I haven’t worn my orthodontic retainers for years and am noticing my teeth are getting crowded again. Can I be “tuned up” again without braces?

This is a real common thing among those of us who had orthodontic treatment in the past.  Our teeth, especially the lower front ones, have a tendancy to want to crowd up again.  Unless we wear a retainer indefinitely (some people actually do but they seem to be a rare species) or have a permanent retainer wire bonded behind the front teeth, this will happen.

However, usually this relapse is no where near as bad as the original situation and can be       “re-tuned” without wires and brackets and all of those dental appointments.  The technique for this uses a series of very thin clear aligners which you wear 24/7.  You can take these out yourself for eating and for brushing/flossing.  Even better they are virtually invisible.  There are more than one of these systems available now but Invisalign TM was the first company to really develop the technology.  The aligners fit over all the teeth of both upper and lower arches and each one of the series moves the teeth about a quarter of a millimeter.  You wear each set of aligners  for two to three weeks. At that point you move on to the next aligner of the series and so on.  Depending on the amount of realignment needed, it can require as little as ten aligners.  The most I’ve ever had to work with was nineteen aligners.  Hence it can take from four to eighteen months to complete the relalignment.

However, you still need some version of long term retainer when it’s done or you eventually may relapse again.

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Does tooth whitening procedures cause cancer?

I have been asked this question by people from time to time.  I guess because tooth whiteners contain hydrogen peroxide.  The answer to this is no, they do not.  Evidence for this comes from a review of many other published studies which appeared in the Journal of Esthetic and Restorative Dentistry (volume 3, issue 3) in June 2006.  The compiled results concluded that tooth whitening products containing hydrogen peroxide do not cause or increase the risk of oral cancer when used as directed.  Exposure to hydrogen peroxide in whiteners is too low and to short in duration (30-60 minutes) to create any changes in oral tissues to increase any oral cancer risk.  In fact, the evidence from this review which included over 4000 human subjects showed no evidence of oral cancer or other effects associated with risk of oral cancer.

Normally when used as directed the concentration of hydrogen peroxide in these products decreases to nearly undetectable levels within 15 minutes to one hour.  Over the counter whitening products have significantly lower peroxide concentrations than those applied in a dental office under close supervision and isolation.

Why does my Dentist want to put a crown (cap) on my tooth that had a root canal?

When the pulp, or nerve in a tooth dies and the nerve canal inside the root is disinfected and sealed up with an internal filling (root canal filling), the tooth no longer has a blood supply.  It’s a “dead” tooth.  If it happens to be a tooth which gets used for chewing like the back teeth do then it takes a  lot of biting force.  Usually a tooth that has a root canal- type of problem has already had it’s share of previous problems and dental work.  It may have had a large and/or deep filling done years ago.  This by itself will compromise the strength of a tooth.  The nerve/pulp inside may succumb to problems years later.  In any case a root canal filling doesn’t strengthen a tooth.  It only makes it’s innerds pain/problem free.  However, like a dead tree branch this tooth is more prone to bigger fracture problems than a live tooth.  Especially if its one of your heavy “chewers”.  Covering the tooth with a crown/cap or other type of “lid” will prevent you from chipping, breaking or splitting off more of the tooth.  If an internal crack develops before a crown can be placed,  it typically starts out small (like a crack in your windshield).  However given enough time and chewing the crack can extend and eventually a piece of tooth can break off simply because it was ready to go.  A crown /cap works like a helmet for the tooth preventing future fractures.  Front teeth are not as at risk of this as back teeth because we (normally) don’t chew with our front teeth.