will develop normally,” says Dr. Turner.

Eloise: The clinic is modern and well designed — it’s a cheerful and happy place. Despite some discomfort, Luca was always happy to go to his appointments and was confident the treatment would work — and it did.

The pros and cons of four types of braces

May 29th, 2014 by

Do you need braces? If so, there are several options to choose from. In this post I describe four types of braces we offer at Turner Lim.

1: Metal braces

metal braces

When you think about braces, you’ll more than likely picture those made of metal — they are certainly the most common.

Metal braces are made from high-grade stainless steel and rubber bands are used to attach the wire. Thankfully, these days, metal braces are smaller, more comfortable and nicer looking than in days gone by.
Metal braces now use heat-activated archwires that use your body heat to move your teeth quicker and with less pain.

Pros: Metal braces are the least expensive. The o-rings also come in a variety of colours, which allow children to express their personalities.

Cons: They are the most noticeable of all types of braces.

2: Ceramic braces

creamic braces

Ceramic braces are popular with adults. This is because they are made of translucent material, which is less noticeable. Some come with tooth-coloured wires, which make them even more appealing.

Pros: They are less visible than metal braces and move teeth faster than clear plastic aligners (Invisalign).

Cons: They are also more expensive than metal braces.

3: Invisalign®

invisalign

Invisalign uses a series of 18 to 30 mouth-guard-like templates (called aligners). These templates are generated by computer simulation and can be removed every two weeks.

The Invisalign system is suitable for adults or teenagers with particular bite problems.

Pros: You can eat and drink what you want. The aligners are clear and almost invisible.

Cons: Invisalign is not effective for serious dental problems. It is a more expensive option and the aligners can get mislaid easily.

4: Self-ligating braces using the Damon System

Damon System

Traditional braces apply pressure by using o-rings to push your teeth into position. Damon braces, on the other hand, don’t use o-rings or metal-tie wires to hold the arch wires in place. Instead, they use a sliding mechanism. Though your teeth are still forced into position, they can move freely. As a result, you may experience less pain.

Pros: Compact and can be easier to clean. Though debatable, you’ll likely experience less pain.

Cons: They are expensive compared to other types of braces.

Don’t forget about a retainer

Once your braces come off, you still need to wear a retainer. If you don’t, all the progress you’ve made will be wasted as your teeth move out of alignment.

Please share if you found this post useful. If you have a question, please leave a comment or contact us.

What is SureSmile and why should you be interested?

April 11th, 2014 by

Have you heard about SureSmile? Actually, it is quite likely you haven’t because, despite the fact that orthodontists in the United States and Australia have been using it for a number of years, SureSmile is quite new to New Zealand.

Turner Lim Orthodontists was actually one of the first New Zealand orthodontic practices to adopt Suresmile technology — first in the North Island

Let me explain why …

What is SureSmile?

You could describe SureSmile as a reinvention of orthodontic treatment. For the patient, the benefits are significant. They include:

• fewer visits to the orthodontist
• less discomfort
• higher-quality results.

How does SureSmile work?

Using an OraScanner — a wand that works like a 3-D camera — your orthodontist takes pictures of your teeth. These are sent to a computer and a detailed 3-D model is constructed. Using this model, your orthodontist can see how your teeth fit together from any angle. And by using virtual tools, which come with SureSmile software, they can determine the final position of your teeth and the best plan for your treatment.

 

orascanner

The OraScanner taking 3-D images of a patient’s teeth.

Sometimes your treatment will start with a scan of your teeth using a Cone Beam Computer Tomagraphy (CBCT). A CBCT scan allows your orthodontist to see the position of your teeth as well as their roots.

Once a treatment plan is determined by your orthodontist, a robot bends a memory alloy archwire in accordance with your prescription. The archwire, once fitted to your teeth, then delivers gentle, consistent forces to move them directly to the desired position.

robot shaping archwire

Robot shaping archwire

To see how this works, view this video.

So, why is SureSmile better?

As I mentioned, there are three key benefits — fewer visits, less discomfort and higher-quality results. Let me explain these benefits in more detail …

Fewer visits to your orthodontist

SureSmile treatment is on average 29% faster than traditional treatment. This is due to the unprecedented precision made possible by the 3-D imaging and the use of a robot to bend the archwire. The archwire will push your teeth in multiple directions to exactly where your orthodontist prescribes — first time around.

So, this means the need for manual adjustments is reduced considerably and your treatment is completed much faster.

Less discomfort

If you know someone who’s worn traditional braces, the chances are they’d say they weren’t very comfortable.

With SureSmile, the system is engineered to maximise the efficiency of each wire — each wire provides smoother movement for a more comfortable experience.  Also, due to the precision of the technology, you don’t have to experience so many uncomfortable adjustments in the orthodontist’s chair.

Higher-quality results

With traditional braces, your orthodontist adjusts the wires manually. As already mentioned, SureSmile wire is adjusted to your prescription by a robot — to a level of precision that no human can match. And when the wires are put in place, each tooth moves directly to the prescribed position. It is this precise movement that produces superior results.

So, I hope this post explains why SureSmile is so good. If you found this useful please share. If you have any questions, please leave a comment or contact us.

Why do I have to wear a retainer?

March 2nd, 2014 by

If you’re about to have your braces removed, no doubt you’ll be pretty happy. After all, they’ve probably been an unwelcome resident of your mouth for months, maybe years. Well, don’t get too carried away — your treatment isn’t over yet. You’ll still need to wear a retainer.

Retainer

It’s important to wear a retainer after your braces are removed.

Why wear a retainer?

Your orthodontist has probably spoken to you about retainers. But if not, let me explain.
In days gone by, once your braces were removed, that was it. However, we now know that retainers are important for keeping your teeth in position.

You see, braces work by applying pressure on your teeth to make them straight. However, when your braces are removed, your teeth still have an inclination to move make to their original crooked positions — it takes time for your mouth to adapt.

Wearing a retainer is a crucial part of your treatment. If your orthodontist tells you to wear one, do it — if you don’t, your teeth will move out of alignment and all the hard work that you and your orthodontist has achieved will be wasted.

How long should I wear a retainer?

Unfortunately, the answer to this question isn’t straight forward — it depends on your situation. When your braces are removed, your orthodontist will make an assessment of your smile, teeth and bone structure. Normally a patient wears a retainer day and night for 6 to12 months. Then, they are usually able to cut down to just wearing it at night for 6 to 12 months.

Without wanting to scare you, ideally, wearing a retainer should be a life-long commitment. However, this may mean just wearing it 1 to 2 nights per week, long term.

Different kinds of retainers

There are three kinds of retainers:

1. Metal retainers (bonded retainers) — these are thin strips of metal going across your teeth and are glued to your teeth with dental resin. These are usually worn long-term.

2. Plates — impressions are made of your teeth. This involves your orthodontist filling a tray with a putty-like substance and placing a tray into your mouth and over your top teeth. These are then used to make a special individual plate that fits only you.

3. Clear trays — once the impressions have been made, clear retainers will be made for you — one for your top teeth and one for your bottom teeth. If you are a habitual tooth grinder, clear retainers are good for protecting the surface of your teeth.

Your orthodontist will work out which retainer(s) is best for you after your braces have been removed.

How do I look after my retainer?

Your mouth is home to bacteria, plaque and left over bits of food. So, you should clean your retainer daily. However, not all retainers are cleaned the same way (there are some retainers that you shouldn’t clean with toothpaste, for example), so ask your orthodontist about what’s best for you.

If you found this post useful please share. Also, if you have any questions about retainers, please leave a comment.