Kristin Cavallari's flawless smile has been featured on TV, film and magazine covers. But the 25-year-old actress and reality-show personality didn't always have a perfect set of teeth. In fact, she told Dear Doctor magazine — where readers recently voted to crown her with the “Smile of the Year” award — that her dental treatments began the same way many do: with orthodontics in sixth grade.

“I had the ‘spaghetti catcher,’ which is what everyone used to call it,” she reminisced. But by that, she didn't mean a strainer — she's talking about what dentists call a “palatal expander.”

In case you're not familiar with this orthodontic device, a palatal expander takes advantage of the natural growth patterns of a child's upper jaw to create additional space for the top set of teeth. How does it work? Basically, it's similar to braces: By applying gentle pressure, the appliance creates changes in the jaw. Unlike braces, however, it's invisible — it fits between the upper teeth, close to the roof of the mouth.

During the three to six months a child wears the palatal expander, it pushes the left and right halves of the upper jawbone apart, and then maintains and stabilizes the new, wider spacing. Since the palatal bones don't fuse until after puberty, tightening it a little bit each day for the first few weeks provides a quick and painless method of making the upper jaw a bit roomier. And that can be a very good thing. Why?

There are lots of reasons. For one, it can relieve the condition called “crowding,” when there is not enough space in the upper jaw to accommodate the proper alignment of the permanent teeth. In the past, teeth often had to be extracted in that situation. It may even allow “impacted” teeth — ones which are blocked from erupting by other teeth — to come in normally.

It can help treat a “crossbite,” when the back top teeth come down to bite inside (instead of outside) the lower back teeth. It also generally shortens the total time a child needs for orthodontic treatment. That's good news for any teenager — even if their own day-to-day “reality show” isn't featured on TV!

If you would like more information about palatal expanders, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Palatal Expanders” and “Early Orthodontic Evaluation.”

Finally: Your braces are off! Break out the taffy, bubble gum, corn on the cob... and... whoa!!... the retainer?

Yes, the retainer. As the name implies, this simple device will ensure that your pearly whites remain in the new, desired position you've worked so diligently to achieve. Here's why:

The same physiological properties that allow your teeth to move when you're wearing braces are always at work — braces simply direct that movability in controlled ways. Teeth are not set into your jaw bone like posts fixed in concrete; rather, the root portion is attached to the bone by elastic periodontal (peri – around; odont – tooth) ligaments that permit micromovement of teeth all the time. The periodontal tissues are living; therefore, they are always changing and “remodeling” (just as hair grows, skin peels, etc.) When a light orthodontic force is placed on a tooth the following processes occur:

• on the pulling or tension side, the periodontal ligament will activate bone-forming cells (osteoblasts) to deposit new bone to fill in the area from where the tooth was previously, and
• on the pressure side, the periodontal ligament will activate bone-resorbing cells (osteoclasts) to remove bone allowing the tooth to move in that direction.

Visualize drawing your hand forward through water: The water parts in front of your hand and fills in behind it.

Once your teeth are in their desired position and your braces are removed, your teeth will tend to return to their old position if they are not stabilized or “retained” in their new one long enough for the bone and ligament to re-form and mature around them. This can take several months. In addition, orthodontic treatment stretches collagen fibers in gum tissues to some extent, contributing to the forces that tend to shift teeth back in the direction from which they came. The gum tissues will continue to exert this pressure until these tissues remodel. This can take longer than the bone and ligament stabilization, as collagen cells reorganize at a much slower rate.

Types of Retainers

The type of retainer you will use, how frequently and for how long will depend on your unique situation. The most familiar type of retainer is removable and one you may not have to wear all the time, at least after the first couple of months. In cases where the retainer is going to be needed for a long-term period, a common alternative is to have thin retainer wires bonded to the inside surfaces of the front teeth so they don't show.

Considering how much time, effort, and sometimes expense is required in improving your smile, the retainer is your assurance that it was all well spent. Even people getting a comparatively simple pedicure/manicure don't leave the salon without letting the polish dry!

If you would like more information about orthodontics and retainers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.”

We're always tickled to see dentists represented in popular culture, especially when portrayed by an actor as handsome as John Stamos. On the hit television show Glee, Stamos played a dentist who made sure the glee club members cleaned up their act when it came to oral hygiene — though perhaps he used a bit too much anesthesia to achieve this admirable goal. While under his care — and lots of sedation — several Glee characters had music-infused hallucinations in which they danced and sang with pop star Britney Spears.

Far-fetched? No doubt. Still, it's worth mentioning that sedation has its place in dentistry. In fact, if you are someone who tends to get anxious or even fearful about dental treatment, you should know that sedation can help you relax both mind and body so you can feel peaceful rather than anxious in the dentist's chair. And that's the whole point: Fear of pain should not stand in the way of your getting the care that will keep you healthy and allow you to keep your teeth for as long as possible.

You may not know this, but when you are afraid, your threshold for pain is actually lower. You become hypersensitive to every sensation and sound, and you tense your muscles. Fear and anxiety trigger the release of certain chemicals that put you in “fight or flight” mode. In this heightened state of alert you experience more pain during and even after treatment.

The good news is that this response can virtually be eliminated with various oral sedatives and/or with nitrous oxide, which is inhaled. Both treatments will allow you to let your guard down and relax. Your apprehension and hypersensitivity to pain will disappear, even though you are still conscious. And when you are relaxed, we are better able to focus on the task at hand, knowing that you are comfortable.

The sedatives used in dentistry have been subjected to rigorous testing and have a strong safety record backed by decades of use. Several even have “amnesic” properties, meaning that you will remember little to nothing of your treatment — unless, of course, you end up singing and dancing with Britney Spears!

If you would like more information about sedation in dentistry, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Oral Sedation Dentistry.” Dear Doctor also has more on “Overcoming Dental Fear & Anxiety.”

Some people are planners, and others just go with the flow. Some spend all winter in the gym, and others try and lose ten pounds right before beach season. Some have every detail of their wedding day planned out months in advance, and others... don't.

No matter which kind of person you are, you'll want to look your best for your wedding day. And that includes sporting a bright, healthy-looking smile. Depending how much time you have beforehand, there's a range of dental treatments that can help you look and feel great — not just that day, but every day. Here's a rundown of what you can do in the time remaining before your big day.

Time Left: Up to two years. If you've planned this far in advance, congratulations! You probably have time for almost any needed dental treatment — including orthodontics, which can straighten misaligned teeth and correct a bad bite. But even if you don't have quite so much time, don't despair: Clear aligners and tooth-colored or tongue-side braces, if recommended, can make orthodontic appliances nearly invisible.

Time Left: Six months to one year. Many dental treatments, like periodontal plastic surgery or tooth implants, can achieve remarkable results in this time. Periodontal surgery can give you a less “gummy” smile and greatly improve the aesthetics of your teeth. Tooth implants are modern dentistry's best option for replacing missing teeth. Natural-looking implants have a success rate of 95%, and can last a lifetime.

Time left: Three or four months. There's plenty you can do! If the roots are intact, a crown can be placed on a damaged tooth to restore its appearance and function. Or, missing teeth can be replaced via bridgework, which supports a false tooth from abutments on either side. Stained or discolored teeth can also be dramatically lightened with veneers, where a porcelain shell replaces the tooth's outermost layer of enamel. Tooth implants are still a possibility, under the right circumstances. We can evaluate your individual situation and come up with the best option to replace missing teeth.

Time left: Six weeks or so. You still have time for some basic, yet effective, treatments. Small chips or discolored fillings can be restored with tooth-colored materials that securely bond to the teeth themselves. You can also brighten your teeth by several shades using the techniques of bleaching. In-office whitening treatments are the fastest, but take-home kits, used under our supervision, offer similar results in a longer time.

Have even less time? At the very least, come in for a thorough cleaning right before the date! This will help remove many surface stains and freshen up your smile. Be sure to call in advance so that you're able to get an appointment. Then, smile for the camera!

If you would like more information about a wedding-day smile makeover, please contact us or schedule an appointment to discuss your treatment options. You can learn more in the Dear Doctor magazine article “Wedding Day Smiles.”

It is not often that you find a celebrity who is willing to speak candidly about any cosmetic or restorative dentistry that he or she has had. Instead, most prefer that their fans just assume that their dazzling “Hollywood” smile is something that just happened naturally. However, that is not the case with Kathy Ireland, the former Sports Illustrated cover girl, current business mogul and founder of kathy ireland Worldwide, a billion dollar marketing and design firm. In a Dear Doctor magazine cover story she talks openly about her dental experiences, injuries and treatment so that people worldwide can understand what may be possible for them.

For Kathy, it happened several years ago when she was playing with her husband and children in their driveway. Kathy decided that she would stand in her children's wagon and surf across their driveway. Instead, she ended up “face-planting,” as she describes it, in a freak accident that left her with a broken nose, split forehead and several broken teeth. She recalls that it sounded like a watermelon had smashed. Luckily, her husband, an emergency room physician, was on hand to care for her. Kathy is just as thankful to her cosmetic and restorative dentist who restored her trademark smile with some veneers and a dental implant. Today, the only reminder she has from this accident is a small scar on her nose that she covers with a little makeup.

You would think that this accident would be enough trauma for one person; however, Kathy describes an earlier accident where she knocked out a tooth and then later knocked it loose again. Kathy also wanted to take the time to let readers know that her dental implant experiences were “pretty easy.” She did recall, “hearing all the sounds while all of it was going on” and then added, “but I have to tell you, that after being a mom and having kids, going to the dentist...is like going to the spa!” She said that she has even fallen asleep in the dental chair.

To learn more about Kathy Ireland, continue reading the Dear Doctor magazine article “Kathy Ireland.” Or if you think cosmetic or restorative dentistry is right for you, contact us today to schedule an appointment to discuss your specific goals.