Posts for: July, 2020
If all goes normally, we have most of our permanent teeth as we enter puberty. Except, though, when it doesn't—sometimes incoming permanent teeth don't fully erupt, often because there's not enough room for them on the jaw. This can leave all or part of a tooth still up inside the gum and bones.
This condition is known as impaction, and it can cause problems with a person's bite and their smile. This is especially true of the upper canines, those pointed teeth located just under the eyes. Without them present, a person's smile can look oddly different. Moreover, it can worsen their bite and increase the risk of trauma and disease for nearby teeth.
Fortunately, there may be a way to coax impacted canines into erupting into their proper position on the jaw. It will involve, though, some minor surgery and orthodontic intervention to accomplish that feat.
First, though, a patient with missing canines should undergo a thorough orthodontic evaluation. This exam will reveal not only what may be going on with the missing teeth, but how the whole bite has been affected. Knowing the big picture will help direct the next treatment steps.
After pinpointing the impacted teeth's exact position (usually through x-rays or cone beam CT scanning), we then decide whether it's feasible to attempt to expose the teeth. Sometimes, a tooth's position is so out of place that it may be best to remove it and consider a dental implant or other restorative measures.
If it is in a workable position, then the impacted teeth would be exposed surgically (usually by an oral surgeon or periodontist). The surgeon would then bond a small bracket to the exposed tooth and then attach a small chain.
After suturing the incised gum tissues back in place, the chain extending outward from the gums would then be looped over orthodontic hardware attached to other teeth. This will place downward pressure on the upper canine tooth, and over several months prod it to fully erupt.
This may sound like an elaborate procedure, but it's fairly routine and predictable. As a result, a patient can finally get the full benefit of all their teeth, enhance their dental health and transform their smile.
If you would like more information on dealing with impacted teeth, 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 “Exposing Impacted Canines.”
The amount of sugar your child consumes has a huge bearing on their tooth decay risk: The more they take in, the higher it is for this destructive disease. That's why you should moderate their intake of the usual suspects: sodas, candies and other sugar-laden foods. But you should also put the brakes on something considered wholesome and nutritious: fruit juices. And that includes all natural juice with no sugar added.
Sugar in any form is a prime food source for decay-causing bacteria. As bacteria consume leftover sugar in the mouth, they produce acid as a byproduct. With an ample source of sugar, they also multiply—and this in turn increases their acid production. Acid at these high levels can soften and erode tooth enamel, which leads to tooth decay and cavities.
Limiting or even excluding sugar-added foods and snacks can help minimize your children's risk for tooth decay. For designated snack times, substitute items like carrot sticks or even popcorn with a dash of spice rather than sweet snacks and candies. If you do allow occasional sweet foods, limit those to mealtimes when saliva, which neutralizes acid, is most active in the mouth.
As you manage sugary items your children may eat or drink, the American Academy of Pediatrics also advises you to moderate their consumption of fruit juices, including all-natural brands with no added sugar. Their recommended limits on daily juice drinking depend on a child's age and overall health:
- Infants (less than one year) or any children with abnormal weight gain: no juice at all;
- Toddlers (ages 1-3): 4 ounces or less per day;
- Younger children (4-6): 6 ounces or less per day; and
- Older children (7-18): 8 ounces (1 cup) or less per day.
As for the rest of your children's daily hydration needs, the most dental-friendly liquid for any of us is plain water. For older school-age children, low- or non-fat milk is also a sound choice.
Preventing tooth decay in your children is a continuous task that requires all of us, parents and dental providers, to do our part. Besides daily hygiene (brushing and flossing) and regular dental visits, keeping sugar at bay—including with juices—is an important part of that effort.
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.”