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It’s vital to understand the difference between an orthodontic emergency and minor orthodontic issues. Minor issues can be handled the next day, or at your next scheduled appointment. When a real orthodontic emergency occurs, however, you will need to see a doctor immediately.

Emergencies can include injuries to your teeth, jaw, mouth, or face. Whether you have braces or oral appliances in your mouth at the time or not, it’s crucial to fix the problem before it gets worse. If you have an injury that affects an orthodontic appliance, that may need to be replaced or adjusted, depending on the extent of the injury.

You can watch for and address some common minor issues on your own, or wait to have them fixed at your next appointment with Dr. Max Mosslehi:

• Poking wire
• Loose bracket
• Loose elastic band
• Loose wire
• Loose appliance
• Headgear does not fit
• Lost or broken elastic band
• General soreness

These minor issues may arise if you eat hard or sticky foods that damage your braces or other orthodontic appliances. Make sure to be extra careful, and avoid brushing your teeth too aggressively to avoid causing damage.

These problems should not be treated as emergencies unless they begin to cause prolonged pain and discomfort. If you notice this happening, contact our Tustin office and we can provide a solution.

Some at-home remedies you can try can include covering loose brackets or wires with wax. Wax can prevent canker sores from forming by covering sharp metal pieces that poke into your gums. If you have wires that have poked out into your gums, you can use tweezers to push the wires gently away from the direction of the sore area. Always make sure you use alcohol to sterilize anything you intend to put into your mouth.

When you get braces initially, you may notice some soreness of the jaw or small abrasions from your mouth getting accustomed to foreign materials. You should not worry too much about this temporary pain.

A warm salt-water solution can be used to alleviate any swelling or discomfort you’re experiencing. Many drug stores have ointment for canker sores that will numb the area if they continue to bother you. If you notice that your pain or swelling doesn’t get better, schedule an appointment with a medical professional as soon as you can.

When in doubt, contact our Tustin office if you are unsure or still have questions about an orthodontic problem you’re facing. If the situation becomes an emergency, don’t hesitate to make an appointment with our team, so we can help provide you with a solution.

Orthodontic emergencies should be taken care of promptly whenever they arise.

While braces play an important part in helping to create a healthy mouth and teeth, you might experience a few side effects while wearing them that are common and can be easily treated.

Even with the best of care, braces can cause soreness to your mouth. As your teeth begin to move, it is natural for your teeth to feel aches and your jaw to develop soreness.

If there are broken wires or loose bands on your braces, a sore tongue, mouth, or canker sore will occur. Canker sores are a common occurrence when braces rub inside the mouth. There are ointments available to reduce the pain and irritation associated with mouth sores. We urge those who experience a sore mouth or any of the following problems to call our office to schedule an appointment.

• Loose brackets: Apply a small amount of orthodontic wax to the bracket temporarily. You might also apply a little between the braces and the soft tissue of your mouth.
• Loose bands: These must be secured in place by your orthodontist. Try to save the band for repair.
• Protruding or broken wires: The eraser end of a pencil can be used to move the wire carefully to a less painful spot. If you are unable to move it, apply orthodontic wax to the tip. If a mouth sore develops, rinse with warm salt water or antiseptic rinse.
• Loose spacers: These will need to be repositioned and sometimes replaced.

Foods to Avoid

Some foods can also help or hurt you while you’re wearing braces. Remember to cut your food into small pieces that can be easily chewed. You will want to avoid hard and chewy foods that can break your hardware. Foods such as corn on the cob, nuts, carrots, apples, ice, and bubble gum should be avoided.

Braces, rubber bands, springs, and other mouth appliances associated with braces will normally attract food particles and plaque. Without the proper care, this could cause staining of your teeth.

Our staff at Max Mosslehi, DMD, Inc. recommends brushing after every meal or snack and carefully removing any food that might be lodged in the braces. A fluoride mouthwash might be helpful as well as flossing. At your next appointment, Dr. Max Mosslehi can advise you how to floss with a brush specially designed for braces!

We’re all friends here, so if you sometimes feel a bit nervous before your dental appointment, no judging! Ask us about any worries you might have. We are happy to explain procedures, equipment, and sedation options so you know just how safe and comfortable your experience can be. And if X-rays are a concern, we can put your mind at ease here as well.

What Exactly Are X-rays?

Sometimes patients feel reluctant about the process of imaging because X-rays are a kind of radiation. But the fact is, radiation is all around us. We are exposed to radiation naturally from our soil and water, sun and air, as well as from modern inventions such as cell phones, Wi-Fi, and air travel.

Why is radiation so common? Because matter throughout the universe constantly gives off energy, and the energy that is emitted is termed radiation. This radiation takes two forms—as particles (which we don’t need to consider!) and as traveling rays. This second type is known as electromagnetic radiation, created by photons traveling in regular waves at the speed of light.

We are exposed to electromagnetic radiation every day, because, whether we can see them or not, these different wavelengths and frequencies create various forms of light. Radio waves, microwaves, infrared, visible, and ultraviolet light, X-rays, and gamma rays are all part of the electromagnetic light spectrum.

Different types of radiation on this spectrum have different wavelengths and different frequencies, and produce different amounts of energy. Longer wavelengths mean lower frequencies and less energy. Because X-rays have shorter wavelengths and higher frequencies than, for example, radio waves and visible light, they have more energy.

How Do Dental X-rays Work?

An X-ray machine produces a very narrow beam of X-ray photons. This beam passes through the body and captures images of our teeth and jaws on special film or digital sensors inside the mouth (intraoral X-rays), or on film or sensors located outside the mouth (extraoral X-rays). These X-ray images are also known as radiographs.

Why are X-rays able to take pictures inside our bodies? Remember that higher energy we talked about earlier? This energy enables X-rays to pass through the softer, less dense parts of our bodies, which are seen as gray background in a radiograph. But some substances in our bodies absorb X-rays, such as the calcium found in our bones and teeth. This is why they show up as sharp white images in radiographs.  

There are different types of common dental X-rays which are used for a number of reasons:

• Bitewing X-rays, which are used to check on the health of the back teeth.
• Periapical X-rays, which allow us to look at one or two specific teeth from crown to root.
• Occlusal X-rays, which show the entire arch of teeth in the upper or lower jaw.
• Panoramic X-rays, which use a special machine to rotate around the head to create a complete two-dimensional picture of teeth and jaws.
• Cone Beam Computed Tomography, an external device which uses digital images to create a three-dimensional picture of the teeth and jaws.

Why Do We Need X-rays?

If all of our dental conditions were visible on the surface, there would be no need for X-rays. But there are many conditions that can only be discovered with the use of imaging—infection, decay, a decrease in bone density, or injuries, for example, can show up as darker areas in the teeth or jaws. Among their many diagnostic uses, X-rays can help us find:

• Cavities between teeth or under old fillings
• Damage to the tooth’s pulp which might require root canal treatment
• Injuries to teeth or roots after trauma
• Abscesses, tumors, or other conditions that might be causing swelling or pain
• Position and development of wisdom teeth
• Ideal placement for implants
• Health and density of the jaw and alveolar bone

X-rays can also serve an important preventative role, by discovering small problems before they become major ones.

How Do Dentists Make Sure Your X-rays Are As Safe As They Can Be?

First of all, the amount of radiation you are exposed to with a dental X-ray is very small. In fact, a set of bitewing X-rays exposes us to slightly less than the amount of radiation we are exposed to through our natural surroundings in just one day. Even so, Dr. Max Mosslehi and our team are committed to making sure patients are exposed to as little radiation as possible.

Radiologists, the physicians who specialize in imaging procedures and diagnoses, recommend that all dentists and doctors follow the safety principal known as ALARA: “As Low As Reasonably Achievable.” This means using the lowest X-ray exposure necessary to achieve precise diagnostic results for all dental and medical patients.

The guidelines recommended for X-rays and other imaging have been designed to make sure all patients have the safest experience possible whenever they visit the dentist or the doctor. We ensure that imaging is safe and effective in a number of ways:

• We take X-rays only when they are necessary.
• We provide protective gear, such as apron shields and thyroid collars, whenever needed.
• We make use of modern X-ray equipment, for both traditional X-rays and digital X-rays, which exposes patients to a lower amount of radiation than ever before.
• When treating children, we set exposure times based on each child’s size and age.

And now that we’ve talked about some things you might like to know,

Please Let Us Know If . . .

• You’re a new patient, with previous X-rays taken during regular exams or for specific procedures. Ask to have your older X-rays sent to our office. With digital X-ray technology, this transfer can be accomplished with e-mail! Having your dental history available lets us notice any changes that have taken place.
• You’re pregnant, or think you might be pregnant. Even though radiation exposure is very low with dental radiographs, unless there is a dental emergency, dentists and doctors recommend against X-rays for pregnant patients.

X-rays play an important part in helping us make sure your teeth stay their healthiest. If you have any concerns, contact our Tustin office. When it comes to making sure you’re comfortable with all of our procedures, including any X-rays that might be necessary, we’re happy to give you all the inside information!

When does an underbite need surgery? The short answer is: when Dr. Max Mosslehi and our team recommend surgery as the best way to give you a healthy, functional bite. But let’s take a longer look, and see just why your doctors might come to that conclusion.

• First, what exactly is an underbite?

In a perfect bite, the upper and lower jaws align, well, perfectly. Upper teeth overlap lower teeth very slightly, upper and lower teeth meet comfortably, and jawbones and joints function smoothly. When the alignment is off, it causes a malocclusion, or “bad bite.”

When we talk about an underbite, or Class 3 malocclusion, it means that the lower jaw protrudes further than the upper jaw. This protrusion causes the bottom teeth and jaw to overlap the upper teeth and jaw.

• What causes an underbite?

Sometimes an underbite is caused by childhood behaviors while the teeth and jaw are developing, including tongue thrusting or prolonged thumb-sucking and pacifier use. (Working to stop these behaviors before they affect tooth and jaw formation is one of the many good reasons children should have regular visits with their dentists and pediatricians.)

Most underbites are genetic, however, and tend to run in families. It’s estimated that from five to ten percent of the population has some form of underbite. The lower jawbone (mandible) might be overdeveloped, the upper jawbone (maxilla) might be underdeveloped, both bones could be affected, or, sometimes, tooth size and placement might cause an underbite. These irregularities in jaw shape and size and/or tooth crowding are not something that can be prevented, and require professional treatment.

• Why? What’s the problem with an underbite?

Even a minor underbite can cause difficulties with biting and chewing. A more severe underbite can lead to speech problems, decay and loss of enamel where the teeth overlap, mouth breathing and sleep apnea, persistent jaw and temporomandibular joint pain, and self-confidence issues.

• Can’t my dentist treat my underbite?

Most probably not. A very mild underbite can be camouflaged cosmetically with veneers, but this does not address the cause of the underbite, and will not work for moderate or severe underbites.

• Can my orthodontist treat my underbite?

Dr. Max Mosslehi will create an underbite treatment plan after a detailed study of each patient’s individual dental and skeletal structure. Treatment options will vary depending on the cause of the underbite, its severity, and even the patient’s age.

Early intervention is especially important for children who show signs of an underbite. That’s why we recommend that children visit our Tustin office by the age of seven.

If an underbite is caused by tooth misalignment or crowding, braces can reposition the lower teeth. Sometimes extractions are necessary to make room for proper alignment.

If the cause is due to jaw structure, children’s bones are still forming, so treatment can actually help correct bone development. Palatal expanders, headgear, and other appliances are various methods of encouraging and guiding bone development.

But braces and appliances aren’t effective for every patient with an underbite, and especially in patients (usually those in their late teens and older) when the jawbones are already fully formed. In this case, we might suggest coordinating treatment with an oral and maxillofacial surgeon.

• What does an oral and maxillofacial surgeon do?

An oral surgeon has the training, experience, and skill to help correct an underbite by surgically reshaping and repositioning the jawbone. This corrective jaw surgery is called orthognathic surgery.

• What will happen during orthognathic surgery?

Your treatment will be tailored to your specific needs. Two of the common surgical procedures for treating an underbite involve repositioning the upper jaw to lengthen it and/or reshaping the lower jaw to shorten it.

Bone is sometimes removed or added, small bone plates or screws are sometimes used to stabilize the bone after surgery—your surgeon will let you know exactly which procedures will give you a healthy, functional bite. The surgery itself is most often performed under general anesthesia and requires a brief stay in the hospital.

• How will my orthodontist and oral surgeon coordinate my treatment?

Correcting a Class 3 malocclusion can take time. Your oral surgeon will work together with Dr. Max Mosslehi to analyze the interrelationship of teeth, bones, and joints to determine dental and skeletal problems, and will develop the best treatment plan possible to create a healthy alignment.

• So, when does an underbite need surgery?

Sometimes, a minor underbite can be corrected with braces and appliances alone. A serious underbite, however, will often require the specialized skills of both Dr. Max Mosslehi and an oral surgeon.

And, while it’s not the primary purpose of surgery, corrective jaw surgery and orthodontics can also make you happier with your appearance and boost your self-confidence. Achieving a lifetime of beautiful, comfortable, and healthy smiles—that’s the answer to your question.