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“I think I have to cancel my appointment.”

Our office has gotten that call more than once in the last several weeks, sometimes just hours before a scheduled visit. Under normal circumstances, we discourage these last-minute cancellations, but these days? Well, we certainly understand when it comes to COVID. In fact, we want you to act with extreme caution.

It is one way that you can help us keep our offices safe and help prevent community spread of this deadly virus.

As you and your family probably have seen, our offices have increased the amount of personal protective equipment we are wearing – sometimes we even don more than one mask! You’ve seen face shields (which are added protection, but should not be relied on instead of a mask) and certainly more hand sanitizer.

Dentist and orthodontist offices always are always fanatical about infection control, but we are even more so now.

And, the good news: we know it’s working.

According to a study from the American Dental Association (ADA), while dentists and orthodontist offices were shut down at the beginning of the pandemic due to fears about COVID spread, less than one percent of dentists have had the virus. That result is far below the rate of other health professionals in the United States. The ADA also noted that “99 percent of dentists are using enhanced infection control procedures such as screening protocols and enhanced disinfection practices when treating patients.”

If you are feeling well, you should feel confident about keeping your regular dentist and orthodontist appointments.

What can you do to help keep our offices free of COVID?

At home and wherever you go:

• Wash your hands frequently with soap and water for 20 seconds or, if you don’t have access to soap and water, use alcohol-based hand sanitizer;
• Maintain at least six feet of distance between yourself and anyone else, especially if they are coughing or sneezing;
• Limit interaction with individuals outside of your household;
• Avoid touching your eyes, nose, and mouth;
• Cover your mouth and nose when you cough or sneeze – do not use your hands; and
• Wear a mask whenever you are outside of your household.

Obviously, if you have a fever, cough, shortness of breath, headache, or have lost your sense of taste or smell, call our office. We’ll discuss your health status, the dental treatment you require, and whether or not visiting our office will be safe for you, our other patients, and our staff. Please also give us a call if you’ve been exposed to someone that has had a positive COVID-19 test. That’s helpful information and we can always see you after you’ve had time to quarantine.

Third, while we know the early bird gets the worm, it also can cause crowding in our waiting rooms. Please be on time, but if you’re more than five minutes early, wait in your car or call to see if we can safety seat you.

Finally, a note about travel, which my patients know that I love! I have not enjoyed being grounded, but COVID-19 can travel with us wherever we go. If you have been out of the area in the last 14 days – anywhere – or if someone in your household has traveled, please let us know. Again, we can always reschedule!

At the heart of every doctor-patient relationship is trust and good communication. If you’re worried about coming in, or wondering if you should keep your appointment, just give us a call and we’ll talk through it. Remember: our job is to keep you and your family smiling and healthy.

Especially, in these times, we’ll understand if you need to reschedule.

Getting braces is a huge step in creating the beautiful smile you want. It’s easy to see how important your wires and brackets are. Week by week, you and your family and friends can see the progress you’re making as your teeth become straighter. That makes all the careful brushing, periodic adjustments at our Bethesda office, and annoying loose ligatures worthwhile.

And while straight, even teeth are the visible reward you get for your months in braces, there’s a benefit that’s every bit as important that might go unnoticed by your friends and family—a healthy, properly aligned bite.

Many people have some kind of malocclusion, or bad bite. There are several different bite problems we treat. Some of the most common are:

• Overjet (the upper front teeth protrude too far forward over the bottom teeth)
• Underbite (the bottom teeth overlap the top teeth)
• Crossbite (one or more teeth haven’t come in in the proper position, often with an upper tooth fitting inside a lower tooth)
• Open bite (the upper and lower front teeth don’t touch).

When the jaws and teeth don’t fit together properly, you might be looking at damaged teeth, headaches, and painful problems with the temporomandibular joint, or jaw joint, in your future. That’s why correcting your bite early is so important. Using rubber bands with your braces is one of the most popular and effective ways to help create a better bite.

Bands are used with your braces to gradually move your teeth into their best position. Specially designed brackets with tiny hooks are bonded to very specific teeth. Why so specific? Because the placement of the brackets depends on which type of malocclusion we are correcting. Rubber bands are then attached to the bracket hooks, usually from an upper tooth to a lower one. When they are in just the right position, those little bands provide just enough force to move your teeth more quickly and effectively than braces alone can.

If you need bands to help correct any kind of malocclusion, you will play a very important part in your orthodontic treatment. It will be your job to attach your bands every day. Don’t worry—while it can seem confusing at first, we’ll make sure you know exactly how and where to place them.

How long should they stay in? You’ll probably need to wear your bands 24 hours a day. It’s while you’re moving your mouth and jaw muscles that your bands are working their hardest. Talk to us about removing them for brushing and flossing, and whether you should wear them while you eat.

Can you use the same bands over several days? Not a good idea. Bands are selected for size and strength to move your teeth very precisely from visit to visit. When bands stay on too long, they become too stretched out to supply the proper pressure needed to move your teeth efficiently. Dr. Sagafi will let you know how long is too long for your specific bands.

Are two bands better than one? Absolutely not. Again, the bands you’re given at each visit are designed for your specific needs. Too much pressure can actually be harmful. Just keep to your recommended schedule of replacing bands, and your orthodontic treatment will stay right on track.

Attaching rubber bands? Keeping them on all during the day? Replacing them as needed? All of these responsibilities might seem a bit overwhelming at first, but we are here to give you all the information and support you need to succeed. Because straight, even teeth and a bite that is healthy and functional? That’s truly how you create your beautiful smile!

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 love to celebrate the holidays with vigor and we'd love to share some unique ways of celebrating Thanksgiving from beyond the Bethesda area to the national level!

When Americans sit down to dinner on the last Thursday of November, the day that Abraham Lincoln designated as the day on which Thanksgiving would be celebrated, they do so thinking that the first Thanksgiving feast was held at Plymouth in 1621. According to National Geographic, the Spanish explorer Francisco Vásquez Coronado and his men celebrated a feast of Thanksgiving in Texas in 1541, giving Texas the distinction of being the first place where Thanksgiving was celebrated.

Different Types of Celebrations

Native Americans had rituals around which they celebrated in hopes of ensuring a bountiful harvest. The Cherokees had a Green Corn Dance that they did for this very purpose. The Pilgrims (not to be confused with the Puritans,) rejected any type of public religious display. They held a three-day long non-religious Thanksgiving feast. Although they said grace, the focus of their celebration was on feasting, drinking alcohol (they did have beer,) and playing games.

The Pilgrims at the Plymouth Plantation celebrated a different day of Thanksgiving in 1623. Plagued by a crop-destroying drought, the settlers prayed for relief. They even fasted. A few days later, they got the rain they so desperately needed. Soon thereafter, they received another blessing when Captain Miles Standish came with staples they couldn't otherwise get. He also told them that a Dutch supply ship was en route. In gratitude for the abundance of good fortune, the Plymouth settlers celebrated a day of prayer and Thanksgiving on June 30, 1623.

The Story of Squanto

No discussion of Thanksgiving is complete without a discussion of Squanto, or Tisquantum, as he was known among his people, the Patuxet Indians. It is believed that he was born sometime around 1580. As he returned to his village after a long journey, he and several other Native Americans were kidnapped by Jamestown colonist, Thomas Hunt. Hunt put them on a ship heading to Spain where they were to be sold into slavery.

As fate would have it, some local friars rescued him and many of the other kidnapped natives. Squanto was educated by the friars. Eventually, after asking for freedom so he could return to North America, he ended up in London where he spent time working as a ship builder. By 1619, he was finally able to get passage on a ship headed to New England with other Pilgrims.

Upon arriving at Plymouth Rock, he learned that his entire tribe was wiped out by diseases that accompanied earlier settlers from Europe. In gratitude for passage on their ship, he helped them set up a settlement on the very land where his people once lived. They called the settlement Plymouth. Since they knew nothing about how to survive, let alone how to find food, Squanto taught them everything, from how to plant corn and other crops, how to fertilize them, how and where to get fish and eels and much more.

After a devastating winter during which many settlers died, thanks to Squanto's teaching, they had an abundant harvest. After that harvest, they honored him with a feast. It is this feast of 1621 which was celebrated between the Pilgrims and Wampanoag Indians that is widely considered the first Thanksgiving celebration.

About the Meal of the Plymouth Settlers

Surviving journals of Edward Winslow that are housed at Plymouth Plantation indicate that the first Thanksgiving feast was nothing like what Americans eat today. The meal consisted of venison, various types of wild fowl (including wild turkey,) and Indian corn. There were no cranberries, stuffing, pumpkin pie, potatoes, or any of the other “traditional” foods that appear on modern menus.

Today, Thanksgiving is celebrated on the fourth Thursday of November, the day that Abraham Lincoln designated as the holiday. It is still a day of feasting, and for some, a day of prayer and thanksgiving. For others, it is a celebration of gathering, especially for families. Still others may celebrate in entirely different ways, including watching college football bowl games, or by playing family games.

If you ever wonder why you're so tired after the Thanksgiving meal, it's because turkey contains an amino acid, tryptophan, and it sets off chemicals whose chain reaction combine to make people sleepy.