Posts for category: Dental Procedures
Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”
Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.
Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:
A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.
If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.
Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.
Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.
Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.
If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”
While it's possible for a teenager to lose a tooth from decay, it's more common they'll lose one from an accidental knockout. If that happens to your teenager, there are some things you should know to achieve a good outcome.
Our top concern is to preserve the underlying bone following tooth loss. Like other tissues, bone has a life cycle: older cells dissolve and are absorbed by the body (resorption), then replaced by new cells. The biting pressure generated when we chew helps stimulate this growth. But bone around a missing tooth lacks this stimulation and may not keep up with resorption at a healthy rate.
This can cause a person to lose some of the bone around an empty tooth socket. To counteract this, we may place a bone graft at the site. Made of bone minerals, usually from a donor, the graft serves as a scaffold for new bone growth. By preventing significant bone loss we can better ensure success with a future restoration.
Because of its lifelikeness, functionality and durability, dental implants are considered the best of the restoration options that can be considered to replace a missing tooth. But placing an implant during the teen years is problematic because the jaws are still growing. If we place an implant prematurely it will appear to be out of alignment when the jaw fully matures. Better to wait until the jaw finishes development in early adulthood.
In the meantime, there are a couple of temporary options that work well for teens: a removable partial denture (RFP) or a fixed modified bridge. The latter is similar to bridges made for adults, but uses tabs of dental material that bond a prosthetic (false) tooth to the adjacent natural teeth to hold it in place. This alleviates the need to permanently alter the adjacent natural teeth and buy time so that the implant can be placed after growth and development has finished.
And no need to worry about postponing orthodontic treatment in the event of a tooth loss. In most cases we can go ahead with treatment, and may even be able to incorporate a prosthetic tooth into the braces or clear aligners.
It's always unfortunate to lose a tooth, especially from a sudden accident. The good news, though, is that with proper care and attention we can restore your teenager's smile.
If you would like more information on how to treat lost teeth in teenagers, 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 for Teenagers.”
Taking care of your child’s teeth is a high priority, not only for their health now but for the future too. And that means dealing with their teeth’s most common and formidable enemy, tooth decay.
Your focus, of course, should be on preventing decay through good oral hygiene practices, a healthy diet low in foods with added sugar and regular office visits for cleaning and checkups. But some children at higher risk or who’ve already encountered tooth decay may also need a little extra help in the form of dental sealants.
The most common use of sealants addresses a weakness in young teeth that disease-causing bacteria exploit. Deep grooves known as pits and fissures form within the biting surfaces of developing back teeth and in the rear of front teeth.Â It’s very difficult to reach these areas with daily brushing, so some plaque may be left behind (hence the importance of semi-annual office cleanings).
Inside the mouth, these pits and fissures are in a warm and moist environment and are a haven for bacteria that feed on plaque and produce high levels of acid as a by-product. The acid softens enamel to eventually create a hole, or a “cavity” in the tooth. Children’s young enamel is highly susceptible to this process — it hasn’t developed enough strength to resist the adverse effects of acid.
A “pit and fissure” sealant made of resin fills in the grooves in the teeth to inhibit the buildup of plaque — a kind of “mini” filling. It’s an added layer of protection that complements other prevention efforts. But applying them isn’t an automatic practice — we only recommend it for children at high risk, especially where decay is beginning or it appears the conditions are conducive for it. When needed, though, it can be quite effective in preventing decay or minimizing its effects.
The best way to know if your child could benefit from a sealant is to have them undergo a complete dental exam. From there we can advise you on whether a sealant application is an important investment in their current and future health.
If you would like more information on dental disease prevention for children, 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 “Sealants for Children.”
Mayim Bialik has spent a good part of her life in front of TV cameras: first as the child star of the hit comedy series Blossom, and more recently as Sheldon Cooper’s love interest — a nerdy neuroscientist — on The Big Bang Theory. (In between, she actually earned a PhD in neuroscience from UCLA…but that’s another story.) As a child, Bialik had a serious overbite — but with all her time on camera, braces were just not an option.
“I never had braces,” she recently told Dear Doctor – Dentistry & Oral Health magazine. “I was on TV at the time, and there weren’t a lot of creative solutions for kids who were on TV.” Instead, her orthodontist managed to straighten her teeth using retainers and headgear worn only at night.
Today, there are several virtually invisible options available to fix orthodontic issues — and you don’t have to be a child star to take advantage of them. In fact, both children and adults can benefit from these unobtrusive appliances.
Tooth colored braces are just like traditional metal braces, with one big difference: The brackets attached to teeth are made from a ceramic material that blends in with the natural color of teeth. All that’s visible is the thin archwire that runs horizontally across the teeth — and from a distance it’s hard to notice. Celebs like Tom Cruise and Faith Hill opted for this type of appliance.
Clear aligners are custom-made plastic trays that fit over the teeth. Each one, worn for about two weeks, moves the teeth just a bit; after several months, you’ll see a big change for the better in your smile. Best of all, clear aligners are virtually impossible to notice while you’re wearing them — which you’ll need to do for 22 hours each day. But you can remove them to eat, or for special occasions. Zac Efron and Katherine Heigl, among others, chose to wear clear aligners.
Lingual braces really are invisible. That’s because they go behind your teeth (on the tongue side), where they can’t be seen; otherwise they are similar to traditional metal braces. Lingual braces are placed on teeth differently, and wearing them often takes some getting used to at first. But those trade-offs are worth it for plenty of people. Which celebs wore lingual braces? Rumor has it that the list includes some top models, a well-known pop singer, and at least one British royal.
So what’s the best way to straighten your teeth and keep the orthodontic appliances unnoticeable? Just ask us! We’d be happy to help you choose the option that’s just right for you. You’ll get an individualized evaluation, a solution that fits your lifestyle — and a great-looking smile!
For more information about hard-to-see (or truly invisible) orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “Clear Aligners for Teenagers.”
Orthodontics shares a principle with the classic tug of war game: if you want things to move in the right direction you need a good anchor. Anchors help braces and other appliances apply constant pressure to misaligned teeth in the direction they need to go to correct a malocclusion (poor bite).
Orthodontic treatments work in cooperation with an existing oral mechanism that already moves teeth naturally in response to biting forces or other environmental factors. The key to this mechanism is an elastic tissue known as the periodontal ligament that lies between the tooth and the bone. Besides holding teeth in place through tiny attached fibers, the ligament also allows the teeth to move in tiny increments.
Braces’ wires laced through brackets affixed to the teeth exert pressure on them in the desired direction of movement –the periodontal ligament and other structures do the rest. To maintain that pressure we need to attach them to an “anchor”—in basic malocclusions that’s usually the back molar teeth.
But not all malocclusions are that simple. Some may require moving only certain teeth while not moving their neighbors. Younger patients’ jaws and facial structures still under development may also need to be considered during orthodontic treatment. That’s why orthodontists have other anchorage methods to address these possible complications.
One example of an alternate anchorage is a headgear appliance that actually uses the patient’s skull as the anchor. The headgear consists of a strap running around the back of the head and attached in front to orthodontic brackets (usually on molar teeth). The pressure it exerts can trigger tooth movement, but it can also help influence jaw development if an upper or lower jaw is growing too far forward or back.
Another useful anchorage method is a tiny metal screw called a temporary anchorage device (TAD) that is implanted into the jawbone above the teeth through the gums. Orthodontists then attach elastic bands between implanted TADs and specific braces’ brackets or wires to exert pressure on certain teeth but not others with pinpoint accuracy. After treatment the TADs can be easily removed.
Using these and other appliances allows orthodontists to customize treatment to an individual patient’s particular malocclusion. With the right anchor, even the most complex bite problem can be transformed into a beautiful and healthy smile.
If you would like more information on orthodontic treatment, 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 “Orthodontic Headgear & Other Anchorage Appliances.”