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Birthdays. Valentine’s Day. Halloween. A trip to the movies. There are just some occasions where a sweet treat is on the menu. Now that you are getting braces, does that mean you have to give up desserts completely? Not at all! The trick to finding the right treat is to know which foods are safe for your braces and which should wait until your treatment is complete.

There are some foods which should always be avoided. They fall into three main categories:

• Hard and Crunchy

Hard candies, peanut brittle, popcorn balls, nutty candy bars—anything that is hard to bite into is hard on your braces, and can damage brackets or even break them.

• Chewy

Caramels, taffy, chewy squares and rolls, licorice and other super-chewy candies can break brackets and bend wires. Not to mention, they are really difficult to clean from the surface of teeth and braces.

• Sticky

Soft foods are generally fine, but soft and sticky candies are another thing entirely. Gumdrops, jelly beans, most gum and other sticky treats stick to your braces, making it hard to clean all that sugar from around your brackets. And even soft sticky candies can bend wires or damage your brackets.

As you have probably noticed, almost all candy falls into one of these categories. Of course, while sugary treats shouldn’t be a major part of anyone’s diet, and careful brushing and flossing are always on the menu if you do indulge, wearing braces does not mean giving up on treats entirely. A better alternative when you are craving something sweet is to choose something that avoids crunchy, chewy and sticky hazards, such as soft puddings, cupcakes or cookies. There are even some candy brands that are safe for your braces.

Talk to Dr. Lapsi the next time you visit our Carlsbad, Mission Viejo, or Laguna Hills office about the dos and don’ts of desserts—we have tasty suggestions that will make those special occasions both sweet for you and safe for your orthodontic work!

Every tooth packs a lot of layers in a very small area. The outer, visible part of our tooth, the crown, is covered in protective enamel, and the lower root area is protected by a similar substance called cementum. Inside these very hard layers is dentin, a hard but more porous tissue which surrounds the pulp. In this central pulp chamber, we have the blood vessels which nourish the tooth and the nerves which send our bodies signals from the tooth. And if one of those signals is persistent tooth pain, you may need a procedure called a root canal.

There are a number of reasons that a tooth may cause you pain, including:

• Fracture—a cracked or broken tooth can allow bacteria to enter the pulp chamber and cause inflammation and infection
• Cavity—an untreated cavity can leave an opening where bacteria can reach the pulp of the tooth, and again lead to infection
• Gum Disease—bacteria can attack from the root area of the tooth if gum disease has become serious
• Injury—an accident or injury to a tooth can damage the nerve or the blood supply which nourishes the pulp
• Abscess—if infection is left untreated, an abscess may form under the root

While a damaged tooth may sometimes be symptom-free, usually there are signs that the pulp has been injured or infected. What symptoms should lead you to give Dr. Lapsi a call?

• Persistent pain in the tooth
• Long-lasting sensitivity to heat or cold
• Gum tissue adjacent to the tooth that is sore, red or swollen
• A cracked, broke, darkened or discolored tooth
• A bump on your gums that persists or keeps recurring—this might indicate an abscess

A root canal is performed by a trained dentist or endodontist. After an anesthetic is used to numb the area, the damaged tissue, including pulp, blood vessels and nerves, is removed from the pulp chamber and each root. The inside of the tooth is then cleaned and shaped, and filled and sealed with a temporary filling. The tooth is filled again permanently, usually on a second visit, and might require a crown in order to protect it from further damage.

The most painful part of a root canal is far more often the time spent suffering before the procedure than the procedure itself. Delaying action when a root canal is necessary can lead to infection, abscess, and even tooth loss. If you experience any of the symptoms mentioned above, please give our Carlsbad, Mission Viejo, or Laguna Hills office a call!

Whenever we bite down, we’re applying force with our jaw muscles. Functional appliances direct these forces to create healthier tooth and jaw alignment. They’re used to help correct bite problems and to encourage symmetrical jaw growth.

Functional appliances aren’t always necessary. Because every child’s teeth and bite are different, orthodontic treatment at our Carlsbad, Mission Viejo, or Laguna Hills office is carefully tailored to your child’s individual needs.

• For the child with minor tooth misalignment, traditional braces or aligners might be all that’s needed.
• For the child with a minor malocclusion, or bite problem, an orthodontist might use elastics (rubber bands) to bring teeth into healthy alignment.
• For the child who has a more serious malocclusion, involving both tooth and jaw alignment, an orthodontist might recommend a functional appliance.

A severe Class II malocclusion can be caused when the upper jaw or teeth are positioned too far forward, and/or the lower jaw is too small or positioned too far back. Common Class II malocclusions include:

• Open bite—the front teeth don’t touch when the back teeth bite down, or the back teeth don’t touch when the front teeth close.
• Overbite—some overbite is normal. A deep overbite occurs when the upper teeth significantly overlap the lower teeth.
• Overjet—the upper front teeth protrude further horizontally than they should.

Today’s functional appliances come in a variety of designs to treat Class II malocclusions. They can be fixed or removable. They can be used with or without braces. Some are designed to expand the upper palate to make sure there’s room for all the permanent teeth. What they all do is advance the position of the lower teeth and jaw to create a healthier, more comfortable bite.

Fixed devices are attached to the teeth and meant to be used full-time. These include the Forsus™ device, the Herbst® appliance, and the MARA appliance.

• Forsus Device

This appliance works with braces. A spring coil rod is most often attached to bands on the first molars on the upper jaw. It’s then connected to the arch wire on the lower jaw. Just like elastics—but more effective!—these spring coil rods provide gentle forward pressure that encourages the lower jaw and teeth forward.  

• Herbst Appliance

The Herbst appliance also applies forward pressure to the lower jaw using telescoping rods connecting the upper and lower teeth. The rods expand as the mouth opens, and telescope together as it closes, positioning the lower jaw further forward while the upper jaw is held back. The Herbst can be worn alone or with braces, and can also be used to expand the upper palate.

• MARA Appliance

The MARA (Mandibular Anterior Repositioning Appliance) uses an adjustable “elbow” piece connecting bands on upper and lower molars to guide the lower jaw and teeth forward when the jaw closes.

Removable appliances such as Bionator and Twin Block appliances can also improve Class II malocclusions. They are meant to be worn for a specific number of hours each day, and can be taken out for sports or other activities as needed. Because it’s essential to get all the necessary hours in, removable appliances require commitment!

• Bionators

A bionator is made of wire and acrylic, and it looks a lot like a retainer. The wire fits around the upper front teeth. It’s attached to a smooth piece of acrylic that sits behind the upper teeth and is shaped to guide the lower jaw forward when biting down. The bionator can also be adjusted to expand the upper palate.

• Twin Block Appliance

The twin block appliance uses two separate pieces made of wire and smooth acrylic. Both pieces are modeled to fit precisely over the upper and lower arches. The acrylic “blocks” fit over the biting surfaces of the teeth, working together like a 3D puzzle. When your child bites down, the upper blocks slide into place behind the lower blocks, pushing the lower jaw and teeth forward. The top plate can also be adjusted to expand the upper palate if needed.

Because these appliances are best used while a child’s bones are still growing and developing, dentists and orthodontists recommend an orthodontic evaluation by age seven. Early treatment with a functional appliance can help correct serious bite problems before or together with braces. In some cases, functional appliances may reduce the need for headgear or surgery.

Todays’ orthodontic technology has made functional appliances more comfortable and efficient than ever before. Talk to Dr. Lapsi to discover how an individualized treatment plan and a custom appliance can give your child a healthy bite and a lasting smile.

Oral health is an important and often overlooked component of an older person’s general health and well-being. Dr. Lapsi and our team know that for many of our older patients, oral health can become an issue when arthritis or other neurological problems render them unable to brush or floss their teeth as effectively as they once did. Today, we thought we would discuss four common oral health issues our older patients face and how they can avoid them:

Cavities: It’s not just children who get tooth decay—oral decay is a common disease in people 65 and older. Ninety-two percent of seniors 65 and older have had dental caries in their permanent teeth, according to the National Institute of Dental and Craniofacial Research. The risk for tooth decay increases because many older adults don’t go to the dentist as often as they used to, thus cavities go undetected and untreated for longer than they should. Keeping regular appointments with Dr. Lapsi is the key to getting cavities treated in a timely manner.

Difficulty eating: Oral health problems, whether from missing teeth, cavities, dentures that don’t fit, gum disease, or infection, can cause difficulty eating and can force people to adjust the quality, consistency, and balance of their diet.

Dry mouth: Also called xerostomia, dry mouth is a common issue for a lot of seniors. Our friends at the Oral Cancer Foundation estimate that 20 percent of elderly people suffer from dry mouth, which means the reduced flow of saliva (saliva plays a crucial role in preventing tooth decay). Many seniors are on multiple medications for a variety of chronic illnesses or conditions. Common medications taken that may cause dry mouth are decongestants, antihistamines, blood pressure medications, pain pills, incontinence medications, antidepressants, diuretics, muscle relaxers, and Parkinson’s disease medications. To help counter this, we suggest drinking lots of fluids and limiting your intake of caffeine and alcohol. We also encourage you to check with Dr. Lapsi during your next visit if you think your medications are causing your mouth to feel dry.

Gum Disease: Gum (periodontal) disease is an infection of the gums and surrounding tissues that hold teeth in place. While gum disease affects people of all ages, it typically becomes worse as people age. In its early stages, gum disease is painless, and most people have no idea that they have it. In more advanced cases, however, gum disease can cause sore gums and pain when chewing.

Gum disease, which can range from simple gum inflammation to serious disease, is usually caused by poor brushing and flossing habits that allow dental plaque to build up on the teeth. Plaque that is not removed can harden and form tartar that brushing simply does not clean. Only a professional cleaning at our office can remove tartar. The two forms of gum disease are gingivitis and periodontitis. In gingivitis, the gums become red, swollen, and can bleed easily; in periodontitis, gums pull away from the teeth and form spaces that become infected.

Proper brushing, flossing, and visiting our office regularly can prevent gum disease. Seniors with limited dexterity who have trouble gripping a toothbrush should ask Dr. Lapsi about modifying a handle for easier use or switching to a battery-powered toothbrush.