Orthodontist Farmington New Mexico

Question: I think and my dentist also thinks that it is the orthodontist's responsibility to help my daughter reduce
her risk to white spots around the braces. As an orthodntist do you agree with our thought process?

Answer: Yes, I do agree that it is the responsibility of the orthodontist to help reduce the risk of white spot lesions on patients while in braces. White spot lesions and gingivitis are of concern to all orthodontists, which is why I have taken a very aggressive approach to reduce the risk of these issues. In order to prevent white spot lesions and gingivitis, I use smaller brackets which allows for better cleaning and apply a fluoride varnish around the brackets of at risk patients every six weeks. In addition, I require all of my patients to receive a dental cleaning and exam, with the removal of their orthodontic wires, by my dental hygiene staff every six months.

Dr. David Herman, Four Corners Orthodontics & Dental

Braces in Farmington New Mexico

Question: Other than providing brushing instructions, does your office do other things to help prevent my son from getting white spots around his braces?

Answer: Yes. Studies show that applying a flouride varnish around the brackets every 6-8 weeks reduces a person's
risk to white spot lesions by 70%. At my office, patients who are at risk to white spot lesions have fluoride
varnish applied around brackets every 6 weeks and all of my patients must have a dental cleaning and exam
every 6 months. I offer the exam and cleaning services at my orthodontic office because cleanings done with
the orthodontic wire removed are much more thourough than cleaning done with the wire remaining. My goal

is to significantly reduce my patient's risk to gum, cavity and white spot lesion problems.

Dr. David Herman, Four Corners Orthodontics & Dental

Questions about Braces with Dr. David Herman Farmington

Question: How does your office prevent white spots around braces?

Answer: At my office, patients who are at risk for white spot lesions receive fluoride varnish around their brackets every 6 weeks. Studies show that applying a fluoride varnish around the brackets every 6-8 weeks reduces a person's risk to white spot lesions by 70%. I also offer dental exams and cleanings at my office. My team removes the orthodontic wire before cleaning which allows for a more thorough cleaning. All of my patients are required to have a dental cleaning and exam every 6 months. My goal with these practices is to significantly reduce my patient's risk to gum disease, cavities and white spot lesions

Dr. David Herman, Four Corners Orthodontics & Dental

Dr. Herman: Four Corners Orthodontics & Dental

Question: I know that poor brushing while wearing braces can cause white spots around the braces. What causes the white spots to form? Are these cavities?

Answer: White spot lesions are not cavities. Poor brushing leads to plaque accumulation around the brackets. The most abundant accumulation is between the bracket and the gum tissue. The plaque contains bacteria that produce acid. A person's saliva normally neutralizes or buffers this acid. However, if there is more acid produced than the saliva can buffer, demineralization of enamel begins. If demineralization occurs for a long enough period of time then white spots appear. My office is one of a few orthodontic practices in the country that has an onsite dental hygiene department to attempt to minimize a patient's risk of getting white spot lesions and make it convenient for a patient to maintain great oral hygiene during orthodontic treatment. Call 1-800-4-BRACES for a free consultation.

-Dr. David Herman, Four Corners Orthodontics & Dental

My son has crooked front teeth. Does he need to lose all his baby teeth before he visits an orthodontist?

No, but I do recommend patients lose their lower first baby tooth molars before beginning orthodontic treatment. These teeth usually fall out between ages 8-10 with girls losing them before boys. They are the teeth behind the canines, and the teeth that replace them are called first premolars. I try to have most of my patients’ orthodontic treatment completed in two years or less. I find that in most cases, waiting until the lower primary first molar falls out helps me achieve this time period. I always offer free consultations, regardless of age or number of baby teeth remaining. Please call 1-800-4BRACES to discuss how orthodontic treatment can improve your son’s smile.

My daughter plays softball and recently got hit in the face with a ball. While she is ok, I think she needs to wear a mouth guard to protect her from future injuries that may occur. What do you recommend?

I see a large number of patients with chipped, broken or lost teeth from sports accidents. The American Dental Association recently reported that about 3 million teeth are knocked out each year during sporting events. The report found that 67% of the parents surveyed said that their child does not wear a mouth guard when participating in sports. The report also showed that athletes who do not wear mouth guards are 60 times more likely to damage their teeth than athletes that wear mouth guards. I advise parents to insist that their children wear proper safety equipment while playing sports to prevent potentially painful injuries.

Someone told me that if my child gets braces as a young teenager, he will need braces again as an adult. Is this true?

Retreatment is only needed when retainers are not worn as instructed and teeth shift. If a person’s teeth move too much, a tune-up would be recommended to get them back to the finished result. I provide tune-ups at a reduced fee. Most of my patients who have tune-up treatment only need to wear braces for a year or less. When I finish treatment, I place a double retainer to ensure the most stable result-- a wired retainer glued on the back of both upper and lower front teeth, as well as clear, removable aligner retainers. If you need an orthodontic tune-up, call 1-800-4Braces today for your free consultation.

I had an overbite that was corrected with braces at age 12. My 6 year old daughter looks like she will also have an overbite. What causes an overbite?

The main cause of an overbite is heredity, so if a parent had an overbite, there is a good chance a child will also have an overbite. Another common cause is a prolonged finger sucking habit. A recent study found that 20-30% of the U.S. population has a mild to severe overbite. Overbites are a result of either the front teeth sticking out too far, the lower jaw being too small and too far back, or a combination of both. I have achieved good results on patients with an overbite without removing any teeth. In cases when the overbite is caused by the lower jaw being too small or too far back, I do not recommend extracting upper teeth. While this plan fixes the overbite, it can create a very flat facial profile. For a free consultation, please call 1-800-4Braces.

I went to another orthodontist for a consultation and told him I was concerned about having teeth pulled. He told me that he extracted teeth only when absolutely necessary and that orthodontists who rarely remove teeth are treating all patients all the same. Is this true?

I am an orthodontist who rarely removes teeth, and I can assure you that all patients I treat have an individualized plan for treatment. If an orthodontist wants to extract teeth from you or your child, I always recommend that you get a second opinion from an orthodontist known for not removing healthy teeth so you can make the decision that is best for you or your child. Call 1-800-4Braces for a free consultation.

If I don't wear my retainers for a couple of days my teeth start to move. My friend never wears her retainers and her teeth have not moved. Why is that?

Orthodontists and researchers have tried for years to explain this stability issue and the answer remains the same. We cannot predict with any degree of certainty how stable a person's result with be over a long period of time. We can say that if you wear your retainer for a certain amount of time, your result will be pretty much remain stable. Our bodies are constantly changing, and the forces on teeth are constantly changing, which cause teeth to shift. Teeth shift even if you never wore braces. Orthodontic patients should always wear retainers as instructed to ensure the most stable result possible.