Posts for category: Dental Procedures
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.”
Advanced decay doesn't necessarily mean it's curtains for an infected tooth. Millions of teeth in that condition have been saved by a tried and true procedure called root canal therapy.
Although they may vary according to the complexity of a case, all root canal procedures share some similarities. After numbing the tooth and gum areas with local anesthesia, the procedure begins with a small hole drilled into the tooth to access the infected pulp and root canals, tiny passageways inside the root.
The dentist then uses special instruments to clear out infected tissue from the pulp and canals, followed by thoroughly sanitizing the resulting empty spaces. This is followed with filling the pulp chamber and root canals with a rubber-like substance (gutta percha) to seal the interior of the tooth from further infection. Later, the dentist typically crowns the tooth for further protection and support.
Root canals have become the standard treatment for teeth with advanced decay. There are, however, some circumstances where performing a root canal isn't a good idea. For example, a previously root-canaled tooth with a crown and supporting post. A dentist would need to fully disassemble the restoration to gain access into the tooth, which could significantly weaken it.
But there may be another option if a standard root canal is out of the picture: a surgical procedure performed by an endodontist (a specialist in interior tooth treatment) called an apicoectomy. Instead of drilling through the tooth crown, the endodontist accesses the tooth root through the adjacent gum tissue.
Like a traditional root canal, the procedure begins by anesthetizing the tooth and surrounding gums. The endodontist then makes a small incision through the gums to expose the diseased tissues at the tooth's root. After removing the infected tissue and a few millimeters of the root tip, they place a small filling to seal the end of the root canal against infection and suture the gum incision.
This is a specialized procedure that requires the state-of-the-art equipment and advanced techniques of an endodontist. But it does provide another possible option for saving a diseased tooth that might otherwise be lost.
If you would like more information on treatments for tooth decay, 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 “Apicoectomy: A surgical Option When Root Canal Treatment Fails.”
Wearing braces can ultimately give you a healthier and more attractive smile. In the short-term, though, your gums in particular may be in for a rough ride.
While we're all susceptible to gum disease, braces wearers are more likely to encounter it. This stems from two related factors: the difficulty braces pose to oral hygiene; and the potential irritation of soft tissues by the braces themselves.
The main cause for any form of gum disease is dental plaque, a thin bacterial film that accumulates on teeth. Removing plaque through brushing and flossing greatly reduces the risk of any dental disease. But braces wires and brackets make it difficult to brush and floss—as a result, some plaque deposits may escape cleaning, which makes a gum infection more likely.
To exacerbate this, braces hardware can irritate the gums and cause swelling and tissue overgrowth, also known as hyperplasia. The one-two punch of ineffective hygiene with hyperplasia are why braces wearers have a higher incidence of gum problems compared to the general population.
To guard against this, patients with braces need to be extra vigilant about keeping their teeth and gums clean of plaque. It may be helpful in this regard to use specialized tools like interproximal brushes with narrower bristle heads that are easier to maneuver around braces.
And rather than using traditional flossing thread, orthodontic patients may find it easier and more effective to use pre-loaded flossing picks or an entirely different method called oral irrigation. The latter involves a handheld wand that directs a stream of pulsating water between teeth to loosen and flush away plaque.
It's also important for patients to see their dentist as soon as possible for any gum swelling, bleeding or pain. The dentist can determine if it relates to gum disease, hyperplasia or a combination of both, and recommend treatment. In extreme cases, it may be necessary to remove the braces until the gums heal, so catching and treating any gum problem early is a priority.
Regardless of the risk for gum disease, orthodontic treatment is still well worth the investment in your health and appearance. Practicing effective oral hygiene and keeping a watchful eye on your gums will help further lower that risk.
If you would like more information on oral care during 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 “Gum Swelling During Orthodontics.”
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.”
Dorit Kemsley isn't shy. Best known to fans as an outspoken and sometimes outrageous cast member of the reality show Real Housewives of Beverly Hills, Kemsley is never reticent about “mixing it up” with fellow castmates or their significant others. Recently, though, she confessed to something that left her less than confident: her smile.
Kemsley has been self-conscious about her smile because her teeth looked noticeably short, worn down from an unconscious habit of grinding her teeth. Although teeth grinding is more common among children (who normally grow out of it by adolescence), it can persist into adulthood, usually from difficulties managing high stress (a likely component in the fashion designer/reality show star's busy life).
Stress-induced teeth grinding can occur during waking hours or, more likely, during deep sleep. The accumulating, long-term effects from the habit can lead not only to worn teeth but to weakened gum support, a high risk of tooth fracture or jaw pain and dysfunction.
So, how do you know if you grind your teeth, especially if it's only happening at night? Typical signs include sore jaws after awaking from sleep, increased tooth pain or sensitivity or, like Kemsley, a noticeable difference in your tooth length. Your family or sleeping partner may also complain about the “skin-crawling” noise you make during the night.
There are ways to lessen the effects of teeth grinding. The first step is to have us verify the underlying cause for the habit. If it's tension from stress, then you might reduce the habit's occurrences by learning better stress management or relaxation techniques through individual counseling, group support or biofeedback therapy. We can also fit you with a mouth guard to wear at night or through the day that reduces the force generated during teeth grinding.
And if you've already experienced accelerated tooth wear like Kemsley with a resultant “small teeth” smile, you might pursue the same solution as the RHOBH star: dental veneers. These thin, life-like wafers of porcelain are custom-made to mask imperfections like chips, staining, slight tooth gaps and, yes, worn teeth.
Veneers are often less expensive and invasive than other cosmetic techniques, yet they can have a transformative effect, as Kemsley's Instagram followers have seen. In conjunction with other dental treatments needed to repair any underlying damage caused by a grinding habit, veneers are an effective fix for the smile you present to the world.
If you suspect you may have a grinding habit, see us for a complete examination. From there, we'll help you protect your teeth and your smile.