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.”
Parents love watching their kids grow up, from those early wobbly steps to their first solo car drive. Of course, you can expect a few mishaps along the way, most of which won't leave them worse for wear. But some risks are just too hazardous to ignore—including the potential for dental injuries.
Each year, one in ten children suffers a traumatic dental injury, many of which require extensive treatment. That's why during National Child Safety and Prevention Month in November, we're highlighting areas of risk for pediatric dental injuries, and how you can prevent them.
That risk changes depending on a child's stage of development. Teething infants, for example, relieve gum pressure by gnawing on things. Make sure, then, that you have items for teething made of cloth or soft plastic, and keep harder items that could damage their gums and emerging teeth out of reach.
Toddlers learning to walk encounter numerous injury opportunities, like a fall that lands them face first on a hard surface. You can reduce this risk by moving tables and other hard furniture out of your child's travel paths, covering sharp edges with padding, or simply isolating your child from home areas with hard furniture.
Pay attention also during bath time. Wet porcelain is notoriously slippery even for adults, and possibly more so for a child. A sudden slip in the bathtub could cause a mouth injury, so encourage your child not to stand until it's time to get out.
School-aged children face another set of perils to their mouth from outside play. At this stage, your best preventive measure is teaching them to observe play safety: Make sure they know not to aim balls, frisbees or other play items at others' heads, and to be on the lookout for the same. You'll also want them to be safety-minded playing on swings, monkey bars or other playground equipment.
If your older kids take an interest in sports, particularly the contact variety, you'll want to protect them with an athletic mouthguard (and encourage them to wear it during both practice and regular games). You can purchase a mouthguard at any retail or sporting goods store, but the most protective and comfortable to wear are custom-made by a dentist. Although more expensive, they'll still cost less than treatment for a traumatic dental injury.
The wonderful adventure of childhood does have its risks, and some are more serious than others. By following these prevention tips, you can help your child avoid a dental injury that could rob them of a healthy mouth.
If you would like more information about childhood dental concerns, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dentistry and Oral Health for Children” and “An Introduction to Sports Injuries & Dentistry.”
Love at first sight—it's an endearing notion found in movies and novels, but perhaps we're a little skeptical about it happening in real life. Then again, maybe it does once in a blue moon. According to supermodel Gisele Bündchen, something definitely happened the first time she met pro quarterback Tom Brady in 2006. And it all began when he smiled.
“The moment I saw him, he smiled and I was like, 'That is the most beautiful, charismatic smile I've ever seen!'” Bündchen said in an article for Vogue magazine. That was all it took. After a three-year romance, they married in 2009 and have been happily so ever since.
Both Brady and Bündchen have great smiles. But they also know even the most naturally attractive smile occasionally needs a little help. Here are three things our happy couple have done to keep their smiles beautiful—and you could do the same.
Teeth whitening. Bündchen is a big proponent of brightening your smile, even endorsing a line of whitening products at one point. And for good reason: This relatively inexpensive and non-invasive procedure can turn a dull, lackluster smile into a dazzling head-turner. A professional whitening can give you the safest, longest-lasting results. We can also fine-tune the whitening solution to give you just the level of brightness you want.
Teeth straightening. When Bündchen noticed one of her teeth out of normal alignment, she underwent orthodontic treatment to straighten her smile. Rather than traditional braces, she opted for clear aligners, removable trays made of translucent plastic. Effective on many types of orthodontic problems, clear aligners can straighten teeth while hardly being noticed by anyone else.
Smile repair. Brady is a frequent client of cosmetic dentistry, sometimes due to his day job. During 2015's Super Bowl XLIX against the Seattle Seahawks, Brady chipped a tooth, ironically from “head-butting” his Patriots teammate Brandon LaFell after the latter caught a touchdown pass. Fortunately, he's had this and other defects repaired—and so can you. We can restore teeth as good as new with composite resin bonding, veneers or crowns.
This superstar couple, known for their advocacy of all things healthy, would also tell you a beautiful smile is a healthy one. You can help maintain your smile's attractiveness with daily brushing and flossing to lower the risk of staining and dental disease, regular dental visits, and “tooth-friendly” eating habits.
And when your teeth need a little extra TLC, see us for a full evaluation. You may not be in the spotlight like this celebrity couple, but you can still have a beautiful smile just like theirs.
If you would like more information on ways to enhance your smile, please contact us or schedule a consultation.
The subject of allergies covers a wide swath in medicine. Among other things, people have allergic reactions to animal fur, various foods and plant pollen. The effects are equally wide-ranging, anything from a mild rash to anaphylaxis, a life-threatening shutdown of the body's vital systems.
Approximately 5% of people are also allergic to various metals including nickel, cobalt, chromium and gold. Reactions to metal can occur when an allergic person comes in contact with items like jewelry, clothing or even mobile phones. There's even a chance of a metal allergy reaction from certain kinds of dental work.
It's unlikely, though, that you should be concerned if you're considering dental treatment or cosmetic work to upgrade your smile. Although allergic reactions like inflammation or a rash have been known to occur with amalgam “silver” fillings, it's quite rare. It's even less of a concern since “tooth-colored” materials for fillings are now outpacing the use of amalgam fillings, which are used in out-of-sight back teeth.
Of course, metal is used for other dental treatments besides fillings, including the most popular of tooth replacement systems, dental implants. An implant is essentially a metal post, usually made of pure titanium or a titanium alloy, which is imbedded into the jawbone. Even so, there's little chance you'll develop an allergic reaction to them.
For one thing, titanium is highly prized in both medical and dental treatments because of its biocompatibility. This means titanium devices like prosthetic joints and implants won't normally disrupt or cause reactions with human tissue. Titanium is also osteophilic: Bone cells readily grow and adhere to titanium surfaces, a major reason for dental implants' long-term durability.
That's not to say titanium allergies don't exist, but their occurrence is very low. One recent study detected a titanium allergy in only 0.6% of 1,500 implant patients who participated.
At worst, you may need to consider a different type of tooth replacement restoration in the rare chance you have a titanium allergy. More than likely, though, you'll be able obtain implants and enjoy the transformation they can bring to your smile.
If you would like more information on allergic reactions and dental restorations, 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 “Metal Allergies to Dental Implants.”
The top cause for adult tooth loss isn't decay or trauma—it's periodontal (gum) disease. The disease may begin with the gums, but it can ultimately damage underlying bone enough to weaken its support of teeth, causing them to loosen and fall out.
But that's not the end of the havoc gum disease can wreak. The consequences of an uncontrolled infection can ripple beyond the mouth and worsen other health problems like diabetes, heart disease or arthritis.
The common link between gum disease and these other conditions is the inflammatory response, a natural mechanism to fight infection caused by disease or trauma. This mechanism changes blood vessels to increase blood flow to hasten the travel of protective white blood cells to the injury or disease location.
But if this mechanism that supports healing becomes chronic, it can actually do harm. The chronic inflammation that occurs with gum disease can damage mouth structures, just as inflammation from diabetes or arthritis can damage other parts of the body. And any form of chronic inflammation, even that found in gum disease, can worsen other inflammatory diseases.
You can lessen this link between gum disease and other conditions—as well as improve your oral health—by preventing or seeking prompt treatment for any periodontal infection in the following ways:
- Practice daily brushing and flossing to clear away bacterial dental plaque, the main cause of gum disease;
- See your dentist regularly for more thorough dental cleanings and checkups;
- See your dentist promptly if you notice red, swollen or bleeding gums, common signs of a gum infection;
- Stop smoking to lower your risk for both gum disease and tooth decay;
- Adopt a healthy diet, which can help you lose weight (a factor in diabetes and other inflammatory diseases) and strengthen your immune system;
- Manage other inflammatory conditions to lessen their effect on your gum disease risk.
Taking these steps can help you avoid the inflammation caused by gum disease that might also affect the rest your body. Seeking prompt treatment at the first sign of an infection will also minimize the damage to your teeth and gums and the effect it could have on the rest of your health.
If you would like more information on prevention and treatment of gum disease, 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 “Gum Disease & Systemic Health.”
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