It would seem the best time to turn your attention to orthodontic problems with your child is when their permanent teeth have come in around early puberty. In fact, you should be attentive much earlier at around 6 years of age.
Here are 3 reasons why an early orthodontic evaluation could be beneficial to your child’s dental health.
We may be able to detect the first signs of a malocclusion. Also known as a poor bite, it’s possible for an experienced dentist or orthodontist to notice the beginning of a malocclusion as the permanent teeth start coming in between ages 6 and 12. Crowding of teeth, abnormal space between teeth, crooked, protruding or missing teeth are all signs that the teeth are not or will not be coming in properly and some type of treatment will eventually be necessary to correct it.
We might spot problems with jaw or facial development. Not all malocclusions arise from faulty erupting teeth position: sometimes they’re caused by abnormal development of the jaw and facial structure. For example, an orthodontist can detect if the upper jaw is developing too narrowly, which can create a malocclusion known as a cross bite. The difference in the source of a malocclusion will determine what present or future treatment will be needed.
We can perform “interceptive” treatment. While braces won’t typically be undertaken until the permanent teeth have come in, there are other treatments that can “intercept” a growing problem to eliminate or lessen future treatment needs. Orthodontists may recommend appliances that help guide incoming teeth, coax impacted teeth to come in fully or expand portions of the upper jaw to normal dimensions.
As with other areas of health, the earlier orthodontic problems are found the better the chances of a successful and less interventional outcome. By having your child examined orthodontically you may be saving money and future difficulties.
If you would like more information on when to begin monitoring bite development in your child, 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 “Early Orthodontic Evaluation.”
The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.
In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?
The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.
Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.
So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”
Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.
If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”
Tooth decay is one of the most common diseases in the world, nearly as prevalent as the common cold. It’s also one of the two major dental diseases—the other being periodontal (gum) disease—most responsible for tooth and bone loss.
Tooth decay begins with high levels of acid, the byproduct of oral bacteria feeding on food remnants like sugar. Acid can erode tooth enamel, leading to a cavity that will require removal of decayed material around it and then a filling.
Sometimes, though, decay can spread deeper into the tooth reaching all the way to its core: the pulp with its bundle of nerves and blood vessels. From there it can travel through the root canals to the bone. The continuing damage could eventually lead to the loss of the infected tooth.
If decay reaches the tooth interior, the best course of action is usually a root canal treatment. In this procedure we access the pulp through the crown, the visible part of the tooth, to remove all of the diseased and dead tissue in the pulp chamber.
We then reshape it and the root canals to receive a filling. The filling is normally a substance called gutta percha that’s easily manipulated to conform to the shape of the root canals and pulp chamber. After filling we seal the access hole and later cap the tooth with a crown to protect it from re-infection.
Root canal treatments have literally saved millions of teeth. Unfortunately, they’ve gained an undeserved reputation for pain. But root canals don’t cause pain—they relieve the pain caused by tooth decay. More importantly, your tooth can gain a new lease on life.
But we’ll need to act promptly. If you experience any kind of tooth pain (even if it goes away) you should see us as soon as possible for an examination. Depending on the level of decay and the type of tooth involved, we may be able to perform the procedure in our office. Some cases, though, may have complications that require the skills, procedures and equipment of an endodontist, a specialist in root canal treatment.
So, don’t delay and allow tooth decay to go too far. Your tooth’s survival could hang in the balance.
If you would like more information on tooth decay treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Root Canal Treatment: What You Need to Know.”
Periodontal disease may start in the gums’ superficial layers, but it’s not likely to stay there. As the disease moves deeper it can wreak havoc on tooth roots and bone as well as gum tissue attachments. Teeth with multiple roots are in particular peril because of the “forks” called furcations that form where the roots separate from each other. Infected furcations can be very difficult to treat.
We primarily treat gum disease by removing its main source, a thin film of bacteria and food particles called dental plaque that builds up on teeth. To remove it we most often use special hand tools or ultrasonic equipment to vibrate it loose. As the plaque and tartar diminish, the infection begins to wane.
But we can’t be completely successful in stopping the disease if any lingering plaque deposits remain. This especially includes furcations where the infection can cause significant damage to the roots. Although cleaning furcations of plaque can be difficult, it’s not impossible with the aforementioned tools and antimicrobial substances to disinfect the area.
The real problem, though, is access—effectively getting to the furcations to treat them. We may need to perform a surgical procedure called flap surgery where we create a hinged flap in the gum tissue to move it aside and access the root area beneath. Afterward we replace the flap and suture the tissue back in place.
In some cases, the infection may have already caused significant damage to the tissue and underlying bone. We may therefore need to graft gum or bone tissues to these damaged areas to stimulate re-growth. We may also need to surgically reshape the gum attachments around a tooth to make it easier in the future to access and clean the area.
These additional treatments around furcations can be very involved and labor-intensive. That’s why the best outcomes occur if we’re able to start treatment in the early stages of an infection. So, if you notice red, swollen or bleeding gums contact your dentist as soon as possible. Treating gum disease as early as possible will help ensure your tooth roots won’t suffer extensive damage.
If you would like more information on treating gum disease, 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 “What are Furcations? Branching Tooth Roots can be Periodontal Nightmares.”
Starting college is one of life’s biggest transition moments, the first time many young people can truly say they’re on their own. Their freshman year can be both exhilarating and frightening.
The reason for this seeming dichotomy is that both exciting opportunities and harmful pitfalls abound in college life. One such pitfall that’s often overlooked involves dental health: it’s all too easy to neglect good habits and adopt bad ones. But while it may not seem as harmful as other dangers, inattention to your dental health could create consequences that plague you long after graduation.
But being diligent about dental care can help you avoid serious problems now and in the future. At the top of the list: brush and floss your teeth daily and continue seeing a dentist at least twice a year. Hopefully, your parents or guardians have trained you in these vital habits—and they’re definitely habits you should continue for the rest of your life.
Close in importance to good oral hygiene is a healthy diet. Besides eating primarily “natural” food—fresh fruits and vegetables and less-processed foods—you should also set limits on your sugar consumption. This carbohydrate is a primary food for disease-causing bacteria, so limiting as much as possible the sugar you eat to just meal times will lower your risk for tooth decay.
Another area in which you should tread wisely is alcohol consumption. Besides the obvious consequences of alcohol abuse, immoderate drinking can also cause dental problems. Alcohol (and smoking) tends to dry out the mouth, which can increase the levels of oral bacteria and in turn increase your risk of both tooth decay and periodontal (gum) disease.
Finally, avoid getting piercings involving the lips, mouth or tongue even if it’s the thing to do. Piercing hardware can chip teeth and contribute to the shrinking back of the gums (recession). And be sure you practice safe sex: unprotected sexual activity could expose you to viral infections that cause oral problems including cancer.
Your college years should be an exciting and memorable experience. By practicing these and other common sense dental habits, you’ll be sure to remember these years fondly.
If you would like more information on dental care during college, 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 “10 Health Tips for College Students.”
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