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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.

Brackets and wires, clear aligners, lingual braces, regular brackets, self-ligating braces, elastics, spacers—you and your orthodontist have had to narrow down a lot of choices to discover the best treatment for your orthodontic needs. Now that the end of treatment is in sight, there’s one more important choice left—your retainer!

Do I Need a Retainer?

No retainer at all is probably the one option that’s off the table from the start. It’s not just your teeth that have changed position; it’s the bone and ligaments holding them that have changed as well.

A retainer prevents your teeth from moving away from their new, ideal location while your bones and ligaments are stabilizing. This process takes months, so keeping your teeth in place as your bone rebuilds and regains density is crucial.

What Are Your Retainer Options?

Three of the most popular retainer options available at our Langley office include:

• Hawley Retainers

This is the traditional retainer, with wires to hold your retainer in place and to keep the teeth properly aligned. The wires are attached to an acrylic plate molded to fit the roof of your mouth or around your bottom teeth. You can customize the acrylic base with colors and patterns for a one-of-a-kind look.

Hawley retainers are adjustable, so minor realignments can take place if necessary. The wire in front of your teeth makes these retainers visible, but, after several months of wearing them all day long, you may end up wearing them only at night.

Hawley retainers are removable, so you need to make sure they are safely in a case when you’re not wearing them. Minor damage can often be repaired, but it’s better to be proactive.

• Clear Plastic Retainers

These retainers look like clear aligners. They are formed by heating a thin piece of plastic and vacuum-forming it around a model of your teeth to create a custom, comfortable fit.

Clear retainers are almost invisible when worn, and can be removed when you eat or drink—which they should be, because food particles and liquids can be trapped inside them.

When you’re not wearing it, a clear retainer should always be in its case, because it must be replaced if the plastic is warped, cracked, or broken.

• Fixed Retainers

A fixed retainer is a small single wire bonded to the back of specific teeth, commonly the six bottom front teeth. Because fixed retainers don’t allow the teeth to move at all, they are often recommended for patients who had serious misalignments, extremely crowded teeth, or teeth with large gaps between them.

Many patients like fixed retainers because they keep teeth in perfect alignment, they won’t be seen, they’re comfortably small, and they can’t end up in the cafeteria recycling bin because you forget to replace them after lunch!

Fixed retainers are usually quite durable, but you’ll need to pay attention to your diet, because crunchy and chewy foods can put pressure on the retainer and damage it. These retainers also require special care with brushing and flossing, to make sure the teeth bonded to the wire stay clean and plaque-free.

The Right Retainer

The process of stabilizing your teeth in the jaw takes time. Choosing your retainer will depend in part on how long and how often you need to wear it: fulltime for months or for years, at night after several months of day-and-night wear, or long-term to make sure your orthodontic work lasts.

And there are other variables, as well. Your retainer might need to be removable. It might need to be adjustable. You might need a retainer for just your upper teeth, just your lower teeth, or both. All these factors and more need to be taken into consideration before deciding on your ideal retainer.

Fixed, removable, wire, plastic, colorful, clear—which retainer is right for you? The one that helps you retain the beautiful smile you’ve worked for all these months. Talk to Dr. Cronin to discover the retainer that will protect that smile for years to come.

Let’s see…

Toothbrush? Check.

Fluoride toothpaste? Check.

Floss? Check.

Two minutes of thorough brushing? Check.

Careful cleaning around your brackets and wires? Check.

Wait… there’s something else… it’s right on the tip of your…

Ah! Your tongue! Whenever you brush, morning, evening, or any time in between, if you want the freshest breath and cleanest teeth, don’t forget your tongue.

Why your tongue? Because the tongue is one of the most common sources of bad breath. Let’s examine just why this occurs.

The tongue is made up of a group of muscles that help us speak and chew and swallow. But there’s more to this remarkable organ than mere muscle. The surface of the tongue is covered with mucous membrane, like the smooth tissue which lines our mouths. But the tongue isn’t completely smooth—it’s textured with thousands of tiny bumps called papillae.

These little elevated surfaces have several shapes and functions. Some make the tongue’s surface a bit rough, which helps move food through your mouth. Some are temperature sensitive, letting you know that your slice of pizza is much too hot. And some are covered with thousands of the taste buds, which make eating that pizza so enjoyable.

All of these papillae with their various functions combine to create a textured surface, filled with miniscule nooks and crannies. And if there’s a nook or a cranny where bacteria can collect, no matter how miniscule, it’s a good bet that they will, and the surface of the tongue is no exception. But bacteria aren’t alone—the tongue’s surface can also hide food particles and dead cells.

How does this unappealing accumulation affect you? These elements work together to cause bad breath, especially the bacteria that break down food particles and cell debris to produce volatile sulfur compounds—compounds which create a particularly unpleasant odor. Including your tongue in your brushing routine helps remove one of the main causes of bad breath.

And that’s not the only benefit! Cleaning the tongue helps eliminate the white coating caused by bacterial film, and might even improve the sense of taste. Most important, studies show that regular cleaning noticeably lowers the levels of decay-causing plaque throughout the mouth.

So, how to get rid of that unwanted, unpleasant, and unhealthy debris?

• When you’re done brushing your teeth, use your toothbrush to brush your tongue.

Clean your tongue by brushing gently front to back and then side to side. Rinse your mouth when you’re through. Simple as that! And just like a soft-bristled toothbrush helps protect tooth enamel and gum tissue, we also recommend soft bristles when you brush your tongue. Firm bristles can be too hard on tongue tissue.

• Use a tongue scraper.

Some people find tongue scrapers more effective than brushing. Available in different shapes and materials, these tools are used to gently scrape the surface of the tongue clean of bacteria and debris. Always apply this tool from back to front, and rinse the scraper clean after every stroke. Wash and dry it when you’re through.

• Add a mouthwash or rinse.

As part of your oral hygiene routine, antibacterial mouthwashes and rinses can assist in preventing bad breath. Ask Dr. Cronin for a recommendation.

• Don’t brush or scrape too vigorously.

Your tongue is a sturdy, hard-working organ, but tongue tissue is still delicate enough to be injured with over-vigorous cleaning.

Taking a few extra seconds to clean your tongue helps eliminate the bacteria and food particles which contribute to bad breath and plaque formation. Make this practice part of your daily brushing routine—it’s a healthy habit well worth remembering!

We’ll give it to you straight: it can be harder to keep your teeth their cleanest while you’re wearing braces. Food particles play hide-and-seek, plaque builds up around brackets, flossing is harder when you need to maneuver around wires. But keeping your teeth and gums healthy is even more important now that you’re wearing braces.

Why? Because when your braces come off, you want to enjoy the beautiful smile you’ve worked so hard for without worrying about discolored enamel, cavities, or swollen gums. Let’s look at some of the possible consequences when brushing and flossing are more challenging.

Decalcification

If you’ve noticed white spots around your brackets, you’re seeing the signs of decalcification, a common problem for those who wear braces.

Decalcification begins when plaque collects on the enamel around your brackets. The bacteria in plaque produce acids. These acids eat away at the minerals which keep your enamel strong, minerals like calcium and phosphorous. Places on the enamel where erosion takes place are left weakened and discolored.  Eventually, these weak spots can lead to . . .

Cavities

When plaque sticks around, whether near your brackets or anywhere on your teeth, it provides the perfect conditions for decay to develop. Left untreated, bacterial acids continue working away at decalcified spots in your enamel. This continuing erosion causes these surface spots to expand, grow deeper, and become cavities.

If you’re having trouble with built up plaque, and brushing isn’t doing the job for you, your dentist can remove it with a professional cleaning. Getting rid of plaque is healthy not only for your enamel, but your gums as well.

Gum disease

When plaque and tartar collect around the gumline, they irritate delicate gum tissue. This irritation causes gingivitis, or early gum disease. And, while young people rarely suffer from serious gum disease, the pain, redness, bleeding, swelling, and bad breath caused by gingivitis are not anyone’s life goals!

Brushing and flossing are essential to keeping your enamel and gums plaque-free. But even if you brush more often, it’s not as easy as it once was now that you have to work around and between brackets and wires. Luckily, there are lots of tools out there to help you get your teeth, gums, and braces their cleanest.

• Orthodontic toothbrushes

Special brushes designed just for braces can help you work around brackets and wires. V- or U-shaped bristle formations let you brush around and over your braces. Curved bristles can fit under wires. Smaller brush heads let you reach those hard-to-reach places.

• Electric toothbrushes

Many people find these brushes can clean more easily and effectively, especially when wearing braces. Tapered orthodontic brush heads are available, and, if you’re a heavy-handed brusher, there are models which alert you if you’re brushing too hard—protecting your braces and your enamel.

• Orthodontic floss

Special orthodontic flosses can help you do the tricky job of fitting floss behind your wires and between your teeth, or use a floss threader, which helps guide uncooperative floss into tight spaces.

• Water flossers

With their pulsing streams of water, water flossers can reach spots where regular brushes and flosses just can’t comfortably fit. There are even flossers available with special orthodontic tips.

Straight teeth are great. Straight and healthy teeth? Even better! You, Dr. Cronin, and our Langley orthodontic staff make a great team. Take advantage of our advice and tips for the best tools and techniques to make sure your smile is both perfectly aligned and perfectly healthy once those braces come off!