Skip to main content
All Posts By

Dr. Markham

Invisalign Aligners

How to Care for Your Invisalign Aligners

By Blog

Is it possible to straighten your teeth without braces? Yes, it is. Welcome to the world of Invisalign aligners. The main “ingredient” in Invisalign aligners is a clear, thermoplastic material that is custom-made to fit your teeth. Unlike conventional braces, Invisalign aligners are removable. More importantly, the clear thermoplastic material makes the aligners invisible, which is ideal if the thought of metal braces and elastics makes you self-conscious.

Invisalign treatmentAccording to Invisalign’s website, you will have to wear your braces around 20 to 22 hours a day, only taking them out when eating or cleaning. Although you won’t expose your aligners to the elements, it’s crucial to clean them and your teeth properly every day. Failure to clean them routinely could end up in problems such as bacteria growing inside the aligners, change in color, tooth decay, and cavities.

For the best results, proper care and handling of your Invisalign aligners are important, here are some pointers for your consideration. 

How to Clean Invisalign Aligners

As patients expose Invisalign aligners to bacteria and plaque daily, you need to clean them as regularly as you brush your teeth. It’s best to clean them every time you are getting ready to use them. Normally you will be taking them out before every meal and you should brush your teeth after that, so by extension, you should at least clean them as many times as you eat in a day. You can drink water with your Invisalign aligners on as long as it’s not too hot. 

Before putting on your invisible braces wash your teeth thoroughly as you would normally do. In order to actually clean the aligners themselves, you may want to leave them on to clean the outer side. Use a soft-bristled toothbrush and plenty of water to remove any possible bacteria or plaque that may be stuck on the outside, avoid using toothpaste as it can have some ingredients that can scratch the aligners. For the inner part, you will have to remove them carefully and then brush and rinse with abundant water. Don’t forget to dry your aligners before use.

Store aligners in a cool, dry, safe place. When you’re not wearing the aligners, store them in the case provided by our office. If you don’t use the case, you can easily lose them. Keeping them out of reach of small children and pets is also a good idea. The last thing you want is for Fido to think your Invisalign aligners are chewing toys.

How to Use Invisalign Cleaning Crystals

Invisalign Cleaning Crystals is a product that’s designed specifically to remove plaque and bacteria from your invisible braces. The steps to use them are incredibly simple, wash your aligners as previously explained, rinse them, pour a packet of cleaning crystals into a glass of warm water, and mix the solution. Then let both aligners rest inside the glass for around 15 minutes, before taking them out give them a gentle shake while inside the liquid.  Finally, rinse your Invisalign aligners thoroughly. 

Using your Invisalign Cleaning Crystals helps prevent bacterial growth and avoids discoloration. To keep your aligners clean you can use the cleaning crystals once or twice a day. If you have Vivera Invisalign retainers the cleaning solution will work on those as well. 

Only Use Water?

Although you can use just water and a toothbrush to keep your Invisalign aligners clean on a day-to-day basis it’s recommended that you use Invisalign cleaning products, such as the cleaning crystals, at least once a week. You can use toothpaste to clean your aligners as long as it doesn’t contain any harsh ingredients. 

Don’t soak aligners in mouthwash. Many popular mouthwash brands contain a color pigment. It’s possible that soaking Invisalign aligners in mouthwash will tint or stain them. Invisalign does not recommend the use of denture cleaners as they could damage the aligners. 

What Foods Not To Eat With Invisalign

Do not eat or drink hot beverages while wearing aligners. It’s a good idea to get in the practice of removing the aligners before eating and drinking. Because of the plastic resin inside the aligners, heat can distort and damage them. Also, eating while wearing the aligners will cause sugar and other food particles to stay on your teeth, which contributes to plaque and tooth decay. On the same note, don’t chew gum while wearing aligners, it will stick and damage the appliance.  

Smoking with Invisalign aligners on can stain them in a matter of days making them a little more visible, defeating the purpose of the invisible aligners. If you are going to smoke, you can simply remove your appliances.  Once done, wash your teeth and the aligners as previously explained.

When it comes to cleaning Invisalign aligners, carefully follow the instructions given by Drs. Markham and Chiang. For more tips and tricks for a successful Invisalign experience, contact our Sacramento or Auburn, CA office!

When Do I Get Rubber Bands?

By Blog
Orthodontics Rubber Bands

After a few visits to your Orthodontics specialist, you have finally gotten accustomed to the little discomfort after adjustments, and suddenly they make an appearance. Yes, we are talking about the elastics (rubber bands). 

Then your orthodontic visit finishes, and you feel like it is your first-time wearing braces again. It is not only about the extra pressure but the feeling of having your mouth a bit restricted. 

However, elastics (rubber bands) are a major player in your treatment success. It turns out elastics exert steady pressure helping move certain teeth to correct your bite. 

If you want to see it differently, they might be called “small heroes” in the battle to conquer a final objective, a healthy and beautiful smile. So, we encourage you to think about the outcome.

Yes, there are several steps, requirements, and efforts patients must undergo to see results, but you will find a pleasant reward during the journey, seeing progress and, in the end, the result. 

So, you might be asking yourself, what does orthodontic treatment success require? Well, the most important part is compliance with your orthodontist’s recommendations, and one of these recommendations is wearing your elastics all the time.

This short but insightful article addresses two major concerns of orthodontic treatment related to the “small heroes” elastics. First, we will shortly tell you what role they play in Orthodontic Treatment? In different words, we will define How do elastics help your orthodontic treatment? And what are the types of elastics used in Orthodontics?  

How Do Elastics Help Your Orthodontic Treatment?

Markham Orthodontics | Orthodontist | rubber bands and bracesIt is all about physics, but we don’t want to go that far explaining it. In a few words, a misaligned tooth reacts (moves) due to the pressure that the “U” shaped wire exerts. 

The wires shape is a staged desired alignment of teeth that slowly molds with each adjustment to the final result. Brackets hold the wires. In some cases, elastics serve to fixate the brackets. 

Stress creates an action and reaction force in which the wire tries to get back to its former position, slowly pulling teeth and repositioning them. The action and reaction also stress a specific tooth that pushes one another in a sort of a chain reaction. 

However, there are malocclusion cases that require an extra effort, like the case of a jaw repositioning. In such cases, elastics attach to brackets with hooks. Not all brackets have these hooks. 

An Orthodontist plans the complete treatment, knowing beforehand which teeth will have these hooks. Elastics hold on to two separated hooks exerting additional stress. The brackets apply force to the band that stretches. At the same time, the band applies force in both directions. 

Finally, the band exerts a constant forth and back force, altering the positioning of the jaws and teeth. 

What Are the Elastic Bands Used in Orthodontics?

We have discussed the elastic (rubber bands) function. However, to grasp a better idea of its hero powers, it is crucial to know a little bit about the types of elastics used depending on the type of malocclusion. So here, we try to depict the best description possible for each elastic type and orthodontic case. 

Types of Elastics Used in Orthodontics According to Malocclusion Cases.

Teeth Gap

Sometimes there is an abnormal lack of space between teeth. For example, class 1 elastics attach to a hook located in the bracket on the first or second molar, in the same lateral quadrant of the opposite hook of the bracket adhered to the cuspid tooth. This generates pulling stress to get the cuspid to move to its proper position. 


This elastic type goes from a hook in an upper tooth to a hook in a lower tooth, pulling back the upper teeth and pushing the lower teeth forward. This serves to reposition the maxillary, moving it back to its proper position. 


The mechanics applied to correct an underbite with elastics are similar to the mechanical movement of overjet, but, in this case, the maxillary moves forward while the jaw moves backward.

Call our office today for your complimentary evaluation at (916) 924-8970.

Your Sacramento Ortho Explains the Difference Between Oral Surgeons and Orthodontists

By sacramento ortho, Orthodontics

orthodontist vs oral surgeon

If you’re in need of care for your bite, jaw, wisdom teeth, or crowded teeth, you may be unsure about which dental professional you should visit—an orthodontist or an oral surgeon. This overview will clear common confusion regarding these two dental professions.

The American Dental Association (ADA) recognizes several dental specialties. A few of the more well-known oral healthcare providers are:

  • General dentists,
  • Endodontists,
  • Periodontists,
  • Prosthodontists,
  • Orthodontists,
  • Oral Surgeons.

Aside from attending dental school and holding memberships in dental organizations, oral surgeons and orthodontists have different roles. How do oral surgeons and orthodontists differ? In a nutshell, an orthodontist specializes in straightening teeth, while an oral surgeon is the surgical specialist of the dental profession.

Continue reading to learn more about the differences between these two professions.

What Does Their Education Look Like?

Both oral surgeons and orthodontists are required to complete a bachelor’s degree and four years of dental school. Afterward, they complete a residency in their specialties.

Oral Surgeons

An oral surgeon’s four-year residency focuses on an in-depth study of the anatomy of the skin, bones, and muscles of the face, mouth, and jaws.

During this program, the residents learn plastic surgery, emergency medicine, and ears, nose, and throat medicine (collectively called otolaryngology). This four-year residency is specifically chosen and accredited by the American Dental Association.

Oral Surgeons are technically titled oral and maxillofacial surgeons. These doctors are specialists focusing on reconstructive surgery of the face, facial trauma surgery, the oral cavity, head and neck, mouth, jaws, and facial cosmetic surgery.


After completing dental school, an orthodontist’s residency focuses on properly aligning teeth. The aim goes beyond delivering beautiful smiles. Orthodontists help patients overcome problems with their speech, biting, and chewing.

Orthodontists focus on non-surgical treatments that realign a patient’s dental structures. We rely on orthodontic appliances such as braces and clear aligners to apply gradual force on patients’ teeth. This process ensures we will safely move your teeth and jaws until they reach the desired position.

The Conditions Treated

Oral surgeons and orthodontists treat a variety of dental issues, and they often work together to fix a common problem. For example, patients who have jaw or facial deformities or need corrective jaw surgery may require both specialists.

Both orthodontists and oral surgeons commonly refer patients to each other for specialized treatments.

Common Oral Surgical Issues Include:

  • Impacted wisdom teeth,
  • Tooth loss,
  • TMJ disorder,
  • Overbite,
  • Underbite,
  • Fractured jawbone,
  • Broken facial bones,
  • Cleft lip,
  • Sleep apnea.

What the Best Orthodontist in Natomas, Sacramento Treats:

  • Crowded teeth,
  • Gapped teeth,
  • Open bite,
  • Overbite,
  • Underbite,
  • Impacted teeth.

Oral Surgeon Vs Orthodontist

Most of the time, patients with jaw and facial deformities will need both oral surgery and orthodontic treatment.

When corrective jaw surgery is necessary, oral surgeons work together with orthodontists to develop comprehensive treatment plans. It’s essential to keep in mind that every individual is different, and so are their treatment needs for the perfect smile.

So, always follow your orthodontist’s treatment recommendations if you want the best results.

What Is Orthognathic Surgery?

Orthognathic surgery is what some people know as corrective jaw surgery or simply jaw surgery. This procedure serves to correct jaw and lower face conditions related to structure, growth, and airway issues.

Some of those problems include sleep apnea, TMJ disorders, and malocclusion problems arising from skeletal disharmonies. Other patients may also require jaw surgery when they suffer from orthodontic bite problems that cannot be easily treated with braces.

If a patient has other facial imbalances, disharmonies, and asymmetries, they may also require orthognathic surgery. These corrections can help improve the patient’s facial aesthetics and self-esteem.

Will You Need Oral Surgery?

No matter what your dental problem, often, the best place to start is with your orthodontist.

Oral surgery is invasive by nature. Orthodontists are more likely to offer conservative treatments to address common dental issues, meaning you will reap the same benefits without sowing as much of your time, money, and energy.

Your orthodontist will have your best interests in mind. They will refer you to an oral surgical specialist if oral surgery is necessary.

You may also want to ask your general dentist for advice on where to start. Your general dentist knows your oral health history, and they will understand your specific needs and goals.

If your teeth have been bothering you for some time now, make sure to get in touch with a general dentist first. You may want to visit someone like our friends from Maidu Dental before you commit to an interdisciplinary team and be subject to invasive surgery.

The journey toward oral surgery is not a fast one. The team will have to prepare and get additional information. We can’t get enough data just with a quick glance in your mouth. Be ready for some advanced imaging like x-rays. Let’s take a look at some scenarios that definitely require oral surgery.

Impacted Teeth

Teeth that cannot fully erupt for several reasons and remain trapped under the gumline are a significant danger to any patient. The most common cause of impacted teeth is Wisdom Teeth. If there isn’t enough space for your third molars to erupt, they will stay under the gumline and create additional complications.

As your gums grow sorer and sorer, you might also develop some infections. These pockets of infected material affect your surrounding teeth, cause significant pain, and even help erode the bone tissue anchoring other dental pieces. These cysts can destroy your oral health.

To avoid all this situation, or also as a way to correct it, you can trust a team of orthodontists and oral surgeons to remove your impacted teeth through oral surgery.

TMJ/TMD Treatment

Another reason why you might require oral surgery is problems with your joints. The little joint that connects your lower and upper jaws can suffer from something we call Temporomandibular Joint Disorder (TMD). People use those two acronyms interchangeably, but they’re not really the same.

The joint that connects your bones is the TMJ, whereas the disorder gets the name TMD.

As a community, dental health specialists have not determined what causes this problem. However, we have identified several risk factors, and we try to help all patients avoid them.

Treatments are usually limited to dealing with the most discomforting symptoms, but you might require oral surgery to correct your oral structures and alleviate the pain in extreme cases.

Dental Implants

Patients who require dental implants for cosmetic or restorative dentistry will require help from a maxillofacial surgeon.

Certainly, the treatment plan will come from another specialist, but when the dental crown or another implant requires installation, a surgeon will imbed a small anchor piece onto your jaw bone or palate. This is the standard procedure for dental crowns, bridges, and dentures.

Your dental health specialists will ensure you have healthy bones and periodontal tissues to anchor the necessary pieces and avoid additional complications.

What Are the Risks of Oral Surgery?

As with any surgery, oral surgeries involve some risks. Even the most common surgery for tooth extractions carries the risk of damaging nerves.

An extreme case involves the damage of facial nerves, leading to loss of feeling or sensibility around the area. However, this is extremely rare.

Common side effects you can expect after undergoing oral surgery are pain, bleeding, swelling, and occasional infections. These side effects are easy to treat and are often quick to disappear. Dental surgeons will usually prescribe antibiotics to prevent and fight off any type of infection.

Schedule an Appointment Today

If you need orthodontic treatment, your Sacramento orthodontists at Markham Orthodontics are prepared and excited to help you achieve a beautiful, fully functioning smile.

Read our testimonials page to hear from our satisfied patients, and browse our website to learn more about our dental practice and the services we offer.

To schedule your appointment with one of our top-of-the-line orthodontists or for any questions, contact our friendly staff today at 916-525-8566.

How Long Will I Need to Wear a headgear? (Wearing Headgear)

By Blog
Markham Orthodontics | Sacramento, CA | Headgear

Wearing Headgear

Well, this is not what we were expecting for today. Headgear braces are such a controversial topic; there’s no easy way to go about it. When we recommend a patient uses braces, we do so because we want to provide you with a non-surgical solution to your dental and jaw alignment problems. But some cases are just too severe and might require more powerful appliances, such as dental braces and headgear.

As with many other orthodontic appliances, your dental headgear works to improve your dental alignment or correct existing jaw malocclusions. These devices, however, are useful mostly in cases of young children or teenagers whose bones are still growing.

What Are Headgear Braces?

Unlike most orthodontic appliances, some parts of the headgear will go outside of your mouth. The many parts of headgear include:

  • A head cap: this piece sits on the patient’s head and anchors all the remaining pieces.
  • Straps: these are used to provide force at a specific angle and, depending on the model used by the patient, will wrap around the back of the neck or over the head.
  • Facebow: this part, usually metal-made and u-shaped, attaches to your molars, head cap, and straps.
  • Elastic bands, tubes, and hooks: As with any other appliance, these parts anchor various parts of the headgear to the molars.
  • Forehead pad, chin cup, and mouth yoke: you may not necessarily require all of them at once but these parts provide additional tension and direction to the force applied over the teeth by the headgear.

How to Use Headgear Braces?

The goal of wearing headgear braces, as with every other tool in orthodontics, is to safely and gradually move teeth until they reach the proper position and desired alignment.

New patients will only have to wear their appliances for a few hours every day. Make sure you ask your orthodontist about what to expect. As with any other appliance, you will go through an adjustment period where your teeth will feel sore.

To successfully move your teeth, you will have to wear your headgear appliance for 12 to 14 hours per day. The good news, however, is that you won’t have to do so for 12 hours straight. A patient can wear their headgear for 8 hours while being asleep and finish the remaining 4 to 6 hours throughout the day. Please keep in mind that the longer and more often the headgear is worn, the quicker the jaws and teeth will move.

You could wear your headgear while doing errands in the house, reading, watching television, or any activities that do not require moving your face too much. However, sudden movements may affect the headgear, so it is important not to run or participate in strenuous sports while wearing such an appliance.

How Long Will I Need to Wear Headgear? Months? Years?

Depending on the patient’s treatment plan, they may need to wear headgear for as little as one year or for a few years. The length of time you spend with a headgear also depends on your overall compliance with our recommendations. Please do your best to wear the headgear for the full 12 to 14 hours every day or as long as your orthodontist indicates.

In general, the longer a patient wears headgear throughout the day, the fewer months you’ll have to wear it.

What Are the Types of Headgear?

We mostly classify these appliances based on the type of force they apply over your teeth and desired motions. Primarily, there are three types of headgear.

High Pull

This variation is particularly useful in cases of overjets and overbites. The straps go attached from the patient’s upper jaw to the top and back of the head.

Keep in mind that these are efficient in patients whose bones are still growing, so children with a diagnosed open bite or other jaw malocclusions are likely candidates for this appliance.

Cervical Pull

This type can also help with extreme cases of upper jaw alignment problems. Young children with an overjet or overbite could receive a headgear for their orthodontic care. Here, the straps won’t go around the top of the head but will wrap around the back of the neck where you have the cervical vertebrae.

Reverse Pull

This case works better for problems with the development of the upper jaw and underbites. Rubber bands will help attach the braces from the headgear to the top teeth and gradually move them where necessary.

What Your Natomas, Sacramento Orthodontist Says

Call our office today for your complimentary evaluation at (916) 924-8970. We want to make sure you get all the help you need. Headgear braces are useful and necessary in extreme cases.

Here at Markham Orthodontics, we work hard to offer our patients the most convenient solutions. Some appliances fit specific lifestyles and routines better than others. Make sure you ask us about headgears and whether you need them or not.

Woman using clear aligners

The Best Way to Straighten One or Two Crooked Teeth

By Blog

The thing is, most patients seeking orthodontic treatment, especially adults, only do so if they have extreme cases of crowding, jaw misalignment, or tooth rotation. However, you might be wondering exactly what to do about a slight case of one or two crooked teeth, inward, outward, or in any way. How can you fix slightly crooked teeth? Will your treatment take too long?

Healthy bites with slightly crooked teeth are usually reasons why many patients decide to forego orthodontic care. Many adults believe wearing braces for over a year seems a bit extreme. The decision is only harder if any uneven teeth compromise the look of your smile only slightly. Not enough that everyone sees it, but just enough that you know it’s there.

Fortunately, as the best orthodontist in Sacramento, CA patients can find, Dr. Markham and his team know how to help patients of any age by offering several tailored options for your orthodontic treatment that account for your goals and needs.

We could treat isolated cases of crooked front teeth with innovative appliances, such as Invisalign® clear aligners, which are virtually unnoticeable to prying eyes. And even if your budget and preference gravitate towards traditional metal braces, we can use accelerators to seed the changes much more efficiently.

Let’s check out a bit more information about what is the main cause of crooked teeth, how your oral care might change due to your orthodontic condition, and what happens after a complete consultation with Natomas’s best orthodontic team.

What Is the Main Cause of Crooked Front Teeth?

If you have one or two crooked teeth, it is most likely the result of overcrowding or a narrow palate. When your teeth do not have enough room, the nearby teeth will push them to the front or back of your smile.

It’s also possible that your teeth moved around after you prematurely lost a baby tooth or permanent one. After such a tooth loss, your surrounding teeth will move in towards the open space causing additional malalignment and potentially rotating the teeth, giving you crooked teeth.

Other, less common reasons for misalignment:

  • Thumb sucking at a late age after a baby has started to teeth,
  • An improper swallowing reflex that causes the tongue to push forward on the front teeth,
  • Overly large teeth.

Can We Get Crooked Teeth Hereditary?

Dental malocclusions, that is to say, tooth misalignment, are most often hereditary. What we’re trying to say here is that if your parents, grandparents, or close relatives suffer from these orthodontic conditions, it’s very likely that you or your children will suffer from them as well.

As we mentioned before, some individuals may suffer from a congenital disease, so abnormal bite patterns, irregular growth of upper and lower jaws, cleft lip, or palate can all lead to crooked teeth.

Can Invisalign Clear Aligners Straighten Slightly Crooked Teeth?

We often recommend Invisalign for minor to moderate orthodontic issues, such as isolated crooked teeth. This treatment is subtler than standard braces, and it often takes less time to complete, especially when you do not need to correct your entire bite.

In fact, in some cases, Invisalign can take as little as six weeks.

Keep in mind that most viable Invisalign patients only face minor cases of orthodontic problems. Adults and teenagers with more severe cases of dental malalignment and jaw malocclusions may also use Invisalign but will equally require additional attachments. That’s a discussion for another time as we’re dealing primarily with cases of a pair of crooked teeth.

If we determine that you are a suitable Invisalign candidate, we will take digital impressions of your teeth. Then we will use these images to design clear aligners on the computer, varying the shape to match the gradual shift of your teeth.

An Invisalign lab will use the molds to create your aligners from clear plastic that will be almost impossible to see. In most cases, you will wear each set of aligner trays for two weeks. Depending on how you respond, you may require additional trays or additional treatment time.

Make sure you ask your orthodontist about the expected treatment length and plan accordingly.

Traditional Braces and Accelerators

If your teeth are severely out of line, we may suggest traditional braces instead. Stainless steel braces and other types of conventional orthodontic appliances are extremely reliable and durable, perfect for your ortho treatment. We also offer clear braces. Even though they use brackets and wires, they are much more discreet than metal.

However, many patients may relieve their initial concerns about treatment length with conventional braces, even in these cases. Fortunately, our team has an ace up our sleeve. You’ll see there are several ways that we can make your orthodontic care easier.

We can also speed your treatment time with state-of-the-art AcceleDent® or the PROPEL system. These treatments use tiny electrical pulses to vibrate teeth and stimulate the nearby bone.

The additional motion helps seed the changes faster and encourages teeth movement. If you use them according to your dentist’s instructions, you can shorten treatment time by up to 60 percent!

What Are the Benefits of Fixing Slightly Crooked Teeth?

Although one or two uneven teeth might seem like a minor concern, orthodontic treatment is very important.

First, of course, it can greatly improve your appearance. Often, isolated uneven teeth can draw attention away from your other facial features, making your entire smile look out of line.

In some cases, they can also cause you to look childlike or older than you actually are.

Second, orthodontic care can also improve your oral health. Overlapping teeth often trap bacteria, and they are very difficult to clean. Therefore, Invisalign or braces can reduce your risk for decay, discoloration, and gum disease.

There are additional relationships between your oral health and heart disease, so ensuring your dental health is as optimal as possible will greatly benefit patients of all ages.

Further, a single crooked tooth can offset the force of your entire bite, causing pressure on isolated teeth. You could eventually suffer from dental erosion, a cracked tooth, or TMJ disorder without the appropriate care.

Finally, you might also feel some relief when considering that correcting crooked or malaligned dental structures helps improve some speech difficulties. As someone struggles with speech impediments, they will certainly appreciate overcoming those issues and enjoying a more relaxed feel when interacting with school or workmates.

Contact Us for a Straight, Beautiful Smile

Correcting your crooked one or two teeth can be an easy and quick process with lifelong benefits. Contact Markham Orthodontics online to schedule an appointment. You can also learn more about your treatment options when you call (916) 924-8970.

Free Consult