Dr Sylvia Tan

Hello, I normally recommend whitening AFTER the braces have been removed. If you are planning to get fixed braces, the braces will cover parts of your teeth and therefore the whitening product will not be able to work on those areas. Similarly, if you are undergoing Invisalign treatment, attachments (ie Bonding of 'bumps' to your teeth) will prevent the whitening agent from working around those areas. I feel that whitening treatment will be more successful once the braces are removed. I hope this helps. Good luck!

There are normally two phases to treat children with crowded teeth. The first phase is what we call the 'interceptive' phase where children are seen as young as 8-9 years old to determine if an expander is needed to expand the jaws and encourage teeth to erupt in a better position. Hopefully this may prevent any teeth extraction due to crowding later on. Some children may not need this phase and hence they can move directly into the second phase.

These are my instructions to my patients when I fit their clear retainers for them: - Rinse them with cold water every time you take them out of the mouth, if you wear them during the day time, you have to clean them after every meal too - Use a medium toothbrush to physically scrub the retainers (both inside and out) - Do not use toothpaste as it may scratch the surface - You may buy specialised retainer cleaner e. g. Retainer Brite Bearing this in mind, the clear retainers can be made using different types of materials and it is best to ask your own orthodontist what his/her regime is.

Thank you for your query. It depends on what you mean by improvement of the nasio-labial lines. If the nasio-labial line is deepened because there is lack of support from your smile and your teeth are collapsed inwards, then braces may help improve these lines. Braces can be used to straighten your teeth and improve your smile arc which 'should' improve the naso-labial lines. I use the word 'should' as this is very variable between patients. However if your naso-labial lines are not due to collapse of the teeth then braces will not help.

Flared teeth can mean two things: 1. Teeth are flared out because the position of each individual teeth are protruding forwards. In this case, orthodontic treatment will be able to correct the position of the protruding teeth by bringing them backwards. There must be enough space for the teeth to move backwards. 2. Teeth are flared due to the size and shape of the teeth. In this case, you may need to have the teeth reshaped +/- braces to correct the position after. In any case, treatment time required to notice any improvement depends on the severity of the flaring.

Majority of patients will feel some sort of discomfort during the first few days of Invisalign treatment. Thereafter, the 'pain' will tend to subside before the next set of aligners. I wouldn't be completely surprised if you do not feel any discomfort. First and foremost, some patients do have a higher threshold of pain, hence they do not feel anything during aligner treatment. No pain does not necessarily mean no movement. Sometimes it could be that the first few aligners put less pressure hence the level of discomfort is very low.

In some cases, teeth can move back very quickly - these are called high risk relapse cases. This may happen for very rotated teeth, or teeth with gaps in the midline. You could consider asking your orthodontist for a fixed retainer, which is a wire retainer glued to the back of your teeth to help maintain the teeth position, whenever you are not wearing your removal retainers. Good luck! And don't ever stop wearing those retainers.

Your question is one that most of my patients do ask. The key to Invisalign treatment with enamel stripping is very careful planning and in doing so, we avoid any bad side effects for your teeth and gums. Enamel stripping or interproximal reduction, if done safely and carefully, does not cause any harm to your teeth. In fact, research has shown that teeth that have been stripped are not at a higher risk of decay or gum diseases compared to virgin teeth.

If the other half of the decayed tooth is still in the gums it is better to get it extracted. Permanent teeth can sometimes improve its position on its own providing there are no blockages. The best thing is to get an xray done to check that there are no blockages (ie extra tooth or root remnants) that is preventing it from coming down in the correct position. If there are no blockages, the rotated tooth can be corrected with braces later on. I hope this helps. Good luck.

Majority of patients do have swollen gums after their braces have been removed, but most subside after one or two weeks with good oral hygiene. If your gums remain swollen, it is better to let your dentist check to ensure there are no gums diseases or leftover remnants of glue that is irritating the gums. With proper cleaning and maintenance, the gums should subside with time. Good luck and don't forget to wear your retainers!

Most attachments are placed on the outside surfaces of the teeth and the inside of the upper front teeth (to make it invisible when you smile). You mentioned that your attachments are on the inside of the lower front teeth. This sometimes needs to be carried out for more specific reasons such as correcting your bite or jumping a bite. The best person to clarify this is with your Invisalign provider. I hope this helps. Good luck!

The type of braces required will depend on the cause of the open bite. I noted that you mentioned the open bite only after wearing the splint? Both fixed braces and Invisalign treatment can treat open bite cases, but these need proper treatment planning to avoid the bite opening up again. Both type of braces will also help with aligning of the lower teeth. Good luck!

May I know how old your little girl is? You are absolutely right. In most cases, the adult teeth will cause the milk teeth to be mobile and subsequently lost, making space for the adult teeth. In this photo, it looks like the two side adult teeth are erupted but the two front milk teeth are still present. My advice will be to seek an opinion from an orthodontist to check for the reason why this has happened BEFORE extacting the milk teeth. Sometimes it may be because two lower adult teeth are missing and in this case, you might want to keep the baby teeth for as long as possible.

There are some cases where patients have had to wear braces more than once. If done correctly, it really doesn’t pose much harm to your teeth. The treatment options really depend on how big the gap is. Your options are: If gap is small, a removable retainer to close the gap first then a fixed retainer after If gap is bigger, you may need fixed braces or Invisalign You may have also fillings or veneers to close the gap but you will need aesthetic advice as this may make your teeth look ‘bigger’ than normal.

You may find that if your teeth have not relapsed too badly and you only need some minor adjustments, there is an Invisalign lite option. This option is for milder cases and therefore it will require less time and will cost less too. Do consult your orthodontist for an assessment first. I recently saw a lady in her 30s, much similarly to yourself, she was too busy as a working mum to bother with her retainers and her teeth gradually become crowded again. It is very important that the current condition of her teeth, gums and roots are checked before re-starting orthodontic treatment.