Health Tips

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 : )

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 : )

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!

Ah, sparkling water - so refreshing with its effervescence! With the popularity of sparkling drinks, I often get the question:

Will sparkling water harm my teeth?

The truth is, any drink with carbonation is going to have a higher acid level. Higher acid levels are not good for your teeth as they can wear away the enamel over time. Acid causes tooth erosion and decay. However, researchers have been looking into this to see if the acid content is enough to weaken your teeth.

The short answer is - no, drinking sparkling water will not harm your teeth.

According to the latest studies, they find that in general, drinking plain, sparkling water will not have a significant effect on the enamel of your teeth. Compared to regular tap water, it essentially has the same long term effect.

Here's the catch and what you need to know for your teeth and orthodontic treatment...

• Everything should be enjoyed in moderation. While sparkling water is fine, regular water is still your best bet as it is great for your overall health and contains fluoride which will help fight against tooth decay.
• Sparkling water is not all the same - some companies add sugar and citrus flavors. The sugars and citrus flavors do make the drink more acidic, and therefore may put the teeth more at risk if they are sipped throughout the day. The more exposure your teeth have to acidic, sugary, carbonated drinks, the greater the risk for enamel wear.
• With the growing popularity of Invisalign treatment, many adults want to know if they have to remove their clear aligners to have a sparkling water drink. Basically, if the sparkling water is plain, it should have a significant effect on the teeth (once again, practice moderation). However, be aware that citrus-flavored or added sugar can sit under the Invisalign aligner which can lead to issues with the enamel.

Questions or interested to learn more about diet recommendations with orthodontic treatment? Let us know - we are here to help : )