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Orthodontists do everything they can to save teeth, but sometimes, a tooth is so damaged by accident, injury, infection, or decay that extraction is the only option. Or perhaps your child’s wisdom teeth are starting to come in—and starting to cause problems. Or, when this is the healthiest alternative, an extraction might be necessary for orthodontic reasons.

While there are several possible reasons an extraction might be necessary, one thing is true for any extraction: you want to make sure that your child is as comfortable as possible and heals as quickly as possible after the procedure.

Aftercare and recovery time isn’t exactly the same for every extraction. Whether your child’s tooth is a baby tooth or a permanent one, whether it’s a single tooth or several, whether it’s erupted or impacted, whether a local anesthetic or sedation is recommended—these factors and more can make a difference in recovery time.

Dr. Zoltan Berky and Dr. Ryan Hinckley will provide you with clear, specific instructions for helping your child to a speedy recovery after an extraction. We’d also like to offer you some general aftercare ideas to make sure your child is as comfortable as possible while recovering.

• Bleeding

Some bleeding is normal after an extraction. Follow your dentist or oral surgeon’s instructions carefully to minimize bleeding at the extraction site. Your child will probably need to keep a gauze pack in place for as long as directed to reduce bleeding and to help a clot form. If bleeding is heavier than expected or goes on longer than expected, call our High Point or Greensboro, NC office.

• Swelling

Swelling is a normal response to extractions. Your dentist might suggest cold compresses to help reduce swelling immediately after the extraction. If you don’t have an ice pack, ask whether a bag of frozen peas or corn can substitute.

With any cold compress, it’s important to protect your child’s skin from injury. Follow your dentist’s suggestions for application and be sure not to exceed the time limits recommended. And don’t apply a compress directly to your child’s face—wrap a towel or cloth around the bag or pack to protect the skin.

• Careful Cleaning

The area around the extraction shouldn’t be disturbed or touched. The blood clot that forms after an extraction protects the area from irritation and infection caused by food particles and bacteria. If a clot is dislodged accidentally, it can lead to a condition called dry socket, which can be very painful.

This means no brushing near the extraction site, and no heavy rinsing or spitting for as long as directed. If your child is younger, you might need to help with brushing over the days following to make sure those sturdy bristles don’t get close to the extraction site before it’s healed.

• Soothing Foods

Have a supply of your child’s favorite comfort foods handy while healing, such as cream soups, mashed potatoes, scrambled eggs, gelatin, yogurt, and smoothies. Hot and cold foods can be irritating, so stick to cool or lukewarm foods for the first few days. Encourage your child to drink lots of liquids, but nothing carbonated. And do wait until any numbness wears off before giving your child chewable foods to avoid biting tongue or cheeks.

Remove spicy favorites from the menu, which can be irritating, as well as chewy, crunchy, or jagged foods like crackers, since tiny, sharp bits of food can make their way inside the site. Remind your child to chew on the side of the mouth opposite from the extraction site. And, since suction is an all-too-easy way to dislodge the clot over the extraction site, no straws!

• Schedule Recovery Time

Make sure your child rests and takes it easy after the procedure. Exercise, lifting, even bending over can dislodge a protective clot, so re-schedule any physically demanding sports and activities until your child is given the dental all clear.

• Medication

If your child has been given a prescription for pain medication or antibiotics, follow the instructions as directed. Dr. Zoltan Berky and Dr. Ryan Hinckley might recommend age-appropriate over the counter pain relievers to have on hand. For severe or continuing pain, call your orthodontist or oral surgeon right away.

• Coordinate Dental Schedules

Orthodontic extractions, if needed, will be scheduled into your child’s orthodontic treatment plan. Treatment can begin or resume when the extraction site has healed.

If an emergency extraction is necessary, call our High Point or Greensboro, NC office so we can be aware of the situation and can coordinate with your child’s dentist or oral surgeon to keep treatment on track as much as possible.

An extraction can be worrying for both patient and parent, so talk to your orthodontist for the best ways to make this experience a positive one for your child before, during, and after treatment.

Since the introduction of the power toothbrush in the 1960s, this tool has undergone many technological advances, from design and bristle motions to rotation oscillation and sonic vibration.

What is rotation oscillation? That’s when the head of the toothbrush alternately rotates in one direction and then the other. Power toothbrushes can deliver up to 50,000 strokes per minute, which is much more effective than the average 300 strokes per minute with a manual toothbrush.

A smaller brush head is available for hard-to-reach areas, which is a good alternative for small mouths. The brush heads are replaceable and should be changed every three to six months. Each family member should have his or her own brush head while sharing the base motor. What a great deal! Check the handle size. A large handle is better for members of the household with arthritis, children, or family with other physical disabilities.

A rechargeable toothbrush is ideal. It should deliver enough power on a full charge for one week of brushing.

We recommend you brush for a minimum of two minutes. Some electric toothbrushes include a signal you can hear, such as a beep every 30 seconds, to indicate it's time to switch to a different area of the mouth. Others sound an alert after the full two minutes has elapsed.

Will an electric toothbrush harm the teeth or gums? Studies indicate that people tend to apply more damaging pressure to their teeth and gums during manual brushing than when they use an electric toothbrush. If you experience tooth sensitivity, choose a model with pressure sensors that stop the toothbrush any time you press too hard.

Who would benefit from an electric toothbrush? Everyone! Consumers with a physical disability may have specific needs that power toothbrushes can address. Children also tend to maintain better oral health hygiene when they use an automatic toothbrush. Plus, many of them find it fun to brush!

Automatic toothbrushes really do remove debris better than the old-fashioned way. You may have heard the term “biofilm.” Better known as plaque when it occurs in the mouth, biofilm is the debris and bacteria that cause infections to your teeth. It regenerates quickly, so healthy habits are the best defense for a healthier you! With a healthier mouth, you face a lower risk of gum disease and other conditions like heart disease: mouth health has been linked to heart health.

When you're ready to make your decisions, be a wise comparison shopper. Consult with Dr. Zoltan Berky and Dr. Ryan Hinckley at Berky Hinckley Orthodontics to decide what is best for you!

As you near the end of your orthodontic treatment, you’re probably already imagining the day when your brackets and wires finally come off. Or the moment you’ve finished with your last set of aligners. That day might come just a bit sooner if Dr. Zoltan Berky and Dr. Ryan Hinckley and our team recommend a positioner.

While not as well-known as other orthodontic treatments, a positioner is an appliance that can shorten your time in traditional braces and aligners by weeks or even months. Curious? Read on!

• What Exactly Is a Positioner?

A positioner resembles a clear mouthguard. Its arched shape is designed to fit snugly over your teeth. It’s sometimes called a finishing appliance, because it’s designed to make those last small adjustments to your alignment and bite. If you’re a good candidate for a positioner, it can replace your braces or aligners for your last several weeks or months of treatment.

• How Are Positioners Made?

This appliance is custom fabricated to fit your very specific orthodontic needs. Commonly, a mold is made of your teeth. A model of your teeth is made from this mold. Precision instruments are used to move the model teeth into your ideal alignment.

Once this model of your future finished smile is complete, it is used to create the positioner. When the thermoplastic material is molded to the model, it creates an appliance with an indentation for each individual tooth in its desired final location.

Available in a variety of materials, a positioner is most often designed as a clear single piece, covering both your upper and lower teeth. This makes sure that your teeth are not only aligned properly, but that your upper and lower teeth are working together for a healthy bite. Openings in the positioner provide airways which allow you to breathe easily.

• How Do Positioners Work?

Because your teeth haven’t settled firmly into place yet (this will happen as you wear your retainer), they’re still able to move. That’s why your positioner is shaped to fit your teeth in their future ideal placement, not where they are at present.

Positioners require your active participation. Your teeth move to the ideal spots molded into the positioner through “exercise”—biting down on your appliance for 15-20 seconds before relaxing your bite, usually every 10-15 minutes during your daily wear. The gentle force provided by your jaw muscles helps guide your teeth into position more quickly. Dr. Zoltan Berky and Dr. Ryan Hinckley will give you instructions on just how to—and how often to—do these exercises.

• How Long Are They Worn?

Positioners are commonly worn at least four hours a day to start with and all night long, or Dr. Zoltan Berky and Dr. Ryan Hinckley might recommend 24 hour a day wear for the first week. As you progress, you’ll wear them for shorter periods during the day, gradually tapering off until your treatment is complete.

Depending on the amount of correction that’s still needed, positioner use ranges from several weeks to several months. One thing that will ensure that your time in a positioner is as short as it can be is your willingness to follow our instructions. The speed and effectiveness of your final tooth movements is largely up to you!

• Caring for a Positioner

Gentle treatment is best. Clean your positioner before and after wearing it using a toothbrush and mild toothpaste. Never boil it or expose it to heat. We will give you instructions for how to clean it more thoroughly, if needed.

Like retainers, clear aligners, and mouthguards, a positioner needs to be protected when it’s not in your mouth. Your positioner will come with a case, so be sure to use it!

Positioners aren’t recommended for every orthodontic patient. But if you feel this might be an option worth pursuing, talk to us when you visit our High Point or Greensboro, NC office. A positioner could be an effective, time-saving step on your path to a lifetime of healthy smiles.

We often think of braces as a rite of passage for kids in middle and high school. So you might be surprised when your child’s dentist recommends a visit to see Dr. Zoltan Berky and Dr. Ryan Hinckley years earlier than you anticipated. In fact, dentists and orthodontists generally suggest a visit to the orthodontist by age seven at the latest.

Why see an orthodontist so early?

After all, your child is still growing, and many adult teeth haven’t come in at that age. And that’s the whole point.

Around this age, your child will probably have a mix of both baby and adult teeth, so your orthodontist will be able to assess whether there’s enough room for the permanent teeth to erupt without crowding or spacing problems. And malocclusions, or bad bites, caused by problems with jaw size or symmetry can be addressed while young bones are still forming and developing.

If your child has a first appointment coming up on the calendar, here’s a heads up on what often happens during a first visit, and potential problems your orthodontist will be on the lookout for.

What can you expect at a first visit?

The first visit is designed to evaluate how your child’s teeth and jaws work together now, and to look for potential future problems with tooth alignment and jaw structure and development.

First, Dr. Zoltan Berky and Dr. Ryan Hinckley will carefully examine your child’s teeth, jaws, and mouth. Your child will be asked to bite down several times to see how the teeth and jaws fit together, and if there’s any discomfort. Other helpful diagnostic tools could include:

• Scans or X-rays to evaluate jaw structure and the position of teeth which haven’t erupted yet
• Photos of your child’s teeth and face
• An impression of your child’s teeth

If there’s no immediate need for treatment, we might recommend periodic checkups at our High Point or Greensboro, NC orthodontic office to follow the growth and development of your child’s teeth and jaws. If interceptive (early) treatment is your child’s best option for a healthy smile, your orthodontist will explain any immediate orthodontic issues and design a treatment plan tailored to your child’s specific needs.

What are the benefits of early treatment?

Interceptive treatment not only helps correct current orthodontic problems, it can help reduce the need for more complicated treatment in the future, when all of the adult teeth have arrived and bones are fully formed. Among its many benefits, early treatment can:

• Prevent crowding

If your child has a small upper palate, it can be gently enlarged while the palate is still growing with the help of a palatal expander. This will give the upper teeth the space they need to come in without crowding.

• Provide space

If primary teeth are lost too early, other teeth can shift out of alignment to fill the empty space. A space maintainer can be custom-made to keep the spot open until the right tooth is ready to erupt. If primary teeth are overstaying their welcome, Dr. Zoltan Berky and Dr. Ryan Hinckley might recommend extraction to allow the adult teeth to erupt in the proper place.

• Create jaw symmetry

Malocclusions can develop because the upper or lower jaw is too narrow, too far forward, too far back, or the jawbones don’t fit together properly. Dr. Zoltan Berky and Dr. Ryan Hinckley might suggest the use of a functional appliance such as the Herbst® appliance or headgear to help guide symmetrical bone development while your child’s young bones are still growing and forming.

• Protect teeth

Children with overjets, or protruding upper teeth, are more likely to suffer chips, cracks, and other trauma to those vulnerable front teeth. Functional appliances can help bring the upper and lower jaws into alignment as needed, and braces can move the teeth into alignment.

Every journey to a healthy smile begins with a first visit. And you don’t need to wait until your child is seven. Any time you’re concerned about an orthodontic issue is a good time for a consultation. Talk to Dr. Zoltan Berky and Dr. Ryan Hinckley about what to expect at your first visit to help create a comfortable experience for your child as you begin this journey together.