By Dentistry For Children & Adults
April 19, 2018
Category: Dental Procedures
RemovingTeethCouldImprovetheOutcomeforaCrowdedBite

The primary goal of dental care is to preserve teeth. But there are circumstances in which removing a tooth, even a relatively healthy one, could prove best in the long run.

A malocclusion (poor bite) related to crowding might fit such a circumstance. Crowding occurs when the size of the jaw is too small for the teeth coming in. With not enough space, some teeth could erupt out of their proper positions. Removing certain teeth frees up space to eventually allow braces or other orthodontic devices to re-align the teeth.

The teeth most frequently removed are the first bicuspids, located between the cuspid (the "eyeteeth" directly under the eyes) and the back teeth, and the second premolar. Removing these won't normally affect appearance or functionality once orthodontic or cosmetic treatments are complete.

Because of the mechanics of jaw development it might be necessary to perform these extractions several years before orthodontic treatment. This could create another potential problem: the time lag could adversely affect bone health.

This is because bone, as living tissue, has a life cycle with cells forming, functioning and then dissolving, and new cells taking their place. When teeth are chewing or in contact with each other they generate force that travels through the tooth roots to the bone and stimulates cell growth at a healthy replacement rate.

But when a tooth is missing, so is this stimulation. This slows the replacement rate and eventually leads to decreased bone volume. Too much bone loss could create obstacles for orthodontic treatment or a future dental implant.

To avoid this, the dentist will often place a bone graft with processed bone mineral within the empty tooth socket right after extraction. The graft serves as a scaffold for bone cells to grow upon. The graft (plus any other added growth boosters) can help maintain a healthy level of bone volume to facilitate future orthodontic or restorative treatments.

Since targeted extraction for orthodontics is time-sensitive, you should have your child's bite evaluated by an orthodontist by age 7 to see if any action is necessary. The earlier a malocclusion is detected, the more likely a more attractive and healthy smile will be the ultimate outcome.

If you would like more information on correcting poor bites, 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.”

By Dentistry For Children & Adults
April 09, 2018
Category: Dental Procedures
3ThingsYouMightnotKnowAboutMovingTeeth

If you press your tongue against your teeth, unless something is badly wrong they won't budge. In fact, your teeth are subjected to a fair amount of pressure each day as you chew and eat, and yet they remain firmly in place.

But there's a deeper reality—your teeth do move! No, it's not a paradox—the gum and bone tissues that hold your teeth in place allow for slight, imperceptible changes in the teeth's position. Their natural ability to move is also the basis for orthodontics. Here are 3 more facts you may not know about your teeth's natural ability to move.

Teeth are always on the move. Teeth are held firmly within the jawbone by an elastic gum tissue called the periodontal ligament and a thin layer of bony-like material called cementum. In response to pressure changes, though, the bone dissolves on the side of the teeth in the direction of pressure and then rebuilds behind it, solidifying the teeth's new position, a process that happens quite slowly and incrementally. And it will happen for most of us—some studies indicate more than 70% of people will see significant changes in their bite as they age.

Orthodontics works with the process. Orthodontic appliances like braces or clear aligners apply targeted pressure in the direction the orthodontist intends the teeth to move—the natural movement process does the rest. In the case of braces, a thin metal wire is laced through brackets bonded to the front of the teeth and then anchored, typically to the back teeth. The orthodontist incrementally tightens the wire against its anchors over time, encouraging tooth movement in response to the pressure. Clear aligners are a series of removable trays worn in succession that gradually accomplish the same outcome.

Watch out for the rebound. That nice, straight smile you've gained through orthodontics might not stay that way. That's because the same mechanism for tooth movement could cause the teeth to move back to their former positions, especially right after treatment. To avoid this outcome, patients need to wear a retainer, an appliance that holds or "retains" the teeth in their new positions. Depending on their individual situations and age, patients may have to wear a retainer for a few months, years or from then on.

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 “The Importance of Orthodontic Retainers.”

By Dentistry For Children & Adults
April 01, 2018
Category: Dental Procedures
WemayNeedtoRemoveoneorMoreTeethBeforeApplyingBraces

“To gain something, sometimes you have to give up something else.”

No, that isn't the latest viral meme on the Internet. It's actually a practical consideration that could arise in orthodontics.

In this case, the “something” to gain is a straighter, more attractive smile; the “something” you may have to part with is a few teeth. This may be necessary if there are too many teeth on a dental arch for its capacity, a situation called crowding. A lack of space is the main reason teeth come in misaligned.

Before we can correct this, we'll need to free up space to allow for tooth movement by removing one or more of the existing teeth. The ideal candidates are those that are near to the teeth we wish to move but not highly visible. The first bicuspids are the most frequent choices for removal: they're located behind the cuspids or eyeteeth (the pointed teeth right under the eyes).

Ideally, we'll remove the target teeth some time before we apply braces to give the gums a chance to heal. At the same time we want to preserve the bone that once supported the teeth we've extracted. This is because when we chew the forces generated by the teeth stimulates bone replacement growth. When a tooth is no longer there the supporting bone doesn't receive this stimulation and may ultimately reduce in volume.

We may try to prevent this by placing a bone graft in the empty socket immediately after removing the tooth. The graft serves as a scaffold to encourage new bone to grow. Hopefully when we're ready to apply braces, the bone will be strong and healthy to handle the movement of the teeth.

As the teeth move under the influence of braces, they'll begin to fill up the space created by tooth removal. Once it's completed, the extracted teeth won't be missed — the other teeth now straightened will completely fill out the smile.

The different steps in this process must be carefully planned and executed precisely, and it will take months or even years to complete. In the end, though, this complicated bite problem can be corrected and replaced with an attractive, straight smile.

If you would like more information on correcting a poor bite, 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.”

By Dentistry For Children & Adults
March 17, 2018
Category: Oral Health
SteelyDanFoundersDeathHighlightsImportanceofEarlyCancerDetection

Fans of the legendary rock band Steely Dan received some sad news a few months ago: Co-founder Walter Becker died unexpectedly at the age of 67. The cause of his death was an aggressive form of esophageal cancer. This disease, which is related to oral cancer, may not get as much attention as some others. Yet Becker's name is the latest addition to the list of well-known people whose lives it has cut short—including actor Humphrey Bogart, writer Christopher Hitchens, and TV personality Richard Dawson.

As its name implies, esophageal cancer affects the esophagus: the long, hollow tube that joins the throat to the stomach. Solid and liquid foods taken into the mouth pass through this tube on their way through the digestive system. Worldwide, it is the sixth most common cause of cancer deaths.

Like oral cancer, esophageal cancer generally does not produce obvious symptoms in its early stages. As a result, by the time these diseases are discovered, both types of cancer are most often in their later stages, and often prove difficult to treat successfully. Another similarity is that dentists can play an important role in oral and esophageal cancer detection.

Many people see dentists more often than any other health care professionals—at recommended twice-yearly checkups, for example. During routine examinations, we check the mouth, tongue, neck and throat for possible signs of oral cancer. These may include lumps, swellings, discolorations, and other abnormalities—which, fortunately, are most often harmless. Other symptoms, including persistent coughing or hoarseness, difficulty swallowing, and unexplained weight loss, are common to both oral and esophageal cancer. Chest pain, worsening heartburn or indigestion and gastroesophageal reflux disease (GERD) can also alert us to the possibility of esophageal cancer.

Cancer may be a scary subject—but early detection and treatment can offer many people the best possible outcome.┬áIf you have questions about oral or esophageal cancer, call our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Oral Cancer.”

By Dentistry For Children & Adults
March 02, 2018
Category: Oral Health
KeepanEyeonYourTeethandGumHealthDuringCancerTreatment

If you’re facing cancer treatment, we wish you the best outcome possible. Treating this disease has advanced tremendously in recent decades, but the available options are still often challenging to endure. It will be your primary focus for the foreseeable future.

As a dental provider we also want you to be aware how the two main treatments, chemotherapy and radiation, could adversely affect your teeth and gums, especially if you’re receiving radiation therapy near the head and neck. The aim of cancer treatment is to attack and destroy cancer cells to prevent their growth. Unfortunately, it can also destroy neighboring healthy cells and lead to harmful consequences in different parts of the body, including the mouth.

Salivary glands, for example, are especially vulnerable to damage during cancer treatment. This could create a situation where the mouth no longer produces adequate saliva flow, leading to a condition called xerostomia or dry mouth. Besides a lot of discomfort, restricted saliva flow can also increase your risk of tooth decay and other dental diseases. This is because saliva is the body’s acid neutralizer (acid can erode tooth enamel) and its first line of defense against microbial infection.

To guard against this, it’s important to support salivary flow as much as possible if you experience dry mouth symptoms during treatment (as well as beyond—it’s possible the damage to these glands could be permanent). Since some medications also contribute to dry mouth, you should speak with your physician about the prescriptions you’re taking: if any have dry mouth side effects ask if there’s an alternative drug without these side effects. You should also drink more water during the day and especially when taking medications. And consider substances like xylitol gum that can help boost saliva flow.

Unfortunately, it may not be possible to fully avoid the effects of these treatments on your teeth and gums. So, be sure you keep up daily brushing and flossing and see your dentist regularly for cleanings and checkups. If necessary, there are a number of restoration options to restore your smile after you’ve completed your treatment.

If you would like more information on dental care during cancer treatment, please contact us or schedule an appointment for a consultation.





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