Posts for: November, 2020
Before we begin correcting a malocclusion (poor dental bite), we need to ask a few questions: How extensive is the malocclusion? How far must we move the teeth to correct it? How might the patient's jaw size impact treatment?
Answering these and other questions help us develop an effective treatment plan. And depending on the answers, we might need to look at other procedures before we install braces—like removing one or more of the teeth.
This isn't a subject to approach lightly: All teeth play an important role in dental function and smile appearance, and ordinarily we want to preserve teeth, not remove them. Sometimes, however, it may be a necessary action to achieve our goal of an improved dental bite.
For example, it might be necessary for correcting a malocclusion caused by severe teeth crowding. This occurs when one or both of the jaws hasn't grown to a sufficient size to accommodate all of the teeth erupting on it. As a result, some of the teeth could come in out of their proper alignment.
If caught early before puberty, we may be able to use other techniques to alleviate crowding, like a device called a palatal expander that influences an upper jaw to widen as it grows. If successful, it could provide later teeth more room to erupt in their proper positions.
But even if additional jaw growth occurs, it may not be enough to avoid a malocclusion or treatment with braces. Alleviating further crowding by removing teeth in little noticed areas could help with subsequent orthodontics.
Removing teeth may also be the answer for other problems like an impacted tooth, in which the tooth has not fully erupted and remains submerged in the gums. It's sometimes possible to use a technique to “pull” the tooth down where it should be; but again, that will still require jaw space that may not be available. The more effective course might be to remove the impacted tooth.
Whether or not tooth extraction will be needed can depend on a thorough orthodontic evaluation and full consideration of all the available options. Even though the ideal situation is to correct a bite with all teeth present and accounted for, it may be for the better good to sacrifice some.
If you would like more information on orthodontic techniques, 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.”
During his exploration of the Americas, Christopher Columbus encountered a native in a canoe loaded with water, food and a strange bunching of leaves. This marked the first European encounter with tobacco, a discovery that still haunts us to the present day. Today, millions smoke tobacco—and many suffer serious health problems as a result, including dental diseases like tooth decay and gum disease.
The American Cancer Society is sponsoring its 44th annual Great American Smokeout this November 19 when health providers across the country encourage smokers to kick the tobacco habit. Dentists will certainly be among them: Studies show that smokers are five times more likely to lose teeth than non-smokers due to a higher incidence of dental disease. Here's why.
Increased plaque and tartar. The main cause for tooth decay and gum disease is dental plaque, a thin, bacterial film that builds up on teeth. Brushing and flossing, along with regular dental cleanings, can keep plaque and its hardened form tartar from accumulating. But substances in tobacco restrict the flow of saliva needed to curb bacterial growth. This in turn can increase plaque accumulation and the risk for disease.
Hidden symptoms. Your gums often “tell” you when you have early gum disease by becoming swollen and red, and bleeding easily. But if you smoke, you might not get that early warning—the nicotine in tobacco interferes with your body's inflammatory response, so your gums, although infected, may look normal. By the time you find out, the infection may have already spread, increasing your chances of tooth loss.
Slow healing. Nicotine can also constrict the mouth's blood vessels, slowing the delivery of nutrients and infection-fighting antibodies to your teeth and gums. As a result, your body may have a harder time fighting tooth decay or gum disease, and diseased tissues can take longer to heal. Slower healing can also complicate the process of getting dental implants.
Increased oral cancer risk. Although it's not as prevalent as other cancers, oral cancer is still among the deadliest with a dismal 50% survival rate after five years. Smokers are six times more likely than non-smokers to develop oral cancer. But by quitting smoking and other forms of tobacco, you could reduce your oral cancer risk to that of a non-user in just a few years.
Kicking the smoking habit often takes a monumental effort, but it's worth it. Quitting not only improves your overall well-being, it could help you gain healthier teeth and gums. To learn how, see us for an up-to-date dental exam—we can show you how getting Columbus's most notorious discovery out of your life could do wonders for your smile and dental health.
If you would like more information about the effects of tobacco on your oral health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Smoking and Gum Disease” and “Strategies to Stop Smoking.”
The monarchs of the world experience the same health issues as their subjects—but they often tend to be hush-hush about it. Recently, though, the normally reticent Queen Elizabeth II let some young dental patients in on a lesser known fact about Her Majesty's teeth.
While touring a new dental hospital, the queen told some children being fitted for braces that she too “had wires” once upon a time. She also said, “I think it's worth it in the end.”
The queen isn't the only member of the House of Windsor to need help with a poor bite. Both Princes William and Harry have worn braces, as have other members of the royal family. A propensity for overbites, underbites and other malocclusions (poor bites) can indeed pass down through families, whether of noble or common lineage.
Fortunately, there are many ways to correct congenital malocclusions, depending on their type and severity. Here are 3 of them.
Braces and clear aligners. Braces are the tried and true way to straighten misaligned teeth, while the clear aligner method—removable plastic mouth trays—is the relative “new kid on the block.” Braces are indeed effective for a wide range of malocclusions, but their wires and brackets make it difficult to brush and floss, and they're not particularly attractive. Clear aligners solve both of these issues, though they may not handle more complex malocclusions as well as braces.
Palatal expanders. When the upper jaw develops too narrowly, a malocclusion may result from teeth crowding into too small a space. But before the upper jaw bones fuse together in late childhood, orthodontists can fit a device called a palatal expander inside the upper teeth, which exerts gentle outward pressure on the teeth. This encourages more bone growth in the center to widen the jaw and help prevent a difficult malocclusion from forming.
Specialized braces for impacted teeth. An impacted tooth, which remains partially or completely hidden in the gums, can impede dental health, function and appearance. But we may be able to coax some impacted teeth like the front canines into full eruption. This requires a special orthodontic technique in which a bracket is surgically attached to the impacted tooth's crown. A chain connected to the bracket is then looped over other orthodontic hardware to gradually pull the tooth down where it should be.
Although some techniques like palatal expanders are best undertaken in early dental development, people of any age and reasonably good health can have a problem bite corrected with other methods. If you are among those who benefit from orthodontics, you'll have something in common with the Sovereign of the British Isles: a healthy, attractive and straighter smile.