People mainly identify orthodontics with braces. But while they’re a major part of it, braces aren’t the only way this important dental specialty can make a difference in a person’s bite.
For example, orthodontics can help guide the development of a younger patient’s facial structure that could head off future upper teeth misalignment. The area of focus is the upper jaw and palate (the roof of the mouth) that jointly make up a structure called the maxilla. The maxilla is actually formed by two bones fused together in the center of the palate along what is known as the midline suture running from front to back in the mouth.
The two bones remain separated until puberty, which helps accommodate rapid structural growth during childhood. But problems can arise if the upper jaw is too narrow, causing a “cross-bite” where the lower back teeth bite abnormally outside the upper ones. This can crowd upper permanent teeth and cause them to erupt improperly.
Using a technique called palatal expansion we can correct this abnormality if we act before the maxillary bones fuse. The technique employs a custom-made appliance called a palatal expander that attaches to the posterior teeth of the upper arch. Expanders have two halves joined by a small screw device to increase tension against the teeth to widen the jaw. A parent or the patient (if old enough) increases the tension by using a special key to turn the adjustment screw a tiny amount each day. This may cause minor discomfort that normally eases in a few minutes.
The patient wears the device until the jaw expands to the desired width and then allows the bones to stabilize in the new position. This can sometimes create a small gap between the upper front teeth, but it often closes on its own or it may require braces to close it.
While palatal expanders are not for every case, they can help normalize development and improve the bite, and thus preclude more extensive orthodontic treatment later. But time is of the essence: after the maxilla has fused, surgery will be necessary to separate them and widen the palate. It’s important then not to delay if your child could benefit from this effective treatment.
If you would like more information on palatal expanders and other orthodontic treatments, 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 “Palatal Expanders.”
Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.
That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!
Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.
Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”
One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.
Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.
Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”Â Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.
If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
Along with thumb sucking, childhood teeth grinding is one of the top concerns anxious parents bring to their dentists. It’s so prevalent, though, many providers consider it normal behavior—the sleep-disturbing sound it can generate is often the worst consequence for the habit.
But that doesn’t mean you should brush aside all concern, especially if the habit continues into late childhood. Long-term teeth grinding could eventually damage the teeth and gums.
Teeth grinding (or clenching) is the involuntary movement of the jaws when not engaged in normal functions like chewing, speaking or swallowing. The action often produces higher than normal chewing forces, which over time can accelerate tooth wear, cause fractures, or contribute to loose teeth, all of which could increase the risk of dental disease. While it can occur at any time it’s most common among children during nighttime sleep.
While stress is the usual trigger for teeth grinding in adults, with young children the causes for the habit are more complex and less understood. Most doctors hold to the theory that most pediatric teeth grinding arises during shifts from lighter to heavier, rapid-eye-movement (REM) sleep. The child’s immature neuromuscular chewing control may engage involuntarily during this shift. Teeth grinding is also prevalent among children who snore or mouth-breathe, or who take anti-depressant medication.
But as mentioned before, there’s usually no cause for concern unless the habit persists beyond about age 11. If the habit isn’t fading, you should speak to your dentist about ways to reduce it or its effects. One way is with a custom-made night guard worn during sleep. The smooth, plastic surface of the appliance prevents teeth from making solid contact with each other during a grinding episode.
You might also seek treatment from an ear, nose and throat (ENT) specialist if your child is having issues with airway obstruction, which could also relieve teeth grinding. And children experiencing stressful situations or events may find relief both emotionally and physically from psychological therapy.
At younger ages, you can safely regard your child’s grinding habit as normal. But if it persists, it’s worth looking for ways to reduce it.
If you would like more information on your child’s teeth grinding habit, 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 “When Children Grind Their Teeth: Is the Habit of ‘Bruxism’ Harmful?”
Dental crowns are an essential means for restoring damaged or unattractive teeth. A well-crafted crown not only functions well, it looks and blends seamlessly with the rest of the natural teeth.
Crowns are artificial caps that cover an entire visible tooth, often used for heavily decayed or damaged teeth or as added protection after a root canal treatment. Most crowns are produced by a dental lab, but some dentists are now creating them in-office with computer-based milling equipment. On the whole, the various crowns now available function adequately as teeth—but they can vary in their appearance quality.
In the early to mid 20th Century the all-metal crown was the standard; but while durable, it could be less than eye-pleasing. Although more life-like dental porcelain existed at the time, it tended to be brittle and could easily shatter under chewing stress.
Dentists then developed a crown that combined the strength of metal with the attractiveness of porcelain: the porcelain fused to metal or PFM crown. The PFM crown had a hollow, metal substructure that was cemented over the tooth. To this metal base was fused an outer shell of porcelain that gave the crown an attractive finish.
The PFM reigned as the most widely used crown until the mid 2000s. By then improved forms of porcelain reinforced with stronger materials like Lucite had made possible an all-ceramic crown. They’re now the most common crown used today, beautifully life-like yet durable without the need for a metal base.
All-ceramics may be the most common type of crown installed today, but past favorites’ metal and PFM are still available and sometimes used. So depending on the type and location of the tooth and your own expectations, there’s a right crown for you.
However, not all crowns even among all-ceramic have the same level of aesthetic quality or cost—the more life-like, the more expensive. If you have dental insurance, your plan’s benefits might be based on a utilitarian but less attractive crown. You may have to pay more out of pocket for the crown you and your dentist believe is best for you.
Whatever you choose, though, your modern dental crown will do an admirable, functional job. And it can certainly improve your natural tooth’s appearance.
Starting college is one of life’s biggest transition moments, the first time many young people can truly say they’re on their own. Their freshman year can be both exhilarating and frightening.
The reason for this seeming dichotomy is that both exciting opportunities and harmful pitfalls abound in college life. One such pitfall that’s often overlooked involves dental health: it’s all too easy to neglect good habits and adopt bad ones. But while it may not seem as harmful as other dangers, inattention to your dental health could create consequences that plague you long after graduation.
But being diligent about dental care can help you avoid serious problems now and in the future. At the top of the list: brush and floss your teeth daily and continue seeing a dentist at least twice a year. Hopefully, your parents or guardians have trained you in these vital habits—and they’re definitely habits you should continue for the rest of your life.
Close in importance to good oral hygiene is a healthy diet. Besides eating primarily “natural” food—fresh fruits and vegetables and less-processed foods—you should also set limits on your sugar consumption. This carbohydrate is a primary food for disease-causing bacteria, so limiting as much as possible the sugar you eat to just meal times will lower your risk for tooth decay.
Another area in which you should tread wisely is alcohol consumption. Besides the obvious consequences of alcohol abuse, immoderate drinking can also cause dental problems. Alcohol (and smoking) tends to dry out the mouth, which can increase the levels of oral bacteria and in turn increase your risk of both tooth decay and periodontal (gum) disease.
Finally, avoid getting piercings involving the lips, mouth or tongue even if it’s the thing to do. Piercing hardware can chip teeth and contribute to the shrinking back of the gums (recession). And be sure you practice safe sex: unprotected sexual activity could expose you to viral infections that cause oral problems including cancer.
Your college years should be an exciting and memorable experience. By practicing these and other common sense dental habits, you’ll be sure to remember these years fondly.
If you would like more information on dental care during college, 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 “10 Health Tips for College Students.”
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