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Tuesday 25 August 2015

Perfect Straight Teeth!

After a total of 13 months I am all finished and very pleased with the results. Since the last blog I have had the elastics changed monthly and the lower Alf removed. Removing the Alf made a big difference from the point of view of my tongue as it felt almost back to normal. The last few months with the fixed (train tracks) was pretty easy, I am now able to clean with the Tepe brush without looking and apart from having to eat everything with a knife & fork – sandwiches included, eating isn’t a problem. I am looking forward to biting into a steak baguette and an apple though!
I had the fixed braces removed on 11th April and a hygienist appointment straight after for a good clean up to remove all that red wine staining! Hilary our hygienist was very pleased that I had managed to keep everything so clean over the course of treatment, I guess over 20 years in dentistry has made me a clean freak!
I have now got fixed retainers on both the upper & lower teeth at the back. It is a very discreet wire that was made at the laboratory by taking an impression ten days before, that then gets cemented on the back of the front six teeth with small blobs of tooth coloured filling material. You can’t floss between the teeth but can still clean between them with a Tepe brush as when the fixed braces were on. You can have removable retainers – which are generally worn all the time for the first 6 months, then night times only for a minimum of 6 months. You can get clear retainers and they are pretty minimal if you prefer.
I am very pleased that I had the work done; it took some getting used to at the start – the teeth hurt from the movement and it was all a bit of a sore mouthful. But before I knew it I was used to it all and some days I had to check it was all still there!

My teeth were not too bad but I had a narrow arch and one of my front teeth stuck out slightly more that the others. I think whatever your teeth are like, if you want to change them then do it. Lots of people wondered why I was doing it and you will always get opposition, but if you want to improve your smile and are prepared to wear the appliances then go for it! I hope that this blog has shown you what to expect from fixed orthodontics and will help you decide it is worth the effort.

Ortho getting there!

Now into November and the time really seems to be flying by, I have now had the upper ALF (expander) removed but still have the one in the lower jaw – you can see in the picture, it is still working to expand and create space in the lower jaw.

Steve has now started to close up the gaps created in the upper jaw, straightening the teeth at the same time. You can just about see in the picture that my front four teeth are now straight and have been wired together to hold them in place, there are then clear coloured chain elastics going from the upper right and left 2 to the upper right and left 3 (the eye teeth) to pull them into alignment.


Hopefully by next month these gaps will be closed, the eye teeth are still quite rotated and they should now start to turn to face the right way.

The cleaning is a pain! I take the little cleaning brushes with me everywhere, on the plus it is good for the waistline as you don’t munch on any old biscuit that crosses your path!

Fixed Braces are well under way!

Now at the beginning of October and I have had the Straightwire (train tracks) in place in the upper arch since the end of August along with an upper ALF appliance (pictured & shown using a mirror the roof of my mouth with the ALF in place)


- this fits behind the teeth and stops the space created by the RN Sagital appliance (the removable appliance initially worn to create space) from being lost. I have had the fixed on the lower since the start of September – we don’t fix it all at once as it would be quite a lot to get used to in one go. You can see in the picture the fixed and I have gone for pink elastics which get changed every month, so you can have a different colour every month!



From a patient point of view it was pretty easy getting it all fitted, fairly quickly after it started to get tender, and within a few hours I couldn’t bite into anything as they were so tender. This lasted for about 3 days and then was comfortable again. So it’s a soft diet for the first few days! I did also get a few sore spots from the brackets rubbing, but you get clear wax that you can stick on to stop it rubbing and within a couple of days you get toughened up and used to it. Now I forget I have it on apart from when I eat and clean.
Cleaning is the most difficult part, I have an electric toothbrush which has a 2 minute timer, I now take about 3.5 minutes with the normal brush head and another minute or so with the interspace head which cleans between the teeth. I also still use the TePe brush mentioned and pictured in the previous blog to clean between the teeth and also carry one of these and a small mirror everywhere in case I eat something - it drives you crazy when something is stuck somewhere not to mention looking pretty grim!

Eating can also be difficult to some extent, you can’t bite into something like a sandwich or apple, proper ‘knife & fork’ food is easiest, and last week I really put it to the test and had some peanut brittle that I made and some crackling! (Not together!) I am still really pleased I am doing it; I am surprised at how quickly the teeth are moving considering I only started in March this year. 

Ortho Blog continues!

Here we are already at the start of August and I have had my lower ALF in place since the start of May, I am now starting to get some visible gaps where they were previously slightly overlapped as you can see in the picture. Last blog I mentioned that the elastics had been placed to create a small amount of space to fit the bands around my lower 6’s which you can now see in the picture (left side picture) the bands and brackets that hold the ALF in place and will also hold the ends of the straight wire (train tracks)










You can see the space that the upper RN Sagital has created (right picture), that along with the width that has been created I am now ready for the upper ALF and fixed straight wire (train tracks) My teeth are a jumble at this stage, but now we can start to line them up. (The lower straight wire will come later)
The lower ALF has been much more comfortable than the upper RN Sagital and I am looking forward to replacing the RN Sagital with the ALF towards the end of the month, I don’t know that I have the lower ALF apart from food getting stuck in behind it – I now always carry a pack of TePe’s and a makeup mirror!

I guess this is preparing me for the food trap of fixed braces and can’t help laughing as I remember Sex & the City when Miranda gets her fixed braces. (Sorry if you have never seen Sex & the City!) I will look like this next time you see me!


Ortho Blog 2

May 2012

I am now 8 weeks into my orthodontics, according to Steve I have just over 1 mm of width created, which I can tell in my bite as my teeth don’t meet the same any more. Wearing the R N Sagital is fine, I don’t really notice it apart from when it is tightened and then my teeth are tender for a couple of days but I can still eat (without the brace in my mouth) with very few problems apart from maybe chewing something hard like a toffee! My speech improved quite quickly and although I feel like I am talking with a bit of a lisp no one else seems to notice.



As you can see from the picture compared to last time there is a gap opened up between my front two teeth and there are also gaps either side of the front two but you can’t see from this angle. Steve says they will look worse before they get better due to creating the space needed to then align them. 



You can also see with the R N Sagital in place it doesn't show much.

I am now due to get the lower ‘Alf’ made, which could be fitted next week – this involves placing some elastics in-between my lower 6 and 7 which over a couple of days will ease the teeth apart and create space to put the bands around that will hold the Alf which is not removable.

Ortho Blog 1

So, I’m 38 this year and have decided to have my teeth straightened . . . . . . . . . . . . again

When I was 13 ish I got dragged along reluctantly to get orthodontics, the orthodontist at the time said I needed four premolars out to create space (as is the way with NHS orthodontics) and then full head gear followed by fixed train tracks to sort out my lovely smile. As you can imagine as a 13 year old this wasn't very appealing to me but after lots of persuasion from my parents decided to go ahead with a compromised version involving taking the 4 teeth out to create space and then have a fairly simple removable appliance to pull back my goofy teeth. The result was ok, but what did we know?



Now, 25 years later and having worked in dentistry since I was 17 I have decided that I want perfect teeth! I now work with Stephen Tittensor who does arch expansion orthodontics. This involves widening the dental arch rather than taking the teeth out to create space and although I have already had the teeth taken out it generally results in a narrow arch that doesn't look as good as the nice wide toothy smile our American friends generally have.

Impressions and x-rays done, and two weeks later I have a lovely removable appliance, called an”R N Sagittal”, that is pushing out my teeth to create some width & space before I have the fixed that will line them all up nicely. I am expecting to have this for about 3 months.

The good thing about this stage is you can’t see it and I can take it out to eat, but I think I will also lose weight as I am used to munching throughout the day and now won’t, as it will mean taking my brace out! The downside is I am talking a little strangely at the moment, and working on reception and on the phone this is a bit tricky, but I don’t expect this to last. It is also a bit strange having something in my mouth at night and I tend to grind occasionally so I am concerned that I will chew through the brace but Steve assures me it will be fine.

As you can see from the picture I don’t have terrible teeth but why not go for perfection now I can afford to.



My upper right central incisor is slightly forward and twisted; as you look at the picture it’s the front tooth on the left, I am narrow in the premolar area from the extractions years ago making the upper left 5 look like there is a gap and my upper left three has rotated.

Thursday 21 May 2015

The Value of Good Oral Hygiene

Value for Health?

How much do you spend on a haircut, getting your nails done, a night out, or a round of golf? You maybe go out for a night or play golf weekly, or have your hair cut every 6-8 weeks….

These things make us feel better but don’t have much effect on our health, if we were to compare the cost of these items, things that we ‘want’ rather than ‘need’ to the price we are prepared to pay for good health, what would the value for health be?

A hygienist appointment is currently £55 for 30 minutes; some may not feel this is worth it. It depends on what value you put on health.

Did you know more adults lose their teeth from gum disease, not tooth decay?

Did you know that poor oral health and gum disease has been linked to heart disease, stroke, prostate inflammation, low birth-weight babies & miscarriages? These are just a few conditions that we are currently aware of. Gum disease also makes controlling diabetes much harder. Of course, you can also lose your teeth.

You wouldn't want any of these conditions, and would probably do everything you could to reduce your risk.

The bacteria around our teeth and gums have a direct link to our blood, which has a direct link to all other parts of the body.

The hygienist can remove the plaque and calculus which harbour these bacteria and show you ways to keep them to a minimum.

Keeping these bacteria to a minimum means less of them to get into your blood stream, and a reduced risk from some fairly major conditions.


Taking all of that into account, the cost of a hygienist appointment and what they can do for you seem pretty good value, maybe visiting the hygienist twice a year is pretty good value for health after all!