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Orthognathic surgery is surgery to correct a wide variety of abnormalities of our patients' jaw and teeth. The surgery is often done in conjunction with orthodontic treatment. While the patient’s appearance may be significantly improved as a result, the primary purpose of the surgery is to correct functional problems including but not limited to:

• Unbalanced facial appearance
• Protruding jaw
• Open bite (upper and lower teeth don’t overlap properly
• Excessive wearing down of the teeth
• Difficulty with chewing or biting
• Chronic mouth breathing
• Sleeping problems such as sleep apnea
• TMJ pain (jaw joint pain)
• Restoring facial injuries

Knowing when to start the orthodontic treatment in preparation for orthognathic surgery can also be tricky if our team at Cronin Orthodontics is treating a teenager. It is important to know when to get started. If orthodontic treatment is initiated too soon and the teenager is still growing, the patient will either need to hold in braces until his or her growth is complete and they are ready for surgery or the braces will have to be removed and then placed again when growth is complete. Neither of these options is attractive since it requires longer time in treatment, which is something all our patients want to avoid. Our team at Cronin Orthodontics strives to get all patients finished with treatment as quickly as possible because it is healthier for the teeth and gums and gives them a beautiful smile to enjoy for a lifetime.

If you are considering orthognathic surgery or you have been told that you need jaw surgery, give us a call to schedule your initial consultation today. Dr. Cronin and our team at Cronin Orthodontics will explain our treatment plan in a way you will understand and we will keep you informed every step of the way.

Congratulations! You have made the decision to get orthodontic treatment at our Langley office. Now it’s time to choose among your various appliance options. Traditional metal brackets and wires, lingual braces, a series of aligners—they all have positives to recommend them. And for some people, ceramic braces are the clear favorite.

Ceramic braces work like regular metal braces. Brackets are bonded to the front of each tooth, and rubber bands surrounding the brackets hold the arch wire that gradually moves the teeth into alignment.

Ceramic braces, however, use brackets made of clear or tooth-colored ceramic or porcelain which blend beautifully with the color of your tooth. The elastic ligatures, or rubber bands, can be chosen to match the brackets or your enamel. There are self-ligating ceramic brackets which don’t use bands at all. Technology is even working on ways to make the arch wire less visible! The end result is braces that are almost undetectable.

If you want a less obvious appliance for professional or personal reasons, talk to us about ceramic braces. As always, there are other factors to consider before you decide, which we will be happy to discuss with you.

• Ceramic brackets are very strong, but they are still more brittle than the metal model. If you play a contact sport, these might not be for you. (But whatever braces you choose, please wear a mouthguard when playing sports.)
• Ceramic braces might not be ideal depending on the amount of alignment and bite correction that is needed. They might also take a bit more time to bring your teeth into alignment. We will be able to tell you if ceramic braces will work for you and if they might require a longer period to move your teeth to their perfect position.
• Brackets can sometimes be somewhat larger (though this isn’t always the case), and, because they can be abrasive, are often recommended for upper teeth only. This way, the lower teeth will not impact, or be impacted by, contact with the upper teeth.
• Oral hygiene can trickier with ceramic braces. Although today’s brackets aren’t as prone to staining, you still need to be careful to brush away the plaque that can accumulate around the brackets. And the bands are susceptible to staining by the usual suspects—coffee, tea, colas, blueberries, or any strongly colored food or beverage.
• Costs will differ depending on the treatment method you choose. Talk to us about cost comparisons with other orthodontic treatments.

Ceramic braces, because they are so much less visible, are a popular orthodontic option, especially for older teenagers and adults. If you are interested, talk to Dr. Cronin about this effective way to straighten your teeth—discreetly. Ceramic might be the clear solution for creating your lasting, beautiful smile.

You’ve worked hard for your attractive, healthy smile, and now you’re making sure it stays attractive and healthy by wearing your retainer. Since wearing a retainer is usually a matter of years, not months, it’s natural to wonder just how long you can count on that retainer to help you maintain your smile.

That answer depends on the type of retainer you get at our Langley office. A Hawley retainer, a clear retainer, and a fixed wire retainer have different lifespans. Because they each have their own advantages, Dr. Cronin will recommend the retainer that’s right for protecting your individual smile.

So let’s look at the average lifespan for different retainers, and, equally important, some of the common mishaps that can shorten that working life.

The Hawley Retainer

This is the retainer most people picture when they think “retainer.” Made of wire securely attached to an acrylic base, the Hawley retainer keeps the teeth in place, and can even be adjusted, if needed, to improve alignment. They generally last anywhere from three to ten years.

How can you make sure your Hawley retainer keeps working for you as long as possible?

• Keep it in its case. While some damages to these retainers can be repaired, why take a chance? And it’s much harder to lose a retainer if it’s in its case as opposed to, say, a cafeteria napkin.
• Keep it away from your pet. Dogs, especially, are tempted by the taste and smell of saliva, but there are safer, less expensive chew toys out there.
• Keep wearing it. Without your retainer, your teeth can shift. Over time, not only will your retainer fail to fit anymore, but you might need to return for further orthodontic treatment. If you notice your retainer is starting to feel uncomfortable, give your orthodontist a call.

The Clear Retainer

Clear retainers look like clear aligners, and, like clear aligners, are almost invisible. Made of vacuum-formed plastic, they’re designed for a close, comfortable fit, often around the entire arch of your teeth. Also like clear aligners, these retainers aren’t made to last forever. If they become loose, warped, or cracked, they should be replaced. With care, they can last from six months to several years. How to protect them?

• Protect your retainer from damage. Keep it in its case when you’re not wearing it. You’ll avoid losing it, and you’ll avoid damaging it.
• Protect it from teeth. And we don’t just mean pets, although they find clear retainers yummy, too. If you grind your teeth, your retainer can suffer. Clear retainers are not the same thing as night guards, so talk to your orthodontist for recommendations.
• Protect it from heat. Hot surfaces like ovens or heaters, hot dashboards, washers and dryers, even very hot drinks can be a problem. (You should only be drinking water while you wear your clear retainer, so that particular issue shouldn’t arise!)

The Fixed Retainer

A fixed retainer is a small piece of wire that is custom-fit and bonded to the back of specific teeth to prevent any movement from occurring. Because it’s bonded to the inside of the teeth, a fixed retainer is completely invisible when you speak or smile. It can last five years, ten years, and in some cases, even longer. Even though you won’t be exposing this retainer to external dangers like hungry pups or the wash-and-rinse cycle, there are still some situations to watch for:

• Watch your diet. The same sticky, crunchy, or hard foods that can damage brackets and wires can also loosen a fixed retainer.
• Watch your dental hygiene. While cleaning around a bonded retainer can be a bit challenging, not cleaning around it can result in plaque and tartar buildup—and your retainer might have to be removed to clean your teeth.
• Watch for changes. If your teeth start to shift, it could mean your retainer has detached from one or more teeth. Ask your dentist to check the retainer’s bond whenever you have a checkup.

So, how long will that retainer last? Depending on the kind of retainer you have, if you don’t keep it in its case, or if you don’t watch your diet, or if you expose it to heat, the answer is—not nearly long enough. Dr. Cronin will give you the very best tips to keep your retainer clean, safe, and working for as long as possible. Now, it’s up to you!

By and large, the human body is a marvel of symmetry. But, of course, no one is perfect. You might have noticed one ear is a bit higher than the other. That you wear a shoe a half-size bigger on your left foot. That one shirtsleeve always looks longer.

Or that your smile looks off-center. This dental asymmetry could be caused by a condition known as “midline misalignment,” and, unlike that left foot, you can do something about it!

The dividing line between our center teeth, upper and lower, is called the midline. If we draw an imaginary line down the middle of a face, from the forehead to the nose to the midpoint of the chin, that line should go right between the front teeth. When it doesn’t, because the teeth have shifted past the midpoint, it’s often due to a condition called midline misalignment.

This kind of misalignment, also known as a deviated midline, can have several causes:

• Baby teeth that are lost too early

Baby teeth do more than promote healthy eating and speech development. They also reserve space for permanent teeth. If a primary tooth is lost too early, permanent teeth might “drift” to fill the empty space, causing the midline to move as well.

• Thumb sucking that goes on too long

As a child gets older, and certainly when by the time permanent teeth start to arrive, aggressive thumb sucking can lead to numerous orthodontic problems, including a deviated midline, as the teeth shift in response to that continuous pressure.

• Missing adult teeth

When you lose a tooth through decay or trauma, or when an adult tooth simply never develops, the remaining teeth can shift over to fill the open spot.

• Spacing issues

Crowded teeth, teeth with significant gaps between them, very large teeth, very small teeth—all of these issues can affect spacing and midline alignment.

• Crossbite

A crossbite is a kind of malocclusion, or bite problem. When you have a crossbite, the teeth don’t fit together properly, with upper teeth fitting inside lower teeth, instead of aligning on the outside where they belong. A deviated midline can indicate a posterior crossbite, where the top back teeth slant inwards or fit inside the bottom back teeth.

A tiny bit of midline shift one way or the other might be nothing to worry about, but if one front tooth is literally the center of attention, or if your teeth are noticeably out of alignment, it’s a good idea to talk to our Langley orthodontic team.

Because there are several potential causes for midline misalignment, Dr. Cronin will carefully analyze your individual situation to determine where the problem lies: with the teeth, the bite, or, rarely, the jaw itself.

Dr. Cronin will also offer you your best dental treatment options. A shift of a few millimeters might be treated with clear aligners or traditional braces. A crossbite could require braces or aligners coupled with elastics (rubber bands) to bring your bite into alignment. A palatal expander can help correct a serious crossbite.

Why visit Cronin Orthodontics because of a little asymmetry? Because a deviated midline is more than a cosmetic concern. If you have a malocclusion to begin with, or if your misalignment leads to changes in chewing habits, which cause new bite problems, you might be facing jaw pain, chipped and cracked teeth, headaches, and all the other unpleasant consequences of malocclusion.

By and large, perfect symmetry in life is unattainable. But if you want a smile that is well-balanced and healthy, talk to us about all the treatments available to make sure your smile—and not a single tooth—is the center of attention.