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Posts for: January, 2015

By Upper Montclair Dental Associates
January 26, 2015
Category: Dental Procedures
FiveFactsAboutPalatalExpanders

Have you heard of palatal expanders? If your child needs orthodontic work, then you ought to hear about them! These small appliances offer plenty of advantages to kids whose smiles, due to a variety of problems, may need some help. Here are five things you should know:

1. Palatal expanders are small orthodontic appliances that fit inside the mouth.

Custom-fabricated for each child, these devices are placed near the roof of the mouth, in between the two rows of upper teeth. They consist of two small metal brackets with a tensioning system that can be adjusted by a tiny key. Not everyone needs one, but they can really benefit kids with certain orthodontic conditions.

2. Palatal expanders take advantage of a child's natural growth processes.

That's part of the reason they work so well. Since the bones of a child's upper jaw don't fuse together until sometime after puberty, it's relatively easy to move them apart before that time. The palatal expander applies gentle pressure to gradually move the left and right halves of the upper jaw apart, over a period of a few months. Then it's left on several weeks longer, allowing new bone to fill in and stabilize the expansion.

3. Palatal expanders are helpful in treating a variety of orthodontic problems.

Crowding — that is, not having enough space in the jaw to accommodate all of the teeth — is one major issue. A related issue is impacted teeth: These are teeth that are blocked from coming in (erupting) by other teeth or jaw structures. A third issue is crossbite: That's when the back top teeth come down to bite inside, rather than outside, the bottom teeth. Gaining additional space in the upper jaw can help relieve all of these problems.

4. Palatal expanders can eliminate the need for tooth extraction.

Once upon a time, extraction was the only way to solve these problems. However it's an invasive (and potentially complex) procedure. A palatal expander can often provide the same — or better — results, via a noninvasive method.

5. Palatal expanders typically shorten overall orthodontic treatment time.

They're generally worn for a total of three to six months, but they can considerably shorten a child's overall orthodontic treatment time. Plus, they're invisible — a big plus to image-conscious teens. Could they benefit your child?

If you have questions about palatal expanders, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Palatal Expanders” and “The Magic of Orthodontics.”


By Upper Montclair Dental Associates
January 23, 2015
Category: Oral Health
FourTipsforPreventingPrematureLossofBabyTeethFromToothDecay

Most often, all of your child’s primary teeth will eventually be replaced by permanent teeth, but you shouldn’t consider them less important — there are serious consequences for losing a primary tooth prematurely. Besides providing a means for a child to chew food and speak clearly, primary teeth also save space for the permanent teeth to erupt; a premature loss could lead to malocclusions (bad bites) that may result in costly orthodontic treatment later.

That’s why it’s important to fight tooth decay in primary teeth. By keeping them healthy and in place until it’s time for their departure, their permanent replacements have a better chance of erupting into their proper positions.

Here are 4 tips for preventing tooth decay in primary teeth:

Begin daily oral hygiene when teeth first appear. Begin brushing with fluoride toothpaste as soon as the first primary teeth come in. Brushing removes bacterial plaque, the primary cause of tooth decay, and fluoride strengthens enamel. Because they tend to swallow toothpaste rather than spit it out, use just a smear of toothpaste for infants and toddlers, and a pea-sized amount for ages two and older.

Start regular dental visits by the child’s first birthday. By beginning regular checkups around age 1, we’ll have a better chance of discovering developing tooth decay or other problems early. You’re also setting a good foundation for what should be a lifelong habit for optimum dental health.

Limit sugar consumption. The oral bacteria that cause tooth decay feed on leftover carbohydrates like sugar, so you should limit intake especially between meals. One culprit to watch out for: a bedtime bottle filled with formula, milk or fruit juices, all of which contain carbohydrates (sugar). Water or no bottle at all is a better alternative.

Consider topical fluoride or sealants for extra protection. In some circumstances, we may advise protecting the enamel of newly erupted teeth with an applied sealant. These protective coatings fill in porous pits and fissures in young teeth to deny access to disease. Supplemental fluoride will further strengthen young tooth enamel.

Taking these measures and remaining vigilant to the first signs of decay can go a long way toward preserving your child’s teeth. Their future oral health depends on it.

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 “Dentistry & Oral Health for Children.”


By Upper Montclair Dental Associates
January 15, 2015
Category: Oral Health
Tags: toothache   tooth pain  
WhyYourTeethMayHurt

Don't ignore tooth pain hoping it goes away. No matter how mild or fleeting it may be, it's a sign that something's wrong. Healthy teeth shouldn't cause discomfort because the parts containing the nerves — the interior pulp and the dentin around it — are shielded by dental enamel and gums.

Here are some common reasons that teeth ache:

  1. Gum Recession. Over time, gums can recede. Improper or excessive brushing can affect them, especially if you are genetically predisposed by having thin gums. When gums retreat, dentin can, or eventually will, be exposed. Besides its susceptibility to sensation, dentin is also more vulnerable to erosion and decay than enamel.
  2. Tooth Erosion/Decay. When acid-producing oral bacteria get the upper hand, they can eat through the tooth's protective enamel to the dentin. You may start feeling sensitivity as the decay gets deeper and closer to the pulp (nerves). Only removal of the decay and filling the cavity can stop the process.
  3. Old/Loose/Lost Filling. Fillings seal off areas of past decay. If they don't fit right or are dislodged altogether, air or food particles can slip inside and irritate exposed nerve endings. A crevice to hide in makes it prime real estate again for bacteria, too.
  4. Cracked Tooth. Teeth grinding and jaw clenching can have a similar impact on teeth that a miner's pick has on rock. At first thin lines in your enamel can develop, then cracks develop that may expose the dentin, and finally the tooth might fracture, exposing the pulp. The earlier this process is caught, the better.
  5. Pulp Tissue Infection/Inflammation. This can be caused by deep decay or trauma and suggests your tooth may be in its death throes. Sometimes the pulp infection travels into the surrounding periodontal (peri – around; odont – tooth) tissues and causes an abscess to develop. This absolutely requires immediate attention.
  6. Residual Sensitivity from Dental Work. Removal of decay before placing a filling can cause tooth sensitivity. It can take 1-4 weeks or so to improve.
  7. Sinus Pain. Congestion can cause “referred” pain in the upper teeth. When the congestion subsides, the pain should, too.

As you can see, it's risky to discount tooth pain and “wait ‘til it goes away.” Our office can help you determine the origin of your pain and the best course of action to resolve it. When in doubt, it's always better to err on the side of caution!

If you would like more information about tooth pain and ways to prevent or treat it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Tooth Pain? Don't Wait!” and “Sensitive Teeth.”


By Upper Montclair Dental Associates
January 07, 2015
Category: Oral Health
Tags: tmj   tmd   tmj disorders  
TreatingTMDLikeOtherJoint-RelatedProblems

After ruling out other causes for your jaw pain, your doctor or dentist has made a diagnosis: a temporomandibular joint disorder (TMD). With TMD, your pain symptoms and other dysfunctions are due to a problem associated with the temporomandibular joint (TMJ) that connects your lower jaw (mandible) to your upper skull (cranium).

There are a number of treatment options, but most can be classified as either aggressive or conservative. Aggressive treatments are more interventional and target problems with the teeth such as bite problems or jaw relationships as they relate to the bite, which are thought to be underlying causes for TMD. Such treatments include orthodontics to realign teeth, crown or bridgework, or surgical treatment to the jaw or joint itself. These treatments are controversial and irreversible — with no guarantee of symptom relief.

It’s thought by many to be appropriate, then, to start with more conservative treatments. Many of these are based on treating the TMJ — which is a joint, a moveable bony structure connected by muscles and tendons — with an orthopedic approach, using treatments similar to those used for other joint problems.

Here, then, are some of those conservative therapies that may relieve your TMD pain and other symptoms.

Physical Therapy. Commonly used to treat pain and dysfunction in other joints, physical therapies like manual manipulation, massage, alternating hot and cold packs or exercises can be used to relax, stretch or retrain the muscles that operate the TMJ while reducing pain and inflammation.

Medications. Medications may be incorporated into the treatment plan to relieve pain, reduce inflammation or relax tense muscles. Besides prescription drugs, over-the-counter anti-inflammatory drugs (such as ibuprofen or acetaminophen) are also commonly used.

Bite Appliances. If night-time teeth grinding or clenching habits are a primary cause for the TMD, you may benefit from wearing an occlusal bite guard while you sleep, designed to specifically fit your upper teeth. Because the lower teeth can’t grip the guard’s smooth plastic surface when biting down, they’ll more likely produce less force. This gives the jaw muscles a chance to relax during sleep.

Diet changes. Changing to softer foods, which don’t require strenuous chewing, and eliminating the chewing gum habit will further help reduce stress on the TMJs and also give your muscles a chance to relax and heal.

If you would like more information on TMD and treatment options, 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 “Seeking Relief from TMD.”