Approximately 4 million tweens and teens are currently undergoing orthodontic treatment for a poor bite (malocclusion) that can cost their families thousands of dollars in braces or clear aligners. But treatment doesn't always have to follow this track: Found early, many malocclusions can be corrected or minimized before they fully develop.
Known as interceptive orthodontics, this particular approach to bite correction often begins as early as 6-10 years of age. Rather than move existing teeth, interceptive orthodontics focuses instead on redirecting jaw growth and intervening in other situations that can cause malocclusions.
For example, a child's upper jaw may not be growing wide enough to accommodate all incoming permanent teeth, crowding later arrivals out of their proper positions. But taking advantage of a gap during early childhood that runs through the center of the palate (roof of the mouth), orthodontists can increase jaw width with a device called a palatal expander.
The expander fits up against the palate with “legs” that extend and make contact with the inside of the teeth. With gradually applied pressure, the expander widens the central gap and the body naturally fills it with new bone cells. The bone accumulation causes the jaws to widen and create more room for incoming teeth.
Another way a malocclusion can develop involves the primary or “baby” teeth. As one of their purposes, primary teeth serve as placeholders for the future permanent teeth forming in the gums. But if they're lost prematurely, adjacent teeth can drift into the vacant space and crowd out incoming teeth.
Dentists prevent this with a space maintainer, a thin metal loop attached to the adjoining teeth that puts pressure on them to prevent them from entering the space. This spacer is removed when the permanent tooth is ready to erupt.
These and other interceptive methods are often effective in minimizing the formation of malocclusions. But it's often best to use them early: Palatal expansion, for example, is best undertaken before the central gap fuses in early puberty, and space maintainers before the permanent tooth erupts.
That's why we recommend that children undergo an orthodontic evaluation around age 6 to assess their early bite development. If a malocclusion looks likely, early intervention could prevent it and reduce future treatment costs.
If you would like more information on interceptive orthodontics, 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.”
Basketball isn't a contact sport—right? Maybe once upon a time that was true… but today, not so much. Just ask New York Knicks point guard Dennis Smith Jr. While scrambling for a loose ball in a recent game, Smith's mouth took a hit from an opposing player's elbow—and he came up missing a big part of his front tooth. It's a type of injury that has become common in this fast-paced game.
Research shows that when it comes to dental damage, basketball is a leader in the field. In fact, one study published in the Journal of the American Dental Association (JADA) found that intercollegiate athletes who play basketball suffered a rate of dental injuries several times higher than those who played baseball, volleyball or track—even football!
Part of the problem is the nature of the game: With ten fast-moving players competing for space on a small court, collisions are bound to occur. Yet football requires even closer and more aggressive contact. Why don't football players suffer as many orofacial (mouth and face) injuries?
The answer is protective gear. While football players are generally required to wear helmets and mouth guards, hoopsters are not. And, with a few notable exceptions (like Golden State Warriors player Stephen Curry), most don't—which is an unfortunate choice.
Yes, modern dentistry offers many different options for a great-looking, long lasting tooth restoration or replacement. Based on each individual's situation, it's certainly possible to restore a damaged tooth via cosmetic bonding, veneers, bridgework, crowns, or dental implants. But depending on what's needed, these treatments may involve considerable time and expense. It's better to prevent dental injuries before they happen—and the best way to do that is with a custom-made mouthguard.
Here at the dental office we can provide a high-quality mouthguard that's fabricated from an exact model of your mouth, so it fits perfectly. Custom-made mouthguards offer effective protection against injury and are the most comfortable to wear; that's vital, because if you don't wear a mouthguard, it's not helping. Those "off-the-rack" or "boil-and-bite" mouthguards just can't offer the same level of comfort and protection as one that's designed and made just for you.
Do mouthguards really work? The same JADA study mentioned above found that when basketball players were required to wear mouthguards, the injury rate was cut by more than half! So if you (or your children) love to play basketball—or baseball—or any sport where there's a danger of orofacial injury—a custom-made mouthguard is a good investment in your smile's future.
If you would like more information about custom-made athletic mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”
Dental implants aren't simply prosthetic teeth, but rather an innovative system that restores both smile appearance and dental function. And while an implant can indeed replace a single tooth, they can do so much more. Integrated with removable dentures or a fixed bridge, they provide a secure solution to multiple missing teeth.
Implants essentially replace a missing tooth's root, the basis for their lifelikeness and functionality. As such, they're also the most sophisticated restoration used today, requiring a high degree of technical and aesthetic skill to place them properly. In reality, implantation is more a process than a procedure.
If you're considering implants, that process begins with a comprehensive dental exam. During the exam, we'll assess the exact condition of your oral and facial structures like the length of remaining teeth, your bite and jaw dimensions. We'll use this information to plan the type and placement of your implants. The exam may also reveal problems like bone loss that might postpone your implants or suggest another form of restoration.
Using digital technology, we then locate the exact positions for your implants on the jaw to ensure the best outcome. This often results in the creation of a surgical guide, a plastic template placed over the jaw that accurately pinpoints the locations for the drilling sequence during implant surgery.
In most cases once the implants are surgically installed, gum tissue may be sutured over the implant to protect it while it integrates with the bone. In some cases, though, a visible crown may be placed immediately, so the patient can enjoy a tooth-filled smile the same day. This immediate crown, though, is temporary and will be replaced with a more durable, permanent one in a few months.
During this interim, the titanium in the implant post will attract bone cell growth, which will build up on the implant surface. This increased bone contact will help secure the implant fully in the jaw, giving the implant its signature durability.
Once the integration is complete, the permanent crown is affixed to the implant (or implants in the case of a fixed or removable dental appliance). It may have been a long road, but you'll have the closest thing to real teeth.
If you would like more information on 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 “New Teeth in One Day.”
If you've been dealing with a tooth that needs to be removed—or it's already missing—you may be looking to replace it with a dental implant. And it's a great choice: No other restoration can provide the appearance and function of a real tooth like an implant.
You and your smile are ready for it. The question is, though, are your gums and underlying bone ready? These dental structures play a critical role in an implant's stability and eventual appearance. A problem with them may make placing an implant difficult if not impossible.
An implant requires around 2.0 millimeters of bone thickness surrounding the implant surface for adequate support and to minimize the chances of gum recession. But tooth loss often leads to bone loss that can drop its thickness below this threshold. This can make placing an implant problematic.
Fortunately, though, we may be able to address the lack of sufficient bone through bone grafting. By placing grafting material within the empty socket, we create a scaffold for new bone cells to grow upon. Over time this subsequent growth may be enough to maintain an adequate thickness of bone for an implant to be placed.
The gums may also pose a problem if they've shrunk back or receded from their normal positions, as often happens because of gum disease (which may also have precipitated the tooth loss). Again, grafting procedures can help ensure there's adequate gum coverage for the implant. And healthier gums may also help protect the underlying bone from loss.
There are several techniques for placing gum tissue grafts, depending on how much recession has taken place. One procedure in particular is often used in conjunction with implant placement. A small layer of synthetic collagen material or gum tissue referred to as pa dermal apron is included with the implant when its placed. Settling into the bone socket, this apron helps thicken the gum tissues, as well as preserve the underlying bone.
During your preliminary exams, we'll assess your bone and gum health to determine if we should take any steps like these to improve them. It may add some time to the implant process, but the end result will be well worth it.
If you would like more information on dental implants, 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 “Immediate Dental Implants.”
National Physical Fitness & Sports Month in May, sponsored by the President's Council on Sports, Fitness & Nutrition, is a fitting time to encourage us to play sports. Many of us already feel the Spring itch to get out there and get involved. Unfortunately, an increase in sports or exercise activities also means an increase in potential physical injury risks, including to the face and mouth.
Although COVID-19 protective measures are delaying group sports, there's hope that many leagues will be able to salvage at least part of their season. If so, you should know what to do to keep yourself or a family member safe from oral and dental injuries.
First and foremost, wear a sports mouthguard, a plastic device worn in the mouth to reduce hard impacts from other players or sports equipment. A custom-fitted guard made by a dentist offers the best level of protection and the most comfortable fit.
But even though wearing a mouthguard significantly lowers the chances of mouth injuries, they can still occur. It's a good idea, then, to know what to do in the event of an oral injury.
Soft tissues. If the lips, cheeks, gums or tongue are cut or bruised, first carefully clean the wound of dirt or debris (be sure to check debris for any tooth pieces). If the wound bleeds, place some clean cotton gauze against it until it stops. If the wound is deep, the person may need stitches and possible antibiotic treatments or a tetanus shot. When in doubt, visit the ER.
Jaws. A hard blow could move the lower jaw out of its socket, or even fracture either jaw. Either type of injury, often accompanied by pain, swelling or deformity, requires medical attention. Treating a dislocation is usually a relatively simple procedure performed by a doctor, but fractures often involve a more extensive, long-term treatment.
Teeth. If a tooth is injured, try to collect and clean off any tooth pieces you can find, and call us immediately. If a tooth is knocked out, pick it up by the crown end, clean it off, and place it back into the empty socket. Have the person gently but firmly clench down on it and call the office or go to the ER as quickly as possible. Prompt attention is also needed for teeth moved out of alignment by a hard blow.
Playing sports has obvious physical, mental and social benefits. Don't let an oral injury rob you or a family member of those benefits. Take precautions and know what to do during a dental emergency.
If you would like more information about, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “An Introduction to Sports Injuries & Dentistry” and “Dental Injuries: Field-Side Pocket Guide.”
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