The final emergence of permanent teeth in late adolescence marks the end of a long process beginning in the womb with the formation of our primary or “baby” teeth. Permanent teeth form in a similar way as buds high in the jaw, continuing to grow until the primary teeth ahead of them fall away. The crowns of the new adult teeth eventually break through the gum tissue and emerge (erupt) into view.
At least, that’s normally what should happen; sometimes, though, a tooth may only erupt partially or not at all, a condition known as impaction. The crown remains partially or fully submerged below the gum line, causing the tooth to press against other teeth, potentially damaging them. It can also make periodontal (gum) tissues adjacent to the area more susceptible to disease. Wisdom teeth are especially prone to this kind of impaction, to the extent they’re often surgically removed (extracted) to avoid future problems to adjacent teeth or the bite.
Upper canines (the “eye teeth” normally located directly below the eyes) are also subject to impaction. But because of their highly visible position, extracting them could have an adverse impact on the patient’s smile. In this case, we often attempt instead to expose and ultimately save the tooth.
Before taking any action, however, an orthodontic examination is conducted first to pinpoint the exact position of the impacted tooth and determine how that position might affect moving teeth into a more desired alignment. If we find the impacted canine is in a workable position, the next step is to surgically uncover the tooth from the gum tissue (a minor procedure usually performed by an oral surgeon or periodontist). Once exposed, an orthodontic bracket with a small attached gold chain is bonded to the tooth. The gums are then sutured back into place with the chain exposed and allowed to heal.
At some future point an orthodontist will attach the chain to orthodontic hardware that will pull the impacted tooth into proper position over several months. As a result, the upper canine becomes “un-impacted”; the dangers to surrounding teeth and tissues are also reduced. And, just as important, we can preserve the tooth and with orthodontics achieve an attractive, normal smile.
If you would like more information on the effects and treatment of impacted 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 “Exposing Impacted Canines.”
If your teenager is in need of orthodontic treatment, you might automatically think braces. But while this decades-old appliance is quite effective, it isn’t the only “tooth movement” game in town any more. Clear aligners are another choice your teenager might find more appealing.
Clear aligners are a sequential set of computer-generated plastic trays that are worn by a patient one after the other, usually for about two weeks per tray. The trays are fabricated using 3-D computer modeling of the patient’s mouth, each one slightly different from the last to gradually move teeth to the desired new positions.
So, why choose clear aligners over braces?
They’re nearly invisible. Because they’re made of a clear polymer material, they’re not nearly as noticeable as metal braces. In fact, they may go completely unnoticed to the casual observer.
They’re removable. Unlike metal braces, which are fixed in place by an orthodontist, clear aligners can be removed by the wearer. This makes brushing and flossing much easier, and they can also be removed for eating or special occasions. That said, though, they should be worn at least 20 to 22 hours each day to be effective.
They’re becoming more versatile. With some complicated malocclusions (poor bites), braces and other orthodontic appliances may still be necessary. But innovations like added power ridges in clear aligners can more precisely control which teeth move and which don’t. This has greatly increased the number of poor bite scenarios where we can appropriately use clear aligners.
If you’d like to consider clear aligners, just remember they require a bit more self-discipline on the part of the wearer than braces. And once the treatment finishes, they’ll still need to wear a retainer just as with metal braces to help keep the repositioned teeth from reverting to their old positions.
If you think your teen is up to the challenge and their particular situation can be corrected with this innovative technology, then clear aligners could be a great choice.
If you would like more information on clear aligners orthodontic 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 “Clear Aligners for Teens.”
Sure, it’s big news when celebs tweet selfies from the dental office… if you’re still living in the 20th century. But in Hollywood today, it’s harder to say who hasn’t posted snaps of themselves in the dentist’s chair than who has. Yet the pictures recently uploaded to Twitter by Mark Salling, the actor and singer who regularly appears as Noah “Puck” Puckerman on the popular TV series Glee, made us sit up and take notice.
“Getting my chipped tooth fixed. Also, apparently, I’m a big grinder,” read the caption. The photo showed a set of upper front teeth with visible chips on the biting surface. What’s so special about this seemingly mundane tweet? It’s a great way of bringing attention to a relatively common, but often overlooked problem: teeth clenching and grinding, also called bruxism.
Although bruxism is a habit that affects scores of people, many don’t even realize they have it. That’s because the condition may only become active at night. When the teeth are unconsciously ground together, the forces they produce can wear down the enamel, cause chipping or damage to teeth or dental work (such as veneers or fillings), or even loosen a tooth! While it’s common in children under 11 years old, in adults it can be a cause for concern.
Sometimes, mouth pain, soreness and visible damage alert individuals to their grinding habits; other times, a dental professional will notice the evidence of bruxism during an exam or cleaning: tooth sensitivity and telltale wear and tear on the chewing surfaces. Either way, it’s time to act.
Bruxism is most often caused by stress, which can negatively impact the body in many ways. It may also result from bite problems, the overuse of stimulating substances (caffeine, alcohol, tobacco, and illegal drugs), and as a side effect of certain medications. Sometimes, simply becoming aware of the habit can help a person get it under control. Common methods of stress reduction include exercise, meditation, a warm bath or a quiet period before bedtime; these can be tried while we monitor the situation to see if the problem is going away.
If stress reduction alone doesn’t do the trick, several other methods can be effective. When bruxism is caused by a minor bite problem, we can sometimes do a minor “bite adjustment” in the office. This involves removing a tiny bit of enamel from an individual tooth that is out of position, bringing it in line with the others. If it’s a more serious malocclusion, orthodontic appliances or other procedures may be recommended.
When grinding is severe enough to damage teeth or dental work, we may also recommend a custom-made night guard (occlusal guard), which you put in your mouth at bedtime. Comfortable and secure, this appliance prevents your teeth from being damaged by contacting each other, and protects your jaw joints from stresses due to excessive grinding forces.
Whether or not you have to smile for a living, teeth grinding can be a big problem. If you would like more information about this condition, call our office to schedule a consultation for a consultation.
Teeth lost to tooth decay can have devastating consequences for a child’s dental health. Not only can it disrupt their current nutrition, speech and social interaction, it can also skew their oral development for years to come.
Fortunately, we have a number of preventive tools to curb decay in young children. One of the most important of these, dental sealants, has been around for decades. We apply these resin or glass-like material coatings to the pits and crevices of teeth (especially molars) to help prevent the buildup of bacterial plaque in areas where bacteria tend to thrive.
Applying sealants is a simple and pain-free process. We first brush the coating in liquid form onto the teeth’s surface areas we wish to protect. We then use a special curing light to harden the sealant and create a durable seal.
So how effective are sealants in preventing tooth decay? Two studies in recent years reviewing dental care results from thousands of patients concluded sealants could effectively reduce cavities even four years after their application. Children who didn’t receive sealants had cavities at least three times the rate of those who did.
Sealant applications, of course, have some expense attached to them. However, it’s far less than the cost for cavity filling and other treatments for decay, not to mention future treatment costs resulting from previous decay. What’s more important, though, is the beneficial impact sealants can have a child’s dental health now and on into adulthood. That’s why sealants are recommended by both the American Dental Association and the American Academy of Pediatric Dentistry.
And while sealants are effective, they’re only one part of a comprehensive strategy to promote your child’s optimum dental health. Daily brushing and flossing, a “tooth-friendly” diet and regular dental cleanings and checkups are also necessary in helping to keep your child’s teeth healthy and free of tooth decay.
Many things can affect your child’s future dental health: oral hygiene, diet, or habits like thumb sucking or teeth grinding. But there’s one you might not have considered: how they breathe.
Specifically, we mean whether they breathe primarily through their mouth rather than through their nose. The latter could have an adverse impact on both oral and general health. If you’ve noticed your child snoring, their mouth falling open while awake and at rest, fatigue or irritability you should seek definite diagnosis and treatment.
Chronic mouth breathing can cause dry mouth, which in turn increases the risk of dental disease. It deprives the body of air filtration (which occurs with nose breathing) that reduces possible allergens. There’s also a reduction in nitric oxide production, stimulated by nose breathing, which benefits overall health.
Mouth breathing could also hurt your child’s jaw structure development. When breathing through the nose, a child’s tongue rests on the palate (roof of the mouth). This allows it to become a mold for the palate and upper jaw to form around. Conversely with mouth breathers the tongue rests behind the bottom teeth, which deprives the developing upper jaw of its tongue mold.
The general reason why a person breathes through the mouth is because breathing through the nose is uncomfortable or difficult. This difficulty, though, could arise for a number of reasons: allergy problems, for example, or enlarged tonsils or adenoids pressing against the nasal cavity and interfering with breathing. Abnormal tissue growth could also obstruct the tongue or lip during breathing.
Treatment for mouth breathing will depend on its particular cause. For example, problems with tonsils and adenoids and sinuses are often treated by an Ear, Nose and Throat (ENT) specialist. Cases where the mandible (upper jaw and palate) has developed too narrowly due to mouth breathing may require an orthodontist to apply a palatal expander, which gradually widens the jaw. The latter treatment could also influence the airway size, further making it easier to breathe through the nose.
The best time for many of these treatments is early in a child’s growth development. So to avoid long-term issues with facial structure and overall dental health, you should see your dentist as soon as possible if you suspect mouth breathing.
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