<?xml version="1.0" encoding="UTF-8"?>
<rss version="2.0"
	xmlns:content="http://purl.org/rss/1.0/modules/content/"
	xmlns:wfw="http://wellformedweb.org/CommentAPI/"
	xmlns:dc="http://purl.org/dc/elements/1.1/"
	xmlns:atom="http://www.w3.org/2005/Atom"
	xmlns:sy="http://purl.org/rss/1.0/modules/syndication/"
	xmlns:slash="http://purl.org/rss/1.0/modules/slash/"
	xmlns:itunes="http://www.itunes.com/dtds/podcast-1.0.dtd"
	>

<channel>
	<title>The Smile Journal - Invisalign and Braces Cumming &#38; Johns Creek GA (Georgia)</title>
	<atom:link href="http://thesmilejournal.com/feed/" rel="self" type="application/rss+xml" />
	<link>http://thesmilejournal.com</link>
	<description>Orthodontist Atlanta GA Braces and Invisalign Walton Orthodontics</description>
	<lastBuildDate>Wed, 18 Jan 2012 12:22:31 +0000</lastBuildDate>
	<language>en</language>
	<sy:updatePeriod>hourly</sy:updatePeriod>
	<sy:updateFrequency>1</sy:updateFrequency>
	
		<copyright></copyright>
		<itunes:author></itunes:author>
		<itunes:summary>Just another WordPress site</itunes:summary>
		<itunes:explicit>No</itunes:explicit>
		<itunes:block>No</itunes:block>
		
		<item>
		<title>When Should I Start Seeing Results from Invisalign?</title>
		<link>http://thesmilejournal.com/2009/04/13/see-results-invisalign/</link>
		<comments>http://thesmilejournal.com/2009/04/13/see-results-invisalign/#comments</comments>
		<pubDate>Tue, 14 Apr 2009 03:44:05 +0000</pubDate>
		<dc:creator>Dr Walton</dc:creator>
				<category><![CDATA[General Discussion]]></category>
		<category><![CDATA[Alpharetta]]></category>
		<category><![CDATA[Braces]]></category>
		<category><![CDATA[Invisalign Results]]></category>
		<category><![CDATA[treatment time]]></category>

		<guid isPermaLink="false">http://thesmilejournal.com/?p=327</guid>
		<description><![CDATA[<p><a  title="Custom Offer For You-Request Appointment" href="http://www.myprojectcenter.net/redeem.php?preview=&#038;coupon_id=260" target="_blank"><img class="alignright" style="margin-left: 10px;" src="http://thesmilejournal.com/wp-content/uploads/2009/04/smalllogo1.jpg" alt="Alpharetta Orthodontist Image" width="200" height="80" /></a>Firstly, Invisalign is a fabulous system. The <a  class="underline" title="Invisalign Advantages" href="/thesmilejournal.com/invisalign-braces-advantages-reviewed/" target="_self">advantages of Invisalign</a> are many. However, it works in a totally different way than normal braces does. It &#034;pushes&#034; teeth. The Invisalign aligner tray fits snugly over the teeth and imparts a pushing force against the teeth to cause them to move. Similar to squeezing a water melon seed out from between your index finger and thumb. As such, tooth movement with Invisalign needs to be planned out precisely. This implies that not all teeth are moving at the same rate or speed. Some teeth won&#039;t be moving at all.</p>
<p><a  href="http://thesmilejournal.com/2009/04/13/see-results-invisalign/" class="more-link">Read more on When Should I Start Seeing Results from Invisalign?&#8230;</a></p>


]]></description>
			<content:encoded><![CDATA[<p><a  title="Custom Offer For You-Request Appointment" href="http://www.myprojectcenter.net/redeem.php?preview=&#038;coupon_id=260" target="_blank"><img class="alignright" style="margin-left: 10px;" src="http://thesmilejournal.com/wp-content/uploads/2009/04/smalllogo1.jpg" alt="Alpharetta Orthodontist Image" width="200" height="80" /></a>Firstly, Invisalign is a fabulous system. The <a  class="underline" title="Invisalign Advantages" href="/thesmilejournal.com/invisalign-braces-advantages-reviewed/" target="_self">advantages of Invisalign</a> are many. However, it works in a totally different way than normal braces does. It &#034;pushes&#034; teeth. The Invisalign aligner tray fits snugly over the teeth and imparts a pushing force against the teeth to cause them to move. Similar to squeezing a water melon seed out from between your index finger and thumb. As such, tooth movement with Invisalign needs to be planned out precisely. This implies that not all teeth are moving at the same rate or speed. Some teeth won&#039;t be moving at all.</p>
<p><span id="more-327"></span></p>
<p>Generally the hardest tooth to move ( customarily the most crooked or twisted tooth ) is going to be staged to move the slowest. Thus , it could take longer with invisalign to see correction in certain problem areas. You&#039;ll usually see faster primary results with braces because all teeth are moving in a comparatively random manner at the same time. Even teeth that are straight, at first are moved out of alignment with braces by the more crooked teeth only to be moved back to their or original position later on in treatment. In orthodontic circles, this less than desirable mode of treatment is named &#034;round tripping&#034;. This isn&#039;t faulty treatment&#8230;it is just the way teeth react to braces and wires. Due to this inherent inefficiency in standard braces, Invisalign treatment often ends up taking less time to finish. I know this does not make sense but our average invisalign case takes roughly twelve months or so to finish. Obviously, more complicated cases are going to take longer.</p>
<p>Full braces cases average eighteen months to 2 years. Please note that there are limitations associated in any treatment option. It is crucial for patients to ask queries so that their treatment goals are met.</p>
<p>Dr. Matt Walton &#8211; <a  class="underline" title="Alpharetta Orthodontist Website" href="http://www.drwalton.com" target="_blank">Alpharetta Orthodontist</a><br />
<a  href="http://thesmilejournal.com/wp-content/uploads/2009/04/smalllogo1.jpg" class="thickbox no_icon" rel="gallery-327" title="smalllogo1"><img class="size-medium wp-image-333" title="smalllogo1" src="http://thesmilejournal.com/wp-content/uploads/2009/04/smalllogo1.jpg" alt="Alpharetta Orthodontist Image" width="200" height="80" /></a></p>
<table border="0">
<thead><strong>Related Articles:</strong></thead>
<tbody>
<tr>
<td><a  class="underline" href="http://thesmilejournal.com/invisalign-teen-introduced/" target="_self">Invisalign For Teenagers</a></td>
</tr>
</tbody>
</table>


]]></content:encoded>
			<wfw:commentRss>http://thesmilejournal.com/2009/04/13/see-results-invisalign/feed/</wfw:commentRss>
		<slash:comments>16</slash:comments>
		</item>
		<item>
		<title>Benefit Of Braces: Study Finds Smile As &quot;Most Attractive&quot; Physical Feature In Others</title>
		<link>http://thesmilejournal.com/2009/04/05/benefit-braces-study-finds-smile-attractive-physical-feature/</link>
		<comments>http://thesmilejournal.com/2009/04/05/benefit-braces-study-finds-smile-attractive-physical-feature/#comments</comments>
		<pubDate>Mon, 06 Apr 2009 00:27:06 +0000</pubDate>
		<dc:creator>Dr Walton</dc:creator>
				<category><![CDATA[Dental Topics]]></category>
		<category><![CDATA[General Discussion]]></category>
		<category><![CDATA[Oral Hygeine]]></category>
		<category><![CDATA[Physical Trait]]></category>
		<category><![CDATA[Smile]]></category>
		<category><![CDATA[Survey]]></category>

		<guid isPermaLink="false">http://thesmilejournal.com/?p=219</guid>
		<description><![CDATA[<h1>The Smile: Number One Most Important Physical Trait</h1>
<p><a  href="http://thesmilejournal.com/wp-content/uploads/2009/04/smile030.jpg" class="thickbox no_icon" rel="gallery-219" title="Braces Smile Image"><img class="alignleft size-small wp-image-315" style="margin-right: 10px; margin-bottom: 5px;" title="Braces Smile Image" src="http://thesmilejournal.com/wp-content/uploads/2009/04/smile030-293x300.jpg" alt="" width="30%" height="30%" /></a>A national survey from the ADA, Crest, and Oral B discovered that the smile is what most folks find most engaging in others. The smile outranked eyes, hair, and the body as the most fascinating physical feature in others. Though males and females both ranked the smile as the most appealing feature in others, the genders differed when it came to looking after their teeth and gums. Of the representative sample surveyed, 86% of women vs. only 66% men said that they brush their teeth twice or more daily while only 49% of those surveyed declared they floss their teeth once every day or more. &#034;We need to constantly get the word out how crucial it is to keep on top of your oral health,&#034; announces Ada Cooper, DDS, an ADA consumer advocate and practicing dentist.</p>
<p><a  href="http://thesmilejournal.com/2009/04/05/benefit-braces-study-finds-smile-attractive-physical-feature/" class="more-link">Read more on Benefit Of Braces: Study Finds Smile As &#034;Most Attractive&#034; Physical Feature In Others&#8230;</a></p>


]]></description>
			<content:encoded><![CDATA[<h1>The Smile: Number One Most Important Physical Trait</h1>
<p><a  href="http://thesmilejournal.com/wp-content/uploads/2009/04/smile030.jpg" class="thickbox no_icon" rel="gallery-219" title="Braces Smile Image"><img class="alignleft size-small wp-image-315" style="margin-right: 10px; margin-bottom: 5px;" title="Braces Smile Image" src="http://thesmilejournal.com/wp-content/uploads/2009/04/smile030-293x300.jpg" alt="" width="30%" height="30%" /></a>A national survey from the ADA, Crest, and Oral B discovered that the smile is what most folks find most engaging in others. The smile outranked eyes, hair, and the body as the most fascinating physical feature in others. Though males and females both ranked the smile as the most appealing feature in others, the genders differed when it came to looking after their teeth and gums. Of the representative sample surveyed, 86% of women vs. only 66% men said that they brush their teeth twice or more daily while only 49% of those surveyed declared they floss their teeth once every day or more. &#034;We need to constantly get the word out how crucial it is to keep on top of your oral health,&#034; announces Ada Cooper, DDS, an ADA consumer advocate and practicing dentist.</p>
<p>Walton Orthodontics &#8211; <a  class="underline" title="Alpharetta Orthodontist Website" href="http://www.drwalton.com" target="_blank">Alpharetta Orthodontist</a></p>


]]></content:encoded>
			<wfw:commentRss>http://thesmilejournal.com/2009/04/05/benefit-braces-study-finds-smile-attractive-physical-feature/feed/</wfw:commentRss>
		<slash:comments>9</slash:comments>
		</item>
		<item>
		<title>Invisalign Advantages:  Invisalign vs. Braces vs. Veneers</title>
		<link>http://thesmilejournal.com/2009/03/17/invisalign-braces-advantages-reviewed/</link>
		<comments>http://thesmilejournal.com/2009/03/17/invisalign-braces-advantages-reviewed/#comments</comments>
		<pubDate>Tue, 17 Mar 2009 19:33:33 +0000</pubDate>
		<dc:creator>Dr Walton</dc:creator>
				<category><![CDATA[Dental Topics]]></category>
		<category><![CDATA[Invisalign Braces]]></category>
		<category><![CDATA[Orthodontic Topics]]></category>
		<category><![CDATA[Braces]]></category>
		<category><![CDATA[Invisilign]]></category>
		<category><![CDATA[Invisiline]]></category>
		<category><![CDATA[Teeth]]></category>
		<category><![CDATA[Veneers]]></category>

		<guid isPermaLink="false">http://thesmilejournal.com/?p=245</guid>
		<description><![CDATA[<h1>Invisalign: The Premiere Choice For A Smile Makeover</h1>
<p>Why should <strong>Invisalign</strong> or <strong><a  class="underline" title="Invisalign Teen Information" href="http://thesmilejournal.com/invisalign-teen-introduced/" target="_self">Invisalign for Teens</a></strong> be a one of your top considerations for a smile makeover? It&#039;s easy to see <strong>Invisalign&#039;s advantages </strong>over other established procedures commonly used in smile makeovers. The advantages of Invisalign will, more than likely, give you a reason to smile.</p>
<p><a  href="http://thesmilejournal.com/2009/03/17/invisalign-braces-advantages-reviewed/" class="more-link">Read more on Invisalign Advantages:  Invisalign vs. Braces vs. Veneers&#8230;</a></p>


]]></description>
			<content:encoded><![CDATA[<h1>Invisalign: The Premiere Choice For A Smile Makeover</h1>
<p>Why should <strong>Invisalign</strong> or <strong><a  class="underline" title="Invisalign Teen Information" href="http://thesmilejournal.com/invisalign-teen-introduced/" target="_self">Invisalign for Teens</a></strong> be a one of your top considerations for a smile makeover? It&#039;s easy to see <strong>Invisalign&#039;s advantages </strong>over other established procedures commonly used in smile makeovers. The advantages of Invisalign will, more than likely, give you a reason to smile.</p>
<p>Comfort, esthetics, and treatment time have always been the primary concerns for the adult patient when it comes to orthodontic treatment. Invisalign, when compared to other teeth straightening options, has been shown to solve many of these concerns.</p>
<p><span id="more-245"></span></p>
<p>To see if Invisalign is right for you please contact <a  class="underline" title="Walton Orthodontics Website" href="http://www.drwalton.com" target="_blank">Alpharetta Orthodontist</a>, Dr. Matt Walton at Walton Orthodontics for a complimentary consultation.</p>
<table style="border-color: black;" border="1">
<tbody></tbody>
</table>
<table style="width: 100%;" border="1" cellpadding="10">
<tbody>
<tr style="background-color: #ec8101; color: white;">
<th> </th>
<th>Invisalign®</th>
<th>Metal Braces</th>
</tr>
<tr>
<th style="background-color: #f9d9b2;">How does it work?</th>
<td>Invisalign® uses a series of clear removable aligners to straighten your teeth without braces, metal wires or brackets</td>
<td>Metal braces use wires and brackets to pressure your teeth into straighter alignment.</td>
</tr>
<tr>
<th style="background-color: #f9d9b2;">Nearly invisible</th>
<td style="font-size: 32; color: #ec8101; text-align: center;">YES</td>
<td>No. Metal braces are usually noticeable</td>
</tr>
<tr>
<th style="background-color: #f9d9b2;">Removable during treatment</th>
<td style="font-size: 32; color: #ec8101; text-align: center;">YES</td>
<td>No. You cannot remove braces until treatment is completed</td>
</tr>
<tr>
<th style="background-color: #f9d9b2;">Treatment doesn&#039;t involve metal that can irritate teeth and gums.</th>
<td style="font-size: 32; color: #ec8101; text-align: center;">YES</td>
<td>No. The metal wires and brackets used with braces can cause mouth irritation or <a  class="underline" title="Nickel Allergy in Orthodontics" href="http://thesmilejournal.com/facts-nickel-allergy-orthodontics/" target="_self">allergic reaction</a>.</td>
</tr>
<tr>
<th style="background-color: #f9d9b2;">Allows you to brush and floss normally during treatment</th>
<td style="font-size: 32; color: #ec8101; text-align: center;">YES</td>
<td>No. Braces hinder the ability to reach the entire tooth/gum area when brushing and flossing.</td>
</tr>
</tbody>
</table>
<h1>What About Veneers or Instant Orthodontics?</h1>
<p><strong>Veneers</strong>have been used for a long time to address many cosmetic dental concerns. Invisalign and veneers cannot necessarily be compared directly with each other even though they address many of the same problems. Veneers are considered a &#034;quick fix&#034; for a whole host of dental issues including crowding, gaps between teeth, overlapping of teeth, irregular alignment, discoloration, tooth-size discrepancies, etc. However, there are some significant drawbacks to veneers.</p>
<h1>Drawbacks To Veneers</h1>
<p>Veneers have several drawbacks:</p>
<ol>
<li>The entire front surface of the tooth&#039;s enamel is permanently removed to accommodate the veneer, which is a thin piece of porcelain or plastic that is glued onto the front of your tooth. This process is irreversible.</li>
<li><strong><em>Veneers Are Not A Permanent Solution.</em></strong> Because veneers are made of ultra thin materials, they have a tendency to chip or break requiring them to be replaced on an individual basis which can be expensive.</li>
<li>Veneers have a limited life span. Even if they don&#039;t break or chip, veneers routinely have to be replaced every 5 to 10 years depending on the quality of the veneer and the dentist&#039;s preparation. At this point, patients have no choice but to replace their veneers, incurring significant costs every time the veneers are replaced.</li>
<li>Veneers are not always the best cosmetic choice. A great deal of technical and dental skill is required to get acceptable results. In some instances, veneers can actually result in unacceptable cosmetic results especially when trying to mask misaligned or gapped teeth.</li>
<li>Most importantly, veneers are purely cosmetic&#8230;they are simply a mask or facade for teeth. They do not correct the intrinsic health problem of the tooth. Instead of straightening teeth as Invisalign does, veneers simply cover up the imperfection.</li>
</ol>
<h2>Final Thoughts</h2>
<p>The major advantage of Invisalign is that it is virtually impossible to see while it is being worn and at the same time it is taking care of alignment and crowding problems that could be affecting the overall health of your teeth. It is not faster than getting veneers, but over a lifetime Invisalign is a much better value since it does not have to be redone over and over again.</p>
<p>Even if veneers are needed, for whatever reason, properly aligning the teeth with Invisalign can decrease the total number of veneers needed and/or improve the appearance of veneers placed by closing gaps, reducing crowding and more ideally aligning teeth. This can result in a significant cost savings. So, before you go to the dentist for veneers, see Dr. Walton for a free consultation to review your options for avoiding veneers or at least limiting them.</p>
<p>Dr. Matt Walton &#8211; Walton Orthodontics- <a  class="underline" title="Walton Orthodontics Website" href="http://www.drwalton.com" target="_blank">Alpharetta Orthodontist</a></p>
<hr />
<h6>Alpharetta Invisalign Invisible Braces Orthodontist Dentist, Dr. Matt Walton serves the following surrounding communities: North Fulton County, Johns Creek, Duluth, GA, Cumming, Forsyth County, Suwannee, Milton, Roswell, Norcross, Woodstock, Dunwoody, Marrietta</h6>


]]></content:encoded>
			<wfw:commentRss>http://thesmilejournal.com/2009/03/17/invisalign-braces-advantages-reviewed/feed/</wfw:commentRss>
		<slash:comments>7</slash:comments>
		</item>
		<item>
		<title>Atlanta-Alpharetta Teeth Whitening-Bleaching $195</title>
		<link>http://thesmilejournal.com/2009/02/17/atlantaalpharetta-teeth-whiteningbleaching-195/</link>
		<comments>http://thesmilejournal.com/2009/02/17/atlantaalpharetta-teeth-whiteningbleaching-195/#comments</comments>
		<pubDate>Tue, 17 Feb 2009 18:21:29 +0000</pubDate>
		<dc:creator>Dr Walton</dc:creator>
				<category><![CDATA[General Discussion]]></category>
		<category><![CDATA[Alpharetta]]></category>
		<category><![CDATA[Atlanta]]></category>
		<category><![CDATA[laser teeth whitening]]></category>
		<category><![CDATA[Teeth Bleaching]]></category>
		<category><![CDATA[Teeth Whitening]]></category>
		<category><![CDATA[teeth whitening gel]]></category>
		<category><![CDATA[teeth whitening trays]]></category>

		<guid isPermaLink="false">http://thesmilejournal.com/?p=202</guid>
		<description><![CDATA[<h2 style="text-align: center;">Walton Orthodontics Offers Teeth Whitening Special Value</h2>
<p>Thats right, <strong>Teeth Whitening</strong> for a short time only!  Walton Orthodontics is offering a Teeth Whitening system for only $195. That includes both upper and lower arches. It also includes the Teeth Whitening trays.</p>
<p><a  href="http://thesmilejournal.com/2009/02/17/atlantaalpharetta-teeth-whiteningbleaching-195/" class="more-link">Read more on Atlanta-Alpharetta Teeth Whitening-Bleaching $195&#8230;</a></p>


]]></description>
			<content:encoded><![CDATA[<h2 style="text-align: center;">Walton Orthodontics Offers Teeth Whitening Special Value</h2>
<p>Thats right, <strong>Teeth Whitening</strong> for a short time only!  Walton Orthodontics is offering a Teeth Whitening system for only $195. That includes both upper and lower arches. It also includes the Teeth Whitening trays.</p>
<p>We will schedule you to come into our <a  title="Contact and Directions Info" href="http://www.drwalton.com/contact.asp" target="_blank">Alpharetta Office</a> for teeth impressions from which we will fabricate your custom teeth whitening bleaching trays. We use only the finest take-home Teeth Whitening system: Nite White® from Discus Dental. <em><span style="color: #ff6600;">To take advantage of this Special Offer mention the code <span style="color: #0000ff;">&#034;Smile&#034; </span>to our receptionist or enter it in the form after clicking the &#039;5 Smiling Faces&#039; image below.</span></em></p>
<p style="text-align: center;"><a  title="Enter Special Code &quot;Smile&quot; in Form" href="http://www.myprojectcenter.net/redeem.php?preview=&#038;coupon_id=260" target="_blank"><img class="alignnone size-full wp-image-206" title="bleaching-ad1" src="http://thesmilejournal.com/wp-content/uploads/2009/02/bleaching-ad1.jpg" alt="" width="500" height="220" /></a></p>
<h1><span id="more-202"></span></h1>
<h1>Plus EXTRA Added Value of a Retainer &#8211; No Extra Charge!</h1>
<p>Yes, that&#039;s right. A retainer to retain your present tooth alignment is included. The Teeth Whitening trays we use are made from the exact same material that is used to fabricate retainers to hold teeth alignment following orthodontic treatment. I know, you are telling yourself: &#034;I am not getting braces nor do I want them&#8230;why should I need a retainer?&#034; The answer to this is, if you have noticed it or not, your teeth are in a constant state of change throughout your lifetime. They are probably not in the same alignment that they were years ago. In other words, they are gradually shifting all the time. The Teeth Whitening or bleaching trays we provide you can double as a set of retainers to prevent your teeth from shifting any more. These are &#034;clear&#034;, sturdy, custom-fit trays that fit your teeth like a &#039;slip-cover&#039;. These are not those flimsy trays you get at the dentist office.</p>
<h2 style="text-align: center;"><a  title="Contact Dr. Walton" href="http://www.drwalton.com/contact.asp" target="_blank">Call Now! 770-663-0955</a></h2>
<h3>Please review video below for considerations before teeth whitening procedures.</h3>
<p><object classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" width="410" height="341" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0"><param name="id" value="veohFlashPlayer" /><param name="name" value="veohFlashPlayer" /><param name="allowFullScreen" value="true" /><param name="allowscriptaccess" value="always" /><param name="src" value="http://www.veoh.com/static/swf/webplayer/WebPlayer.swf?version=AFrontend.5.3.11.1.1003&amp;permalinkId=v17893672zkztfKdM&amp;player=videodetailsembedded&amp;videoAutoPlay=0&amp;id=19061664" /></object><br />
<span style="font-size: xx-small;">Watch <a  href="http://www.veoh.com/browse/videos/category/lifestyle/watch/v17893672zkztfKdM">Walton Orthodontics &#8211; Alpharetta Teeth Whitening Considerations &#8211; 770.663.0955</a>  |  View More <a  href="http://www.veoh.com">Free Videos Online at Veoh.com</a></span></p>
<p><strong>Note:</strong>Research has shown that, other than speed, take-home Tooth-Whitening systems work just as well if not better than the &#034;chairside&#034; systems (Zoom!®, Brite Smile®, etc). The disadvantages to 1Hour chairside systems are the exorbitant cost ($500 and above) and fact that you would have to repeat the procedure and cost when your teeth start to discolor again. With the take-home system you would only have to purchase a refill of the bleaching solution which is relatively inexpensive.</p>
<h3>Teeth Whitening Recommendations and Disclaimer</h3>
<p>We will consider teeth whitening procedures only on patients with sound, healthy dentitions. A good dental cleaning prior to bleaching will improve results. The results of Tooth Whitening &amp; Bleaching procedures are variable. Everyone reacts differently. Teeth Whitening works best on unrestored teeth (no fillings, bonding, or caps). Individuals with yellowish tones to their teeth respond more favorably to Teeth Whitening than those with grayish or other severe discolorations.</p>


]]></content:encoded>
			<wfw:commentRss>http://thesmilejournal.com/2009/02/17/atlantaalpharetta-teeth-whiteningbleaching-195/feed/</wfw:commentRss>
		<slash:comments>3</slash:comments>
		</item>
		<item>
		<title>The Facts About Nickel Allergy in Orthodontics</title>
		<link>http://thesmilejournal.com/2009/02/08/facts-nickel-allergy-orthodontics/</link>
		<comments>http://thesmilejournal.com/2009/02/08/facts-nickel-allergy-orthodontics/#comments</comments>
		<pubDate>Mon, 09 Feb 2009 02:45:34 +0000</pubDate>
		<dc:creator>Dr Walton</dc:creator>
				<category><![CDATA[Orthodontic Topics]]></category>
		<category><![CDATA[Patient Education]]></category>
		<category><![CDATA[allergic reaction]]></category>
		<category><![CDATA[archwires]]></category>
		<category><![CDATA[brackets]]></category>
		<category><![CDATA[contact dermatitis]]></category>
		<category><![CDATA[Nickel Allergy]]></category>
		<category><![CDATA[patch test]]></category>
		<category><![CDATA[piercings]]></category>
		<category><![CDATA[skin rash]]></category>
		<category><![CDATA[stainless steel appliance]]></category>

		<guid isPermaLink="false">http://thesmilejournal.com/?p=89</guid>
		<description><![CDATA[<p><a  href="http://thesmilejournal.com/wp-content/uploads/2009/01/piercings-alpharetta-orthodontist.jpg" class="thickbox no_icon" rel="gallery-89" title="piercings-alpharetta-orthodontist"><img class="alignleft size-medium wp-image-92" style="margin: 4px 6px;" title="piercings-alpharetta-orthodontist" src="http://thesmilejournal.com/wp-content/uploads/2009/01/piercings-alpharetta-orthodontist-223x300.jpg" alt="" width="134" height="180" /></a></p>
<h6><a  title="Definition" href="http://en.wikipedia.org/wiki/Evidence-based_medicine" target="_blank">An Evidenced Based Article</a></h6>
<h2>Do Braces Cause An Increased Sensitivity to Nickel?</h2>
<h3><a  title="Ask Dr. Walton A Question?" href="http://www.myprojectcenter.net/questions.php?disk_id=350" target="_blank"><span style="color: #ff6600;">Click Here To Ask Dr. Walton A Question</span></a></h3>
<p>The popularity of body piercing in today&#039;s generation of orthodontic aged patients can mean that many of these patients may have already been sensitized to nickel by the time they see an orthodontist. Though, body piercing is not the subject of this article, it must be noted that that much of the metal used in jewelry contains nickel. You might ask, &#034;what does nickel have to do with orthodontics?&#034;  Nickel is a metallic element used in many of the &#034;high tech&#034;, ultra-flexible wires, auxiliaries, and stainless steel appliances used in orthodontic practice today, including the braces themselves. Nickel is known to cause more cases of <a  href="http://en.wikipedia.org/wiki/Contact_dermatitis">allergic contact dermatitis</a> than all other metals combined.<sup>[1] </sup>Most cases of nickel contact dermatitis are the result of direct contact from jewelry, clothes, watches, and glasses. Nickel is present in a large number of commonly used objects and can therefore cause contact dermatitis.</p>
<p><a  href="http://thesmilejournal.com/2009/02/08/facts-nickel-allergy-orthodontics/" class="more-link">Read more on The Facts About Nickel Allergy in Orthodontics&#8230;</a></p>


]]></description>
			<content:encoded><![CDATA[<p><a  href="http://thesmilejournal.com/wp-content/uploads/2009/01/piercings-alpharetta-orthodontist.jpg" class="thickbox no_icon" rel="gallery-89" title="piercings-alpharetta-orthodontist"><img class="alignleft size-medium wp-image-92" style="margin: 4px 6px;" title="piercings-alpharetta-orthodontist" src="http://thesmilejournal.com/wp-content/uploads/2009/01/piercings-alpharetta-orthodontist-223x300.jpg" alt="" width="134" height="180" /></a></p>
<h6><a  title="Definition" href="http://en.wikipedia.org/wiki/Evidence-based_medicine" target="_blank">An Evidenced Based Article</a></h6>
<h2>Do Braces Cause An Increased Sensitivity to Nickel?</h2>
<h3><a  title="Ask Dr. Walton A Question?" href="http://www.myprojectcenter.net/questions.php?disk_id=350" target="_blank"><span style="color: #ff6600;">Click Here To Ask Dr. Walton A Question</span></a></h3>
<p>The popularity of body piercing in today&#039;s generation of orthodontic aged patients can mean that many of these patients may have already been sensitized to nickel by the time they see an orthodontist. Though, body piercing is not the subject of this article, it must be noted that that much of the metal used in jewelry contains nickel. You might ask, &#034;what does nickel have to do with orthodontics?&#034;  Nickel is a metallic element used in many of the &#034;high tech&#034;, ultra-flexible wires, auxiliaries, and stainless steel appliances used in orthodontic practice today, including the braces themselves. Nickel is known to cause more cases of <a  href="http://en.wikipedia.org/wiki/Contact_dermatitis">allergic contact dermatitis</a> than all other metals combined.<sup>[1] </sup>Most cases of nickel contact dermatitis are the result of direct contact from jewelry, clothes, watches, and glasses. Nickel is present in a large number of commonly used objects and can therefore cause contact dermatitis.</p>
<p>There has been a lot of research done on nickel hypersensitivity over the years. A Recent study in the American Journal of Orthodontics &amp; Dentofacial Orthopedics set out to determine the prevalence of nickel hypersensitivity in orthodontic patients and compare it with the prevalence in the general population. A <a  title="Definition" href="http://en.wikipedia.org/wiki/Meta-analysis" target="_blank">meta-analysis</a> was performed on all previous valid studies to come up with a consensus view or recommendation. </p>
<h2>How Does Nickel Cause Allergic Reactions?</h2>
<p>Allergic reactions occur when the immune system reacts adversely to a foreign substance (antigen). Nickel induces a contact dermatitis, which is a <a  title="Definition" href="http://en.wikipedia.org/wiki/Hypersensitivity" target="_blank">Type IV delayed hypersensitivity</a> <a  title="Definition of Immune response" href="http://www.umm.edu/ency/article/000821.htm" target="_blank">immune response</a>.<sup>[2]</sup> There are 2 phases to this process. The sensitization phase occurs the instant the allergen (nickel) enters the body and causes a response. The elicitation phase occurs after the body is re-exposed to the antigen (nickel) a second time which causes the appearance of the full clinical manifestations. The initial exposure usually does not elicit symptoms, but subsequent contact with the antigen is usually enough to cause a more visible reaction.</p>
<h2>Occurrence of Nickel Allergy: Who Is At Risk? What are the Symptoms?</h2>
<p>The percentage of nickel in orthodontic appliances ranges from 8% (in stainless steel) to more than 50% (in nickel-titanium alloys).<sup>[3-5] </sup>Estimates are that 4.5% to 28.5% of the total population are sensitized to nickel.<sup>[6-9] </sup> Nickel hypersensitivity is more prevalent in females than in males by a factor of 10 to 1. <sup>[6]</sup>This disproportionate hypersensitivity in females is thought to be related to their more frequent exposure to and contact with detergents, jewelry, earrings, and other metal objects such as watches, metal buttons, and buckles. For males, nickel hypersensitivity is related more to occupational exposure for example in industries where nickel is used as a raw material.<sup>[7,10,11] </sup></p>
<p>Another study reported that oral contact with nickel in normal, non-sensitized individuals may actually cause those individuals to become more resistant to nickel allergy.<sup>[12]</sup>Sensitization to nickel is thought to be increased by mechanical irritation, skin maceration, or oral mucosal injury, all of which can occur in orthodontic practice. </p>
<p>Symptoms of nickel allergy include development of an allergic dermatitis and/or lesions of contact <a  title="Stomatitis Definition" href="http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/stomatitis.jsp" target="_blank">stomatitis</a> which can be highly variable in nature and at times barely visible.<sup>[13]</sup> Itching is not usually a common symptom and outside the mouth reactions (most commonly associated with headgear wear) are more common than inside the mouth reactions.</p>
<h2>Diagnosis of Nickel Allergy</h2>
<p>Nickel hypersensitivity induced contact dermatitis is confirmed through the use of a <a  title="Patch Test Definition" href="http://allergies.about.com/od/contactdermatitis/a/patchtesting.htm" target="_blank">patch test</a> in which small amounts of allergens are applied to the skin for a period of time. The dermatologist then measures the intensity of the skin&#039;s reaction. A patch test score of +4 (the most severe of reactions) is characterized by the presence of erythema, edema, papules, and vesicles at the test site while a score of +2 presents in only erythema which is a much less intense allergic response. An erythematous allergic reaction is depicted below.</p>
<p style="text-align: center;"> <a  href="http://thesmilejournal.com/wp-content/uploads/2009/02/250px-rash.jpg" class="thickbox no_icon" rel="gallery-89" title="250px-rash"><img class="size-medium wp-image-179 aligncenter" title="250px-rash" src="http://thesmilejournal.com/wp-content/uploads/2009/02/250px-rash.jpg" alt="" width="250" height="208" /></a></p>
<p> </p>
<p>Correct diagnosis of nickel hypersensitivity is important. The following patient medical history would suggest a diagnosis of nickel allergy:</p>
<ul>
<li>a previous allergic response after wearing earrings or other metal item</li>
<li>appearance of allergy symptoms following insertion of orthodontic components containing nickel</li>
<li>extra-oral (outside the mouth) rash adjacent to headgear arms</li>
</ul>
<p>It is very important to eliminate lesions associated with other causes: </p>
<ul>
<li>herpetic stomatitis</li>
<li>candidiasis</li>
<li>ulcers due to mechanical irritation</li>
<li>allergies to other materials such as acrylic</li>
</ul>
<h2>Recommendations For Nickel Sensitive Patients</h2>
<p>As mentioned previously, many orthodontic components contain nickel alloys. Stainless steel contains approximately 8% nickel, while nickel titanium archwires contain approximately 50% or more nickel. It is important to note that <strong>most research has determined that all intra-oral orthodontic components made of stainless steel are safe to use in nickel hypersensitive patients because the molecular structure of stainless steel prevents the release of nickel and renders it </strong><br />
<strong>unreactive.<sup>[14]</sup></strong> However, a nickel-free alternative to stainless steel brackets are available in the following forms:</p>
<ul>
<li>ceramic brackets</li>
<li>polycarbonate or plastic brackets</li>
<li>titanium brackets</li>
<li>gold-plated brackets</li>
</ul>
<p>Stainless steel orthodontic archwires are also considered safe in nickel sensitive patients.  On the other hand, many high technology ultra-flexible nickel-titanium wires used in orthodontics today should be avoided in nickel sensitive patients. Alternate wires such as twist-o-flex, TMA, pure titanium, and gold-plated can be used without risk.</p>
<p>If a patient experiences a positive nickel sensitivity (positive patch test) reaction during orthodontic treatment it is recommended that all intraoral and/or extraoral appliances (braces) containing nickel be removed until the adverse reaction subsides. Once the lesions have healed, nickel-free appliances can be placed.</p>
<h2>Conclusion</h2>
<p>The popularity of body piercing in the teenage population will no doubt cause the sensitization of more orthodontic aged patients to the effects of nickel allergy in the coming years. Severe intra-oral reactions of nickel allergy are very rare, however, extra-oral reactions are more common. In the final analysis, research has concluded that orthodontic treatment <strong>is not</strong> associated with an increased occurrence of nickel sensitivity unless patients had his or her ears pierced.</p>
<p>Walton Orthodontics &#8211; <a  title="Walton Orthodontics" href="http://www.drwalton.com/contact.asp" target="_blank">Alpharetta Orthodontist</a></p>
<p>Please let us know if you have any questions by clicking the link above.</p>
<p> </p>
<h2>References</h2>
<p>1 Fisher AA. Contact dermatitis. Philadelphia: Lea &amp; Febiger; 1973; pd. 2.</p>
<p>2 Aaolu G, Arun T, Izgü B, Yarat A. Nickel and chromium levels in the saliva and serum of patients with fixed orthodontic appliances. Angle Orthod 2001; 71: 375–79.</p>
<p>3. Park HY, Shearer TR. In vitro release of nickel and chromium from stimulated orthodontic appliances. Am J Orthod. 1983; 84:156–159.</p>
<p>4. Brantley WA. Orthodontic wires. In: Brantley WA, Eliades T, eds. Orthodontic Materials: Scientific and Clinical Aspects. Stuttgart, Germany: Thieme; 2001: 77–103.</p>
<p>5. Eliades T, Athanasiou AE. In vivo aging of orthodontic alloys: implications for corrosion potential, nickel release, and biocompatibility. Angle Orthod. 2002; 72:222–237.</p>
<p>6. Peltonen L. Nickel sensitivity in the general population. Contact Dermat. 1979; 5:27–32.</p>
<p>7. Blanco-Dalmau L, Carrasquillo-Alberty H, Silva-Parra J. A study of nickel allergy. J Prosthet Dent. 1984; 52:116–119.</p>
<p>8. Janson GRP, Dainesi EA, Pereira ACJ, Pinzan A. Clinical evaluation of nickel hypersensitivity reaction in patients under orthodontic treatment. Ortodontia. 1994; 27:31–37.</p>
<p>9. Schäfer T, Böhler E, Ruhdorfer S, Weigl L, Wessner D, Filipiak B, Wichmann HE, Ring J. Epidemiology of contact allergy in adults. Allergy. 2001; 56:1192–1196.</p>
<p>10. Wilkinson JD, Rycroft RJG. Contact dermatitis. In: Champion RH, Burton JL, Ebling FJG. Textbook of Dermatology. 5th ed. Oxford: Blackwell Scientific Publications; 1992: 648– 729.</p>
<p>11. Gawkrodger DJ, Vestry JP, Wong WK, Buxton PK. Contact clinic survey of nickel-sensitive subjects. Contact Dermat. 1986; 14:165–169.</p>
<p>12 Vreeburg K J, de Groot K, von Bloomberg M, Scheper R. Induction of immunological tolerance by oral administration of nickel and chromium. J Dent Res 1984; 63: 124–8.</p>
<p>13. North American Contact Dermatitis Group. Epidemiology of contact dermatitis. Arch Dermatol. 1973; 108:537</p>
<p>14. Toms AP. The corrosion of orthodontic wire. Eur J Orthod. 1988; 10:87–97.</p>


]]></content:encoded>
			<wfw:commentRss>http://thesmilejournal.com/2009/02/08/facts-nickel-allergy-orthodontics/feed/</wfw:commentRss>
		<slash:comments>0</slash:comments>
		</item>
		<item>
		<title>The Facts On Osteoporosis and the Risk of Developing Jaw Complications in Dental Patients</title>
		<link>http://thesmilejournal.com/2009/01/20/dental-patients-osteoporosis-risk-developing-jaw-complications/</link>
		<comments>http://thesmilejournal.com/2009/01/20/dental-patients-osteoporosis-risk-developing-jaw-complications/#comments</comments>
		<pubDate>Tue, 20 Jan 2009 22:27:30 +0000</pubDate>
		<dc:creator>Dr Walton</dc:creator>
				<category><![CDATA[Dental Topics]]></category>
		<category><![CDATA[Orthodontic Topics]]></category>
		<category><![CDATA[Patient Education]]></category>
		<category><![CDATA[bisphosphonate associated osteonecrosis]]></category>
		<category><![CDATA[bone fracture]]></category>
		<category><![CDATA[dental hygiene]]></category>
		<category><![CDATA[dentist]]></category>
		<category><![CDATA[jaw]]></category>
		<category><![CDATA[orthodontist]]></category>
		<category><![CDATA[osteonecrosis]]></category>
		<category><![CDATA[Osteoporosis]]></category>

		<guid isPermaLink="false">http://thesmilejournal.com/?p=132</guid>
		<description><![CDATA[<p><a  title="Evidenced-Based-Article" href="http://en.wikipedia.org/wiki/Evidence-based_medicine" target="_blank">Evidenced Based</a> Article</p>
<p>This article is a summary of the latest research presented in the <a  title="Journal of the American Denatl Association" href="http://jada.ada.org/cgi/content/abstract/140/1/61" target="_blank"><span style="color: #ff6600;">Journal of the American Dental Association (JADA)</span></a> and a report published by the ADA <a  title="American Dental Association" href="http://www.ada.org/prof/resources/topics/topics_osteonecrosis_bisphosphonate_report.pdf" target="_blank"><span style="color: #ff6600;">Council on Scientific Affairs</span></a>containing recommendations for treatment of dental patients who are taking oral bisphosphonates.</p>
<p><a  href="http://thesmilejournal.com/2009/01/20/dental-patients-osteoporosis-risk-developing-jaw-complications/" class="more-link">Read more on The Facts On Osteoporosis and the Risk of Developing Jaw Complications in Dental Patients&#8230;</a></p>


]]></description>
			<content:encoded><![CDATA[<p><a  title="Evidenced-Based-Article" href="http://en.wikipedia.org/wiki/Evidence-based_medicine" target="_blank">Evidenced Based</a> Article</p>
<p>This article is a summary of the latest research presented in the <a  title="Journal of the American Denatl Association" href="http://jada.ada.org/cgi/content/abstract/140/1/61" target="_blank"><span style="color: #ff6600;">Journal of the American Dental Association (JADA)</span></a> and a report published by the ADA <a  title="American Dental Association" href="http://www.ada.org/prof/resources/topics/topics_osteonecrosis_bisphosphonate_report.pdf" target="_blank"><span style="color: #ff6600;">Council on Scientific Affairs</span></a>containing recommendations for treatment of dental patients who are taking oral bisphosphonates.</p>
<h1>What is Osteoporosis?</h1>
<p>Osteoporosis (os-tee-oh-puh-roh-sis) is a disorder of the skeletal system which severely weakens bones and significantly increases the chance of bone fractures, especially of the hip, spine and wrist.  Bone density is decreased by osteoporosis. A person&#039;s bone density is determined by several factors including heredity, hormones, lifestyle, diet, physical activity and certain medications.  Also, bone density and bone strength is usually decreased as people age.</p>
<p>Approximately 10 million Americans are affected by osteoporosis, of those, 8 million are women.  An additional 34 million are at risk of developing the condition.  More women are affected by this disease than cancer, stroke or heart disease combined.  Certain prescription drugs called &#034;<strong><a  title="Oral Bisphosphonates Definition" href="http://courses.washington.edu/bonephys/opbis.html" target="_blank"><span style="color: #ff6600;">oral <span>bisphosphonates</span></span></a></strong>&#034;  (bis-fos-foh-nates) are used to treat these patients including well known brand name medications such as <a  title="FOSAMAX" href="http://www.rxlist.com/fosamax-drug.htm" target="_blank"><span style="color: #ff6600;"><strong>Fosamax</strong></span></a>, <a  title="Actonel" href="http://www.rxlist.com/actonel-drug.htm" target="_blank"><span style="color: #ff6600;"><strong>Actonel</strong></span></a>, and <a  title="Boniva Information" href="http://www.rxlist.com/boniva-drug.htm" target="_blank"><span style="color: #ff6600;"><strong>Boniva</strong></span></a>.<sup>[1]</sup>  The table below lists brand name, manufacturer and generic name for both oral and intravenous bisphosphonates. (Click on table to enlarge)</p>
<p> <a  href="http://thesmilejournal.com/wp-content/uploads/2009/01/oral-and-iv-bisphosphonates-table4.jpg" class="thickbox no_icon" rel="gallery-132" title="oral-and-iv-bisphosphonates-table4"><img class="alignnone size-medium wp-image-160" style="margin-left: 100px;" title="oral-and-iv-bisphosphonates-table4" src="http://thesmilejournal.com/wp-content/uploads/2009/01/oral-and-iv-bisphosphonates-table4-283x300.jpg" alt="" width="283" height="300" /></a><a  href="http://thesmilejournal.com/wp-content/uploads/2009/01/oral-and-iv-bisphosphonates-table1.jpg"></a></p>
<h2>Osteoporosis And Bone Fractures: Who Is At Risk?</h2>
<p>Bone fractures as a result of osteoporosis are serious. Fractures of the spinal column and hip can be life-threatening and are the most common problems associated with osteoporosis.<sup>[2]</sup> An average of 24 percent of patients 50 years and older with hip fractures die within one year of their injury as reported by <a title="National Osteoporosis Foundation" href="http://www.nof.org/osteoporosis/index.htm" target="_blank"><span style="color: #ff6600;"><strong>National Osteoporosis Foundation</strong></span></a>.  The foudation also reports that 1 in 2 women and 1 in 4 men over the age of 50 will have an osteoporosis-related fracture in their lifetime. Of the patients that experience a hip fracture, 1 in 5 will end up in a nursing home and only 15 percent of these patients are able to walk across a room without help six months after. The risk of hip fractures in women is equal to their combined risk of developing breast and ovarian cancers.<sup>[1]</sup></p>
<p><span style="color: #0000ff;">Estimates are that bisphosphonates (alendronate) can reduces the risk of hip fractures in patients with osteoporosis by 40 percent.</span>  Therefore, this drug could possibly prevent more than 100,000 hip fractures and thousands of deaths each year<sup>[3]</sup> Obviously, there are risks associated osteoporosis and the benefits of oral bisphosphonate therapy are well documented, patients should never stop taking these medications without thoroughly discussing the benefits and risks with their physician, dentist or othodontist.</p>
<h2>Bisphosphonates And Osteonecrosis Of The Jaws</h2>
<p>Complications of the jaw have been linked to the use of bisphosphonates in the scientific literature.<sup>[4-7]</sup> These drugs have been associated with the development of <strong><span style="color: #0000ff;">osteonecrosis of th</span></strong><strong><span style="color: #0000ff;">e jaws (ONJ)</span></strong> which is a serious, but uncommon, c<a  href="http://thesmilejournal.com/wp-content/uploads/2009/01/osteonecrosis-of-the-jaw1.jpg" class="thickbox no_icon" rel="gallery-132" title="osteonecrosis-of-the-jaw1"><img class="alignleft size-small wp-image-153" style="border: white 8px solid;" title="osteonecrosis-of-the-jaw1" src="http://thesmilejournal.com/wp-content/uploads/2009/01/osteonecrosis-of-the-jaw1-300x203.jpg" alt="" width="275" height="182" /></a>ondition that causes significant destruction of the jawbones. Osteonecrosis is caused by reduction, obstruction or inhibition of the local blood supply to the bone causing it to die or undergo necrosis.  Many patients who take bisphosphonates to treat or prevent osteoporosis have become confused and alarmed by <a  title="LA Times Article" href="http://www.latimes.com/news/science/la-sci-bones3-2009jan03,0,6502999.story" target="_blank"><span style="color: #ff6600;"><strong>news reports</strong></span></a> of these associated problems.  The majority of reported <span style="color: #0000ff;"><strong>Bisphosphonate Associated Osteonecrosis (BON)</strong></span> of the jaws cases have occurred in patients with cancer who receive therapy with <em>intravenous bisphosphonates</em>, which absorb differently from <em>oral bisphosphonates</em>. It is important to note, that even though the risk for developing BON remains uncertain, the current scientific literature on cases reported so far, <strong>&#034;&#8230;a patient&#039;s risk for developing BON is minute with oral bisphosphonate therapy as compared to intravenous bisphosphonate therapy in cancer patients.&#034;</strong> <sup>[8]</sup><br />
 </p>
<h2>Other Risk Factors and Clinical Symptoms</h2>
<p>BON can occur spontaneously, but is more commonly associated with the following medical and dental conditions:</p>
<ul>
<li>Invasive dental procedures or conditions that increase the risk of for bone trauma like dental extractions.<sup>[6-7]</sup></li>
<li>Patients 65 years and older</li>
<li>Periodontists (Gum Disease)</li>
<li>Corticosteroid use for chronic conditions</li>
<li>Prolonged use of bisphosphonates (more than 2 years)</li>
<li>Smoking</li>
<li>Diabetes</li>
</ul>
<p> <br />
<strong>Clinical Appearance And Symptoms Of Osteonecrosis Of The Jaws</strong></p>
<p>You should tell your dentist immediately if you have any of the following symptoms, now or in the months following treatment:</p>
<ul>
<li>Feeling of numbness, heaviness or other sensations in your jaw</li>
<li>Pain in your jaw</li>
<li>Swelling of your jaw</li>
<li>Loose teeth</li>
<li>Drainage</li>
<li>Exposed bone (See image above)</li>
</ul>
<p> <br />
<strong>Should I stop taking the oral bisphosphonates?</strong></p>
<p>The benefits of bisphosphonates for the treatment of osteoporosis and its complications are well documented. Research has not shown that stopping use of these drugs will decrease your risk for developing osteonecrosis. You should talk with your physician if you have any questions.</p>
<h2>General Recommendations</h2>
<p>Routine dental treatment should not generally be modified because of the use of oral biphosphonates (Consult your physician and dentist).</p>
<p>Routine dental examinations are a must. Patients who are prescribed oral bisphosphonates and are not receiving regular dental care would likely benefit from a comprehensive oral examination before or early during their bisphosphonate therapy.</p>
<p>All patients taking oral biphosphonates should be informed that:</p>
<ul>
<li>Oral bisphosphonate use places them at very low risk for developing BON. The actual incidence is unknown with estimates ranging from zero to 1 one in 2,260 cases for oral bisphosphonate users. The low risk for developing BON may be minimized but not eliminated.</li>
<li>An oral health program consisting of sound oral hygiene practices and regular dental care may be the optimal approach for lowering the risk for developing BON.</li>
<li>There is no validated diagnostic technique currently available to determine if patients are at increased risk for developing BON.</li>
<li>Discontinuing bisphosphonate therapy may not eliminate any risk for developing BON.<br />
 </li>
</ul>
<p><strong>Orthodontics</strong></p>
<p>Although there are no documented studies examining the effects of bisphosphonates on orthodontic treatment, some case studies have witnessed inhibited tooth movement in patients taking bisphosphonates.<sup>[9-10]</sup></p>
<p>Walton Orthodontics &#8211; <a  title="Alpharetta-Orthodontist" href="http://www.drwalton.com/default.asp" target="_blank">Alpharetta Orthodontics<br />
</a>Alpharetta, GA</p>
<p> <br />
<strong><span style="text-decoration: underline;">References</span></strong></p>
<p>1National Osteoporosis Foundation. Osteoporosis Fast Facts. Available at: <a  href="http://www.nof.org/osteoporosis/diseasefacts.htm">http://www.nof.org/osteoporosis/diseasefacts.htm</a> . Accessed Mar 27, 2007.</p>
<p>2Riggs BL, Melton LJ 3rd. The worldwide problem of osteoporosis: insights afforded by epidemiology.Bone. 1995 Nov;17(5 Suppl):505S-511S.</p>
<p>3 Nguyen ND, Eisman JA, Nguyen TV. Anti-hip fracture efficacy of biophosphonates: a Bayesian analysis of clinical trials. J Bone Miner Res. 2006 Feb;21(2):340-9.</p>
<p>4 Migliorati CA, Casiglia J, Epstein J, Jacobsen PL, Siegel MA, Woo S-K. Managing the care of patients with bisphosphonate-associated osteonecrosis. JADA 2005;136:1658-68.</p>
<p>5 Marx RE. Pamidronate (Aredia) and zoledronic acid (Zometa) induced avascular necrosis of the jaws: a growing epidemic. <a  title="Journal of Oral and Maxillofacial Surgery" href="http://www.joms.org/" target="_blank">J Oral Maxillofac Surg</a> 2003;61:1115-7.</p>
<p>6 Migliorati CA. Bisphosphonates and oral cavity avascular bone necrosis. <a  title="journal of clinical oncology" href="http://jco.ascopubs.org/" target="_blank">J Clin Oncol</a> 2003;21:4253-4.</p>
<p>7 Ruggiero SL, Mehrotra B, Rosenberg TJ, Engroff SL. Osteonecrosis of the jaws associated with the use of bisphosphonates: A review of 63 cases. J Oral Maxillofac Surg 2004;62:527-34.</p>
<p>8 Dental Management of Patients Receiving Oral Bisphosphonate Therapy―Expert Panel Recommendations:Report of the Council on Scientific Affairs; <a  title="American Dental Association" href="http://ada.org/" target="_blank">American Dental Association</a>;July, 2008</p>
<p>9 Schwartz JE. Ask us: Some drugs affect tooth movement. <a  title="Journal of American Association of Orthodontics" href="http://www.braces.org/studentsteachers/history/" target="_blank">Am J Orthod Dentofacial Orthop</a> 2005;127:644.</p>
<p>10 Rinchuse DJ, Rinchuse DJ, Sosovicka MF, Robison JM, Pendleton R. Orthodontic treatment of patients using bisphosphonates: A report of 2 cases. Am J Orthod Dentofacial Orthop 2007;131:321-6.</p>


]]></content:encoded>
			<wfw:commentRss>http://thesmilejournal.com/2009/01/20/dental-patients-osteoporosis-risk-developing-jaw-complications/feed/</wfw:commentRss>
		<slash:comments>0</slash:comments>
		</item>
		<item>
		<title>New Tooth Cavity Protection: Nanoparticles Make Surface Too Slippery For Bacteria To Adhere</title>
		<link>http://thesmilejournal.com/2009/01/18/tooth-cavity-protection-nanoparticles-surface-slippery-bacteria-adhere/</link>
		<comments>http://thesmilejournal.com/2009/01/18/tooth-cavity-protection-nanoparticles-surface-slippery-bacteria-adhere/#comments</comments>
		<pubDate>Mon, 19 Jan 2009 03:46:55 +0000</pubDate>
		<dc:creator>Dr Walton</dc:creator>
				<category><![CDATA[Dental Topics]]></category>
		<category><![CDATA[Add new tag]]></category>
		<category><![CDATA[cavities]]></category>
		<category><![CDATA[dental cleaning]]></category>
		<category><![CDATA[dental hygiene]]></category>
		<category><![CDATA[dentist]]></category>
		<category><![CDATA[enamel]]></category>
		<category><![CDATA[plaque bacteria]]></category>
		<category><![CDATA[polishing]]></category>
		<category><![CDATA[silica nanoparticles]]></category>
		<category><![CDATA[teeth polishing]]></category>

		<guid isPermaLink="false">http://thesmilejournal.com/?p=104</guid>
		<description><![CDATA[<h2>Are Cavities A Thing of The Past?</h2>
<p>(December 22, 2008) <em><a  href="http://www.sciencedaily.com/releases/2008/12/081220085436.htm" target="_blank">Science Daily</a> </em>recently released news of new research conducted at Clarkson University which may revolutionize dental cavity protection.  Professor Igor Sokolov and graduate student Ravi Gaikwad have discovered a way to protect teeth from cavities by polishing them to a before-unheard-of level of smoothness using ultra-fine silica nanoparticles.</p>
<p><a  href="http://thesmilejournal.com/2009/01/18/tooth-cavity-protection-nanoparticles-surface-slippery-bacteria-adhere/" class="more-link">Read more on New Tooth Cavity Protection: Nanoparticles Make Surface Too Slippery For Bacteria To Adhere&#8230;</a></p>


]]></description>
			<content:encoded><![CDATA[<h2>Are Cavities A Thing of The Past?</h2>
<p>(December 22, 2008) <em><a  href="http://www.sciencedaily.com/releases/2008/12/081220085436.htm" target="_blank">Science Daily</a> </em>recently released news of new research conducted at Clarkson University which may revolutionize dental cavity protection.  Professor Igor Sokolov and graduate student Ravi Gaikwad have discovered a way to protect teeth from cavities by polishing them to a before-unheard-of level of smoothness using ultra-fine silica nanoparticles.</p>
<p>The researchers utilized polishing technology commonly used in the semiconductor industry called <a title="What is this?" href="chemical mechanical planarization" target="_blank">chemical mechanical planarization</a> to polish human teeth down to a nanoscale level of smoothness.  Only a few nanometers of roughness is left on the tooth which is equivalent to 100,000 times smaller than a grain of sand.<sup>[1]</sup></p>
<p>The researchers showed that <a  title="Normal Surface vs. Polished Surface" href="http://www.sciencedaily.com/images/2008/12/081220085436.jpg" target="_blank">teeth polished</a> in this way are so smooth and &#034;slippery&#034; that the destructive bacteria known to attack and destroy dental enamel cannot adhere to the surface as before.<sup>[2-4]</sup> It can then be easily removed from the tooth enamel before damage is done.  The image below shows the normal surface vs. the polished surface under ultra high magnification.</p>
<p><a  href="http://thesmilejournal.com/wp-content/uploads/2009/01/dental-teeth-cleaning.jpg" class="thickbox no_icon" rel="gallery-104" title="dental-teeth-cleaning"><img class="size-medium wp-image-119       alignright" style="margin-left: 20px;" title="dental-teeth-cleaning" src="http://thesmilejournal.com/wp-content/uploads/2009/01/dental-teeth-cleaning-300x139.jpg" alt="Normal Surface vs. Polished Surface (High Magnification)" width="300" height="139" /></a></p>
<p>Polishing teeth with silica particles has been used before, however, the use of nanosized particles has never been reported. In the final analysis, the researchers believe that this polishing process may ultimately protect teeth from the cavity causing effects of bacteria because the bacteria can be more easily removed from polished tooth surfaces.</p>
<h3>Final Thoughts</h3>
<p>This is interesting research.  I don&#039;t know how practical this process is at this time, as far as instrumentation or equipment is concerned.  This is new research so it could be several years away.</p>
<p>Basic dental hygiene will always be the key to combating dental disease processes (tooth decay, cavities, periodontal disease).   Anything that will improve and simplify the removal of bacterial plaque (the causative agent of dental disease) from teeth will be welcomed.</p>
<p>Walton Orthodontics &#8211; <a  title="Alpharetta-Orthodontist" href="http://www.drwalton.com/default.asp" target="_blank">Alpharetta Orthodontist</a></p>
<p>Alpharetta, GA</p>
<p>1. Clarkson University. &#034;New Tooth Cavity Protection: Nanoparticles Make Surface Too Slippery For Bacteria To Adhere.&#034; ScienceDaily 22 December 2008. 12 January 2009 .</p>
<p>2. Department of Physics, Clarkson University, 8 Clarkson Ave., Potsdam, NY 13699, USA;</p>
<p>3. NanoBio Laboratory (NABLAB),</p>
<p>4. Dept. of Chemistry and Biomolecular Science, and NY Center for Material Processing (CAMP), Clarkson University, Potsdam, NY 13699, USA</p>


]]></content:encoded>
			<wfw:commentRss>http://thesmilejournal.com/2009/01/18/tooth-cavity-protection-nanoparticles-surface-slippery-bacteria-adhere/feed/</wfw:commentRss>
		<slash:comments>0</slash:comments>
		</item>
		<item>
		<title>New Invisalign Teen Introduced</title>
		<link>http://thesmilejournal.com/2009/01/03/invisalign-teen-introduced/</link>
		<comments>http://thesmilejournal.com/2009/01/03/invisalign-teen-introduced/#comments</comments>
		<pubDate>Sat, 03 Jan 2009 23:45:11 +0000</pubDate>
		<dc:creator>Dr Walton</dc:creator>
				<category><![CDATA[Invisalign Braces]]></category>
		<category><![CDATA[Orthodontic Topics]]></category>
		<category><![CDATA[Add new tag]]></category>
		<category><![CDATA[Aligners]]></category>
		<category><![CDATA[Alpharetta Invisalign]]></category>
		<category><![CDATA[Alpharetta-Orthodontist-Dentist]]></category>
		<category><![CDATA[Braces]]></category>
		<category><![CDATA[Clear Braces]]></category>
		<category><![CDATA[Invisalign Teen]]></category>
		<category><![CDATA[Invisaline]]></category>
		<category><![CDATA[Invisible Braces]]></category>

		<guid isPermaLink="false">http://thesmilejournal.com/?p=7</guid>
		<description><![CDATA[<p><a  title="Alpharetta Invisalign" href="http://www.invisalign.com/WhatIs/Pages/HowMade.aspx" target="_blank"><img class="alignleft size-medium wp-image-20" style="margin-left: 4px; margin-right: 4px;" title="alpharetta-invisalign-teen-logo" src="http://thesmilejournal.com/wp-content/uploads/2009/01/alpharetta-invisalign-teen-logo.jpg" alt="" width="239" height="180" /></a><em><strong><em><span>Invisalign </span></em></strong><a  class="underline" title="Invisalign Website" href="http://www.invisalign.com/Pages/Home.aspx" target="_blank"><span style="font-style: normal;">(Align Technology)</span></a><span style="font-style: normal;"> has announced a new product for teenagers called Invisalign Teen for non-adult, comprehensive orthodontic treatment. </span><span style="font-style: normal;"><a  class="underline" title="Alpharetta Invisalign" href="http://www.drwalton.com/default.asp" target="_blank">Walton Orthodontics</a></span><span style="font-style: normal;">, a board certified Invisalign braces orthodontist, has been using the Invisalign adult system with great success since 2001. It was first introduced in 1999 as another tool for orthodontists to correct malocclusions (bad bites) and align “crooked teeth” in a truly innovative way without the use of traditional braces and wires. <strong><em>Invisalign</em></strong> straightens teeth using a series of clear, nearly invisible, removable appliances (aligners) that gently move teeth to a desired final position. The <a  class="underline" href="/thesmilejournal.com/invisalign-braces-advantages-reviewed/" target="_self">advantages of Invisalign</a> over braces and veneers (Instant Orthodontics) are undeniable when you factor in the pain and discomfort associated with braces and the permanent removal (filing down or grinding) of healthy tooth enamel and the commitment to a lifelong schedule of periodic replacement of veneers.<br />
</span></em></p>
<p><a  href="http://thesmilejournal.com/2009/01/03/invisalign-teen-introduced/" class="more-link">Read more on New Invisalign Teen Introduced&#8230;</a></p>


]]></description>
			<content:encoded><![CDATA[<p><a  title="Alpharetta Invisalign" href="http://www.invisalign.com/WhatIs/Pages/HowMade.aspx" target="_blank"><img class="alignleft size-medium wp-image-20" style="margin-left: 4px; margin-right: 4px;" title="alpharetta-invisalign-teen-logo" src="http://thesmilejournal.com/wp-content/uploads/2009/01/alpharetta-invisalign-teen-logo.jpg" alt="" width="239" height="180" /></a><em><strong><em><span>Invisalign </span></em></strong><a  class="underline" title="Invisalign Website" href="http://www.invisalign.com/Pages/Home.aspx" target="_blank"><span style="font-style: normal;">(Align Technology)</span></a><span style="font-style: normal;"> has announced a new product for teenagers called Invisalign Teen for non-adult, comprehensive orthodontic treatment. </span><span style="font-style: normal;"><a  class="underline" title="Alpharetta Invisalign" href="http://www.drwalton.com/default.asp" target="_blank">Walton Orthodontics</a></span><span style="font-style: normal;">, a board certified Invisalign braces orthodontist, has been using the Invisalign adult system with great success since 2001. It was first introduced in 1999 as another tool for orthodontists to correct malocclusions (bad bites) and align “crooked teeth” in a truly innovative way without the use of traditional braces and wires. <strong><em>Invisalign</em></strong> straightens teeth using a series of clear, nearly invisible, removable appliances (aligners) that gently move teeth to a desired final position. The <a  class="underline" href="/thesmilejournal.com/invisalign-braces-advantages-reviewed/" target="_self">advantages of Invisalign</a> over braces and veneers (Instant Orthodontics) are undeniable when you factor in the pain and discomfort associated with braces and the permanent removal (filing down or grinding) of healthy tooth enamel and the commitment to a lifelong schedule of periodic replacement of veneers.<br />
</span></em></p>
<p><em><span style="font-style: normal;">It is so popular because it is nearly impossible to tell anything is being worn on the teeth and it is virtually free of the discomfort issues associated with traditional braces. Originally, <strong><em>Invisalign</em></strong> was designed for patients with a fully erupted adult dentition (no baby teeth present). Younger, growing patients typically were not good candidates for Invisalign due to concerns about patient compliance and ongoing development of the permanent dentition.</span></em></p>
<p><strong><em>Invisalign Teen</em></strong> gives orthodontists the ability to offer comprehensive orthodontic treatment to their non-adult patients by addressing previous concerns of patient compliance and dentition challenges (erupting 2nd molars) common in teen patients. With this product, teenagers get clear, removable aligners that will straighten their teeth without the hassle, discomfort, and embarrassment of traditional braces that will also fit into their busy schedules and give them the ease and flexibility to remove the aligners for sports, music lessons and for meals at school or on the go.</p>
<p><object classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" width="410" height="341" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0"><param name="allowFullScreen" value="true" /><param name="allowscriptaccess" value="always" /><param name="src" value="http://www.veoh.com/veohplayer.swf?permalinkId=v17500414kS8NCTD6&amp;player=videodetailsembedded&amp;videoAutoPlay=0&amp;id=19061664" /><embed type="application/x-shockwave-flash" width="410" height="341" src="http://www.veoh.com/veohplayer.swf?permalinkId=v17500414kS8NCTD6&amp;player=videodetailsembedded&amp;videoAutoPlay=0&amp;id=19061664" allowfullscreen="true" allowscriptaccess="always"></embed></object><br />
<span style="font-size: xx-small;">Contact Walton Orthodontics <a  class="underline" href="http://www.drwalton.com/contact.asp" target="_blank">Invisalign Alpharetta</a>: Walton Orthodontics Offers Invisalign For Teens &#8211; Straight Teeth, No Braces | Ask Dr. Walton A Question? <a  class="underline" href="http://www.myprojectcenter.net/questions.php?disk_id=350" target="_blank">Click Here!</a></span></p>
<h2><span style="color: #3366ff;">New Enhancements Incorporated Into Invisalign Teen:</span></h2>
<p><span style="font-weight: normal;"><span style="font-style: normal;">Aligners come with embedded </span></span><span style="font-weight: normal;"><span style="font-style: normal;"><strong><em>compliance indicators</em></strong></span></span><span style="font-weight: normal;"><span style="font-style: normal;"> that provide a visual cue of patient wear and compliance for the doctor and parents to monitor.</span></span></p>
<div><strong></strong></div>
<p><span style="font-weight: normal;"><span style="font-style: normal;">• Aligners can now accommodate for erupting teeth (teeth that are not in yet or partially in) along with specially engineered </span></span><span style="font-weight: normal;"><span style="font-style: normal;"><strong><em>“eruption tabs”</em></strong></span></span><span style="font-weight: normal;"><span style="font-style: normal;"> to compensate for erupting second molars.</span></span></p>
<p><span style="font-weight: normal;"><span style="font-style: normal;">• A new feature called <strong><em>&#034;</em></strong></span></span><span style="font-weight: normal;"><span style="font-style: normal;"><strong><em>Power Ridges&#034;</em></strong></span></span><span style="font-weight: normal;"><span style="font-style: normal;"> are incorporated into aligners designed to help achieve certain difficult tooth movements.</span></span></p>
<h2><strong></strong></h2>
<h2><strong><span style="color: #3366ff;"><span style="font-style: normal;">What Parents Need To Know About Invisalign For Teens:</span></span></strong></h2>
<p><span style="font-style: normal;"><span style="font-weight: normal;">• The compliance indicators located on the upper aligner help you gauge the approximate amount of time your teen spends wearing the product.</span></span></p>
<p><span style="font-style: normal;"><span style="font-weight: normal;">• Aligners are most effective when worn 20 to 22 hours per day – and removed only for eating, brushing, and flossing. Each set of aligners is worn for approximately two weeks.</span></span></p>
<p><span style="font-style: normal;"><span style="font-weight: normal;">• Lost or broken aligners can be replaced easily in a matter of a few days, in most cases.</span></span></p>
<p><span style="font-style: normal;"><span style="font-weight: normal;">• If your child is 18 years old, ask your orthodontist for the most appropriate product to use i.e. the Invisalign adult product or Invisalign Teen. Your child may benefit from some features of the Invisalign Teen product even though they may be a candidate for the Invisalign adult product.</span></span></p>
<p><span style="font-style: normal;"><span style="font-weight: normal;">• The benefits of <strong><em>Invisalign Adult</em></strong> and <strong><em>Invisalign Teen</em></strong> are the same. Invisalign Teen differs from Invisalign Adult only by the three new features (listed above) designed specifically for the needs or the type of dentition found in the teen age-group.</span></span></p>
<p><span style="font-style: normal;"><span style="font-weight: normal;">• <strong><em>Invisalign Teen</em></strong> requires very little adjustment or maintenance by the doctor. Appointments will be very limited in time and will usually be scheduled every six weeks to check on treatment progress and to provide your child with their next three sets of aligners.</span></span></p>
<p><span style="font-style: normal;"><span style="font-weight: normal;">• In the hands of a skilled and experienced practitioner and when worn as instructed, <strong><em>Invisalign Teen</em></strong> can be as effective as traditional braces for many types of treatment. See an orthodontic specialist.</span></span></p>
<p><span style="font-style: normal;"><span style="font-weight: normal;">• Since aligners can be removed for eating and brushing teeth, it is much easier to maintain proper oral hygiene than it is with traditional metal braces. It also eliminates other common problems associated with traditional braces such as decalcification of teeth, office visits for broken braces, poking wire emergencies, and the like.</span></span></p>
<p><a  class="underline" title="Walton Orthodontics Website" href="http://www.drwalton.com/default.asp" target="_blank">Walton Orthodontics - Alpharetta Orthodontist</a></p>
<p>Alpharetta, Georgia</p>


]]></content:encoded>
			<wfw:commentRss>http://thesmilejournal.com/2009/01/03/invisalign-teen-introduced/feed/</wfw:commentRss>
		<slash:comments>9</slash:comments>
		</item>
	</channel>
</rss>

