Understanding Dental Botox

Botox, scientifically known as botulinum toxin, is a neurotoxin produced by the bacterium Clostridium botulinum. It works by temporarily paralyzing or relaxing the muscles it is injected into.  This is how the appearance of fine lines and wrinkles are reduced. While most associated with its cosmetic uses, such as smoothing facial wrinkles, Botox has also proven to be effective in treating certain dental conditions.

Who can benefit from Botox?

TMJ Disorders and Bruxism Treatment

Temporomandibular joint disorders (TMJ) and bruxism (teeth grinding) are common dental conditions that can lead to jaw pain, headaches, and even tooth damage. Dental Botox can be used to relax the muscles responsible for these issues, offering relief to patients. By injecting small amounts of Botox into the affected muscles, dentists can effectively reduce muscle tension, alleviate pain, and mitigate the harmful effects of teeth grinding.

Patients Seeking Facial Aesthetics

Dental Botox is now being employed as a treatment to enhance dental and facial esthetics and smile designs. By precisely injecting Botox into specific facial muscles, we can create a more symmetrical smile, minimize gummy smiles, and correct other dental-related concerns. This approach allows for a comprehensive approach to improving a patient’s overall appearance.

In my practice, we see adults and children.  Many of my adult patients come in focusing on their teeth and request either Invisalign or braces to fix their bite and improve their facial esthetics.  They are often surprised to hear of the other benefits of Botox and its ability to improve their smile and facial proportions!

Dr. Rachel Feinstein is a board-certified orthodontist who specializes in Invisalign and braces for young children, teens, and adults. We take a 360 approach to orthodontic care and individualize treatment based on your specific needs and lifestyle. Feinstein 360 Orthodontics is located at 14628 Hancock Village Street, Chesterfield Virginia.  If you are interested in enhancing your smile and ‘Flaunting your Feinest smile’ please contact us at (804) 532-4536 or schedule directly from our website for your complimentary consultation!

The post The Rising Popularity of Dental Botox: Who Can Benefit? first appeared on Feinstein 360 Orthodontics.

In this post, we will cover the following: what are Invisalign attachments and rubber bands? Can Invisalign work without these attachments? And finally, is the use of rubber bands truly necessary?

Invisalign Attachments Explained

Invisalign attachments are tooth-colored “bumps” that are bonded to the teeth with dental composite.  They are small and barely noticeable but serve a big purpose. “I design and place specific attachments in order to achieve optimal results,” says Dr. Feinstein.  “Attachments allow me to achieve more complex tooth movements and increase the efficiency of tooth movements which results in a faster treatment time.”

Invisalign and Rubber Bands Explained

Some tooth movements cannot be accomplished with Invisalign aligners alone.  For example, if you need to align your bite, which is the way your upper and lower teeth come together, you will often need elastic rubber bands to shift both jaws and teeth into their ideal positions.

This is where Invisalign rubber bands come in! “Before you begin your Invisalign treatment, we’ll discuss with you if we think you will need to wear elastic rubber bands,” says Dr. Feinstein.  “These rubber bands in combination with aligners are extremely efficient at correcting overbites, openbites, underbites, and crossbites, when worn properly.”

How long should I wear my Invisalign elastics?

Your customized treatment plan will determine how long you wear your Invisalign elastics. Some patients wear them throughout their entire Invisalign treatment, while others use them only for a portion of the process. You will also be advised if nighttime wear or full time wear is recommended.  Just like with braces, your Invisalign rubber bands will stretch out as you talk, laugh and yawn so make sure to change them 3 times a day!

How do I wear my rubber bands, and what if they break?

The thought of wearing rubber bands with your Invisalign trays can be intimidating.  Fortunately, we will go over exactly how and when to wear them. During your consultation and then again when you are ready during treatment, Dr. Feinstein will provide you with detailed instructions on how to wear them. Dr. Feinstein’s rules for elastics are as follows:

•  Never wear your rubber bands without your aligners in your mouth
• If you forget your rubber bands at home, you can still wear your aligners without the rubber bands
• Start with the hook or button on either the top or bottom aligner and then use your fingers to stretch the rubber band to the button or hook in the opposite arch
• Repeat step 3 on the other side of your mouth if prescribed.
• Switch your rubber bands 3 times a day
• If your rubber bands break or pop, replace as needed – do not worry about running out since we will gladly give you replacement bags!
• If your hook or button falls off your tooth call our office so we can put it back on.

Do I absolutely need attachments and elastics?

The short answer is no! Sometimes, if your smile just needs a few touch-ups, then attachments and rubber bands are not required.  “Every patient that walks into my office receives a personalized treatment plan,” says Dr. Feinstein.  “Attachments and rubber bands are great orthodontic tools, but I always feel it is important to listen to my patients and see what is important to them, focus on their esthetics, and what fits into their lifestyle.”

At Feinstein 360 Orthodontics, we understand that you may have additional questions or concerns about Invisalign, attachments, and rubber bands, and we are always here to help!

If you need further assistance, don’t hesitate to reach out to our office.  And if you haven’t started treatment yet but are interested in Invisalign in Chesterfield, Moseley, Chester, and Midlothian greater area, we invite you to schedule a complimentary consultation with us today!

The post Do I really need attachments or rubber bands during Invisalign treatment? first appeared on Feinstein 360 Orthodontics.

A palatal expander is an orthodontic appliance used to widen the upper jaw (maxilla). It is typically used in children and adolescents to correct problems with the teeth and jaw.

A palatal expander consists of a small metal device that is bonded to the upper molars using dental cement. The device has a central screw that can be turned using a special key provided by our office. As the screw is turned, the device expands and gradually widens the upper jaw. This process takes several weeks to several months, depending on your child’s needs.

I commonly use palatal expanders in combination with other orthodontic treatments, such as braces or Invisalign, to correct a range of problems with the teeth and jaws. They are well-tolerated and are effective at correcting problems with the upper jaw.

Benefits of jaw expansion

A palatal expander gently widens the roof of the mouth (palate) over time by separating bones that do not permanently fuse together until puberty. It is most often used to create more room for crowded teeth. Using an expander before extensive orthodontic work on children can reduce the amount of time spent in braces and Invisalign, making the process smoother and less uncomfortable.

Traditionally, a palatal expander corrects:

• A narrow jaw
• A crossbite or underbite
• Crowded teeth
• Difficulty biting and chewing
• Speech difficulties

It is important to understand that a palatal expander may be used to improve upper airway breathing problems. The expansion of the upper jaw can help to create more space in the upper airway, potentially improving breathing problems such as sleep apnea, snoring, mouth breathing, and poor sleep quality. Over time, poor sleep quality can affect children’s ability to focus and perform in school and in social situations. A palatal expander is not a treatment for all upper airway breathing problems, and it may not be the most appropriate treatment option in all cases.

If your child is experiencing upper airway breathing problems, it is important to consult with a healthcare professional for a proper diagnosis and treatment plan. They will be able to assess your individual needs and recommend the most appropriate treatment options for your specific condition.

Do expanders hurt?

Palatal expanders can cause some discomfort or difficulty speaking and eating during the initial adjustment period. Normally my patients say after just a few days their child is eating and speaking like they did before the expander was placed.

If you think your child may need an expander to help with a small upper jaw, crowding, or upper airway breathing, it is better to do so sooner rather than later. Simply contact our office for a complimentary consultation by Dr. Feinstein by calling (804) 532-4536 or request an appointment online. At your consultation, Dr. Feinstein will do a comprehensive evaluation and she will explain if treatment is indicated and what your treatment options are.

Dr. Rachel Feinstein is a specialty-trained, board-certified orthodontist. Her expertise in treating young children and adults allows her to improve you and your children’s health and smile in an esthetic and efficient manner that integrates into your lifestyle. Dr. Feinstein practices in Chesterfield, Virginia treating orthodontic patients from Chesterfield, Mosely, Midlothian, Richmond, Chester, and Henrico County.

The post Everything you need to know about Palatal Expanders first appeared on Feinstein 360 Orthodontics.

I want to help parents think through this question since it is a good one!

The short answer is: of course! However, your child needs to take some precautions. There could also be a better option, which I will explain at the end of this post.

Precautions for Kids with Braces Playing Contact Sports

As a mother and healthcare provider, I truly appreciate the benefits of extracurricular sports. Sports provide numerous benefits for our children, including physical and mental health, the development of social skills, confidence, self-esteem, and character development.

I will always remember a call I received on a Friday evening. One of my patients was playing in his varsity basketball game when a defender attempted to block his shot and inadvertently knocked him to the ground, causing him to fall face-first. When he stood up, he realized his lip was stuck to his braces! I met him after his game and was thankfully able to unhook his lip and fix his wire, and he was good to go!

Benefits of Mouthguards for Children with Braces

I spoke with his mom after the game and after reassuring her everything was ok, I explained how this significant lip and braces injury could have been easily avoided if her son was wearing a mouthguard. There are several benefits of wearing a mouthguard, including:

• Protection of braces: The mouthguard acts as a barrier between the braces and any impact, helping to prevent damage to the braces or the teeth.
• Prevention of injury: The mouthguard helps absorb the force of impact and reduces the risk of injury to the lips, tongue, and cheeks.
• Comfort: The mouthguard helps reduce discomfort caused by braces rubbing against the cheeks or lips.
• Preservation of treatment progress: Wearing a mouthguard helps protect the progress made by the braces, reducing the risk of having to start the treatment process over again due to damage.
• Peace of mind: Wearing a mouthguard while playing sports can give you peace of mind knowing that you’re doing everything you can to protect your braces and your teeth.

A Safer Alternative? Invisalign

Another option parents should consider is Invisalign. Invisalign is great for athletes because accidents like the one mentioned above won’t happen because there aren’t any brackets or wires. Invisalign works through a series of aligners where I meticulously program and customize tooth movement for each patient.

In conclusion, with the necessary precautions, both braces and Invisalign are great options for athletes. It is important to understand the benefits of each, and how a mouthguard could be beneficial to keep your teeth protected during physical activity.

Dr. Rachel Feinstein is a specialty-trained, board-certified orthodontist. Her expertise in treating young children and adults allows her to improve your and your children’s health and smile in an esthetic and efficient manner that integrates into your lifestyle. Dr. Feinstein practices in Chesterfield, Virginia treating orthodontic patients from Chesterfield, Mosely, Midlothian, Richmond, Chester, and Henrico County. Get in touch for your complimentary consultation!

The post Can my child get braces if they play sports? first appeared on Feinstein 360 Orthodontics.

After I put braces on, I go over specific brushing and flossing techniques to make sure my patients are successful in their orthodontic journey and are on their way to “Flaunting their ‘Feinest’ smile.” Toothpaste takes away staining, eliminates plaque, and changes the pH of your mouth so that your enamel stays healthy and strong.

Bet you didn’t know your toothpaste could do this…

There are many uses for toothpaste beyond just brushing your teeth. Some of these include:

• Cleaning: Toothpaste can be used to clean items such as silverware, jewelry, and even car headlights.
• Acne treatment: Some toothpastes contain ingredients such as baking soda and hydrogen peroxide that can help dry out pimples and reduce redness.
• Whitening: Some toothpastes contain mild abrasives that can help remove surface stains and improve the overall appearance of teeth.
• Bug bites: Toothpaste can be used to soothe the itching and pain of insect bites.
• Relief for burns: A small amount of toothpaste can be applied to minor burns to help soothe the skin and reduce pain.
• Cleaning walls and baseboards: Toothpaste can be used to remove scuffs and marks from walls and baseboards.
• Removing crayon marks: Toothpaste can be used to remove crayon marks from walls and other surfaces.

It’s important to note that I am an orthodontist, so these other uses for toothpaste are not actually its intended use! It’s always best to do your own research before using toothpaste for purposes beyond oral hygiene.

Dr. Rachel Feinstein is a specialty-trained, board-certified orthodontist. Her expertise in treating young children and adults allows her to improve your and your children’s health and smile in an esthetic and efficient manner that integrates into your lifestyle. Dr. Feinstein practices in Chesterfield, Virginia treating orthodontic patients from Chesterfield, Mosely, Midlothian, Richmond, Chester, and Henrico County.

The post 7 Amazing Toothpaste Tricks first appeared on Feinstein 360 Orthodontics.

How teeth whitening works

Tooth whitening works by removing intrinsic and extrinsic stains on natural teeth. Extrinsic staining is on the outside surface of your enamel and the discoloration is caused by environmental factors such as coffee, curries, teas, food dyes, and smoking. It is important to understand that whitening does not work on dental implants, veneers, crowns, or fillings.

Is teeth whitening while doing Invisalign an option for me?

All my treatment recommendations are patient-specific. I look at a variety of factors before recommending whitening during Invisalign treatment.

• Are your teeth extremely crooked and overlapping?
• Are your teeth overly sensitive?
• What whitening product do you intend to use?

Whitening works by the whitening product physically being in contact with your teeth. As a result, I like to postpone my patient’s teeth whitening until their teeth are relatively lined up.

Some people naturally have more sensitive teeth than others. The most common reasons are either having thinner enamel or gingival recession. Other causes contributing to tooth sensitivity can be decayed, broken, or chipped teeth, among other reasons. Tooth sensitivity can be worsened by whitening so it is important to choose the right whitening agent.

Whitening options

• Whitening products can be over-the-counter or dentist directed.
• The two most common active ingredients in whitening products are carbamide peroxide and hydrogen peroxide.
• It is important to understand which active ingredient and what percentage concentration is recommended for you in order to achieve your desired results.
• In general, whitening products with carbamide peroxide are less abrasive and need to sit on your teeth longer to achieve results.
• Whitening agents with hydrogen peroxide require less time in contact with your teeth but can lead to more irritation.

There are so many teeth whitening products and treatments available. It is important to consult your dentist about what is best for you.

I love being an advocate and cheerleader for my patients. Often, whitening while straightening their teeth with Invisalign is what is best for my patients, but it is always important to look at everyone as an individual and treat them as one.

If you are local to Chesterfield, Virginia and are interested in enhancing your smile with Invisalign, you can call us at (804) 532-4536. Your “feinest” smile is waiting for you!

The post Can I whiten my teeth during Invisalign? first appeared on Feinstein 360 Orthodontics.

These three questions are the most common questions I get asked at Feinstein 360 Orthodontics.

The answer to the first question is easy. Your braces or Invisalign will be taken off when your teeth and bite are in a stable, functional, and esthetic position.

The answers to the second and third questions are not as clear cut and before I answer directly, it is important to understand a few fundamentals.

How do teeth move?

Teeth are held in bone by periodontal ligaments connecting the root of teeth to their surrounding bone. These fibrous tissues are malleable, which means they can stretch and re-orient themselves. Periodontal ligaments are what allow teeth to move when pressure is applied to teeth. These flexible ligaments are also what allow teeth to relapse and move back to their original position after they are straight, and orthodontics is completed.

How do braces or Invisalign straighten teeth?

Teeth move once constant pressure is applied to them. It does not matter if these forces are applied by brackets and wires, with clear aligner systems such as Invisalign, or even rubber bands. I like to use the analogy of rolling a ball up a hill. If you roll a ball halfway up a hill and let go, it will simply roll back down, and all your hard work will be undone. Teeth react similarly. They need a certain amount of constant force applied to them and then, over time, they will move.

How do I stop my teeth from shifting back after braces or Invisalign?

After orthodontic treatment is completed, there are a few key protocols I ask my patients to follow.

• First, I will assess if a permanent retainer is necessary. I do not often recommend a permanent retainer, also known as a “fixed” retainer.  Patients will sometimes ask for them because they do not want to wear a removable retainer after their orthodontic treatment is completed. The reality of fixed retainers is that they are high maintenance because they are plaque traps, are difficult to floss and keep clean, and can debond from the teeth they are attached to, so I recommend a backup removable retainer that fits over the permanent retainer. Think of it like a belt and suspenders.
• There are two main types of removable retainers. One is called a Hawley retainer which is the classic retainer with a wire going across your front teeth.
• The other is a more modern version of a retainer is called an Essix retainer, which looks like Invisalign. I prefer the Essix retainer because it is more comfortable, esthetic, and protective from grinding since it covers the top and sides of your teeth.

To keep your teeth from shifting back after braces or Invisalign, it is important to wear your retainer consistently. I recommend a minimum of 16 hours of daily wear for approximately 6 months. I chose 16 hours so children do not have to bring their retainers to school, and adults can also enjoy a workday without having to wear their retainers. After this 6-month period, it is important to wear your retainers nightly if you want your teeth to stay in their current position. Over time your teeth will stabilize so you can reduce the number of nights you wear your retainers.  It is important to at least pop in your retainer once a week to see if it starts fitting tighter, which would mean your teeth are shifting!

Dr. Rachel Feinstein is a board-certified Orthodontist, and founder of Feinstein 360 Orthodontics, Richmond’s only Digital Orthodontic boutique. We specialize in Invisalign and braces in an esthetic and efficient way that will work with your lifestyle. Dr. Feinstein practices in Chesterfield, Virginia treating adults, teens, and young children from Chesterfield, Mosely, Midlothian, Richmond, Chester, and Henrico County.

The post Why do I have to wear a retainer after braces? first appeared on Feinstein 360 Orthodontics.

Typically, you are able to use your HSA or FSA for eligible orthodontic treatment. Not sure how to open, contribute to, or access your account? Get answers to some of the most common HSA/FSA questions below.

HSA and FSA FAQ for Orthodontic Patients

Both types of accounts have tax benefits, but there are some important differences to consider.

FSAs come only as part of a benefits package from an employer — you can’t get one on your own. To contribute to an HSA, you must have a High Deductible Health Plan.

What happens to the money when I contribute it?

• HSAs: With an HSA your money will go into an account with a custodian, similar to an investment account. The money you contribute usually can be invested until it is needed. Importantly, if you don’t spend the money on medical costs right away, the balance can grow tax-free.
• FSAs: The money you contribute is held until you need it for qualified health care costs. Unused funds go to your employer, who can split it among employees in the FSA plan or use it to offset the costs of administering benefits.

What impacts will contributions have on my taxes?

• HSAs: Contributions are tax-deductible, but can also be taken out of your pay pre-tax. Growth and distributions are tax-free if used for eligible medical expenses.
• FSAs: Contributions are pre-tax and distributions are tax-free and can only be used for eligible medical expenses.

Does this money expire? Does this money roll over?

• HSAs: The balance rolls over year to year, so you can save to the account today and use it for medical expenses in the future, even after you no longer have a High Deductible Health Plan! Your HSA can follow you as you change employment.
• FSAs: Generally it’s a “use it or lose it,” meaning you lose any amount you haven’t spent at the end of the calendar year. While you can’t get any money back, there are two cases where you may get a little extra time to spend your FSA:
  • A grace period, when you can keep spending FSA money up to 2½ months past the end of the plan year. Because most plan years are calendar years, this option usually allows you to use the money from Jan. 1 to March 15 the next year.
  • A rollover option, where you can move up to $500 to next year’s balance.

Is there a contribution limit for HSAs and FSAs?

• HSAs: In 2022, people with individual health insurance can save up to $3,650, and up to $7,300 for a family.
• FSAs: Individuals can save up to $2,850, and your spouse can also contribute up to $2,850 to their FSA if their employer offers one.

When should I start contributing to this account?

• HSAs: The IRS allows you or your employer to contribute in the current plan year or up to the due date of your tax return – usually in April for the previous calendar year.
• FSAs: Normally, you can only elect contributions into your FSA during a yearly open enrollment period, but there are exceptions. When a qualifying event occurs, many employers allow you to make a mid-year change in elections. A few qualifying events are employment changes, change in marital status, or change in number of dependents.

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