Sometimes it seems that appearances count for everything—especially in Hollywood. But just recently, Lonnie Chaviz, the 10-year-old actor who plays young Randall on the hit TV show This Is Us, delivered a powerful message about accepting differences in body image. And the whole issue was triggered by negative social media comments about his smile.
Lonnie has a noticeable diastema—that is, a gap between his two front teeth; this condition is commonly seen in children, but is less common in adults. There are plenty of celebrities who aren’t bothered by the excess space between their front teeth, such as Michael Strahan, Lauren Hutton and Vanessa Paradis. However, there are also many people who choose to close the gap for cosmetic or functional reasons.
Unfortunately, Lonnie had been on the receiving end of unkind comments about the appearance of his smile. But instead of getting angry, the young actor posted a thoughtful reply via Instagram video, in which he said: “I could get my gap fixed. Braces can fix this, but like, can you fix your heart, though?”
Lonnie is raising an important point: Making fun of how someone looks shows a terrible lack of compassion. Besides, each person’s smile is uniquely their own, and getting it “fixed” is a matter of personal choice. It’s true that in most circumstances, if the gap between the front teeth doesn’t shrink as you age and you decide you want to close it, orthodontic appliances like braces can do the job. Sometimes, a too-big gap can make it more difficult to eat and to pronounce some words. In other situations, it’s simply a question of aesthetics—some like it; others would prefer to live without it.
There’s a flip side to this issue as well. When teeth need to be replaced, many people opt to have their smile restored just the way it was, rather than in some “ideal” manner. That could mean that their dentures are specially fabricated with a space between the front teeth, or the crowns of their dental implants are spaced farther apart than they normally would be. For these folks, the “imperfection” is so much a part of their unique identity that changing it just seems wrong.
So if you’re satisfied with the way your smile looks, all you need to do is keep up with daily brushing and flossing, and come in for regular checkups and cleanings to keep it healthy and bright. If you’re unsatisfied, ask us how we could help make it better. And if you need tooth replacement, be sure to talk to us about all of your options—teeth that are regular and “Hollywood white;” teeth that are natural-looking, with minor variations in color and spacing; and teeth that look just like the smile you’ve always had.
Because when it comes to your smile, we couldn’t agree more with what Lonnie Chaviz said at the end of his video: “Be who you want to be. Do what you want to do. Do you. Be you. Believe in yourself.”
If you have questions about cosmetic dentistry, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Magic of Orthodontics.”
While children are less likely than adults to experience periodontal (gum) disease, the same can't be said for tooth decay. One aggressive form of decay called early childhood caries (ECC) can have a profound effect on a child's dental development and future health.
That's why dentists who treat young children often use a variety of preventive measures to reduce the risk of ECC and other dental diseases. One popular method is dental sealants, dental material coatings applied to the biting surfaces of teeth that fill in the naturally occurring pits and crevices. These areas are highly susceptible to plaque formation, a bacterial biofilm of food particles that tends to accumulate on teeth. It's the bacteria that live in plaque that are most responsible for the formation of tooth decay.
Roughly one third of children between the ages of 6 and 11 have received some form of dental sealant. It's a quick and painless procedure applied during a routine office visit. The dentist brushes the sealant in liquid form on the teeth, and then hardens it with a special curing light. It's common for children to begin obtaining sealant protection as their molars begin to come in.
With their increased popularity among dentists, researchers have conducted a number of studies to see whether dental sealants have a measurable effect reducing tooth decay. After reviewing the cases of thousands of children over several years, many of these studies seemed to show that children who didn't receive sealants were more than twice as likely to get cavities as children who did.
As evidence continues to mount for dental sealants' effectiveness protecting young children from decay, both the American Dental Association and the American Academy of Pediatric Dentistry now recommend it for all children. Not only can sealants help preserve children's teeth now, but they can reduce future costs for dental treatment that results from tooth decay.
A loose baby tooth is normal and expected; a loose permanent tooth is quite another matter: it’s an advanced sign of disease that could lead to losing the tooth.
The reasons for its looseness may vary. You may have experienced “primary occlusal trauma,” in which the teeth have experienced a prolonged excessive biting force beyond their tolerance. This can be caused by habitual grinding or clenching the teeth.
You may have also experienced “secondary occlusal trauma”: although the biting forces are within normal ranges, the teeth still can’t handle the stress due to degraded bone support and gum tissue detachment. Clenching habits combined with weakened bone and gums will only accelerate and worsen the damage.
The most frequent cause in adults for loose teeth is secondary trauma from periodontal (gum) disease. Bacterial plaque built up on teeth from poor oral hygiene causes a chronic infection that eventually weakens gum attachment to the teeth. A loose tooth is a late sign of this damage.
Treatment for disease-based loose teeth has a twofold approach. First, we thoroughly clean the tooth, root and gum surfaces of all plaque and calculus (hardened plaque deposits) to reduce the infection and inflammation and restore tissue health. This is often accompanied by antibiotic treatments to reduce bacteria below the gum tissue.
For the loose teeth themselves, we may need to modify the forces against them while the gums and bone heal. One way to lessen the biting force on a tooth is to reshape its and the opposing tooth’s biting surfaces. For extensive looseness we can also splint the affected tooth or teeth with other teeth. Temporarily, we can apply splinting material to the outside of both the loose and stable teeth or cut a small channel into them and apply bonding material to join them. A permanent option is to crown both the affected teeth and nearby stable teeth and fuse the crowns together.
These and other stabilizing techniques, like occlusal night guards to reduce the effects of teeth grinding or orthodontic treatment, will help secure the teeth. Coupled with disease treatment and renewed dental care and hygiene practices, you may be able to keep that loose tooth from being lost.
If you would like more information on treating loose teeth, 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 “Treatment for Loose Teeth.”
We've known for decades that fluoride strengthens tooth enamel and lowers the risk for decay. And while adding it to toothpaste and drinking water are the more common ways for getting it into the body, an increasingly popular way—especially for children—is to apply fluoride directly to the teeth.
But is topical fluoride really worth the effort and expense? And, are there any side effects to treating teeth this way?
As to the first question, researchers have performed numerous studies measuring fluoride's effectiveness for preventing tooth decay. The Cochrane Oral Health Research Group recently reviewed studies on topical fluoride applications involving nearly 10,000 children and adolescents between the ages of 2 and 15. The combined average for all the studies showed a 28% reduction in decayed teeth for patients who received topical fluoride compared to those who didn't.
This was especially true for children at high risk for decay: directly applying fluoride gels, foams or varnishes to teeth reduces that risk substantially. But there are also side effects to this application. Fluoride in general has only one known safety concern, a condition known as fluorosis. Too much fluoride over time can cause heavy discoloration of the teeth. This does not affect the health of the teeth, but it can look unattractive and require cosmetic treatment to reduce its effect.
There's little to no risk for fluorosis with the controlled treatments offered by dentists; the fluoride solution remains on the teeth no more than a few minutes. But there is a possible side effect during treatment due to the relatively high dose of fluoride used. If the patient accidentally swallows some of the solution, the concentration of fluoride can cause stomach upset, vomiting or headaches.
Dentists minimize the chances for this by usually using the more difficult to swallow varnish form of topical fluoride on younger patients, and using trays or other barrier devices to isolate the fluoride solution from the rest of the mouth. Under professional supervision, it's rare for an accidental ingestion to occur.
The risks for these side effects are quite low, and the benefits of topical fluoride for reducing the chances for decay can more than outweigh them. Fluoride applications are one of many ways we can protect your child's current and future dental health.
If you would like more information on decay prevention techniques like topical fluoride, 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 “Fluoride Gels Reduce Decay.”
When they’re introducing a new movie, actors often take a moment to pay tribute to the people who helped make it happen — like, you know, their dentists. At least that’s what Charlize Theron did at the premiere of her new spy thriller, Atomic Blonde.
"I just want to take a quick moment to thank my dentists," she told a Los Angeles audience as they waited for the film to roll. "I don’t even know if they’re here, but I just want to say thank you."
Why did the starring actress/producer give a shout-out to her dental team? It seems she trained and fought so hard in the action sequences that she actually cracked two teeth!
“I had severe tooth pain, which I never had in my entire life,” Theron told an interviewer from Variety. At first, she thought it was a cavity — but later, she found out it was more serious: One tooth needed a root canal, and the other had to be extracted and replaced with a dental implant — but first, a bone grafting procedure was needed. “I had to put a donor bone in [the jaw] to heal,” she noted, “and then I had another surgery to put a metal screw in there.”
Although it might sound like the kind of treatment only an action hero would need, bone grafting is now a routine part of many dental implant procedures. The reason is that without a sufficient volume of good-quality bone, implant placement is difficult or impossible. That’s because the screw-like implant must be firmly joined with the jawbone, so it can support the replacement tooth.
Fortunately, dentists have a way to help your body build new bone: A relatively small amount of bone material can be placed in the missing tooth’s socket in a procedure called bone grafting. This may come from your own body or, more likely, it may be processed bone material from a laboratory. The donor material can be from a human, animal or synthetic source, but because of stringent processing techniques, the material is safe for human use. Once it is put in place your body takes over, using the grafted material as a scaffold on which to build new bone cells. If jawbone volume is insufficient for implants, it can often be restored to a viable point in a few months.
Better yet, when grafting material is placed in the tooth socket immediately after extraction, it can keep most of the bone loss from occurring in the first place, enabling an implant to be placed as soon as possible — even before the end of a movie’s shooting schedule.
Will Atomic Blonde prove to be an action-movie classic? Only time will tell. But one thing’s for sure: When Charlize Theron walks down the red carpet, she won’t have to worry about a gap in her smile.
If you have questions about bone grafting or dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Immediate Dental Implant.”
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