Posts for category: Dental Procedures
QB sensation Johnny Manziel has had a varied career in professional football. After playing two seasons for the NFL Cleveland Browns, he quarterbacked for a number of teams in the Canadian Football League. More recently, he joined the Zappers in the new Fan Controlled Football league (FCF). But then with only a few games under his belt, he was waylaid by an emergency dental situation.
It's unclear what the situation was, but it was serious enough to involve oral surgery. As a result, he was forced to miss the Zappers' final regular-season game. His experience is a reminder that some dental problems can't wait—you have to attend to them immediately or risk severe long-term consequences.
Manziel's recent dental problem also highlights a very important specialty of dentistry—oral surgery. Oral surgeons are uniquely trained and qualified to treat and correct a number of oral problems.
Tooth extraction. Although some teeth can be removed by a general dentist, some have complications like multiple roots or impaction that make regular extractions problematic. An oral surgeon may be needed to surgically remove these kinds of problem teeth.
Disease. Oral surgeons often intervene with diseases attacking areas involving the jaws or face. This includes serious infections that could become life-threatening if they're not promptly treated by surgical means.
Bite improvement. Some poor bites (malocclusions) arise from a mismatch in the sizes of the jaws. An oral surgeon may be able to correct this through orthognathic surgery to reposition the jaw to the skull. This may compensate for the difference in jaw sizes and reduce the bite problem.
Implants. Dental implants are one of the best ways to replace teeth, either as a standalone tooth or as support for a fixed dental bridge or a removable denture. In some cases, it may be better for an oral surgeon to place the implants into a patient's jawbone.
Reconstruction. Injuries or birth defects like a cleft lip or palate can alter the appearance and function of the face, jaws or mouth. An oral surgeon may be able to perform procedures that repair the damage and correct oral or facial deformities.
Sleep apnea. Obstructive sleep apnea is usually caused by the tongue relaxing against the back of the throat during sleep and blocking the airway. But other anatomical structures like tonsils or adenoids can do the same thing. An oral surgeon could address this situation by surgically altering obstructing tissues.
It's likely most of your dental care won't require the services of an oral surgeon. But when you do need surgical treatment, like Johnny Manziel, these dental specialists can make a big difference in your oral health.
If you would like more information about oral surgery, please contact us or schedule a consultation.
At what age should you begin treating a poor bite? Many might say with braces around late childhood or early adolescence. But some bite problems could be addressed earlier—with the possibility of avoiding future orthodontic treatment.
A crossbite is a good example. In a normal bite, all of the upper teeth slightly cover the lower when the jaws are shut. But a crossbite occurs when some of the lower teeth, particularly in back, overlap the upper teeth. This situation often happens when the upper jaw develops too narrowly.
But one feature of a child's mouth structure provides an opportunity to intervene and alter jaw development. During a child's early years, the palate (roof of the mouth) consists of two bones next to each other with an open seam running between them. This seam, which runs through the center of the mouth from front to back, will fuse during puberty to form one continuous palatal bone.
An orthodontist can take advantage of this separation if the jaw isn't growing wide enough with a unique device called a palatal expander. This particular oral appliance consists of four, thin metal legs connected to a central mechanism. The orthodontist places the expander against the palate and then uses the mechanism to extend the legs firmly against the back of the teeth on both sides of the jaw.
The outward pressure exerted by the legs also widens the seam between the two palatal bones. The body will respond to this by adding new bone to the existing palatal bones to fill in the widened gap. At regular intervals, the patient or a caregiver will operate the mechanism with a key that will continue to widen the gap between the bones, causing more expansion of the palatal bones until the jaw has grown to a normal width.
The palatal expander is most effective when it's applied early enough to develop more bone before the seam closes. That's why it's important for children to undergo bite evaluation with an orthodontist around age 6. If it appears a bite problem is developing, early interventions like a palatal expander could slow or stop it before it gets worse.
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 “Palatal Expanders.”
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.”
Losing teeth can make it more difficult to eat, not to mention the effect it can have on your smile. But that could be just the beginning of your problems. Missing teeth can contribute to extensive bone loss within your jaws and face. Here's why.
Bone is like any other living tissue—cells develop, function and eventually die, and new cells take their place. Forces generated during chewing stimulate this new growth, helping the jawbone maintain its normal volume and density.
But you lose this stimulus when you lose teeth. This can cause a slowdown in bone cell regrowth that can eventually diminish bone volume. And it can happen relatively quickly: you could lose a quarter or more of jawbone width around a missing tooth within a year.
As this loss continues, especially in cases of multiple missing teeth, the bone can eventually erode to its base level. This loss of dental function can make chewing more difficult, place more pressure on the remaining teeth and adversely affect facial appearance. It could also prevent an implant restoration to replace missing teeth.
Dentures and other forms of dental restoration can replace missing teeth, but not the chewing stimulus. Dentures in particular will accelerate bone loss, because they can irritate the bony gum ridges they rest upon.
Dental implants, on the other hand, can slow or even stop bone loss. Implants consist of a metal post, typically made of titanium, imbedded into the jawbone at the site of the missing tooth with a life-like crown attached. Titanium also has a strong affinity with bone so that bone cells naturally grow and adhere to the implant's surface. This can produce enough growth to slow, stop or even reverse bone loss.
This effect may also work when implants are combined with other restorations, including dentures. These enhanced dentures no longer rest on the gums, but connect to implants. This adds support and takes the pressure off of the bony ridge, as well as contributes to better bone health.
If you've lost a tooth, it's important to either replace it promptly or have a bone graft installed to help forestall any bone loss in the interim. And when it's time to replace those missing teeth, dental implants could provide you not only a life-like solution, but a way to protect your bone health.
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 “The Hidden Consequences of Losing Teeth.”
During election season, you'll often hear celebrities encouraging you to vote. But this year, Kaia Gerber, an up-and-coming model following the career path of her mother Cindy Crawford, made a unique election appeal—while getting her wisdom teeth removed.
With ice packs secured to her jaw, Gerber posted a selfie to social media right after her surgery. The caption read, “We don't need wisdom teeth to vote wisely.”
That's great advice—electing our leaders is one of the most important choices we make as a society. But Gerber's post also highlights another decision that bears careful consideration, whether or not to have your wisdom teeth removed.
Found in the very back of the mouth, wisdom teeth (or “third molars”) are usually the last of the permanent teeth to erupt between ages 17 and 25. But although their name may be a salute to coming of age, in reality wisdom teeth can be a pain. Because they're usually last to the party, they're often erupting in a jaw already crowded with teeth. Such a situation can be a recipe for numerous dental problems.
Crowded wisdom teeth may not erupt properly and remain totally or partially hidden within the gums (impaction). As such, they can impinge on and damage the roots of neighboring teeth, and can make overall hygiene more difficult, increasing the risk of dental disease. They can also help pressure other teeth out of position, resulting in an abnormal bite.
Because of this potential for problems, it's been a common practice in dentistry to remove wisdom teeth preemptively before any problems arise. As a result, wisdom teeth extractions are the top oral surgical procedure performed, with around 10 million of them removed every year.
But that practice is beginning to wane, as many dentists are now adopting more of a “wait and see” approach. If the wisdom teeth show signs of problems—impaction, tooth decay, gum disease or bite influence—removal is usually recommended. If not, though, the wisdom teeth are closely monitored during adolescence and early adulthood. If no problems develop, they may be left intact.
This approach works best if you maintain regular dental cleanings and checkups. During these visits, we'll be able to consistently evaluate the overall health of your mouth, particularly in relation to your wisdom teeth.
Just as getting information on candidates helps you decide your vote, this approach of watchful waiting can help us recommend the best course for your wisdom teeth. Whether you vote your wisdom teeth “in” or “out,” you'll be able to do it wisely.