Posts for: February, 2020
In the world of movies and television, the lead actors get the lion’s share of the credit. In reality, though, there wouldn’t be much of a show without the supporting cast. You’ll find a similar situation in your mouth: While your teeth get most of the attention, another dental structure plays a critical supporting role—your gums.
It’s only fitting, then, that we put the spotlight on your gums, especially in February. The second month of the year is Gum Disease Awareness Month, when we highlight the importance of our gums and the dangers they face.
While the gums are an important part of your smile, they’re not just for show. Your gums play a critical role in helping to keep your teeth securely attached within the jaw. Their network of blood vessels also supplies nutrients and disease-fighting agents to your teeth. We’re not exaggerating, then, when we say your teeth can’t survive without them.
But although they’re resilient, they do have one major vulnerability: a bacterial infection known as periodontal (gum) disease. Gum disease arises from bacteria that thrive within a thin, built-up film of bacteria and food particles called dental plaque. Untreated, an infection can advance deep into the gums, down to the tooth roots and jawbone.
Gum disease is as much a problem for your teeth as it is for your gums: Weakened gum attachment and loss of bone can put your teeth in danger of being lost. Fortunately, though, there are things you can do to keep gum disease from ruining your dental health.
Brush and floss. To prevent a gum infection, you must keep plaque from building up on your teeth. The best way is a combination of thorough brushing and flossing. Don’t neglect the latter, which is necessary to remove hard-to-reach plaque between teeth. And do it every day—it doesn’t take long for a gum infection to occur.
Get your teeth cleaned. Even the most diligent hygiene practice may still miss some plaque and its hardened form calculus (tartar). These stubborn deposits, though, are no match for our dental cleaning equipment and techniques. Semi-annual visits are also a good time to evaluate your overall dental health, including your gums.
See us at the first sign of infection. Gum disease is often symptomless, especially in the beginning. But there are signs to look for like gum swelling, redness or bleeding. If you notice any of these, see us as soon as possible. The sooner you begin treatment, the less harm the disease will cause.
Taking care of your gums isn’t just good for your dental health—it’s good for your overall health and well-being. It also doesn’t hurt that your gums are good for your appearance as an important part of a beautiful smile.
If you would like more information about gum disease prevention and treatment, please contact us or schedule a consultation.
Moving teeth through orthodontics may involve more than simply wearing braces. There are many bite conditions that require extra measures before, during or after traditional orthodontic treatment to improve the outcome.
One such measure is extracting one or more teeth. Whether or not we should will depend on the causes behind a patient's poor dental bite.
Here, then, are 4 situations where tooth extraction before orthodontics might be necessary.
Crowding. This happens when the jaw isn't large enough to accommodate all the teeth coming in. As a result, later erupting teeth could erupt out of position. We can often prevent this in younger children with space maintainers or a palatal expander, a device which helps widen the jaw. Where crowding has already occurred, though, it may be necessary to remove selected teeth first to open up jaw space for desired tooth movement.
Impacted teeth. Sometimes an incoming tooth becomes blocked and remains partially or fully submerged beneath the gums. Special orthodontic hardware can often be used to pull an impacted tooth down where it should be, but not always. It may be better to remove the impacted tooth completely, as well as its matching tooth on the other side of the jaw to maintain smile balance before orthodontically correcting the bite.
Front teeth protrusion. This bite problem involves front teeth that stick out at a more horizontal angle. Orthodontics can return the teeth to their proper alignment, but other teeth may be blocking that movement. To open up space for movement, it may be necessary to remove one or more of these obstructing teeth.
Congenitally missing teeth. The absence of permanent teeth that failed to develop can disrupt dental appearance and function, especially if they're near the front of the mouth. They're often replaced with a dental implant or other type of restoration. If only one tooth is missing, though, another option would be to remove the similar tooth on the other side of the jaw, and then close any resulting gaps with braces.
Extracting teeth in these and other situations can help improve the chances of a successful orthodontic outcome. The key is to accurately assess the bite condition and plan accordingly.
If you would like more information on orthodontic 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 “Removing Teeth for Orthodontic Treatment.”
While crooked teeth are usually responsible for a malocclusion (poor bite), the root cause could go deeper: a malformed maxilla, a composite structure composed of the upper jaw and palate. If that’s the case, it will take more than braces to correct the bite.
The maxilla actually begins as two bones that fit together along a center line in the roof of the mouth called the midline suture, running back to front in the mouth. The suture remains open in young children to allow for jaw growth, but eventually fuses during adolescence.
Problems arise, though, when these bones don’t fully develop. This can cause the jaw to become too narrow and lead to crowding among the erupting teeth and a compromised airway that can lead to obstructive sleep apnea. This can create a cross-bite where the upper back teeth bite inside their lower counterparts, the opposite of normal.
We can remedy this by stimulating more bone growth along the midline suture before it fuses, resulting in a wider maxilla. We do this by installing a palatal expander, an appliance that incrementally widens the suture to encourage bone formation in the gap, which over time will widen the jaw.
An expander is a metal device with “legs” extending out on both sides and whose ends fit along the inside of the teeth. A gear mechanism in the center extends the legs to push against the teeth on both sides of the jaw. Each day the patient or caregiver uses a key to give the gear a quarter turn to extend the legs a little more and widen the suture gap. We remove the expander once the jaw widens to the appropriate distance.
A palatal expander is an effective, cost-efficient way to improve a bite caused by a narrow jaw, but only if attempted before the bones fuse. Widening the jaw after fusion requires surgery to separate the bones — a much more involved and expensive process.
To make sure your child is on the right track with their bite be sure to see an orthodontist for an evaluation around age 6. Doing so will make it easier to intervene at the proper time with treatments like a palatal expander, and perhaps correct bite problems before they become more expensive to treat.
If you would like more information on treating malocclusions, 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.”