Question: I recently read that TMJ jaw pain can be reduced by visiting an orthodontist. Is this true?

Dr. Herman's Answer: Yes, visiting an orthodontist will help most TMJ cases. TMJ or Temporal Mandibular Dysfuntion is usually a multifactorial problem that affects the muscles around the jaw and the back of the neck. It often leads to ringing in the ears, earaches and/or headaches. Women get it 7 times more than men. People who are under stress and/or grind their teeth, as well as those who have a deep bite or over bite, are at increased risk. I’ve had a great level of success in reducing or eliminating TMJ pain by changing a person's over bite to a more normal bite.

Question: My daughter’s teeth have started to come in. When should I start brushing and using toothpaste on her teeth?

Dr. Herman's Answer: To familiarize your baby with brushing, wipe her gums with a moist, soft cloth or piece of gauze after every meal. As soon as the first tooth comes into place, start brushing with a soft-bristle toothbrush designed for babies. Use water rather than a fluoride toothpaste until your child is about 2 years of age. Once your child is able to spit, she may be ready to brush her own teeth using a pea-sized amount of fluoride toothpaste while you supervise. Be sure to have the child spit out the toothpaste. It also recommended by the American Academy of Pediatric Dentistry that your child visit a dentist by her 1st birthday.

Question: My baby just got his first tooth. Can he get cavities?

Dr. Herman's Answer: Yes, cavities can develop in your baby's teeth. For this reason, you should limit the time teeth are exposed to liquid containing sugar. Juice, formula and milk all contain sugar and can encourage the development of cavities. You should never put your child to bed with a bottle or “sippy cup” that is filled with any liquids containing sugar—only warm water is acceptable. This applies to pacifiers as well and I would strongly advise against dipping your child’s pacifier in honey or any sweetener. You may have the urge to reward your child with sweets, but remember that high-levels of sugar exposure at a young age can be disastrous to your child’s oral health.

Question: My son had very crooked teeth, so he started braces. He looks good, but there are still a few things that could be improved. However, he has been in treatment for four years—when is enough, enough?

Dr. Herman's Answer: The question of when to conclude treatment is based on the ethical principle of beneficence. This means comparing the benefits of more treatment to the risk of longer treatment. You and your son entrust the orthodontist to exercise his/her best judgment to provide your son with the best possible results. At four years into treatment your orthodontist needs to have a risk versus benefit discussion with you and your son. Some questions to discuss are: How much better of a result can we reasonably expect? How long will that take to achieve? What are the risks of staying in braces longer?

Question: Why do you check for cavities at every orthodontic appointment? How do you determine if a tooth has a cavity?

Dr. Herman's Answer: I check for cavities at every orthodontic appointment because healthy teeth and gums are necessary for successful orthodontic treatments. I want my patients to have great results—that’s why I take the extra time to check for cavities. I use the "International Caries Detection and Assessment System." This system is based on visual inspection of a tooth and involves checking color, translucency, and dental hardness. When doing a 6 month dental exam, I also use X-ray images to assess for cavities. If a patient does have a cavity we discuss treatment options as well as ways to improve at home care to prevent future cavities.

Question: My son fell off his bike and hit the side of his face. His right jaw hurts and his bite has moved over to the right. What happened?

Dr. Herman's Answer: He most likely fractured the right condoyle of his lower jaw bone (mandible). This type of accident is the most common type of broken jaw. The severity of the break dictates the treatment needed to stabilize the bone while it heals. Treatment can be as simple as a maintaining a diet of soft foods or more intense such as placing braces on his teeth for several weeks. If left untreated, the jaw could heal crooked leaving not only an asymmetric bite, but his face will also look longer on the left side compared to the right. Surgery would be required if left untreated to correct the asymmetry. Only in rare circumstances does a broken condoyle cause growth problems. You should schedule an appointment with your child’s dentist or orthodontist for an evaluation.

Question: My orthodontist just took my braces off and my smile looks good. My girlfriend was treated by you and her smile is much wider than mine. We both had the same type of problem, so why is her smile so much wider?

Dr. Herman's Answer: Your doctor treated you with traditional braces and I treated your girlfriend with the Damon® System of braces. Traditional braces do a great job of straightening teeth but do little to widen the bone holding your teeth. Traditional treatment often requires removal of healthy teeth to make space—this approach is often uncomfortable and can leave a narrower arch and a flat profile. The Damon System of Braces straightens teeth and widens the bone resulting in full, natural, wide smiles. If a wide smile is important to you call my office for your free consultation. Please visit herman4braces.com for before and after photos of my patients.