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.”
A third of people treated for cancer develop adverse side effects within their mouth. But while these effects can be devastating to teeth and gums, there are ways to minimize the damage.
Treatments like chemotherapy and radiation work by destroying cancer cells. Unfortunately, they may also destroy normal cells. The accumulation of this “collateral damage” ultimately affects uninvolved areas and organ systems of the body. Chemotherapy, for example, can interrupt bone marrow blood cell formation and decrease the body's ability to fight infection.
These ripple effects can eventually reach the mouth. It's not uncommon for cancer patients to develop mouth sores or see an increase in tooth decay or periodontal (gum) disease. The treatments may also inhibit saliva flow: because saliva neutralizes acid and provides other benefits that lower disease risk, dental disease is more likely to develop when the salivary flow is reduced.
The first step to minimizing these effects is to improve oral health before cancer treatment begins. An unhealthy mouth vastly increases the chances for problems during treatment. Cooperating with your cancer physicians, we should attempt to treat any diseases present as soon as possible.
During cancer treatment we should also monitor your oral health and intervene when appropriate. If at all possible, you should continue regular dental visits for cleaning and checkups, and more so if conditions warrant. We can also protect your teeth and gums with protective measures like antibacterial mouth rinses, saliva stimulation or high-potency fluoride applications for your enamel.
What's most important, though, is what you can do for yourself to care for your mouth during the treatment period. Be sure to brush daily with a soft-bristle brush and fluoride toothpaste. You can use a weak solution of one-quarter teaspoon each of salt and baking soda to a quart of warm water to rinse your mouth and soothe any sores. And be sure to drink plenty of water to reduce dry mouth.
While you're waging your battle against cancer, stay vigilant about your teeth and gums. Taking care of them will ensure that after you've won your war against this malignant foe your mouth will be healthy too.
If you would like more information on taking care of your teeth and gums during cancer 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 “Oral Health During Cancer Treatment.”
Losing a tooth from disease or accident can be traumatic. The good news, though, is that it can be replaced with a life-like replica that restores your smile. One of the most popular and durable solutions is a dental implant, which replaces not only the root of the tooth but the crown as well.
But there's a possible wrinkle with implants — for accurate placement there must be a sufficient amount of bone around it. This could be a problem if you've been missing the tooth for sometime: without the stimulus provided by a tooth as you chew, older bone cells aren't replaced at an adequate rate. The bone volume gradually diminishes, as up to 25% of its normal width can be lost during the first year after tooth loss. A traumatic injury can damage underlying bone to an even greater extent.
There is a possible solution, but it will require the services of other specialists, particularly a periodontist trained in gum and bone structure. The first step is a complete examination of the mouth to gauge the true extent of any bone loss. While x-rays play a crucial role, a CT scan in particular provides a three-dimensional view of the jaw and more detail on any bone loss.
With a more accurate bone loss picture, we can then set about actually creating new bone through grafting procedures. One such technique is called a ridge augmentation: after opening the gum tissues, we place the bone graft within a barrier membrane to protect it. Over time the bone will grow replacing both the grafting material and membrane structure.
Once we have enough regenerated bone, we can then perform dental implant surgery. There are two options: a “one-stage” procedure in which a temporary crown is placed on the implant immediately after surgery; or a “two-stage” in which we place the gum tissue over the implant to protect it as it heals and bone grows and attaches to it. In cases of pre-surgical bone grafting, it's usually best to go with the two-stage procedure for maximum protection while the bone strengthens around it.
Necessary preparation of the bone for a future dental implant takes time. But the extra effort will pay off with a new smile you'll be proud to display.
Sure, it’s big news when celebs tweet selfies from the dental office… if you’re still living in the 20th century. But in Hollywood today, it’s harder to say who hasn’t posted snaps of themselves in the dentist’s chair than who has. Yet the pictures recently uploaded to Twitter by Mark Salling, the actor and singer who regularly appears as Noah “Puck” Puckerman on the popular TV series Glee, made us sit up and take notice.
“Getting my chipped tooth fixed. Also, apparently, I’m a big grinder,” read the caption. The photo showed a set of upper front teeth with visible chips on the biting surface. What’s so special about this seemingly mundane tweet? It’s a great way of bringing attention to a relatively common, but often overlooked problem: teeth clenching and grinding, also called bruxism.
Although bruxism is a habit that affects scores of people, many don’t even realize they have it. That’s because the condition may only become active at night. When the teeth are unconsciously ground together, the forces they produce can wear down the enamel, cause chipping or damage to teeth or dental work (such as veneers or fillings), or even loosen a tooth! While it’s common in children under 11 years old, in adults it can be a cause for concern.
Sometimes, mouth pain, soreness and visible damage alert individuals to their grinding habits; other times, a dental professional will notice the evidence of bruxism during an exam or cleaning: tooth sensitivity and telltale wear and tear on the chewing surfaces. Either way, it’s time to act.
Bruxism is most often caused by stress, which can negatively impact the body in many ways. It may also result from bite problems, the overuse of stimulating substances (caffeine, alcohol, tobacco, and illegal drugs), and as a side effect of certain medications. Sometimes, simply becoming aware of the habit can help a person get it under control. Common methods of stress reduction include exercise, meditation, a warm bath or a quiet period before bedtime; these can be tried while we monitor the situation to see if the problem is going away.
If stress reduction alone doesn’t do the trick, several other methods can be effective. When bruxism is caused by a minor bite problem, we can sometimes do a minor “bite adjustment” in the office. This involves removing a tiny bit of enamel from an individual tooth that is out of position, bringing it in line with the others. If it’s a more serious malocclusion, orthodontic appliances or other procedures may be recommended.
When grinding is severe enough to damage teeth or dental work, we may also recommend a custom-made night guard (occlusal guard), which you put in your mouth at bedtime. Comfortable and secure, this appliance prevents your teeth from being damaged by contacting each other, and protects your jaw joints from stresses due to excessive grinding forces.
Whether or not you have to smile for a living, teeth grinding can be a big problem. If you would like more information about this condition, call our office to schedule a consultation for a consultation.
If you're ready to put the "pizzazz" back into your smile, your dentist may be able to help. It's possible your dull, dingy smile could be transformed with teeth whitening.
Teeth whitening or bleaching is a technique that applies a solution with a bleaching agent (usually up to 35% hydrogen peroxide in an office setting) to the teeth to whiten them. Although there are Do-It-Yourself home whitening kits you can use, there are a few good reasons why you should first consider a whitening procedure in a dental office setting.
To begin with, you should first have your teeth examined by a dentist to determine why they're discolored. Certain foods and beverages we consume or tobacco habits are the usual culprits causing stains on the enamel, the outermost tooth layer. These are the kinds of stains targeted by most whitening solutions.
But the interior of a tooth can also become discolored for reasons like trauma, past dental work or tetracycline use at an early age. If your staining is internal (intrinsic) rather than external (extrinsic) reducing that discoloration will require an invasive procedure only a dentist can perform—a home kit won't be able to do the job.
Another reason for having your teeth whitened by your dentist (even extrinsic staining) involves your time and the degree of brightness you'd like. Because dentists use stronger bleaching solutions (home kits usually use a weaker solution of 10% carbamide peroxide) it takes fewer sessions than home kits to achieve results—and they may last longer. In addition, dentists have more control over the level of brightness to match your expectations of a more subdued, natural look or a dazzling "Hollywood" smile.
A dentist can also help you navigate special circumstances like matching and managing natural teeth whiteness with dental restorations (which don't bleach) or special whitening situations like a single discolored tooth.
Even if you eventually decide to go the home kit route, consulting with a dentist first can still prove helpful. You'll get expert advice on products, tips on how to apply them and how to prolong the whitening effect. Whichever way you go, home kit or dentist, you can gain a brighter, more confident smile with teeth whitening.
If you would like more information on teeth whitening, 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 “Important Teeth Whitening Questions…Answered!”
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