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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. Tony Skanchy 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. Tony Skanchy 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. Tony Skanchy 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 Sandy, UT office. A positioner could be an effective, time-saving step on your path to a lifetime of healthy smiles.

Time to brush! So, you make sure you gently brush the plaque off the outside surfaces of your teeth. You want to present a gleaming smile to the world, after all. And you make sure to brush the inside surfaces as well, because who wants to feel a fuzzy patch of plaque every time their tongue hits their teeth? And, naturally, you remember to clean the tops of your molars, because those crevices make them more cavity-prone than any other surface.

Done? Not quite!

You might be surprised to learn that no matter how well you’ve brushed all the visible surfaces of your teeth, you’ve left quite a bit of enamel untouched—the adjoining, or touching, surfaces of the teeth that sit next to each other.

You’ve probably noticed that your bristles can’t . . . quite . . . reach all the enamel between your teeth (especially between your molars!) when you’re brushing. This means that food particles and plaque have an easier time sticking around. And when the bacteria in plaque are left undisturbed, especially with a banquet of food particles available, they produce acids which gradually eat away at the enamel covering our teeth, creating a cavity.

Here’s where we work in some specific dental vocabulary. “Interproximal” means between the adjoining, or touching, surfaces of the teeth. And an interproximal cavity is a cavity that develops on one of those side surfaces of your teeth.

• Preventing Interproximal Cavities

Fortunately, prevention is about as basic as it can be—brushing and flossing effectively. Dentists recommend brushing for two minutes at least twice a day and flossing once each day. While most of us are good about keeping up with brushing, sometimes that daily flossing is more a goal than a reality.

But it’s flossing which really does the trick when it comes to interproximal cleaning. If you floss correctly, food particles and plaque are removed from between the teeth and around the gum line—places where bristles just can’t reach.

When you wear braces, though, flossing isn’t quite so basic. Getting that floss just where it needs to be in between brackets and wires and in between teeth can be a challenge!

The good news is there are many products designed just to make flossing easier while you’re in orthodontic treatment:

• Floss threaders are flexible hoops that help you thread floss behind your wires easily.
• Precut floss strands use a stiff tip at one end for threading floss through wires.
• Interproximal brushes are tiny, cone-shaped brushes which can fit between your teeth and braces for precise cleaning.
• Water flossers eliminate floss altogether, using a pulsing stream of water to clean between and around teeth and braces.

During your next visit to our Sandy, UT office, Dr. Tony Skanchy can give you tips on how to use any of these tools effectively for cleaner teeth and cleaner braces.

Preventing cavities on the exterior surfaces of your teeth is probably pretty much automatic by now, but don’t forget the potential for stealth decay! If we find signs of erosion on the sides of your teeth, or if your hygienist lets you know that you’ve got a lot of interproximal plaque buildup, work with your dental team to make sure “interproximal cavity” doesn’t become a working part of your dental vocabulary.

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. Tony Skanchy 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!

Brackets and wires, clear aligners, lingual braces, regular brackets, self-ligating braces, elastics, spacers—you and your orthodontist have had to narrow down a lot of choices to discover the best treatment for your orthodontic needs. Now that the end of treatment is in sight, there’s one more important choice left—your retainer!

Do I Need a Retainer?

No retainer at all is probably the one option that’s off the table from the start. It’s not just your teeth that have changed position; it’s the bone and ligaments holding them that have changed as well.

A retainer prevents your teeth from moving away from their new, ideal location while your bones and ligaments are stabilizing. This process takes months, so keeping your teeth in place as your bone rebuilds and regains density is crucial.

What Are Your Retainer Options?

Three of the most popular retainer options available at our Sandy, UT office include:

• Hawley Retainers

This is the traditional retainer, with wires to hold your retainer in place and to keep the teeth properly aligned. The wires are attached to an acrylic plate molded to fit the roof of your mouth or around your bottom teeth. You can customize the acrylic base with colors and patterns for a one-of-a-kind look.

Hawley retainers are adjustable, so minor realignments can take place if necessary. The wire in front of your teeth makes these retainers visible, but, after several months of wearing them all day long, you may end up wearing them only at night.

Hawley retainers are removable, so you need to make sure they are safely in a case when you’re not wearing them. Minor damage can often be repaired, but it’s better to be proactive.

• Clear Plastic Retainers

These retainers look like clear aligners. They are formed by heating a thin piece of plastic and vacuum-forming it around a model of your teeth to create a custom, comfortable fit.

Clear retainers are almost invisible when worn, and can be removed when you eat or drink—which they should be, because food particles and liquids can be trapped inside them.

When you’re not wearing it, a clear retainer should always be in its case, because it must be replaced if the plastic is warped, cracked, or broken.

• Fixed Retainers

A fixed retainer is a small single wire bonded to the back of specific teeth, commonly the six bottom front teeth. Because fixed retainers don’t allow the teeth to move at all, they are often recommended for patients who had serious misalignments, extremely crowded teeth, or teeth with large gaps between them.

Many patients like fixed retainers because they keep teeth in perfect alignment, they won’t be seen, they’re comfortably small, and they can’t end up in the cafeteria recycling bin because you forget to replace them after lunch!

Fixed retainers are usually quite durable, but you’ll need to pay attention to your diet, because crunchy and chewy foods can put pressure on the retainer and damage it. These retainers also require special care with brushing and flossing, to make sure the teeth bonded to the wire stay clean and plaque-free.

The Right Retainer

The process of stabilizing your teeth in the jaw takes time. Choosing your retainer will depend in part on how long and how often you need to wear it: fulltime for months or for years, at night after several months of day-and-night wear, or long-term to make sure your orthodontic work lasts.

And there are other variables, as well. Your retainer might need to be removable. It might need to be adjustable. You might need a retainer for just your upper teeth, just your lower teeth, or both. All these factors and more need to be taken into consideration before deciding on your ideal retainer.

Fixed, removable, wire, plastic, colorful, clear—which retainer is right for you? The one that helps you retain the beautiful smile you’ve worked for all these months. Talk to Dr. Tony Skanchy to discover the retainer that will protect that smile for years to come.