Posts for tag: orthodontics
Teeth crowding is a difficult bite problem (malocclusion) that often involves the entire jaw structure to be evaluated. Normally occurring when the jaw doesn’t have adequate space for normal tooth eruption, teeth coming in later put pressure on other teeth, causing them to develop improperly.
Crowding also makes it difficult to realign teeth with braces because there’s simply not enough room for sufficient movement to take place. The solution may then be to consider the removal of some of the teeth to create enough space for orthodontic treatment.
Not just any tooth can be removed, however — we must first conduct a careful analysis to determine which can be removed to facilitate optimum movement of the remaining teeth without disrupting normal mouth function or affecting appearance. The teeth most frequently removed for this purpose are the bicuspids, located between the cuspids or eyeteeth (which are positioned directly under the eyes) and the molars, the largest teeth in the back of the mouth. Sometimes one premolar tooth on each side of the jaw can be removed without sacrificing future form or function.
There are a few important considerations we must keep in mind when extracting teeth for orthodontic reasons; perhaps the most important is preserving bone at the extraction site. Because continuing bone growth depends on the forces generated by teeth when we bite or chew, bone near a missing tooth socket will tend to diminish over time. If there’s insufficient bone during orthodontic treatment, it may result in gum recession and root exposure — not only damaging to the teeth themselves but also to a person’s smile appearance. To avoid this, we sometimes will consider inserting a bone graft, which will stimulate bone growth, into the empty socket immediately after extraction. While this isn’t commonly done, it’s being considered if the patient’s bone is thin and a concern during healing.
We must also consider how to accommodate other, unrelated tooth loss to assure the final result is visually appealing. It may be necessary in these cases to maintain the space at the missing tooth site for a future restoration once the orthodontics is completed. This takes planning as well as the use of restorations like dental implants, bridges or partial dentures.
Regardless of your bite issues, the field of orthodontics has the appliances and techniques to overcome even the most complicated condition. When necessary, using procedures like tooth extraction can help turn an unappealing, dysfunctional bite problem into a beautiful smile.
If you would like more information on orthodontic teeth extractions, 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 “Tooth Removal for Orthodontic Reasons.”
Children losing their primary (“baby”) teeth is both natural and necessary. So, is it really that much of a concern if they lose one early?
The answer is yes — premature primary tooth loss could have long-term consequences for the permanent teeth as they develop within the jaw before eruption. Primary teeth play a crucial role in this development: as the permanent teeth form and grow the primary teeth serve as placeholders until they’re ready to erupt. A natural process then takes place in which the primary tooth’s roots dissolve (resorb) to allow them to fall out. Once they’re out of the way, the permanent teeth can then erupt.
If, however, they’re lost before the permanent teeth are ready, it leaves a space in the child’s bite. The dynamic mechanism between teeth and the periodontal ligament causes adjacent teeth to move or “drift” into the space. This can crowd out the permanent tooth intended for the space, causing it to come in improperly forming a malocclusion (bad bite), or it may become impacted and remain partially or fully below the surface of the gums.
This poor dental development could lead to extensive orthodontic treatment later in life, which is why we seek to preserve even decayed primary teeth for their entire natural lifespan. If the tooth is lost, however, we need to take action to preserve the space for the permanent tooth and avoid costly treatment later.
This usually calls for a “space maintenance” appliance — a type of orthodontic “retainer” — worn by the child to prevent other teeth from drifting into the space. Designed by your orthodontist, the appliance can also perform a cosmetic and social function by causing the space to appear unnoticeable.
Maintaining that space requires monitoring — especially by an orthodontist — and continued dental hygiene and care both at home and at the dentist’s office. The extra care preserving the space caused by premature tooth loss will help to ensure your child’s dental structure develops properly and their future smile will be an attractive one.
If you would like more information on the care and treatment of primary 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 articles “Early Loss of Baby Teeth” and “Losing a Baby Tooth.”
At your child's latest dental visit, you found out one of their primary (“baby”) teeth has become decayed and in danger of loss. Of course, you may think, it's only a primary tooth — it's going to come out sooner or later.
But a primary tooth lost “sooner” rather than “later” can create long-term negative consequences for your child's dental health. For the sake of the future permanent tooth, the best treatment strategy could be to put forth the effort and expense to save it.
Besides its role in eating and chewing, a primary tooth's most important function is as a “trailblazer” for the permanent tooth developing below it. A primary tooth doesn't normally loosen and let go until the new permanent tooth is ready to erupt. Until then they hold the new tooth's space in the jaw.
But if the primary tooth is lost prematurely, nearby teeth can drift into and crowd the space so that the permanent tooth comes in out of position. This can result in a malocclusion, or poor bite.
Depending on the state of your child's jaw development, it may be advisable to attempt saving the tooth through a filling or, in the case of deep decay, a modified root canal treatment. If the tooth can't be saved, then placing an orthodontic appliance known as a space maintainer might be necessary. Cemented to a tooth next to the empty space, this appliance has a looped band of metal that butts against the tooth on the other side of the gap, and prevents both teeth from drifting into the space.
Intervening for a decayed primary tooth can seem a waste of time and money since it has a limited lifespan to begin with. But for the health of its companion permanent tooth, as well as possibly avoiding orthodontic treatment, it could be well worth it for your child's long-term dental health.
If you would like more information on dental care for your child, 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 “Importance of Baby Teeth.”
If you are considering having your teeth straightened, for cosmetic or other reasons, the idea of using clear aligners rather than traditional braces may be appealing.
Here are the answers to some frequently asked questions about clear aligners.
What are clear aligners?
Clear aligners are clear removable custom fitted “trays” that gradually straighten teeth. Used sequentially, each individual tray is slightly different from the one before and is worn every day for two weeks before going on to the next one in the series. This slowly moves your teeth to a new position.
How are they made?
The trays are computer-generated, based on impressions and models of your mouth combined with the knowledge of growth, development of teeth and jaws, and most importantly how and why teeth move.
How long does this treatment take?
By wearing clear aligners for at least 20 hours per day for two weeks before changing to the next tray in the sequence, treatment time can range from six months to two years depending on your individual situation.
Can children wear clear aligners?
Clear aligners are generally used for adults who have all their teeth and when jaw growth is complete, but can be used for younger people depending upon the extent and severity of their situation.
What situations can clear aligners be used for?
Clear aligners can realign or straighten teeth, close mild spaces, treat elongated teeth and tip teeth into better position. They are usually recommended for correcting mild to moderate crowding of teeth, particularly if your back teeth already fit together properly.
When are clear aligners probably not the right choice?
If you have a bad bite (your back teeth do not fit together well), or if you have a severe overbite or underbite, traditional braces are probably a better choice for treatment. If your teeth are severely crowded, or if your situation is complex, clear aligners will probably not be the right treatment choice.
How do you decide whether clear aligners are right for you?
An orthodontic assessment of your individual situation must be performed by our office.
What is considered in the assessment?
The assessment includes specialized x-rays of your teeth, jaws and skull, along with photos, impressions, and models of your bite.
For more information about clear aligners vs. traditional braces, make an appointment with us for a consultation and an examination of your own situation. You can learn more by reading the Dear Doctor magazine article “Clear Orthodontic Aligners: An Alternative for Adult Orthodontics.”
Metal braces for correcting teeth alignment have long been a fixture of adolescence. But although they're effective, they tend to put a crimp on a teenager's life with changes in diet and irritation and discomfort from the devices and regular adjustments. For many teens, though, these are minor compared to the change in their appearance that comes with traditional braces, and the embarrassment they may feel.
In recent years, there's been a growing use of another orthodontic device that reduces many of these inconveniences, especially regarding appearance. Known as the clear aligner, this transparent, “almost invisible” device can be taken out for eating, cleaning or important social events.
Clear aligners are a sequential set of clear trays made of polyurethane plastic that are generated for an individual patient using information derived from x-rays, photographs or models. Each tray in the sequence is slightly different from the previous one to account for the tooth movement achieved wearing the previous tray. The patient will wear a tray for about two weeks and then, if all looks well, move to the next tray. This process continues until the teeth arrive at the proper alignment, a period of about six to twenty-four months depending on the patient's initial condition and their progress.
Up until recently, aligners were a viable option for a limited category of patients, mainly adults. Recent advances have changed that. Aligners now include tiny “power ridges” that enable them to move teeth in more than one plane, something previous versions were unable to do. “Eruption tabs” can also be incorporated into aligner sets to hold the space for permanent teeth that haven't erupted yet — a must for many younger patients. We can also temporarily bond attachments to the teeth known as buttons (made with a composite that blends in with the natural tooth color) that give more leverage and stability to the aligner.
With these changes, clear aligners are now an effective choice for a wider group of patients, including many teens. Aligners are comfortable to wear, easy to care for, and for teens acutely conscious of their appearance, less obtrusive than traditional metal braces.
If you would like more information on clear aligners, 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 “Clear Aligners for Teens.”