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Probiotics in Orthodontics

November 15th, 2018

It has long been understood that fixed brackets, bands, and wires used in orthodontic treatment are convenient areas for the retention of food. In fact, one of the most troubling side effects of orthodontic treatment are white spot lesions left behind after treatment has ended. Since oral hygiene becomes more difficult while undergoing treatment, appliances become a perfect ecosystem for the growth of microorganisms which can cause tooth decay and white spot lesions.

Although fluoride varnishes, toothpastes, and sealants are used to mitigate the damage caused by these microorganisms, it is often found that their effectiveness can only be observed when they are regularly used. This disadvantage led researchers to explore probiotics as an alternative.

“Probiotics have been associated with gut health for a while now,” said Dr. Yan Razdolsky. “And while most clinical interest has focused on the prevention or treatment of gastrointestinal infections and diseases, an increasing number of suggested health effects of probiotic bacteria have been reported in the last decade. These include enhancement of the adaptive immune response, treatment or prevention of urogenital and respiratory tract infections, and prevention or alleviation of allergies. And, now that research suggests probiotics may play a significant role in our oral health, the implications of this are very interesting.”

Bacterial therapy or replacement treatment is an alternative way of fighting infections by using harmless bacteria instead of pathogenic microorganisms such as antibiotics. In fact, the benefits of probiotics in the prevention of tooth decay, halitosis, and periodontal disease have been accepted, and more health practitioners are using probiotic treatment for these issues due to the spread of antibiotic resistance in bacteria. Because of this and other perceived health benefits, probiotics can be found in an increasing number of dairy foods including milk, cheese and even ice cream! Research even indicates that probiotics added to a regular daily diet may benefit orthodontic patients as well.

Although the mouth is colonized by 200 to 300 bacterial species, the two main microorganisms that cause tooth decay are Streptococcus mutans (S mutans), responsible for initial tooth decay, and Lactobacillus, which plays a role in those white spot lesions we talked about earlier. Recent studies even suggest the use of probiotic products in orthodontic patients may reduce salivary S mutans and Lactobacillus levels in patients. And while the studies demonstrating the effect of probiotic products and probiotic delivery methods are limited, the good news is researchers did find a decrease in salivary microbial colonizations in orthodontic patients who consumed probiotics daily.

For example, in one study researchers explored daily ingestion of probiotics and the application of a topical probiotic toothpaste and their impact on salivary microbial colonizations in orthodontic patients. While the group who used the probiotic toothpaste did see some reduction in harmful bacterial growth, the group who consumed kefir, a bacterial fermented milk, appeared to experience greater decrease in salivary microbial colonizations.

While the outcome of this study is promising, more studies are needed to compare the relevant probiotic systems and to evaluate the effect of different probiotic products in the fight against tooth decay in orthodontic patients. In the meantime, consumption of daily probiotics with your doctor’s approval may just help protect your smile and minimize your chances for white spot lesions.

“We now understand that at least some probiotic bacteria used in various products may colonize the oral cavity during the time they are in use and therefore are important to understand,” said Dr. Razdolsky. “The extent to how probiotics influence damaging microorganisms is difficult to predict, so this research is important as it may provide new means of preventing or treating oral diseases.”

Traveling Orthodontist

October 15th, 2018

In most countries, the cost of braces will depend on the position of your teeth and the going rate in the area. Exceptions are made if you have a challenging case, jaw or health-related issues, or are seeking treatment from a specialist who provides cosmetic orthodontics.

But did you know that, in some countries, braces are set at a fixed cost or even covered by universal healthcare? Sometimes, this changes the entire course of treatment. For example, some practitioners select appliance and materials that are based solely on keeping patients in treatment longer! Can you believe?

Thankfully, Dr. Razdolsky and his wife Anna didn't meet such orthodontists on their most recent trip to Spain. However, they did take the time to visit several colleagues overseas to learn about the good standards of practice from international leaders in their field. Just another example of how Dr. Razdolsky explores ways to improve patient care at Forever Smiles.

H2O So Good

October 2nd, 2018

Excessive consumption of sweets can have significant impact on your overall health. But for your oral health, one of the worst things you can do is consume lots of sugar. Why? Bacteria and sugar mix to create toxic acid which gets trapped in leftover food debris or dental appliances in the mouth. This acid can wear away the enamel of your teeth and lead to tooth decay. Even the chemical substances found in diet or sugar-free soft drinks alone can harm your teeth over time.

While brushing your teeth after consuming sugary foods or drinks can help, it’s equally as easy to prevent cavities and tooth decay if you just avoid soda, energy or sports drinks and switch to water. Just how much sugar can you avoid in one 16-ounce drink? Let’s look at the numbers...


Coca-Cola          52g Sugar (13tsp)

Sprite                  41g Sugar (10.25tsp)

Fanta                   59g Sugar (14.75tsp)


Red Bull              49g Sugar (2.25tsp)

Gatorade           36g Sugar (9tsp)

Powerade         29g Sugar (7.25tsp)

If you really want to make the best decision for your overall health, drink lots of water! Plus, tap water is infused with fluoride which helps strengthen your tooth enamel while you stay hydrated. So, next time you’re reaching for that soft drink, think about how much sugar is in it and consider having some healthy H2O instead.

Understanding How Long You’ll Wear Braces

September 18th, 2018

So, your family dentist just referred you to Dr. Razdolsky for braces. Now what? How long will it take for braces to straighten your teeth? From gaps to overbites, to teeth or jaw alignment there are many factors that can affect the duration a patient will need to wear braces. Read on to learn what you can expect.

The short answer? It depends.

There are many factors that determine the amount of time a person must wear braces including age, type of treatment and individual needs or issues that should be addressed. The latter factors have the greatest impact on duration, as a patient’s issues could be as simple as minor adjustment, or as major as jaw realignment.

While the time it takes for braces to do their thing varies greatly by patient, after an initial evaluation and consultation, Dr. Razdolsky can help you better understand the amount of time that may be required for your unique case. So, when your dentist says it’s time to begin treatment, Dr. Razdolsky and the Forever Smiles team will schedule your initial exam and you can have a better idea of what to expect.

Now that you know the short answer, let’s discuss the details…

At your initial appointment, Dr. Razdolsky will do a thorough oral and facial new patient examination to assess overall oral health and your unique orthodontic needs. Depending on this assessment a CBCT scan, facial photographs, digital impressions and/or x-rays may also be taken. Review and recommendation for your patient treatment program is provided upon a second appointment. This ensures Dr. Razdolsky and his team have had ample opportunity to evaluate all the data collected. It is at this treatment conference Dr. Razdolsky will review your orthodontic records, and show you examples of braces, clear aligners or any appliances that may be involved in your prescribed course of treatment. Also at that appointment, Dr. Razdolsky can answer questions specific to your case, as well as talk about the anticipated duration of your treatment.

On average, how long do braces take to work?

The average orthodontic treatment falls somewhere between 16-18 months, but can sometimes take as long as 24 months, or even more. Be wary of promises from anyone who says you can have a straight smile in only six months. While some patients may think they only need to close a gap, treatment in less than six months is fairly rare. What some patients may not see or know is whether their bite is appropriately aligned, the airway is properly open or is the palate formed correctly. These are the hidden maladies that can impact long term oral and systemic health. Only a qualified orthodontist like Dr. Razdolsky has the experience necessary to ensure you have the best results.

In cases of adult braces, the average length of treatment can be a bit longer than for children. Again, the actual time depends on the patient’s specific needs but since adult teeth have stopped growing and are set, they require more pressure to move. This means many adult patients can look to have braces anywhere from 18 months to about three years.

I hear some kids have to wear braces even longer!

Could be. In some cases, a younger patient may have a major alignment problem, such as a tooth coming in in the wrong place. In that case it could require tooth extraction and waiting for others to come in. Depending on the wait for remaining adult teeth, this process could take considerably longer. The Forever Smiles team can advise you of what to expect in your case.

Can I shorten the time for braces treatment?

Maybe. A patient who carefully follows treatment instructions can increase the likelihood they get their braces off sooner. This can be something as simple as maintaining proper oral hygiene or, in the case of aligners or removable appliances such as bands, wearing them for the full prescribed treatment time every day.

Patients should also practice proper eating habits while wearing braces. This includes avoiding sticky or hard food like gum, corn, popcorn, hard pretzels or chips and most candy, as this can improve the treatment time. Broken or missing brackets can stretch out the time required for treatment.

Finally, not everyone realizes how much more challenging it is to brush your teeth with braces, but doing it properly is very important. The good news is there are techniques for proper brushing that can also help to ensure your treatment plan stays on track. Dr. Razdolsky and the Forever Smiles team have some information which can help you understand the best way to take care of your braces at home and at school or work.

It is important to note, regardless of how long your treatment is scheduled to last, the time a patient is required to wear braces does not include the post-treatment retainer that’s necessary to ensure your Forever Smile lasts a lifetime.

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