When Extraction Is Your Best Option

June 25th, 2025

Orthodontists and dentists use advanced procedures to treat and save teeth. But sometimes, a tooth just can’t be saved and needs to be extracted. Sometimes it’s due to extensive decay, or infection, or serious injury. Or sometimes, to create a healthy bite, an extraction is necessary during orthodontic treatment.

When does an orthodontist recommend an extraction? Conditions which call for extraction include:

  • Incoming Wisdom Teeth

Not many people have enough space in their mouths for four wisdom teeth! And when there’s no room to erupt properly, wisdom teeth can become decayed or infected, push your other teeth out of place, and damage the roots of nearby molars. Extracting wisdom teeth protects your teeth and your bite alignment.

Usually, orthodontic treatment takes place before the wisdom teeth begin to erupt. But if yours start to make an appearance during treatment, your orthodontist and dentist will work together to schedule extraction without interfering too much with your orthodontic treatment plan.

  • Tooth and Jaw Structure

Dr. Ryan Hinckley and the team at Berky Hinckley Orthodontics carefully plan your treatment based on examinations, X-rays, and/or 3D imaging. The goal is to align your teeth and jaws for an attractive smile and a healthy, functional bite. When overcrowding is severe, or if there is a serious malocclusion (bite problem), or if a particular tooth is unusually large or misshapen, your orthodontist might recommend an extraction.

Sometimes more room can be made for teeth with appliances such as palatal expanders or, in other cases, with the help of oral surgery. Extractions are only recommended when they are absolutely necessary.

  • Baby Teeth Which Aren’t Coming Out 

Baby teeth normally fall out in a predictable pattern. Front teeth first, canines and molars last. Baby teeth have small roots, and these roots begin to break down when the adult teeth underneath put pressure on them as they start to erupt. As the root gets smaller and smaller, the baby tooth gets looser and looser—until it falls out. 

Sometimes, though, the roots of primary teeth don’t break down, and the baby teeth stay right where they are. This means that the permanent teeth have to erupt someplace else—usually behind those baby teeth. This creates a double row of teeth, and your permanent teeth can become crooked or overlap as they try to fit in. Extracting stubborn baby teeth allows your adult teeth to come in just where they’re supposed to. Because of their small roots, extracting primary teeth is usually simple and straightforward, and can be done in your dentist’s office. 

  • Too Many Teeth

Most of us have 32 adult teeth, including wisdom teeth. It’s rare, but sometimes an extra, or supernumerary, tooth develops. Your jaw is most probably not equipped to accommodate any extras, so, in this case, the extra tooth or teeth are removed to give the rest of the teeth the space they need to avoid overlapping or crowding.

When your orthodontist recommends an extraction, it’s because it’s important for your dental health. Dr. Ryan Hinckley will refer you to a dentist or a specialist like a periodontist or oral surgeon, who will: 

  • discuss the extraction procedure with you, including sedation options
  • numb the area 
  • gently loosen and then extract the tooth
  • provide options for pain management after the procedure
  • give you detailed instructions for aftercare
  • work with your orthodontist to keep your treatment on schedule

Extraction is never your first choice, or your orthodontist’s! But when an extraction is necessary for tooth and bite alignment, everyone at Berky Hinckley Orthodontics in High Point or Greensboro, NC will coordinate a treatment plan to create your best—and healthiest—smile.

Xylitol: A significant factor for improving your oral health

June 19th, 2025

Xylitol is a naturally occurring sweetener found in tree bark, plants, fruits, and vegetables. The human body also produces it in small amounts. It looks and tastes like sugar, so as part of a health regimen, most people require no willpower to use it.

Xylitol is safe (approved by the World Health Organization) because only a small amount is needed for health benefits. With a glycemic index of seven, it is safe for diabetics. It has less than three calories per gram and 40% fewer calories than other carbohydrates. If eaten in extremely large amounts too quickly, it has a laxative effect in humans.

Tooth decay happens when bacteria in your mouth consume the sugars you eat. When you eat food that contains ordinary sugar, it gives energy to the bacteria on your teeth, allowing them to multiply and start making acids that destroy the enamel on the teeth.

Since xylitol is a natural sweetener derived from the fibrous parts of plants, it does not break down like sugar, so it helps maintain a neutral pH level in the mouth. Xylitol also prevents bacteria from sticking to the teeth because they are unable to digest it. That is how it protects the teeth from cavities.

With xylitol, the acid attack is diminished. With less bacteria and acid, your teeth stay healthier. The frequency of xylitol ingestion is important: aim for five grams a day, or one gram every three hours.

Studies of xylitol use as either a sugar substitute or a small dietary addition have demonstrated a dramatic reduction in new cavities. It has also stopped and even reversed some existing cavities. This effect is long lasting and possibly permanent. Low cavity rates persist even years after the trials have been completed.

Xylitol needs to be one of the first ingredients in a product to be effective. It is convenient and easy to use. You can find it in health food stores and specialty grocery stores. Xylitol can be delivered to your teeth in chewing gum, tablets, or even candy and mints.

It also comes in toothpaste, mouth rinse, baby oral wipes, gel and pacifiers, nasal wash, dry mouth spray, a granulated form for cooking, granulated packets to add to drinks, and commercially prepared foods. It can replace sugar on a one-to-one ratio.

Sweet rewards in xylitol are good for the body and the teeth! If you have specific questions please feel free to contact Berky Hinckley Orthodontics. We look forward to seeing you soon!

Gum Disease Awareness

June 12th, 2025

February is Gum Disease Awareness month, a timely reminder that preventing gum disease is one of the best ways to protect our oral health. 

Gum disease is easily treated in its earliest stages. Left untreated, the progressive nature of gum disease makes it one of the leading causes of tooth loss in adults. 

And while we often think of gum disease as an older person’s disease, the fact is that teens and young adults can suffer from gum disease, too. Irregular brushing and flossing habits, hormone fluctuations, family history, and even orthodontic treatment can make people of any age more vulnerable to gum disease.

Let’s take a moment in this shortest month of the year to discuss how understanding, treating, and, above all, preventing gum disease can help us enjoy long-lasting healthy smiles.

How Gum Disease Develops

Gingivitis is the first, mild stage of gum disease. 

  • Gingivitis begins with plaque. 
  • Plaque irritates gum tissue, causing inflammation, which is the body’s reaction to injury or infection. 
  • Typical symptoms include gums which are swollen or red. The gums might feel tender or bleed easily when you brush or floss. You could develop persistent bad breath. 

With proper care, gingivitis is reversible. Because gingivitis symptoms can be very mild, they’re sometimes overlooked. That’s why it’s important to keep up with regular checkups to discover and treat the disease in its earliest stages. 

Periodontitis is a serious gum disease which is destructive to the structures which support our teeth: gums, connective tissue, and bone. 

  • Plaque, when it’s not removed, hardens into tartar, which can form on the tooth above and below the gumline. 
  • The gums pull away from plaque and tartar deposits, creating a space between the gum tissue and tooth roots. 
  • As the gums continue to recede, pockets form between the teeth and gums.
  • Infection-causing oral bacteria thrive in these pockets. Gum infections can lead to painful abscesses—but gum disease is not just an infection.
  • The body normally responds to bacterial infection with inflammation. With periodontitis, this inflammation becomes destructive chronic inflammation. 
  • Over time, chronic inflammation and infection break down the gum tissue, bone, and connective tissue holding teeth in place. Teeth become loose or shift out of alignment.

The tooth’s support structure eventually becomes so compromised that extraction is the only option. That’s why prompt treatment is essential.

Treating Gum Disease

Several options are available to treat gum disease, depending on its severity.

Treatment for gingivitis can be as simple as paying more careful attention to your brushing and flossing and, if necessary, seeing your dentist for a professional cleaning. In some cases, your dentist might recommend an antimicrobial mouthwash or rinse.

Periodontitis requires specialized treatment from your dentist or periodontist, and this treatment will be based on how advanced the condition is:

  • Topical, oral, or time-release medications treat infection.
  • Non-surgical deep cleaning procedures called scaling and root planing remove plaque and tartar above and below the gumline, allowing gum tissue to reattach to the tooth. 
  • Flap surgery treats more advanced gum infection by reducing pocket depth and re-securing the gums snugly around the teeth.
  • If needed, bone grafts, gum grafts, and other regenerative procedures are available which help repair and restore damaged tissue.

Preventing Gum Disease

What many people aren’t aware of is just how preventable gum disease is! Because wearing braces can make brushing and flossing more challenging, it’s especially important during these months to stay on top of your dental hygiene and be on the lookout for signs of gingivitis.

  • Brush twice a day for two minutes each time, after every meal, or more often if your orthodontist recommends it. 
    • Use proper brushing technique, angling your brush toward the gums to gently clean around and below the gum line. Be sure to brush around your brackets and under your wires. Use a soft-bristled brush to protect both gum tissue and tooth enamel.
  • Floss once each day, after every meal, or as directed by Dr. Ryan Hinckley. 
  • There are specialized brushes and flossers available to make cleaning around brackets and wires much easier. Electric toothbrushes and water flossers can also be helpful in removing hard-to-reach plaque. Ask Dr. Ryan Hinckley to recommend the flossing tools and techniques which will work best for you.
  • See your dentist regularly. Gum disease can be invisible in its beginning stages. Discovered early, treatment is simple and effective. 
  • Having your teeth cleaned every six months, or as recommended, will remove tartar buildup which brushing alone can’t handle. 

Your dental hygienist is experienced in cleaning teeth when patients wear braces. And you can get tips for better brushing and flossing techniques from the team at Berky Hinckley Orthodontics in High Point or Greensboro, NC, too!

Even when it seems like there aren’t enough days in the month or hours in the day, it takes just a few minutes daily to care for your gums and teeth. And when you’re aware of just how much those few minutes mean to a healthy smile, it’s time well spent!

Warming Up for Summer Weather

June 4th, 2025

School’s out. The barbecue’s fired up. T-shirts and shorts are back in style. Sandy beaches and sidewalks are sizzling. Summer’s officially here, and it’s time to get back into hot weather mode. This means getting back into some healthy summer habits.

Be Ready to Hydrate!

Warm weather can lead to dehydration before you know it. And water does more than hydrate—it rinses away food particles after eating or snacking, neutralizes enamel-eroding acids in the mouth, and helps us keep up healthy levels of saliva. 

  • A reusable water bottle is a summer shopping list must. When you’re out walking, hiking, exercising, or camping, you can’t always be sure you’ll have fresh water available. Fill your water bottle before you leave home—you’ll help yourself stay hydrated, save money, and protect the environment, too!
  • When you’re on the go, rinse with water after snacking to help remove food particles from teeth and braces.
  • Go light on the sports drinks and sodas when planning your summer menus. They’re often filled with sugars and acids—two very unhealthy ingredients for your teeth. 

Restock Your Sunscreen

Sunscreen helps protect skin of all shades and all ages. Exposure to ultraviolet rays is known to cause skin cancer and premature aging. Lip tissue is thin and delicate, especially at risk from the sun’s damaging UV rays. 

  • Check your sunscreen for its expiration date. Protective sunscreens and lip balms lose effectiveness once that date has passed.
  • Some sunscreens are designed for use on lips. If yours isn’t, look for a protective lip balm. All of your sunscreens and balms should have an SPF (Sun Protection Factor) of 30 or higher.
  • Bring your sunscreen and balm with you when you’re out and about, and reapply every two hours, or sooner if you’re eating, drinking, or getting wet.

Prep for Summer Adventures

If you’re travelling this summer, make sure the right dental and orthodontic supplies are part of your gear. A travel size toothbrush and toothpaste, a well-ventilated toothbrush case, and your orthodontist’s and dentist’s emergency contact information are basic necessities. If you wear braces, add dental wax and extra rubber bands. If you have aligners or a retainer, don’t forget your case.

Once you have the basics, you can tailor your kit to your summer plans:

  • Flying? Make sure every liquid, gel, or aerosol you’ll need is the proper size for carry-on flight rules, 3.4 oz (100 ml) or less. Toothpaste and mouthwash are included in these categories, so look for travel sizes in your favorites. 
  • Going overseas? Don’t forget plug adaptors or voltage converters if needed for your electric toothbrush.
  • Camping? An emergency kit with cotton rolls, over-the counter pain relief, oral pain relief gel, dental wax (for damaged braces or a broken tooth), and even temporary fillings and a tooth preservation kit can be crucial in case of unexpected dental injuries.

Make Sure Dental Care Is on Your Summer Calendar

Laid-back summer days are the best, but laid-back dental care really isn’t! Follow your healthy dental routine even during the lazy days of summer.

  • Keep up with your brushing and flossing. Brush two minutes twice each day with a fluoride toothpaste, and floss at least once a day—or more often as your orthodontist recommends.
  • If you’re planning a trip, don’t ignore warning signs. If you have tooth pain or sensitivity, see your dentist to treat any problems before you’re cruising at 30,000 feet or enjoying a remote campout miles from anywhere.
  • See your orthodontist as scheduled, and make sure to let the office know if you have travel plans which might disrupt your regular treatment schedule.
  • Keep your appointments for dental exams and cleanings to ensure year-round dental health.

Whether you’re basking in the warm outdoor weather, relaxing in the shade with a cool drink and a good book, on the road to adventure, or wherever your summer plans take you, we hope these easy tips will help you create a summer filled with bright, healthy smiles.

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