Sunday, June 28, 2009

Summer is here. Your Markham Orthodontist Reminds you to Protect Yourself in the Sun!

It looks like summer has finally made it. School has ended, exams are done, and the hot weather is here. Our phone is going off the hook with patients scheduling consultations for braces and Invisalign. If you wish to schedule your complimentary evaluation, please call us at 905-477-7750.

Your Unionville braces and Richmond Hill Invisalign team at Markham Centre Orthodontics wish all of our patients and family a wonderful and safe summer. Stay cool and protect yourself from the sun. Below is information from Health Canada regarding fun in the sun.

Exposure to UV radiation, primarily UVB, can cause sunburns and may eventually result in skin cancer. It is important to note that while sunscreens can help reduce sunburn, they are not as effective against the other harmful effects of UV rays, such as premature aging of the skin and depression of the immune system.

All sunscreens have a sun protection factor (SPF) on their labels. The SPF represents the length of time that sunscreen-protected skin can be exposed to UVB rays before a minimal redness (erythema) appears, compared to the length of time it takes on unprotected skin. In other words, it indicates how much longer you can be exposed to the sun before getting a sunburn.

The amount of time it takes for unprotected skin to burn depends on skin type. In general, fair skin burns more quickly than darker skin. If you have the type of skin that would burn after 20 minutes in the sun without protection, then the proper application of sunscreen with SPF 15 would allow you to spend up to 300 minutes (15 times longer) in the sun without getting a sunburn. However, this does not mean that your skin is protected from all UV effects. Damage to your skin, other than sunburning, may have already started.

The SPF varies depending on the nature of the sunblocking ingredients in the product. Since the SPF refers only to protection against UVB, it is important to choose a "broad spectrum" sunscreen that also protects you from UVA radiation.

How Sunscreens Protect Your Health

There are many different brands of sunscreen available. They are classified according to their active ingredients, as some products contain chemical filters, some contain physical filters, and some contain both.

* Chemical filters absorb some of the UV radiation and convert it into heat. There are more chemical filters that absorb UVB rays than absorb UVA rays.
* Physical filters are small particles (usually zinc oxide or titanium dioxide) that scatter and reflect both UVB and UVA rays.

Minimizing Your Risk

Protect your health by using a broad spectrum sunscreen with an SPF of at least 15. Look for claims on the label indicating that the product has staying power (e.g., water resistant, very water resistant, waterproof).

For best results, be sure to follow the instructions on the product label. Use the recommended amount of sunscreen and respect the waiting period between application and exposure to the sun. Reapply sunscreen 20 minutes after you go out, so that the product stabilizes on your skin and gives you maximum protection. If you are sweating heavily or swimming, reapply sunscreen frequently to get the best protection.

Here are other steps that Health Canada recommends you take to protect against UV exposure:

* If possible, avoid being in the sun between 11:00 a.m. and 4:00 p.m.
* Look for shade, stay under a tree, or use an umbrella.
* During outdoor activities, wear sunglasses to protect your eyes. When the UV index is three or higher, you should also wear protective clothing and a large-brimmed hat.
* Remember to apply sunscreen to all exposed areas of your skin.

Monday, June 22, 2009

Your Markham Braces and Richmond Hill Invisalign Orthodontist Says That Gum Disease Can Affect Your Heart

Recent research shows that there is a direct connection between gum disease (also known as periodontal disease) and heart disease. There are several theories that explain the connection between gum disease and heart disease, but the most common theory contests that gum disease is caused by teeth that are not aligned properly. Plaque causing bacteria will begin to form on and between the teeth. The bacteria can be carried into the body’s blood stream causing blood clots that restrict nutrients and oxygen from reaching the heart.

The connection between orthodontics and periodontics is so important that Dr. Tam attended the February 2009 American Association of Orthodontics and American Academy of Periodontolgy Joint Specialties Conference in Orlando. Continuing education is an extremely important part of Dr. Tam's ongoing attitude towards providing the most up-to-date treatment possible.

By brushing your teeth at least twice a day, flossing and undergoing orthodontic treatment if your teeth are not perfectly aligned, you can prevent plaque buildup that results in heart complications. Remember, your teeth are a part of your body; and just like any other part of your body, your mouth is just as susceptible to disease!

Here's a 7 minute video clip from ABC on the subject.

Call (905)477-7750 for your complimentary orthodontic consultation with braces and Invisalign in Markham, Toronto, Unionville, Richmond Hill, Scarborough, Pickering, Ajax, Stouffville, York Region, Downtown Markham, North York, Thornhill, and the rest of the Greater Toronto Area. Let Markham Centre Orthodontics show you the Secret Behind Markham and Greater Toronto's Best Smiles!

Monday, June 8, 2009

ClearCorrect Tries to Woo Doctors Unhappy with Invisalign Proficiency Requirements

There has been a lot of talk about Invisalign's new proficiency requirements for their doctors. Your Markham Invisalign and Richmond Hill Braces orthodontist broke the story for you last week. It seems perfect timing for another company, ClearCorrect, to come out and try to take some market share. Currently, they have FDA approval, but are still waiting to get into the Canadian market.

Here is an email that was forwarded to me by a colleague:

ClearCorrect is based in Houston, Texas and according to the company, was founded by some of the biggest users of aligners. They offer two products. A two year treatment of up to 64 aligners, or a limited treatment of up to 12 aligners. The mid-course correction and refinement are included, as long as the treatment stays within the number of allotted aligners. Refinements of up to 4 sets are available for an additional cost. Their price point for doctors is about 70% that of Invisalign. Another difference to orthodontists or dentists is that one set of retainers is provided in the lab cost (may or may not make a difference to the patient cost). They are also provided with a model in case they wish to fabricate additional retainers in-office.

Although there is no literature or video published on the manufacturing process, they claim to have a similar process compared to Invisalign. All work is done in-house in Houston. They claim to cut costs by not requiring field reps in each territory. They also claim that their aligners are more clear. Online certification is available for doctors to discuss the process, and like Invisalign, does not show doctors how to move teeth. Other than that, it does not appear that there is any online continuing education. Invisalign now has over 200 hours of CE online as a part of their pathways to proficiency.

This is the second major company that has tried to compete with Invisalign. OrthoClear, started by the one of the founders of Invisalign, was bought out by Align within a very short period of time. They had promised lower prices, better service, etc for doctors unhappy with Invisalign. It caused a tremendous problem for doctors and patients who were left stranded in the middle of treatment. Invisalign took the high road and offered to continue treatment for these patients after the buyout. It is far too early in the game to see if ClearCorrect will be able to survive in this market dominated by Invisalign. From our standpoint, Markham Centre Orthodontics will not use ClearCorrect unless it is proven to be superior to Invisalign, and shows longevity in the market. Our patients deserve to be treated as over one million Invisalign patients, rather than with a company we cannot yet vouch for.

Invisalign does not seem too worried about ClearCorrect. The goal of their proficiency requirements was to prevent less experienced doctors from using their product, often incorrectly. This includes both orthodontists and GPs, resulting in claims by both doctors and patients that "Invisalign doesn't work". Many of the doctors who are upset with Invisalign are those that wish to offer it as a "bait and switch", but usually tell patients they will need alternative treatments. Invisalign seems happy to let these doctors who treat one or two patients annually, work with another company.

Remember that proper treatment planning and diagnosis is the key to successful Invisalign in Markham and braces in Unionville. To schedule your complimentary examination with your Richmond Hill orthodontist, call 905-477-7750. We look forward to the opportunity to meet you!

Friday, June 5, 2009

Markham Orthodontist Provides Details about Invisalign Proficiency

Here at Markham Centre Orthodontics, we draw Invisalign patients from all over the Greater Toronto Area, including Markham, Richmond Hill, Thornhill, Unionville, Scarborough, Pickering, Ajax, Stouffville, and more. Our patients are well-educated about Invisalign and understand that they are choosing an experienced Premier Provider Invisalign orthodontist for their treatment.

While Invisalign is a fantastic way to straighten teeth without braces, it isn't as easy as taking an impression, seeing a movie, and expecting to see a result. There are many important aspects to proper Greater Toronto Invisalign treatment, requiring knowledge of how teeth move with aligners.

The parent company of Align Technologies has recognized that there is a problem with less experienced providers, including both dentists and orthodontists. As such, they have made a move to ensure a certain level of competency and experience for Invisalign providers. Interestingly, the majority of complaints about this new program are from a large number of general dentists and a smaller number of orthodontists. On a side note, this move has been applauded by the American Association of Orthodontists.

Our Markham Invisalign patients should feel assured that we met the requirements in the first month of 2009. In fact, we have far exceeded the minimal levels and are in the top 5% of Invisalign Providers in North America. We have also been the choice of Invisalign certified Markham dentists and their family members for their own Invisalign braces. You are in good hands :).

Contact us at 905-477-7750 to schedule your complimentary initial assessment for Richmond Hill Invisalign, Thornhill Invisalign Teen, and Markham Invisalign Express with your Greater Toronto Invisalign Premier Provider Orthodontist. Find out more about Invisalign here.

Press release from Invisalign:

Align Technology Announces Invisalign® Proficiency Program to Help Doctors Build Product Experience

New product proficiency baseline requires 10 case starts and 10 CE credits per year
SANTA CLARA, Calif., June 2, 2009 -- Align Technology, Inc. (Nasdaq: ALGN) today announced that it is implementing a product proficiency program in North America to help ensure that Invisalign-trained doctors have the experience and confidence necessary to achieve high quality treatment outcomes for Invisalign patients. The Invisalign System is an evolving, skill-based procedure that requires regular usage and ongoing education to develop proficiency with the product and technique. The Invisalign proficiency initiative, along with ongoing improvements in Invisalign products, training and support, is evidence of Align’s commitment to helping Invisalign-trained doctors gain the knowledge and experience they need to be successful with Invisalign.

Effective June 1, the Invisalign product proficiency program requires every Invisalign provider in North America to start 10 Invisalign cases and complete at least 10 Invisalign-specific continuing education (CE) credits each calendar year to maintain active provider status. Doctors who do not meet the annual case start and CE requirements by the end of each calendar year, starting with December 31, 2009, will be able to continue treating any cases in-progress, but they will not be eligible to submit new Invisalign cases or to use Invisalign marketing resources. Doctors can reactivate their provider status by retaking Invisalign Clear Essentials I training and meeting the proficiency requirements during the new calendar year.

“Based on more than a million patients treated to date, we know that a doctor’s proficiency levels with Invisalign are a reflection of his or her Invisalign case experience,” said Dan Ellis, vice president North America Sales. “We are committed to helping our customers gain the product knowledge and confidence they need to achieve high quality treatment outcomes. In addition, by ensuring a baseline of experience, Align can also better support the needs of Invisalign providers by tailoring programs and services to help doctors build and maintain a working knowledge of Invisalign.”

As part of the Invisalign proficiency program, Align has created a Proficiency Pathway to ensure that doctors have the appropriate education tools and support to be successful with Invisalign. The Proficiency Pathway provides clinical educational opportunities to help doctors achieve confidence with Align Technology Inc. 881 Martin Avenue Santa Clara, CA 95050 Tel: (408) 470-1000 Fax: (408) 470-1201

Align Technology, Inc. Announces Invisalign Proficiency Program case selection and treatment planning, case submission and treatment management, as well as aspects of practice development. The pathway is divided into six milestones and under each milestone Align has identified courses or content specifically related to increasing a doctor’s knowledge and confidence based on his or her current case experience level.

Dr. Randol Womack completed Invisalign training in 1999 and has been teaching Invisalign courses since 2001. “As with any health-related service, the doctor has the obligation to become proficient in his or her proposed treatment method in order to represent a predictable resolution to the patient’s prime concern and expectation.” said Dr. Womack. “The combination of training and sufficient experience with the Invisalign System is key to ensuring the doctor has the confidence needed to provide patients with the great outcomes they expect.”

Invisalign-trained doctors now have a range of Invisalign products that provide treatment solutions for most day-to-day treatment needs. In 2008, Align introduced three new product offerings with new features, tools and delivery options to meet specific clinical demands while providing a family of end-to-end solutions for doctors. With the launch of these new products, the Invisalign product family includes: Invisalign Express for simple/limited treatment cases, Invisalign Full or Invisalign Assist for comprehensive or complex cases, Invisalign Teen for younger patients, and Vivera Retainers for post-treatment retention.

Thursday, June 4, 2009

We Don't use Damon Braces at Markham Centre Orthodontics... Here's Some New Evidence Why...

EDIT: It appears this post has generated quite a bit of discussion. Please note that the proper treatment planning by an orthodontist, not the appliance, results in healthy, successful smiles. We appreciate your comments and have added another abstract from one of the world's most respected orthodontists, Dr. Brite Melsen. This is not specific to Damon, but is also about self-ligation.

Transversal Expansion and Self-Ligating Brackets: A CBCT Study

Paolo Cattaneo, L. Cevidanes, M. Treccani, A. Myrda, B. Melsen

Aarhus, Denmark

Aim: To perform 3D assessment of the transverse changes of the maxillary alveolar bone on patients treated with active and passive self-ligating brackets. Material and Methods: Pre- and post-treatment CBCT-scans of 50 patients were taken. 3D models were generated from the scans, were registered using the cranial base stable structures, and superimposed. Changes in basal alveolar bone and dental arches were evaluated using a 3D colored mapping. Results: Expansion happened mostly in the canine and more in the premolar region, and was achieved by buccal tipping. No transverse augmentation of basal bone could be detected. High variation and strong patient-related patterns of transversal expansion were observed.

There has been a lot of media buzz about Damon braces with claims that extractions are not required, and that bone is generated due to extremely light forces. There are also unsubstantiated claims about moving teeth faster. Most people don't want teeth taken out and want fast treatment. With ads showing Miss Seventeen wearing them, who wouldn't want a Damon orthodontist?

At Markham Centre Orthodontics, we strive to provide evidence-based treatment for your Unionville braces and Markham orthodontics. Despite the hype and buzz about this "revolutionary" technology, we want to be sure we are providing our patients with the best and healthy options possible. It is important to realise that it is the orthodontist, treatment planning, and diagnosis, that produce successful outcomes, not a particular product, be it Damon, Invisalign, or any other type of appliance.

A study has come out of the University of Oklahoma by Paventy to scientifically refute the claims by Damon users. They used cone beam technology, similar to that of CAT scans, to measure bone around the teeth after trying to correct severe crowding that Damon braces claim to be able to correct without extractions.

Here is the abstract:

Nonextraction Treatment Using the Damon System: A CBCT Evaluation

Anthony M. Paventy

University of Oklahoma

Objective: To evaluate facial bone changes using CBCT after arch development using the Damon System in nonextraction treatment of moderate to severe crowding.

Methods: 19 patients with clinical crowding of 5+ mm were treated following the Damon System. ACBCT scan was taken prior to bonding (T1) and again after arch development (T2). T1 data served as the internal control group.

Results: The maxillary 1st premolars, mandibular 1st and 2nd premolars and mandibular molars all showed significant facial bone height loss. Additionally, every maxillary tooth showed significant mean facial bone width loss. The same was true for the mandible

Conclusion: The Damon System effectively expanded both dental arches. However, facial bone did not correspondingly adapt after arch development was completed. In fact, facial bone decreased significantly in height and width for nearly all teeth measured.

What this means is that while teeth can be straightened when there is inadequate space, the supporting structures around the teeth can be weakened, leading to an increased likelihood of future gum and tooth mobility problems. The data is beginning to show that severe crowding and transverse expansion may not be best treated without extractions, expanders, or surgery, regardless of what appliance is being used.

Note that the use of self-ligation with proper treatment planning has produced many successful results. However, studies unequivocally show that they are no faster than traditional brackets, and that some brands may actually be more uncomfortable. The data presented at the AAO in Boston and AAO/AAP joint meeting in Orlando confirm that there may be no advantage of self-ligation over traditional brackets.

Orthodontics should be directed at creating healthy smiles that last a lifetime. There are times that it is healthier to remove teeth than to try and fight the natural balance of our bodies. Seek your own professional opinion regarding your own personal situation. Please call 905-477-7750 to schedule your complimentary evaluation for Richmond Hill braces, Scarborough Invisalign, and Markham orthodontics.