Our Blog

Midline Misalignment

September 21st, 2022

By and large, the human body is a marvel of symmetry. But, of course, no one is perfect. You might have noticed one ear is a bit higher than the other. That you wear a shoe a half-size bigger on your left foot. That one shirtsleeve always looks longer.

Or that your smile looks off-center. This dental asymmetry could be caused by a condition known as “midline misalignment,” and, unlike that left foot, you can do something about it!

The dividing line between our center teeth, upper and lower, is called the midline. If we draw an imaginary line down the middle of a face, from the forehead to the nose to the midpoint of the chin, that line should go right between the front teeth. When it doesn’t, because the teeth have shifted past the midpoint, it’s often due to a condition called midline misalignment.

This kind of misalignment, also known as a deviated midline, can have several causes:

  • Baby teeth that are lost too early

Baby teeth do more than promote healthy eating and speech development. They also reserve space for permanent teeth. If a primary tooth is lost too early, permanent teeth might “drift” to fill the empty space, causing the midline to move as well.

  • Thumb sucking that goes on too long

As a child gets older, and certainly when by the time permanent teeth start to arrive, aggressive thumb sucking can lead to numerous orthodontic problems, including a deviated midline, as the teeth shift in response to that continuous pressure.

  • Missing adult teeth

When you lose a tooth through decay or trauma, or when an adult tooth simply never develops, the remaining teeth can shift over to fill the open spot.

  • Spacing issues

Crowded teeth, teeth with significant gaps between them, very large teeth, very small teeth—all of these issues can affect spacing and midline alignment.

  • Crossbite

A crossbite is a kind of malocclusion, or bite problem. When you have a crossbite, the teeth don’t fit together properly, with upper teeth fitting inside lower teeth, instead of aligning on the outside where they belong. A deviated midline can indicate a posterior crossbite, where the top back teeth slant inwards or fit inside the bottom back teeth.

A tiny bit of midline shift one way or the other might be nothing to worry about, but if one front tooth is literally the center of attention, or if your teeth are noticeably out of alignment, it’s a good idea to talk to our Doylestown orthodontic team.

Because there are several potential causes for midline misalignment, Dr. Adams will carefully analyze your individual situation to determine where the problem lies: with the teeth, the bite, or, rarely, the jaw itself.

Dr. Adams will also offer you your best dental treatment options. A shift of a few millimeters might be treated with clear aligners or traditional braces. A crossbite could require braces or aligners coupled with elastics (rubber bands) to bring your bite into alignment. A palatal expander can help correct a serious crossbite.

Why visit Adams Orthodontics because of a little asymmetry? Because a deviated midline is more than a cosmetic concern. If you have a malocclusion to begin with, or if your misalignment leads to changes in chewing habits, which cause new bite problems, you might be facing jaw pain, chipped and cracked teeth, headaches, and all the other unpleasant consequences of malocclusion.

By and large, perfect symmetry in life is unattainable. But if you want a smile that is well-balanced and healthy, talk to us about all the treatments available to make sure your smile—and not a single tooth—is the center of attention.

Orthodontics and Implants

September 14th, 2022

Maybe you’ve wanted braces since childhood. Maybe you had them, but your teeth have shifted over time. Maybe you’re tired of living with an uncomfortable bite. Good news! If you’re not happy with your adult smile, that doesn’t mean you’ve missed the opportunity to have the healthy, attractive smile you’ve always dreamed of.

While there are many benefits to having orthodontic work done as a child, there’s a lot to be said for orthodontic treatment as an adult. After all, you know exactly what you want. You’re dedicated to following your treatment plan. You have plenty of discreet orthodontic options available now, from clear aligners to lingual braces, to make your treatment as inconspicuous as possible.

But, on occasion, adult treatment does come with some adult baggage. Worried about your crowns, fillings, or veneers? If these restorations are part of your dental history, we can generally work with them. Dental implants? Those might fall into a slightly different category.

Implants are a great way to restore your smile because they function like your natural teeth. They are designed to look just like natural teeth, and they allow you to speak, chew, and bite with confidence. Implants even stimulate the jawbone when we chew just as natural teeth do, helping to prevent bone loss in the jaw as we age.

But there is one important difference between implants and natural teeth: implants are firmly anchored in the jaw, while your natural teeth can change position.

Why is this a concern? Because tooth movement is one of the basics of orthodontic treatment. Unlike implants, our teeth aren’t firmly anchored in our jaws. They are held in their sockets by a ligament which cushions them and connects the tooth to the bone.

When braces or aligners gently apply consistent pressure to the teeth, the ligaments and eventually the bones holding the teeth reshape themselves in response to this pressure, and then become stable again during the retainer phase of treatment.

Implants, on the other hand, are crowns attached to a metal cylinder or screw that is surgically implanted into the jawbone. After several months, osseointegration takes place—which is a technical way of saying that the metal base fuses with the bone. This means that there won’t be any movement taking place—good when you’re chewing, but not helpful for realignment!

If you haven’t yet replaced a missing tooth with an implant, it’s often best to wait before starting orthodontic work. We can design treatment around a missing tooth, leaving room to accommodate an implant in just the right spot when your orthodontic treatment is finished.

If you have an implant already, the placement of your implant will help determine your treatment:

  • If your implant is already perfectly placed for your future alignment, braces or aligners can be designed to work with and around your implant.
  • If the placement is almost ideal, you might find a very small degree of misalignment acceptable, and we can plan your treatment around your existing implant.
  • If it’s not possible to work with your implant where it’s presently located, it is possible to remove an implant. You would then have the implant procedure redone after your orthodontic work is complete.

Talk to Dr. Adams about your treatment possibilities. By analyzing your orthodontic goals and working with your dental history, we can let you know exactly what can be done for your teeth and bite—even if you have an implant.

True, there are many benefits to having orthodontic work done in your childhood, but there’s a lot to be said for orthodontic treatment as an adult. And the greatest benefit of all? You’ll finally have the healthy, self-confident smile you’ve always dreamed of. Talk to our Doylestown team about making that smile a reality.

Power Chains

September 7th, 2022

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. Adams 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 Doylestown 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. Adams 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. Adams 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!

Overbite Overview

August 31st, 2022

An overbite is one of the most common malocclusions. If Dr. Adams and our team have diagnosed you with an overbite, you probably have lots of questions. Let’s try to answer some of them!

Just what is an “overbite”?

A malocclusion is another way of saying that you have a problem with your bite, which is the way your jaws and teeth fit together when you bite down. In a healthy bite, the front top teeth project slightly beyond, and slightly overlap, the bottom teeth. A normal overlap is generally considered one or two millimeters.

An overbite is a Class II malocclusion, and means that the upper front teeth cover more of the lower teeth than they should. But that’s a very general definition, and we will diagnose and treat your own, very specific, bite and teeth alignment.

Because overbites aren’t all alike. They might be barely noticeable. Upper teeth might overlap lowers by an extra millimeter or two. In more severe overbites, the upper teeth might cover the lower teeth completely. The amount of overlap and the cause of the overbite will determine your treatment.

What causes an overbite?

Overbites can be dental, caused by tooth alignment, or skeletal, caused by bone development, or a combination of both. They are usually hereditary, so, most often, an overbite is something you’re born with.

The size and position of your jaws, the shape and position of your teeth, all affect your bite alignment. But early oral habits, such as prolonged and vigorous thumb-sucking or pacifier use can contribute to overbite development. Missing teeth and bruxism, or tooth grinding, can also affect the alignment of your bite.

How do we treat an overbite?

There are many types of treatment available. Dr. Adams will recommend a treatment plan based on the type and severity of your overbite. Because some treatments are effective while bones are still growing, your age plays a part as well.

  • Braces and Aligners

If dental issues are the main reason for your overbite, braces or clear aligners can be very effective. Rubber bands are commonly used to help bring teeth and jaw into alignment.

  • Functional Appliances

If the overbite is caused by a problem with upper and lower jaw development, devices called functional appliances can be used to help guide the growth of the jawbones while a child’s bones are still forming.

For young patients, there are several appliances that can help correct an overbite. Some, like the Herbst appliance, work inside the mouth, while others, like headgear, are worn externally. Your orthodontist will recommend the most effective appliance for your needs.

  • Surgical treatment

In some cases, where the problem is skeletal rather than dental, surgical treatment might be necessary to reshape the jawbone itself. This is especially true for adults, whose bones have finished forming.

If we recommend surgery, oral and maxillofacial surgeons are experts in surgical procedures designed to create a healthy and symmetrical jaw alignment. Dr. Adams will work with your surgeon to design a treatment plan, which will usually include braces or other appliances following surgery.

Why treat your overbite?

Sometimes, a very slight overbite won’t require treatment. A serious, moderate, or even mild overbite, though, can lead to many dental and medical problems, including:

  • Crooked, crowded teeth
  • Worn teeth and enamel
  • Problems speaking or chewing
  • Difficulty sleeping
  • Headaches, facial, and temporomandibular (jaw) joint pain

When you work with our Doylestown team to correct your overbite, you’ll not only prevent these unpleasant consequences, but you’ll achieve major benefits as well—a healthy, comfortable bite, and an attractive, confident smile. If you’d like more than an overbite overview, Dr. Adams can provide the specific information and treatment plan you need to make that healthy bite and that confident smile a reality!