“Orthodontic treatment” and “braces” almost seem like synonymous terms. But while braces certainly are orthodontic, it isn't the only tool in an orthodontist's toolkit.
A good example is a device is known as a Herbst appliance. It's used in situations where the upper jaw is outpacing the growth and development of the lower jaw during childhood. If not corrected, this could cause the top teeth to protrude abnormally beyond the lower teeth.
The Herbst appliance gently and gradually coaxes the lower jaw to grow in a more forward direction, thus “catching up” with the upper jaw. The top part of the device consists of two metal tubes hinged to small elastic bands, which are cemented to the cheek side of the upper back teeth (molars), one on either side of the jaw.
Two smaller tubes are attached in like fashion to the lower teeth, and then inserted into the larger tubes. As the lower jaw moves, the smaller tubes move within the larger to create pressure that gently pushes the jaw forward. Over time, this can sync the growth progress of both the upper and lower jaws, and reduce the chances of a poor bite.
For best results, a Herbst appliance is usually placed to coincide with a child's most rapid period of jaw growth, usually between 11 and 14. They could be placed as early as 8 or 9, however, in situations where the front teeth are already protruding well beyond the lips. In any event, the goal is to positively influence the growth of the lower jaw to alleviate or at least minimize the need for future orthodontic treatment.
As a fixed device, there's no need for a child or parent to tend to it as with other methods, like orthodontic headwear worn in conjunction with braces. A Herbst appliance can, however, alter the normal sensations associated with eating, swallowing and speaking, which may take a little adjustment time for the child. Wearers will also need to be extra vigilant with daily brushing and flossing because of a higher risk of tooth decay.
These, though, are minor inconveniences compared with the benefit of improved bite development. As such, a Herbst appliance could be a positive investment in your child's dental future.
If you would like more information on interceptive 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 “The Herbst Appliance.”
Introduced to the United States in the 1980s, dental implants have quickly become the go-to restoration for tooth replacement. And for good reason: they're not only incredibly life-like, they're highly durable with a 95% success rate.
But as desirable as they are, you may face a major obstacle getting one because of the condition of the bone at your implant site. To position the implant for best appearance and long-term durability, we must have at least 4-5 mm of bone available along the horizontal dimension. Unfortunately, that's not always the case with tooth loss.
This is because bone, like other living tissue, has a growth cycle: Older cells die and dissolve (resorb) and newer cells develop in their place. The forces transmitted to the jaw from the action of chewing help stimulate this resorption and replacement cycle and keep it on track. When a tooth is lost, however, so is this stimulus.
This may result in a slowdown in cell replacement, causing the eventual loss of bone. And it doesn't take long for it to occur after tooth loss—you could lose a quarter of bone width in just the first year, leaving you without enough bone to support an implant. In some cases, it may be necessary to choose another kind of restoration other than implants.
But inadequate bone isn't an automatic disqualifier for implants. It's often possible to regenerate lost bone through a procedure known as bone augmentation, in which we insert a bone graft at the missing tooth site. The graft serves as a scaffold for new bone cells to grow upon, which over time may regenerate enough bone to support an implant.
Even if you've had a missing tooth for some time, implementing bone augmentation could reverse any loss you may have experienced. In fact, it's a common practice among dentists to place a bone graft immediately after a tooth extraction to minimize bone loss, especially if there will be a time lag between extraction and implant surgery.
Bone augmentation could add extra time to the implant process. But if successful, it will make it possible for you to enjoy this popular dental restoration.
If you would like more information on dental implant restoration, 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 After Previous Tooth Loss.”
Mike Tyson made a splash when he faced off against sharks during the Discovery Channel's Shark Week 2020. But there's bigger news for fans of the former undisputed world heavyweight champion: After a 15-year absence, he will enter the ring again for two exhibition matches in the Fall. However, it's not just Tyson's boxing action that made news during his 20-year career. His teeth have also gotten their fair share of press.
Tyson used to be known for two distinctive gold-capped teeth in the front left side of his mouth. He made headlines when he lost one of the shiny caps—not from a blow by a fellow pugilist but from being headbutted by his pet tiger as Tyson leaned in for a kiss. Tyson's teeth again garnered attention when he had his recognizable gold caps replaced with tooth-colored restorations. But the world champion may be best known, dentally at least, for his trademark tooth gap, or “diastema” in dentist-speak. Several years ago, he had the gap closed in a dental makeover, but he soon regretted the move. After all, the gap was a signature look for him, so he had it put back in.
That's one thing about cosmetic dentistry: With today's advanced technology and techniques, you can choose a dental makeover to suit your individual taste and personality.
An obvious example is teeth whitening. This common cosmetic treatment is not a one-size-fits-all option. You can choose whether you want eye-catching Hollywood white or a more natural shade.
If your teeth have chips or other small imperfections, bonding may be the solution for you. In dental bonding, tooth-colored material is placed on your tooth in layers and then hardened with a special light. The material is matched to your other teeth so the repaired tooth fits right in. This procedure can usually be done in just one office visit.
For moderate flaws or severe discoloration, porcelain veneers can dramatically improve your appearance. These thin, tooth-colored shells cover the front surface of the tooth—the side that shows when you smile. Veneers are custom-crafted for the ideal individualized look.
Dental crowns can restore single teeth or replace missing teeth as part of a dental bridge. Again, they are manufactured to your specifications. With restorations like crowns and veneers, the smallest detail can be replicated to fit in with your natural teeth—even down to the ridges on the tooth's surface.
And if, like Mike Tyson, you have a gap between your teeth that makes your smile unique, there's no reason to give that up if you opt for a smile makeover. Whether you would like a small cosmetic enhancement or are looking for a more dramatic transformation, we can work with you to devise a treatment plan that is right for you.
If you would like more information about smile-enhancing dental treatments, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine article “Cosmetic Dentistry: A Time for Change.”
As they mature, your child's teeth, gums and jaws develop—if all goes well, they'll all be healthy and functioning normally when they enter adulthood. But tooth decay and other problems could derail that development and cause lingering oral health issues later in life.
Following these 4 guidelines now during your child's early years will help ensure their teeth and gums have a healthy future.
Start oral hygiene early. There's no need to wait for their first teeth to come in to begin your child's regular oral hygiene. Start with wiping their gums right after feeding with a clean wet cloth to minimize bacterial development. Then, start brushing as soon as teeth appear—to begin with, use a slight smear of toothpaste on the brush. As they mature, teach them to brush and later floss for themselves.
Check your water. Most utilities add tiny traces of fluoride to their drinking water supply. If your water supplier does, it can make a big difference (along with fluoride toothpaste) in helping your child avoid tooth decay. If your system doesn't, then speak to your dentist about whether your child could benefit from topical fluoride applied directly to their teeth.
Keep a check on sugar. Decay-causing bacteria thrive on the sugar added to processed foods, candies and many beverages. Even milder forms of sugar like lactose found in milk or formula can stimulate bacterial growth. So, in addition to daily brushing and flossing, do your best to minimize sugar in your child's diet. And don't put infants or toddlers to bed with a bottle filled with any liquid other than water.
See the dentist. Starting around their first birthday, regular dental visits can help keep your child's dental development on track. Dental visits are also an opportunity for preventive treatments against decay like sealants or topical fluoride. Your dentist may also detect the early signs of bite problems that if addressed now, could lessen their impact later in life.
Your child's dental health could get off course before you even realize it. But partnering with your dentist, you can help make sure your child's teeth and gums have a bright and healthy future.
If you would like more information on how best to care for your child's oral 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 “Top 10 Oral Health Tips for Children.”
If your child has seen the dentist regularly, and brushed and flossed daily, there's a good chance they've avoided advanced tooth decay. But another problem might already be growing right under your nose—a poor dental bite (malocclusion).
A dental bite refers to the way the upper and lower teeth fit together. In a normal bite the teeth are in straight alignment, and the upper teeth slightly extend in front of and over the lower when the jaws are shut. But permanent teeth erupting out of position or a jaw developing abnormally can set the stage for a malocclusion.
Although the full effects of a malocclusion may not manifest until later, there may be signs of its development as early as age 6. If so, it may be possible to identify a budding bite problem and “intercept” it before it goes too far, correcting it or reducing its severity.
Here are 6 signs your school-age child could be developing a malocclusion.
Excessive spacing. If the spacing between teeth seems too wide, it could mean the size of your child's teeth are out of proportion with their jaw.
Underbite. Rather than the normal upper front teeth covering the lower, the lower teeth extend out and over the upper teeth.
Open bite. There's a space or gap between the upper and lower teeth even when the jaws are shut.
Crowding. Due to a lack of space on the jaw, incoming teeth don't have enough room to erupt and may come in misaligned or “crooked.”
Crossbites. Some of the lower teeth, either in front or back of the jaw, overlap the upper teeth, while the rest of the upper teeth overlap normally.
Protrusion or retrusion. This occurs if the upper front teeth or jaw appear too far forward (protrusion) or the lower teeth or jaw are positioned too far back (retrusion).
Besides watching out for the preceding signs yourself, it's also a good idea to have your child undergo a comprehensive bite evaluation with an orthodontist around age 6. If that does reveal something amiss with their bite, intervention now could correct or lessen the problem and future treatment efforts later.
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