At any given time some 4 million teens and pre-teens are wearing braces or other orthodontic appliances to correct a malocclusion (poor bite). While most cases are straightforward, some have difficulties that increase treatment time and cost.
But what if you could reduce some of these difficulties before they fully develop? We often can through interceptive orthodontics.
This growing concept involves early orthodontic treatment around 6 to 10 years of age with the goal of guiding the development of a child’s jaws and other mouth structures in the right direction. These early years are often the only time of life when many of these treatments will work.
For example, widening the roof of the mouth (the palate) in an abnormally narrow upper jaw takes advantage of a gap in the bone in the center of the palate that doesn’t fuse until later in adolescence. A device called a palatal expander exerts outward pressure on the back teeth to influence the jawbone to grow out. New bone fills in the gap to permanently expand the jaw.
In cases with a developing overbite (the upper front teeth extending too far over the lower teeth when closed), we can install a hinged device called a Herbst appliance to the jaws in the back of the mouth. The hinge mechanism coaxes the lower jaw to develop further forward, which may help avoid more extensive and expensive jaw surgery later.
Interceptive treatments can also be fairly simple in design like a space retainer, but still have a tremendous impact on bite development. A space maintainer is often used when a primary (“baby”) tooth is lost prematurely, which allows other teeth to drift into the empty space and crowd out the incoming permanent tooth. The wire loop device is placed within the open space to prevent drift and preserve the space for the permanent tooth.
To take advantage of these treatments, it’s best to have your child’s bite evaluated early. Professional organizations like the American Association of Orthodontists (AAO) recommend a screening by age 7. While it may reveal no abnormalities at all, it could also provide the first signs of an emerging problem. With interceptive orthodontics we may be able to correct them now or make them less of a problem for the future.
If you would like more information on orthodontic treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Interceptive Orthodontics.”
You might not be aware how much force your jaws generate while you eat or chew. But you can become aware in a hurry when part of your inside cheek or lip gets in the way.
What may be even worse than the initial painful bite are the high odds you’ll bite the same spot again—and again. That’s because of a feature in the skin’s healing process.
As a surface wound heals, it often forms a cover of fibrous tissue consisting of the protein collagen. This traumatic fibroma, as it’s called, is similar to a protective callous that develops on other areas of damaged skin. In the process, though, it can become “taller” than the surrounding skin surface, which increases the chances of another bite.
This second bite often results in more fibrous tissue formation that rises even higher from the skin surface, which then becomes more likely to be bit again. After repeated cycles, the initial wound can become a noticeable, protruding lump.
These kinds of sores are typically not cancerous, especially if they’ve appeared to form slowly over time. But they can be a nuisance and the occasion of sharp pain with every subsequent bite. There is, though, an effective way to deal with it—simply have it removed.
While it involves a surgical procedure—an oral surgeon, periodontist or dentist with surgical training usually performs it—it’s fairly minor. After numbing the area with a local anesthetic, the dentist will then completely excise the lesion and close the resulting gap in the skin with two or three small sutures (it could also be removed with a laser). The wound should heal within a few days leaving you with a flat, flush skin surface.
The tissue removed is usually then biopsied. Although it’s highly unlikely it was more than an annoying sore, it’s still common procedure to examine excised tissues for cancer cells. If there appears to be an abnormality, your dentist will then see you to take the next step in your treatment.
More than likely, though, what you experienced was a fibroma. And with it now a thing of the past, you can chew with confidence knowing it won’t be there to get in the way.
If you would like more information on dealing with common mouth sores, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Common Lumps and Bumps in the Mouth.”
Did you make any New Year's resolutions this year? For many of us, these pledges reflect a sincere desire for self-improvement—whether it's in terms of our career, our personal lives, or our health. Yet it isn't always possible to keep every promise we make…and while exercising every day and cutting out desserts are worthwhile goals, they may also be very difficult to maintain. Fortunately, when you resolve to improve your oral health, there are some simple things you can do to help keep your smile looking healthy and bright.
Get Into the Oral Hygiene Habit
Got a minute? How about two minutes, twice a day? If so, you have time to brush your teeth properly. According to the American Dental Association (ADA), brushing twice daily with a soft-bristled brush that fits comfortably in your mouth—and replacing that brush every three to four months—is essential to good oral hygiene. The ADA also recommends flossing once a day to clean all the places where your brush can't reach—like in between teeth and under the gum line. Brushing and flossing are the best ways to maintain good oral hygiene at home.
Think Before You Drink
Here's another way to make a big difference in your oral health: Pass up those sugary and acidic drinks, and choose plain, refreshing water instead. We're talking about regular and diet soda, as well as fruit juice and those so-called “sports” or “energy” drinks. The sugar and acid in these drinks can spell disaster for your teeth: Sugar promotes the growth of bacteria that can cause tooth decay, while acid softens the hard enamel covering of your teeth, allowing cavities to get started. Water, on the other hand, satisfies your body's need for hydration without adding calories or harmful ingredients. That what makes it the best drink for your diet—and your oral health.
See Your Dentist Regularly
There are some jobs best left to the pros—like removing the hardened deposits called “tartar” from your teeth, and checking for tooth decay, gum disease and other oral health problems. We'll take care of all that at your routine dental checkup. Plus, you'll get a thorough cleaning and a chance to “brush up” on oral hygiene techniques that can help you keep your mouth healthy throughout the year.
If you have questions about improving your oral hygiene, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Daily Oral Hygiene” and “Think Before You Drink.”
For whatever reason, you’ve put off replacing a missing tooth for awhile. Now you want to fill that empty gap in your smile with a dental implant restoration.
But if your tooth’s been missing for a long time, there could be a problem with space. This is because the teeth on either side of the space may have gradually drifted into it, leaving no room for the implant. You could need orthodontic work first to return these teeth to their proper position.
We could use braces, metal orthodontic devices with wires threaded through brackets bonded to the teeth that are then anchored, usually to back teeth. The orthodontist uses elastics or springs as well as possibly incrementally tightening of the wire against the anchors. These techniques create pressure or tension on the teeth for the desired direction of movement. The teeth’s natural mechanism for movement does the rest.
But while effective, braces can be quite noticeable, an embarrassing thought for many adults having to wear them over several months of treatment. But there may be an alternative: clear aligners, a succession of slightly different plastic trays usually worn in two-week intervals. Sequentially wearing each tray gradually moves the teeth to their desired positions.
Though not appropriate for all bite situations, clear aligners have a number of benefits when they can be used. They’re nearly invisible to others and can be removed for hygiene tasks or rare special occasions. What’s more, the orthodontist may attach a temporary prosthetic (false) tooth to the trays to camouflage the missing space during treatment.
There’s one other issue you may have to deal with: if your tooth loss was related to periodontal (gum) disease, the gums and underlying bone may be in poor condition. In fact, substantial bone loss could rule out an implant altogether. But we may be able to remedy both gum and bone deficiencies through grafting or plastic surgery. It may be possible to regenerate enough bone to support the implant; and surgically repairing your gums will help ensure the implant appears natural.
If you have problems like these, don’t give up on your restoration goal just yet. With some orthodontic and dental work ahead of time, we may still be able to make implants a reality for you.
Tooth decay can wreak more havoc than just producing cavities. It can work its way into the innermost parts of the tooth — the pulp and tiny passageways called root canals that lead to the tooth's connection with the bone.
If that happens, you'll need more than “drilling and filling.” Without intervention, your tooth could be lost. That intervention is a root canal treatment, a procedure that removes the infection from within the tooth and preserves it from re-infection.
You've probably heard the old belief that root canal treatments are painful. With modern anesthetic techniques to deaden pain, that's not true. In fact, root canal treatments stop the pain caused by infected nerves within the pulp and root canals. More importantly, it saves your tooth.
Root canals can be performed by a general dentist. More extensive decay or complex root canal networks may require the services of an endodontist, a dentist who specializes in root canal anatomy and treatments. Endodontists have advanced techniques and equipment to handle even the most difficult case.
Regardless of who performs it, the basic procedure is the same, as is the goal: to completely remove all diseased tissue within the tooth and seal it with a special filling to prevent re-infection. To access the diseased pulp, we first drill an access hole, usually in the biting surface of a back tooth or the back of a front tooth. We then use specialized instruments to remove the infected tissue and flush out the space with antibacterial solutions.
We then insert a filling called gutta percha into the empty pulp chamber and root canals, seal off the filling with adhesive cement, and close the access hole with filling. These fillings and sealants prevent bacteria from reentering the tooth. For added protection against infection and fracturing, we also recommend placing a full-coverage dental crown. This also enhances the appearance of the tooth, which must be modified during the root canal procedure.
The end result: your once endangered tooth has been preserved for hopefully many years to come. So if we recommend you undergo a root canal treatment, don't wait — the tooth you save may be your own.
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