Posts for category: Dental Procedures
As permanent teeth gradually replace primary (“baby”) teeth, most will come in by early adolescence. But the back third molars—the wisdom teeth—are often the last to the party, usually erupting between ages 18 and 24, and the source of possible problems.
This is because the wisdom teeth often erupt on an already crowded jaw populated by other teeth. As a result, they can be impacted, meaning they may erupt partially or not at all and remain largely below the gum surface.
An impacted tooth can impinge on its neighboring teeth and damage their roots or disrupt their protective gum attachment, all of which makes them more susceptible to tooth decay or periodontal (gum) disease. Impacted teeth can also foster the formation of infected cysts that create areas of bone loss or painful infections in the gums of other teeth.
Even when symptoms like these aren’t present, many dentists recommend removing the wisdom teeth as a preemptive measure against future problems or disease. This often requires a surgical extraction: in fact, wisdom teeth removal is the most common oral surgical procedure.
But now there’s a growing consensus among dentists that removing or not removing wisdom teeth should depend on an individual’s unique circumstances. Patients who are having adverse oral health effects from impacted wisdom teeth should consider removing them, especially if they’ve already encountered dental disease. But the extraction decision isn’t as easy for patients with no current signs of either impaction or disease. That doesn’t mean their situation won’t change in the future.
One way to manage all these potentialities is a strategy called active surveillance. With this approach, patient and dentist keep a close eye on wisdom teeth development and possible signs of impaction or disease. Most dentists recommend carefully examining the wisdom teeth (including diagnostic x-rays and other imaging) every 24 months.
Following this strategy doesn’t mean the patient won’t eventually have their wisdom teeth removed, but not until there are clearer signs of trouble. But whatever the outcome might be, dealing properly with wisdom teeth is a high priority for preventing future oral health problems.
If you would like more information on wisdom teeth and their potential impact on dental health, 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 “Wisdom Teeth: Coming of Age May Come with a Dilemma.”
There are several reasons why dental implants are so popular. Perhaps the most important, though, is their longevity: if maintained properly implants can last for decades. However, they’re not indestructible—certain mouth conditions could put them at risk for early failure. But if you address emerging problems early, you may be able to prevent that unfortunate outcome.
Your implants may be in danger, for example, if you have a teeth grinding or clenching habit. This occurs when a person involuntarily and repeatedly bites down on their teeth when not chewing or speaking. Usually triggered in adults by high stress, teeth grinding can subject both natural teeth and implants to damaging levels of force. Over time this can cause bone loss around an implant and weaken their support. It could also cause a direct break in an implant.
But there are ways to stop or at least reduce the effects of teeth grinding. One effective way is a custom-made bite guard you wear while you sleep. Made of hard plastic, the guard prevents the teeth from making solid contact with each other, reducing the amount of force generated.
A more prominent problem is periodontal (gum) disease, a bacterial infection caused by built-up dental plaque on tooth surfaces. This can trigger inflammation, a normal defensive response that when it persists for an extended period of time can damage tissues and supporting bone. It can also cause a specific form of gum disease related to implants called peri-implantitis, in which the tissues that support an implant become infected and weaken, leading eventually to possible implant failure.
If you have implants, then, you should brush and floss daily to prevent gum disease, as well as see your dentist at least every six months for cleanings and checkups. And if you notice anything like reddened, swollen or bleeding gums, see your dentist immediately. The sooner you undergo treatment, the better the outcome for your implants as well as your overall health.
Dental implants can give you years of great service and can prove to be well worth the cost. But you’ll have to stay on your guard against gum disease and other mouth conditions that could endanger them down the road.
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.”
A poor bite (malocclusion) could be more than simply teeth out of alignment. There could be complex causes for the malocclusion, possibly involving the facial bone structure.
An example of this is the development of a cross-bite due to problems with the upper jaw and palate (the roof of the mouth), jointly called the maxilla. The maxilla is in fact formed by two bones fused together in the center of the palate in what's called the midline suture. The suture doesn't completely fuse until after puberty.
Sometimes a maxilla's development doesn't follow a normal track. The upper jaw doesn't widen as it should, which leads to the cross-bite where the upper back teeth abnormally bite inside the lower teeth. The upper front teeth continue to bite normally in front of the lower front teeth. This also can have profound influence on breathing, causing sleep apnea.
We can correct this by using an orthodontic appliance called a palatal expander before the midline suture fuses. The expander gradually widens the upper jaw to its normal width and thus eliminates the cross-bite.
Positioned at the roof of the mouth, the expander has metal arms that extend from a central hinge to exert pressure on the inside of the upper teeth. The patient or a caregiver uses a small key to turn a mechanism that extends the arms toward the teeth a tiny amount each day. This gradually widens the jaw, while at the same time stimulating bone growth at the midline suture. Eventually the gap fills with bone to solidify the new width as the suture fuses.
It's important to undertake this treatment before fusion. If you wait until after puberty, you will need to separate the bones first to attempt it. The overall impact and cost is much less if you act promptly in the early years.
Palatal expansion may not be the right treatment in every case, so we'll need to perform a thorough orthodontic exam first. If, however, we do determine it can help, using an expander can improve function, correct future breathing problems and make possible a more attractive future smile.
If you would like more information on orthodontic treatment 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 “Palatal Expanders: Orthodontics is more than just Moving Teeth.”
You’ve lived most of your life with crooked teeth and an imperfect smile. You feel you should have done something about it years ago, but now you’re approaching your golden years — what would be the point?
Here’s the point: there’s a growing trend of older adults undergoing orthodontic treatment. People are discovering the life-changing benefits of straightening their teeth — even if they’re no longer teenagers.
So, what’s really holding you back?
I’m too old to have my teeth straightened. Not true — teeth can be straightened at any age, not just during childhood or adolescence. If anything would prevent orthodontic treatment it would be the state of your oral and general health, not your age. Your teeth’s supporting bone must be reasonably sound and healthy; likewise, systemic problems like bleeding disorders, leukemia and uncontrolled diabetes can make orthodontics difficult. But if you and your mouth are reasonably healthy, you can have your teeth straightened.
It’s too much to spend just to look better. Yes, orthodontic treatment can transform your smile — but it can also improve your oral health. Misaligned teeth are harder to keep clean, increasing the risks for tooth decay and periodontal (gum) disease; they also don’t work well together so chewing is more difficult. By correcting your bite, you can reduce your chances of dental disease and improve overall mouth function.
I’d look silly at my age in braces. Self-consciousness about wearing these traditional appliances is common at any age. It’s understandable — the glint of metal is the first thing people see when you smile. But there’s a good chance you may be able to wear an alternative appliance that’s barely noticeable: clear aligners. These are a series of removable, clear plastic trays that you wear in sequence to gradually move your teeth. Not only are they less noticeable than braces, you can take them out for special occasions.
Don’t let these or other excuses keep you from a more attractive smile and healthy mouth. Visit your dentist for an examination to see if orthodontics can work for you.
If you would like more information on transforming your smile through orthodontics, 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 “Orthodontics for the Older Adult.”
Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”
Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.
Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:
A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.
If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.
Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.
Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.
Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.
If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”