My Blog

Posts for: March, 2014

By Phil Hart, DDS
March 24, 2014
Category: Dental Procedures
Tags: orthodontics  
TreatingImpactedCanineTeeth

There are only a few teeth that are known by nicknames. The big, late-blooming third molars (“wisdom teeth”) are one set; another set is the sharply-pointed canines, also called the “eyeteeth”. These two sets of teeth have something else in common: They can both suffer from the failure to develop in the proper place. Impacted wisdom teeth are a well known problem; impacted canines, however, are an issue that’s seen less frequently — but can often be effectively treated without extraction (removal).

What does the term “impacted” mean? In dental terminology, it indicates a tooth that is growing in a position where it can’t erupt (grow in to the bite) properly. This sometimes happens in cases where the bite is “crowded” — that is, where there isn’t enough space in the jaw for all of the teeth to develop properly. An impacted tooth remains “buried” to some extent in the tissues of the gums and jaw. It may eventually cause various problems with the roots of neighboring teeth, or even form a cyst (fluid-filled sac). That’s why treatment of impacted teeth is so important.

Impacted third molars (wisdom teeth) are generally removed (extracted), and are rarely missed. Canines, however, are located near the front of the mouth, forming an important component of an aesthetically pleasing smile. Therefore, whenever possible, it’s preferable to bring these teeth into good alignment with the rest of the smile rather than remove them. How is this done?

The process begins with a series of radiographic images (x-rays or CT scans) that show the exact positions of the affected teeth. Next, a minor surgical procedure, performed under local anesthesia, is used to expose the crowns (surfaces) of the impacted teeth. Then, a bracket is bonded to the surface of the tooth, which can be attached to orthodontic appliances. These appliances will, in time, move the tooth into a better position.

Impacted canines can be a serious problem — but the good news is that, with the proper treatment, it’s often possible to bring them into alignment with the rest of your smile. If you would like more information about treating impacted canine teeth, call our office for a consultation. You can learn more in the Dear Doctor magazine article “Exposing Impacted Canines.”


By Phil Hart, DDS
March 21, 2014
Category: Dental Procedures
CherylColesSee-ThroughBraces

What if you had orthodontic treatments to enhance your smile — and nobody knew about it until it was all done?

That (almost) happened to British singer, cover girl and television personality Cheryl Cole. Since her big break in 2002, on the British reality show Popstars: The Rivals, Cole has had a successful music career, taken turns judging both the British and American versions of The X Factor, and graced the covers of fashion magazines like Elle and Harpers Bazaar.

And somewhere along the way, Cole wore an orthodontic appliance. It very nearly went undetected… until a colleague spilled the beans. That’s when Cole was forced to divulge her secret: For a period of time, she had been wearing clear aligners on her teeth. Until her frenemy’s revelation, only a few people knew — but when you compare the before-and-after pictures, the difference in her smile is clear.

So what exactly are clear aligners? Essentially, they consist of a series of thin plastic trays that are worn over the teeth for 22 hours each day. The trays are custom-made from a computerized model of an individual’s mouth. Each tray is designed to move the teeth a small amount, and each is worn for two weeks before moving on to the next in the series. When the whole series is complete, the teeth will have shifted into their new (and better aligned) positions.

Besides being virtually unnoticeable, aligners are easy to remove. This makes it easy to keep the teeth clean — and can come in handy for important occasions (like cover-photo shoots and acceptance speeches). But don’t remove them too frequently, or they won’t work as planned. If that’s a possibility (with teens, for example), aligners are available with “compliance indicators” to ensure they’re being worn as often as they should be. They can also be made with special tabs to hold a place for teeth that haven’t fully erupted (come in) yet — another feature that’s handy for teens.

So if you need orthodontic work but prefer to stay “under the radar,” ask us whether clear aligners could be right for you. Cheryl Cole did… and the results gave her something more to smile about.

If you would like more information on clear aligners, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Clear Orthodontic Aligners” and “Clear Aligners for Teenagers.”


ExtraCareisRequiredWhenTreatingTeenagersWithLostTeeth

Permanent tooth loss at any age greatly affects long-term oral health. But because their jaw and facial structures are still developing, it’s particularly consequential for adolescents. Add to that any planned orthodontic treatment, and a little extra care is warranted when a teenager loses a tooth.

The biggest concern is potential bone loss caused by the missing tooth. Because the mouth structures are still developing, bone loss can be especially problematic for any future restorations of missing teeth. One of the best ways to slow or stop bone loss is to surgically insert bone-grafting material at the time of an extraction. Bone grafts act as scaffolds that the body builds natural bone upon; eventually the natural bone completely replaces the graft material.

When it comes to the matter of orthodontics, the treatment plan will be to either close the space so that future tooth replacement isn’t necessary or maintain the space for future tooth replacement. If the choice is the latter, the orthodontist will maintain enough space during installation of the braces for future replacement. In the meantime, the orthodontist can install temporary, color-matched tooth replacements within the braces to cover the gap. After the braces have been removed, artificial crowns may also be incorporated into the retainers for a more natural appearance until receiving a permanent replacement.

The best choice for that permanent replacement is a dental implant, a “stand-alone” system that encourages bone maintenance and doesn’t interfere or impact adjacent teeth. The only real question for adolescents is when to install the implants.

The mouth’s structural development doesn’t conclude until early adulthood: in males around ages 20, and in females typically a year or so earlier. Your dentist will evaluate your adolescent’s growth and development to determine if he or she is ahead or behind the growth curve. Natural teeth grow and develop along with the corresponding bone growth, but implants are artificial devices that don’t “grow” with the natural bone. It’s important, therefore, to postpone an implant installation until the jaw structure has fully developed — if done too early, the implant crown’s length won’t appear to be proportionally right (especially in relation to natural teeth) as the jaw continues to grow.

If you would like more information on dental implants for teenagers, 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 “Dental Implants for Teenagers.”


ReducingtheRisksandEffectsofDentalSportsInjuries

Sports are an important element in human society — besides providing enjoyment they also build discipline, teamwork and character.

But sports activities, especially for children and teenagers, also carry the risk of physical injury — and your teeth and mouth aren’t immune. About 22,000 mouth injuries occur annually in individuals under the age of 18. As the degree of contact within the sport rises, so does the risk of dental injuries.

To reduce this risk, it’s important to adopt a comprehensive approach to dental injuries, beginning with protection. For any sport that involves a ball, stick, puck or physical contact with another player, athletes should incorporate two pieces of equipment to fully protect against mouth injury: headgear and a mouthguard. Both help to evenly distribute the forces generated during an impact and thus reduce the chance or severity of injury.

The design of headgear will depend on other factors involving a particular sport. Mouthguards are more singular in their purpose, and so what works in one sport should work in another. While there are a number of types like stock or “boil and bite,” the highest level of protection is a custom-fitted mouthguard created by a dentist to specifically fit the individual’s bite. Although more costly than other options, it can better reduce the chances of an even more costly mouth injury.

Because we can only reduce the risk of injury but never eliminate it, protection is only part of the approach. Individuals, parents and sports officials should have plans in place for treating dental injuries should they occur. Depending on the level of trauma, individuals should have access to a dentist as soon as possible. It’s also important to know what to do when specific injuries occur, whether they require an immediate, urgent or less urgent response. The Dear Doctor magazine article, “The Field Guide to Dental Injuries” is an excellent primer on dental injury treatment.

Sports can have a positive effect on physical, emotional and social development. Adopting a well-rounded approach to dental injury prevention and treatment will help keep the focus on those benefits.

If you would like more information on protection and treatment from sports-related dental injuries, 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 “An Introduction to Sports Injuries & Dentistry.”