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Your smile is just about perfect. There’s just that one tooth that’s out of place. So, do you really need to see an orthodontist?

Absolutely! Why? There are several good reasons.

First, let’s check to make sure there is no physical problem causing that turned tooth. A crooked tooth might result from an early oral trauma while the tooth is developing, or a baby tooth lost too early, or the loss of a nearby adult tooth. But a sudden change in a tooth’s orientation might also be caused by a cyst or a tumor. If you notice any changes in your tooth’s position, it’s a good idea to talk to Dr. Groisser.

Second, we want to make sure your bite is aligned properly. If your tooth is crooked due to crowding by your other teeth, or if it has rotated a bit because there is too much space between your teeth, your bite might be affected as well. Malocclusions, or bad bites, can lead to a number of unpleasant consequences, including headaches, jaw pain, and increased pressure and stress on the teeth.

Third, a crooked tooth can lead to more difficulty brushing and flossing between and around the teeth, which increases the chance of tooth decay.

Fourth, we provide the professional medical care you need. Some people with a turned tooth attempt self-help with rubber bands, dental floss, or other home remedies. Not only is this unlikely to work, it can actually lead to infection, root problems, and even tooth loss.

Maybe there are no health concerns causing, or caused by, your crooked tooth. Your bite is strong, and you like your unique smile just the way it is. In that case, smile on!

But if you are interested in aligning that one crooked tooth with the rest, give our Clarksburg, Gaithersburg, and Hagerstown office a call, and we’ll get to the root (literally!) of the problem. Depending on the reason your tooth is twisted, we’ll suggest the braces or clear aligners that will provide your most effective orthodontic treatment, and give you safe and lasting options for achieving the smile you’ve always wanted. Perfect!

Let’s talk science! From the vastness of the cosmos to sub-atomic particles, science helps us understand the world around us and how it works. So, let’s take some familiar scientific fields of study and apply them to your toothbrush.

My toothbrush?

Yes, indeed! When it comes to your oral health, your toothbrush is the first line of defense, so understanding how and why it works so well might help us use this handy tool even more effectively.

Biology—the study of living organisms

Unfortunately for your toothbrush, the living organisms we’re talking about here are the bacteria which cause tooth decay and those which can lead to illness. How do these problems arise, and how do we prevent them?

Fight Plaque

Plaque is the sticky film that builds up on teeth, and millions of oral bacteria help make up this biofilm. These bacteria convert sugars and other carbohydrates in the foods we eat into acids. And these acids erode our tooth enamel, leading to tooth decay. (More on this when we get to Chemistry.) The best ways to get rid of plaque?

• Brush often. The recommended minimum is two minutes of brushing twice a day, but when you’re having orthodontic work done, it’s even more important to banish the plaque that can stick to your braces or inside aligners. Ask us what brushing schedule is best for you.
• Try an electric toothbrush. For some people with braces, cleaning the teeth is easier and more thorough with an electric brush.
• Replace your brush regularly. Brushes become worn and frayed after three or four months, and you won’t be brushing as effectively.

Stop Germs from Spreading

• Don’t share. Sharing toothbrushes can lead to an increased risk of colds and infections.
• Rinse thoroughly after brushing, making sure you remove any toothpaste or debris left after you brush.
• Store the brush upright and let it air-dry. Covering the brush or keeping it in a closed container can promote the growth of bacteria more easily.
• Keep different brushes separate when they’re drying to avoid cross-contamination.
• Replace your brush regularly!

Chemistry—the study of what makes up substances, their properties, and how they interact

When it comes to improving your brushing chemistry, the best thing you can do for your toothbrush is to put a dab of fluoride toothpaste on it! Why fluoride? Let’s look at the chemistry of tooth enamel.

Tooth enamel is the strongest substance in our bodies—even stronger than bone. But it is not indestructible, and acidic substances can dissolve the mineral bonds which give our enamel its strength, whether they come from the bacteria in plaque or are found in our favorite foods and drinks (sodas, coffee, tomatoes, and citrus are among the tasty, but acidic, culprits).

The enamel in our teeth contains calcium and phosphate ions, minerals which help make it the strongest substance in our bodies. But when the level of acidity in our mouths becomes too high, these minerals begin to dissolve. Eventually, teeth become pitted, bacteria can penetrate more deeply, and decay is the result.

So what can we do? While our saliva helps neutralize acidity naturally, and we can cut back on acidic foods in our diets, using fluoride toothpaste actually helps restore the strength of our enamel in a process known as “remineralization.”

Fluoride works on the surface of enamel to both attract and anchor calcium ions, reducing mineral loss and strengthening the weakened enamel. Fluoride also interacts with the calcium and phosphate compound to create a new compound that is even stronger and more acid-resistant.

When you brush with fluoride toothpaste, you help replace and restore the mineral composition of your enamel—and there’s evidence that fluoride might even interfere with oral bacteria’s ability to produce acid. Now that’s good chemistry!

Physics—the study of matter and energy and their interactions

The matter here is your tooth enamel, and the energy is the force you use when brushing. And this is one time the force should not be with you.

• Over-vigorous brushing can not only damage your brackets, but can also irritate delicate gum tissue and wear down enamel. A “sawing” back-and-forth motion is both hard on your enamel and misses plaque and debris between the teeth. We’ll be happy to show you the safest and most effective way to brush with braces. Just remember, “Massage, don’t scrub.”
• A soft toothbrush is almost always your best option when you use a manual brush, but if you’re still a heavy-handed brusher, or have sensitive teeth and gums, consider an electric model. An electric toothbrush should provide a continuous brushing motion without needing any heavy pressure from the brusher. Some models will even let you know when you are brushing too hard.

Brushing harder is not brushing better, and your teeth, gums, and braces will be heathier with careful brushing habits. If you need tips on brushing with braces, contact our Clarksburg, Gaithersburg, and Hagerstown office and ask!

There’s a lot of science in the simple act of brushing, but we don’t need to spend hours studying to get a passing grade in dental health. The things you do normally—brushing at least two minutes twice a day, using fluoride toothpaste, and applying proper brushing technique—will help create a smile which will earn you top marks from Dr. Groisser for a lifetime!

TMJ is the quick way of referring to your Temporomandibular Joint. Pardon the pun, but that’s quite a mouthful! What is this joint, what does it do, and, if your Dr. Groisser and our team have told you that you have a TMJ disorder, what can we do to help?

The Temporomandibular Joint

Your two temporomandibular joints are amazing works of anatomical design. These are the joints where the temporal bone in the skull meets the mandible bone of the jaw, and allow our mouths to open and close, move back and forth, and slide from side to side. Muscle, bone, and cartilage work together to provide easy movement and to cushion the joint. But sometimes, the joint doesn’t work as smoothly as it should, and this can lead to Temporomandibular Joint Disorder, or TMD.

When Should You Suspect You Have TMD?

You might have TMD if you experience any of these symptoms:

• Painful chewing
• Pain around your TMJ, or in your face or neck
• Earaches
• Changes in your bite
• Jaws that are limited in movement or lock open or shut
• Clicking, popping or grating noises when you open and shut your jaw

There are many conditions linked to TMD. If you grind your teeth at night, have arthritis in the jaw, have suffered an injury or infection in the area, or have problems with your bite, for example, you might be more likely to have TMJ problems. If you suspect you have TMD, or suffer from any of the symptoms listed above for an extended period, give us a call.

Treating TMD

During your visit to our Clarksburg, Gaithersburg, and Hagerstown office, we will check your medical history, and examine your head and neck. We can take an X-ray or scan if needed for further examination of the joint. Because there is no real scientific agreement yet about the best way to treat TMJ disorders, a conservative treatment plan is often best. If you do show signs of TMD, we might first suggest relaxation techniques, over-the-counter pain relievers, or the use of ice packs or moist heat compresses. A change to a softer diet can help, and you should stop chewing gum and making any exaggerated jaw movements.

If these self-care practices aren’t effective, we might suggest a nightguard. This appliance is a comfortable and flexible mouthguard custom fitted for you, and will bring relief from teeth grinding when worn at night. If this treatment is not effective, talk to us about other options.

Luckily, most cases of TMD are temporary and don’t become worse over time. But any persistent discomfort is a good reason to visit us. Whether you have TMD, or any other problem causing you pain in the head or jaw, we want to help.

The alarm sounds in the morning, you wake up and realize "I forgot to wear my retainer!"

If this only happened once, don't panic. Missing one night with a retainer is unlikely to cause significant teeth movement. However, if it has happened often, give our Clarksburg, Gaithersburg, and Hagerstown office a call to make sure your teeth haven’t shifted position.

Here are some tips from Dr. Groisser to help you remember your retainer:

1. Write down the instructions we give you for wearing the retainer, whether you should wear it all day or at night, or just a few times a week. Writing things out like this helps set the schedule in your memory.

2. Clean the retainer when you take it out each time. If you don’t you may not have time when you’re rushing to get to work or school to clean it properly and may be tempted not to wear it.

3. Put a note on your mirror or in your purse or wallet reminding you to wear your retainer.

4. Set an alarm on your mobile phone to remind you when it’s time to put the retainer in. If you have email with a calendar you can set up daily reminders, too.

5. Always put the retainer in its case when you take it out to eat or sleep. You’ll reduce your risk for losing it or accidentally throwing it away.

6. If you don’t have to wear the retainer every day, you can use some recurring events to help you remember. With this system for example, watching your favorite weekly TV show, laundry day, or family pizza night can all serve as reminders that you should put in your retainer.

7. Don’t be shy about asking for help if you’re forgetful. Assure your spouse, parents, siblings, or roommates that you won’t consider if nagging if they remind you to wear your retainer.

8. Surf online for examples of how teeth can shift when retainers are not properly used. Those stories can serve as timely warning not to let the same thing happen to you!

Remember, you can always call our Clarksburg, Gaithersburg, and Hagerstown office if you feel your retainer is uncomfortable or painful. We'll work with you to protect your smile!