I ran across this website for dental bands called Teeth Gap. They are designed to close a tooth gap without having to get braces. Are you familiar with these? Do they actually work?

Brad

Dear Brad,

I am glad you wrote before ordering these. First, I see the prices vary from $25 up to $70. Aside from being very expensive for what is, at their essence, fancy rubber bands, they can actually do real damage to your teeth. These do not work like orthodontics do. With braces or other type of orthodontic, such as Invisalign or Spark Aligners, the movement of your teeth is carefully controlled.

This is not the case with these dental band type of treatments. They tip the tooth to move it. This has the potential of creating gaps on the outside of the bands as they move the teeth inward. However, they can also do serious damage to your teeth as well. It can even cause healthy, adult teeth to come loose.

This before and after image is an example of a case by the Teeth Effects Company. While the gap is closed, this patient now has a few problems. The first thing I noticed is how the front tooth on our left looks like it has been pulled out of the socket a bit. I have a strong suspicion that this tooth is now a bit loose.

Whenever you use traditional braces, after each carefully planned movement there is a pause to give the bone time to integrate with the tooth root again. There is no way to do that with the teeth bands. What you don’t want is to have teeth that no longer have a gap, but can fall out of your mouth! In fact, I read of a case where a young woman had her adult teeth come loose as a result of this type of procedure. You can read about it here.

Additionally, you will notice that there are small gaps on either side of the central incisors that were not there previous to treatment. It may even be that the gaps are bigger than they seem here because there is no way to verify this. It looks like the teeth in that area have been photoshopped a bit too because the lateral incisors are a different shape than they were before the treatment.

An Alternative to Traditional Braces

Because you are just talking about tooth gaps, you may be a candidate for Fastbraces. However, if you absolutely don’t want any type of metal braces, there are two aligner treatments that are a good option for you: Invisalign and Spark Aligners. Both of these can straighten your teeth without using metal. No one will even know that you are straightening your teeth.

This blog is brought to you by Bee Cave Orthodontist Dr. Alberto Tostado.

I have a problem with my two front teeth looking way too big and long. They also stick out in front of the rest of my teeth. Everytime I look in the mirror, I feel like I look like a beaver. I don’t know what to do with them. My dentist suggested either braces, which won’t really change how long they are or removing them and putting dental implants in the area. What do you think?

Sandra

Dear Sandra,

Please do not have your teeth taken out. There is a much simpler solution for your situation. Bear in mind that I haven’t actually examined you. Going just on what you described, I would have the teeth shaved down a bit on the biting edges as well as the sides. This can be done with diamond burs and diamond strips.

After that is complete, you can have an Invisalign or Spark Aligners procedure done. Both of these systems use clear aligners to straighten your teeth. These are not visible even at a conversational distance. They will also straighten your teeth in about half the time as traditional braces will.

Combining these two procedures means that you can get rid of the Beaver look without having to get rid of the teeth themselves! Find a great orthodontist who can do an in-person exam you and give you their recommendation.

This blog is brought to you by Bee Cave Orthodontist Dr. Alberto Tostado.

I was never able to get braces as a child. Now that I am more financially independent, I am hoping to get Invisalign, but I am missing a few teeth on my bottom arch. Will Invisalign work in this type of situation? My dentist doesn’t think it will, but I am wondering how much that has to do with the fact that he doesn’t do Invisalign himself.

Janice

Dear Janice,

I am glad you wrote. Invisalign does a fine job working around missing teeth. However, even among dentists who do the Invisalign procedure there are varying levels of comfort in which cases they would feel comfortable handling.

One thing I would suggest is that you talk to an orthodontist who also uses Invisalign. Plus, there is more than one brand of invisible braces. Another one is Spark aligners. This brand can only be done by an orthodontist. Sometimes Invisalign requires buttons to be added which is not the case with the Spark aligners. Plus, their scalloped design reduces irritation.

It is important that you do not try and force a dentist into a procedure they are not comfortable doing even though you are a good candidate. The results rarely work out how you’d like.

You are better off finding a dentist or orthodontist who can do the procedure with training and confidence.

This blog is brought to you by Bee Cave Orthodontist Dr. Alberto Tostado.

I had my invisalign treatment started about three months ago. At first everything was going well, then about four weeks ago my attachments started coming off. First it was the one on my upper right and I had it put back on, then it was one on my lower right the following week. Now another one has come off, and I’m wondering what is going on. Is it something I’m doing or not doing?

Help me.

Candy

Dear Candy,

For those who aren’t sure what these Invisalign attachments are, in some cases,  tooth-colored attachments are bonded directly onto some of your teeth and your clear aligners snap on over these. It’s sometimes necessary to help with the tooth movement.

These attachments aren’t designed to be permanent and will be removed at the completion of your treatment. As such, they do occasionally come off, and this is not a cause for concern. Simply call your orthodontist when one comes off. They may say it’s fine to wait until your next appointment, or they may ask you to come in for an urgent orthodontic appointment.

During the normal course of treatment, there are times that your teeth will be shifting, and this movement can cause pressures that cause the attachments to pop off. This is common, and temporary.

My one concern is the number of them you’ve had come off in this short time period. There are some possibilities of what could be causing this.

1: Your attachments are too “tight”. The clear aligners should fit semi-loosely over the attachments, snug enough to cause retention, but loose enough that the patient can easily snap the trays in and out quickly. If you’re struggling to take them out, that may be putting undue pressure on the attachments. The doctor may simply need to lightly polish the attachment to ever-so-slightly “loosen” the fit.

2: The bonding material may be the cause. If the etching and bonding materials are either expired, compromised, or otherwise weakened in any way, they will not perform to expectations and will easily pop off. I’m sure your doctor or their staff wouldn’t mind double-checking the condition of the materials, just to be on the safe side.

3: Lots of acidic foods or alcohol. If you are someone who takes in a lot of acidic foods and drinks, including alcohol, the acids from these foods may weaken the bond between the attachment and your enamel. Switch to gentler foods/drinks, or rinse immediately after consuming them.

4: Your technique in placing/removing aligners may be in need of adjustment. Some patients lift and “twist” the clear aligners in an improper manner, causing pressures that pull the attachments off. There’s a trick to it, to remove them without causing damage, and you’ll get quick with it very soon–you haven’t had these that long. Ask your doctor or a staff member to go over proper technique with you at your next appointment.

I would talk to your orthodontist about this and he or she can help you determine if there is something unusual going on in your particular case.

This blog is brought to you by Bee Cave Orthodontist Dr. Alberto Tostado.

I am on my final pair of aligners for my Invisalign treatment. I’ve just got a promotion that requires immediate relocation. It’s the job of my dreams so I don’t want to pass on it. Can I just finish these aligners and be done or will I need to find an Invisalign dentist right away for some post procedure treatment? I remember my dentist saying something about needing a retainer.

Paisley

Dear Paisley,

I don’t think you need to rush out and get an Invisalign dentist the day you move. While you will need a retainer to prevent your teeth from shifting back out of alignment, there is a way to use your final aligner as a retainer while you get settled. Then, when things calm down, you can see either an Invisalign dentist or an orthodontist to get a sturdy retainer.

Keep your final aligners on for at least a month, then you can start gradually backing off. This is the procedure I want you to follow for that. After that month or so, start wearing them every other day. If when you’ve been out of them for a day the aligners are a little harder to put it, in means your teeth have shifted and you need to go back to every day longer. If they’re fine, wear them every other day for a month or more.

From there you can try backing off a little more by doing it every three days, always being sure to check that there has been no shifting. Then go to once a week. By then, you will probably be settled and able to get things checked out by a professional. Your old Invisalign dentist is ethically bound to share all his treatment notes and diagnostics with whoever you see next, so make sure you get those transferred.

I hope this helps. Congratulations on the new job and I hope your move goes smoothly.
This blog is brought to you by Bee Cave Orthodontist Dr. Alberto Tostado.

I don’t know what it is called for my daughter whether she has an over bite or something else. Her smile makes it look like she has a receding chin. She’s very embarrassed by her smile. A lot of her friends are getting Invisalign. Will that help her situation?

Karen

Dear Karen,

Whether Invisalign will work for your daughter will depend on how bad her overbite is. It sounds like she has some rather complicating factors. I would not just go to a dentist for this. I would go to an orthodontist who also does either Invisalign or Spark aligners, which are two great brands of clear aligners. While a general dentist can do Invisalign, only an orthodontist can do Spark.

Given your daughter’s complicated situation, I would expect that she will need that additional training in order to receive the proper treatment. Be aware I haven’t seen your daughter’s bite or read any diagnostic notes from your dentist, so it is hard to give you any concrete treatment suggestion.

Based on what you described, her treatment could range anywhere from simple clear aligners, to traditional braces, all the way to the need for surgical orthodontics. This is why it is important she is seen by someone with real expertise.

The good news is, regardless of the situation, her bite CAN be fixed and she can have a smile she is proud to share with the world. Step one is get her to an orthodontist who handles a variety of treatment options.

This blog is brought to you by Bee Cave Orthodontist Dr. Alberto Tostado.

I am supposed to get my braces off in one month. I just realized I have some back teeth coming in. Will that mean I can’t get my braces off? Do I need to call the orthodontist right away so he can get braces on them? Would this be an emergency or do I just wait for my next appointment?

Brandy

Dear Brandy,

The good news is that you are not dealing with an orthodontic emergency. Everything is intact. My guess is that your orthodontist took x-rays before your case was planned. If so, he would have known that you had more teeth coming in and when they could be expected.

As long as your new adult teeth are coming in straight, then you should not have any problems. As long as all your teeth are erupted and straight there should not be any problems with you having your braces removed.

It will be important that you wear a retainer once your braces are removed. Doing that, will help your teeth to stay in their proper position even while the new teeth are coming in.

I would not call the orthodontist to go in early, but just bring it up at your next appointment.

I hope this puts your mind at ease. I’m excited you’ll be getting your braces off soon. It’s always fun to have a brand new smile.

This blog is brought to you by Bee Cave Orthodontist Dr. Alberto Tostado.

My older sister had braces and her enamel ended up deteriorating. When her braces come off there were the white spots and they turned into cavities. I’m about to have braces and I am terrified that I’m going to have the same thing happen. Is there anything that I can do that will keep that from happening to me?

CeeCee

Dear Cee Cee,

I am glad you wrote. The fact that these white spots turned into decay tells me that your sister was not under good dental care. There is a solution when this happens. Either her dentist did not know the solution or did not bother to tell her. Neither of those are good in my book. But first, let’s talk about how you can prevent this.

The white spots are decalcification. this means that your sister wasn’t quite getting the areas around her braces really clean. Granted that is tricky, but it can be done with persistance. You will need to brush your teeth diligently, really getting in the spots around the metal wires and brackets. If you do that, there should not be a problem with white spots.

A second option is to get some aligner based orthodontics, such as Invisalign or Spark Aligners. These use clear aligners instead of metal wires and brackets to clean your teeth. These have the benefit of allowing you to remove the aligners in order to brush and floss your teeth, making it easier to get your teeth completely clean.

Let’s says that you still got metal braces and you ended up with those white spots. The solution would be to see a cosmetic dentist who can use microabrasion on the white spots and then cover that area with dental bonding.

That being said, this is avoidable with careful oral hygiene during your treatment.

This blog is brought to you by Bee Cave Orthodontist Dr. Alberto Tostado.

I need some advice. I paid almost $5k for Invisalign. The purpose was to fix my midline and close up some space between teeth four and five. He worked the computer and said that it should fix in nine months. Nine months came and went. The area closed up but the midline still had problems. We did another nine months, still no result. I got very frustrated because now he is talking about a full set of porcelain veneers. I went to see an orthodontist and he said Invislign never should have been used for this and it needs traditional orthodontics. I feel like I’ve wasted a year and a half and $5,000. Is there a way to get my money back on this?

Karen

Dear Karen,

While fixing a midline is a bit trickier than some other cases, it can sometimes be repaired with Invisalign. I’d be curious to know if this an orthodontist who also does Invisalign or is one of the orthodontists who eschews Invisalign. Some orthodontists see it as a threat and don’t recommend it under any circumstances. My recommendation would be to get a second opinion from an orthodontist who does both procedures. Then, if he or she says that Invisalign was inappropriate in your particular case then you’ll have a better chance of getting a refund.

There have been major advancements with Invisalign and they can do many things that traditional braces can do. However, there are those more complicated situations where you really need a specialist. Your typical dentist may rely too heavily on Invisalign’s advances and hope things will work out.

You should also be aware that there is another type of clear aligner braces, Spark aligners, that are only available through orthodontists. These have some advantages over Invisalign. When you get that second opinion, see if those will work better for you. They may keep you from needing metal braces.

As to how to go about getting that refund,  I would start with just politely asking. This will be easier with that recommendation from an orthodontist who does both procedures. If that doesn’t work, you can threaten to take it to the dental board. You have another practitioner on your side, so this will be a black mark on his record he would not really want. Finally, you can get a lawyer. I don’t think it should come to that if you have someone who does both procedures backing you up, but be prepared for that possibility.

This blog is brought to you by Bee Cave Orthodontist Dr. Alberto Tostado.

My daughter, who is about to go to college had braces for two years and then wore a permanent retainer for close to three years. It was time to remove the permanent retainer. Unfortunately, when the orthodontist did remove it, he ended up damageing one of her teeth. It is now recessed. It has also changed colors and hurts her when she bites down. I’ve taken her to another dentist and he said she needs a root canal treatment. I’m very frustrated about this. Should the orthodontist be responsible for paying for this treatment? This has been a frustrating treatment from the beginning. Not only have we spent a fortune, but the majority of the time we didn’t even see him. He just had one of his assistants do the work. The whole reason we went to an orthodontist was to have someone with extra training. I have a son that is about to need braces and I’m wondering if we would be better off with just taking him to a dentist for something like Invisalign.

Joyce

Dear Joyce,

A fixed retainer is fairly easy to remove. I am interested in hearing more about how this tooth was damaged. Either way, the orthodontist you saw is liable for the damage he did. He should cover the root canal treatment and dental crown. You didn’t say which tooth was damaged, but if it is a front tooth make sure your dentist uses a porcelain crown. Additionally, you should chose the dentist to do the repair work, not the orthodontist. He will either pick a friend or the cheapest dentist he can find to lower his expense in this situation.

It does not sound like this is the best orthodontist for your family. When you are spending all that money for a specialist, you want the specialist to be the major contributor in the treatment. I understand your frustration.

Given your experiences, I would suggest a different orthodontist for your son. You do not have to go to a dentist to get Invisalign. There are orthodontists who will do Invisalign or even Spark aligners. Spark Aligners have some advantages over Invisalign, but can only be done by an orthodontist.

I am sorry this happened to your daughter.

This blog is brought to you by Lake Travis Orthodontist Dr. Alberto Tostado.