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If there’s one meal that can claim the title of “Sweetest Meal of the Day,” it’s almost certainly breakfast. Sugary cereals, syrup-covered waffles, oatmeal with honey, cinnamon toast (which is literally sugar poured on toast)—it’s hard to imagine another menu even coming close. But you’re trying to keep your diet as healthy as possible. What to do?

First, no need to deprive yourself of the occasional pastry or stack of pancakes. The real problem with breakfast isn’t so much sugar as it is added sugar.

• Just a Spoonful of Sugar? What’s So Bad About That?

Nothing! Many healthy foods have natural sugars. Milk contains lactose sugar, and it also contains calcium and is enriched with vitamin D—both of which are essential for strong bones and teeth. Fruits get their sweetness from a sugar called fructose, and deliciously provide vitamins, minerals, antioxidants, and fiber to our diets.

Even processed sugar is surprisingly low in calories. In fact, a teaspoon of white sugar has only about 15 calories. But this teaspoon is also rich in nutrients for cavity-causing bacteria. The oral bacteria in plaque use sugars and carbohydrates from food particles as a fuel source to produce acids. These acids erode enamel and lead to cavities.

Choosing breakfast foods without additional sugars, then, is an easy way to reduce the number of empty calories in your diet while safeguarding the health of your teeth. We have a few suggestions.

• Be Selective with Cereals

If the word “sugar” or “honey” or appears on the box, that’s a hint that your favorite cereal is heavy on the sugar. But there’s a more scientific way to tell just how much sugar is in that spoonful.

While the colorful packaging and playful mascots are eye-catching, check the black-and-white panel with nutritional facts found on every box. If one serving equals 27 grams, and the sugar in that serving equals 15 grams, you know you have a problem. And cereals marketed to children are especially “rich” in added sugar.

But luckily, you don’t need to give up your morning bowl. Many cold cereals are available that offer whole grains, protein, and fiber without a lot of added sugar. Spend some time in the cereal aisle comparing, or, to make life easier, there are many online sites which recommend the best (and worst) cereals in terms of sugar content.

• Use Your Judgment with Juices

Fruits are packed with important nutrients. Not only do they provide essential vitamins and minerals, they’re a great source of water and fiber. If you drink 100% fruit juice, you are getting the benefit of most of the vitamins and minerals found in fruit. (You’re also getting less of the fruit’s natural fiber, and more of the fruit’s natural sugar, so consider fresh fruit as an option occasionally.)

But when fruit juice comes with “cocktail,” or “punch,” or “ade” attached to the end of it, there’s often something else attached—added sugar. For natural fruit flavor and the least amount of sugar, stay with 100% unsweetened fruit juice.

• Search Out “Surprise” Sugars

Remember the childhood excitement of searching through your cereal box for the prize inside? Fun! What’s not so much fun? The surprises you might find when you search through the labels on your favorite breakfast items—because added sugars make their stealthy way into many of our morning favorites.

When you compare plain, Greek, and low-fat yogurts, for example, the low-fat options are often higher in added sugar. A container of low-fat yogurt can provide 19 grams of sugar—that’s a tablespoon and a half!

And while you’re at it, be sure to compare the sugar content in granola bars. Some are full of nuts and grains, and some are full of added sugar.

Going out for a breakfast smoothie? Those can contain 70 grams of sugar and more. Making your own at home might be a little more time-consuming, but if you use fresh fruit as your sweetener, you can make sure that what you’re not consuming is added sugar. If you’re on the go, check out all-fruit options at your favorite smoothie shop.

Drs. Lawrence Hier and Michelle Palmer and our team aren’t asking you to eliminate sugar from your breakfast diet altogether. (Everyone loves a doughnut now and again.) But substituting some alternatives for your regular menu choices can reduce the amount of added sugars by tablespoons every meal. That’s another great reason to greet the morning with a smile!

Press Pause

If you are getting braces in the near future, it’s very important to see your regular dentist first. That way, any cavities or other dental problems can be treated before your first orthodontic appointment at our Boynton Beach, FL office.

Play it Safe

Once you have your braces, you’ll hearing a lot about how you need to be especially careful with your dental hygiene. Why? Because wires and brackets are obstacles to getting your teeth and gum area their cleanest. Plaque and food particles tend to stick to braces, and all too often can be missed while brushing. Plaque builds up around your gum line and brackets, and, in a very short time, can lead to sensitivity, demineralization, and cavities.

What can you do to prevent tooth decay?

• Increase Your Brushing Time

Instead of brushing twice a day, start brushing for two minutes after every meal. Put together a travel bag with a small toothbrush, toothpaste, floss, and interproximal brushes to clean your teeth when you’re on the go. If you absolutely can’t brush, rinse carefully with water, and then brush as soon as you can.

• Flossing—More Important than Ever

Use the flossing tools designed just for braces to make sure you’ve removed food particles and plaque from around your braces and gums. A water flosser can be helpful if manual flossing isn’t effective.

• Keep Up with Your Regular Dental Care

Schedule regular checkups and professional cleanings at your dentist’s office. They will be able to remove plaque you might miss at home.  

• Follow Our Advice

We’ll give you instructions on how to brush and floss, what products to use, and diet suggestions (such as keeping sugary and sticky foods off the menu and away from your braces). If we notice plaque building up around your gums and brackets, we’ll let you know that you need to step up your hygiene habits. We can also suggest rinses and toothpastes that help fight plaque.

But if, despite all your efforts, you do get a cavity? There are options!

• Ignoring Your Cavity?

Not an option. You shouldn’t wait until you are out of braces to get a cavity treated. This just gives decay a chance to spread further.

• Working With Your Braces

Repairing a cavity means removing the decay in the tooth, cleaning the area, and then filling the tooth. If your cavity isn’t located near your bands, brackets, or wires, your dentist might be able to work around your braces, and you can get your cavity treated during a regular dental appointment.

• Removing Parts of Your Braces for Treatment

Sometimes a cavity is located in a spot that your dentist can’t reach because of your braces. In that case, we’re able to coordinate with your dentist and remove a wire or bracket temporarily so you can have your tooth filled. Make an appointment to replace your bracket and re-attach your wire, and you’ll be back on schedule as soon as possible.

Fast Forward

Keep your eyes on your goal--you’re in braces because you want a beautiful smile. Keeping on top of your dental health is an essential part of creating that smile. Talk to Drs. Lawrence Hier and Michelle Palmer about tips for getting your teeth their cleanest. If you do develop a cavity, we’ll help you figure out the best way to treat it without causing too much delay in your orthodontic treatment. Taking care of your teeth now is the best way to create a future of beautiful smiles!

Poor April. While other months celebrate romance, or giving thanks, or costumes and candy, April has—April Fool’s Day and a tax deadline. We might be forgiven for thinking these two dates seem more like warnings than celebrations.

So here’s a new topic for the April calendar: National Facial Protection Month! Take the opportunity this month to review your safety practices while you’re enjoying your favorite activities.

• Mouthguards

If you have a mouthguard for sports or athletic activities, wear it! In any activity or sport where humans come into contact with solid objects (including other humans) tooth injury is possible. A mouthguard will help protect you from dental injuries caused by falls, physical contact, or other accidents that might happen in your active life. And it’s not just your teeth—mouthguards protect your lips, tongue, and jaw as well.

You can buy mouthguards in stock sizes or shape-to-fit models, or you can have a guard made especially for you at our Boynton Beach, FL office. Custom mouthguards fit perfectly and are designed to make breathing and speaking easy and comfortable. If you wear braces, a custom mouthguard can be designed to protect your smile and your appliance. Just talk to Drs. Lawrence Hier and Michelle Palmer for suggestions!

After all the time and work you’ve put into your orthodontic care, don’t let a sports injury set you back. What else should you consider for your facial protection?

• Helmets

If there’s a helmet available for your sport, use it! Helmets are especially important for protecting athletes from brain injury and concussion, and they help protect the face and jaw as well.

• Face Guards

If you’ve experienced a puck speeding toward you, or a defensive tackle hurtling your way, or a fast ball coming in at 90 miles an hour, you know the importance of wearing a face guard. These guards can help protect your eyes, face, teeth, and jaws. Many sports now recommend using face guards—it’s worth checking to see if your sport is one of them.

• Eye Protection

And let’s not forget eye protection. Whether it’s safety glasses or a visor, protecting your eyes and the bones around them is extremely important. You can even get sports goggles or protective sports glasses with prescription lenses to keep you safe and seeing clearly.

So here are a few suggestions for your calendar this month:

• If you haven’t gotten a mouthguard yet, now’s the time. Tooth and mouth injuries occur in sports beyond hockey and football. If you play basketball, ski, skateboard, ride a bike—in fact, almost any sport where you can fall or make contact with a person or object—a mouthguard is a must.
• If you need to replace an ill-fitting or damaged helmet and face guard, do it before your next game. And do replace a bike helmet if you’ve been in a crash—most likely it won’t be as protective, even if damage isn’t visible.
• Talk to your eye doctor about protective eyewear if off-the-rack products don’t work for you.
• If you are a parent or caregiver, make sure your child athlete has the proper facial protection—and uses it.
• If you are a coach, make sure your athletes have the right protective gear—and wear it.
• It’s also a great time to commit to using your protective gear every single time you’re active.

But, wait—these reminders are helpful and important, but weren’t we promised something to celebrate this April? Good catch! The great news is, using facial protection for sports and athletic activities gives you rewards you can celebrate all year: fewer injuries, fewer visits to the emergency room, and a beautiful, healthy, intact smile. Suit up!

When does an underbite need surgery? The short answer is: when Drs. Lawrence Hier and Michelle Palmer and our team recommend surgery as the best way to give you a healthy, functional bite. But let’s take a longer look, and see just why your doctors might come to that conclusion.

• First, what exactly is an underbite?

In a perfect bite, the upper and lower jaws align, well, perfectly. Upper teeth overlap lower teeth very slightly, upper and lower teeth meet comfortably, and jawbones and joints function smoothly. When the alignment is off, it causes a malocclusion, or “bad bite.”

When we talk about an underbite, or Class 3 malocclusion, it means that the lower jaw protrudes further than the upper jaw. This protrusion causes the bottom teeth and jaw to overlap the upper teeth and jaw.

• What causes an underbite?

Sometimes an underbite is caused by childhood behaviors while the teeth and jaw are developing, including tongue thrusting or prolonged thumb-sucking and pacifier use. (Working to stop these behaviors before they affect tooth and jaw formation is one of the many good reasons children should have regular visits with their dentists and pediatricians.)

Most underbites are genetic, however, and tend to run in families. It’s estimated that from five to ten percent of the population has some form of underbite. The lower jawbone (mandible) might be overdeveloped, the upper jawbone (maxilla) might be underdeveloped, both bones could be affected, or, sometimes, tooth size and placement might cause an underbite. These irregularities in jaw shape and size and/or tooth crowding are not something that can be prevented, and require professional treatment.

• Why? What’s the problem with an underbite?

Even a minor underbite can cause difficulties with biting and chewing. A more severe underbite can lead to speech problems, decay and loss of enamel where the teeth overlap, mouth breathing and sleep apnea, persistent jaw and temporomandibular joint pain, and self-confidence issues.

• Can’t my dentist treat my underbite?

Most probably not. A very mild underbite can be camouflaged cosmetically with veneers, but this does not address the cause of the underbite, and will not work for moderate or severe underbites.

• Can my orthodontist treat my underbite?

Drs. Lawrence Hier and Michelle Palmer will create an underbite treatment plan after a detailed study of each patient’s individual dental and skeletal structure. Treatment options will vary depending on the cause of the underbite, its severity, and even the patient’s age.

Early intervention is especially important for children who show signs of an underbite. That’s why we recommend that children visit our Boynton Beach, FL office by the age of seven.

If an underbite is caused by tooth misalignment or crowding, braces can reposition the lower teeth. Sometimes extractions are necessary to make room for proper alignment.

If the cause is due to jaw structure, children’s bones are still forming, so treatment can actually help correct bone development. Palatal expanders, headgear, and other appliances are various methods of encouraging and guiding bone development.

But braces and appliances aren’t effective for every patient with an underbite, and especially in patients (usually those in their late teens and older) when the jawbones are already fully formed. In this case, we might suggest coordinating treatment with an oral and maxillofacial surgeon.

• What does an oral and maxillofacial surgeon do?

An oral surgeon has the training, experience, and skill to help correct an underbite by surgically reshaping and repositioning the jawbone. This corrective jaw surgery is called orthognathic surgery.

• What will happen during orthognathic surgery?

Your treatment will be tailored to your specific needs. Two of the common surgical procedures for treating an underbite involve repositioning the upper jaw to lengthen it and/or reshaping the lower jaw to shorten it.

Bone is sometimes removed or added, small bone plates or screws are sometimes used to stabilize the bone after surgery—your surgeon will let you know exactly which procedures will give you a healthy, functional bite. The surgery itself is most often performed under general anesthesia and requires a brief stay in the hospital.

• How will my orthodontist and oral surgeon coordinate my treatment?

Correcting a Class 3 malocclusion can take time. Your oral surgeon will work together with Drs. Lawrence Hier and Michelle Palmer to analyze the interrelationship of teeth, bones, and joints to determine dental and skeletal problems, and will develop the best treatment plan possible to create a healthy alignment.

• So, when does an underbite need surgery?

Sometimes, a minor underbite can be corrected with braces and appliances alone. A serious underbite, however, will often require the specialized skills of both Drs. Lawrence Hier and Michelle Palmer and an oral surgeon.

And, while it’s not the primary purpose of surgery, corrective jaw surgery and orthodontics can also make you happier with your appearance and boost your self-confidence. Achieving a lifetime of beautiful, comfortable, and healthy smiles—that’s the answer to your question.