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You’ve decided—now’s the time to talk to Dr. Donald Neely about straighter teeth and a better bite. So what’s holding you back? If you are concerned because you have a missing tooth, don’t let that stop you from making that first appointment. Orthodontists today have many options to help you achieve the benefits of a more attractive, and even healthier, smile.

How can we accommodate a patient with a missing tooth or teeth? Because each patient is different, our approach will be tailored to your specific needs.

A Lost or Missing Permanent Tooth

There are a number of treatment options available, depending on the position of your other teeth.

• If your teeth are already crowded, it might be possible to close a small gap left by a missing tooth with braces.
• If the space between your teeth is the perfect size for a replacement tooth, your orthodontic appliance will keep that spot open as your braces move the rest of the teeth into alignment.
• If you need more space for a replacement tooth, braces can help widen the space between your surrounding teeth for an ideal fit.

Tooth loss can occur for a number of reasons. Accidents, decay, and gum disease can lead to tooth loss.  Congenitally missing teeth, teeth that simple never developed, are also a fairly common condition. But missing teeth are not merely a cosmetic issue, and should not be ignored. A gap in your smile can lead to shifting of the teeth around it, bite problems, difficulty chewing, and gradual loss of bone tissue beneath the missing tooth.

Today’s implants are a permanent, natural-looking replacement for a lost tooth. If you decide that an implant is your best option for tooth replacement, you are still a candidate for orthodontic treatment. Dr. Donald Neely and your oral surgeon can decide on a schedule that will provide the best timing for each phase of your treatment.

A Lost Baby Tooth

Finally, let’s not forget younger patients. Sometimes children benefit from orthodontic care before all of their adult teeth have erupted. If your child has lost a baby tooth too early, a space maintainer can be used to prevent shifting and misalignment of the remaining baby teeth and leave room for the adult tooth to erupt in its proper spot.

We recommend that your child have a first orthodontic assessment around age seven, but if your child has lost a primary tooth before its time, give our Hanover, NH office a call. We can let you know if a space maintainer is the best way to prevent future dental and orthodontic problems.

If you have concerns about a missing tooth or teeth, talk to us! Orthodontic treatment is always custom-designed to fit the needs of each individual patient. We can discuss your specific goals, and how orthodontic treatment can help you achieve them. There is no reason to let a missing tooth keep you from a more attractive, healthier smile!

Gum disease is one of our most common dental diseases, affecting both children and adults. If you are considering getting braces or aligners, make sure your gums are their healthiest before beginning orthodontic treatment.

• Gingivitis

For both younger and older patients, gingivitis (mild gum disease) can be the result of poor brushing and flossing habits. When plaque builds up around the teeth and gums, it irritates delicate gum tissue. The gums become inflamed, and symptoms such as redness, swelling, tenderness, bleeding, and bad breath can result. Usually, your dentist can treat early stages of gingivitis with tips on more efficient brushing and flossing, a professional cleaning, and suggestions for mouth rinses if needed.

Because brushing and flossing with braces can be more difficult, you need to devote special attention to your cleaning routine to prevent gingivitis from developing after you start treatment. Talk to us any time about how to brush and floss most effectively when you wear braces. Dr. Donald Neely can also recommend tools designed especially for braces wearers to get your teeth and gums as clean and plaque-free as possible. If you are a candidate for clear aligners, this option can make it easier to keep your teeth their cleanest. We’ll work with you to keep your gums healthy as your orthodontic work takes place.

• Periodontitis

For older patients, gingivitis, left untreated, can eventually lead to periodontitis (severe gum disease). This chronic infection can lead to the formation of pockets between your gums and teeth that become home to bacteria and infection. Over time, periodontitis can lead to the destruction of gum, ligament, and bone tissue. Left untreated, it can lead to loose teeth and even bone and tooth loss.

Making sure you schedule regular dental exams will allow your dentist or periodontist to detect and treat any signs of periodontitis as early as possible. If you have any of the symptoms of gum disease, it’s important to treat the cause of these symptoms as soon as possible to protect your gums, bone, and teeth. Deep cleaning procedures such as scaling and root planing, topical and oral antibiotics, and oral surgeries such as flap surgery or bone and tissue grafting can help reverse the effects of periodontitis.

Because orthodontic treatment involves moving the teeth and re-forming the ligament and bone tissue, which hold them in place, you need healthy periodontal ligaments and bones to begin treatment. If you have suffered shifting teeth or bone loss due to periodontitis, talk to us. We will let you know at your visit to our Hanover, NH office if you are a good candidate for orthodontic work, and which type of appliance is best for your periodontal health.

We are happy to talk to you about the best way to achieve an attractive smile and a healthy bite if gum disease has been a problem in the past. Most important, we want to make sure that your teeth and gums are their healthiest even before you begin orthodontic treatment. Preventing and treating gum disease will provide the foundation you need for a lifetime of beautiful smiles.

Your trusty manual toothbrush has been with you from pre-school through high school—well, obviously not the same manual toothbrush, because that would be seriously unhygienic—but it’s the kind of toothbrush you’re used to and comfortable with.

Now, though, you’re off to college, and your lifestyle will be changing. Late night study sessions complete with study session snacks. Getting caught up in a project and making dinner from dorm vending machines. Grabbing fast food on the way to the practice field, or work-study job, or evening class. You get the point—meals can be hectic, unscheduled, and less than tooth friendly.

And if you’re wearing braces or aligners, you know you need to keep on top of brushing more than ever. It’s challenging to brush away cavity-causing plaque when it sticks around brackets and wires. And with aligners, teeth don’t benefit as much from the constant cleansing action of saliva, so it’s really important to brush away plaque and food particles before you replace the aligners after eating.

Maybe it’s time to consider an electric toothbrush. After all, anything that can make your life easier and more efficient during busy college days deserves a spot in your dorm room.

• Electric Brushes Are Effective

The most important reason to switch to an electric toothbrush is its effectiveness. Several studies have shown that regular use of an electric toothbrush leads to a marked reduction in plaque, that bacteria-filled film which sticks to the teeth and leads to cavities and gingivitis. And it’s really no surprise that an electric brush can out-perform a manual brush.

Electric toothbrushes offer several design options, from oscillating/rotating brushes to oscillating/rotating/pulsating models to brushes using sonic vibration technology. What these technologies all have in common is the ability to remove plaque far more efficiently than we can on our own, because electric brushes provide the equivalent of thousands and even tens of thousands of brushstrokes per minute, compared to the hundreds we can achieve by hand.

There might be a bit of a learning curve to discover how to use your brush around wires and brackets. Ask us for the best method of using an electric brush with your braces, and check out brush heads specifically designed for orthodontic work.

If you use buttons with aligners, electric toothbrushes should be safe to gently clean around the buttons to remove built-up plaque. It’s usually best to stick with a manual brush for cleaning your aligners themselves—we’re happy to give you your best cleaning options, no matter which brush you choose.

You know by now what your brushing habits are like. If you tend to be a bit cavalier with your brushing and flossing, make sure you set yourself up for success. Because you have better things to do during semester breaks and summer vacations than visiting Dr. Donald Neely!

• Electric Brushes Can Make Life Easier

Several of today’s electric brushes come with options designed to do more than simply remove plaque. They can let you know if you’ve brushed for the recommended two minutes and remind you when it’s time to replace the brush head. They can even alert you if you’re brushing too hard, which is especially important when you’re wearing braces.

Want more from your electric brush? Some models offer apps that can map out just where you’ve brushed, in case there are a few spots that often get overlooked. Or provide different brushing modes for daily cleaning, deep cleaning, whitening, and more. Or come with a travel case that can recharge while you’re busy exploring the world—or going home for a visit.

In the end, it’s up to you. Do some independent study and research the toothbrushes that will give you the best results for your individual brushing habits. You might not need or want a brush with all the technological bells and whistles.

If you’re comfortable with your manual brush and you get good grades when you visit our Hanover, NH office, stick with it. But if you think you might benefit from the ease and efficiency of an electric toothbrush, if an electric toothbrush makes your teeth and gums healthier and your smile brighter, that’s extra credit worth pursuing.

By now, you’re very familiar with the basic building blocks of your braces. Brackets, wires, and ligatures are no mystery to you. But suddenly, you’re hearing a brand new term—“power chains.” What exactly are these power chains, and why does your orthodontist think you need them? Let’s see how power chains are *linked* to your orthodontic treatment.

• First, why power chains?

They’re not really chains in the necklace or bike chain sense—in fact, they’re only very rarely made with metal. These chains are most often a string of O ring loops just like your elastic ligatures, attached in a row to resemble a chain.

Chain lengths are tailored to your specific needs. Dr. Donald Neely will attach each individual loop in the chain around a single bracket, linking selected teeth together. Chains might stretch across a few teeth, several teeth, or your entire upper or lower arch.

• Second, why power chains?

Because these chains are usually made of the same elastics that your ligatures, or bands, are made from, they want to hold their original shape. They will try to return to that original shape even as they are stretched between your brackets. As they contract, they help move your teeth together. 

Over time, just like an over-stretched rubber band, they lose their elasticity, and won’t work as effectively. That’s why you’ll probably get a new power chain whenever you come in to our Hanover, NH office for an adjustment.

• Third, why power chains?

This is the most important question. How can a power chain improve your smile?

Usually, power chains become part of your treatment after the first phase of alignment. They can be used to help align your teeth or correct your bite, but are most often used to close gaps between the teeth.

You might have a gap after a tooth has been extracted. Or, as your teeth move into their new positions, you might suddenly see noticeable spaces between them. Power chains move the teeth closer together to eliminate these gaps, and do it more quickly than brackets and wires alone can do.

• How long will you need them?

This is something Dr. Donald Neely will discuss with you. Whether it’s a matter of weeks or months, your treatment plan is designed to move your teeth into their best positions, and to do it carefully for a lasting, healthy alignment.

• Power chain options

Depending on the size and spacing of your teeth and your treatment plan, these chains usually take one of three forms: closed/continuous, short, and long. The only difference is the distance between the rings.

We will choose the type of chain that’s best for your treatment. Your contribution is to personalize your power chain. Power chains come in a rainbow of colors, allowing you to mix and match. You can even coordinate with your ligatures if you have ties as well as chains. If your goal is to have your braces blend in, various shades of white, silver, or clear colors are available. Want to mix things up? Choose a different color with every adjustment.

• Anything else?

You might experience some discomfort for the first few days with a new power chain, just as you might with any adjustment. Dr. Donald Neely will have suggestions for making those first days as comfortable as possible.

Also, like brackets and ligatures, power chains can trap food particles, so be sure to follow our instructions for keeping your teeth and your braces their cleanest.

Now that you’re all caught up on what power chains are and what they can do for you, let’s mention one more benefit. This is a process where you can actually see the gaps between your teeth closing over the weeks you wear your power chains. Keep a selfie record of your progress as you create your beautiful, healthy smile. That’s an em*power*ing experience!