REPOST: Adult braces: More are seeking treatment to get straighter teeth

The number of adult patients seeking dental braces has reached a record high, increasing by 14 percent to over 1.2 million annually, according to the American Association of Orthodontists. The article below discusses the new orthodontic advances available for people who want straighter teeth.


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Frank Mott isn’t a vain person, but even he admits that, thanks to his braces, “my teeth are progressing perfectly, just the way I want them.”

Just another middle schooler looking forward to getting his braces off in time for the summer? Hardly. A 54-year-old Pompton Plains resident who works for PSE&G, Mott is just one of the growing numbers of adults who are embracing braces for their aesthetic and health benefits.

Back in the day, braces conjured up images of a mouth full of gray metal, while the teens who wore them were ridiculed.

“You’d opt to get your teeth extracted before getting braces put on,” Mott joked. But thanks to advances in technology, braces have become smaller and more unobtrusive and a new generation of adults is more than willing to take the plunge in the name of perfect pearly whites.

According to Michael Messana, immediate past president of the New Jersey Dental Association in North Brunswick, new orthodontic options available over the past 10 to 15 years have made adults feel that “maybe there’s something for me,” while a 2013 survey by the American Association of Orthodontists confirmed that the number of adult patients seeking orthodontia between 2010 and 2012 increased by 14 percent to over 1.2 million annually, a record high.

“People want a better smile and they also understand the systemic link between a healthy mouth and overall well-being,” said David Caggiano of Caggiano Orthodontics in Parsippany.

“When teeth are straight, they’re easier to keep clean, which helps prevent gingivitis, periodontal disease and other types of inflammation that can increase the risk of heart disease and other chronic conditions. In addition,” he said, “by fixing crowding or spacing issues, overbites, or misaligned bites, braces can also help adults eliminate grinding, chipping and other issues causing them to wear their teeth adversely.”

Many options

Today’s braces can be white or translucent ceramic glass that blends in with the teeth, so they’re not as noticeable, Caggiano said.

“Standard metal braces are the least expensive and are available in two versions — traditional braces which use clear or colored elastic connectors that hold the wire into the braces, or the more convenient self-ligating kind, which constantly tighten themselves between bimonthly visits,” Caggiano said.

Another common approach is the use of a series of clear or invisible aligners such as those popularized by Invisalign, which patients wear for two weeks at a time, remove when they eat and brush their teeth, and which gently move teeth into their final, pre-determined position.

As a final option, Caggiano said, lingual braces are positioned behind teeth and can be more uncomfortable for patients to get used to as well as more difficult for dentists to maneuver around, but in the end it’s about patient preference.

Worn anywhere from nine months to two years, Caggiano said adult braces require about an hour to install and their price tag ranges from $5,000 to $6,500 for non-lingual types of braces.

“Thirty-five percent of our current patients for braces are adults in their 20s through their 70s,” Caggiano said.

“I put my daughter through braces so that she could have nice teeth, so it seemed hypocritical of me not to correct my own teeth at some point,” said Mott, who will have his braces removed in October. “Having a better smile will give me a lot of self-satisfaction and I feel great for having done it.”

Dr. Darrin J. Hirt is highly trained in all phases of pediatric and adolescent dentistry.  He currently practices at Beverly Hills Pediatric Dentistry, where he delivers personalized dental care services in a comfortable and friendly setting. Visit this website to learn more about Dr. Hirt’s practice.



REPOST: Why neglecting your teeth can have serious consequences

According to a recent report by the Pew Charitable Trust, tooth decay is the most common childhood disease and dental care is the greatest unmet need for health services among children. To establish good dental hygiene, adults and children must observe proper and habitual tooth brushing and flossing, as well as regular dental visits. Consumer Affairs has the full story:

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Cavities have always been a trial of childhood, along with getting the mumps and chicken pox. By the time children shed their baby teeth and get their permanent ones, they hopefully have established good dental hygiene that limits these problems in the future.

While that’s the goal, a recent report by the Pew Charitable Trust finds that reality presents a different picture. It calls dental care the single greatest unmet need for health services among children. It identifies tooth decay as the most common childhood disease, with nearly 60% suffering some kind of dental problem.

The Great Recession made the problem worse, with a survey by FORBA, a dental practice management company, finding low-income families with children reduced their children’s dental care since 2008. Twenty percent said their children did not see a dentist at least once a year.

Adults appear to be skimping on visits to the dentist’s office as well, putting off treatment of dental issues until things get serious. The American Dental Association reports the number of dental emergency room visits in the U.S. rose from 1.1 million in 2000 to 2.1 million in 2010. The study also noted that 41.8 percent of all these emergency visits were for conditions that could have been easily prevented with proper dental care.

The cavity

The root cause of most dental problems is the cavity, a hole in the enamel of the tooth that, left untreated, can expose the root to bacteria and become infected. There’s a lot of confusion about what causes a cavity, with many people assuming too much candy and sugary soft drinks are the catalysts.

“The reality is that based on all the evidence we now know, it’s a lot more involved than that,” said Dr. Joseph Field, a dentist at the Peninsula Center of Cosmetic Dentistry in Los Altos, Calif.

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Food for bacteria

Field points out that sugar doesn’t cause cavities, the waste from bacteria in the mouth that feed on that sugar is the culprit. The waste is an acid that eats away at tooth enamel.

To prevent cavities, Field said, you really should brush after every meal. If you have fruit juice, high in acid, drink some water afterward. It will help wash away some of the bacteria waste before it can attack your tooth enamel.

While foods high in sugar and carbs are bad for teeth, probiotics like yogurt can have a healthy effect.

“It’s about the whole body,” Field said.

It’s also about brushing. Fields recommends a fluoride toothpaste after meals, using an electric toothbrush for two minutes, flossing at least once each day. He says a fluoride mouthwash can also help.


Dr. Darrin J. Hirt is a pediatric dentist who provides specialized oral health services for infants, children, and adolescents. Follow this Twitter page for the latest news and updates on dental care.

REPOST: Baby Teeth

There are a lot of changes in a woman’s body during pregnancy.  Learn how the oral hygiene of a mother affects her baby during pregnancy in this article from

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South of the chin, it’s pretty obvious where a woman plumps up during pregnancy. Less noticeably, her gums become swollen, too. Not only are puffy gums painful, but they also pose a risk to the unborn baby.

During pregnancy, blood vessels expand throughout the body, including the gums, says Dr. Dana Keiles, who practices dentistry in Yorktown Heights, N.Y. Enlarged vessels make the gums tender and more likely to bleed.

On top of that, about 50 percent of women experience pregnancy gingivitis, a gum disease caused by elevated hormone levels, according to the American Academy of Periodontology. The hormones react with plaque at the gum line, causing inflammation. Studies show that women with gum disease are more likely to give birth prematurely or bear full-term babies with low birth weights, which puts the infants at risk of developing serious health problems such as cerebral palsy, blindness and deafness. In addition, a study published in the April 2010 issue of the Journal of Periodontology suggested that women with gum disease are more likely to develop gestational diabetes.

The transfer of bacteria from a mother’s mouth to her unborn child and the rest of her body is probably to blame for these systemic health problems; however, other factors such as stress may come into play as well, says Dr. Jennifer Holtzman, assistant professor of clinical dentistry, University of Southern California, Los Angeles.

In the general population, gum disease has been linked to heart disease and stroke.

“The best way to prevent and control gum disease is to make sure you clean the plaque off your teeth,” Holtzman says, adding that there are over-the-counter “disclosing agents” people can buy to dye and reveal any bacteria they missed while brushing and flossing.

Keiles recommends that women undergo a thorough dental exam if they are planning to get pregnant and that they have their teeth professionally cleaned every three months once they’re expecting.

She also recommends that pregnant women who suffer morning sickness or nausea rinse their mouths out if they vomit because stomach acid can damage tooth enamel.

“There’s a saying, ‘Have a baby, lose a tooth.’ It’s an old wives’ tale,” she says, “but there are a lot of hormonal things going on during pregnancy that can cause serious problems, so it’s important to practice good oral hygiene.”

Dr. Darrin Hirt practices pediatric and adolescent dentistry in Beverly Hills. Read more about his professional profile at this website.

REPOST: Oral Health Topics: Chewing Gum

The American Dental Association (ADA) presents a clinical overview of the link between gum-chewing and oral health.

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What is chewing gum?

Chewing gum in various forms has been around since ancient times.  The Greeks chewed sap from the mastic tree, called mastiche.  On the other side of the world, the ancient Mayans favored the sap of the sapodilla tree (called tsiclte).  Native Americans from New England chewed spruce sap—a habit they passed on to European settlers.  Today, the base used for most gum products is a blend of synthetic materials (elastomeres, resins and waxes in various proportions).  However, chewing gum is as popular as ever.

Consumers may be used to thinking about chewing gum as a kind of candy, but this category of the ADA Seal recognizes chewing gum that has demonstrated scientifically that it can protect the teeth.  For an informative article on the history of chewing gum, visit (Link opens in separate window. Pop-up Blocker may need to be disabled.)

What does chewing gum do?

The physical act of chewing increases the flow of saliva in your mouth.  If you chew after eating, the increased salivary flow can help neutralize and wash away the acids that are produced when food is broken down by the bacteria in plaque on your teeth.  Over time, acid can break down tooth enamel, creating the conditions for decay.  Increased saliva flow also carries with it more calcium and phosphate to help strengthen tooth enamel. Clinical studies have shown that chewing sugarless gum for 20 minutes following meals can help prevent tooth decay.

In the future, look for chewing gum that delivers a variety of therapeutic agents that could provide additional benefits to those provided by the ability of gum to mechanically stimulate saliva flow. For instance, some gum might contain active agents that could enhance the gum’s ability to remineralize teeth and reduce decay, or enable gum to help reduce plaque and gingivitis.

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Does chewing gum replace brushing and flossing?

No, chewing gum is an adjunct to brushing and flossing, but not a substitute for either. The ADA recommends brushing twice a day with a fluoride toothpaste and cleaning plaque from between your teeth once a day with dental floss or other interproximal dental cleaners.

What is in chewing gum and how is it made?

Chewing gum typically consists of:

  • Gum base
  • Artificial sweeteners (such as aspartame, sorbitol or mannitol)
  • Softeners (glycerin or other vegetable oil products)
  • Flavorings and colorings

The process for making chewing gum has six basic steps:

  1. Gum base ingredients are melted together
  2. Other ingredients are added until the warm mix thickens like dough
  3. Machines called extruders are used to blend, smooth and form the gum
  4. The gum is shaped (flattened or molded into tablet shapes and coated)
  5. The gum is cooled for up to 48 hours in a temperature controlled room
  6. The gum is packaged.

Source: National Association of Chewing Gum Manufacturers.

How does chewing gum get the Seal?

A company earns the ADA Seal for its product by showing with scientific evidence that the chewing gum is effective for one or more specific indications, such as reducing plaque acids, promoting remineralization of tooth enamel, reducing cavities and/or reducing gingivitis.  Studies must also show that the gum is safe to oral tissues.  The manufacturer must provide the results of both laboratory studies and clinical studies in humans.

Does the ADA award its Seal to sugar-containing gum?

To date, the only gum with the ADA Seal are sugarless.  They are sweetened by non-cavity causing sweeteners such as aspartame, sorbitol or mannitol.  Chewing sugarless gum has been shown to increase the flow of saliva, thereby reducing plaque acid, strengthening the teeth and reducing tooth decay.  Of course, chewing sugar-containing gum also increases saliva flow, but it also contains sugar which is used by plaque bacteria to produce decay-causing acids. Further research needs to be done to determine the effects of chewing sugar-containing gum on tooth decay.

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Why look for chewing gum that displays the ADA Seal?

The Seal is your assurance that the Sugar-free Chewing Gum has met the ADA criteria for safety and effectiveness. You can trust that claims made on packaging and labeling for ADA-Accepted products are true, because companies must verify all of the information to the ADA. Look for the ADA Seal because products with the ADA Seal say what they do and do what they say.

Dr. Darrin Hirt is a specialist in adolescent and pediatric dentistry who received additional training on dental care, child psychology, and child growth and development under the auspices of the American Dental Association. View his extensive portfolio of dental work on this website.