If your child has a malocclusion (bad bite), he or she could benefit from two phases of orthodontic treatment, based on an examination of your child's mouth and study of diagnostic records. The goal of this treatment is to create a better environment for your child's permanent teeth.

A FIRST PHASE OF TREATMENT IS INITIATED TO:
Prevent a problem from developing (preventive treatment),
Intercept a developing problem (interceptive treatment),
Guide the growth of the jaw bones that support the teeth (growth modification).

Without this first phase of treatment, your child's problem, if left alone, could create an unhealthy environment for the growth and development of your child's teeth, gums, jaws and face. The treatment will be timed to predictable stages of dental development to provide the greatest potential for improvement and correction of your child's malocclusion (bad bite).

Most patients will require a second phase of treatment, often with traditional braces, to complete the tooth and jaw alignment that was started during the first phase of treatment.

HOW DOES TWO-PHASE TREATMENT BENEFIT MY CHILD?
A first phase of treatment benefits patients physically, enabling them to bite or chew more effectively. It may reduce the risk of breaking front teeth that protrude. And for many patients, there is improvement in self-esteem. Younger patients may be more cooperative and follow the orthodontist's instructions on appliance wear and oral hygiene. And the desired changes that result from a first phase treatment may contribute to long-term stability, meaning that teeth stay where the orthodontist has moved them. A second phase of treatment moves permanent teeth into their final positions.

DOES A CHILD'S GROWTH AFFECT ORTHODONTIC TREATMENT?
Orthodontic treatment and a child's growth can complement each other. By timing orthodontic treatment to predictable stages of dental development, the orthodontist may be able to take advantage of your child's growth and development. Some problems that can be treated quite well in a growing child may require corrective surgery if treated after growth has occurred.

THE GOALS OF TWO-PHASE TREATMENT

YOUR ORTHODONTIST HAS THESE GOALS IN MIND FOR YOUR CHILD'S TREATMENT:
A proper relationship of teeth and jaws, so that they work correctly,
Correct alignment of the teeth, for a beautiful smile,
Positioning of the teeth and jaws for an attractive face and profile.

TO REACH THESE GOALS, YOUR CHILD NEEDS TO:
Follow instructions for appliance wear,
Keep the appliance, teeth and gums clean by brushing and flossing as prescribed,
Keep scheduled appointments with the orthodontist,
Visit the dentist at least every six months,
Avoid food that may damage the appliance,
Maintain a healthy diet.

HOW DO I KNOW TWO-PHASE TREATMENT IS RIGHT FOR MY CHILD?
Orthodontic care is not a "one size fits all" approach. Each patient has a unique problem that requires a unique treatment plan. What is right for one child may not be right for another. The diagnosis of your child's problem and the treatment plan are the result of study of your child's mouth and diagnostic records.

Achieving healthy, beautiful smiles is a team effort that involves the orthodontist, the family dentist, the patient and parents. Follow the orthodontist's instructions so that teeth and jaws move as desired and on schedule.

 

Permalink| Comments

Gingivitis
Gingivitis is medically classified as "swelling of the gums", which doesn't sound that serious, but it can lead to much more serious conditions and should be treated promptly and effectively at the first sign in order to prevent further complications. Gingivitis is actually an entry level form of periodontal disease, which attacks the gum tissue and eventually works its way to the jaw bone and causes permanent damage, including loss of teeth. If you notice any change in the appearance or sensitivity of your gums or notice bleeding when you floss or brush, you should see your dentist for an exam and cleaning. Gingivitis is easy to treat.....if you have the right plan in place & catch it early! Poor oral hygiene while you have braces can easily result in gingivitis. It's important to stay on top of your oral hygiene - brush & floss daily and see your regular dentist for cleanings.

Periodontal Disease
Periodontal means "around the tooth" and periodontal disease is a chronic bacterial infection that affects the gums and bones supporting the teeth. It begins when plaque causes gums to become inflamed (gingivitis) and can advance to periodontitis when toxins produced by the bacteria in plaque spreads and grows below the gum line. The toxins stimulate a chronic inflammatory response in which the body turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. The infection of your gums along with loss of bone and tissue supporting your teeth can lead to loss of teeth which can cause problems with speaking and eating. Periodontitis is also linked with a higher risk for heart disease and strokes. The damage from periodontitis can be very costly to repair and is easily avoided by practicing good oral hygiene.

Healthy Gums
• Pink
• Tight to teeth
• Scalloped appearance around each tooth

Gingivitis
• Swollen
• Bleeding
• Bright Red
• May be tender to the touch

Periodontitis
• Gums pull away from teeth
• Loose teeth
• Pus between gums and teeth

Advanced Periodontitis
• Bad breath
• Inflamed gums with pus
• Noticeable decay and loss of bone

Five to Follow:

1) Twice a Day! Brush & floss every morning after breakfast and every night before you go to bed. If you can brush after every meal... GREAT! If you can't, rinse your mouth with water several times throughout the day.

2) Brush ALL tooth surfaces! Get the inner and outer surfaces and the chewing surfaces. Don't just brush the front teeth... get all the way back to the molars!

3) Get the gum line! Hold the toothbrush at a 45° angle and gently brush the area where your gums meet your teeth. Remember, healthy gums don't bleed when you floss and brush.

4) The Two-Minute Rule! Brush for no less than two minutes EVERY time you brush. Insufficient brushing will leave plaque and bacteria behind.

5) Use Proper Pressure! A soft bristle brush with a compact head along with minimal pressure is enough to do the trick. Go slow and use a circular motion across surface areas of every tooth. Brushing too hard can cause loss of enamel and may contribute to a receding gum line.

Permalink| Comments

Orthodontic retainers are custom-made appliances, made usually of wires or clear plastic, that hold teeth in position after orthodontic treatment while assisting with the adjustment of the surrounding gums and changes in the bone. There are three different options for retainers and it's important to discuss with your orthodontist which retainer is the best option for you or your child. It's important that you're comfortable with your retainer because, after all, you'll be wearing it for a very long time to ensure your beautiful new smile lasts a lifetime!

Hawley Retainers
These are removable retainers made of a metal wire that surrounds the teeth and is anchored in an acrylic arch that sits in the palate or lingual walls of the mouth. The advantage of this retainer is that the metal wires can be adjusted to finish treatment or move teeth as needed. Hawleys are worn 24 hours a day for the 1st year of retention.

Essix Retainers
These are removable retainers made of a PVC material. This clear or transparent retainer fits over the entire arch of teeth. These retainers are easier to wear and less conspicuous than Hawley retainers, but are more apt to need replacing because the PVC material is prone to breakage and deterioration over time. Essix are worn every night for the first year of retention.

Bonded Retainers
A bonded retainer is not removable, taking some of the responsibility of retainer wear off of the individual. It is a fixed wired bonded to the lingual surface (tongue-side) of the teeth. Typically prescribed where orthodontic treatment has affected great changes in the bite and there is high risk for reversal of these changes. Fixed retainers require meticulous cleaning to maintain oral health.

Permalink| Comments

After many months of hard work and sacrifice, you finally get your braces off and see your beautiful new smile! Some may think this is the end of their orthodontic treatment, but it's not! The final and arguably the most important step to your orthodontic treatment is retention. Why are retainers necessary? Once we have corrected all dental and skeletal problems, we really want your fabulous results to last! After braces are removed, your teeth are in proper alignment, but gums and bones have not completely settled into their new position. Because of this, it is possible for some teeth to shift back toward their original position. In order to avoid jeopardizing your beautiful final results, we recommend that you wear your retainers as instructed for the first year after braces are removed. However, one year of retainer use is not enough! We strongly advise patients to continue retainer wear at night while sleeping to stabilize teeth... forever! Children and teens will continue to grow and studies have shown that all young adults go through "maturational change" in their early 20s. This growth and change can cause teeth that were previously straight to appear crowded. The most common maturational change is crowding of the lower incisor (front) teeth. Continuing to wear retainers as instructed after orthodontic treatment will stabilize teeth and can prevent most of this change. There are three different types of retainers available. Talk to your orthodontist about which type is best for you or your child. Dr. Robertson and the entire team at Star Orthodontics are so excited when a patient completes treatment and sees their beautiful smile for the first time. We are committed to helping you make that smile last a lifetime! We continue to see patients for the first year after treatment has ended for "retainer checks" to ensure your retainers are fitting properly and teeth have not shifted. After that first year, we're happy to schedule an appointment for you if you have a question or concern about your retainers.

Permalink| Comments

For the last 10 years, energy drink consumption has been on the rise in the United States, promising consumers more "oomph" in their day. In fact, it is estimated that the energy drink market will reach $10 billion in sales in 2010. Good news for the energy drink companies, but bad news for the oral health of consumers who sometimes daily rely on these drinks for an extra boost! The high acidity of these popular energy drinks and soda contributes to the erosion of tooth enamel. According to a study by the Academy of General Dentistry, popularity of energy drinks is most rapidly growing among adolescents and young adults, putting them most at risk. This age group,s permanent teeth are more susceptible to attack from acids found in energy and soft drinks due to the porous quality of their immature tooth enamel. The damage caused by these drinks can lead to irreversible decalcification and other severe dental issues. Drink responsibly for your oral health!

Permalink| Comments

Decalcification reveals itself as white spots or white areas on the surface of your teeth and is the earliest form of decay resulting from both a poor oral hygiene and a diet rich in sugar & acid. Once you have decalcification spots on your teeth, they are permanent scars and the damage cannot he reversed. Poor oral hygiene leads to plaque build up on your teeth and when you consume food and beverages high in sugar~ the plaque on your teeth consumes the dietary sugars and produces acids that cause the tooth enamel to weaken. The acidic plaque actually begins to leech the calcium from the enamel~ thus the term "decalcification~~.Calcium is what makes the enamel on your teeth strong and without it~ the enamel becomes soft~ leaving your teeth severely weakened and susceptible to cavities. Drinking acidic beverages such as soda~ sports drinks~ and energy drinks intensifies the decalcification process. Individuals with braces are more at risk because it is more difficult to properly clean the teeth.

Follow these tips to avoid ruining your beautiful new smile!

Prevention Tips:

• Brush twice a day with a fluoride toothpaste
• Floss at least once a day
• See your dentist for regular cleanings (at least every 6 months)
• Avoid sugary or starchy snacks
• BEWARE! Carbonated soft drinks are full of sugar and acids that quickly erode tooth enamel
• Sports drinks & energy drinks are also another major culprit of decalcification so limit consumption & avoid slow sipping these acidic beverages over a long period of time!
• Use a straw positioned at the back of the mouth so that sugary and acidic liquids avoid the teeth
• Rinse the mouth with water after drinking acidic beverages

Permalink| Comments

Why should you floss your teeth every day?

Brushing alone only cleans 65% of the surfaces where harmful bacteria grows. The other 35% can only be cleaned by flossing!

1. Avoid cavities - bacteria in your mouth consumes the left over food particles & produces acid which eats into your tooth enamel, creating a cavity. The only way to rid your mouth of ALL of the acid producing bacteria is to brush AND floss daily. Flossing is the only way to get the bacteria that lives between the teeth and along the gumline.... surfaces you can't reach with a toothbrush!

2. Prevent heart disease - studies show that the bacteria that forms in your mouth is the same bacteria that causes heart disease. If you don't floss, the bacteria that forms along your gumline causes infection and inflammation that allows bacteria to enter your bloodstream and have easier access to your heart. Oral infections can also contribute to strokes & diabetes.

3. Have better breath - bacteria that grows in your mouth produces a rancid scent... and no one likes to talk to a person with bad breath.

4. Stop gingivitis - when you don't floss it leads to build up of plaque and tartar on all of the spots your toothbrush can't reach. This greatly increases your chance to develop gingivitis & periodontal disease (gum disease) which can lead to very expensive dental restorations due to extreme decay, bone loss, and tooth loss.

Permalink| Comments

Called "wisdom teeth" because they emerge later in life, the upper and lower third molars generally cause problems because there is not enough room in the mouth for them to erupt, or break through the gum, into a normal position. As a result, these molars are often left impacted in the gum or jawbone. Impacted teeth can lead to a variety of problems including pain, infection, crowding, or damage to adjacent teeth, and can contribute to more significant health problems.

10. Limited space for wisdom teeth to erupt can lead to infection and inflammation that can spread to other teeth.

9. Oral inflammation associated with wisdom teeth may contribute to preterm or low birth weight infants.

8. Fully erupted wisdom teeth rarely provide meaningful use and are difficult to keep clean.

7. Impacted wisdom teeth may develop associated cysts and/or tumors that could require extensive procedures to remove & repair jaw function and appearance.

6. Chance of complications related to the removal of wisdom teeth increases with age.

5. Gum disease and inflammation associated with wisdom teeth may lead to receding gum tissues, deterioration of the jawbone and tooth loss.

4. Full eruption of wisdom teeth may lead to crowding of nearby teeth.

3. Even wisdom teeth that seem to be problem-free remain a breeding ground for oral infection & inflammation. This inflammation can enter the bloodstream and contribute to the development or progression of diabetes, heart disease, and stroke.

2. Wisdom teeth removed at an early age allows for easier and faster recovery.

1. PEACE OF MIND & a healthy SMILE!

*Source American Association of Oral and Maxillofacial Surgeons

Permalink| Comments

By Lalitha M. Janaki, M.D.

CORPUS CHRISTI - I was asked repeatedly within the last two months about where I have been and what I do these days. My answer has been, "I'm on my third Political Rotation." As you know, when in medical school and after, we have clinical rotations. But, in some lives, there are these Political Rotations!!

I started my career in Corpus Christi, some time ago, and was affiliated with a major medical system for about ten years. Then suddenly these exclusion critera kicked in and exclusive contracts went into place. Of course, you can be excluded, because of your affiliation or whatever. That was my first rotation.

Moving on with life, by the grace of God, and the help of good friends, you set up your tent with another medical system. A decade goes by, you make good money for the system, like the one before, but then, the same old drama, another exclusivity. Suddenly, you do not belong to the correct society, or class, or creed, or color, and on and on. I completed my second rotation.

My third decade began with a privately owned facility and still goes on. Politics are everywhere, just like air, water, sunshine, and hopefully, ANGELS. We need them for survival.

This reminds me of an article I wrote in 1992 for this magazine about the game of chess. My conclusions then are still valid now. Sometimes, we are just pawns.

(Editor's note: the 1992 article can be found on the NCMS website: www.nuecesmedsociety.org)

Permalink| Comments

By Carolina Pradario, M.D.

CORPUS CHRISTI - I had the privilege of participating in the 2011 Nueces County Healthy Living Health Fair, both as a volunteer and as a participant. Having attended many health fairs throughout the years, I was unsure about what to expect from the health fair here in Corpus Christi. When I arrived at the American Bank Center, I was pleasantly surprised.

I have found that there are three key components to a successful health fair: organization, educational content, and most importantly the contribution of the community. All of which I'm proud to say that I witnessed at Saturday's event. The fair was extremely well planned and the exhibitors were in abundance. This was the perfect forum for introducing healthcare providers to members of the community and to help educate them on achieving and maintaining healthy lifestyles. There were also a handful of exhibitors who volunteered to provide useful information about the latest in preventative health care.

What really made this event stand out was the community's contribution. Not just the many volunteers who helped make this happen, but more importantly the attendance of my fellow Nueces County citizens. Even with the threat of a tropical storm potentially affecting the attendance of the Health Fair, over 7,000 people attended this event. This proves more and more that people are becoming aware of the importance of living a healthy lifestyle and assuming responsibility for their own health.

The Nueces County Health Fair was a perfect way to give back to the community by providing educational information on prevention and early detection of disease. I am proud to have been part of this year's health fair and I look forward to many more successful ones in the future.

Permalink| Comments

By Lalitha M. Janaki, M.D.

CORPUS CHRISTI - I have been asking our Dermatology colleagues to share some information in their field of expertise, so we all can learn, since we live in South Texas right on the sunny coast.

Health fair this year was a big eye opener for me. As I walked through the aisles and saw these long lines at the skin cancer screening booths, I decided to spend some time there. Lots of questions were being asked and I was amazed to find out how little I know about skin care. Then I went home and did some reading, and here are a few facts that I discovered:

- Men over 40 get the most sun.

- As our life expectancy over 50 has risen, protecting the skin becomes more important.

- Skin protection is important, no matter how old one is.

- Skin cancer is rarely seen on women's faces, but this is the most common site for men. (I guess that is why most make-up we use includes sunscreen.)

- About 2 million Americans develop skin cancer every year.

- Sunscreens block UVB radiation and UVB radiation causes the visible burns. But, UVA 1 & UVA 2 are the cancer causing solar wavelengths. These are the rays that penetrate deeper into the skin and cause cancer.

I am frequently asked:

- How about sun bathing under a shady area or on a cloudy day? (Clouds block sunrays reaching the earth but unprotected skin exposure on a cloudy day is not recommended.)

- What SPF is better? Does higher SPF give better protection? (Any SPF between 30 and 50 is as good as SPF of 70.)

- What kind of sunscreen is better - sticks, gels, sprays, lotion, cream, or wipes? (All are effective when applied properly. Creams are good and last longer - a good example would be for swimmers. Sticks are good for touch ups, sprays are good when not wearing a bathing suit. Lotions are really recommended on the beach. Wipes are handy because they are spill proof and easy to carry around. None of these sunscreen products are waterproof, sand proof, towel proof, etc. Dermatologists recommend that you apply sunscreen every hour when swimming.)

We do know that skin makes Vitamin D in response to ultraviolet ray exposure. Sun screens do not block the sunrays completely and we do end up making some Vitamin D which has several important functions. It acts as an anti-inflammatory agent, boosts immunity, promotes Calcium absorption, etc. The American Academy of Dermatology recommends Vitamin D supplements and protecting the skin with sunscreen products to prevent skin cancer, and that is far more important than a Vitamin D deficiency.

Anything and everything in moderation is good, I suppose that includes sunbathing.

Permalink| Comments

By Lalitha M. Janaki, M.D.

CORPUS CHRISTI - Heart Disease is the number one killer of men and women in the United States and the world. About 50 million people in the United States suffer from cardiovascular disease, at any given time.

Prevention is better than a cure; we hear this over and over, but it needs periodic reemphasis.

The health fairs in different parts of the city are a definite indication of the community's effort toward early diagnosis. Within the next two weeks, there will be two health fairs in the surrounding communities, one in the Annaville area and the other in Aransas Pass.

The fact is that the younger generation, such as the SIESTA SMILE group, is coordinating projects, which demonstrate an understanding of the need to start healthy habits at a younger age, is fascinating.

The way we remind ourselves about this pump (which is really a hollow organ) in our daily lives is amazing. Heartfelt thanks, hearty congratulations sounds good. How about heart to heart talk, from the bottom of my heart, lose heart to, break someone's heart, by heart, take to heart, have heart, cross one's heart, at heart, one's heart content, on and on. You don't want to call anybody heartless.

Could someone please explain what a heart attack is? Who attacks whom?

My favorite one is hearty laugh. I always believed in the saying, "Laughter is the Best Medicine" as opposed to some critics who feel differently. The latest study on laughter shows it is a very cost effective treatment.

How about this!! Fifteen minutes of hearty laughter is equivalent to thirty minutes of aerobics. If you think people may think you are crazy for laughing alone, share the fun with a friend who enjoys laughing with you and get two for one.

It is not a bad idea to watch Dumb and Dumber daily for fifteen minutes or even an episode of the Three Stooges. Smiling and laughter have so much in common, cost wise and health wise.

A smile is the most inexpensive makeup.

Permalink| Comments

I sneeze, my competition gets a cold and their competition has pneumonia, and we all receive broad spectrum antibiotics!

The advanced technology in our community is amazing and puts Corpus Christi on the map time and time again. In our community, we have the large bore CT scanner for simulation for our friendly South Texas (TEXAS size) population and the CyberKnife in one of the major hospital systems. Hi-Art Tomo Therapy unit is the latest addition to the area and it completes the broad spectrum of treatments that our patients can experience.

In our radiation oncology world, we love to have whatever the better gadget is, that allows us to give less radiation to normal structures and the maximum dose that can be given to the tumor. Radiation for cancer treatment has been around for over 100 years, and 65 to 70% of patients with a solid tumor diagnosis require radiation therapy at some point in their treatment course.

The evolving technology is fascinating. The Hi-Art Tomo Therapy unit is a combination of advanced technology of both diagnostic and therapeutic radiology. Historically, we had in diagnostic radiology, a stationary X-ray machine and then a portable X-ray machine and we followed with CT scanners and on and on. In the radiation therapy world, we have gone from the KV Units to Cobalt therapy to linear accelerators, Gamma X-ray knife, Peacock system, CyberKnife and now, we have the Hi-Art Tomo Therapy unit.

This unit is a CT scanner that also provides radiation treatments. The CT that is done prior to every treatment through the treatment area is called the CTrue image. A single beam radiation is modulated into smaller beams which are delivered in a helical pattern. It is like multiple small windows that open around the tumor and close around the normal structures.

The real thrill for us as physicians is the ability to look at the CTrue image prior to every treatment and notice the change. Our patients do not have to travel long distances today, as Corpus Christi now has this state of the art unit to care for them.

Competition is good for the community and we will all receive the benefit, including those patients that are not insured and need help with their treatment and medication.

In order for you to succeed, your desire for success should be greater than your fear of failure.

Permalink| Comments