Dental Health

By Dr. Negaar Sagafi

After moving to the United States from Iran, my family settled in Massachusetts where Henry David Thoreau was born, raised, and wrote Walden. Thoreau said, “Kindness to children. Love for children. Goodness to children … These are the only investments that never fail.”

Every visit to my office is an investment. Not only because the time I spend with my patients will result in a healthier smile, but because compassionate care will form lifetime opinions about the importance of dental health and my profession.

Taking a few extra seconds to connect with a child matters.

We know an appointment with the dentist is anxiety-producing. A visit with the orthodontist can be even more so. As a result, according to a 2018 DentaVox survey, 61 percent of the Americans say they suffer from dental fear. Four percent said they were so afraid that they have never seen a dentist. These patients will be more likely to suffer from ill health.

As clinicians, it is imperative that we act with empathy.

I find that children’s anxiety disappears quickly when my staff and I connect what we are doing to their teeth to their unique interests.

This task is pretty easy when I’ve got patients who are excited about math, science, or the arts. For one very young patient, I simply talked explicitly about what tooth number I’m referring to and ask them to count along with me. For students interested in physics or technology, I discuss in detail how BRIUS uses artificial intelligence to help move teeth. With one teenage patient, we’ve gotten so deeply into the details that she’s interested in an internship! I hope the time we’ve spent together not only encourages her to pursue a medical degree, but to become an empathetic practitioner.

For my chess-loving patients, we focus on strategy. If I do this on the top row of teeth, how is that going to impact what’s happening on the bottom, or even their bite? And, trust me, if your child loves history, I can go way back! Did you know, for example, that the Etruscans (who lived outside of what we now know as Rome) are responsible for some of the earliest orthodontics?

My staff and I also just ask a lot of questions. I always try to remember what the Spanish cellist Pablo Casals said. He told children, “You are a marvel. … There has never been another child like you. Your legs, your arms, your clever fingers, the way you move. You may become a Shakespeare, a Michelangelo, a Beethoven. You have the capacity for anything.”

Whether it is music, athletics, or academics, our patients have the potential to become anything. Simply asking kids to describe what they’re up to — what makes them smile! — is a great way to make anxiety disappear and to put them on a path toward a lifetime of good dental health.

Dentists and orthodontists also need parents’ help in our efforts to reduce dental fear.

According to a 2015 survey of parents with children 12 and under, 48 percent said they are nervous themselves about going to the dentist. It was no coincidence, then, that roughly the same number of children (47 percent) said they were nervous. As Dr. Bill Kohn, Delta Dental Plans Association’s vice president of dental science and policy, said, “It’s easy for kids to pick up on their parents’ anxieties … so parents should try to stay positive when talking with their children about dental visits.”

Parents must remain relaxed.

Especially since we’re actually seeing increased anxiety lead to dental problems. In an ironic and painful twist, while anxiety can keep people away from the dentist and orthodontist, it also can drive them to us. According to a ADA Health Policy Institute study, in February 2021 more than 70 percent of dentists said they have observed an increase in the number of patients experiencing stress-related teeth grinding and clenching. That number is up from just under 60 percent in the fall of 2020.

Americans are more anxious than ever. For the sake of their long-term health, we need to make a greater effort to connect with kindness.

Adult patients who seek orthodontic treatment usually fall into one of two camps: those who did not undergo orthodontic treatment as a child or those who had braces at one point but stopped wearing retainers for one reason or another.

At Bethesda Orthodontics, we are happy to offer a variety of treatment options to straighten our patients’ teeth. We believe you’re never too old to straighten your teeth. And we have many adult patients who are currently undergoing treatment. In fact, did you know that roughly 30 percent of all orthodontic patients these days are adults?

Invisalign® is a great treatment option for adults. The Invisalign aligners are easy to wear and are not visible to most people. Plus, Invisalign's clear aligners are removable, so there are no restrictions on what you can eat during treatment. When considering Invisalign, we tell adults to determine if they can be diligent about wearing the aligners at all times and make them part of their lifestyle for the duration of treatment.

BRIUS also is a great option since this device fits on the back of the teeth and cannot be seen. Plus, because it uses artificial intelligence, BRIUS moves teeth faster! Learn more about this option here.

If you have been thinking about obtaining a beautiful smile, please give us a call at our convenient Bethesda office for an initial consultation. Our team welcomes children, teens, and adults alike. Call us today for an appointment!

If there’s one meal that can claim the title of “Sweetest Meal of the Day,” it’s almost certainly breakfast. Sugary cereals, syrup-covered waffles, oatmeal with honey, cinnamon toast (which is literally sugar poured on toast)—it’s hard to imagine another menu even coming close. But you’re trying to keep your diet as healthy as possible. What to do?

First, no need to deprive yourself of the occasional pastry or stack of pancakes. The real problem with breakfast isn’t so much sugar as it is added sugar.

• Just a Spoonful of Sugar? What’s So Bad About That?

Nothing! Many healthy foods have natural sugars. Milk contains lactose sugar, and it also contains calcium and is enriched with vitamin D—both of which are essential for strong bones and teeth. Fruits get their sweetness from a sugar called fructose, and deliciously provide vitamins, minerals, antioxidants, and fiber to our diets.

Even processed sugar is surprisingly low in calories. In fact, a teaspoon of white sugar has only about 15 calories. But this teaspoon is also rich in nutrients for cavity-causing bacteria. The oral bacteria in plaque use sugars and carbohydrates from food particles as a fuel source to produce acids. These acids erode enamel and lead to cavities.

Choosing breakfast foods without additional sugars, then, is an easy way to reduce the number of empty calories in your diet while safeguarding the health of your teeth. We have a few suggestions.

• Be Selective with Cereals

If the word “sugar” or “honey” or appears on the box, that’s a hint that your favorite cereal is heavy on the sugar. But there’s a more scientific way to tell just how much sugar is in that spoonful.

While the colorful packaging and playful mascots are eye-catching, check the black-and-white panel with nutritional facts found on every box. If one serving equals 27 grams, and the sugar in that serving equals 15 grams, you know you have a problem. And cereals marketed to children are especially “rich” in added sugar.

But luckily, you don’t need to give up your morning bowl. Many cold cereals are available that offer whole grains, protein, and fiber without a lot of added sugar. Spend some time in the cereal aisle comparing, or, to make life easier, there are many online sites which recommend the best (and worst) cereals in terms of sugar content.

• Use Your Judgment with Juices

Fruits are packed with important nutrients. Not only do they provide essential vitamins and minerals, they’re a great source of water and fiber. If you drink 100% fruit juice, you are getting the benefit of most of the vitamins and minerals found in fruit. (You’re also getting less of the fruit’s natural fiber, and more of the fruit’s natural sugar, so consider fresh fruit as an option occasionally.)

But when fruit juice comes with “cocktail,” or “punch,” or “ade” attached to the end of it, there’s often something else attached—added sugar. For natural fruit flavor and the least amount of sugar, stay with 100% unsweetened fruit juice.

• Search Out “Surprise” Sugars

Remember the childhood excitement of searching through your cereal box for the prize inside? Fun! What’s not so much fun? The surprises you might find when you search through the labels on your favorite breakfast items—because added sugars make their stealthy way into many of our morning favorites.

When you compare plain, Greek, and low-fat yogurts, for example, the low-fat options are often higher in added sugar. A container of low-fat yogurt can provide 19 grams of sugar—that’s a tablespoon and a half!

And while you’re at it, be sure to compare the sugar content in granola bars. Some are full of nuts and grains, and some are full of added sugar.

Going out for a breakfast smoothie? Those can contain 70 grams of sugar and more. Making your own at home might be a little more time-consuming, but if you use fresh fruit as your sweetener, you can make sure that what you’re not consuming is added sugar. If you’re on the go, check out all-fruit options at your favorite smoothie shop.

Our team isn't asking you to eliminate sugar from your breakfast diet altogether. (Everyone loves a doughnut now and again.) But substituting some alternatives for your regular menu choices can reduce the amount of added sugars by tablespoons every meal. That’s another great reason to greet the morning with a smile!

The community health awareness group Oral Health America has reported that 82 percent of adults are unaware of the role that infectious bacteria can play in tooth decay or cavities, and almost three out of five children aged 12 to 19 have tooth decay. Since June is National Smile Month, our team at Bethesda Orthodontics thought we’d remind our patients about the importance of good oral hygiene visits between office visits.

To keep your family’s smiles healthy and beautiful for years to come, be sure to:

• Brush at least twice a day with fluoride toothpaste
• Floss every day to clean between your teeth
• Eat a healthy, well-balanced diet
• Reduce your intake of sugary foods and drinks
• Visit us for scheduled appointments

If you want to know more about healthy home care habits, feel free to ask our team at your next appointment, or ask us on Facebook!

At Bethesda Orthodontics, we have found that patients who like their smiles have better self-esteem. People who don’t like their smiles are often skittish about talking to other people. According to the National Women’s Health Resource Center, when women are asked about what they’d most like to change about themselves, many point to their smile. Despite wanting to change their smiles, quite a few of the people who are unhappy about that part of themselves won’t consider getting braces.

Most Americans Don’t Have Straight Teeth

The American Association of Orthodontics estimates that 4.5 million Americans wear braces or other orthodontic equipment to straighten their teeth and to get a healthier mouth. One in five of those braces wearers are women. The organization’s statistics also show that about 75 percent of the population doesn’t have straight teeth, and those people would benefit from getting braces.

While the main benefit of braces is straight teeth, and to improve the look of your smile, there are other benefits that make braces even more useful, including:

• Straighter teeth help people chew better.

• Straighter teeth give people a proper bite.

• People speak better when they have straighter teeth.

• When people have straight teeth, they have better overall gum and mouth health. A healthier mouth means flossing and brushing are easier, and that means your entire mouth stays healthy.
• A healthy mouth is also linked to a healthy body.

When you feel proud of those pearly whites, you feel better about your smile, and that contributes to a better self-image and improved self-esteem. Ultimately, that can lead to greater career success and a more fulfilling social life.

I was not your typical teen. My mom was a pediatric dentist. I watched as she helped thousands of kids get, and keep, their beautiful smiles. Braces excited me. Even the idea of headgear was appealing. I begged for it!

Like I said: not your typical teen.

One reason for my orthodontic appliance excitement was that, because of the work my mom and her colleagues did, I could easily see a result. I heard endless stories about how patients were more confident after all the hard work was over. As a teen, I associated braces with confidence, not disaster. (Breakouts before the big dance? That was another story.)

Our teens and children could use a confidence boost these days. According to DoSomething.org, an organization that helps young people create social change:

• Three-quarters of girls with low self-esteem reported engaging in negative activities like cutting, bullying, smoking, drinking, or disordered eating.
• More than 40 percent of boys in middle and high school regularly exercise with the expressing goal of increasing muscle mass (not being healthy).
• About 20 percent of teens experience depression before they reach adulthood.

The power and relentlessness of social media makes it even more difficult for teens to feel confident, but there is another issue that worries me. Boys and girls are able to rely on camera filters to hide every flaw. If they can change their appearance with an app, why explore changes that actually would improve their health and wellbeing?

Getting braces, Invisalign, and BRIUS are not just about creating a better selfie — it’s about creating a strong smile that reflects better health. As the American Association of Orthodontists says, “Oral health is a window into your overall health. … A good bite makes it easier for you to bite, chew and speak.” We even know now that routine dental care might protect against severe cases of COVID-19.

My young patients’ glee often is infectious once their orthodontic appliance comes off. But that glee is not confined to the kiddos.

I’ve been welcoming more and more adults into my office who are exploring orthodontia. These men and women either skipped braces as kids, or need a little tune up because they didn’t wear their retainers to keep their teeth in place. Often they are not just looking for a better smile, though. Perhaps a bite that has been off is now causing severe jaw pain.

There are many reasons people pursue orthodontia as an adult. Whatever the reason, they are as happy with the results as teens. I want my patients to walk out of the office feeling like they can do anything.

That is the power of good self-esteem. I love this line from Confidence Code authors Claire Shipman, Katty Kay, and Jillellyn Riley in The Atlantic: “Confidence is an essential ingredient for turning thoughts into action, wishes into reality.”

Having a beautiful smile obviously is not the single ingredient we need to build young peoples’ confidence, but it helps. As a recent article in Shape explained:

“Research suggests that dental disorders such as malocclusion (misaligned teeth) can cause a ‘profound impact’ on self-esteem, thereby negatively affecting the overall quality of life. While studies show this to be more common in adolescents (especially given their age and ‘increased aesthetic desire’ and ‘unique social and physiological needs’), a 2019 poll of 2,000 people emphasizes that adults are also subject to insecurities around their teeth. The study, conducted by OnePull and funded by teeth-whitening company Snow, found that seven in 10 Americans are self-conscious about their teeth, and 50 percent try to smile with their mouths closed (perhaps as a result).”

In addition to improving health and self-confidence, we know that straighter, whiter teeth can impact employment prospects and perceptions of leadership capability.

According to a survey by Kelton and Invisalign, Americans perceive those with straight teeth to be 45 percent more likely than those with crooked teeth to get a job when competing with someone who has a similar skill set and experience. Additionally, 73 percent of Americans would be more likely to trust someone with a straight smile than someone with a good job, outfit, or car.

So, skip the trendy new shoes. Come in for a consult instead so we can discuss how to create lasting confidence.

It's springtime and it's again time to remind our patients at Bethesda Orthodontics to protect their faces and pearly whites while out on the field playing sports. According to the National Youth Sports Safety Foundation, children, high-school athletes and adults have more than 5,000,000 teeth knocked out in sporting events annually.

If you are planning on participating in spring sports, it’s imperative to have a proper-fitting mouthguard. Mouthguards can prevent chipped or broken teeth, lip and cheek injuries, jaw fractures, mouth lacerations and even concussions.

Having a mouthguard can make the difference between losing your teeth or not, and because many of our patients who play high school sports have jaws that are still growing, last year’s mouthguard may no longer fit as it should. Our team at Bethesda Orthodontics can fit you for a new guard.

To learn more about mouthguards or for general questions about your treatment at our Bethesda office, please give us a call!

The term malocclusion refers to misalignment of teeth. You may have been born with malocclusion, so your teeth simply grew in crooked, or the misalignment and crowding of your teeth occurred over a period of time. Either way, not only can malocclusion pose cosmetic issues, but it can have a negative effect on your speaking and eating abilities as well.

Types of Malocclusion

Malocclusion encompasses multiple types and classifications of misalignment issues, including twisting or rotation of the teeth and molars that do not meet when you bite down. In some cases, the top front teeth are pushed outward in an upper protrusion.

In other cases, a misplaced midline results when the front top teeth don’t meet with the front bottom teeth. Transposition occurs when teeth protrude through the gums in a position where another tooth is supposed to be.

Practically any type of crowding or spacing issues, rotation or twisting of the teeth, or bite problem – including overbite, underbite, open bite, or crossbite – is included under the umbrella of malocclusion.

Malocclusion Classifications

There are three classifications of bite or misalignment problem.

• Class 1 malocclusion: While the bite may be normal, the upper teeth overlap the lower teeth slightly. This is the most common type.

• Class 2 malocclusion: Known as overbite or retrognathism, class 2 involves a severe overlap of the upper teeth and jaw over the bottom teeth and jaw.

• Class 3 malocclusion: Known as underbite or prognathism, class 3 occurs when the lower teeth and jaw overlap the upper teeth and jaw. Thus, the lower jaw juts forward.

Causes of Malocclusion

The most common cause of malocclusion is genetics. However, there may be other causes, including the development of abnormally-shaped teeth, lost teeth, or impacted teeth; thumb sucking or overuse of a pacifier as a small child; having fillings or crowns that do not fit correctly; a serious injury that causes misalignment of the jaw; or developing a tumor of the mouth or jaw.

Treating Malocclusion

Orthodontic care at Bethesda Orthodontics is the main treatment available for malocclusion, which includes getting braces, Invisalign, BRIUS or other corrective treatments. Treatment is ideal not just to have your smile improved, but because it makes the teeth easier to clean and maintain, lowers the risk of gum disease and tooth decay, and can even take pressure off the jaw and teeth.

Think about orthodontic treatment if you (or your child) display any signs of malocclusion. Early treatment of malocclusion during childhood can lessen expensive treatment later on.

Getting braces or BRIUS comes with a lot of rules. No sticky candies, watch out for popcorn, and steer clear of chips. These rules leave many wearers wondering what they can still eat without hurting their teeth or their expensive orthodontic appliances. Fortunately, constructing a braces-friendly lunch is straightforward once you know which foods to avoid.

Foods to Avoid When Wearing Braces

There are a few food categories to avoid when you have braces or BRIUS. Sticky foods also stick to the metal in your braces, and can potentially break wires or individual braces. For example: bubblegum, candy bars, caramel, licorice, fruit roll-ups, and Starbursts should be avoided. Many of these foods also contain high levels of sugar, which can cause plaque build-up if not brushed away properly.

Also, be wary of hard foods that can harm your orthodontic appliances. Avoid eating hard taco shells, chips, Rice Crispy treats, hard candy, beef jerky, and popcorn. Some healthy foods, such as carrots, apples, corn on the cob, and nuts, are hard on braces. To eat these foods safely, cut them into smaller pieces before eating.

Remember that certain habits may be harmful to your braces. For example, crunching on ice cubes may be a reflexive response when you’re enjoying a cold beverage, but this can significantly harm your braces and extend treatment time. To stay on the safe side, Dr. Negaar Sagafi and our team at Bethesda Orthodontics recommend you drink beverages without ice or add crushed ice whenever possible.

Lunch Recipe

Even with braces and BRIUS, it’s easy to enjoy a healthy, nutritious lunch. For example, make a panini on whole wheat bread with slices of turkey deli meat, a piece of Swiss cheese, and tomato slices. Spread 1 tbsp. of mustard or mayonnaise on the bread before toasting the sandwich in a panini grill. Serve the panini with ½ c. low-fat cottage cheese and a sliced pear or apple for a balanced meal. Then grab a pudding cup or some JELLO for dessert. Wash it all down with water containing a lemon wedge or all-natural fruit juice. Make sure to brush your teeth or rinse with mouthwash after lunch to wash away sugars and food residue that can get trapped in braces and cause decay.

If you have any questions about what you can and can’t eat with braces during your treatment at Bethesda Orthodontics, be sure to ask our team during your next appointment at our Bethesda office!

We are about to mark the one-year anniversary of our nation’s collective COVID-19 shutdown. Montgomery County, Md. and Washington, D.C. – where my two practices reside – went into lockdown on March 13, 2020.

Resilience is a word that is sometimes overused, but it was definitely more appropriate than ever in 2020. I am so proud of the schoolchildren who are my patients. They learned to … well … learn in a whole different way over the last 12 months. And parents? They are my superheroes! I cannot imagine working from home while monitoring schoolwork.

I am also proud of my staff and my fellow orthodontists and dentists. Even though we know the care we provide is essential, last spring we were kept for many weeks from doing what we love and what we know is a vital service to our community. We didn’t know when our livelihoods would bounce back … or if they would.

I’m especially proud that, since our practices opened up again last summer, we have proven that our offices are safe places where patients can get routine and emergency care in a COVID-free environment.

According to a new study published in The Journal of Dental Hygiene, the estimated prevalence rate of COVID-19 in U.S. dental hygienists is low. In fact, a survey of nearly 5,000 hygienists revealed only 3.1 percent had ever tested positive or been diagnosed with the virus. Masking up keeps the virus from spreading!

That study came after one published in October 2020 in The Journal of the American Dental Association that indicated fewer than one percent of U.S. dentists had been diagnosed with COVID-19. That result was far below the rate of other U.S. health professionals. The Journal also reported 99 percent of dentists were using enhanced infection control procedures such as screening protocols when treating patients.

We are committed to patient safety.

My practices not only have increased screening protocols and disinfection practices – I am scrubbing and hand sanitizing so much now that I sleep with gloves and moisturizer on my hands! – we have altered our personal behavior outside of the office to ensure our offices stay COVID-free.

I love to travel and have not been on a plane since last February. We are not carpooling with friends and neighbors – and we are not taking car or ride shares either – and we are celebrating birthdays and other family milestones from the safety of our own homes, with only those who live under our roofs. And, of course, we are excited to report that, as frontline healthcare workers, most of us have received our COVID-19 vaccines!

We miss social interaction and vacations just like everyone else, but with so many people still unvaccinated, going on a little weekend jaunt is not worth the risk.

While our practices were deemed non-essential at the beginning of the pandemic, we also know now that dentists, orthodontists, and other oral health experts actually can help diagnose COVID-19. According to Dr. Aravindhan Karunakaran, the virus can cause lesions on the tongue that might be the only symptom of COVID-19.

I hope these measures and this academic research will reassure parents and caregivers. According to a survey by C.S. Mott Children's Hospital National Poll on Children’s Health, 40 percent of parents have avoided seeking dental care for their children during the pandemic, citing concerns about infection, office closures, and cost.

Not only does this set a bad precedent about how children will view dentists and orthodontists long-term (they’re scary or non-essential), it threatens overall health. What happens with your teeth can impact everything from quality of sleep to heart health. And, according to a report in Dentistry Today, patients with COVID-19 and gum disease were 4.5 times more likely to need a ventilator, and almost nine times more likely to die than those without gum disease.

Dental care is essential. And during COVID-19, it is safe.

February has officially arrived! This is a great time to “brush up” on your child’s dental hygiene in honor of National Children’s Dental Health Month! The tips below won’t only benefit the kiddos, however. Parents should take note too!

Dental care for your child begins in infancy. The bacteria in your mouth is dynamic and changes as kids age. Brushing always is important but becomes even more so with each candle you add to the birthday cake.

Getting your child to brush their teeth every day, twice a day can prove challenging and exhausting at times but don’t give up! Just keep telling them to do it. Building a habit takes time, but it ultimately pays off when you teach your child healthy habits that will last the rest of their life. When your child undergoes orthodontic treatment the diligence of their oral hygiene routine becomes even more important. If you don't brush while having braces, it will leave spots.

When it comes to selecting toothpaste for your child I would choose one with minimal amounts of fluoride. Kids aren't great at swallowing so less fluoride actually is better. No more than a pea-size amount of toothpaste is necessary - that is plenty!

One of the most important parts of maintaining a healthy smile is maintaining a healthy diet! Diet becomes particularly important while undergoing orthodontic treatment. Smoothies and veggie-packed soups are great, especially for kids with sore teeth from braces.

As for when to bring your child in for their first appointment, it can vary. For dental visits, it used to be 3 years old, but the American Association of Pediatrics now recommends younger. For ortho, the recommended age is 7 years old. Sounds early, but that is what the AAO recommends! Here is a link where you can learn more: https://www.bethesdaorthodontics.com/early-orthodontic-treatment

If your child is worried or scared about their oral health visits, be mindful about projecting your own anxiety. Try not to refer to your own difficult dental stories! Preparing your child well before their first appointment is highly encouraged, but talking through their worries is better than falling back on past experiences.

And, when in doubt, go the library! There is a great book called "Smile" that explains orthodontia and its benefits. I've had children tell me that it really prepared them to come in for their first appointment. Like the book (it's a graphic novel), my office is colorful and inviting. And we always smile!

If you have any questions or concerns or want to learn more, our team is always happy to discuss them with you—any time of year! We should celebrate children's dental health every month!

It’s true that orthodontic braces can give you a beautiful smile. But did you know there are other benefits of having braces than just getting perfectly straight teeth? Our team want you to understand the other positives that can come out of having braces and relate to your oral health.

When teeth are crooked or crowded, it’s hard to brush and floss effectively. When there isn’t enough space in your mouth, bacteria and plaque can build up between these teeth. This can lead to serious issues like tooth decay and gum disease. When braces correct the spacing between teeth, and get rid of the tight spaces, patients are able to brush and floss more effectively and not miss essential areas of the mouth.

Surprisingly, braces can also address speech problems. They can shift problem teeth that may be causing embarrassing speech impediments. When an overbite or underbite gets adjusted, patients can pronounce certain words more clearly.

Spaces between teeth may also cause whistling, which braces can fix by closing off the gaps. Word slurring can also be improved with the help of braces by realignment of the jaw or teeth, which opens room for your tongue to move with greater ease.

Braces can also be helpful in supporting the bones and tissues in your mouth. Braces move periodontal ligaments by stretching the connective tissues and nerves. The bones naturally rebuild once they’re settled in their new spot.

Without support from poorly aligned teeth, gum tissue can erode. Braces help prevent erosion of the gums, and will alleviate pressure from the jawbone by fixing a bad bite over time.

If teeth are misplaced, they may not break down food effectively before it enters your stomach. Teeth aid with digestion when you can thoroughly chew your food. If your teeth are badly placed, braces can straighten them for optimal alignment. Once you can chew properly with the help of braces, your food will be more easily and fully digested.

If you have questions regarding braces and how they can help you, contact our Bethesda office and set up a consultation appointment. Braces can help with many oral health problems, and may save you a lot of money and time in the future.

If you’re not sure whether braces would be worth your time or money, consider the benefits above, and how they add to the value of this treatment. You’ll be getting more than just a beautiful smile!

You may have a talent for home repairs. You may be able to rebuild your computer. You may even be able to put together a whole room of furniture armed only with flat-box kits and an Allen wrench. But, please—don’t try do-it-yourself orthodontics!

Now that generic clear aligners are available, you might consider giving them a try to save some money. But is straightening your own teeth really a good idea? Before you are tempted, let’s look more closely at the products and the dental science involved.

Invisalign®

• Invisalign clear aligners are used by orthodontists and dentists with experience in custom treatment for your smile. A 3D image of your teeth will be captured by the iTero Element® scanner. Using special software, your doctor can map out each projected shift in your teeth, and even show you a projection of your finished smile!
• Your Invisalign aligners will be tailored to fit your teeth precisely using the 3D scan and 3D printing. They are made from SmartTrack® material, a product specifically engineered for a perfect, comfortable fit. Invisalign aligners are even trimmed to fit your individual gumline to prevent irritation.
• When your first sets of Invisalign aligners arrive at our Bethesda office, we'll check for fit, answer any questions you might have about use and care, and let you know what to look for and what to expect. Your progress will be monitored with visits every six to eight weeks. (And for parents of teens, Invisalign aligners can offer blue “compliance indicators” to let you know they are being worn the 20-22 hours a day necessary for the best and fastest results.)

Generic Aligners

• You might be required to make a putty mold of your own upper and lower teeth, which is not the easiest thing to do well, and to take selfies of your teeth.
• The aligners will be sent to you in the mail. They are generally made of hard plastic with generic gumlines. There will be no one to tell you if the aligners fit properly.
• They are sometimes less expensive because there is no in-person medical supervision. A dental professional working for the company will look at the model created from molds you submit, and recommend a series of aligners to correct the problems he detects by looking at the model and your selfies. This supervisor will not be able to assess the overall dental health of each patient to make sure teeth and gums are healthy and ready to start treatment, and will not be able to tell if the teeth are moving properly or improperly once the aligners are in use.

Finally, while generic aligners may potentially have some success in minor tooth straightening, they are not created to deal with complex bite issues or malocclusions.  In fact, using generic aligners with no supervision can cause more serious dental problems than a patient started with.

Sure, sometimes a do-it-yourself project turns out well. But your teeth and bones are too important for home improvement. When it comes to creating a beautiful, even smile and balanced, comfortable bite while making sure of your dental health, it’s always best to trust a professional to provide you with gentle, tested, and successful care!

Time.

There really does not seem to be enough of it these days and, with all due respect to the fathers who come through my office door (and there are a lot of them!), balancing work from home and school from home is taking the harshest toll on mothers.

Consider this telling statistic: in December 2020, the American economy lost a net 140,000 jobs. Men actually gained 16,000 jobs, but women lost 156,000. Last fall, Facebook’s Chief Operating Officer, and founder of the LeanIn.Org, Sheryl Sandberg urged companies to be more flexible – or risk losing their top female talent.

I hear the stress in the voices of the mothers who come into my office, whether they hold jobs outside of being wife and parent or not. This crisis has taken a toll.

The medical community can make things just a tiny bit easier by embracing digital technologies that allow us to check in and follow up with our patients virtually.

Both of my offices use Dental Monitoring by DentalMind, for example. With the app on iOS and Android, patients capture their treatment progress, communicate them to my office, and receive any necessary instructions or changes directly from me. This technology allows me and my patients to maintain consistent contact between appointments in a safe, seamless, and time-saving way.

I also offer virtual consults. Patients take a few snaps of their smiles and, based on these photos alone, I can come up with a preliminary treatment plan. We will meet face to face as a next step, but there is no reason not to use technology to get things started.

Digital technologies also are super convenient in a pinch.

A couple of weeks ago, my front desk fielded a call from a mom in Middleburg, Va. who was supposed to bring her teenage son in that day for an in-person consult. Even under normal circumstances, Middleburg is quite a drive to the Washington, D.C. area and, on this particular day, everyone was just running behind.

I could hear the relief in mom’s voice when I told her the consult could be done digitally. After all, why do we carry around high-resolution cameras and computers in our purses if we can’t use them to save ourselves a few minutes? I hope that mom was reassured, too, that if she chose our office for her son, many of our follow-ups could be completed from her own living room.

Smartphones also can be incredibly helpful when assessing emergency situations with your dentist or orthodontist. A friend of mine who is a pediatric dentist evaluated a young patient on a Friday night who fallen (err, jumped) off a couch and landed on a set of drums. (Ouch!) Teeth were broken, but the dentist also clearly could see that stiches were needed. While mom still was not happy with the stage dive, at least her dentist-by-iPhone gave her a clear path forward and at least some reassurance.

Telehealth not only saves time, it saves money. According to an April 2020 article in U.S. News & World Report, for medical visits, “The national median cost for a video-based virtual visit is $50, compared to $85 for low-severity treatment at a doctor’s office, $130 for an urgent care facility visit, and $740 for an emergency room visit.”

One more benefit?

Telehealth also is good for the environment. When researchers from the University of California at Davis studied the use of telehealth in the Golden State, they found “telemedicine utilization saved the air almost 2,000 metric tons of carbon dioxide, 50 metric tons of carbon monoxide, 3.7 metric tons of nitrogen oxides and 5.5 metric tons of volatile organic compounds.”

Digital health: good for the planet … easy on your schedule.

So, take an easy breath next time you’re worried about making time for your appointment. Give us a call, and we’ll determine if we can do it virtually instead.

Valentine’s Day is the holiday to celebrate all the treasured relationships in your life. It’s a time to honor love in all shapes and forms with cards, social gatherings, and sometimes even binge eating of sweets.

It's hard to look the other way when grocery stores and pharmacies are invaded with goodies connected to the Valentine’s Day theme, and especially if you’re on the receiving end of some of these sweets. We get it. In fact, we’re all for it!

However, we also support a cavity-free smile. So in the interest of your dental and general health, and because we think it’s genuinely tasty, we recommend an alternative to the Valentine treats you may be accustomed to: dark chocolate.

Yes, Healthy Chocolate Exists

Studies have shown that dark chocolate is high in flavonoids, an ingredient found in the cocoa beans used to make chocolate. Flavonoids can help protect the body against toxins, reduce blood pressure, and improve blood flow to the heart and brain.

By opting for dark chocolate rather than milk chocolate, you get to reap these benefits! Pretty sweet, right? Just make sure to stick to high-quality dark chocolates that have undergone minimal processing.

Dark Chocolate, AKA Protector of Teeth

Not only does dark chocolate provide some nice benefits for your overall health, it also helps protect your teeth against cavities! According to the Texas A&M Health Science Center, dark chocolate contains high amounts of tannins, another ingredient present in cocoa beans.

Tannins can actually help prevent cavities by interfering with the bacteria that causes them. Think of them as scarecrows for bacteria. They don’t always prevail, but isn’t it nice to have them there?

Smooth Never Sticky

Unlike many popular candies, dark chocolate is less likely to stick in the crevices of your teeth. Chewy, gooey sweets are more likely to hang around in your mouth for longer periods of time, which means they raise the odds of your harboring cavity-creating bacteria.

While some dark chocolates have additives like caramel or marshmallow, it’s best to opt for the plain varieties, which are just as delicious. If you’re feeling festive, though, a dark chocolate with caramel is still better than a milk chocolate with caramel, so that’s the way to go!

While dark chocolate has some pretty sweet benefits, the most important thing to remember (whether you go the dark chocolate route or not), is that moderation is key. That being said, we hope you have fun satisfying your sweet tooth and shopping for treats for your friends and loved ones. Happy Valentine’s Day from all of us at Bethesda Orthodontics!

Our team at Bethesda Orthodontics knows that there are many ways you can protect your pearly whites throughout your orthodontic treatment. If you follow the rules and brush your teeth twice a day, floss often, and protect your appliances from damage, you should have a successful treatment.

But did you know there’s another way to keep your teeth sparkling and healthy during your time wearing braces?

Fluoride, the mineral that helps you prevent cavities and tooth decay, can also help keep your teeth strong. Fluoride comes in two varieties: topical and systemic. Depending on your oral health or our recommendation, you may be required to have a fluoride treatment every three, six, or 12 months. We may also prescribe a fluoride product such as a mouthwash, gel, or antibacterial rinse for at-home treatment to keep your teeth happy in between visits.

If you have any other questions about fluoride or your treatment, please don’t hesitate to give us a call!

It might be the most wonderful time of the year, but if you’re dashing through the snow to an emergency orthodontic appointment, you’re not feeling very jolly. And post-holiday, no one wants to start off their New Year’s Resolutions with “Get Cavities Filled.” How to survive the sweetest of seasons with braces and enamel intact?

Candies and sweets would normally be on the naughty list, but we’re not Scrooges! Indulging in a treat or two is part of the holiday fun, and we have some advice for how to enjoy them guilt-free. But first, some treats are definitely more naughty than nice. Which are the ones that are better as decorations than desserts?

• Candy Canes

If you’ve ever suffered a broken bracket or a chipped tooth after an innocently biting down on a much-harder-than-expected piece of candy, you know that caution is in order. That’s why we tend to savor candy canes, letting them dissolve slowly in the mouth. Of course, the drawback to this strategy is that now we’re slowly bathing our teeth in sugar, encouraging the growth of plaque and cavity-causing bacteria.

Candy canes, peppermints, and other hard candies are potentially bad for your teeth and braces when you crunch away, and definitely bad for your teeth if you let them dissolve slowly.

• Gumdrops

Glistening, colorful gumdrops. Roofing your gingerbread house, trimming a gumdrop tree, or simply sitting in a bowl, they are one of the sweetest ways to decorate for the holidays.  And when we say “sweet,” we mean that literally. Most gumdrops are basically made of corn syrup and sugar—and then rolled in more sugar.

But their sugar content isn’t the only problem. This is sugar in an extra-gummy form that sticks between our teeth and along our gums, and gets caught around brackets and wires.

• Toffees, Caramels, Taffy

They might come in lovely ribboned boxes, but these extremely sticky foods are not a gift to your teeth.

Not only do chewy candies stick to enamel, they stick to fillings, crowns (especially temporary crowns), and orthodontic wires and brackets. No one wants an unexpected trip to the dentist or orthodontist because dental work has been damaged or dislodged!

• Gingerbread Houses

Nothing says the holidays like a gingerbread house—chewy, sticky gingerbread covered with hard sugar icing, gumdrops, and peppermints. Great for your décor; not so great for your dental health. Eat one gingerbread man if you’re in a spicy mood and leave your architectural masterpiece intact.

Well, this list wasn’t very jolly. So as a little holiday gift for you, here are some suggestions to help you enjoy your desserts in the healthiest way possible.

• Be choosy.

Just like you search for the perfect presents for your family and friends, take the time to choose the perfect holiday treats for yourself. If you are wear braces, or are worried about cavities, or are just generally concerned with your oral health, stay away from sticky, hard, and excessively sugary desserts.

What can you accept from your holiday hosts with a grateful (and relieved) smile? The occasional soft chocolate should be nothing to stress about—and if you make it dark chocolate, you’ll actually get nutritional bonuses like magnesium and antioxidants. Soft cakes, cupcakes, cookies, and pies should be braces-friendly—yes, they are made with lots of sugar, but it is the holidays after all. Just be sure to follow our next suggestions to make that slice of cheesecake guilt-free.

• Eat sweets with a meal.

Saliva does more than keep our mouths from getting dry. It also helps prevent cavities by washing away food particles and neutralizing the acids from food and bacteria which damage enamel.

Eat dessert with a meal, and you benefit from increased mealtime saliva production. When you snack throughout the day, this acid-neutralizing ability is greatly reduced.

• Rinse after eating.

Rinsing your mouth with water after a meal or a snack, especially a sugary one, also helps wash away the sugars and carbs which oral bacteria convert into cavity-causing acids.

• Brush immediately. (Maybe.)

If you wear braces, you want to make sure there are no food particles stuck around your brackets and wires. If you wear aligners, you want to get rid of food particles on and around your teeth before you replace your aligners after eating.

But if you’ve eaten acidic foods like citrus or colas, the acids in the food can weaken your enamel just enough to cause some potential enamel damage if you scour your teeth immediately after eating. We often recommend waiting about 30 minutes to brush to give your enamel a chance to recover.

Since every mouth is different, especially when you wear braces, make sure to ask us about the best times and methods for holiday brushing.

You don’t want to ho-ho-hope that we can fit you in at our Bethesda office for a bracket repair. Make your holiday dessert list and check it twice, and make sure you’re brushing and flossing more often if you’re indulging in seasonal treats—give yourself these two gifts, and you’ll be ringing in the New Year with a beautiful, healthy smile. Sweet!

At Bethesda Orthodontics, we know that eating with braces can be tricky. You want to avoid damaging the bands, brackets, and wires, since any damage can delay the progress of your treatment. After adjustments, your mouth may also feel sore, which will make eating more of a chore than a pleasure.

The good news is you do not have to avoid all of your favorite foods; there are ways you can still enjoy them. Try some of these ideas and recipes for great snacks that are friendly to your braces.

Fruits and Vegetables

You still need to eat fruits and vegetable for the healthy nutrients. The trick is to cut harder items into small pieces that you can chew easily with your back teeth. Canned fruits are also a great choice, but select fruits packed in water to avoid the heavy, sugary syrups. It’s a good idea to avoid excess sugar with braces, since sugar build-up around your braces can lead to plaque formation.

Single-serving packages are available to make your snack portable and convenient. Enjoy vegetables with a small amount of a healthy dip. Hummus or yogurt can be used for flavor without adding unnecessary fat or calories.

Banana and Honey Smoothie

Smoothies are a healthy treat, and you can create these drinks with your favorite ingredients. You can use a variety of yogurt types for your smoothie: regular, low or non-fat, and Greek are all great choices.  Here’s one of our favorite smoothie recipes:

• 6 ounces of your choice of yogurt
• 1 or 2 teaspoons of honey
• 1 ripe banana
• 6 ounces milk

Chop the banana into smaller pieces and put all your ingredients into a blender. Blend on low until everything is mixed and then blend on high for about 20 seconds to make your smoothie fluffy.

The great thing about this recipe is that you can substitute just about any small or cut-up fruit for the banana. Try blackberries, raspberries, or peaches for variety. Try to avoid fruits with small seeds; strawberries can leave bits stuck in your braces. You can even make a smoothie with peanut butter and jelly!

Please ask our team if you have any concerns regarding the foods you can safely eat while wearing braces.

Now that you have braces, it is more important than ever to maintain good oral hygiene during your treatment. While we trust you will continue brushing and flossing on a regular basis throughout your treatment at Bethesda Orthodontics, you also have to mindful of what you eat. While all those sweet, sour, and sticky candies may taste great, these treats can actually damage your teeth and braces!

Sour candies  can be acidic to your teeth, and actually wear down the enamel that protects them, resulting in tooth decay and cavities. If you do indulge in eating these candies at some point during your treatment, be sure to wash your mouth out with water, drink milk or eat a few slices of cheese. These foods will help neutralize the acid in your mouth.

Besides cavities and tooth decay, many people do not realize that good oral health and hygiene are important to your overall health, too; researchers have discovered the connection between periodontal disease and other major health concerns, such as heart disease. Therefore, it is important to maintain a good oral hygiene routine just as you did before your braces. This includes visiting your dentist here in Bethesda every six months, brushing and flossing daily, and using an antibacterial mouthwash, as well as visiting our office for your regular adjustment appointments.

For more questions about foods you should avoid while wearing braces, or if you have any general questions about your treatment, we encourage you to give us a call, ask us at your next adjustment appointment or ask us on Facebook!

The best way to avoid orthodontic emergencies is to know how to take care of your braces properly throughout your entire treatment. However, emergencies are … well, emergencies, and sometimes no matter how cautious you are or how well you take care of your braces, the wires loosen, the bands pop, or you experience orthodontic discomfort.

Common orthodontic emergencies include broken braces, poking wires, lost or broken retainers, mouth sores, and mouth injuries sustained playing sports, which often happens when you don’t wear a mouthguard to protect your teeth and appliance.

Food

It’s important to avoid foods that can damage your braces. Most people wear braces for about two years. All chewy, sticky, crunchy, and hard foods should be avoided during that time. While this may seem like a long time to go without popcorn or bubble gum, hard foods can break the brackets of your braces and sticky foods can bend the wires. If you have a loose wire, don’t try to fix it yourself. Call Bethesda Orthodontics. In the meantime, if a wire is poking into your cheek or lip and causing irritation, put wax or a wet cotton ball over it to dull the sharp edge.

Pain and Discomfort

Some discomfort is a normal part of orthodontic treatment, especially in the hours after the braces are placed on your teeth or after a recent tightening or adjustment. However, if the pain doesn’t subside in three to five days, it’s a good idea to schedule an appointment at Bethesda Orthodontics. Until then, try dissolving a teaspoon of salt in an eight-ounce glass of water and gargling with the solution. Over-the-counter pain medication will relieve discomfort, too.

Playing Sports

Just because you wear braces doesn’t mean you can’t play sports. You just need to take some extra precautions. Sports-related injuries to the mouth and jaw are common. The best way to protect your mouth and your appliance is to wear a mouthguard. There are several different types of mouthguards available, so be sure to ask what’s best for you.

Brushing and Flossing

In order to keep your braces in good condition and avoid orthodontic emergencies, it’s important to brush and floss thoroughly after every meal. It’s easy for small particles of food to get trapped in your braces, and if the food isn’t removed, it gets wedged between the teeth and gums and causes plaque.

Need more tips on how to avoid orthodontic emergencies? Just ask any member of our Bethesda team.