Invisalign versus At-home orthodontics

Turn on your TV or scroll through your Facebook feed and you’ll come across some new at-home gimmick that promises a pain-free, low-cost remedy to those crooked teeth that you never thought you could afford to straighten. These services offer various iterations of the same concept , which all promise a perfect smile with little effort. They appeal to the masses because at first glance the price is lower than the quote for braces they got for their kids and they’re told it only takes a few iPhone pictures and voila, the magical trays appear on your doorstep and you only need to follow the tray schedule. While this may seem like an easy option, maybe even less expensive, I have to caution you as to the safety and efficacy of this process. It works by you taking your own impressions, snap a few photos of the inside and outside of your mouth and submit them to the company who then prescribes a course of treatment that lasts, according to their claims, an average of 20 weeks. This is a treatment plan that is unsupervised by dental professional. But if you like the end result, that’s the barometer of success, right? It’s not so simple.

First, these insta-smile companies don’t and can’t account for potential land mines such a lurking decay in your teeth, gum disease that could potentially cause you to lose your teeth, where your teeth are in the jawbone and how that could be adversely affected by even the slightest misalignment. I’ve even heard of patients who have lost their healthy teeth because the treatment moved their teeth outside of what was otherwise a normal, healthy bone! One of my patients came to me after starting this at-home service, and she was frustrated by trays that didn’t fit, kept rubbing her tongue raw and the company’s solution was for her to simply take 20 more photos of how the trays were improperly fitted under her tongue. Suffice to say, a smartphone camera wasn’t designed to take photos in your mouth.

At our office, we provide Invisalign to cases that I hand select and I personally supervise the entire course of treatment from beginning to end. I’m a firm believer in Invisalign because it enhances the treatment process in several ways that at-home packages do not. First, it uses precise attachments that are bonded on to your teeth which provides more optimal movement of each individual tooth at a healthy and predictable pace. Second, the process can be amended based on the performance of teeth movement and whether they are tracking according to the original treatment plan. If a tooth goes off-plan (which they can often do) Invisalign allows for easier remediation with little impact to the original plan and there is no added cost to my patient. Plus, you’re not cramming a smartphone camera in your mouth hoping the picture isn’t blurred by pieces of that day’s lunch.

You be the judge. On the surface, these at-home options appear easy and low-cost, but as with any self-directed medical or dental treatment, it’s what lies below the surface that will always bite you. Pun intended. Always seek a professional opinion (which we give for free if you’re in my dental chair)


Implant versus bridge versus denture

I don’t want a fake tooth!!
Whew! We’re explaining a lot today so hold tight!! When you’re missing a tooth, you have many options to replace it. One option is to leave the space as is. The downside to this, besides cosmetic concerns, is that adjacent teeth will move into this side… Usually by tilting into the space, which can mess up your bite. Also, the opposing tooth likes to have something touching it when you bite, so that tooth will appear to “stretch” into that hole, compromising that tooth as well!
A second option is a denture. A denture can come in two forms, replacing all of your teeth in one arch (upper or lower) is called a full denture. A full denture relies only on the soft tissue and muscles to hold it in place. An upper full denture uses the palate to form a seal and can have much better retention than the lower. The lower full denture sits on top of the ridge and usually moves quite a bit with tongue movement… Think, eating or talking. A denture replacing one or a few teeth is called a partial denture. A temporary partial denture is commonly called a flipper… Not the dolphin!! A partial denture relies on the adjacent teeth to hold it in place using clasps for retention. Most all dentures, full or partial, have to be removed for 6-8 hours a day, recommended while sleeping, to let the gum tissue rest and recover. (Think shriveled fingers after a day of swimming!) Full or partial dentures can also get added retention by attaching them to dental implants.
A third option is a bridge. A bridge is a multiple-unit crown that attaches on one or both sides to natural teeth or implants. (Dr Macalik doesn’t recommend attaching bridges using both implants and teeth in one bridge). A bridge attached on one side is called a cantilever bridge and is only recommended in certain instances. The downside of using a bridge to replace a missing space is that at least one tooth, usually two, have to be reduced in size for the bridge to be placed. The average lifespan of a bridge is 3-5 years due to the connected teeth not being properly cleaned and developing decay under the bridge. A cantilever acts just as that: a lever, which can add additional forces to the tooth which can compromise it’s bone support.
The best option, if you’re a candidate for it, is an implant. An implant is an artificial tooth root that goes into the bone and fuses to the surrounding bone. It forms, fits, feels, functions, and flosses just like a natural tooth. When the implant is ready to be restored (after it’s healed), an impression is taken to make a custom fit connector (abutment) and a crown. As the implant is healing there are two temporary options used solely for cosmetic reasons: a temporary abutment or a flipper. A flipper, as we mentioned earlier, is a removable partial denture used to replace missing teeth temporarily. A temporary abutment is actually attached to the implant, but not put in function to reduce the strain and stress on the implant while healing.
There are lots of factors that come into play when considering which option is right for you. Dr Macalik firmly believes you should be fully informed about all your options. Please call today if you have more questions or to set up a consult to figure out what’s right for you!!

TMJ what??

TMJ what??

“What’s a “TMJ”?” It’s also known as your Temporal Mandibular joint, where the temporalis bone and the mandible bone come together, otherwise known as your jaw joint. Most people refer to TMJ when they are having a problem with their jaw joint or sore muscles in that area. This is actually called TMJD or Temporal Mandibular Joint Disorder.
“How do I know if I have TMJD?” Do you have clicking or popping in your joint? Do you have soreness of your jaw muscles? Do you have a limited opening? Do you clinch or grind your teeth? All of these point to the possibility of TMJD.

Dr. Macalik has taken many courses regarding TMJD at the LD Pankey Institute and the Frank Spear Institute. When your teeth don’t align properly it causes your jaw joint to shift to allow your teeth to fit correctly, leaving your jaw joint in a bad position. Over time, this can cause destruction of the jaw joint on one or both sides. Or some people just have a genetical disposition to be “clinchers and grinders”.

“What can I do about this?” Well, you need to make sure that your jaw joints and your teeth are protected adequately. The first thing we can do is get you into a well-fitting bite splint to protect your teeth and jaw joints while you’re sleeping and not aware that your clinching or grinding your teeth. A bite splint is actually different than a nite guard in that a nite guard protects your teeth and a bite splint protects the teeth and joints. This bite splint should help to relieve any jaw or muscle pain that you may be having as well. On the rare chance that you have actually deteriorated your jaw bone, a bite splint can help to prevent any further destruction.

Most people don’t have a perfectly aligned bite, even if they have gone through orthodontics. Equilibration is a process to balance the patient’s bite to get it to fit evenly and at the same time as the jaw joint is in the correct, seated position. Equilibration consists of shaping teeth by addition or subtraction of tooth structure to allow them to fit correctly.
Give us a call today so we can take a look at your unique situation and decide what is best for your teeth and your TMJ!

First blog post

First blog post

“Dentist?! Why would you want to be a dentist?”

This is a question that I often got as I was growing up, as I’ve known this is what I wanted to do since I was twelve. Most people have a fear of the dentist. I think this comes from not understanding what’s going to happen at each visit, or possibly a bad experience in the past. The dental chair really is a vulnerable position to be in. I have that same fear when sitting in the dental chair as well, but for me, the desire to become a dentist came from my orthodontic experience when I was younger. My orthodontist was so kind and patient and always encouraging. They would always answer my questions about the stages and processes. I, in turn, enjoyed my experience with braces! This is my goal for each and every patient that walks through my door. I want to help them restore their teeth to a level of health and then maintain it, and I want to explain and answer any questions they have along the way. I love being able to alleviate the fears of patients, and the best compliment that we receive is when a patient says, “Was that it? That didn’t hurt at all!!”. We aim to go the extra mile for our patients to make them feel how much we care about them. Our office provides a number of amenities for helping patients to relax during their visits ranging from blankets and eye masks to headphones and iPods to nitrous oxide to help patients relax. We even offer some forms of sedation dentistry.

Before you go swearing off dentists, give our office a try. We’d love to be able to dispel another myth that the dentist is a scary person!