Our Blog

Midline Misalignment

October 12th, 2022

By and large, the human body is a marvel of symmetry. But, of course, no one is perfect. You might have noticed one ear is a bit higher than the other. That you wear a shoe a half-size bigger on your left foot. That one shirtsleeve always looks longer.

Or that your smile looks off-center. This dental asymmetry could be caused by a condition known as “midline misalignment,” and, unlike that left foot, you can do something about it!

The dividing line between our center teeth, upper and lower, is called the midline. If we draw an imaginary line down the middle of a face, from the forehead to the nose to the midpoint of the chin, that line should go right between the front teeth. When it doesn’t, because the teeth have shifted past the midpoint, it’s often due to a condition called midline misalignment.

This kind of misalignment, also known as a deviated midline, can have several causes:

  • Baby teeth that are lost too early

Baby teeth do more than promote healthy eating and speech development. They also reserve space for permanent teeth. If a primary tooth is lost too early, permanent teeth might “drift” to fill the empty space, causing the midline to move as well.

  • Thumb sucking that goes on too long

As a child gets older, and certainly when by the time permanent teeth start to arrive, aggressive thumb sucking can lead to numerous orthodontic problems, including a deviated midline, as the teeth shift in response to that continuous pressure.

  • Missing adult teeth

When you lose a tooth through decay or trauma, or when an adult tooth simply never develops, the remaining teeth can shift over to fill the open spot.

  • Spacing issues

Crowded teeth, teeth with significant gaps between them, very large teeth, very small teeth—all of these issues can affect spacing and midline alignment.

  • Crossbite

A crossbite is a kind of malocclusion, or bite problem. When you have a crossbite, the teeth don’t fit together properly, with upper teeth fitting inside lower teeth, instead of aligning on the outside where they belong. A deviated midline can indicate a posterior crossbite, where the top back teeth slant inwards or fit inside the bottom back teeth.

A tiny bit of midline shift one way or the other might be nothing to worry about, but if one front tooth is literally the center of attention, or if your teeth are noticeably out of alignment, it’s a good idea to talk to our Mount Vernon, WA orthodontic team.

Because there are several potential causes for midline misalignment, Dr. Andrew Nalin will carefully analyze your individual situation to determine where the problem lies: with the teeth, the bite, or, rarely, the jaw itself.

Dr. Andrew Nalin will also offer you your best dental treatment options. A shift of a few millimeters might be treated with clear aligners or traditional braces. A crossbite could require braces or aligners coupled with elastics (rubber bands) to bring your bite into alignment. A palatal expander can help correct a serious crossbite.

Why visit Nalin Orthodontics because of a little asymmetry? Because a deviated midline is more than a cosmetic concern. If you have a malocclusion to begin with, or if your misalignment leads to changes in chewing habits, which cause new bite problems, you might be facing jaw pain, chipped and cracked teeth, headaches, and all the other unpleasant consequences of malocclusion.

By and large, perfect symmetry in life is unattainable. But if you want a smile that is well-balanced and healthy, talk to us about all the treatments available to make sure your smile—and not a single tooth—is the center of attention.

What's on your fall reading list?

October 5th, 2022

How better to spend the fall months than inside by the fireplace with a warm cup of cider and a book in hand? Dr. Andrew Nalin and our team at Nalin Orthodontics encourage you to warm up your mind this fall season with a few great books. Sure it may be easy to put off reading when balancing a hectic schedule, but reading is vital to brain development. Besides, reading is always a blast!

This week, we thought we’d ask what you or your child are reading this fall. Do you have any suggestions for must-read books this year? Out of ideas for great fall reads? Ask us for suggestions, and we would be happy to provide a few. You may also ask a local librarian here in Mount Vernon, WA for some ideas.

Happy reading! Be sure to share with us your fall picks or your all-time favorites below or on our Facebook page!

Orthodontic Treatment—The Sequel

September 28th, 2022

Some experiences are great, and we look forward to enjoying them again and again. Others have wonderful outcomes, but you feel no need for a sequel. If you’re wondering whether you need to revisit orthodontic treatment, you’re probably in this second group.

After all, you put in your time as a teenager. All those days in bands and braces, all the adjustments, all that cleaning with little tiny tools in little tiny places. That was a lot of work, and you reaped the rewards of your conscientious orthodontic habits with beautifully aligned teeth and a healthy, comfortable bite.

But now you’ve started to notice that your teeth aren’t quite as beautifully aligned, or your bite’s not quite as comfortable. So, what’s happened? Let’s look at some possibilities, and whether a return to the orthodontist’s office is in order.

  • You’ve Lost a Tooth

If you’ve lost a tooth because of injury or decay, that gap is an open invitation for surrounding teeth to move in to fill the void. Whenever you lose a tooth, consider an implant. Implants function, look, and maintain healthy spacing just like natural teeth.

One thing implants can’t do? Move like our own teeth will during orthodontic treatment. Your natural teeth can move because they are held in place within the bone by flexible periodontal ligaments. Implants, on the other hand, are anchored directly to the bone for stability.

If you’re considering new or further orthodontic work and want to replace a lost tooth with an implant, it’s a good idea to talk to Dr. Andrew Nalin to discover the best timing and scheduling for your procedures.

  • You’ve Gained a Tooth

Problems with your alignment can also arise if you add a tooth or teeth. If you’re in your late teens or early twenties, wisdom teeth could be in your near future. And a new tooth can throw off the spacing and alignment of your existing teeth.

Talk to Dr. Andrew Nalin about your options if your wisdom teeth are about to make an appearance, and if it looks like your tooth and bite alignment might be affected.

  • You’re Getting Older

Our teeth naturally tend to shift as we age. Teeth move forward, causing crowded or crooked front teeth—especially on the lower jaw. There’s even a medical term for this phenomenon: mesial drift. While we don’t know exactly why this drifting occurs, we can treat it.

Adults make up a large—and growing—segment of orthodontic patients. If your teeth have lost their ideal alignment over time, a visit to our Mount Vernon, WA office is a great way to bring your youthful smile back. And you’ll probably find your treatment much shorter and more comfortable than it was decades earlier!

  • You Haven’t Been Wearing Your Retainer

Remember that word “conscientious” in the second paragraph? You need to wear your retainer conscientiously, for as often and for as long as recommended by Dr. Andrew Nalin.

If you’ve been ignoring a damaged retainer, or you keep forgetting to look for your lost retainer, or you have a perfect, undamaged retainer sitting unworn on your dresser, your teeth can start to shift out of their hard-won alignment within a short time.

Does this mean it’s back to months of bands and adjustments and appointments? Maybe not! See us as soon as you notice any changes in your teeth or bite. When caught early, shifting teeth can be treated much more easily.

What can we do to help you regain your best smile? A lot!

  • Treatment Planning

When you need to accommodate implants, wisdom teeth, or other dental work which could affect your tooth alignment, Dr. Andrew Nalin can work with your dentist to make sure your alignment isn’t disturbed in the process. They can also map out a treatment schedule which coordinates your other procedures with any orthodontic treatment.

  • Retainer Evaluation/Adjustment

Your retainer is probably a passive retainer, meaning it keeps your teeth in place instead of moving them. If you notice your alignment shifting, or if your retainer is uncomfortable when you try to put it on after a lapse in nightly wear, ask us about a replacement.

  • Active Retainers

An active retainer helps move teeth into alignment rather than simply keeping them in place. A new active retainer might be just what you need to correct a slight shift.

  • Aligners or Braces

If you have some serious shifting going on, we might recommend a second round of treatment with clear aligners or braces. But there’s good news here, as well! Treatment to correct an orthodontic relapse usually takes less time than it did originally, and treatment options are more comfortable and less noticeable than ever before.

Talk to Dr. Andrew Nalin about an orthodontic sequel if you have any concerns about changes in your bite or alignment. You might need only a simple retainer adjustment or a short time in clear aligners or traditional braces to make your smile its best and healthiest once again. And this time, remember to wear your retainer to make sure there’s no need for Orthodontics—Part III!

Water Flossers and Braces

September 21st, 2022

You devote a lot of energy to your orthodontic treatment. Appointments, rubber bands, adjustments, cleaning (so much cleaning)—and why? Because you know that your attractive, healthy smile will be well worth the effort.

But if you find that keeping your teeth and braces clean requires more time and energy than it should, and you’re still not getting the results you’d like, a water flosser might be just the tool you need to help make your cleaning routine easier and more effective.

Plaque and tartar can be a real problem when you wear braces. Cleaning around braces and wires can be a challenge, and it can be difficult to get floss between your teeth and close to your gums, even with special threaders or floss designed to slip behind your wires.

But ignoring bacteria and plaque build-up can lead to cavities, weakened or discolored enamel, and gum problems. Fortunately, a water flosser can help wash away food particles, bacteria, and plaque even in tight, hard-to-reach spaces, while providing gentle cleaning along sensitive gums.

Water flossers use a pulsing stream of water to remove food particles and plaque between and around teeth. You can adjust the water pressure to apply just the right amount of cleaning power, and then direct the flow to your gum line, between your teeth, around your brackets, or anywhere else you need. Some models even offer tapered heads with brushes designed specifically for cleaning braces.

You might consider investing in a water flosser if you have:

  • Mobility issues. If you have joint or mobility issues, a water flosser will let you clean those hard-to-reach areas more easily.
  • Lingual braces. Because lingual braces are on the inside of the teeth, they can be more difficult to clean effectively with regular brushing and flossing.
  • Problems removing plaque. If you find that you are brushing and flossing regularly, but still have plaque build-up around your braces, give water flossing a try.

A beautiful smile is well worth all the time and effort you are devoting to it. If you think a water flosser might save you a bit of that time and effort, and provide better cleaning power, talk to Dr. Andrew Nalin  about your options during your next visit to our Mount Vernon, WA office. We’ll let you know if traditional flossing, a water flosser, or a combination of the two will give you your cleanest, healthiest smile.