I was walking through the mall the other day and witnessed a sight that is becoming more and more common in the landscape of today’s youth. A group of 5 or 6 young adults were taking a typical stroll along the storefronts, enjoying the indoor comfort and conveniences of mall shopping and basking in the camaraderie of being together with good friends. What caused me to do a double take was that all these individuals sported all sorts of body jewelry. They had earrings, and nose rings, and lip rings, and tongue rings, and who-knows-what-else-rings. In other words, they had more piercings than a well used dart board. Now I’m not a complete fuddy duddy and certainly believe in the freedom of self expression, but I wonder if these young men and women were really aware of the health consequences of these modifications of their body parts—especially in the oral regions.

Tongue splitting and piercings that involve the tongue, lips, cheeks or uvula (that tiny piece of tissue that hangs down at the back of your mouth) can be risky. Often times, pain and swelling may result. The swelling can sometimes be so severe that it interferes with your ability to breathe. Unsterile technique or inadequate follow-up care may result in infection. Blood vessels may be inadvertently damaged during the procedures which can lead to serious bleeding problems. Jewelry-related complications include chipped teeth, gum damage, tissue overgrowth or accidental swallowing or inhalation. Furthermore, these dense metal objects can block the transmission of x-rays, thus interfering with proper dental diagnosis. I’ve even heard of an occasion where a tongue ring got accidently ensnared in the corner of an orthodontic brace. So although tongue piercing and oral jewelry may seem like a trendy way to express your self image, please consider the possible effects such a choice can have on your oral and overall health. We worked too hard to achieve that beautiful smile and we definitely want you to keep it for an entire lifetime!

Have you ever wondered what distinguishes your orthodontist from the one down the street, across town or in the next county? In addition to obvious factors such as genuine compassion, technical ability and interpersonal skills, one of the most useful discriminators is the orthodontist’s work ethic and their desire to keep current with a rapidly changing profession. Most state dental boards require a minimum number of continuing education courses just for license renewal. In our practice, however, our doctors go way above and beyond the required standards. Over the past several years, I’ve personally attended classes and seminars addressing Invisalign technology, temporary anchorage systems, facial growth and development, dentofacial orthopedics, bracket and archwire technology and temporomandibular dysfunction just to name a few. I also subscribe to online journal review programs that keep me up to date on the latest scientific developments in my profession-- orthodontic techniques, radiation safety, disinfection and sterilization, business management and the like. I’ve attended numerous annual meetings of the American Association of Orthodontists and the American Dental Association, spoken directly with leaders of orthodontic research and development, written articles for local trade journals and mentored fellow dentists and dental students. Although I graduated from my orthodontic specialty program in 1995, I remain firmly committed to your orthodontic care through my own commitment to continued orthodontic learning and practice.

With a last name like “Huang”, you can imagine I’ve been called a lot of different things over the years. Anything from “Dr. Wang” to “Dr. Wong”, “Dr. Hu-ang” to “Dr. Hong”, “Dr. Hung” to “Dr. Hu-awn.” Did you know that “Huang” is one of the most common names in China? It is translated as the word “yellow” and is correctly pronounced like “Hwong”. As difficult as that may be for my patients to remember, I’m kind of glad I wasn’t born with these names. Believe it or not, these are actual names of practicing dentists I found listed on the web. Dr. Pullman, Dr. Filler, Dr. Fear, Dr. Rensch (pronounced “wrench”), Dr. Pick, Dr. Tusk, Dr. Drewel (pronounced “drool”), Dr. Tucek (pronounced “tooth check”), Dr. Chu, Dr. Shugar, Dr. Pang, Dr. Butcher, Dr. Harm, Dr. Hurt, Dr. Toothaker (not kidding), Dr. Lynch, Dr. Root, Dr. Nasti, Dr. Paine/Payne/Pain (notably Daryl B. Payne), Dr. Smiley, Dr. Schotz, Dr. Hale (pronounced “hell” in our neck of the woods), Dr. Bliss, Dr. Lancit, Dr. Gager, and Dr. Eke. After going through that list, I guess there’s nothing “wrong” with “Huang” after all.

I’m sorry to report that of the nearly 1500 people across the US who were tested by the American Dental Association about their knowledge of oral health and hygiene, no one scored higher than 85 percent while the lowest score was only 29 percent. Although most participants could define gingivitis, only 6 percent knew the proper age of when children should be able to brush their own teeth, and only one in four knew when a child should have their first dental visit. As an orthodontist, I was not surprised to discover that of those surveyed regarding physical attractiveness, a nice smile outweighed skin, eyes, hair and build or figure as the single most important attribute. Eighty five percent of respondents indicated that a good smile is extremely or very important for finding a job, and one in five people have shied away from a social event because of problems with their teeth. If you are interested in learning more about how your own dental IQ compares to the national average, you can visit the website MouthHealthy.org and check out an abbreviated and interactive version of the survey.

What did “modern” braces look like back in the early 1900s? Mostly they consisted of rings of gold, silver, platinum or steel around every single tooth together with metallic archwires and a multitude of loops, hooks, spurs and ligature ties to provide forces on the different teeth. Gold was used because it was malleable and easy to shape but it was also extremely expensive and required frequent adjustments. Nowadays, orthodontists use mainly heat-activated nickel –titanium alloy wires. These specially alloyed wires (developed by NASA) are designed specifically to deliver light and gentle forces over longer periods of time. As they warm to body temperature they become active and gradually move the teeth in the anticipated direction with fewer adjustments. The gold rings wrapping around the teeth have been replaced by direct bonding technology whereas the orthodontic brace is glued directly onto the tooth enamel with an adhesive that is hardened by a special ultraviolet light source. As a result, braces are more cosmetic, comfortable and much more patient friendly than a century ago. As we move further into the 21^st century, continued advancements are being made in the areas of digital radiography, temporary implant anchorage, self-ligating brackets, lingual orthodontics, and computerized assisted treatment planning. The advent of the Invisalign clear aligners has recently revolutionized the practice of orthodontics giving patients a “brace-free” method of developing that perfect smile. It’s certainly quite a difference from the “metal mouth” look of my first set of braces!

I treated my first orthodontic patient back in the 1980’s, but the history of braces dates back a little earlier—actually several thousands of years earlier with the discovery by archeologists of mummified ancients with crude metal bands wrapped around individual teeth. Later in 400-500 BC, both Aristotle and Hippocrates also devised and wrote about ways to straighten crooked teeth. However, it was not until the 1700s that significant events in the field of orthodontics really developed. In 1728, French Dentist Pierre Fauchard published a book called “The Surgeon Dentist” with an entire chapter devoted to straightening teeth. He used a horseshoe-shaped piece of precious metal (somewhat similar to some of the appliances still used today) to expand the dental arches. The term orthodontia was coined by Joachim Lafoulon in 1841, gum elastics were first employed by Maynard in 1843, Tucker was the first to cut rubber bands from rubber tubing in 1850, and in the late 1800’s, Eugene Solomon Talbot first used X-rays for orthodontic diagnosis. Norman W. Kingsley, a dentist, writer, artist, and sculptor has often been referred to as the “Father of Orthodontics.” In 1858, he wrote the first official scientific article on orthodontics, and in 1880, his book “Treatise on Oral Deformities” was published. Here in America in the early 1900s, Edward H. Angle devised the first orthodontic classification system for dentists to describe how teeth fit together. He also contributed significantly to the design of orthodontic appliances, founded the first college of orthodontics, organized the American Society of Orthodontia (which became the AAO in the 1930s), and founded the first orthodontic professional journal in 1907. These notables were just a few of the individuals that laid the groundwork for our current practice of modern orthodontics--which I’ll address in my next blog.

February is National Children’s Dental Health month so last month I had the privilege of participating in the ExplorAsmile program sponsored by our local dental society. For an entire week, elementary school children from central and eastern Kentucky were invited to the Explorium (formally the Lexington Children’s Museum) for a day of fun and oral health instruction. In addition to learning all about teeth and oral structures, students were treated to visits from the “tooth fairy” and given dental screening exams as part of their overall dental experience. It was quite encouraging to note that most of the kids I screened had relatively healthy mouths. I vividly remember that back in the early 1980’s, 1 out of 3 kids screened had multiple cavities, gum abscesses and missing permanent teeth. Oh what a difference a couple of decades of preventive oral health care emphasis, dental sealants, fluoridated water and general access to dental care can make. Let’s all keep up the good work to keep our children healthy. Please make sure you visit your dentist regularly during the course of your orthodontic treatment. 

For both Wildcat and Cardinal basketball fans, this season is shaping up to be something quite special. I love not only basketball, but all sports in general and have been privileged to treat many patients who have gone on to successful athletic careers. After working so diligently to achieve that beautiful smile, I always want to make sure that all my patient’s teeth stayed perfectly aligned for the rest of their lives. Unfortunately accidents do occasionally happen where teeth are loosened, displaced, fractured or even knocked out due to a blow to the mouth. According to the Centers for Disease Control and Prevention, more than half of the seven million sports and recreation-related injuries that occur each year are sustained by youth between ages 5 and 24. The average high school baseball pitcher can throw a fast ball between 75-85 miles per hour (comparable to being hit by a speeding car) and cheerleading is one of the most dangerous sports, accounting for 65% of all injuries in high school girls’ athletics. Despite the statistical risks, many kids are still not wearing any mouth protectors during sporting activities. The American Association of Orthodontists is encouraging kids to “play it safe” and consistently wear mouth guards and other protective gear during competitions and practices. These devices can usually be easily adapted to fit over braces and other orthodontic appliances.  Parents, coaches and athletes need to understand that many sports injuries to the mouth and teeth can be prevented or reduced by simply wearing a mouth guard. Your smile is worth protecting!

Let me take a couple of moments to tell you about two people I have gotten to know quite well over the years—my orthodontic partners, Dr. Doug Durbin and Dr. Tom Garner. Other than my wife, I spend more time with these two individuals than with anybody else in my life so I do feel somewhat qualified to comment. Dr. Durbin and I have been practicing together for nearly sixteen years. During that time, I have found him to be a person of utmost integrity with an unsurpassed passion for his chosen profession. He continues to amaze me with his boundless enthusiasm and energy, always striving to develop and incorporate new strategies and technologies within our practice. Dr. Garner has become an integral part of our practice since joining our team in 2006. In these five short years, he has treated all of our patients with much admirable gentleness and care, bringing his leading edge expertise and talents into all of our 9 offices. Although a fervent Louisville Cardinal fan, he also happens to be one of the nicest people I have ever met. All three of us doctors were blessed with unique talents and personalities. When you become part of our orthodontic family, you’ll be benefitting from the professional knowledge and expertise of all of us. Our goal is to not only get to know each and every one of our patients personally, but also to partner together to create that beautiful smile just for you.

I just finished participating in another 5K run in downtown Lexington. As always, I was pleasantly surprised by the thousands of individuals who turn out for these events. Not only do they appear to thoroughly enjoy themselves during the pre race festivities, but hundreds of them pass me during the race as if I were standing still. It’s hard to believe that with all these runners, one national magazine recently voted Lexington as the most sedentary U.S. city. I, for one, don’t believe it for a second. Lexingtonians (and most Kentuckians for that matter) do care about health and fitness—including oral health and fitness. A healthy and straight smile is critical for proper chewing, speech and self esteem. At the Kentucky Center for Orthodontics, no matter what type of shape you are in, we make it easy for you to achieve fitness for your smile. We can’t guarantee that you’ll run any faster, but we do promise you’ll be smiling more when you cross that finish line!  

During my first tour of duty as an Army dentist, I was stationed at Ft. Jackson, SC—a basic training post where one of my responsibilities was to process in new recruits.  Each of these incoming enlistees was given a dental exam as part of their indoctrination into Uncle Sam’s Army.   I’m proud to say that over the course of three years, my nimble fingers painstakingly caressed the molars of thousands of new soldiers, many who were seeing a dentist for the first time.  My army issued stamped signature was permanently affixed to their official army dental record as proof of our encounter.

Several years later as I was laboring through another bureaucracy induced record audit, I came across my signature in the chart of a patient who was killed in Operation Just Cause—the invasion of Panama.  I wish I could say I remembered this brave individual when I treated him, but in reality, his memory to me at that time was nothing more than my signature on his dental chart.  It’s hard for me to describe, but nevertheless, that small connection sadly reminded me that a part of that dental record once belonged to a live human being—a person with a family who grieves daily for their loss and a person with a country who should be forever grateful for their sacrifice.

I’m sure all of you have your own personal remembrances of family members who served valiantly in the military, and I encourage you to reflect back upon them today.  We may gripe about taxes, health care, the economy and such but the United States is still the model of freedom—a democracy founded on Judeo-Christian values proclaiming God as our creator and espousing the liberty and holiness championed by the life and teachings of Jesus Christ.  That life is something that we should all guard and treasure in our hearts, souls and minds.  A life we should all be willing to die for.