Posts for: February, 2015
Teeth crowding is a difficult bite problem (malocclusion) that often involves the entire jaw structure to be evaluated. Normally occurring when the jaw doesn’t have adequate space for normal tooth eruption, teeth coming in later put pressure on other teeth, causing them to develop improperly.
Crowding also makes it difficult to realign teeth with braces because there’s simply not enough room for sufficient movement to take place. The solution may then be to consider the removal of some of the teeth to create enough space for orthodontic treatment.
Not just any tooth can be removed, however — we must first conduct a careful analysis to determine which can be removed to facilitate optimum movement of the remaining teeth without disrupting normal mouth function or affecting appearance. The teeth most frequently removed for this purpose are the bicuspids, located between the cuspids or eyeteeth (which are positioned directly under the eyes) and the molars, the largest teeth in the back of the mouth. Sometimes one premolar tooth on each side of the jaw can be removed without sacrificing future form or function.
There are a few important considerations we must keep in mind when extracting teeth for orthodontic reasons; perhaps the most important is preserving bone at the extraction site. Because continuing bone growth depends on the forces generated by teeth when we bite or chew, bone near a missing tooth socket will tend to diminish over time. If there’s insufficient bone during orthodontic treatment, it may result in gum recession and root exposure — not only damaging to the teeth themselves but also to a person’s smile appearance. To avoid this, we sometimes will consider inserting a bone graft, which will stimulate bone growth, into the empty socket immediately after extraction. While this isn’t commonly done, it’s being considered if the patient’s bone is thin and a concern during healing.
We must also consider how to accommodate other, unrelated tooth loss to assure the final result is visually appealing. It may be necessary in these cases to maintain the space at the missing tooth site for a future restoration once the orthodontics is completed. This takes planning as well as the use of restorations like dental implants, bridges or partial dentures.
Regardless of your bite issues, the field of orthodontics has the appliances and techniques to overcome even the most complicated condition. When necessary, using procedures like tooth extraction can help turn an unappealing, dysfunctional bite problem into a beautiful smile.
If you would like more information on orthodontic teeth extractions, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Removal for Orthodontic Reasons.”
If you regularly participate in sports or other physical activity, you’re at a higher risk for dental injuries. While chipped teeth are the most common result of these injuries, a few may result in more serious trauma — dislodged, cracked or knocked out teeth. In these cases, the core of the tooth — the pulp — and the root may have been damaged. Saving the tooth may require endodontic treatment and possibly the expertise of a specialist in the field, an endodontist.
Endodontics, from the Greek words for “within” and “tooth,” is a specialty of dentistry that treats disease or damage affecting the inner parts of a tooth, particularly the pulp chamber, the root canals, and the root. While all dentists are trained in endodontic procedures, an endodontist has advanced training, experience and specialized equipment to address complex cases.
The type of endodontic treatment needed for an injured tooth will depend on the extent of damage. A mature, permanent tooth with pulp damage, for example, may require a root canal treatment. In this procedure the pulp chamber and root canals are thoroughly cleaned out, and then are filled with a special filling to prevent any future infection. Later the tooth should be crowned to permanently seal it. Although a general dentist may perform a root canal, more complex cases, such as a tooth with an extensive root canal network, may need to be performed by an endodontist using microscopic equipment.
A tooth that has undergone severe trauma, especially a knocked out tooth, will need extensive follow-up care by a general dentist and possibly an endodontist to improve its chances of long-term survival. Because of the severity, the tooth may lose viability and the body ultimately may begin to reject it. For this reason, the tooth should be monitored on a regular basis and may need further treatment from time to time, even up to five years after the injury.
One final word: if you participate in sports or exercise activity, you can significantly reduce your risk of dental injury with a mouthguard. There are various types, but the best protection is one custom designed to fit the specific contours of your mouth. We’ll be glad to advise you further on how to protect your teeth from injury.
If you would like more information on dental injury prevention and treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Trauma & Nerve Damage to Teeth.”
For a lifetime of healthy teeth and gums, it takes a lifetime of personal and professional care. Starting your child’s daily hygiene with the first tooth eruption is a must; but you should also consider beginning regular dental visits in their early years, around or before their first birthday.
There’s evidence that early dental visits hold a number of benefits that could lead to reduced oral care costs over their lifetime.
Familiarity with professional dental care. Children need to feel comfortable and safe in their surroundings, especially new places. Beginning dental visits early improves the chances your child will view the dentist’s office as a regular part of their life. It’s especially helpful if the dental professional has training and experience with young children to put them at ease.
Early monitoring for dental disease or other problems. A young child’s teeth are highly susceptible to tooth decay. Dental visits that begin early in a child’s life increase our chances of detecting any developing dental problems early. In addition to treating decayed teeth, your child may also need preventative actions like sealants or additional fluoride applications to protect teeth if they are at a higher risk for disease. As the child develops, we may also be able to catch early bite problems: with interventional treatment, it may be possible to reduce future orthodontic costs.
Parental help and support. As we discuss your child’s dental care with you, we’ll be able to provide essential information and training for how to care for their teeth and gums at home. We’ll also be able to ease any common concerns you may have, such as thumb sucking or other oral habits, as well as give you sound advice and techniques for dealing with these problems.
As with other areas of childhood development, starting off on the right foot with oral care can make all the difference to their future dental health. The sooner you begin regular dental visits with your toddler, the better their chances for a lifetime of healthy teeth and gums.
If you would like more information on dental care for children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Taking the Stress out of Dentistry for Kids.”
Did you know that the bacteria that cause tooth decay are usually transmitted to children from their parents, through sharing the same spoon or kissing? Once inside the child's mouth, the bacteria live on the teeth in what is called a biofilm. When the child consumes sugary foods or drinks, the bacteria act upon the sugar to produce acids that eat away at the child's teeth, producing tooth decay.
These bacteria thrive on carbohydrates such as bread, sweets, and sodas. Even fruit juices, which offer more vitamins than soda, are filled with sugars that lead to decay. The child's saliva works hard to neutralize the acidity produced from these foods, but if the child often snacks between meals this neutralization process doesnÃ¢Â€Â™t have a chance to occur.
The first sign of decay may be white spots on the teeth, an indication that minerals in the surface enamel have been dissolved in certain locations. Before it goes any farther, this process can be reversed by reducing the exposure to acids and using fluorides to strengthen the tooth surface.
Make sure your child sees a dentist by his first birthday, to provide preventive care and treat any beginning decay.
You can also help your child develop the habit of brushing his teeth with fluoridated toothpaste. It is important to use only a smear of toothpaste on the brush for very young children, and a pea-sized amount on the brush for children over the age of 2. Sometimes small children swallow their toothpaste, and excessive amounts of fluoride can cause staining on the teeth. When your children are very young, you must brush their teeth. As they get older, they can do it themselves, with your supervision. We can also apply fluoride varnish to strengthen the tooth surface and make it resistant to acids.
Brushing twice a day is a good start. But it can't prevent tooth decay when a child is eating carbohydrates all day. One way to reduce the use of sugar is to use xylitol, a naturally occurring sweetener that looks and tastes like table sugar and improves oral health. Studies have shown that use of this sweetener reduces tooth decay in children.
Another good idea is to wean children from bottles and training cups as early as possible. Sometimes children are given bottles filled with milk or sugary beverages at bedtime to help them relax. A better idea for their teeth is to teach them to drink from a regular cup filled with milk — or preferably, with water.
Contact us today to schedule an appointment to discuss your questions about tooth decay in children. You can also learn more by reading the Dear Doctor magazine article “Managing Tooth Decay In Children With Chronic Diseases.” While this article focuses on children with health challenges, it contains excellent advice to help all children prevent tooth decay.