I was a patient of yours 5 years ago and now my son is ready for braces. It’s been a while since I was a patient. Is there still a family discount I can use for my son?

Yes! We reward loyal patients with our “Smile Miles” program. Any patient that I’ve ever treated gets a credit toward future treatment that can be used on other family members. It is a straight forward program focused on affordable care. No prizes or contests here – just lower monthly payments for you! Call Riiana at 1-800-4Braces to see how many Smile Miles you have waiting for you and how they can be used on a family member or yourself!

My son just had his braces removed. He has removable retainers, but I do not think he is wearing them as much as he was instructed to wear them. What should I do?

Your concern is justified. A recent study found that the average patient wears his or her retainers an average of just 7 hours per day, not the 12 to 24 hours recommended. Often, patients do not wear retainers for days. To help prevent relapse of teeth, I provide all of my patients with glued-on wire retainers on the backs of their front teeth in addition to the removable retainers. This means that my patients get double retainers for both upper and lower teeth. These glued-on wire retainers are an extra benefit that I provide my patients in the Four Corners area.

I looked at my teeth in a magnifying mirror, and I noticed some lines on my front teeth. I went to my dentist, and he said they were "craze lines" and are normal for my age. He said no treatment was needed. Should I get a second opinion?

While you are always entitled to a second opinion, your dentist's recommendation of no treatment is supported by research. Most craze lines are not noticeable except under bright light and some magnification. Craze lines are not cracked or chipped teeth. They are shallow changes in a person's enamel. As people age, most get some craze lines. Treatment would be considered too invasive by most dentists because treatment would be caps (crowns) or veneers. I agree with your dentist in recommending what is best for you and your teeth.

My teenage son is using smokeless tobacco (chewing tobacco). I am afraid that this may lead to smoking. Is my concern justified?

A recent study says that your concern is justified. This study showed that there is a strong association between adolescents using chewing tobacco and smoking. The study also found that using tobacco is strongly correlated with other risk-taking behaviors. This may not be news to any of us who have raised teenagers. Intervention through education may help, but results for teens are extremely varied. The study found that getting teens involved in activities that prohibit the use of tobacco products, like school sports, may be even more beneficial to preventing tobacco use than education on the harm of tobacco or parental intervention.

On my child's last appointment she got her braces adjusted, an exam, a cleaning and one filling. It was great – I was able to combine three appointments into just one visit! Why did you hire a dentist and start providing dental services?

I expanded our services because patients and parents kept requesting that we provide additional dental care. Another reason is a 2011 study on orthodontic treatment that found a separation of responsibilities between doctors during orthodontic treatment had less satisfactory outcomes for a significant number of patients. This study convinced me that providing an environment where dental and orthodontic services could be completed together could help my patients’ dental health during treatment. Patients at my office are welcome to continue services with their existing dental providers or use the dental services at my office for convenience. Call 1-800-4Braces for your free consultation.

I have heard of fluoride treatment at the dentist’s office to help prevent cavities. What is fluoride varnish?

Fluoride varnish is a type of topical fluoride that is "painted" on the teeth and dries quickly. The 2.36% strength varnish has been shown to be very effective in preventing cavities. Cavity varnish is rapidly replacing the 1.23% fluoride gel as the procedure of choice for topical fluoride cavity protection. Almost all patients like the varnish much better than the gel for two main reasons. First, the varnish is quickly painted on teeth with a small brush, while the gel is delivered in a big foam tray that has to be in a patient's mouth for 4 minutes. Additionally, patients can eat 15 minutes after the varnish is placed, but with the gel, it is best to wait several hours before eating to maximize its preventive benefits. My hygienist routinely recommends varnish during orthodontic treatment to prevent cavities.

My 8 year old son grinds his teeth at night. Should I be concerned?

A recent study in The Journal of Sleep Medicine answered this question. Almost half of all first graders in the study had parents reporting that their child grinded his or her teeth at least one time per week. This study found that grinding (bruxing) was not associated with breathing disorders during sleep or snoring. The study did find that there was an association with increased internalizing behaviors such as being depressed, being withdrawn or having anxiety. Chronic, frequent bruxism was also associated with increased health problems and decreased neurocognitive performance (learning). Grinding once a week is probably not a reason for concern. Grinding a few times a week should be checked out.

My teeth are sensitive to hot and cold sensations. What causes this problem?

Tooth sensitivity can be caused by a number of reasons. Some of the more common culprits are cavities, cracked teeth, broken fillings, grinding your teeth, and receding gums. Everyone has microscopic tubules in their enamel that connect with the nerve of a tooth. If these tubules are exposed, temperature changes from eating hot or cold foods are transmitted more easily too the nerve. If your sensitivity is from a cracked tooth or grinding, then the changes in pressure on the tooth are causing your sensitivity. If your sensitivity does not go away after a few days, you can call 1-800-4Braces for a free consultation to discuss this problem.

I want to get my teeth straightened and I want to bleach them to make them whiter. Should I do it before or after treatment? How does bleaching work?

If you are using Invisalign aligners to straighten your teeth then it can be done before, after or even during treatment. If you are getting braces, after is best. The active ingredient in bleaching gel is hydrogen peroxide. Hydrogen peroxide is applied to your teeth using a clear plastic tray. As the hydrogen peroxide degrades it produces free radicals that diffuse rapidly through enamel and dentin. These free radicals are strong oxidizers that split up pigmenting compounds that diffuse out of your teeth, causing the tooth to absorb less light. This process causes teeth to look lighter. Call 1-800-4Braces for a free consultation.

Soul Surfer’ Bethany Hamilton endorses the Damon® System of Braces to promote fast, high-tech, comfortable orthodontic treatment! Here’s more information from Bethany and the makers of the Damon System…

Pro Surfer, Bethany Hamilton began orthodontic treatment at age 14 for a severe underbite with significant crowding and a narrow arch. She also had an open bite, which means there was open space between her upper and lower teeth when her jaw was closed. These types of cases are typically among the most difficult to treat and often require surgery. Hamilton relied on the Damon System instead of traditional braces for her treatment.

The light pressure used in the Damon System stimulates broad, natural arch development and typically delivers results up to 25 percent faster than traditional braces, according to clinical studies. While traditional braces require elastic ties to hold wires in place, these ties can accumulate bacteria and often require "tightening" that can hinder tooth movement and prolong treatment.

In contrast, the Damon System combines "tieless" braces with high-tech memory-shaped wires that don't need to be "tightened." Damon System braces are easier to keep clean, which promotes better patient hygiene throughout treatment. Additionally, treatment with the Damon System rarely requires tooth extractions and frees patients from the use of headgear, rapid palatal expanders and other invasive appliances. The cost of treatment with the Damon System is comparable to that of traditional braces.

"Smiles are a blessing and an infectious tool for spreading happiness and bringing joy to others. "The Damon System transformed my smile, allowing me to confidently share my story of perseverance and encourage others undergoing adversity,” said Bethany Hamilton.

To learn more visit, damonbraces.com

Q: I am use to getting dental x-rays where they put the film in your mouth. My orthodontist took an x-ray with a machine that circled my head. It produced an x-ray of all of my teeth and jaw. Why take this x-ray?

Dr. Herman's Answer: The x-ray is called a panorex and is taken by most orthodontists and dentists. It is used to look for missing teeth, extra teeth and pathology in your jaw bone, like a tumor. As a screening x-ray it is taken by dentists every 2-3 years in non-adult patients and about every 5 years for adults. Orthodontists and your dentist find that the panorex is the best way to assess if wisdom teeth are coming in straight or are impacted. As an orthodontist, I also use the panorex to check for movement of stuck teeth, other than wisdom teeth, or to assess if the roots of teeth are getting straight or are still slanted.

Q: I have a missing upper front tooth and I have crooked teeth, what are my options?

Dr. Herman's Answer: Since I rarely take out teeth, I suggest two options. One is to correct the crowding problem through orthodontics and replace the missing tooth with an implant. This is the more expensive plan but usually the best option. It involves placing a titanium screw (implant) into the bone and placing a cap or crown over the implant. The 2nd option is called a substitution plan which involves using another tooth next to the space and moving it into the empty spot. It can work surprisingly well. The main advantage is the cost is minimal and is not an extra charge if part of your orthodontic plan. I recommend a free consult with me to discuss which option may be best for you.