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5 Tips for Going Back To School With Braces - by Dr. Carrie Bell

August 12th, 2019

Where in the world did the summer go? It seems like each summer I find myself asking this question sooner and sooner. With all of the fun summer trips, camps, and pool time I feel like every parent is probably wondering the same thing. And yet, whether we’re ready or not, it’s already time to start a new school year! Getting prepared for the new school year can be exciting for kids (and parents)! However, for students who have recently started orthodontic treatment, starting school can feel a little more stressful than usual. With changes in appearance, daily oral hygiene routines and meal options, what seemed like small changes at home may be a little overwhelming at school, particularly in the first few weeks. At Mitchell, Bartlett & Bell Orthodontics we try our very best to make every patient’s orthodontic experience as easy and fun as possible. If you have a child who is going back to school with braces, here are some helpful tips we’ve put together to make the transition as smooth and stress-free as possible!

  1. Keep a braces care kit on hand

At MB2Ortho each patient who enters orthodontic treatment with braces is given a care kit. We recommend every student take this with them to school because you never know when these helpful items may be needed. Some of the best items to have in this kit are:

  • A soft bristled toothbrush
  • Fluoride toothpaste
  • Dental floss
  • Dental wax
  • Lip balm

Because braces tend to cause more food entrapment when eating so it is always a good idea, if possible, to have students brush their teeth after lunch. Brackets and wires can also cause mild irritation to the lips and cheeks from time to time. When this happens it is great to have some dental wax on hand to cover any areas that are causing irritation until the problem can be fixed. 

  1. Keep snacks and lunches braces-friendly

Unfortunately, food limitations can be one of the hardest things for new braces patients to get used to and going back to school can make this even more daunting. At Mitchell, Bartlett & Bell Orthodontics we give each patient a list of “No-No Foods” to avoid. These are extremely important because broken brackets can lead to discomfort and/or delays in treatment. Foods that are too sticky, crunchy or chewy should be avoided because they have the potential to break wires and brackets. This may be easy to avoid during the summer when parents are preparing meals and snacks, but if your child buys their lunch or has access to vending machines at school, the temptation to grab one of those no-no foods can be strong. Take the time to review the school’s weekly lunch menu and make sure there is something that your child can eat on the list. If their choices are not braces-friendly, you may find that packing a lunch will make things easier on everyone. Cutting foods into bite-sized pieces makes eating with braces much easier. Prepping bite-sized pieces the night before will save time and also keep the amount of food being trapped in the brackets and wires to a minimum. This will also make brushing and flossing easier for your child, which is always a plus! Healthy snacks like yogurt and applesauce are always a great way to supplement your child’s lunch and keep them feeling full and satisfied all day long.

  1. Keep a mirror handy

Eating with braces is an interesting new challenge that takes time to master. There are many small parts and pieces to grab onto food debris, which can be unsightly and embarrassing. The sugar and food particles that get trapped around your child’s braces can increase the chance of cavity-causing bacteria setting up shop, which increases the likelihood of developing tooth decay. Unfortunately, most people don’t like to point out when someone has food stuck in their teeth or braces! Encourage your student to keep a small mirror in their locker or backpack to check their teeth for food particles after eating.

  1. Purchase a mouthguard for your student athlete

If your child has braces and also plays sports, or has gym class, you may want to consider investing in an orthodontic mouthguard. Sports and other physical activity can increase the risk of braces being damaged or your child’s cheeks, gums, or mouth being injured. The good news is that braces act as a shock absorber for the teeth. So if your student athlete does experience an injury while in braces, most of the time the teeth will be protected. Orthodontic mouthguards are fabricated to be worn with braces, and they are the simplest way to prevent injury and ensure oral health. These mouthguards are usually available at all major sporting goods stores and online. A brand that I usually recommend is called Shock Doctor. They have a version specifically for children in braces that comes in a variety of colors and sizes so your student athlete will feel comfortable and excited about wearing it on game day! 

  1. Carry a water bottle for quick hydration

Staying hydrated is such an important part of your child’s overall health, but drinking water is also an easy way to keep food particles from sticking to the teeth and braces. At Mitchell, Bartlett, & Bell Orthodontics we encourage water over other liquids, especially soda, sports drinks, and sweet tea. These sugary drinks cover the teeth and braces in sugar and acid, which can stain the teeth, and result in white spots when the braces are removed. I always tell my new braces patients that if they insist on drinking the occasional soda or juice, they should make sure to brush, or atleast rinse their mouth with water, afterward to prevent the sugar sitting on the teeth for too long.

It is normal to feel a little nervous about going back to school with braces, but with your encouragement and a lot of patience, your child can get through the first few days with a smile! The journey to a gorgeous smile and healthier mouth takes time, but we aim to make it as easy and fun as it can be. We want to help make this school year a success for all of the students we treat, so if you or your child has any questions or concerns just give us a call. 

Mitchell, Bartlett, & Bell Orthodontics wishes all students and teachers a great start to the school year!

Or call us today at any of our 2 convenient locations: Greensboro or Kernersville 

Understanding Early Orthodontic Treatment - by Dr. Kelly Mitchell

May 10th, 2019

What is Interceptive (Early) Treatment?

Parents may be surprised and skeptical if a dentist recommends seeing an orthodontist when their child still has as many baby teeth as permanent teeth.  Having your child seen by an orthodontist by age 7 – a recommendation supported by the American Association of Orthodontists – can help uncover possible dental and jaw growth issues like crowding, crossbites and other more serious concerns.  Treating these problems early can prevent them from worsening as your child grows, possibly reducing time in full braces or Invisalign™ as a teenager and potentially preventing the need for more invasive treatments such as tooth extractions or surgery.

This early orthodontic intervention is called Interceptive or Phase 1 Treatment. Because it’s only indicated for certain problems, not every child who comes to our office will end up needing early treatment.  We definitely will let you know if we feel a single phase of comprehensive treatment at an older age is best. If your child would benefit from early interceptive treatment, we will discuss the options and help you decide on the most optimal path, taking into consideration your child’s emotional readiness and weighing the costs, in both time and money, relative to the benefits.  There is no charge for our initial evaluation.

What is involved?

Depending on whether the problem is dental or jaw-growth related, early treatment may involve partial braces or an orthopedic (growth guidance) device like an expander.  Sometimes it can even be as simple as an active retainer.

Our goal is to address the identified problems with as little intervention as possible, knowing that we’re trying to head something off before it worsens, but we’re not aiming for perfection since so many permanent teeth still need to grow in.  Our guiding principle is to have targeted goals and to accomplish them as quickly and efficiently as possible to save you time and money. This early phase of treatment can take anywhere from 6 to 18 months, ideally no more than 12.

One thing parents must be aware of is that interceptive care is typically the first of two phases of treatment, which is why it is also called Phase 1.  Phase 2 (comprehensive) treatment will occur after the rest of the permanent teeth have grown in. Phase 2 is likely to be simpler and shorter than a single round of full braces would have been because of the progress made in Phase 1.

When is it needed?

One of the reasons we aim to keep interceptive treatment relatively short is that we like to give children at least a 1-year break between phases, preferably 2-3 years.  This usually means that Phase 1 treatment is most appropriate in 7 to 10 year olds. Also, there are growth conditions that respond to treatment much better before age 10, such as underdevelopment of the upper jaw (an underbite tendency).

There are a number of reasons why interceptive orthodontic treatment is recommended.  Some examples include:

  •       Expanding the upper jaw to eliminate crossbites, reduce upper crowding, and improve airway and breathing
  •       Developing upper and lower arches to create room for crowded teeth that are blocked out and may become “impacted”
  •       Restricting or promoting upper or lower jaw growth to correct a bad bite (“malocclusion”) caused by an unfavorable growth pattern
  •       Preserving or regaining space for permanent teeth if baby teeth have been lost prematurely
  •       Retracting protruded upper front teeth to reduce “overjet” and the risk of dental trauma
  •       Placing a “habit appliance” to help eliminate thumb/finger habits or tongue habits that are negatively influencing jaw growth and bite development

How does it help?

Some parents ask why their child should undergo early treatment – won’t the problems improve on their own over time?  When appropriately recommended, Phase I treatment targets problems that don’t get better with growth or that are harder to correct in a single round of treatment later.

For example, the lower jaw continues growing after the upper jaw has stopped, so the adolescent growth spurt may help a child with a small lower jaw, but it will worsen the situation for a child with a large lower jaw or small upper jaw.  That’s why underbites are best corrected before age 10.

In crowded situations, we know that the space available for permanent teeth decreases over time because the permanent molars migrate forward in the mouth as baby teeth are lost.  Unless it’s clear that the crowding is so severe that permanent-tooth extractions are inevitable, it’s helpful to develop the dental arches early to try fitting all the teeth in. This is especially true for children who struggle with airway and breathing issues since the size of the dental arches determines the space available for the tongue.  Our low-dose 3D x-ray technology allows us to measure airway volume to help with that decision.

Studies have shown that improving a child’s self-esteem is also a very valid reason for doing early orthodontic treatment.  Often the teeth aren’t ready for full braces until late middle school or early high school. Children who are self-conscious about their teeth being crooked or protruded benefit significantly from getting their front teeth straight before the sensitive middle school years start.

What happens next?

Following Phase I interceptive treatment, we recommend periodic visits to monitor your child’s dental development and jaw growth.  This allows us to anticipate whether Phase 2 treatment will be needed and what the ideal timing would be. Occasionally, Phase 2 treatment is not necessary because of the correction accomplished in Phase I, but we can't guarantee that.  In any case, Phase 2 treatment should be shorter than single-round comprehensive treatment would have been. We do not charge for these observation visits between phases.

See the evolution of two of our patients below: 

One of our cases was my son, Mitch, who had 6 months of partial upper braces to correct his upper protrusion and make room for his blocked out upper canines.  He also had his upper baby canines removed and currently wears a retainer at night.

Another great case was  our patient Ella. You can see her Phase 1 and Phase 2 evolution:

 

 

Signs That a Child is Suffering From Sleep Apnea

February 4th, 2019

Signs That a Child is Suffering From Sleep Apnea

Does your child seem drowsy during the day? Does he or she snore or wake up breathless in the middle of the night? They could have Obstructive Sleep Apnea (OSA) - a chronic condition where breathing stops periodically during sleep because soft tissue is relaxing and obstructing the airway. These periodic stops can happen as many as 20-30 times in an hour and cause a lack of oxygen to the brain, waking up your child so that they restart proper breathing. All that waking up can leave one pretty sleepy the next day - even if they don’t remember waking up!

Untreated, obstructive sleep apnea can affect school work and overall alertness as well as raise your child’s risk of serious health problems down the road. These include:

  • High blood pressure
  • Stroke
  • Heart disease
  • Diabetes
  • Chronic acid reflux
  • Obesity
  • and even Depression

According to the American Academy of Otolaryngology (ENTs) sleep disordered breathing affects approximately 12 percent of children.

Luckily, sleep apnea is treatable. It just needs to be diagnosed. That’s where you come in: if your child has any of the following symptoms, bring them to see us for a free consultation and sleep apnea test at Mitchell, Bartlett and Bell Orthodontics.

Here’s what to look for:

  • Insomnia or difficulty sleeping (tossing and turning or night sweats)
  • Loud snoring at night
  • Waking up at night short of breath
  • Long pauses in breathing
  • Chronic mouth breathing during sleep
  • Snorting or choking sounds during the night (indicating a restart of breathing)
  • Extreme drowsiness throughout the day
  • Changes in mood, misbehavior or decline in school performance
  • Hyperactivity or inattention (in some cases children who are diagnosed with ADHD are actually not hyperactive but rather are showing the clinical symptoms of OSA.

Orthodontists are leading specialists in spotting Sleep Apnea early because of our familiarity and expertise in working with the soft tissue in children’s mouths. As both orthodontists and parents, Dr. Kelly Mitchell,  Dr. Brian Bartlett, and Dr. Carrie Bell make a point of asking all parents if they’ve noticed any of these symptoms when they first consult with new patients.

If your child is exhibiting any of these symptoms, bring them in for a free consultation. We can help with a treatment plan and make sure your kids are sleeping soundly!

While Sleep Apnea can have very serious side effects, it is treatable. The most important thing you can do is pay attention and have your child evaluated.

Please reach out to us today if your child is exhibiting any of the above signs. At Mitchell, Bartlett and Bell Orthodontics we offer complimentary consultations and have 2 convenient locations in Greensboro and Kernersville.

 

WAIT! Don’t Order Orthodontic Treatment Online Before Reading This

November 2nd, 2018

WAIT! Don’t Order Orthodontic Treatment Online Before Reading This

It’s easy to do so many things these days with the click of a button. Order shoes! Get a ride across town. Watch your favorite blockbuster movie! It seems like every day there’s a newer and easier way to do almost everything. We’ve been programmed to accept that anything can be ordered online and delivered right to our front door. However, at Mitchell, Bartlett and Bell Orthodontics, there is one thing that we believe has no easy replacement: orthodontic treatment. There is no match for a trained, experienced professional when it comes to your oral health.

The American Association of Orthodontists (AAO) agrees. They recently issued a Consumer Alert listing key questions to ask about direct-to-consumer orthodontic companies. You can download a print-friendly version here.

The issue is that many direct-to-consumer orthodontic companies don’t involve the in-person evaluation and/or in-person supervision of your treatment that we provide at Mitchell, Bartlett and Bell Orthodontics. In-person supervision and expertise is important because there is more to creating a healthy, beautiful smile than moving the visible portions of your teeth. If not done correctly any dental work can lead to potentially irreversible and expensive damage such as tooth and gum loss, changed bites, and other issues.

The Top 10 Questions To Ask

The AAO advises that when researching orthodontic treatment (including treatment models from direct-to-consumer companies like SmileDirectClub, SmileLove, Candid Co., SnapCorrect, Orthly, etc), you should consider many key questions, some of which include:

  1. As part of your treatment, are comprehensive diagnostic records like x-rays taken before your treatment?
  2. As part of your treatment fee, do you receive any in-person visits to a dentist’s or orthodontist’s office during your treatment?
  3. Is only one treatment type offered (such as invisible aligners or a certain appliance)?
  4. If a dentist or orthodontist is involved with your treatment, do you know the name of the dentist or orthodontist who will be specifically involved with your case (for example, is it available on the company’s website or elsewhere)?
  5. What are the possible risks (financial, health, etc.) associated with your orthodontic treatment?
  6. Who is responsible for detecting any issues that may occur during your orthodontic treatment? Is it you? If it is a doctor not associated with your treatment, who pays for those check-ups?
  7. If a doctor is involved with your orthodontic treatment, how can you contact him or her over the course of your treatment? How can you contact him or her if an emergency arises?
  8. If an emergency arises, does the company have a dentist or orthodontist in your area that you can see in-person? If not, who would cover the costs associated with seeing a dentist or orthodontist in your area?
  9. If you are injured or have another dispute involving your orthodontic treatment, how is it handled (litigation, arbitration, etc.) and what rights do you have?
  10. Does the treatment model comply with the dental laws in your state? To check your state’s dental laws, click https://www.aaoinfo.org/state-laws-and-regulations. Information for your state dental board can be found at https://www.aaoinfo.org/aao/state-dental-board-info.

Where You Receive Your Health Care Is A Very Important Personal Decision
Remember that orthodontic treatment is not a product or device – it is a professional, medical service. Dr. Kelly Mitchell received her dental and orthodontic degrees from UNC-Chapel Hill, Dr. Brian Bartlett from Northwestern University Dental School and The Ohio State University College of Dentistry, and Dr. Carrie Bell from University of Mississippi and University of Tennessee. Each doctor has spent years providing orthodontic treatment to their patients and has received numerous awards and honors. (See our site for details!)

Before making any decision about orthodontic treatment, consider doing some research and having a complimentary in-person consultation at Mitchell, Bartlett and Bell Orthodontics. We recognize that all our patients are unique and deserve to receive orthodontic care that reflects their individual needs. Our experienced and talented team is committed to working with you and your family to create a comfortable, stress-free, and rewarding orthodontic experience every time you visit our practice.

Contact us today for a free consultation at either of our 2 convenient locations: Greensboro or Kernersville or click below to schedule an appointment!. We’re happy to answer all questions and we'll make sure you or your child receives the right treatment plan for them.

 

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