Friday, April 30, 2010

Braces: No Pain, receding Gums & Falling Brackets

Everytime I put on braces on a patient, I always try to remember the teeth and it's basic structure.

I am moving teeth and to do so I must consider how each part of the teeth & its supporting structures are affected.



ENAMEL
Putting the braces, I must consider the condition of the enamel, which is the outermost layer of the tooth . Is it  hard and healthy or is it chalky or mottled which will make brackets hard to stick to it?

 mottled enamel

DENTIN & PULP
Once the braces are on, I must now regulate the quality, quantity & direction of the forces so that the dentin and pulp containing the nerves will not hurt, or worst, be injured. Too much force or too long a force will cause pain.




BONE & LIGAMENT SUPPORTS
Once the teeth have moved, we now see beyond the pulp and consider whether continuous or interruptive force will be appropriate to protect the gums and surrounding bone of the teeth. Here is where the length of force applied matters and affects the tooth support the most. Too much of the strong force if applied too long will eventually make one lose bone and thus gums to go down to a level where the roots of the teeth show, termed  "recession".
receding gum on upper canine 

From the start of treatment be aware and be wary :-)  


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