Before we begin correcting a malocclusion (poor dental bite), we need to ask a few questions: How extensive is the malocclusion? How far must we move the teeth to correct it? How might the patient's jaw size impact treatment?
Answering these and other questions help us develop an effective treatment plan. And depending on the answers, we might need to look at other procedures before we install braces—like removing one or more of the teeth.
This isn't a subject to approach lightly: All teeth play an important role in dental function and smile appearance, and ordinarily we want to preserve teeth, not remove them. Sometimes, however, it may be a necessary action to achieve our goal of an improved dental bite.
For example, it might be necessary for correcting a malocclusion caused by severe teeth crowding. This occurs when one or both of the jaws hasn't grown to a sufficient size to accommodate all of the teeth erupting on it. As a result, some of the teeth could come in out of their proper alignment.
If caught early before puberty, we may be able to use other techniques to alleviate crowding, like a device called a palatal expander that influences an upper jaw to widen as it grows. If successful, it could provide later teeth more room to erupt in their proper positions.
But even if additional jaw growth occurs, it may not be enough to avoid a malocclusion or treatment with braces. Alleviating further crowding by removing teeth in little noticed areas could help with subsequent orthodontics.
Removing teeth may also be the answer for other problems like an impacted tooth, in which the tooth has not fully erupted and remains submerged in the gums. It's sometimes possible to use a technique to “pull” the tooth down where it should be; but again, that will still require jaw space that may not be available. The more effective course might be to remove the impacted tooth.
Whether or not tooth extraction will be needed can depend on a thorough orthodontic evaluation and full consideration of all the available options. Even though the ideal situation is to correct a bite with all teeth present and accounted for, it may be for the better good to sacrifice some.
If you would like more information on orthodontic techniques, 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 “Removing Teeth for Orthodontic Treatment.”
Being a parent can be a rewarding role. But it's also hard work, especially the effort required in keeping children healthy. In that respect, there's one area you don't want to overlook—their dental health.
Taking care of their teeth and gums has two aspects: their current state of dental health and their ongoing development that impacts future health. Fortunately, you can address both the present and the future by focusing on the following areas.
Prioritizing oral hygiene. From the moment your child is born, you'll want to practice daily oral hygiene to keep their teeth and gums clean of disease-causing bacterial plaque. This starts even before teeth erupt—simply wipe their gums with a clean wet cloth after feeding. As teeth emerge, begin brushing each one with a small amount of toothpaste. Around your child's second birthday, start training them to brush and floss on their own.
Limit their sugar intake. The biggest threat to your child's teeth is tooth decay, which is caused by bacteria. These bacteria multiply when they have plenty of sugar available in the mouth, one of their primary food sources. It's important then to reduce the sugar they eat and limit it to mealtimes if possible. Also avoid sending them to bed with a bottle filled with sweetened liquids, including juices and even formula.
Visit the dentist. You're not in this alone—your dentist is your partner for keeping your child's teeth healthy and developing properly. So, begin regular visits when your child's first teeth appear (no later than their first birthday). You should also consider having your child undergo an orthodontic evaluation around age 6 to make sure their bite is developing properly.
Practice oral safety. Over half the dental injuries in children under 7 occur in home settings around furniture. As your child is learning to walk, be aware of things in your home environment like tables and chairs, or hard objects they can place in their mouths. Take action then to move these items or restrict your child's access to them.
Good habits in each of these areas can make it easier to keep your child's teeth and gums healthy and on the right developmental track. That means good dental health today that could carry on into adulthood.
If you would like more information on children's dental care, 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 “Top 10 Oral Health Tips For Children.”
Chipped a tooth? Don't beat yourself up—this type of dental injury is quite common. In fact, you probably have a favorite celebrity who has chipped one or more of their teeth. The list is fairly long.
Some chipped a tooth away from the limelight, such as Tom Cruise (a hockey puck to the face as a teen), Jim Carrey (roughhousing on the playground) and Paul McCartney (a sudden stop with a moped). Others, though, chipped a tooth while “on the job.” Taylor Swift, Hillary Duff and Jennifer Lopez have all chipped a tooth on stage with a microphone. And chipped teeth seem to be an occupational hazard among professional athletes like former NFL star, Jerry Rice.
Since smiles are an indispensable asset to high-profile celebrities, you can be sure these stars have had those chipped teeth restored. The good news is the same procedures they've undergone are readily available for anyone. The two most common restorations for chipped teeth are dental bonding and veneers.
The least invasive way to fix a chipped tooth is bonding with a material known as composite resin. With this technique, resin is first mixed to match the tooth color and then applied to the chipped area or applied in layers of color to get just the right look. After a bit of shaping, curing and adjustment, we're done—you can walk out with a restored tooth in one visit.
Bonding works well with slight to moderate chips, but it could be less durable when there is more extensive damage. For that, you may want to consider porcelain veneers. Veneers are thin wafers of dental porcelain that are bonded to the front of teeth to mask blemishes like stains, slight gaps or, yes, chips. Veneers can be so lifelike that you won't be able to tell the veneered tooth from your other teeth. They are fashioned to match the color and shape of an individual's teeth. Because of the time and design detail involved, veneers are more expensive than bonding, yet still within an affordable range for many.
Teeth require some alteration before applying traditional veneers because otherwise the teeth can appear bulky when the veneer is bonded to the existing tooth. To compensate, we remove a little of the tooth enamel. Because this loss is permanent, you'll need to wear veneers or have some other form of restoration for the tooth from then on. For many people, though, that's a small price to pay for a smile without chips.
Your first step to repairing a chipped tooth is to come in for an examination. From there, we'll recommend the best option for your situation. And regardless of which, bonding or veneers, we can change your smile for the better.
If you would like more information about restoring injured teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Porcelain Veneers: Strength and Beauty as Never Before.”
Brushing and flossing daily, and dental visits at least twice a year: These are the essential things you should be doing to protect your teeth and gums against dental disease. But you're also getting an automatic assist from your body through saliva, that humble fluid swishing around in your mouth, to protect your oral health.
It's more than simply “mouth water”: Without saliva and its various components, your risk for tooth decay or periodontal (gum) disease would be much higher. Here are 4 ways saliva helps you keep your teeth and gums healthy.
Cleansing. Chewing prepares your food for digestion, but in the process produces tiny particles of food debris. Settling on tooth surfaces, these bits become part of the dental plaque that forms on your teeth and develops the ideal breeding ground for disease-causing bacteria. Saliva helps rinse away much of this debris—particularly sugar, the primary food source for bacteria.
Protection. Saliva is the first line defense against disease-causing microorganisms entering the mouth. The primary source of this protection is a protein-based antibody called Immunoglobulin A (IgA), which directly fights infection-causing organisms. Another protein in saliva, lactoferrin (also found in tears), interferes with bacterial growth.
Buffering. The main enemy of tooth enamel is mouth acid, produced by oral bacteria and the foods that we eat. Saliva neutralizes acid to help the mouth maintain its normally neutral pH range. And it works fast: Saliva can buffer acid and restore balance within thirty minutes to an hour after eating.
Re-mineralization. It's normal for acid to build up after eating, and for it to quickly remove minerals from surface enamel, a process called de-mineralization that can soften and weaken the enamel. But saliva helps restore some of these lost minerals as it's neutralizing acid. This re-mineralization re-strengthens enamel against tooth decay.
Saliva is so important for maintaining a healthy mouth, it's worth your efforts to protect it. Diminished saliva production not only produces an unpleasant dry mouth, it may increase your risk for disease. If this is a constant problem, speak to your dentist about causes and remedies. You'll be doing your teeth and gums a favor.
If you would like more information on the role of saliva in maintaining oral health, 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 “Saliva: How it is Used to Diagnose Disease.”
Little things add up. Like your three meals a day, which could total over 87,000 by the time you're eighty. If you average a full night's sleep every night, you will have whiled away over a quarter of a million hours in slumber by your diamond birthday. And if you're the typical American, you will also have spent over 900 hours (or nearly 40 days) brushing your teeth.
If that last example sounds like a lot, it's actually not: If it's a daily habit, that's about two minutes of brushing a day. But that little bit of time could have an incredible impact on your dental health over a lifetime. That's why dental providers commemorate October as National Dental Hygiene Month to call attention to just how important those 900-plus hours can be to a healthy mouth.
Brushing is important because of what a few strains of bacteria can do to your oral health. While most of your mouth's microscopic inhabitants do no harm (and some are even beneficial), the malevolent few cause tooth decay and gum disease, both of which could lead to tooth loss.
These bacteria live in and feed off of a thin biofilm of food particles called dental plaque. Over time, plaque and tartar (a hardened, calcified form) can build up on tooth surfaces. As it grows, so does the mouth's bacterial population and the risk for disease. In fact, just a few days of undisturbed plaque growth is enough time for a gum infection to get started.
Brushing your teeth removes this plaque accumulation, which reduces the bacterial levels in your mouth. A thorough brushing of all surfaces usually takes about two minutes, but it must be done every day to keep plaque at bay. So, yes, a little time spent brushing every day can be a big deal. That said, though, it's not the be-all and end-all of oral hygiene. You should also floss daily since plaque accumulates just as readily in the spaces between teeth where brushing can't reach. We, along with the American Dental Association, recommend brushing twice a day and flossing once a day for optimal oral health.
But no matter how proficient you are with brushing and flossing, you may still miss some spots. Be sure, then, that you also see us regularly for dental cleanings to thoroughly clean your teeth of plaque and fully minimize your risk of dental disease.
Oral hygiene only takes a little of your time each day. But it does add up—not only in the “days” you'll spend doing it, but in a lifetime of better dental health.
If you would like more information about getting the most out of your daily oral hygiene, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Daily Oral Hygiene.”
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