Patient education

Tips for wearing a mouthguard with braces

February 22nd, 2021

Adolescents are active, so it is no surprise that there are plenty of questions about mouthguards when it comes to orthodontic treatment. In general, a mouthguard is a great investment for protecting the teeth, especially in high-contact sports. They should be considered for many sports and activities, even if braces are not being worn. Here are some common questions and answers:

  • Can you wear a mouthguard if you have braces?

    Yes, you can wear a mouthguard when you have braces. There are special mouth guards that are made specifically to fit over braces.

  • What sports require a mouthguard with braces?

    Many high school sports associations require a mouthguard for football, hockey, field hockey, lacrosse, and wrestling. The ADA also recommends a mouthguard for other contact sports like basketball and martial arts, as well as other limited contact sports such as baseball, softball, and extreme sports.

  • Is it recommended to use a mouthguard while in braces?

    Unless specifically required by your sports association, it can be a personal decision based on your comfort level and ability to breath adequately while performing. The benefit of a mouth guard is it will limit damage to teeth and soft tissues around the mouth when worn properly. Not only will it help protect the teeth, but it will protect the lips and cheeks from injury from any orthodontic appliances.

  • What is the best mouthguard for braces?

    In our office, we have found that the Shock Doctor Braces Mouthguard has worked well for many patients. It has a strap so that it can be used in sports like football. The strap can also be removed so that it can be used in sports like basketball.

    [caption id="attachment_308" align="alignleft" width="300"] Shock Doctor ® Braces mouthguard[/caption]

  • Can you use a boil and bite mouthguard with braces?

    No, you should not use a build and bite mouth guard with your braces. It may wrap around the braces and get stuck in place, or cause damage to the braces. Also, keep in mind that the teeth are continuing to move, so you do not want to have a mouthguard specifically molded to your teeth as they are changing.

  • Can I use a custom made mouthguard while in braces?

    No, you will not likely be able to use a custom mouthguard since your teeth are still moving. The mouthguard will not fit for the duration of the treatment, and it may get stuck on the braces if it is forced in place.

  • Where can I get a mouthguard for braces?

    You can find a mouthguard for braces online or in some sporting goods stores. Some orthodontists may also have them in their office for patients. At Zach Frazier Orthodontics, we have the Shock Doctor Braces Mouthguard available in office for our patients.

  • Can I wear a mouthguard with Invisalign?

    If you are in Invisalign treatment, you should still wear a mouthguard for sports if it is recommended by your association or a sport with significant contact or injury risk (football, basketball, hockey). You can remove your Invisalign and use a general one-size-fits-all mouthguard while playing the sport. You will not be able to use a custom fitting or boil and bite mouthguard as your teeth are still moving. If you are in a non-contact or limited-contact sport, you should continue to wear your Invisalign while you are playing the sport.

  • Can I wear a mouthguard with a palatal expander?

    Yes, you can wear a mouthguard with a palatal expander. It will need to be trimmed and adjusted around the expander to allow it to fit properly.

I hope this is helpful to provide some insight on mouthguard recommendations for braces. As always, if you need more information, please reach out to our office anytime - we are happy to help : )

Tips for Managing TMJ Pain During Orthodontic Treatment: Questions and Answers

February 10th, 2021

According to the National Institute of Dental and Craniofacial research, the prevalence of TMJ problems (also known as temporomandibular joint and muscle disorder) is between 5% - 12% of the population. It is more common in females than males, and tends to affect younger people more often.

While orthodontic treatment does not cause TMJ issues, studies also show that it cannot prevent or treat TMJ pain either. Here are some common questions that you may have if you are in orthodontic treatment and are now experiencing some jaw joint pain.

What does TMJ stand for and what is it?

  • TMJ stands for temporomandibular joint. It is located directly in front of your ears, and it is where your lower jaw hinges upon opening and closing.

What are TMJ problems?

  • TMJ problems include clicking/popping joints, painful joints, or restricted jaw movement. TMJ problems may vary in severity from mild pain to severe pain, and the pain may be a temporary pain or a constant pain. TMJ problems may be related to the actual joint (bones and ligaments), or it may be related to the muscles around the joint.

What causes TMJ problems?

  • TMJ problems may be caused by an injury to the face or jaw, grind/clenching of teeth, stress, muscle fatigue or overuse of the jaw joint. Additionally, it is linked to hormonal changes in women that cause laxity of the ligaments in the jaw joint. TMJ problems are most common in teenage girls and young women.

What can I do to improve my TMJ problems or TMJ pain?
Most TMJ problems can be managed by these conservative measures:

  • Maintain a soft diet, and avoid chewy food and chewing gum.
  • Use warm, moist heat on the jaw muscles to increase blood flow and massage the muscles. Alternate the warm moist heat with an ice pack on the joint area which will help reduce inflammation of the joints.
  • Use anti-inflammatory medications to help reduce pain and inflammation. Ibuprofen is the most common, but you should consult your physician with which anti-inflammatory medication is best for you.
  • Avoid clenching your teeth by setting up reminders to keep your teeth apart and jaw muscles relaxed.
  • Monitor your stress and manage it to avoid muscle tension and clenching.

What if my symptoms do not improve with conservative therapy?

  • If your symptoms are not improving, a referral will be made to another doctor who specifically manages TMJ problems. They may recommend more diagnostic imaging (like an MRI) to evaluate the jaw joint to find the cause of the problem. In some cases, a night guard may be recommended to help alleviate some pain.

Can I continue my orthodontic treatment?

  • In some cases, orthodontic treatment may be paused for a period of time, and occasionally it may be discontinued depending on the circumstances. The recommendations are on a case by case basis.

If you have any other questions, please let your orthodontist know. More often than not, a little patience and conservative measures will improve the TMJ pain, so hang in there : )

How we use technology to eliminate unpopular dental procedures

February 8th, 2021

Perhaps you have memories of sitting in a dental chair anxiously waiting for a dental impression (dental mold).  Memories of a cold, gooey mixture inching closer down your throat. Memories of drool hanging off the edge of your lip while the mold is held in place. The very thought of it for some people will make them gag!

We have good news for you: meet the intraoral scanner. While this technology has been out for some time, it is still not universally used. Here are some information about what it is and how it will make your trip to the orthodontist much better.

Dr. Zach Frazier, orthodontist in Downers Grove, with a 3D tooth scanner used for braces and Invisalign treatment.

  1. What is 3D digital intraoral scanner?

    1. It is a high-tech video camera that captures images of your teeth to create a 3D digital model of your teeth.
  2. Does it use any radiation like an x-ray?

    1. No radiation is used - it is simply a video camera that stitches many images together to create the 3D image of your teeth.
  3. How long does it take to have your teeth scanned?

    1. It depends on the experience of the user, but in most cases it will take less than 5 minutes to get a full scan of all of your upper and lower teeth.
  4. What do you do with the 3D image?

    1. We can use the image in lots of ways. We can use it to diagnose your bite or create 3D printed physical models of your teeth. With the printed models, we can make all sorts of orthodontic appliances and retainers without ever having to take a dental mold.
  5. Do you still have to take a mold to get retainers?

    1. No way : ) Our patients do not have to have dental impressions taken at any time.
  6. Can this be used for Invisalign clear aligner treatment?

    1. Yes! Additionally the aligners will be better fitting as a 3D intraoral scanner is more accurate than traditional dental molds.

We absolutely love the 3D intraoral scanners in our office. Treatment is dramatically more comfortable for our patients leading to a better experience. Additionally, we are getting more accurate orthodontic appliances which leads to better treatment and reduced time spent at the orthodontist. Finally, it is great form an environmental standpoint as there are fewer steps, fewer appointments, and less waste by using the scanner.

If you're interested in pursuing braces treatment or you are considering Invisalign clear aligner treatment, make sure you visit an orthodontist with a 3D intraoral scanner. You will thank me later ; )

Thumbs, Fingers, and Pacifiers: Kick the Habit

September 6th, 2020

All of us are born with the innate sucking reflex. It is needed to survive as an infant and helps us eat as babies. As we develop, some babies will use a thumb, finger, or a pacifier as a comforting mechanism. However, at some point, this habit can start to cause harm to the developing teeth and bones of the mouth.

At what age do kids need to stop sucking thumbs or using pacifiers?
- Depending on how much sucking pressure your child uses on his thumb or pacifier, you may start to see changes as soon as age 2-4 years old. You may notice flaring of the front teeth and changes to the shape of the smile. Typically, these changes can self-correct if the child is done with the habit by age 6 before the adult teeth start to erupt.

Why do we need to break the habit?
- The habit can permanently change shape of bones of the mouth and permanently change the shape of the smile.  Some long-term habits can cause irreversible changes that cannot be fixed with orthodontic treatment alone. Additionally, it will create issues that can make orthodontic treatment more time-consuming, more complex, and more expensive.

How can we start to break a pacifier habit?
Typically a thumb habit is more challenging to break than a pacifier habit because you cannot take a thumb away : ) In most cases, you will start this process at a younger age while the child is still a toddler, and in many cases they will stop on their own. Avoid harsh words or punishment as this is not effective for this age group. Praise progress and use rewards charts to help encourage them to quit. Beware - in some cases, a new thumb or finger habit may emerge!

How can we start to break a thumb habit?
- Be conservative at first! If your child in pre-school or early elementary school, start by talking about it. Kids must be on board to quit; if they do not want to quit, conservative approaches may not be successful, and you may have to revisit it again after waiting a few months. The earlier you start the conversation, the better of you are since the upper front adult teeth will come in around age 6-7. I recommend starting out with simple reminders such as wearing a Band-Aid on the thumb or finger.

My kid is now on board - what can we do to help him quit his thumb habit?
- While they may relapse at times to find comfort, you may need to use additional items to help kick the habit. You can try a baseball batting glove, thin winter glove, or sock over the hand at night time. You can loosely add medical tape around the wrist to make it more difficult to remove, but please be sure it is not too tight. Another product is Mavala Stop which is a sour tasting nail polish to serve as a reminder. Always remember - couple the reminders with a tracking and reward system to celebrate the small wins. Praise will help keep the kids motivated - remember they want to make you happy!

What if the conservative habit break measures don't work?
- More aggressive physical reminders in addition to the above may be needed. An Ace bandage wrap around the elbow will make it more difficult to bend the elbow which will restrict their ability to bring their hand towards the mouth. You may also consider a wrist guard thumb habit appliance (TGuard brand) that is fixed to the wrist and plastic around the thumb/fingers

What if everything else does not work - what is our last resort?
- Orthodontic appliances are the last resort. If all else fails and we see the habit is causing significant bone changes, we can make what we call a "habit appliance" and cement it to the molars in the mouth. It is like a metal cage that fits near the roof of the mouth and difficult to remove. Typically, we will keep it in place for 9 months, but no less than 6 months in order to break the habit. If this appliance is needed, many times a palatal expander will be needed afterwards to correct the changes that have occurred due to the habit.

Orthodontists are skilled in helping you and your child with their habit issues. Additionally, we are skilled at correcting the problems that prolonged habits may cause. Be sure to talk to your local orthodontist early about breaking the habit - it will certainly make a difference in the long run!

What are orthodontic tooth separators or spacers?

May 17th, 2020

Orthodontic separators (also known as “spacers”) are small latex-free rubber bands that fit in between two teeth to make space in preparation for fitting an orthodontic band or ring around the tooth. These are commonly placed before a palatal expander is placed.

What can my child expect after the separator or "spacer" is placed?

  1. Mild soreness from the spacer is expected – use over the counter pain medications as needed.
  2. Pressure or feeling of something stuck between the teeth is normal.
  3. If the spacer falls out a few days before the next appointment, that usually means enough space has been made.

Tips:

  1. Do not try to remove the spacers at home – this may delay fitting the orthodontic band or appliance at the next appointment
  2. Avoid sticky and chewy foods that may dislodge the spacer
  3. Brush the area normally but do not floss the area with the spacers

If the spacer falls out before your next appointment, the ring around the tooth should still fit in most cases so there is no need to come in for a separate appointment. If you have any questions or concerns about the spacer, please call our office, as we are happy to help!

Re-opening office after temporary closure: Updates and what to expect at your visit

May 8th, 2020

After being temporarily closed for a long 8 weeks, we are ready to make you smile again! We had to postpone hundreds of appointments, so we have a long road ahead to catch up. Rest assured, we will get there!

As we move forward with some new guidelines, we ask for patience and understanding. The new guidelines are for everyone's benefit in order to have a safe environment for care as well as to provide an efficient way to get everyone back on track.

Here is what you need to know:

APPOINTMENTS AND SCHEDULING:
- PLEASE WAIT FOR OUR OFFICE TO CONTACT YOU FOR AN APPOINTMENT. We have a long list of people to contact, and this will make for more efficient scheduling by our team.
- COMFORT/URGENT APPOINTMENTS: These appointments will still only be seen on an as-needed basis for significant pain or bleeding. For now, broken brackets are not considered urgent comfort appointments. Need advice - click here!
- RETAINER CHECKS: All retainer check appointments will be postponed until the fall with exception of certain cases that Dr. Zach sees necessary; if you have retainer concerns, please call us and we can still schedule an appointment
- GROWTH CHECKS: Growth check appointments will be seen on a case-by-case basis; in many cases, they will be postponed until the fall; if you have concerns and would like to be seen sooner, please call us and we can still schedule an appointment

BEFORE YOUR VISIT:
- PLEASE BRUSH YOUR TEETH THOROUGHLY RIGHT BEFORE YOUR APPPOINTMENT and do not come in with excessive food or debris on your teeth/braces. Our tooth brushing station is closed and is now a designated station for our patients to wash their hands.
- EVERYONE WHO ENTERS OUR BUILDING MUST HAVE A MASK (both patient and parents). Please come prepared.

YOUR VISIT:
- FOR ALL MINORS (18 and younger), a parent must be at the appointment to sign a questionnaire regarding COVID symptoms and exposure. If you cannot come, you must contact our office prior to the appointment for the form and send a SIGNED COPY with your child. Unfortunately, we cannot make any exceptions to this rule.
- PLEASE ARRIVE ON-TIME. We have staggered arrival times to limit the number of people in our building at any given time. Arriving too early will likely lead to waiting, and late arrivals may need to be rescheduled.
- When you arrive, REMAIN IN YOUR CAR AND CALL our office to let us know you have arrived. We will let you know when to come in.
- For any minor patient, ONE parent/guardian should come in to sign a questionnaire form regarding COVID symptoms and exposure. Absolutely no other individuals will be allowed. We encourage that parents return to their car after signing our questionnaire.
- DO NOT COME IF YOU ARE FEELING ILL. Any question indicating recent exposure to COVID-19 or anyone with signs/symptoms will be asked to leave immediately and will not be able to return for at least the specified 14-day self-quarantine requirement.
- THE PATIENT’S TEMPERATURE WILL BE TAKEN using a touchless thermometer. If the temperature is > 100 degrees F, you will be asked to leave immediately and will not be able to return for at least the specified 14-day self-quarantine requirement.
- PLEASE MAINTAIN 6-FOOT SOCIAL DISTANCING guidelines while in the office and seated in the waiting room. Reception furniture has been limited to accommodate this guideline.
- Patients will be asked to wash or sanitize their hands before and after their appointment.
- Patients will be asked to rinse with Colgate Peroxyl mouth rinse at their chair where an assistant will suction.
- We ask for understanding as we try to address all of your needs at your visit. Individuals with multiple broken brackets or issues may not have everything completed during the visit due to strict scheduling times. If you anticipate you or child needs more time for these issues, let us know beforehand.

AFTER THE VISIT:
- DO NOT DRIVE HOME RIGHT AWAY - WE NEED TO SCHEDULE YOUR NEXT VISIT! For child patients, one of our team members will call you to update you on progress and schedule the next appointment. We will not be scheduling at our front desk at this time.
- ADULT PATIENTS – you will be scheduled while seated in the chair.

OUR NEW PROTOCOLS:
- HOURS: Our office hours are now Monday to Friday 8:00am to 4:00pm until further notice. We have extended our clinic hours to space out appointments, catch up on overdue treatment, and allow for extensive cleaning of our office twice per day. We will notify you once normal hours of operation resume in the future.
- BARRIERS: You will notice clear barriers at our front desk as well as in our consult room. Additionally, we have placed barriers between our chairs in the clinic (which are 7 feet apart). We will continue to operate our medical grade HEPA filter in our treatment area (this has been present prior to the pandemic).
- CLEANING: Office cleaning will take place in the morning, midday, and evening.
- RECEPTION ROOM: Furniture has been limited and no magazines or books are available. We encourage non-patients (parents/guardians) to wait in the car or outside.

TEAMWORK:
- OUR TEAM IS SCREENED ON A DAILY BASIS with a questionnaire, and temperature is taken daily. Any team member with COVID symptoms or a fever >100 degree F will be required to go home.
- OUR TEAM HAS BEEN THOROUGHLY TRAINED on the new protocols. Please be patient as things may take more time at first as we are adapting to our new protocols.

Our priority has always been delivering the absolute best orthodontic in a safe and timely manner - that still remains our top priority. We are still committed to this community for the long haul, so while some things will be different about our office in the short-term, our mission has not changed!

Questions or concerns should be addressed by calling or emailing our office - we are here for you. We understand this may be the first time many of you are leaving your home in 8 weeks, so please do not hesitate to let us know how we can make you feel safe and secure. See you soon!

  • Dr. Zach
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