Ask Dr. Tom/FAQs

Dr. Tom and PatientsDr.Tom enjoys answering the many questions his clients have.  If you have a question for Dr. Tom, feel free to email him at:  

Here are some of the questions are often asked.

Why do I need elastics or rubber bands?
Have there been any new innovations in braces?
Why are my gums puffy?
Why do some people get white spots on their teeth?
What is a tooth exposure?
What role does my family dentist play during my orthodontic treatment?
How can I tell if my child needs orthodontic treatment?
What are study models?
What happens at the end of treatment?
Which toothbrush is right for me?
Is orthodontics the career for me?
Why does my friend wear an appliance?
How long must I wear my retainers?
What habits might hinder my progress?
Can I wear braces and still eat candy?
Can I play an instrument while I'm wearing braces?
What do you think about tongue piercing?
Can I wear a mouth guard with braces?
Where do I go to get my teeth whitened?
Why is tooth grinding harmful?

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Elastics and Rubber Bands

Q: Why do I need elastics or rubber bands?

A: Rubber bands help move the teeth and align the bite. They attach to tiny hooks on the braces and are taken on and off by the patient.  Elastics are used to correct many orthodontic problems that, if not corrected, may lead to extractions, jaw surgery, or the use of headgear and expanders.

The elastics may take a day or two to get used to and it is important to change them at least once a day to keep the proper amount of force on the teeth. However, they can be removed to eat, brush, or floss. Their consistent wearing, even at night, is key to achieving desired results quickly. Taking breaks from wearing them, or not changing them often enough, slows down progress and in some cases the ideal result may never be realized.

It usually takes a partnership between our younger patients and their parents to make sure the elastics are worn properly. A lot of work. But it is so worth it!

Imagine the day you get your braces off and see your beautiful new smile. It is amazing how quickly and how well treatment progresses when the rubber bands are worn correctly. So don¹t delay progress by not wearing them. Keep your elastics on, and get those braces off!

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New Innovations

Q: Have there been any new innovations in braces?

A: I’m happy to tell you that the answer is yes, and that we have it right here at Kadar! The Damon SystemTM is just about as advanced as you can get. Damon System braces are smaller, and much more comfortable. Their bracket design uses light force wires in a "sliding door" mechanism, which eliminates those elastic ties and ligature wires!

We’ve chosen the Damon System™ because of comfort. It reduces friction up to five hundred times compared to other systems and also dramatically reduces treatment time. In addition, you’re less likely to need a palatal expander, or to have teeth pulled before the straightening begins!

At Kadar, we’ve all had to have specialized training, so that we can offer the Damon System to all of our patients. This system is great for adults, since the lower forces are so comfortable, and because it requires fewer visits. And kids like the system because it’s cutting-edge, and also less visible to others.

If you’re interested in learning more about the Damon System, please ask us for a demonstration, or find out more information here.

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Puffy Gums

Q: Why are my gums puffy?

A: Puffy gums are also known as hyperplasia. But you don't need a big word to know that it's a signal of gum inflammation.

Inflammation causes changes in the size, shape and color of your gum tissues, and it's almost always caused by bacterial plaque. (Sometimes, certain medications or allergies can also cause puffy, inflamed gums.)

Bacterial plaque is that white, sticky film you can see and feel around and under the brackets, wires and bonding cements of your braces. It flourishes in that little crevice between the gum and tooth, because it's warm and dark, where tiny bits of food and sugars remain - the ideal climate for different kinds of bacteria.

Because you can't stop eating, the only defense is offense. Control the plaque, and you can almost always reverse gum puffiness. The technique is simple:

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White Spots

Q: Why do some people get white spots on their teeth?

A: Perhaps you've noticed that some people who wear braces develop white spots on their teeth. Basically, the discoloration indicates decay due to improper cleaning.

According to recent scientific studies, the depth of this type of tooth decay can be reduced by rinsing with sodium fluoride. It is recommended that patients with fixed braces rinse daily with a .05% solution of sodium fluoride. Of course, the best prevention is to keep teeth meticulously clean through a combination of tooth brushing, flossing and proxy brushes.

At Kadar Orthodontics, our goal is to complete a treatment program with bright health teeth and gums - and a great smile. However, this can be achieved only if the patient makes a concerted effort for daily care and has teeth cleaned professionally on a regular basis.

Ultimately, it is the patient's responsibility to follow our instructions on how to clean and maintain teeth and braces - information that we provide on the day braces are put in place.

We encourage all patients to ask for help if, at any time, they need assistance with cleaning.

Remember: when white spots do occur on teeth following orthodontic treatment; it's not because the patient is wearing braces. The spots occur as a result of poor hygiene.

Keep brushing! Keep smiling!

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Tooth exposure

Q: What is a tooth exposure?

A: Entering high school, making new friends, beginning to date - these are just some of the many changes and challenges of becoming a teenager. For many teens, the rites of passage also includes orthodontic treatment to straighten an impacted adult tooth. The most commonly affected tooth is the cuspid or "eye tooth."

Since the cuspid is in the front of the mouth, it is extremely important for appearance and chewing.

If baby teeth do not come out on time, it is not uncommon for a teenager's permanent teeth to become imbedded beneath the gum tissue without sufficient space to come in on their own. If a tooth isn't uncovered (exposed), it can become impacted and could eventually have to be extracted.

Most teens find that a tooth exposure is less traumatic than a pop quiz!

If the cuspid is on the outside toward the lip, a surgeon makes a small incision in the gum and raises it as you would a window shade to reveal the tooth. Then a bracket is placed on the tooth to bring it to the level of the other teeth.

However, if the tooth is on the inside toward the roof of the mouth, the surgeon can uncover it, insert a small chain or wire and replace the tissue back over the tooth. This wire or chain is used to guide the tooth down through the gum.

Although it requires some time to move a tooth, it is certainly worth the effort. Bringing an impacted tooth into position eliminates the need for a false tooth or an implant. The orthodontist guides and positions the impacted adult teeth to provide the most pleasing appearance and best functioning smile.

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Family Dentists

Q: What role does my family dentist play during my orthodontic treatment?

A: Your family dentist will be a key player and determine the need for an orthodontic specialist.

After an orthodontic evaluation, both the family dentist and the orthodontist will chart a plan for the best result. Orthodontic treatment should not begin until the health of the teeth and gums has been evaluated by the family dentist.

If major dental work is needed, orthodontic treatment will be scheduled after the dental problems have been resolved. However, some cases will warrant orthodontic care prior to the dentist’s care in order to complete a particular treatment successfully.

When managing a complicated procedure, the orthodontist and dentist will remain in contact with each other throughout the active tooth movement phase.

We always recommend that our patients continue to see their family dentist at their regularly scheduled times.

If a tooth requires a filling or any dental attention, that will take priority over our orthodontic treatment. The family dentist will continue to perform all cleanings, check ups and fillings during orthodontic treatment.

Our goal is to provide the best orthodontic care and results so patients can resume their regular routine.

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Ortho Treatment

Q: How can I tell if my child needs orthodontic treatment?

A: There are several key indicators every parent can look for to determine if their child may need an orthodontic evaluation. The family dentist is the best source to recommend pursuing orthodontic treatment.

Here are some other ways you can notice early problems with your child’s teeth.

Look for excess spacing and crowding. If large gaps are present or overlapping teeth become obvious, orthodontic correction is necessary. Teeth that erupt incorrectly, typically function improperly and look less pleasing.

Another indicator is how the front teeth fit when the teeth are biting. Have your child close their teeth and see if the upper front teeth stick out or protrude when compared to the lower teeth. If the upper teeth bite behind the lower teeth, this is also an indicator for treatment. Check for symmetry by comparing the middle of the upper teeth to the middle of the lower teeth.

Any of these problems can cause functional and developmental deficiencies.

Thumb/finger or lip sucking are detrimental to dental health. To avoid permanent deformation of the teeth, you should encourage your child to stop these habits.

If your child has any of these indicators, seek professional advice from your family dentist or an orthodontist.

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Study Models

Q: What are study models?

A: When it comes to making study models of our patients’ teeth, technology has made things a whole lot easier!  We now have a scanner that makes a digital model of the teeth.  These models are much more accurate and aid in improving the quality of the care we provide.  If a stone model is necessary, we could have a "Flavor of the Month Club." In fact, we have almost two dozen flavors of putty-gel material that is used to obtain impressions of our patients’ teeth.

We've certainly come a very long way from the days of my youth. I have a vivid memory of being 13 and having a study model made of my teeth.

Back then, the gooey substance had absolutely no flavor and took five minutes until the tray was removed. It felt like an hour. Boy, do I wish I could have had the new technology that I can now offer my patients!

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Finally Done!

Q: What happens at the end of treatment?

A: Everyone looks forward to the big day when the braces come off! It is the end of a lengthy commitment and the culmination of all the effort invested by both the patient and the orthodontist.

The final phase may last from three weeks to six months and usually includes using rubber bands to help teeth and jaws achieve maximum fit.

It is a crucial time when final adjustments determine ideal results and when attention to detail achieves your perfect smile and most comfortable bite.

At your final appointment, a hygienist will remove the braces, polish tooth surfaces where the braces were attached and make impressions for retainers, take photos and one final x-ray.

You will leave the office with an appointment to return in a week to receive your retainer and you will do so with a big, bright, beautiful new smile!

The retainer phase is simpler but every bit as important as the active treatment phase. The retainer is designed to prevent unwanted tooth movement and is custom fitted for your comfort.

To guide your progress, our office will determine how you should wear it, how often and for how long. All you have to do is follow some simple rules.

Take it from me — a former orthodontic patient — it’s worth it!

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Q: Which toothbrush is right for me?

A: Whether you wear braces or not, tooth brushing is not only essential, but continues as the most effective way to assure clean teeth and good hygiene. With so many different types of brushes available, the basic rule of thumb is to select a soft brush that has rounded bristles.

Hard-bristled brushes may damage tooth enamel or injure soft tissue and gums. Select a brush with a proper head. A smaller size is better to reach difficult-to-clean areas which are more prone to collecting plaque.

As you brush your teeth, tilt the brush to a 45-degree angle against the gum line. Use short, gentle circular strokes, and give extra attention to back teeth and areas around fillings, crowns and other restorations as well as braces.

We recommend changing your toothbrush regularly. After three months, bristles will show signs of wear and will not clean as efficiently. Recent studies indicate that the average person exerts much more pressure on teeth when using a manual brush compared to a mechanical brush (i.e., electric toothbrush).

We encourage patients with thin or recessed gums to use motorized toothbrushes, such as the Oral-B,  Braun, Interplak or Sonicare. Used properly, both the manual and mechanical brushes are very effective in maintaining proper hygiene.

With patience and the right guidance, brushing will result in a dazzling smile.

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Q: Is orthodontics the career for me?

A: In today’s high-tech media world, young people have a broad knowledge of an entire spectrum of career opportunities they can pursue. Some want to be orthodontists!

Orthodontics is, first and foremost, a science. If you have an aptitude for science, like to work with your hands and love to be with people, then you might consider orthodontics as a career.

Academically, it is a long and sometimes arduous course of study. Following four years of college, there are four years of dental school, followed by another two-to-three years of orthodontic training.

However, the rewards are many. There is immense satisfaction in watching young smiles improve, along with the person’s self esteem and confidence. And, since the average treatment time is between 1-2 years with another 1-2 years of follow-up durting retention, I get to know and become friends with my young patients, their parents and often, their younger brothers and sisters who become patients as well.

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Q: Why does my friend wear an appliance?

A: Not so very long ago, orthodontic patients wore braces. Just braces. Now patients wear a variety of appliances with familiar names such as headgear and retainers. Others names not so familiar include Maras, Herbsts and bionators.

The list is endless, but the appliances have one singular goal: to provide you with straight, healthy teeth.

The appliances we use are customized, highly technical devices that allow us to achieve the very best results in the most efficient manner.

Unfortunately, many of us have unfavorable jaw and tooth growth. The further from the ideal, the more complicated the treatment! And the appliance!

Orthodontists can make these corrections with new and innovative appliances. In more severe cases, the skills of an oral surgeon may be required in the treatment.

When you see someone wearing an unusual looking appliance, know that a great effort is being made to improve his/her health and appearance.

Patients who persevere through the very difficult treatment programs are to be applauded for their efforts. Adjustment to the more unusual appliances can be difficult.

Soon, they will be feeling and looking great! With the persistence and encouragement of others, the results are definitely worth the effort.

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Q: How long must I wear my retainers?

A: As a patient progresses through orthodontic treatment, the question is "How long must I wear these braces?"

Then, when the braces are removed and retainers are being used, the noun may change, but the question remains the same: "How long must I wear this retainer?"

Patience - It took time to shift your teeth into their straight alignment and to give you that special smile.  It is best to think of retainers as a "Lifetime Commitment."

Once your braces are removed, it’s essential to hold those teeth in their new positions. Normal wear and growth and chewing can shift teeth forward.

With a retainer and a positive attitude, any shifting is usually minimal. We can often tell which patient will undergo more shifting in the retention phase based on the severity and type of the pre-treatment problems, most prevalently, severe spacing or crowding. For these patients I usually recommend a bonded/permanent retainer.

When a retainer is not used properly, braces may have to be reapplied to restore lost results. If patients follow simple guidelines of retainer wear and keep their schedule of appointments during their first year of the retention phase, the rare problems that arise are corrected easily.

So, how long should you wear your retainer?  As much as necessary to keep them from shifting.  For most people that ends up being at least once a week long-term, or more often during times when the retainer feels "tight."  Retainer wear is the best way to protect your investment - keep smiling!!

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Bad Habits

Q: What habits might hinder my progress?

A: There are a number of oral habits which can impede progress during the course of orthodontic treatment.

Most common habits include thumb and lip sucking, tongue thrusting, nail or cheek biting, grinding, lip chewing, ice chewing and pen/pencil biting.

Teeth move or respond to these types of pressure and may move in undesired directions. Therefore, it is essential to determine if any of these habits exist.

For example, in the case of thumb sucking, the thumb rests on top of the lower front teeth and pushes them back towards the tongue.

Additionally, the thumb rests inside the upper teeth and pushes them forward in a flared position.

An extremely protrusive appearance is the result of this habit. If the habit can be broken, the teeth will spontaneously resume a more normal direction.

We use many methods to control habits. Appliances, positive reinforcement and speech therapy can be effective. However, the most effective preventive method is for the patient to be ready and willing to stop. We have an excellent rate of success with patients who truly want to control their habit.

Please discuss any concerns about oral habits that you or your child may exhibit.

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Braces and Candy

Q: Can I wear braces and still eat candy?

A: When you wear braces, there are certain candies that could haunt you after Halloween is over.

If it’s sticky, chewy, hard or crunchy, it is a food that anyone wearing braces or retainers should avoid. The real bad guys are caramel, gum and taffy.

You should also stay away from peanuts, taco chips and frozen candies.

On the other hand, plain chocolate candy, peanut butter cups, Oreo cookies, fruit pies and ice cream are all A-OK!

But candy lovers who gobble up sugary treats should always remember to brush their teeth thoroughly afterwards.

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Music and Braces

Q: Can I play an instrument while I'm wearing braces?

A: The answer is 'yes' - but it may take a bit of adjustment. When I got my braces, I played the trumpet. I remember, at first, that my lips would tire quicker and the sound was slightly different.

However, after three or four weeks, my playing returned to normal. Most of my musician patients say it takes about a month to get used to playing their instruments with braces. It seems to take longer to adjust if you play a brass instrument.

Should irritation occur while playing an instrument, ask us for some extra wax. That should take care of any problem. However, if the wax doesn't help, there are special lip bumpers that can be used to ease any pressure.

The bottom line is: You can work through it by practicing normally and consistently - and by asking your music instructor to be a little patient with you.

Of course, there's no worry at all if you play the piano!

Keep smiling!

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Piercing and Teeth

Q: I really want to get my tongue pierced, but one of my friends got it done and the stud chipped her teeth. What do you think?

A: Chips in teeth caused by jewelry in the tongue, lips, and cheeks are more common than most people realize. But that’s not the only problem.

Infection at the site of the piercing is also very common. Oral bacteria that enters the bloodstream at the site of the piercing can cause inflammation of the heart valves and tissues. Infection can also cause the tongue to swell. If the swelling is severe enough, the airway can be blocked.

Metal jewelry inside the mouth can damage the soft tissue of the gums, causing bleeding and infection. It can cause extra saliva to be produced and that can make it difficult to chew and swallow food or even to pronounce words properly.

And of course there is always the potential for choking when oral jewelry accidentally comes loose in the mouth.

I urge you to think carefully about the consequences before you proceed with oral piercing. If you’d like to talk with me about it, please call.

Keep smiling!

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Mouth Guards

Q: Can I wear a mouth guard with braces?

A: Everyone knows that mouth guards (MG) are required for certain sports and activities in which children and adults participate. Patients frequently ask if they can play sports with braces or orthodontic appliances. Our answer is: YES!

Some teenage boys believe they can’t get braces because they play football. We remind them that when Terrell Davis of the Denver Broncos was named MVP of Super Bowl XXXII, guess what was under his MG? Braces!

In fact, several Philadelphia Eagles have played with braces last year. And you can bet they all wore their mouth guards. Now you know you can play sports with braces. The right mouth guard can help you succeed.

For athletes without braces, a regular mouth guard (the kind boiled in water and formed to your teeth) is fine. But for those who wear braces or orthodontic appliances, a ‘moldable’ MG is not recommended. The MG may prevent proper tooth movement or cause brackets to break off from the teeth.

For those who wear braces while playing sports, Kadar Orthodontics provides a specially designed MG that protects teeth and soft tissues without harming the braces or appliances. The MGs are available with or without straps, depending on helmet requirements.

We recommend you wear the orthodontic MG at home a few times before heading to practices or games. This will allow you to become comfortable with the MG fit so you can concentrate on winning!

We hope our orthodontic MG never has to be put to the test, but you and your teeth will be glad you’ve got the extra protection if you need it.

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Bright New World

Q: Where do I go to get my teeth whitened?

A: There's nothing more dazzling than a bright white smile. And new tooth whitening procedures make it safer and more successful than ever before.

According to the ADA, tooth whitening accounts for the bulk of 60 million cosmetic dental procedures performed in the U.S.

Discoloration and darkening of the teeth occurs over many years as a result of stains from food and drink. Now, it's possible to remove stains in as little as two weeks.

The dental office is the best place to start if you're interested in attaining a whiter smile. Non-professional, quick-fix solutions may not provide the desired results.

Although younger patients have realized success, we believe that age 18 is a safe age to consider bleaching.

We recommend using a shade guide and bleaching only the upper teeth initially. The upper teeth are more visible which allows you to compare the whitening and judge the level of success.

The procedure itself is simple. The dentist takes an impression of the teeth to create a custom application or tray. Then, an oxygen-releasing gel (whitening agent) is placed over the teeth.

The tray holds the gel in contact with the teeth and keeps out saliva that would dilute and wash away the agent. The gel is applied daily for a period of two weeks, then as needed.

Not all teeth will "whiten" the same. Yellowed teeth usually bleach well; brown- or gray-hued teeth may not bleach well at all. We can assist your general dentist and evaluate your situation.

The ADA says that a dental consultation can lead to a brighter smile and a smile that doesn't sacrifice safety in the process.

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Tooth Grinding

Q: Why is tooth grinding harmful?

A:Occasional clenching and grinding of the teeth, called bruxism, usually will not cause harm. However, if grinding is occurring on a regular basis the teeth can be damaged by extensive wear. This can also cause headaches, earaches and can even cause gum recession.

Approximately 20% of adults and 15-30% of children grind or clench their teeth usually at night during sleep. Children tend to grind mostly with their baby teeth. When their permanent teeth have fully erupted, most children lose the grinding habit.

Causes of clenching and grinding in both children and adults has been linked to stress, anxiety and excessive use of stimulants such as cafeine. However, one of the main contributing factors of bruxism is when the teeth and bite are improperly aligned.

Orthodontics can correct the alignment of the teeth but we cannot always control the grinding habit in our sleep. Of course, we should try to reduce stress and cafeine use. But, if grinding continues especially during sleep, it may be necessary for your general dentist to evaluate and it your teeth with a night guard appliance.

A night guard is a fitted appliance that covers the biting surfaces of either the upper or lower teeth.Worn at night, it protects the teeth against excessive wear, prevents the teeth from locking together and may assist in preventing the headaches, earaches, and jaw pain associated with grinding.

Here at Kadar Orthodontics, the goal of treatment is to achieve the best possible alignment of teeth and arches. Once we achieve a bright healthy smile, your general dentist continues in the care of your teeth and gums so that your beautiful Kadar smile will last you a lifetime.


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