Posts for tag: orthodontic treatment
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.”
It’s a common sight to see someone wearing braces—and not just teens or pre-teens. In the last few decades, people in their adult years (even late in life) are transforming their smiles through orthodontics.
If you’re an adult considering treatment to straighten your teeth, this particular dental specialty might be an unfamiliar world to you. Here are 3 things you may not know about orthodontics.
Orthodontic treatment cooperates with nature. There would be no orthodontics if teeth couldn’t move naturally. Teeth are actually held in place by an elastic tissue called the periodontal ligament that lies between the teeth and bone. Small fibers from the ligament tightly attach to the teeth on one side and to the bone on the other. Although it feels like the teeth are rigidly in place, the ligament allows for micro-movements in response to changes in the mouth. One such change is the force applied by orthodontic appliances like braces, which causes the bone to remodel in the direction of the desired position.
Treatment achieves more than an attractive smile. While turning your misaligned teeth into a beautiful, confident smile is an obvious benefit, it isn’t the only one. Teeth in proper positions function better during chewing and eating, which can impact digestion and other aspects of health. Misaligned teeth are also more difficult to keep clean of bacterial plaque, so straightening them could help reduce your risk of tooth decay or periodontal (gum) disease.
Possible complications can be overcome. Some problems can develop while wearing braces. Too much applied force could lead to the roots dissolving (root resorption), which could make a tooth shorter and endanger its viability. Braces can also contribute to a loss of calcium in small areas of tooth enamel, which can make the teeth more vulnerable to oral acid attack. However, both these scenarios can be anticipated: the orthodontist will watch for and monitor signs of root resorption and adjust the tension on the braces accordingly; and diligent oral hygiene plus regular dental cleanings will help prevent damage to the tooth enamel.
If you’re dreaming of a straighter and healthier smile, see us for a full examination. We’ll then be able to discuss with you your options for transforming your smile and your life.
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 article “Moving Teeth with Orthodontics.”
While crooked teeth are usually responsible for a malocclusion (poor bite), the root cause could go deeper: a malformed maxilla, a composite structure composed of the upper jaw and palate. If that’s the case, it will take more than braces to correct the bite.
The maxilla actually begins as two bones that fit together along a center line in the roof of the mouth called the midline suture, running back to front in the mouth. The suture remains open in young children to allow for jaw growth, but eventually fuses during adolescence.
Problems arise, though, when these bones don’t fully develop. This can cause the jaw to become too narrow and lead to crowding among the erupting teeth and a compromised airway that can lead to obstructive sleep apnea. This can create a cross-bite where the upper back teeth bite inside their lower counterparts, the opposite of normal.
We can remedy this by stimulating more bone growth along the midline suture before it fuses, resulting in a wider maxilla. We do this by installing a palatal expander, an appliance that incrementally widens the suture to encourage bone formation in the gap, which over time will widen the jaw.
An expander is a metal device with “legs” extending out on both sides and whose ends fit along the inside of the teeth. A gear mechanism in the center extends the legs to push against the teeth on both sides of the jaw. Each day the patient or caregiver uses a key to give the gear a quarter turn to extend the legs a little more and widen the suture gap. We remove the expander once the jaw widens to the appropriate distance.
A palatal expander is an effective, cost-efficient way to improve a bite caused by a narrow jaw, but only if attempted before the bones fuse. Widening the jaw after fusion requires surgery to separate the bones — a much more involved and expensive process.
To make sure your child is on the right track with their bite be sure to see an orthodontist for an evaluation around age 6. Doing so will make it easier to intervene at the proper time with treatments like a palatal expander, and perhaps correct bite problems before they become more expensive to treat.
If you would like more information on treating malocclusions, 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 “Palatal Expanders: Orthodontics is more than just Moving Teeth.”
Many otherwise attractive smiles have one noticeable blemish — a large gap between the two upper front teeth. If you have such a gap, there’s a solution that could transform your smile.
The most likely reason for the gap is an issue with a bit of muscle tissue between the gums and upper lip known as the frenum, part of the face’s muscular system. The frenum, though, can overdevelop and grow between the two front teeth into the front part of the palate (roof of the mouth). This can keep or push the teeth apart to form a gap.
To correct the issue, it’s first necessary to consult with an orthodontist, a specialist in bites and tooth alignment. It’s possible for there to be other factors contributing to the spacing including tongue thrusting or finger sucking habits, or missing or misaligned teeth. If the examination reveals an overly large frenum, then the treatment usually commences in two stages.
First, we would need to close the gap by the moving the teeth toward each other with some form of orthodontic appliance like braces or clear aligners. Once closed, the next stage would be to surgically remove the excess frenum tissue and cosmetically alter the gums if necessary.
The order of treatment is important — if you remove the frenum tissue first, any resulting scar tissue could prevent closing the gap with orthodontics. Further, cosmetic surgery on the gums beforehand could result in the loss of the papillae, the small triangular gum tissue between teeth, which results in an unattractive “black” hole.
A frenectomy, the procedure to remove the excess frenum, is a relatively minor procedure that can be performed by a periodontist (gum specialist), oral surgeon, or a general dentist with surgical training. The area is numbed with a local anesthetic, the tissue dissected with a small scalpel, and the resulting small wound closed with a few stitches (another option is to use a surgical laser to remove the frenum). Healing should be complete in about a week with only minor discomfort.
Depending on your individual circumstance, full treatment can take time. But in the end these otherwise routine dental procedures can have a huge impact — a more attractive smile without the noticeable gap.
If you would like more information on treating abnormal teeth spacing, 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 “Space between Front Teeth.”
Think you’re too old to have your teeth straightened? In reality, healthy teeth can be moved at any age to better positions. For the many adults who have some form of malocclusion (bad bite), orthodontics is still a viable option even in later years.
As important as it is to self-image and confidence, treating misaligned teeth can benefit you more than just improving your smile. Misaligned teeth may be harder to keep clean, setting up a mouth environment advantageous to the development of tooth decay or periodontal (gum) disease, the risks of both rising with age. And normally aligned teeth are easier to chew with than those misaligned.
Age isn’t the determining factor for whether you’re a good candidate for orthodontics — but your dental health is. Gum disease in particular can cause supporting bone loss, which can complicate orthodontic treatment. It’s important then that we first perform a complete oral examination and attempt to treat problems such as decay or gum disease first before attempting tooth movement.
What type of orthodontic treatment you’ll need will depend on the type of malocclusion you have and its relationship to the way your jaws fit together. Because your adult jaws have fully developed you may need orthognathic (“jaw straightening”) surgery to address certain advanced forms of malocclusion. If your bite problems aren’t that severe (the majority of situations) they can be treated with braces or, an increasingly popular alternative, clear aligners. These customized clear plastic trays are nearly invisible compared to metal braces and are effective for most patients.
Following the completion of tooth movement and other bite procedures, you will most likely need to wear a retainer to help prevent the teeth from reverting to their older positions. You may need to wear the retainer for a longer period than a younger patient, or perhaps indefinitely. Even with this mild inconvenience, though, you’ll still experience the positive effects of healthier and better functioning teeth and a great new 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 “Orthodontics for the Older Adult.”