Each year, millions of children and teenagers wear braces or clear aligners to straighten a crooked smile. But there may be a way to treat some of these bite problems and avoid braces—by intercepting the problem at an earlier age.
This can often be done if the bite problem stems from abnormal jaw development rather than misaligned teeth. An example of this occurs when the upper jaw growth outpaces the lower jaw, causing the upper teeth to protrude beyond the lower teeth. Aside from the effect on appearance, protruding front upper teeth may extend beyond the protection of the lip and be more prone to injury.
A device called a Herbst appliance could prevent this from happening. The top of the device has two hinged metal tubes that connect to elastic bands bonded to the back teeth on both sides of the upper jaw. The bottom also has tubes affixed in the same way to the bottom teeth, except they're slightly smaller and fit within the upper tubes.
The lower tubes sliding within the upper tubes produces slight pressure against the lower jaw to ease it forward. This gradually influences the lower jaw to grow at a pace equal with the upper jaw to decrease the chances of poor bite development. Unlike other corrective methods, the Herbst appliance fixed in place and out of the way won't interfere with sports or other physical activities.
An installed Herbst appliance may change a patient's sensations during swallowing, eating or speaking, but most children adapt to the changes within a few days. And, because the device can create challenges for keeping the back teeth clean, many dentists recommend adding a fluoride rinse to daily brushing and flossing as an added boost against tooth decay.
The Herbst appliance is most effective during the period of most rapid physical growth between the ages of 11 and 14, but if the teeth are already beginning to protrude it can be undertaken as early as 8 or 9. Either way, this important orthodontic tool could help address a complicated bite problem and reduce the need for more costly orthodontic treatment later on.
If you would like more information on early interventions for 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 “The Herbst Appliance.”
Nothing beats the form and function of a real tooth—but dental implants come pretty close. That's why they're tops among both dentists and patients for replacing missing teeth.
Much of an implant's functionality and durability can be credited to its material construction, from the titanium metal post imbedded in the jawbone to the lifelike porcelain crown attached at its other end. But an implant's “nuts and bolts” isn't the only reason why this premier dental restoration is so popular: A good portion of their success comes from the adjunct support provided by digital technology.
Without this varied array of computer-based applications used in planning, designing and installing them, implants couldn't produce the level of satisfactory outcomes they currently do. Here then are a few of the high-tech tools dentists use to make sure your implants result in a winning smile.
CBCT scanning. Implant placement requires a high degree of precision often complicated by various anatomical structures like nerves, blood vessels and sinuses within the gums and jaws. Cone Beam Computer Tomography (CBCT) scanners rotate around a patient's head, taking hundreds of digital x-ray images that are then assembled into a 3-D model image. Dentists can view this model from various angles to identify obstacles and better pinpoint the best implant locations.
Digital impressions. Dentists can also create a 3-D digital impression model of the inside of a patient's mouth that can give them views of their current teeth and gums from any angle. This aids in determining the size and type of implant so that it blends seamlessly with remaining teeth. A digital impression can also provide both the dentist and patient a preview appearance of their future smile after treatment.
3-D printed surgical guides. To accurately drill the implant site during surgery, dentists often create a custom-made device called a surgical guide that fits into the patient's mouth during the procedure. Using results from scanning and digital impressions, highly accurate guides can be created with a 3-D printer. This further ensures that the implant will be in the exact best location for the most attractive and functional outcome.
Implantology is as much art as it is science in achieving a beautiful smile. These and other digital tools help make that desirable end a reality.
If you would like more information on dental implants, please contact us or schedule an appointment for a consultation.
So…you faithfully brush and floss your teeth every day. Kudos to you! Along with regular dental visits, daily hygiene is the best thing you can do to keep your teeth and gums disease-free.
Dental plaque, that thin film of bacteria and food particles that builds up on teeth, is the number one cause for tooth decay and periodontal (gum) disease. Thoroughly removing it daily through brushing and flossing drastically reduces your chances for disease.
But just the acts of brushing and flossing aren’t enough—both are skills requiring some level of mastery for truly effective plaque removal. Otherwise, any leftover plaque could be an invitation for infection.
So, how can you tell if you’re getting the job done? One way is a quick swipe of the tongue across your teeth after brushing: If they still feel gritty rather than smooth, chances are you left some plaque behind.
A more comprehensive method, though, is with a plaque disclosing agent, a product found in stores that sell dental care items. These kits contain liquids, tablets or swabs that when applied to the teeth right after brushing or flossing temporarily dye any leftover plaque a particular color. You’ll be able to see the results for yourself in the mirror.
A plaque disclosing agent can also reveal patterns of remaining plaque that indicate where you need to improve your hygiene efforts. For example, a scalloping effect along the gum line could mean you’re not adequately reaching high enough in these areas with your brush as well as your floss.
The dye effect is temporary, but it might take a few hours for the staining to fade away. You should also avoid swallowing any solution and avoid getting it on your clothes. And while disclosing agents can help improve your hygiene skills, your dentist or hygienist is still your best resource for dental care advice—so keep up those regular dental visits.
If you would like more information on best hygiene practices, 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 “Plaque Disclosing Agents.”
Sometimes, looking at old pictures can really bring memories back to life. Just ask Stefani Germanotta—the pop diva better known as Lady Gaga. In one scene from the recent documentary Five Foot Two, as family members sort through headshots from her teen years, her father proclaims: "Here, this proves she had braces!"
"If I had kept that gap, then I would have even more problems with Madonna," Lady Gaga replies, referencing an ongoing feud between the two musical celebrities.
The photos of Gaga's teenage smile reveal that the singer of hits like "Born This Way" once had a noticeable gap (which dentists call a diastema) between her front teeth. This condition is common in children, but often becomes less conspicuous with age. It isn't necessarily a problem: Lots of well-known people have extra space in their smiles, including ex-football player and TV host Michael Strahan, actress Anna Paquin…and fellow pop superstar Madonna. It hasn't hurt any of their careers.
Yet others would prefer a smile without the gap. Fortunately, diastema in children is generally not difficult to fix. One of the easiest ways to do so is with traditional braces or clear aligners. These orthodontic appliances, usually worn for a period of months, can actually move the teeth into positions that look more pleasing in the smile and function better in the bite. For many people, orthodontic treatment is a part of their emergence from adolescence into adulthood.
Braces and aligners, along with other specialized orthodontic appliances, can also remedy many bite problems besides diastema. They can correct misaligned teeth and spacing irregularities, fix overbites and underbites, and take care of numerous other types of malocclusions (bite problems).
The American Association of Orthodontists recommends that kids get screened for orthodontic problems at age 7. Even if an issue is found, most won't get treatment at this age—but in some instances, it's possible that early intervention can save a great deal of time, money and effort later. For example, while the jaw is still developing, its growth can be guided with special appliances that can make future orthodontic treatment go quicker and easier.
Yet orthodontics isn't just for children—adults can wear braces too! As long as teeth and gums are healthy, there's no upper age limit on orthodontic treatment. Instead of traditional silver braces, many adults choose tooth-colored braces or clear aligners to complement their more professional appearance.
So if your child is at the age where screening is recommended—or if you're unhappy with your own smile—ask us whether orthodontics could help. But if you get into a rivalry with Madonna…you're on your own.
If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics For The Older Adult.”
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.”
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