“Wires can poke, brackets can loosen and braces can cause irritation of the cheeks and gums,” said Dr. Li. “While many patients rarely experience a true orthodontic emergency, they can face minor discomforts that can typically be fixed at home.”

The dental veneers provider has put together a list of helpful tips on how to deal with various orthodontic problems.
1- Poking wires – This discomfort usually occurs in the early stage of treatment, as teeth begin to move, the wire used to straighten them has nowhere else to go but to the back of the molar band area, irritating the cheeks. This discomfort can easily be resolved by pushing the wire away from the cheek using a cotton swab or tweezers. If the wire will not move, try trimming the wire with sanitized nail clippers or cover the wire with wax.

2- Broken bands – Bands are the metal rings that are cemented around the teeth. If the band becomes loose, do not try to put it back on. If the rubber band comes off, simply cover it with a piece of wax and make an appointment as soon as you can.

3- Loose bracket – Brackets are attached to your teeth using a composite resin and they can sometimes become unglued from your teeth. Because the bracket is attached to the wire, it will usually just slide from side to side. This is not something that has to be taken care of urgently and can be re-bonded at your next appointment.

4- Toothaches and pain – After braces have been applied or adjusted, patients may often experience discomfort for a few days. Painkillers that contain acetaminophen or ibuprofen are great at relieving pain. However, if the pain is caused from rubbing wires or brackets, swish around a warm saltwater rinse to elevate pain and prevent infection.

Braces are strong orthodontic devices that can withstand many things, but by not following the rules, you could maximize damage and minimize treatment progress, said Dr. Li.

For the first 72 hours of getting braces or having them adjusted, stick to soft foods until you get used to chewing. You need to protect your orthodontic appliances throughout the length of your treatment, so cut up tough foods and avoid eating hard, sticky, chewy and crunchy foods all together.

“Eating tough foods like beef jerky or sticky foods like taffy can cause serious damage to your dental work,” said the laser dentistry professional. “It is your responsibility to fully examine your braces and ensure you are taking proper care of them from day one.”

Before you brush your teeth it is best to rinse your mouth out with warm water to dislodge any food particles. You may use a waterpik to remove stubborn debris from your brackets as well. You can use a soft toothbrush, an orthodontic-cut toothbrush or an electric toothbrush to effectively clean your teeth. To floss, you will need regular dental floss and a plastic threader, which your dentist can provide for you. Brushing and flossing twice a day is a very important part of your orthodontic treatment, said Dr. Li.

If at any time you are not able to resolve your orthodontic issues at home, it is best to visit your dentist or orthodontist immediately or if you are out of town, find a dentist who can see you as soon as possible.

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“People have a fear of the dentist, sometimes because of their previous bad experiences,” said Dr. Pamela Li, an Ottawa family dentistry provider. “By practicing good oral hygiene, your mouth will be healthier, your smile will be whiter, and your visits to the dentist will be simple and pain-free.”

Dr. Li suggests you follow these simple steps to achieve good oral hygiene:

Visit the Dentist Regularly

Routine checkups and professional dental cleanings are the best way to prevent or treat dental problems at their earliest. The dentist will usually do an evaluation of your mouth, compare the X-rays to your previous visit, and check for signs of oral cancer and cavities.

“It is important to maintain a steady routine of visiting the dentist, as oral ailments that go unnoticed may lead to serious health problems,” said TMJ dentist Dr. Li. “We have the skills and knowledge to diagnose and treat oral issues as they arise.”

Maintain Good Habits

You should brush your teeth twice a day and floss at least once daily, preferably in the evening. The way in which you brush your teeth is important as well. While circular motions are good for short bursts, you need to move the toothbrush from your gums to the top of your teeth. Don’t neglect the inside of your teeth or your back molars. Brush with gentle, but firm pressure and don’t forget about your tongue. It is important to remove bacteria, as it will help freshen breath and help decrease the overall bacterial levels in your mouth.

Diet

Food and drink that contain a lot of sugar and certain starches can cause your mouth to be more acidic, which leaves it susceptible to tooth decay. Maintain a balanced intake of whole grains, vegetables and fruits to keep a steady amount of acid in your mouth. Choose harder fruits such as apples to help reduce tartar buildup. Drink plenty of water and if you must drink a soda, be sure to rinse with water to prevent bad breath and remove food debris.

Clean and Replace Your ToothbrushYour toothbrush should be replaced every three months, the cosmetic dentistry professional who offers dental implants said. The bristles on your toothbrush will begin to wear out and accumulate bacteria, which have proven to not rinse away with water alone. If you would like to disinfect your toothbrush, Dr. Li recommends soaking your toothbrush in hydrogen peroxide for seven minutes. Simply rinse the brush after the soak and you are ready to resume proper oral habits. Soft bristle brushes are recommended, but good quality electric toothbrushes such as Oral-B and Sonicare are the best option.  They are effective in removing plaque and biofilm.

“While your mouth does contain a certain amount of bacteria, it is important to follow these steps to prevent the bad bacteria from spreading,” said the Invisalign provider. “If you ever have any bleeding while brushing or flossing or if you experience any pain in your mouth, visit your dentist as soon as possible.”

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While extra padding and a titanium face cage can go a long way, most people forget about or improperly use the most vital piece of equipment, the mouth guard, said Ottawa downtown dentist Dr. Pamela Li.

“The importance of an athlete wearing a mouth guard when playing almost any type of sport cannot be over emphasized,” said family dentist Dr. Li. “Today’s mouth guards aren’t just for protection. With advances in technology, they can improve balance, endurance and increase strength.”

Sports guards are acrylic dental appliances that are worn over teeth to provide protection for the mouth’s soft tissues (lips, cheeks, gums, tongue) and hard tissues (teeth and jaw bones).

There are several types of mouth guards available: stock, boil and bite and custom-made.

Stock mouth guards are available at most sporting stores, come in limited sizes and are least expensive and protective. They come ready to use, which means they are bulky and lack retention. They have to be held in place by biting down.

“Athletes that choose the stock guards are limiting their ability to speak and interfering with proper breathing,” said Dr. Li. “Often times they will cut the guard down for comfort, but what they are really doing is reducing the guard’s protective properties.”

Boil and bite mouth guards require you to boil the guard in water and form it to your teeth by using finger, tongue and biting pressure. They may not cover all the back teeth and athletes cut them down for a better fit.

“The biggest complaint people have of the boil and bite guards is that they cause gagging because they are so bulky,” said Dr. Li. “And once again cutting them down to fit reduces its purpose and can leave the athlete more vulnerable to injury.”

Custom-made guards are made by your dentist and address the important issues in the fitting of the mouth guard. Although it is the most expensive option, it offers the most protection and fit over guards on the shelves at the store.

While most benefits for wearing a mouth guard are easily seen when the player puts it in their mouth, others are not so obvious, said the snoring and sleep apnea professional.

The custom-made mouth guards can be designed to correct misalignment of the jaw, which enhances performance by increasing oxygen intake during physical activity and reducing tension in the jaw.

“Tension in the jaw created by misalignment prevents the body from working to its fullest potential,” said Dr. Li. “When muscles are relaxed and the airway is open, athletes experience improved balance, strength, agility and flexibility.”

Mouth guards can also help protect athletes from concussions. On the moment of impact, a player clenches their jaw muscles around the mouth guard, which in turn stabilizes the skull and neck. They also lessen the severity of injury as a properly fitted mouth guard creates a cushioning pocket of air between the jawbone and the skull, reducing the blow.

“Mouth guards protect more than then mouth, so wearing them is a no brainer,” said Dr. Li, who offers dental services for athletes.

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“The evidence to support this is ever-growing, but a notable research was a study conducted by The Journal of Periodontology in 2007,” said cosmetic dentist Dr. Li. “The results showed that stress can lead people to neglect their oral hygiene, specifically routines such as brushing, flossing and attending teeth cleaning appointments (http://www.joponline.org). By dismissing the most basic hygiene regimens, people are leaving themselves open tooth decay, gum disease and many other problems.”

Stress can directly affect your oral health in many ways, and while some problems are treatable, others may have long-term, irreversible effects.

Canker Sores: small ulcers that appear on the inside of the mouth, which are not contagious and usually disappear within 10 days. When the sores appear in the mouth, it is harder to keep teeth clean due to tenderness; most experts recommend a rinse of warm water and salt or a topical anesthetic as pain remedies.  There are also a number of over-the-counter products that may help for a period of time.  Canker sores may be due to sodium lauryl sulfate, a common foaming agent in toothpaste, so choose toothpaste without sodium lauryl sulfate such as Biotene, said Dr. Li.

Cold Sores: Also known as fever blisters, they appear on or around the lip. They are highly contagious and should be treated with prescription antiviral drugs.

Teeth Clenching or Grinding: Often referred to as bruxism, a condition where people grind or clinch their teeth at night or during the day. This can lead to pain, limited range of motion, a wearing down of the teeth, tooth sensitivity and problems with the temporomandibular joint. Bruxism is usually treated with a mouth guard and stress reducing therapy.

Dry Mouth: People who suffer from stress and anxiety breath differently, which causes a lack of saliva to keep the mouth wet. Saliva helps digest food, protect teeth from decay, prevent infection by controlling bacteria in the mouth and allows for chewing and swallowing. Common treatments include practicing breathing techniques and/or meditation and yoga.

Burning Mouth: A persistent burning sensation in or around the mouth. The burning can be felt on the top of the tongue, lips or the part of the hard palate behind the upper front teeth. Usually treated with anti-anxiety medications and antidepressants.

Gum Disease: Stress is also known to compromise the immune system, the dental veneers provider said. This leaves patients more susceptible to infections and the risk of gum disease greatly increases. Stress can also increase the amount of dental plaque in the mouth, which can cause bleeding gums, gingivitis or bad breath.

“Start with a well-balanced, healthy diet and get at least eight hours of sleep a night,” said Dr. Li. “Limit your intake of caffeine, alcohol and tobacco. Take breaks during work and find activities that help you cope with stress such as exercising or listening to music. But never neglect daily brushing or flossing because stress can ruin your mood and your smile.”

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“Not only do children run the risk of developing buck teeth and an open bite, they also face the possibility of constricted dental arches, crowding and lisping,” said Dr. Pamela Li who practices family and cosmetic dentistry. Ottawa, ON is where her practice is located. She offers porcelain veneers and other general dentistry services. “The severity of teeth displacement correlates directly with the number of hours per day spent sucking, rather than the magnitude of pressure.”
Orthodontic soothers such as NUK are a good alternative to thumbsucking.  The soother is shaped to encourage the proper shape of the palate.  Soothers are also easier to remove, which is ideal for children that are having a difficult time breaking the thumbsucking habit.

Deformation of Facial Structures
Thumbsucking causes a constriction of the upper jaw and also forces the palate to grow upwards.  When the upper jaw is narrow and constricted, the lower jaw cannot grow properly and can become stuck behind and constricted.  Once the jaws become retruded, they can close off the airway, leading to sleep apnea.

The hard palate is also known as the floor of the nose.  As the hard palate grows upward, forming a high palatal vault, it causes the floor of the nose to rise up.  This can lead to a deviated septum and infringes upon the sinus cavity. This can lead to sinus problems and a decreased nasal airway.

Malocclusion
When the jaws become narrow and constricted, it causes crowding of the teeth, leaving them to grow in crooked and rotated.  But if the upper jaw is very narrow, it can lead to a crossbite, which can cause more serious problems if the upper teeth are inside the lower teeth instead of vice versa.

Thumbsucking can also lead to a large overjet.  The thumb forces the upper front teeth out and the lower front teeth back, known as “buck teeth.” The upper lip is often protruded and the lower lip is retruded, leading to difficulties in speech.

“Early elimination of thumbsucking is very important to the facial growth structure,” said dental care professional, Dr. Li. “Ninety percent of facial growth is completed by age 12, so you can not wait until the child is 10 or 11 years old as the damage is already done.  All children should be screened by age seven. Orthodontics can of course help regain some growth, but the help of an ENT specialist may be necessary in some cases.”

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Cosmetic Gum Surgery
Some people have too much gum tissue or their gums may be uneven. Either way, Ottawa cosmetic dentistry provider Dr. Pamela Li says a laser gum re-contouring procedure can make a world of difference.

“Gummy” smiles are caused by an overgrowth of gum tissue or bone tissue, which dominates the mouth, making the teeth appear almost secondary in appearance. This can be due to heredity, improper development or caused by certain health problems or medications.

“Gum re-contouring is one of the most underutilized procedures for cosmetic treatments, yet it is an effective way to achieve the smile you’ve always wanted,” said family dentistry Ottawa professional, Dr. Li. “Gum re-contouring using a diode laser is straightforward and completed in one visit, with minimal discomfort.”

The term laser in Odyssey Diode laser stands for Light Amplification by Stimulated Emission of Radiation, which means it is a device that produces and amplifies light. The wavelengths of the light produced will determine what types of tissues can be modified by the light’s energy. The diode laser is used to raise and even out the gum line, exposing more of the tooth and revealing a more aesthetically balanced smile.
After a local anesthetic is applied to the gums, your general dentist will remove the extra gum tissue. Then, your dentist will use the laser to reshape the edges of your gums that form a smile. The laser vaporizes unwanted tissue, sealing blood vessels and nerve endings for minimal cutting and bleeding. Gum contouring with the diode laser only takes about 15 to 30 minutes if only a small quantity of tissue needs to be removed.
“Gum contouring can be performed by itself or in conjunction with other procedures, such as porcelain veneers as part of a smile makeover,” said Dr. Li.  “Gums frame the teeth and are an important part of the overall smile design.”

Laser Treatment for Periodontal Disease
The diode laser is also used as an important tool in the treatment of periodontal disease, as the laser is well absorbed by melanin and hemoglobin. The laser energy transmitted through a thin fiber can easily penetrate into deep periodontal pockets to deliver its therapeutic effects.
“Periodontal disease is a chronic inflammatory disease caused by a bacteria infection,” said Dr. Li. “The light energy in the laser helps decrease inflammation and increase healing.”
Previous treatments for periodontal disease required Dr. Li to cut into the patient’s gum and peel them back from the teeth so that teeth could be scraped clean of plaque. Then she would fold the gum back down and suture it so it could heal.
“The pain after this procedure is intense and uncomfortable,” she said.

The major advantage of the laser versus the scalpel includes bloodless operation, minimal swelling and scarring, and much less or no post surgical pain.
Tartar is removed from the root surfaces of the patient’s teeth using small instruments and an ultrasonic scalar. The laser gently removes the diseased tissue and also reduces the related bacteria in the area.
“When patients are told they have periodontal disease, they imagine painful and expensive surgery,” said Dr. Li. “It doesn’t have to be that way. There are many treatment options available that minimize discomfort and recovery time. However, do not take this diagnosis lightly, as it can have serious effects.”
The early stage of periodontal disease is gingivitis, resulting in plaque buildup, which can cause the gums to be red and inflamed. The most common sign is bleeding during brushing and flossing.

If the gingivitis is not treated and reversed, it becomes periodontitis- a more serious gum disease that can lead to tooth loss.
Gum disease puts patients at a major risk of cardiovascular disease, including stroke and heart attack. Patients with diabetes are at a greater risk of developing gum disease and, therefore, must be extra careful with their oral health.
“It is more important than ever to maintain routine dental visits.” Dr. Li said. “Taking certain medications, bad oral habits, smoking and a family history of gum disease can be risk factors as well. Patients should come in for a cleaning more than twice a year to stay on top of the problem. Neglecting the diagnosis could lead to serious illness and even death in some cases.”

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The first step in obtaining Invisalign aligners is that the dentist or orthodontist will take detailed measurements of a patient’s mouth. Then he or she can show the patient a computer model demonstrating how the teeth will move over time and what the final smile will look like.
A series of customized clear plastic aligners is created for the patient; they shift teeth steadily and gently over time. Every other week, the patient switches out an old aligner for a new model.
Appearance: Invisalign invisible braces are less noticeable than a mouthful of brackets and wires. Many patients see that as a huge advantage.
“Teenagers are particularly concerned about their appearance,” observes Dr. Li, an emergency dentist. “If they use Invisalign, they can feel less self-conscious and are likely to smile more.”

Removable: Invisalign aligners can be removed by the patient when needed, unlike metal braces which must be removed by the dentist or orthodontist. Patients may remove them to eat, drink or brush.  Since the aligners must only be present in a patient’s mouth approximately 20-22 hours a day, they may also take them out for special activities.

The fact that you can remove the aligners is advantageous when you are brushing your teeth.
“Regular braces often make it difficult during teeth cleaning,” explains Dr. Li, who has an Ottawa dental clinic. “However, when patients can remove the aligners, they can brush their teeth like normal. You’re far less likely to find cavities after the treatment is completed.”
On the other hand, the system only works well with diligent patients who remember to always put their aligners back in.

Comfort: “Patients often notice how comfortable the Invisalign system is,” explains Dr. Li. “There are no brackets stuck to your teeth and no wires that bend or poke the inside of your mouth.”
Patients also find it easy to use. They need only visit the dentist occasionally, but with regular braces, patients usually need to see the dentist or orthodontist every four or five weeks.  Traditional braces can also have a detrimental effect on a patient’s gums and supporting tissues, but using the Invisalign system can prevent that.

Eating: Metal braces require many restrictions on what you eat – either because food is easily stuck in the braces or because certain kinds of food can damage the wires or brackets.  “Invisalign has no restrictions,” notes Dr. Li.  “You can eat whatever you want.”

Disadvantage: The biggest disadvantage to Invisalign is that it cannot perform all the same movements as traditional braces.  Every patient needs to be assessed to make sure they are a good candidate.

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“Acid wears down and erodes the tooth enamel, increasing the risk of decay and causing sensitivity in the teeth,” explains Dr. Li, an Ottawa smile makeover provider.  When acid wears away tooth enamel, it also makes your teeth look darker. There are many sources of acid, many of which patients are unaware of.  Hidden sources of acid include pop, vinaigrette salad dressings, red wine, juices, energy drinks, pickles, various kinds of fruit (including citrus, kiwi, pineapple) and tomatoes.
If you eat acidic foods as part of a meal, it will help neutralize the acid – in part because increased saliva helps to wash away the acid.  However, saliva production decreases at night, so right before bedtime is the worst time to consume acidic foods or beverages. Also, if you’re drinking an acid-causing drink, using a straw will minimize contact with the teeth. It’s also helpful to drink quickly to avoid bathing the teeth in acid over a long period of time.

“It’s important to remain aware of the dangers of acid and reduce your exposure to sources of acid,” says Dr. Li, a TMJ dentist in Ottawa. “If you do ingest acid, you can dilute or neutralize it by drinking or rinsing your mouth with water.” However, brushing after ingesting acid will not help.  Brushing, especially with abrasive toothpastes, wears down the tooth’s dentin or enamel more quickly.

If you have a lot of heartburn, that can also cause acid damage to your teeth. Gastroesophageal reflux disease (GERD) can cause stomach acid to back up into the mouth and erode tooth enamel.  GERD can be caused by carbonated beverages, chocolate, caffeine, red wine, mint and other foods. “Sometimes my patients aren’t even aware that they have an acid problem until I find that it’s damaging their teeth,’ explains Dr. Li, an Ottawa tooth whitening provider. “But if you can control the GERD with medicine or changes to your diet, you can avoid eroding your teeth further.”

A big problem caused by acid is the sensitivity of the teeth. There are many different kinds of toothpaste designed to help sensitive teeth, but Dr. Li particularly recommends Sensodyne Proenamel. “It is very gentle and does not contain SLS (sodium lauryl sulfate) which is a known irritant and possible carcinogen,” notes Dr. Li, an Ottawa headache dentist.  SLS is found in the majority of toothpastes, which use it as a foaming agent.

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Below are some of the most common dental emergencies and what to do about them.

Knocked Out Tooth: Rinse the tooth in contact lens solution (saline solution) or water if it’s dirty, but don’t remove any attached tissue.  Do not touch the root.  Reinsert if possible, but don’t put it back in if there’s a chance you might swallow it. If it isn’t possible to reinsert, put it in a glass of cold milk. 

“In any case, get to a dentist as quickly as possible,” advises Li, the owner of a dental clinic in Ottawa.  “The sooner a dentist can re-attach the tooth, the better the odds are that you can get the tooth to take root again.  Within 30 minutes is best.”  So if you’re in Ottawa find a dentist right away.

Bitten Lip or Tongue: If a lip or tongue it bitten badly enough to cause bleeding, it needs to be dealt with immediately.  Put pressure (using a clean cloth) on the area that is bleeding. Use cold compresses or an ice pack to keep swelling down.  “If the bleeding continues, go to a hospital emergency room,” explains Li, an Ottawa tooth whitening expert.

Toothache: First try flossing to remove any material that might be caught between teeth.  If the pain persists, try taking an over the counter pain medicine. You can also try an ice pack on your face near the sore tooth, but do not put heat on the tooth or your face.  “However, if the toothache does not go away, call your dentist and ask for an appointment as soon as possible,” says Li, an Ottawa teeth cleaning specialist.

Object Between Teeth: Don’t use a sharp pointy object like a pin or toothpick to remove the item – you might scratch your gums or teeth.  Instead try to gently remove it with dental floss.  If the floss doesn’t work, call your dentist for an appointment.

Broken Tooth or Lost Filling: You need to see a dentist as soon as possible even if there is no pain.  The tooth will need to be repaired with a filling or a crown.  The hole makes a great food trap. Food and bacteria will lodge there and you will get recurrent decay.

Cracked Tooth: If your tooth hurts when you put pressure on it, it may have a crack; the pain is from stress on the nerve inside the tooth. If you suspect a crack, avoid chewing on that side of the mouth.  Visit your dentist to see if he or she can detect a crack; sometimes they are not visible on X-rays. “Small cracks may not need to be treated,” notes Li, an Ottawa dental services provider. “But severely cracked teeth may need to be extracted, but they can also be fixed with crowns, root canals or bonding depending on the size and location of the crack.”

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• HIV/AIDS
• thyroid problems
• iron deficiency/anemia
• leukemia

This article will address three additional medical conditions in detail below.   Diabetes: “Diabetes is linked with gum disease in two different ways,” notes Li, an Ottawa dentures provider. “First, diabetes can cause gum disease and other infections in the mouth.  But, researchers have also found that existing gum disease can increase blood sugar levels and exacerbate diabetes.”

Dentists sometimes suspect diabetes when we see certain types of oral health problems such as dry mouth, taste impairment, fungal infections, poor healing and infections. “If you know you have diabetes, be sure to inform us and let us know how you are treating the condition,” advises Li, an Ottawa dental bridge provider.

Oral Cancer: Oral cancer has a higher mortality rate than either breast or prostate cancer, with close to one in three patients succumbing to it.  However, it can be treated successfully if it is detected early.  And, dentists are on the front line of early detection. “We can notice subtle changes in your mouth that you might not detect and refer you for further testing,” explains Li, an Ottawa teeth cleaning provider.
Risk factors for oral cancer include smoking, high alcohol consumption, a history of human papillomavirus infection (HPV), or a diet low in fruits and vegetables. Be sure to notify us if you have unusual sores, lumps, or patches on your lips or gums that last more than two weeks. Other symptoms include pain, numbness, bleeding, or swelling.

Eating Disorders: Bulimia and anorexia nervosa not only lead to excessive weight loss, but even can cause death. Bulimic patients usually vomit a lot; the constant exposure to stomach acid deteriorates the tooth enamel leading to worn teeth and other oral health problems. In addition, if you are not eating properly, you are starving the body of the vitamins, minerals and other nutrients that it needs to maintain good oral health.

“Many patients don’t like to admit to having an eating disorder, but we can help protect your teeth if we know what’s going on,” notes Li, an Ottawa, ON dental implants provider. “And we can help you get treatment for the condition.”
Li is the person to look for if you want to find a dentist in Ottawa, ON.

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