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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 Denver, NC orthodontic team.

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

Dr. Todd Hamilton and Dr. Bryan Whitecotton 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 Hamilton and Whitecotton 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.

Modern dentistry has made the most of today’s technological innovations. And we’ve come a long way from the fraying sticks our ancestors used as toothbrushes.

On the other hand, while it’s a lot better than a fraying stick, the manual toothbrush model you’ve used for years might be ready for an upgrade. Should you take this opportunity to try out some new technology offering all the bells and whistles? Let’s answer that question by asking a few more questions.

Happy with your manual brush?

If you like your manual toothbrush and it’s doing the job, by all means, stick with it. But even your old familiar brush can evolve:

• There are lots of bristle options, but soft bristles are almost always the way to go. Medium and hard bristles can be too abrasive for your enamel.
• Heads come in a variety of sizes, so make sure the head size is comfortable. You want to be able to maneuver to reach every tooth surface, which a too-large brush head just can’t do.
• Try a different handle shape if you’re having trouble maneuvering and keeping a firm grip.
• Change your brush regularly. Brushes are effective for about three months before the bristles start to fray and breakdown. This is a good opportunity to experiment with different brands and styles.

Does your old brush suit your current needs?

Different types of manual toothbrushes are available for effective and comfortable brushing when you need options that a typical brush doesn’t provide:

• Special orthodontic toothbrushes are designed with bristles trimmed to fit around brackets and wires and smaller heads to reach into tight places.
• For those with mobility issues, brushes with larger or easy-grip handles make cleaning more comfortable.
• Brushes with extra-soft bristles are available if you have enamel erosion or sensitive gums.
• Because many women find their gums become especially sensitive during pregnancy, there are brushes designed especially for moms-to-be.

Is it time to go electric?

If you haven’t tried an electric toothbrush before, you might find that getting braces is a great reason to give one a spin.

• Electric toothbrushes can outperform manual models. A dedicated brusher might manage hundreds of brushstrokes for each minute of brushing, while an electric brush can provide thousands. If, despite your regular brushing, you have plaque build-up, an electric brush might be a good alternative to your manual brush.
• Models are available which can alert you when you’re brushing too hard—which is important for your enamel if you’re a heavy-handed brusher.
• If you tend to *think* you’ve brushed for the recommended two minutes, but have *actually* brushed 32 seconds, some electric brushes come with timers!
• There are tapered electric orthodontic brush heads designed just for people with braces.
• Electric brushes have bigger handles and can be easier to grip.

Is your current brush doing the job?

So, should you stick with the familiar toothbrush that’s worked for you all these years, or take this opportunity to try out some new technology that offers all the bells and whistles? The answer is clear: the right brush for you is the one that works!

If your regular checkups show that plaque is under control, you’re doing just fine with the brush in hand. If you or Dr. Todd Hamilton and Dr. Bryan Whitecotton notice plaque buildup, it’s time to consider making some changes. Whether it’s a question of tools, techniques, or time spent brushing, your Denver, NC dental team has the answers you need for state-of-the-art dental hygiene.

Analyzing strong points, looking for potential problems, making comparisons—it’s bracketology time! Nope, not basketball (although we hear they have something similar), but a brief analysis of your orthodontic options when it comes to choosing a winning bracket.

If you’re getting braces, you’re probably already familiar with how they work—brackets are bonded to the teeth to hold an archwire, which provides gentle, controlled pressure to move the teeth into alignment. But within that basic bracket-and-wire system, there are several different bracket designs available to you at our Denver, NC orthodontic office. Let’s see what the scouting report has turned up on our final four, pointing out their distinct advantages as well as some potential mismatches.

Traditional metal brackets

Advantages:

• Traditional braces with metal brackets are effective for more than just straightening teeth. They can be used to correct rotated teeth, differences in tooth height, and bite problems. For severe bite and alignment problems, traditional braces are most often the right choice.
• Metal construction makes these brackets able to handle the controlled pressure needed to treat serious malocclusions.
• Cost-effective. These are usually the least expensive option.

Potential Disadvantage:

Clear/Ceramic Brackets

Advantages:

• Lack of visibility! Whether you go for clear brackets or brackets tinted to match your enamel, you’ll be keeping a low-profile with this choice.
• Stronger and more stain-resistant than ever before, using the latest in ceramic, porcelain, or plastic materials.

Potential Disadvantages:

• Not as durable. Unlike metal, these clear brackets can crack or break. If you play a contact sport, these might not be for you.
• Some ceramic brackets are larger than other choices, so might be recommended only for the top teeth.
• Clear or tinted brackets can be more expensive.

Self-Ligating Brackets

Advantages:

• These brackets use a clip or trapdoor mechanism to hold your archwire without the need of bands. Ceramic options are available if you want an even more discreet appearance.
• Can be more comfortable with less friction between wire and bracket.

Potential Disadvantages:

• Self-ligating braces are generally more expensive.

Lingual Braces

Advantages:

• Lingual braces use metal brackets, but they attach to the back of each tooth for almost invisible bite correction.
• Custom-made. Lingual brackets can be designed and fabricated to fit your individual teeth perfectly.

Potential Disadvantages:

• Trickier to clean because of their placement behind teeth.
• Might not be suitable for a deep bite if there’s not enough clearance between top and bottom teeth.
• Initial discomfort caused by the tongue’s contact with the braces when you speak and eat.
• Custom-made brackets are more expensive.

So that’s a brief rundown of your bracket choices. But, unlike sports bracketology, there are no losers here! Dr. Todd Hamilton and Dr. Bryan Whitecotton can give you the pros and cons of each bracket design, so you can make an informed decision based on the kind of braces which will work best for you. With coaching like that, no matter which bracket option you choose, the final result is the same—a winning smile!

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. Todd Hamilton and Dr. Bryan Whitecotton 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!