Keeping your child’s teeth and gums healthy may sometimes seem like “one step forward, two steps back.” You do all the right things like daily brushing and flossing, and keeping sugar consumption to a minimum. But they’re still getting too many cavities.
We can add something else to what you’re already doing to decrease their cavity rate: apply a concentrated fluoride mixture (stronger than what’s found in toothpaste or drinking water) directly to their teeth. Studies have shown that topical fluoride is effective at reducing the risk of new cavities in children at high risk for decay, and may even reverse early decay.
Topical fluoride can be applied as a gel, foam or varnish. The particular method used depends on factors like the child’s age or the preference of the dentist. But any of the three methods can deliver a short-term, high dose of fluoride to the teeth.
As a result, the burst of fluoride strengthens tooth enamel against decay, with plenty of evidence of its effectiveness. As such, the American Dental Association recommends periodic topical fluoride applications for children older than 6, and especially those that appear to be at higher risk for decay.
You might, however, be concerned about the long-term health effects of these stronger concentrations of fluoride. Again, research indicates that the only long-term hazard associated with too much fluoride is a condition called fluorosis, which produces heavy tooth staining. Fluorosis, though, is more of an appearance issue and doesn’t harm the tooth itself. And it can be avoided in the case of topical fluoride by performing the procedure correctly and conservatively.
There’s also a short-term risk of a reaction to the fluoride mixture if the child swallows too much during the procedure, which could cause stomach upset and pain, vomiting or headaches. We can avoid this by using precautions like dental dams and other isolation methods to prevent the child from ingesting it.
Using proper precautions and procedures, topical fluoride is a safe and effective way to give your child added protection against decay. Avoiding this destructive disease can help ensure they’ll enjoy good dental health for the rest of their lives.
If you would like more information on keeping your child’s teeth and gums healthy, 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 “Fluoride Gels Reduce Decay.”
Sometimes you need only a single solution to improve your smile: teeth whitening to brighten stained teeth; porcelain veneers or crowns to mask dental flaws; or a life-like dental implant to replace a missing tooth. But not all dental situations are that simple and sometimes require a combination of treatments.
A case in point: restoring a missing tooth within a poor bite. The absent tooth itself may be the cause of the bite problem if it’s been missing for some time: The nearby teeth tend to move or “drift” into the empty space, leaving no room for implant placement.
When this happens, you’ll first need orthodontic treatment to correct the bite problem. Not only will this open the space for the implant, it also comes with its own benefits. It obviously improves your smile appearance—but straighter teeth are also easier to keep clean of bacterial plaque, which reduces your disease risk. You may also experience better digestion after your teeth are properly aligned and able to function as they should during eating.
The traditional way to improve a bite is through metal braces. But there are some downsides: For one, braces can make it difficult to keep teeth adequately clean, making wearers more susceptible to tooth decay and gum disease. Braces are also quite visible and can detract from a person’s appearance (even more so if a missing tooth is involved).
Unless your situation requires braces, you can choose clear aligners as an alternative. These clear, computer-generated plastic trays are worn in sequence to gradually move teeth to their desired positions. Unlike braces, you can remove aligners for eating, cleaning or rare special occasions. And, they’re barely noticeable to others.
If you also have a missing tooth, you can have a temporary prosthetic (“false”) tooth built into your aligner trays. In this way you can still enhance your smile while undergoing aligner treatment.
Once your bite has been corrected, we can then proceed with restoring your missing tooth permanently with a dental implant. Although orthodontics adds to the time and expense of restoration, its often necessary to achieve the best result. Your future smile will be the better for it.
We treat most malocclusions (bad bites) with braces or clear aligners. But not all malocclusions are alike — some can require extra procedures to achieve successful results.
One such example is when incoming teeth crowd other teeth and cause them to erupt abnormally. The crowding also reduces the space needed to move the misaligned teeth to better positions. To make more room we'll often remove some of the teeth before undertaking orthodontics.
The key is to extract the right teeth. The best candidates are those whose absence will have minimal effect on both appearance and dental function. That's commonly the bicuspids, located right on the edge of the “smile zone” (the teeth most visible when we smile) between the cuspid (eye) teeth and the back molars.
Once we choose and remove the teeth our next concern is to protect the bone at the extraction site.Â The bone in our jaws benefits from the pressure created when we bite or chew. This stimulates new bone cells to form and replace older cells. Without it, as when we have a missing tooth, the amount of bone can diminish over time and affect the success of any future orthodontics.
To prevent this, we take care not to damage the gums and bone removing the tooth. We may also install a graft under the empty socket to encourage bone growth.
If we've removed teeth outside the smile zone, the resulting orthodontics will move teeth into the opened space. In the end, you won't even notice they're gone. Teeth lost or congenitally missing in the smile zone, though, may eventually require a replacement tooth. A dental implant is the best choice, but it should be put on hold for a younger person until their jaw has fully developed.
In the meantime, we can install a spacer or a temporary restoration to hold the empty space and prevent other teeth from drifting into it. This can be incorporated into braces or aligners, or with a removable partial denture or a temporary modified bridge.
Extracting teeth to aid orthodontics first requires a well-laid plan that could encompass several years. The end result, though, can be well worth the time and effort — better function and a new, attractive smile.
If you would like more information on the process of straightening 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 article “Tooth Removal for Orthodontic Reasons.”
Sometimes, looking at old pictures can really bring memories back to life. Just ask Stefani Germanotta—the pop diva better known as Lady Gaga. In one scene from the recent documentary Five Foot Two, as family members sort through headshots from her teen years, her father proclaims: "Here, this proves she had braces!"
"If I had kept that gap, then I would have even more problems with Madonna," Lady Gaga replies, referencing an ongoing feud between the two musical celebrities.
The photos of Gaga's teenage smile reveal that the singer of hits like "Born This Way" once had a noticeable gap (which dentists call a diastema) between her front teeth. This condition is common in children, but often becomes less conspicuous with age. It isn't necessarily a problem: Lots of well-known people have extra space in their smiles, including ex-football player and TV host Michael Strahan, actress Anna Paquin…and fellow pop superstar Madonna. It hasn't hurt any of their careers.
Yet others would prefer a smile without the gap. Fortunately, diastema in children is generally not difficult to fix. One of the easiest ways to do so is with traditional braces or clear aligners. These orthodontic appliances, usually worn for a period of months, can actually move the teeth into positions that look more pleasing in the smile and function better in the bite. For many people, orthodontic treatment is a part of their emergence from adolescence into adulthood.
Braces and aligners, along with other specialized orthodontic appliances, can also remedy many bite problems besides diastema. They can correct misaligned teeth and spacing irregularities, fix overbites and underbites, and take care of numerous other types of malocclusions (bite problems).
The American Association of Orthodontists recommends that kids get screened for orthodontic problems at age 7. Even if an issue is found, most won't get treatment at this age—but in some instances, it's possible that early intervention can save a great deal of time, money and effort later. For example, while the jaw is still developing, its growth can be guided with special appliances that can make future orthodontic treatment go quicker and easier.
Yet orthodontics isn't just for children—adults can wear braces too! As long as teeth and gums are healthy, there's no upper age limit on orthodontic treatment. Instead of traditional silver braces, many adults choose tooth-colored braces or clear aligners to complement their more professional appearance.
So if your child is at the age where screening is recommended—or if you're unhappy with your own smile—ask us whether orthodontics could help. But if you get into a rivalry with Madonna…you're on your own.
If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics For The Older Adult.”
Breathing: You hardly notice it unless you're consciously focused on it—or something's stopping it!
So, take a few seconds and pay attention to your breathing. Then ask yourself this question—are you breathing through your nose, or through your mouth? Unless we're exerting ourselves or have a nasal obstruction, we normally breathe through the nose. This is as nature intended it: The nasal passages act as a filter to remove allergens and other fine particles.
Some people, though, tend to breathe primarily through their mouths even when they're at rest or asleep. And for children, not only do they lose out on the filtering benefit of breathing through the nose, mouth breathing could affect their dental development.
People tend to breathe through their mouths if it's become uncomfortable to breathe through their noses, often because of swollen tonsils or adenoids pressing against the nasal cavity or chronic sinus congestion. Children born with a small band of tissue called a tongue or lip tie can also have difficulty closing the lips or keeping the tongue on the roof of the mouth, both of which encourage mouth breathing.
Chronic mouth breathing can also disrupt children's jaw development. The tongue normally rests against the roof of the mouth while breathing through the nose, which allows it to serve as a mold for the growing upper jaw and teeth to form around. Because the tongue can't be in this position during mouth breathing, it can disrupt normal jaw development and lead to a poor bite.
If you suspect your child chronically breathes through his or her mouth, your dentist may refer you to an ear, nose and throat (ENT) specialist to check for obstructions. In some cases, surgical procedures to remove the tonsils or adenoids may be necessary.
If there already appears to be problems brewing with the bite, your child may need orthodontic treatment. One example would be a palatal expander, a device that fits below the palate to put pressure on the upper jaw to grow outwardly if it appears to be developing too narrowly.
The main focus, though, is to treat or remove whatever may be causing this tendency to breathe through the mouth. Doing so will help improve a child's ongoing dental development.
If you would like more information on treating chronic mouth breathing, 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 Trouble With Mouth Breathing.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.