So you're at the movies with your best friend and he's eating a big bucket of popcorn by himself. The temptation is too much, so you grab a handful. Next thing you know, you've got a wire twisted out and poking your cheek. Or maybe you're at your softball game and you're chugging down a cold drink. You accidentally bite down on a piece of ice and feel a pop. Your molar brace is loose and flopping around back there scratching your cheek.

DON'T PANIC! The first thing you need to do is look for your wax packet so you can roll a ball of wax over the wire or bracket to save your cheek. Okay, so you didn't bring the wax with you but no worries. Dig through your mom's purse until you find a piece of sugarless gum. (Or maybe you could ask the nice lady sitting next to you at the movies.) Chew up the gum and pinch a little piece off to use just like you would a piece of wax. Now mind you, the operative word here is SUGARLESS! We don't want you putting a bunch of sugary gum on your tooth and leaving it there all day. That would not be good for your teeth.

When you get home you can ask mom or dad to clip your wire off. If you need to remove the loose bracket, have them clip the wire behind the next bracket over. The easiest way to do this is to have them get a q-tip and a small wire cutter. They can use a nail clipper in place of the wire cutter just make sure you wash either one thoroughly before use. They'll use the q-tip to hold the cheek out and clip the wire, then they can use the q-tip to sweep the piece of wire out of your mouth. Comfortable now? Great! Your next step is to call the office and leave a message with your name and phone number. We'll call you back and schedule an appointment to have your brace put back on. You're in the clear.

We don't have many true emergencies in Orthodontics. Mom or dad can usually fix you up at home. If they have trouble, or are not sure what to do, they can call the office and a message will direct them to our emergency line. We have a technician on call who can usually walk them through a fix right over the phone. There are times that you may need to be seen outside of office hours. For instance, you try to get food out of your expander and pull it loose or maybe you get hit in the face while you're playing and you need some help. The technician on call will be glad to meet you at the office to take care of you. On the rare occasion that the on call tech can't handle the situation alone, she'll call Dr Eric or Dr Larry who will be happy to come to the rescue. We've got your back!

"There are rubber bands all over my house! Little tiny things on the bathroom floor, in my washer and my dryer. On the kitchen counter, the living room table, even in the baby's diaper bag! They are everywhere except in my daughter's mouth! It wouldn't be so bad if I could find another use for them but they're just too small." A mom really did say this to me and I could relate having found elastics all over my own house when my kids were in braces! Those little nuisances end up in the oddest places. One day Leber Orthodontics may have to have a contest for the strangest place someone has found orthodontic elastics!

Those tiny little rubber bands may be annoying but they serve a very important function in your treatment. Without them, we wouldn't be able to get your top teeth to fit nicely with your bottom teeth. Let me explain how they work and hopefully, you'll feel a little more charitable towards them. There are certain movements of the teeth which can't be done through wire adjustments alone. Getting the upper and lower jaws to line up relative to each other requires a vertical force. Elastic bands are prescribed in a certain configuration, such as a triangle or square, to help the peaks (or cusps) of the upper row of teeth to fit into the valleys of the lower teeth, and vice versa. A perfect bite has the appearance of a horizontal zigzag pattern.

Elastic wear is a good example of when the patient has a great deal of control over the outcome of his/her treatment. Wearing the rubber band in the correct configuration and in the amount of time prescribed keeps your treatment on schedule. Not wearing your rubber bands properly can prolong the time for which you have to wear your braces. We know that they aren't the most fun but Dr. Eric wouldn't prescribe them if they weren't a very necessary part of the treatment.

By the way, the leftover elastics are great for creating cool hairstyles or attaching bows to a small dog's hair.

The Why of Retainers

One of the questions we're most frequently asked is "Will I have to wear a retainer when my braces are off?"

Okay, it actually sounds more like this: "Wait, what? I just got my braces off and now I have to wear something else? Why do I have to wear a retainer? What if I don't wear it, then what happens?"

The short answers to those questions are:
"Yes."
"Because the doctor said so."
And, "You'll probably have to wear braces again and your parents will be mad."

None of those answers satisfy the average teenager so we asked Dr Eric to explain it for us. Without all the really technical stuff, this is the reason why he prescribes a retainer after your braces treatment: When we move the teeth to a more optimal position we are also moving the roots of your teeth through the bone. The bone dissolves and then reforms around the roots but this takes time. The teeth need to be supported in their new position while this is happening.

How Long Will I Have to Wear a Retainer?

Ideally, we'd like to leave your braces on passively holding your teeth steady for about a year or so. Not many of our patients would find that option acceptable so a retainer is the next best thing.

Generally speaking, we have you wear the retainer for one to four weeks full time taking it out only to eat and brush. After that you'll wear it while you're sleeping. Many long term studies have shown that wearing the retainer for about three years gives the best results.

Towards the end of that three year period we have you start phasing your retainer out by skipping a night and seeing if the retainer is tight when you put it in the next night. If it's not, then you go two nights off, etc. Some people find that wearing the retainer a few nights a week indefinitely works well for them.

What we don't like to see happen is for someone to stop wearing their retainer early and have to come back for re-treatment. We really like catching up with all of our past patients, but we'd much rather you just stop by to say hello!

We're often asked how gluing little metal squares on teeth can make them straight. Actually, it can't. That's probably not the answer you were expecting so let me explain the mechanics of braces to you.

The braces are made up of several different parts: The brackets (those little metal squares), the wires and the colorful, little elastic ties. The brackets are bonded to your teeth. Each one has a horizontal slot for the wire. Sometimes we need more anchorage to move the teeth so we'll cement bands, with the brackets welded to them, around your molar teeth.

Once the brackets are attached to your teeth, we slide a wire into each slot and keep it in place with the little elastic ties. We start with a very thin and flexible round wire. The wire is formed into the shape of a 'U' and wants to go back to that shape no matter how crooked it gets when we put it in the bracket slot. While it's reverting to its original shape it brings your teeth along for the ride, moving the roots through the bone. Once we've gotten your teeth relatively straight we move up to a square, but flexible wire. This wire is sized to fill the bracket slot completely and allows for three dimensional movement of the teeth and roots. At this time we also close any spaces between your teeth.

Now that the roots are paralleled in the bone, the crowns of the teeth are straight and spaces between teeth have been eliminated, the real work begins! We swap out your flexible wires for a stiff wire that will hold bends. Dr Eric and Dr Larry start the painstaking process of fitting your bite together and lining each tooth up individually so that you get the most perfect smile possible. Since we all have unique sizes and shapes to our teeth, this part requires foresight and an artistic flair coupled with patience and determination. We techs think that this attention to detail sets our orthodontist apart and it makes us proud to be on the Leber Orthodontic team.

We are often asked just how Invisalign works and what is involved in the treatment. Invisalign moves your teeth through a series of clear aligners which you change every two weeks. At your records visit we take photographs of your teeth, an x-ray of your jaw relationship and a mold of your teeth. These are sent to Invisalign along with a treatment plan from Dr Eric. Invisalign's computer program designs the series of aligners to move your teeth gradually from aligner to aligner as Dr Eric requests.

Some Invisalign cases require little tooth colored attachments to be bonded onto some of the teeth to help move them into the proper position. These attachments blend in with your teeth so they are not noticeable to others but you will feel them slightly as a little bump on a tooth or on the aligner.

The aligners are removable for eating and brushing but must be worn at least twenty hours a day if they are going to work properly. Having the flexibility to remove the aligners for a big presentation at work or school has been a plus for many of our patients. Most patients tell us that after a few weeks of getting used to the aligners they feel very comfortable wearing them.

At the end of your first series of aligners, Dr Eric assesses the alignment of your teeth as well as the fit of your bite. He may then decide to order a series of refinement aligners to fine-tune the position of your teeth and finish your treatment.

The major differences between Invisalign and traditional braces are the invisibility of the aligners and the ease of brushing and flossing. If these are appealing to you, and you are okay with the extra cost, then Invisalign would be a great choice for your treatment.

We have many patients who are apprehensive about having their braces placed. We understand. It's a little bit scarey to go to the orthodontist when you have no idea what's going to happen. Let me take the mystery away and explain exactly how it's done:

The first thing we do is to place a lip retractor to help keep the teeth dry. Our glue doesn't stick to wet teeth and without the retractor it's impossible for you to move your lips out of the way. The next step is to put a little bit of gel on your teeth to remove any film that may be on them. The gel isn't very tasty. In fact, it's a little sour. After about 30 seconds we wipe most of it off and rinse your teeth well being careful to rinse your tongue too. We don't want you sitting with that sour taste in your mouth!

Once the teeth are rinsed and dried we paint on a very important sealant. We want to be sure to protect your teeth underneath the braces. The sealant bonds to your tooth surface so that we can bond the brace to the sealant, instead of directly to your enamel.

Now comes the placing of the braces. An assistant will put glue on the back of each brace and set the brace on a tooth, removing the excess glue and repeating the process until each tooth has it's own special brace. The assistant will then call Dr Eric or Dr Larry over to position each brace exactly where it needs to be in order to move each tooth into proper alignment. The doctor has to visualize your tooth in a straight position and place the brace accordingly. It's not as easy as it sounds but Dr Eric and Dr Larry are very good at it.

We're almost finished at this point. All that's left to do is to shine our special UV light onto the edge of each brace to set the glue. Once we have cured all the glue we can remove the lip retractor, place the wire that has been prescribed by the doctor and explain care and maintenance of your new braces!

See how simple it is? All you have to do is sit back and relax for awhile. If you'd like you can listen to your ipod or take a little nap while we put your braces on. Leave the work to us!

There are a few foods we'd rather you not eat while wearing braces. They are mostly hard or sticky candies. There really is a good reason for avoiding some candies. We wouldn't ask you to if it wasn't important. Biting into something hard can cause a brace to come loose from your tooth. When this happens we have to have you come in to re-attach that brace. We know you're busy and making a special trip in to see us isn't always convenient, so to save you time and annoyance here is a list of foods you should probably avoid:

• Hard candy like Jolly Ranchers, lollipops and mints
• Sticky candy like Laffy Taffy, Starburst and caramel
• Bubble gum and sugary chewing gum
• Popcorn. Those little half popped kernels are such a nuisance!
• Ice! It's fun to crunch but hard on your teeth as well as your braces!
• Pencils and pens. (I know! They aren't really food but some people like to chew on them.)
• Apples and carrots unless they are sliced very thin, in which case you can still eat them.
• Corn on the cob. You should have your mom cut the kernels off, it will be easier to eat that way.

Just use your best judgement. If you think something is too hard or sticky, it probably is. We aren't completely hard-hearted. You've probably noticed that sugarless gum isn't on the list. We don't mind if you chew a piece once in awhile as long as you make sure none of it is stuck to your braces when you're finished.

I've been working as an assistant in a dental specialty since 1991 so I'm often asked by friends to help them choose a dentist from a list of providers supplied by their dental insurance companies. This is why I always recommend a privately owned practice:

Your dentist's reputation is at stake whenever he (or she) performs treatment on you. It is in his best interest (and yours) to give you the best treatment possible. He wants to keep you as a patient and hopes that you will tell your friends about his practice. The cost of advertising is preclusive for most private practices but your nod of approval is free and bears more weight with your friends than a commercial does.

The managing dentist is ultimately responsible for whatever happens in his practice so you will never be a number on a computer screen to him. He sets his own hours, determines how much time each patient will need and can adjust that time to accommodate any special needs. If you have an issue you will be able to resolve it face to face with the office staff rather than being referred to a corporate office in another state.

When you choose a privately owned orthodontic practice you will be forming a relationship with your dentist and his staff. There will be no revolving door of dental practitioners who contract for short term employment and leave when their contracts expire. Your dentist will have set down roots in your community and is committed to his practice.

In closing, I would like to point out that shopping at a chain store will save you money but using that mentality when choosing a dentist could end up costing you big in the long run. After all, can you return that filling or root canal if you don't like how it turned out?

We have a lot of patients who are curious about what type of education is involved in becoming an orthodontist. It's a very good question and one you should ask yourself before choosing someone to straighten your child's teeth (or yours).

All orthodontists must be dentists but not all dentists who do braces are orthodontists. Confusing? Yes, but let me explain. All dentists must go through a certified dental college to obtain their Doctor of Dental Surgery degree, the DDS after their name ( some universities call this a Doctor of Medicine in Dentistry degree, or DMD). They are then qualified to practice dentistry or continue their education in a dental specialty. When a dentist decides to specialize in orthodontics he must be accepted into a certified orthodontic college and complete a two and one half year residency for his master's degree.

Orthodontics is one of the most difficult specialties to advance into. It is a unique combination of dental biology and mathematics with an artistic flair thrown in. The orthodontic student is required to complete a certain number of full cases while studying the science behind moving teeth and fitting the bite together. If we all had teeth like the ones on those little plastic models your dentist has in his office it would be pretty simple and straightforward to align teeth. Unfortunately, few of us are that lucky, so we see an orthodontist for help. It's his job to come up with a treatment plan and then adjust it for our personal biology. Phew, he really works hard for that MS he added to his DDS.

As I mentioned earlier, a dentist doesn't have to have a degree in orthodontics to practice orthodontia in his office. He can take weekend classes or online courses to learn about orthodontics but he may not specialize or call himself an orthodontist without a master's degree from an orthodontic residency program.