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Posts for category: Dental Procedures

By Natasha Lee DMD
May 07, 2021
Category: Dental Procedures
Tags: aging  
KnowingHowtheMouthandFaceGrowCanImproveBiteTreatment

Correcting a bite problem involves more than applying braces. Orthodontists must consider a wide range of factors, including the type of bite problem involved, complications like impacted or missing teeth, and their patient's overall dental condition.

Orthodontists must also keep in mind the future—how will a treatment implemented now impact a patient's appearance and dental function many years from now? In reality, orthodontists perform these treatments within a dynamic growth environment, especially involving children and teenagers whose mouth and facial structures are still maturing.

And although these growth changes slow in adulthood, they don't stop—orofacial structures continue to change throughout life. For example, a person's lips steadily thicken in size until the mid-teen years, and then slowly thin out over the rest of their lifetime. The distance between the lips both at rest and while smiling may also narrow in later years. Other changes continue to occur in the bones and soft tissues of the mouth and face.

Fortunately, this structural growth follows a fairly consistent track. Although variations do occur, an orthodontist can project the growth changes their patients will undergo as they age, and use that knowledge to plan out bite treatment. With this understanding, orthodontists plan not only what treatments will be needed, but when to perform them, and to what extent.

This may involve a number of treatment stages, spaced out to coincide with regular development. An orthodontist may focus first on general bite correction to bring the teeth and jaws into a reasonable state of alignment. Later, they'll use more refined methods to fine-tune corrections that better align with later adult growth.

More intensive treatments may be necessary to build a foundation for future treatment. For example, orthognathic surgery may be needed to correct a severe case of an over-extended lower jaw. During the procedure, surgeons move the lower jaw to a joint position higher on the skull. This retracts the lower jaw into a more normal alignment with the upper jaw, and can dramatically change the facial profile for the better.

Each orthodontic patient is different, and each requires their own a unique treatment plan. That plan has a greater chance of long-term success by applying knowledge of future growth changes.

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 “Understanding Aging Makes Beauty Timeless.”

By Natasha Lee DMD
April 27, 2021
Category: Dental Procedures
WeMayBeAbleToTreatSomeBiteProblemsEarly

In any given year, 4 million tweens and teens are in the process of having their teeth straightened with braces or clear aligners. It's so common we tend to consider orthodontic treatment for young people as a rite of passage into adulthood.

But it doesn't necessarily have to be that way—it might be possible to stop or at least minimize a poor bite before it fully develops. That's the goal of interceptive orthodontics—treatments that head off or “intercept” a bite problem early.

The goal isn't necessarily to reposition misaligned teeth, but to correct a problem that can lead to misalignment. Here are some examples.

A narrow jaw. A narrowly developing jaw can crowd incoming teeth out of their normal positions. For the upper jaw, though, we can take advantage of a temporary separation in the bones in the roof of the mouth (palate) with a device called a palatal expander. Placed against the palate, the expander exerts outward pressure on the teeth and jaw to widen this separation. The body fills in the gap with bone to gradually widen the jaw.

Abnormal jaw alignment. It's possible for a jaw to develop abnormally during childhood so that it extends too far beyond the other. Using a hinged device called a Herbst appliance, it's possible to interrupt this abnormal growth pattern and influence the bones and muscles of the jaw to grow in a different way.

Missing primary teeth. An important role for a primary (baby) tooth is to hold a place for the future permanent tooth. But if the primary tooth is lost too soon, other teeth can drift into the space and crowd out the intended permanent tooth. To prevent this, we can insert a space maintainer: This simple looped metal device prevents teeth from drifting and preserves the space for the permanent tooth.

Although these and other interceptive treatments are effective, some like the palatal expander do their best work within a limited age frame. To take advantage of interceptive orthodontics in a timely manner, parents should seek a bite evaluation for their child from an orthodontist around age 6. The earlier we detect a growing bite problem, the greater your chances for successful intervention.

If you would like more information on treating emerging bite problems early, 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 “Interceptive Orthodontics.”

TakeItFromTaylorSwift-LosingYourOrthodonticRetainerisNoFun

For nearly two decades, singer-songwriter Taylor Swift has dominated the pop and country charts. In December she launched her ninth studio album, called evermore, and in January she delighted fans by releasing two bonus tracks. And although her immense fame earns her plenty of celebrity gossip coverage, she's managed to avoid scandals that plague other superstars. She did, however, run into a bit of trouble a few years ago—and there's video to prove it. It seems Taylor once had a bad habit of losing her orthodontic retainer on the road.

She's not alone! Anyone who's had to wear a retainer knows how easy it is to misplace one. No, you won't need rehab—although you might get a mild scolding from your dentist like Taylor did in her tongue-in-cheek YouTube video. You do, though, face a bigger problem if you don't replace it: Not wearing a retainer could undo all the time and effort it took to acquire that straight, beautiful smile. That's because the same natural mechanism that makes moving teeth orthodontically possible can also work in reverse once the braces or clear aligners are removed and no longer exerting pressure on the teeth. Without that pressure, the ligaments that hold your teeth in place can “remember” where the teeth were originally and gradually move them back.

A retainer prevents this by applying just enough pressure to keep or “retain” the teeth in their new position. And it's really not the end of the world if you lose or break your retainer. You can have it replaced with a new one, but that's an unwelcome, added expense.

You do have another option other than the removable (and easily misplaced) kind: a bonded retainer, a thin wire bonded to the back of the teeth. You can't lose it because it's always with you—fixed in place until the orthodontist removes it. And because it's hidden behind the teeth, no one but you and your orthodontist need to know you're wearing it—something you can't always say about a removable one.

Bonded retainers do have a few disadvantages. The wire can feel odd to your tongue and may take a little time to get used to it. It can make flossing difficult, which can increase the risk of dental disease. However, interdental floss picks can help here. ¬†And although you can't lose it, a bonded retainer can break if it encounters too much biting force—although that's rare.

Your choice of bonded or removable retainer depends mainly on your individual situation and what your orthodontist recommends. But, if losing a retainer is a concern, a bonded retainer may be the way to go. And take if from Taylor: It's better to keep your retainer than to lose it.

If you would like more information about protecting your smile after orthodontics, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Importance of Orthodontic Retainers.”

DentalImplantsAreEvenMoreAdvancedThanksToTheseOtherTechnologies

When dental implants hit the scene in the 1980s, they revolutionized the field of dental restorations. But as groundbreaking as they were then, they're even more advanced now.

Some of the advancements have to do with improvements in implant design and manufacturing. Implant sizes and shapes were once quite limited, but today they come in a variety of forms to better match the types of teeth they replace.

But there has also been important progress in complementary technologies that help us realize better outcomes. Many of these other advances have had a positive impact on the planning and surgical stages of implant installation.

CT/CBCT scanning. For the best outcome, it's critical to install an implant at the most appropriate location on the jaw. This can be difficult to determine, however, because of the location of oral and facial structures like nerves or sinuses that might interfere with implant placement. But using a type of computer tomography (CT) scanning called cone beam CT, we can produce a 3-D computer graphic image that helps us navigate possible obstructions as we pinpoint the ideal location for an implant.

Digital smile displays. We're now able to produce digital models of the mouth, which can assist with more than implant placement—we can also use them to visualize what a new smile with implants will look like before we install them. This is especially helpful in situations where only a few teeth need to be replaced: We want to ensure that the new implant crowns blend seamlessly with the remaining teeth for the most natural appearance.

Custom-made surgical guides. We've been using surgical guides to mark the exact drilling locations during implant surgery for many years. But 3-D printing technology can now help us produce surgical guides that are even more useful and precise. Using a 3-D printer, we can produce oral devices based on the patient's individual dental dimensions captured through digital scanning. That produces a better fit for the guide on the teeth and more accurate implant placement.

Together, these and other technological advances are helping us achieve even more successful results. Not only can they help us produce implant outcomes that can last for years or even decades, but also the most beautiful smiles possible.

If you would like more information on dental implant restorations, 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 “How Technology Aids Dental Implant Therapy.”

TopicalFluorideCouldBoostYourChildsAvoidanceofToothDecay

Tooth decay is perhaps the biggest danger your child's teeth can face. Not only can it rob them of primary teeth now, but the loss of teeth at this early age could also lead to future bite problems.

That's why it's important to reduce the risk of tooth decay through daily brushing and flossing and regular dental cleanings. You child may also benefit from another measure that enhances those other hygiene efforts—topical fluoride applied directly to tooth surfaces.

Fluoride is a naturally occurring chemical that's been demonstrated to strengthen tooth enamel against contact with acid, the main cause of tooth decay. Today, fluoride is added not only to toothpastes and other dental hygiene products, but also in minute amounts to drinking water supplies across the country.

Even if your child takes in fluoride through one or more of these sources, there may still be a benefit to a topical application. For one, topical applications are usually stronger than fluoride toothpaste or fluoridated water supplies and can have greater effect. And because fluoridated water is ingested first before traveling through the bloodstream to the teeth, directly applied fluoride can strengthen them much faster.

But are these stronger concentrations of topical fluoride safe? Studies have shown no long-term health risk, but there can be temporary side effects like stomach pain, vomiting or headaches if the patient accidently swallows too much of the solution during the application. These side effects, however, can be minimized through safety measures dentists put in place during the procedure.

One study by the Cochrane Oral Health Research Group seems to show that the long-term benefit of topical fluoride is well worth this minor risk of side effects. After reviewing several scientific studies involving thousands of patients, the group found an overall 28% reduction in decayed, filled or missing teeth over a number of years among those who received a topical fluoride treatment.

Because of these and other forms of evidence, fluoride applications in either gel, foam or varnish forms have become a routine part of preventive care for children. Discussing it with your dentist, you may find it could be an extra weapon for your child in fighting tooth decay.

If you would like more information on how to protect your child's teeth from decay, 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.”