Shiny and New

It isn't surprising that Lindsay Lohan is all over the news this week, but one of the hot topics regarding this Hollywood starlet is the dramatic change that her teeth have undergone in the past couple of weeks. Lindsay tweeted with the picture below that she had gotten a Zoom! teeth whitening treatment and thanked her dentist for her pearly whites.

There has been a lot of skepticism regarding whether or not Lindsay had more work done than just teeth whitening. Some doctors have suggested that she may have gotten crowns or veneers. I am not going to discredit what anyone has contended or opined, but here is what I am going to say: The Zoom! Teeth Whitening System, a service that we offer at Aesthetic Orthodontics, delivers amazing whitening results. That being said, Zoom! bleaching does not have the capability of changing the structure or the shape of a tooth. It is meant only to deliver a whiter smile.

Orthodontic treatment is similar. With braces, I create straight beautiful smiles, aligned jaws, and comfortable bites for my patients, but orthodontic treatment will not dramatically change the shape of their teeth.

Regardless of the cause of Lindsay Lohan's dental dilemmas,the best advice I can give to avoid issues like discoloration and tooth decay is to live a healthy lifestyle. Eat a well-balanced diet, exercise, and avoid drugs, chemicals, and foods that can cause dental erosion.

World Health Organization Urges Move Away from Dental Amalgam | The Holistic Dentist

I came across this post by a holistic dentist in Glendale, CA. Many of you are aware that my father, Dr. Jack Alpan, practiced dentistry and was also a naturopathic doctor. Through his tutelage and research of my own, I believe that using dental amalgam, or mercury-containing fillings, is dangerous and potentially very toxic to the body. If you have amalgam fillings, my recommendation would be to replace those fillings with composite or another less toxic alternative.

World Health Organization Urges Move Away from Dental Amalgam | The Holistic Dentist:

There’s been plenty of good news lately on the effort to end the Age of Toxic Dentistry, such as the Malibu City Council’s resolution supporting the global phase-out of dental mercury, which was unanimously approved just last week.

Malibu now joins Costa Mesa and Santa Ana as California cities opposed to dental amalgam.

And now more good news: The World Health Organization has finally released its 2009 report on the “Future Use of Materials for Dental Restorations,” which likewise urges a global “phase down” of toxic mercury amalgam.

The report has been released in preparation for the third of five Intergovernmental Committee deliberations that are expected to lead to the adoption of a legally binding treaty on mercury by 2013. Here is an excerpt from the report:

"In a clear sign that dentistry’s amalgam era is fading, the World Health Organization (WHO) just released its long-awaited report on dental amalgam. In Future Use of Materials for Dental Restoration, WHO urges “a switch in use of dental materials” away from amalgam.

“[F]or many reasons,” WHO explains, “restorative materials alternative to dental amalgam are desirable.” The report describes three of these reasons in detail:

WHO determines that amalgam releases a “significant amount of mercury”: WHO concludes that amalgam poses a serious environmental health problem because amalgam releases a “significant amount of mercury” into the environment, including the atmosphere, surface water, groundwater, and soil. WHO says “When released from dental amalgam use into the environment through these pathways, mercury is transported globally and deposited. Mercury releases may then enter the human food chain especially via fish consumption.”

WHO determines that amalgam raises “general health concerns”: While the report acknowledges that a few dental trade groups still believe amalgam is safe for all, the WHO report reaches a very different conclusion: “Amalgam has been associated with general health concerns.” The report observes, “According to the Norwegian Dental Biomaterials Adverse Reaction Unit, the majority of cases of side-effects of dental filling materials are linked with dental amalgam.”
WHO determines that “materials alternative to dental amalgam are available”: WHO concludes that “Materials alternative to dental amalgam are available” – and cites many studies indicating that they are superior to amalgam. For example, WHO says “recent data suggest that RBCs [resin-based composites] perform equally well” as amalgam. And compomers have a higher survival rate, says WHO, citing a study finding that 95% of compomers and 92% of amalgams survive after 4 years. Perhaps more important than the survival of the filling, WHO asserts that “Adhesive resin materials allow for less tooth destruction and, as a result, a longer survival of the tooth itself.”
We have come a long way. Less than a year ago, dental trade groups were circulating an unedited and unreviewed draft of this report to government officials, implying that it was WHO’s final position. But the draft was riddled with factual errors and scientifically unsupported claims. Consumers for Dental Choice – working with non-governmental organizations, scientists, and environmentalists from around the globe – organized a letter-writing campaign to insist that the draft be immediately withdrawn, accurately rewritten, and properly reviewed.

And it worked! Now WHO has removed all claims of amalgam’s safety. Now WHO has committed itself to “work for reduction of mercury and the development of a healthy environment.” Now “WHO will facilitate the work for a switch in use of dental materials.”

Thank you to everybody who urged WHO to take this important step to protect future generations from dental mercury."

Loving Your Braces Can Lead to Love

Love is in the air at Aesthetic Orthodontics. One of my patients was sitting in the chair the other day making a big to-do about the fact that she couldn't go to Vegas and have fun with her girlfriends because she had her braces on. She said she didn't feel comfortable dating. "I'm on a dating hiatus," she said. Another patient a couple of chairs down had overheard her complaining and said, "Are you kidding me? I met my boyfriend this way, and now I know he really likes me for me." Everyone started laughing.

A lot of my single adult patients worry about being able to date with braces. Anxiety can arise with the thought of going through orthodontic treatment. "I'll never be able to date." "Men won't find me attractive." "Women won't think they are sexy." "Braces are going to ruin my game." "I won't be pretty." Some people decide that they aren't going to date at all. Honestly, would a woman kick Tom Cruise out of bed for having ceramic braces? Would a man not be interested in Nikki Taylor or Gwen Stefani because their teeth adorn little brackets? Not so much.

Think of having braces as a time to reform and transform. Carry off a positive attitude, and you'll have no problem carrying off braces. Find someone who is interested in you for being the incredible person you are and put some faith into the fact that you look amazing with or without your braces. If other people can't see past your braces, they aren't even worth your time.

It's been a joke at our office lately that love is in the air because lots of patients are getting braces before weddings or meeting their soul mate with their braces. A couple of patients are getting married with their braces. Some of my women patients in their forties and fifties don't mind keeping their braces on even longer than they need to because the braces give their lips the "botox effect." They love them because it makes their lips feel fuller and they attract younger guys. As for my male patients, braces make them seem like a risk taker and make them look younger - what isn't attractive about that? The truth is, the object of your affection is going to be interested in you regardless of what's in your mouth (unless what's in your mouth is yesterday's breakfast and seriously bad oral hygiene - nothing attractive about that). So put a big smile on your face and your best foot forward, and nothing, not even a mouth full of metal, will stand in your way.

A Happy Marriage: You and Your Retainer

Retainer, meet patient. Patient, meet retainer. Get to know each other well because you will be seeing a lot of each other. In fact, I now pronounce you patient and retainer til death do you part. Yes, retainers are for life, but the good news is, your teeth are straight for life as well!

Retainers are completely loyal to you as long as you are loyal to them. But if you should decide that you would rather be single for awhile, when you come back to your retainer, the retainer may not be the right fit for you anymore. So what happens when your retainer doesn't fit? Well, it's time to schedule a visit with me. The best case scenario - I'll make you a new retainer. Worst case scenario - you will need to start treatment all over again to get your teeth straight again.

If you have found that you haven't been tried and true to your retainer and it isn't fitting right anymore, schedule an appointment with us as soon as possible. If you think that all hope is lost, it might not be. There are affordable products available that can help make small changes - perhaps that's all you need. Either way, it's best to see an orthodontist just to make sure your bite hasn't shifted and that everything is aligning properly.

After you have finished your treatment and have been in retention (wearing a retainer) for over a year, I always recommend that my patients schedule a yearly appointment to make sure that everything is fitting properly.

There are a few different kinds of retainers. I've highlighted a couple of them below:

Hawley retainers are very common and you probably have seen this type of retainer before. These retainers are removable, and usually gum-colored, but they are available in a number of different colors and patterns. They are a great option for most patients and are a sturdy, reliable retainer.

This is a fixed retainer and is a permanent retainer, so it cannot be removed. It consists of a passive wire bonded to the lingual (tongue) side of the teeth. The wire is thin and barely noticeable. This is a great option for patients who aren't compliant, lose retainers, or don't want to deal with a removable retainer!

For Invisalign and Invisalign Teen patients, Vivera retainers are a good option. They are clear, just like aligners, but are thicker than typical aligners to help hold the teeth in place. These are nice retainers, but for long term, permanent use, I try to encourage other types of retainers.

Spring aligners can serve multiple functions. In addition to being a retainer, they can also be used as a night guard because they are made from a hard acrylic. Spring aligners are also great for making minor adjustments to teeth.




Retainers are essential to keeping your teeth, jaw, and bite in the alignment they were in when you got your braces off and finished your treatment. The key to a happy marriage? Wear your retainer.

Change is Good

We are making some exciting changes at Aesthetic Orthodontics. This week we launched our new website, which has a more modern look and feel to it and is more user-friendly. The new website will make it easier for patients to find information about our offices, different treatment options that we offer, and answers to common questions that patients have before and during treatment. We continue to provide T.Link, a patient account system, making it easy to manage appointments, see before and after photos, suggest referrals, and view account balances. Earlier this year, we created a new logo that has made our brand more identifiable and cutting-edge. Additionally, we have new marketing materials and promotional items available to our patients and are planning on implementing new contests and games to keep an overall sense of community amongst our team and our patients. We are very excited about these new changes and hope that you will spend a few minutes reacquainting yourself with Aesthetic Orthodontics.

Face Value

In our society and culture, a full smile showing teeth is a sign of trust and friendliness, but many people feel self-conscious about showing off their full set of pearly whites. People value smiles, but how much do you value your own smile? How comfortable are you with your smile? Are you only smiling half way? Are you less confident talking with coworkers, friends, and strangers than you'd like to be? Do other people seem comfortable talking with you and looking you in the face? Do you feel like your teeth have changed over the years and are now less confident with the impression you feel you are making with your smile? All of these are valid questions in a society that values straight teeth and beautiful smiles.

If you are in the market for a job, perhaps you feel like you'd make a better impression in an interview with a healthier smile. If you are negotiating deals, perhaps you'd feel like you'd seem more credible with beautiful teeth.

A lot of people would like to change their smile but many never take action. Often it is because they are afraid of the costs of treatment and dental work or they don't like the idea of having to wear braces. But, they don't realize that there are many options and alternatives available. At Aesthetic Orthodontics, we work with you to come up with a customized treatment plan, and we do whatever we can to make it as affordable as possible.

If you are ready for a change and would like to find out how we can help you create that smile that you have been dreaming of, give us a call for a completely free consultation. Even if you have been told by another doctor that you need surgery or dental work, we may be able to come up with better, more affordable options for you. We provide exceptional care so that you will leave smiling with confidence.

Seven Common Questions Parents Have

The article below was posted on the American Association of Orthodontists website and I think it is a great starting place for parents who are considering orthodontic treatment. The Aesthetic Orthodontics website offers more in-depth information about orthodontic treatment. As always, I invite you and your family to come in for a free consultation to evaluate the treatment options that may be available to you.

Seven Common Questions Parents Have:

Today, nearly four million children in the United States and Canada are receiving treatment from members of the American Association of Orthodontists (AAO). And while parents know that orthodontic treatment results in a healthy, beautiful smile, many don’t realize the important long-term health benefits.

As part of its commitment to education, the AAO provides parents with this list of answers to commonly asked questions about orthodontic care.

1. Why is orthodontic treatment important?
A: Straight teeth and properly aligned jaws contribute to good dental health as well as overall physical health. Orthodontic treatment can boost a person’s self-image as teeth, lips and jaws move into position and improve appearance.

2. How do parents know if their child needs orthodontic treatment?
A: The best way is to visit an orthodontist. The AAO recommends that all children get a check-up with an orthodontist no later than age seven.

3. What if my child still has baby teeth at age seven? Should they still see an orthodontist?
A: Yes. By age 7, enough permanent teeth have arrived for orthodontists to evaluate how the teeth and jaws meet, and to identify current or developing problems. If a problem is detected, the orthodontist and parents can discuss when treatment may be necessary.

4. How does a child’s growth affect orthodontic treatment?
A: Treatment and growth often compliment each other. In some cases, the orthodontist takes advantage of a child’s growth to guide jaws and teeth into their ideal positions.

5. How often do you visit your orthodontist while in orthodontic treatment?
A: Typically a child will see the orthodontist every 6-12 weeks throughout the course of treatment.

6. If you currently don’t have an orthodontist, what is the best way to find someone to treat orthodontic problems?
A: To find an orthodontist near you, ask for a referral from your family dentist, your pediatrician or your child’s school nurse. Or you can visit www.braces.org and click on the Find an Orthodontist service. It is important to choose an orthodontist who is a member of the AAO. Orthodontists receive an additional two to three years of specialized education beyond dental school to learn the proper way to align and straighten teeth. Only those with this formal education may call themselves “orthodontists,” and only orthodontists may be members of the AAO.

7. What is the average cost of orthodontic treatment?
A: Fees will vary, depending on the treatment needed. Most orthodontists offer convenient payment plans, making treatment more affordable than ever. Most orthodontists will work with you to find a plan that fits your family budget. In addition, many patients have dental insurance that includes orthodontic benefits. Check with your employer’s human resources department to learn about your coverage.

Is there something in my teeth?

Tooth decay is the one of the most common diseases in children and adults. Maintaining good oral hygiene during orthodontic treatment is of the utmost importance. It is more difficult to brush and floss around braces, but patients without good oral hygiene during orthodontic treatment put themselves at greater risk of plaque developing around the braces, potentially causing cavities and permanent staining of the teeth.

I recommend brushing after every meal, and if that can't always be accomplished, at least brushing twice a day - after breakfast and before bed. I always tell my patients to see a dentist every 4-6 months. It is especially important to keep up with dental cleanings and exams during orthodontic treatment to keep the hard-to-reach areas clean and maintain healthy teeth and gums. Some people use a small interproximal brush to clean areas that are too small for a regular toothbrush and too large for dental floss.

Flossing can definitely be tricky during orthodontic treatment, but making it a part of a daily routine is essential because flossing will remove plaque between the teeth. Using waxed floss is better than using unwaxed floss because unwaxed floss can fray on the edges of braces bands or brackets. Oral B makes a great product called Superfloss that has a stiff end making it easy to get the floss behind the archwire, a regular section for between the teeth, and a spongy section for wider spaces. My favorite product, however, is the Waterpik Flosser. This is a battery-powered device with a replaceable rubber tip that vibrates to cleanse away plaque, and massages gums to prevent gingivitis. Follow up brushing and flossing with the Waterpik Oral Irrigator, a device that bursts jets of water between teeth and gums to remove food particles and wash away plaque already dislodged by brushing and flossing. You can purchase the Waterpik Flosser and the Oral Irrigator at Aesthetic Orthodontics.

Remember that bacteria feed on sugar, so keeping a well-balanced, healthy diet will also decrease the risk of developing tooth decay. Patients with healthy teeth and gums will have an easier time with braces, making their treatment more enjoyable. At AO, we are always happy to give instruction on how to brush and floss effectively.

Embracing Your Braces

Crest and Oral B have created a contest called “Life Opens Up” where people submit videos about how their mouth has helped them open up to the world, and how the world has opened up to them in return. Crest and Oral B created several videos to show people the types stories they are looking for, and our patient, Ruby, was selected to shoot one of these videos because of her story about having braces as an adult. I wasn't able to embed her video in this blog, but check it out here.

Ruby has really conquered the fears and apprehensions about having braces as an adult and exudes the kind of contagious self-confidence that draws people in. We joke about braces being magnetic, but in Ruby’s case, hers really are. Ruby not only found her boyfriend during treatment, she embraced her social life and increased her self-confidence. Since the video was made, Ruby has gotten her braces off and loves her new smile. She is a great example of how patients can make the most of their orthodontic treatment.

If you are worried about having braces, try to take Ruby’s advice: Put yourself out there! Post a couple of pictures of you with your braces. Remember that you are only temporarily in treatment. Thousands of people have braces, and the people who truly care about you will be supportive of your treatment. Braces are becoming trendy as more and more adults are choosing to start orthodontic treatment. Focus on the changes that you see as your treatment progresses, and look forward to the end result. Enjoy your braces while they last and always embrace your smile.

Making Smiles Affordable

Waiting for Guffman has been showing on cable lately, and when I saw this clip, it really got me wondering what goes through my patients' heads when we discuss treatment plans. Choosing to have orthodontic treatment yourself or to provide it for a child is a financial commitment, and in this economy, people are being more selective with expenditures. I truly believe that everyone deserves to have the smile of their dreams, and because of that, we offer fair prices and a number of different payment options to make it easier on my patients and their families.

In addition to honoring several insurance policies and working with our Medi-Cal patients, at Aesthetic Orthodontics, we provide different financing opportunities including a no-interest in-house program. My team and I do everything we can to create a comfortable financial situation for our patients so that we can then do what we do best – give them a perfect smile!

Every once in awhile, I get into a situation where I feel like Corky. Someone comes in desiring orthodontic treatment. An evaluation is made, a number is thrown out, and the patient is unprepared for the overall cost of treatment. Of course, Corky was being completely unreasonable, whereas I propose a price that fits under the bell curve. It isn’t typical when a patient looks at me like I’m an alien, but it can happen because of a few reasons. Either the patient didn’t do any research and imagined that orthodontic treatment would be priced differently, the number was expected but isn’t one that the patient feels financially secure enough to pay, or the patient had self-assessed the issue to be one that is more easily resolved than the exam would then reveal to me. By the end of the conversation, we’ve both explained our positions and come to an agreement on the most comfortable treatment program.

Discussing money and payment is not easy for anyone, but even in an economic downturn, we strive to make orthodontic treatment attainable by creating a financial plan within your means and by offering a large selection of braces products and appliances. If you are considering treatment for yourself or your family, give us a call, schedule a consultation, and at least find out what your options are. I think you’ll be pleasantly surprised at the opportunities available to you.

Hermione's Magical Teeth

This week will mark the beginning of the end of an era as the world sits in anticipation for the release of Harry Potter and the Deathly Hallows Part 2. I must warn you that I have never read the Harry Potter books, but my patients, especially my younger ones, have been counting down the days until July 15th - the movie's scheduled release - for months.

To pay homage to the successful series and world trend, the topic of this post will be one of everyone's favorite characters, Hermione Granger. Actually, Hermione Granger's teeth. For those of you who haven't read the Harry Potter series, Hermione Granger is the daughter of two muggles (people who are not witches), who were very accepting of their daughter's identity as a witch. Mr. and Mrs. Granger were both dentists who worked along side each other at their Australian practice. Hermione was extremely clever, always at the top of the class; she was that girl in school that always raised her hand for everything and read the entire book before the class got through the first chapter.

Hermione was also given the gift of unusually large front teeth and a crooked smile.

So, just how did Hermione manage to straighten her teeth? Fortunately for Hermione, she lives in a magical world. In Harry Potter and the Goblet of Fire, Hermione's classmate Malfoy put a spell on her, giving her large fangs.

"Hermione" Ron said, looking sideways at her, suddenly frowning, "Your teeth..."
"What about them?" she said.
"Well, they're different... I've just noticed...."
"Of course they are-- did you expect me to keep those fangs Malfoy gave me?"
"No, I mean, they're different to how they were before he put that hex on you.... They're all... straight and-- and normal-sized."
Hermione suddenly smiled very mischievously, and Harry noticed it too: It was a very different smile from the one he remembered.
"Well... when I went up to Madam Pomfrey to get them shrunk, she held up a mirror and told me to stop her when they were back to how they normally were," she said. "And I just... let her carry on a bit," she smiled even more widely. Mum and Dad won't be too pleased. I've been trying to persuade them to let me shrink them for ages, but they wanted me to carry on with my braces. You know, they're dentists, they just don't think teeth and magic should-- look! Pigwidgeon's back!"

In the real world, Hermione's parents would have been right. Teeth and magic just don't mix for the majority of us muggles. Actress Emma Watson, who plays Hermione, ended up having conventional orthodontic treatment to straighten her pearly whites. Emma Watson is all grown up now, and with or without sorcery, it seems her braces have magically disappeared.

To all you Harry Potter fans, all of us at Aesthetic Orthodontics hope you enjoy the bittersweet ending to magical world of Harry Potter. Wear your Gryffindor scarves proudly and immerse yourself in the final battle where Harry, Ron, Hermione, and their allies defend Hogwarts and the magical world civilization against the Dark Lord.

And, if, perchance, your enemy happens to cast a spell on you and you grow fangs or your teeth suddenly get crooked, give us a call. We may not have magical powers, but we surely can help.

The Importance of Orthodontic X-Rays

Merely mentioning the word x-ray to my patients can bring up fear, unpleasantry, and an automatic association to cancer and birth defects. Our society is laden with cancer, and because the disease touches all of us in one way or another, we have been inundated with information about preventing various forms of cancer. X-rays are a form of radiation and radiation of any kind can pose a risk to our health, but it is important to realize that radiation has many important and beneficial uses.

X-rays in the practices of dentistry and orthodontics are used to routinely diagnose and treat a number of conditions that could otherwise not be diagnosed properly. At Aesthetic Orthodontics we take x-rays before and after treatment. As an orthodontist, I work not only with teeth, but with the entire dental-facial complex of teeth, bones, lips, joints, sinuses, cartilage, nerves, and muscles. X-rays help me determine if there are underlying structural or alignment issues with the jaw and teeth. They also help me determine in which direction teeth will likely grow or move, and to evaluate the relationship of teeth to other neighboring structures.

Patients usually understand the need for x-rays at the beginning of treatment, but some think that x-rays upon treatment completion are unnecessary. Their teeth are straight and they are happy with their smile, so why do they need to have more x-rays taken? The answer to that is simple. I need to make sure that the bones have developed properly, that the teeth and jaw bones are aligned properly, and that there is nothing further that needs to be done that I may not have been able to detect without the use of an x-ray. X-rays after treatment are also a veritable reference to have if a patient comes in with any issues in the future. I try to make clear to each patient the importance of before and after x-rays before treatment begins.

Understanding the importance of orthodontic x-rays plays a big role in accepting x-ray imaging as part of treatment. However, radiation still leaves patients a bit squeamish. So, just how much radiation are you exposed to? I tell my patients it's like sitting in the sun for ten minutes on a hot day. Radiation is measured in rems, but a rem is a very large unit, so we measure in millirems as well. One thousand millirems equal one rem. At Aesthetic Orthodontics we use ultra-low dose digital imaging. Each x-ray exposes you to less than 0.5 millirems. To put that into perspective, you are exposed to 10 millirems per year cooking with natural gas and 1 millirem - a little more than 2 dental x-rays - for each short flight you take. (perhaps Los Angeles to Las Vegas.) A mammogram exposes each breast to 500 millirems, or the equivalent of 2,000 dental x-rays. I understand the importance of living a healthy lifestyle and avoiding unneccessary risks. At Aesthetic Orthodontics, we do everything we possibly can to ensure that you are getting the lowest dose of radiation to keep you happy and healthy, while still capturing the images and the data we need to make your treatment as successful as possible.

If you need more quantifiable information, listen to the informative podcast below on the risks of dental x-rays by Dr. Sean Carlson, associate professor at my alma mater, the Arthur A. Dugoni School of Dentistry at the University of the Pacific. And as always, if you still have questions or concerns, feel free to contact any one of our offices, or email us at info@aeortho.com