Although distressing to many parents, infants and toddlers sucking their thumb is a common if not universal habit. Most children phase out of it by around age 4, usually with no ill effects. But thumb-sucking continuing into late childhood could prove problematic for a child’s bite.
Thumb sucking is related to how young children swallow. All babies are born with what is called an infantile swallowing pattern, in which they thrust their tongues forward while swallowing to ensure their lips seal around a breast or bottle nipple when they nurse. Thumb-sucking mimics this action, which most experts believe serves as a source of comfort when they’re not nursing.
Around 3 or 4, their swallowing transitions to a permanent adult swallowing pattern: the tip of the tongue now positions itself against the back of the top front teeth (you can notice it yourself when you swallow). This is also when thumb sucking normally fades.
If a child, however, has problems transitioning to an adult pattern, they may continue to thrust their tongue forward and/or prolong their thumb-sucking habit. Either can put undue pressure on the front teeth causing them to move and develop too far forward. This can create what’s known as an open bite: a slight gap still remains between the upper and lower teeth when the jaws are shut rather than the normal overlapping of the upper teeth over the lower.
While we can orthodontically treat an open bite, we can minimize the extent of any treatments if we detect the problem early and intervene with therapies to correct an abnormal swallowing pattern or prolonged thumb sucking. For the former we can assist a child in performing certain exercises that help retrain oral and facial muscles to encourage a proper swallowing pattern. This may also help diminish thumb sucking, but we may in addition need to use positive reinforcement techniques to further discourage the habit.
To stay ahead of possible problems with thumb sucking or the swallowing pattern you should begin regularly taking them to the dentist around their first birthday. It’s also a good idea to have an orthodontic evaluation around age 6 for any emerging bite problems. Taking these positive steps could help you avoid undue concern over this common habit.
If you would like more information on managing your child’s thumb-sucking 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 “How Thumb Sucking Affects the Bite.”
If you've undergone treatment for periodontal (gum) disease, you know how involved it can be. After several sessions of plaque and calculus (hardened plaque deposits) removal, your swollen, red gums finally begin to regain their healthy pink color.
But with gum disease, the battle may be over but not necessarily the war. If we don't remain vigilant, there's a high chance you'll experience a re-infection.
That's why periodontal maintenance (PM) is so important for gum disease patients after treatment. Plaque, the thin film of bacteria and food particles responsible for the infection, can grow again on your tooth surfaces as it did before. You'll have to practice diligent, daily brushing and flossing to curb that development.
But it's also important to keep up regular dental visits for advanced cleaning to remove hard to reach plaque and calculus. For most people that's usually twice a year, but for gum disease patients it could be up to four times a year, especially just after treatment. And there's more to these visits than cleaning.
Since our goal is to reduce the chances of re-infection as much as possible, we'll thoroughly examine your teeth, gums and any implants for signs of disease (we'll also include an oral cancer screening). We want to assess the health of your teeth and gums and to see how well you're doing hygiene-wise with plaque control.
If we find signs of gum disease, we'll discuss this with you and schedule a new round of treatment. The sooner we initiate treatment, the better your outcome. In some cases, we may perform procedures that make it easier to access and clean areas where plaque tends to build up.
Overall, we want to prevent the occurrence of any future disease and treat it as soon as possible if it re-occurs. Keeping up diligent PM will help ensure your gums continue to stay healthy.
The red, scaly rash suddenly appearing on your face doesn’t cause you much physical discomfort, but it’s still embarrassing. And to make matters worse treating it as you would other skin ailments seems to make it worse.
Your ailment might be a particular skin condition known as peri-oral dermatitis. Although its overall occurrence is fairly low (1% or less of the population worldwide) it seems to be more prevalent in industrialized countries like the United States, predominantly among women ages 20-45.
Peri-oral dermatitis can appear on the skin as a rash of small red bumps, pimples or blisters. You usually don’t feel anything but some patients can have occasional stinging, itching or burning sensations. It’s often misidentified as other types of skin rashes, which can be an issue when it comes to treatment.
Steroid-based ointments that work well with other skin ailments could have the opposite effect with peri-oral dermatitis. If you’re using that kind of cream out of your medicine cabinet, your rash may look better initially because the steroid constricts the tiny blood vessels in the skin. But the reduction in redness won’t last as the steroid tends to suppress the skin’s natural healing capacity with continued use.
The best treatment for peri-oral dermatitis is to first stop using any topical steroid ointments, including other-the-counter hydrocortisone, and any other medications, lotions or creams on it. Instead, wash your skin with a mild soap. Although the rash may flare up initially, it should begin to subside after a few days.
A physician can further treat it with antibiotic lotions typically containing Clindamycin or Metronidazole, or a non-prescription, anti-itch lotion for a less severe case. For many this clears up the condition long-term, but there’s always the possibility of relapse. A repeat of this treatment is usually effective.
Tell your dentist if you have recurring bouts of a rash that match these descriptions. More than likely you’ll be referred to a dermatologist for treatment. With the right attention—and avoiding the wrong treatment ointment—you’ll be able to say goodbye to this annoying and embarrassing rash.
We’ve been treating one of your decay-prone teeth for some time with one filling after another. Each incident required a little more removal of decayed tooth material until now there isn’t enough structure to support another filling.
We could remove the tooth and replace it with a bridge or a dental implant, both viable restoration options. But keeping the tooth if possible would be more beneficial in the long-run for your gums, bone and remaining teeth. If it still has a healthy and stable root, it’s possible to permanently cover or “cap” the tooth with a life-like crown.
Crowns have been used for decades: the first were mainly composed of metal like gold or silver and later dental porcelain, a ceramic material that could be molded, shaped and oven-fired to resemble a real tooth. The earliest porcelains, though, were brittle, so a hybrid with a metal interior for strength and a fused exterior porcelain layer for appearance came into prominence.
Today, advances in materials have led to all-porcelain crowns strong enough to withstand biting forces. While the metal-porcelain hybrid still account for about 40% of crowns installed annually, the all-porcelain types are steadily growing in popularity.
Regardless of the type, though, the process for fitting any crown is relatively the same. The first step is to reshape the affected tooth so that the future crown will fit over it, followed by an impression mold of the tooth a dental technician will use to form a custom crown. Once the new crown has been prepared, we then permanently bond it to the tooth.
With a crown, you’ll be able to enjoy normal function and have a tooth that looks as healthy and normal as its neighbors. Be aware, though, that your underlying tooth is still subject to decay — so diligent, daily hygiene and regular dental visits are a must. With proper care your newly crowned tooth can continue to serve you and your smile for many years to come.
If you would like more information on dental restoration options, 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 “Crowns & Bridgework.”
There’s a lot to like about dental implants for replacing missing teeth. Not only are they life-like, but because they replace the root they also function much like a natural tooth. They also have another unique benefit: a track record for long-lasting durability. It’s estimated more than 95% of implants survive at least ten years, with a potential longevity of more than 40 years.
But even with this impressive record, we should still look at the few that didn’t and determine the reasons why they failed. We’ll soon find that a great number of those reasons will have to do with both oral and general health.
For example, implants rely on adequate bone structure for support. Over time bone cells grow and adhere to the implant’s titanium surface to create the durable hold responsible for their longevity. But if conditions like periodontal (gum) disease have damaged the bone, there might not be enough to support an implant.
We may be able to address this inadequacy at the outset with a bone graft to encourage growth, gaining enough perhaps to eventually support an implant. But if bone loss is too extensive, it may be necessary to opt for a different type of restoration.
Slower healing conditions caused by diseases like diabetes, osteoporosis or compromised immune systems can also impact implant success. If healing is impeded after placement surgery the implant may not integrate well with the bone. An infection that existed before surgery or resulted afterward could also have much the same effect.
Oral diseases, especially gum disease, can contribute to later implant failures. Although the implant’s materials won’t be affected by the infection, the surrounding gum tissues and bone can. An infection can quickly develop into a condition known as peri-implantitis that can weaken these supporting structures and cause the implant to loosen and give way. That’s why prompt treatment of gum disease is vital for an affected implant.
The bottom line: maintaining good oral and general health, or improving it, can help keep your implant out of the failure column. Perform daily brushing and flossing (even after you receive your implant) and see your dentist regularly to help stop dental disease. Don’t delay treatment for gum disease or other dental conditions. And seek medical care to bring any systemic diseases like diabetes under control.
If you would like more information on dental implants, 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 “Dental Implants: A Tooth-Replacement Method that Rarely Fails.”
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