Posts for: December, 2018
The primary goal of dental care is to preserve teeth. But there are circumstances in which removing a tooth, even a relatively healthy one, could prove best in the long run.
A malocclusion (poor bite) related to crowding might fit such a circumstance. Crowding occurs when the size of the jaw is too small for the teeth coming in. With not enough space, some teeth could erupt out of their proper positions. Removing certain teeth frees up space to eventually allow braces or other orthodontic devices to re-align the teeth.
The teeth most frequently removed are the first bicuspids, located between the cuspid (the "eyeteeth" directly under the eyes) and the back teeth, and the second premolar. Removing these won't normally affect appearance or functionality once orthodontic or cosmetic treatments are complete.
Because of the mechanics of jaw development it might be necessary to perform these extractions several years before orthodontic treatment. This could create another potential problem: the time lag could adversely affect bone health.
This is because bone, as living tissue, has a life cycle with cells forming, functioning and then dissolving, and new cells taking their place. When teeth are chewing or in contact with each other they generate force that travels through the tooth roots to the bone and stimulates cell growth at a healthy replacement rate.
But when a tooth is missing, so is this stimulation. This slows the replacement rate and eventually leads to decreased bone volume. Too much bone loss could create obstacles for orthodontic treatment or a future dental implant.
To avoid this, the dentist will often place a bone graft with processed bone mineral within the empty tooth socket right after extraction. The graft serves as a scaffold for bone cells to grow upon. The graft (plus any other added growth boosters) can help maintain a healthy level of bone volume to facilitate future orthodontic or restorative treatments.
Since targeted extraction for orthodontics is time-sensitive, you should have your child's bite evaluated by an orthodontist by age 7 to see if any action is necessary. The earlier a malocclusion is detected, the more likely a more attractive and healthy smile will be the ultimate outcome.
If you would like more information on correcting poor bites, 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 “Tooth Removal for Orthodontic Reasons.”
As December brings the old year to a close, it’s a great time to set goals for the year to come. This might include a major life change, such as a new job—or even a new romance! If one of these items is on your list for 2019, a smile makeover may be just the thing to help you get there.
Having a great smile can give your self-confidence a real boost. It can also affect how you are perceived by others. According to a survey by the American Academy of Cosmetic Dentistry, 99.7% of adults believe a smile is an important social asset and 96% believe an attractive smile makes a person more appealing to members of the opposite sex. At the same time, three quarters of adults feel that an unattractive smile can hurt a person’s chances for career success.
If you aren’t pleased with your smile and want a new look, we can help you figure out which cosmetic dental treatments could be right for you. The answer might be something simple—like an overall brightening of the smile with professional teeth whitening, or fixing a small crack or chip in a single tooth with cosmetic tooth bonding. If you’re unhappy with worn-down or crooked teeth, dental veneers or orthodontic treatment might be the way to go. In fact, many adults find that orthodontic treatment with clear aligners is a great way to get a beautiful, straight smile without drawing attention to the fact that a makeover is in progress.
Of course, it’s not only important for your smile to look good but also for your whole mouth to stay healthy. So if you are experiencing any tooth pain, unusual mouth sores or gum problems, it’s time for you to come in for an exam. And if it’s been a while since you’ve had a dental checkup and professional teeth cleaning, why not make an appointment for early in the year? Don’t start the new year with last year’s dental problems!
If you would like more information about cosmetic dental treatments or preventive dentistry, please contact us or schedule a consultation. You can also learn more by reading the Dear Doctor magazine articles “How Your Dentist Can Help You Look Younger” and “Dental Hygiene Visit.”
Tooth decay is as relentless as it is destructive, and it makes little distinction between age, gender, ethnicity or social status. Although risk levels vary from person to person, we’re all potentially in the crossfire for this harmful disease. Getting ahead of it early could save your teeth.
Tooth decay begins with oral bacteria. While feeding on dental plaque that accumulates on the teeth, bacteria multiply and produce acid as a by-product. Too much acid softens and erodes tooth enamel, which enables decay to advance deeper into the tooth.
If it isn’t stopped, decay can eventually infect and weaken the roots and bone, and ultimately lead to a lost tooth. By stopping it as early as possible before it reaches the inner pulp and root canals, we can greatly limit the damage.
Regular dental care is crucial for early detection. Here’s how we can stay ahead of developing decay during dental visits.
Visible inspection. There are visible signs a trained dentist may notice that point to tooth decay. Besides an already formed hole or cavity, we might also pick up on other unusual appearances like white spot lesions: these slight blemishes often occur in the areas of contact with other teeth, which we can treat with topical fluoride.
X-rays. This tried and true diagnostic tool has been a mainstay of dental care for nearly a century. The images they produce can indicate decay as darker spots or areas on or within the tooth that may not yet be visible to the eye. And with advances in digital processing and more streamlined equipment, we can effectively do this with a very low dosage of radiation exposure.
Advanced technology. We’ve developed other means for better disease detection that complement x-rays and visual inspections. Specialized microscopes and lasers are now important tools for analyzing suspected areas of early decay.
Even if decay gets a foothold we can effectively stop it and restore a tooth with a root canal treatment or a similar procedure. The best outcome, though, is to not allow this destructive disease to get that far. With dedicated oral hygiene and regular dental visits that uncover early decay, chances are good your teeth can remain healthy for a lifetime.
If you would like more information on fighting tooth decay, 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 “Tooth Decay: How to Assess Your Risk.”
Children losing their primary (“baby”) teeth is both natural and necessary. So, is it really that much of a concern if they lose one early?
The answer is yes — premature primary tooth loss could have long-term consequences for the permanent teeth as they develop within the jaw before eruption. Primary teeth play a crucial role in this development: as the permanent teeth form and grow the primary teeth serve as placeholders until they’re ready to erupt. A natural process then takes place in which the primary tooth’s roots dissolve (resorb) to allow them to fall out. Once they’re out of the way, the permanent teeth can then erupt.
If, however, they’re lost before the permanent teeth are ready, it leaves a space in the child’s bite. The dynamic mechanism between teeth and the periodontal ligament causes adjacent teeth to move or “drift” into the space. This can crowd out the permanent tooth intended for the space, causing it to come in improperly forming a malocclusion (bad bite), or it may become impacted and remain partially or fully below the surface of the gums.
This poor dental development could lead to extensive orthodontic treatment later in life, which is why we seek to preserve even decayed primary teeth for their entire natural lifespan. If the tooth is lost, however, we need to take action to preserve the space for the permanent tooth and avoid costly treatment later.
This usually calls for a “space maintenance” appliance — a type of orthodontic “retainer” — worn by the child to prevent other teeth from drifting into the space. Designed by your orthodontist, the appliance can also perform a cosmetic and social function by causing the space to appear unnoticeable.
Maintaining that space requires monitoring — especially by an orthodontist — and continued dental hygiene and care both at home and at the dentist’s office. The extra care preserving the space caused by premature tooth loss will help to ensure your child’s dental structure develops properly and their future smile will be an attractive one.
If you would like more information on the care and treatment of primary 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 articles “Early Loss of Baby Teeth” and “Losing a Baby Tooth.”
Dental implants are by far the best way to replace missing teeth. But they do more than improve your smile: they can restore your ability to eat, chew and talk properly, especially if the teeth replaced are in the back of your mouth. What’s more, they can improve the entire look of your face by restoring facial height and cheek support lost because of the missing teeth.
There is, however, one obstacle to overcome before receiving dental implants — a lack of sufficient bone at the implant site. Bone loss usually occurs when teeth have been missing for some time. This is because when we chew the forces generated by the teeth stimulate continual bone growth to make up for older bone that has dissolved (resorbed). This stimulation doesn’t occur after teeth are lost, which slows the rate of bone growth. Over time the amount of healthy bone diminishes.
Without enough bone for support, implants can’t be placed properly. Fortunately, some of the bone can be regenerated through techniques that place bone grafting material at the site to stimulate and serve as a scaffold for new bone.Â The new bone will eventually replace the graft.
For missing upper back teeth with bone loss, we can take advantage of facial anatomy to grow the bone needed for implants. This area of the face is where the maxillary sinuses, air spaces lined with a tissue membrane, are located on either side just above the upper jaw. After determining their exact size and location through detailed x-ray imaging, we can surgically access the area inside the mouth just above the missing teeth.
The sinus cavity is an area where bone growth can occur by placing a bone graft between the floor of the sinus and the sinus membrane. Sometimes bone growth enhancers are used to stimulate and speed up regeneration. The procedure can usually be performed with local anesthesia (much like a routine tooth filling), with only mild discomfort afterward for a few days managed by an anti-inflammatory drug like ibuprofen and a decongestant for sinus swelling.
After six to seven months, we re-evaluate the area to see if sufficient bone has returned for implant surgery. If so, you will be well on your way to achieving a new look and better function through dental implants.
If you would like more information on building new bone through sinus surgery, 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 “Sinus Surgery.”