Our Blog

Alternatives to Having Teeth Removed for Braces

September 1st, 2017


Many patients are concerned about having teeth extracted in order to get the smile they’re looking for. You can relax because this procedure is not necessary for most of our patients! Depending on your specific problems and your individualized treatment plan, tooth extraction may be one alternative to consider when the final outcome is a beautiful smile and ideal bite. So, why are extractions sometimes recommended and what are the alternatives?

The primary reason for tooth extraction is severe crowding. When there isn't enough space for all the teeth, extraction may be used to create space so the rest of the teeth can be moved into the correct position. Extractions are also recommended when the size of your jaws don’t match up or in the case of severe protrusion. Alternatives to extraction include…

Moving Molars Back
This procedure is commonly done in younger patients in order to create more room for the front teeth. Because these patients are still growing, it’s relatively easy to accomplish with braces or devices such as headgear. In adults, this can be more difficult because they are no longer growing.

Arch Expansion
This is commonly done, and it is highly successful in younger patients. Extensive expansion however can come with risks. If retainers aren't worn long enough, the teeth and bones can very easily move back into their old positions. Also, because this procedure moves the roots of the teeth outwards, this creates a thinner layer of bone over the roots which could lead to receding gums later in life.

Jaw Surgery
When a patient has a severe overjet or underbite, having surgery to move the lower jaw forward or backward can be an alternative to removing teeth to correct the problem. However, most patients choose to have a couple of teeth removed rather than to go through this extensive surgical procedure.

Tooth Reshaping
This is more commonly done for adults, especially those who have lower crowding or whose teeth have become misshapen over time. A small amount of enamel is removed from the edges of the teeth. Removing fractions of a millimeter from several teeth can create spacing to eliminate crowding while leaving plenty of strong enamel on the teeth so that they are resistant to cavities and sensitivity.

Mouth Guards and Orthodontics Are a Perfect Match!

August 15th, 2017


April is National Facial Protection Month. With spring comes an increase in outdoor activities and a greater chance of damaging those pearly whites. Here at Peninsula Orthodontics we know a lot of our patients are active and play sports and we want to remind you about the importance of taking a few precautions to preserve your teeth and be protected from facial injuries. One of the most important pieces of sports equipment you can wear is a mouth guard.
What are mouth guards?

Mouth guards are a flexible, removable device made of soft plastic. They are adapted to fit comfortably with the shape of the upper and/or lower teeth.

Why are mouth guards and orthodontics a match?
A blow to the face could chip a tooth, damage the brackets or other fixed orthodontic appliances. The mouth guard will protect your teeth from impact and most instances prevent damages from occurring. A mouth guard also provides a barrier between the braces and your cheek or lips, limiting the risk of soft tissue injuries. Research shows us that most oral injuries occur when athletes are not wearing mouth protection.

How to choose a mouth guard that’s right for you while in orthodontic treatment?
You want to choose a mouth guard that comes pre-formed, ready to wear. Be sure to avoid mouth guards that custom form to your teeth as these will resist any tooth movements we are trying to achieve during your orthodontic treatment. If you do choose a custom form, please remember to place orthodontic wax over your braces before shaping your new mouth guard.

If you forget to block your braces with wax before placing you custom mouth guard, your may find yourself needing to come into the office to have it removed by us like our patient did!

Some tips for caring for your mouth guard
• Rinse before and after each use or brush with a toothbrush and tooth paste.
• Transport a mouth guard in a sturdy container to help keep clean.
• Check for wear and tear to see if it needs replacing.
• Never share your mouth guard!!

A mouth guard is an essential piece of athletic gear that should be part of your standard equipment. By using it and other forms of facial protection like helmets, protective eyewear and face shields, you will avoid serious oral injuries with or without braces.

The next time you’re in for an appointment, we encourage you to let us know if you’re playing or planning to play any sports. We can produce or provide a mouth guard that will work best for you.

The Dangers of Oral Piercings

August 1st, 2017


So, you’ve been thinking of satisfying your inner “wild child”. Tattoos, piercings and other forms of body modification have become main stream in our culture as a means of expressing one’s inner self. You may want to dabble in these art forms, and may be thinking that a lip or tongue piercing is something to try. After all, piercings, as opposed to - let’s say - tattoos, are reversible. But are they really reversible?

You may think that once you’ve decided to stop wearing your oral piercings the holes will close and there will be no permanent reminder of your choice. The problem is, that may not be the case. Tongue and lip jewelry can lead to PERMANENT changes to your gums and teeth. I have recently seen a number of our patients who have had oral piercings undergo gingival recession. These changes are “permanent” but can be treated if the piercings are removed soon after the changes are noticed. If the piercings are not removed, there is a real danger of tooth loss.

Here’s what happens. The piercings, like chewing tobacco, are an irritant to your gum tissue. Our gums are designed by nature to withstand chewing, but not constant irritation from chemicals or metal. When gums are rubbed on too much, the tissue breaks down and the attachment to the root surface is disrupted. With no attachment to the root surface, the gums move down the root towards the bottom of the tooth. The opposite is true if the piercing is on the upper lip. The gums will move up towards the top of the tooth.

Once this happens, the gums will NEVER grow back. The teeth in turn can become more sensitive to cold and toothbrush abrasion. And since the surfaces of your roots are not covered with enamel, they become very susceptible to decay. The only thing that can be done at this point is to have a gingival grafting procedure. This is done by taking a small piece of gum tissue from the roof of your mouth and transplanting it to the area of recession. This procedure is usually quite successful, so long as the recession is not too extreme.

If you do have oral piercings, please check your gum tissue every time you brush. Also consider removing your piercings on a regular basis to allow your tissue to rest from the trauma. The first row of picture shows what happened in just ONE year of this lip piercing.


This picture shows recession on the inside of the back teeth from a tongue bar.

"Do I Really Need to Wear my Rubber Bands?

July 15th, 2017

The best answer to that is… YES, if you really want to get the best possible results from your orthodontic treatment. Many orthodontic patients will never be asked to wear rubber bands, and if you are one of those people consider yourself fortunate. If rubber bands are a critical part of your treatment, wearing them will move your teeth into the desired position.

We may ask you to wear your rubber bands full time, meaning that they should only be taken you when you eat and brush your teeth, and they should be replaced with new bands if possible. Other times, you may be asked to wear them part time only at night.

The Purpose of Elastics
Customized for each patient, rubber bands typically stretch over tiny hooks on the top and bottom brackets. If worn consistently, these tiny elastics will apply light steady pressure needed to guide your teeth into the correct position.

If you lose your rubber bands or run out, please call the office and we can mail you a pack, or you can stop by the office and pick up more. Rubber bands are crafted from medical-grade latex, which is safe to be in contact with your mouth. For patients who are allergic to latex, we offer latex-free rubber bands.

The Do’s and the Don'ts
DO - Get in the habit of carrying around extra rubber bands and replace them as quickly as possible after removal for eating and brushing.
DON'T - Double up on elastics except when prescribed by Dr. Ross, as this will cause too much pressure on the tooth or teeth and can actually harm their roots.
DO - Always wash your hands whenever possible before removing or replacing the rubber bands.
DON'T - Overstretch the rubber band or it will lose its strength and it will be ineffective.
DO - Call us if you run out of rubber bands.
DO - Have fun with your braces and rubber bands. There are many different colors available that can let you show off your soon-to-be perfect smile.

Rubber bands are a key part of your orthodontic treatment, and learning how to remove and replace them is an important part to maintaining your braces. Before we set you on your journey to a perfect smile, we'll make sure you understand all there is to know about how to take care of your braces. Of course, if you have any questions about your orthodontic treatment, or orthodontics in general, be sure to contact us.