Posts for category: Oral Health
Around ages 6 to 8, a child's primary teeth will begin to loosen to make way for their permanent teeth. If all goes well, the new set will come in straight with the upper teeth slightly overlapping the bottom.
But sometimes it doesn't go that well: a child may instead develop a poor bite (malocclusion) that interferes with normal function. If we can detect the early signs of a developing malocclusion, however, we may be able to intervene and lessen its impact. You as a parent can play a vital role in this early detection.
The first thing you should be watching for is teeth spacing.Â Normal teeth come in straight with a slight gap between them. But there are two abnormal extremes to look for: teeth having no space between them or crowded together in a crooked, haphazard manner; or they seem to have too much space between them, which indicates a possible discrepancy between the teeth and jaw sizes.
You should also notice how the teeth come together or “bite.” If you notice the lower front teeth biting in front of the upper (the opposite of normal) it may be a developing underbite. If you see a space between the upper and lower teeth when they bite down, this is a sign of an open bite. Or, if the upper front teeth seem to come down too far over the lower, this could mean a deep bite: in extreme cases the lower teeth actually bite into the roof of the mouth behind the upper teeth.
You should also look for crossbites, in which the teeth in one part of the mouth bite abnormally in front or behind their counterparts, while teeth in other parts bite normally. For example, you might notice if the back upper teeth bite inside the lower teeth (abnormal), while the front upper teeth bite outside the lower front teeth (normal).
The important thing is to note anything that doesn't look right or seems inconsistent with how your child's teeth look or how they function. Even if you aren't sure it's an issue, contact us anyway for an examination. If it really is a developing bite problem, starting treatment now may lessen the extent and cost of treatment later.
It’s been a long road with your braces, but now they’re finally off. Hopefully the first glimpse of your new smile more than made up for the time and effort they required.
But while braces removal is a big milestone, it’s not the end of your treatment—not, that is, if you want to keep that new smile! You’ll now need to wear an appliance called a retainer for a few years or, in some cases, from now on.
Orthodontic retainers are a must after braces for the same reason braces work in the first place—your teeth can move. While the teeth attach to the jawbone via the roots, they’re firmly held in place by an elastic gum tissue network called the periodontal ligament. This tough but elastic tissue lies between the teeth and gums and attaches securely to both with tiny fibers.
While the ligament provides stability, it’s also dynamic—constantly remodeling to allow the teeth to move in response to biting pressure and other mouth factors. Orthodontists use this mechanism when moving teeth to better positions. The braces apply pressure on the teeth in the desired direction and the periodontal ligament responds as the teeth move.
Afterward, however, the ligament can still retain a kind of “muscle memory” for a time of the teeth’s old positions. Free of the pressure once supplied by the braces the teeth have a tendency, especially early on, to “rebound” to where they were.
A retainer helps prevent this by exerting just enough pressure to “retain” the teeth in their new positions. In the beginning this may require wearing the appliance around the clock, but you may be able later to reduce wear time to just a few hours a day. Rebounding is unpredictable, so you should continue to follow your orthodontist’s recommendations on retainer wear.
Wearing a retainer may seem like a drag, but it’s absolutely essential. Being diligent about it will help ensure that the beautiful smile you and your orthodontist worked so hard to obtain stays with you for years to come.
If you would like more information on getting a new smile through 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 “The Importance of Orthodontic Retainers.”
On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.
“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”
Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.
Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.
A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.
Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.
So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.
If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”
Even with picture perfect teeth, you may still be unhappy with your appearance. The problem: too much of your upper gums show when you smile.
There’s no precise standard for a “gummy smile”—it’s often a matter of perception. As a rule of thumb, though, we consider a smile “gummy” if four or more millimeters of upper gum tissue show while smiling. In any event if you perceive you have a gummy smile, it can greatly affect your self-confidence and overall well-being.
The good news is we can often correct or at least minimize a gummy smile. The first step, though, is to find out why the gums are so prominent.
There are a few possible causes: the most obvious, of course, is that there’s more than normal gum tissue present. But the cause could be the front teeth didn’t fully erupt in childhood and so the gums appear more prominent. Other causes include the upper lip moving too far upward when smiling (hypermobile) or an elongated upper jaw that’s out of proportion with the face.
Finding the exact cause or combination of causes will determine what approach we take to minimize your gummy smile. If too much gum tissue or not enough of the teeth show, we can use a surgical procedure called crown lengthening to expose more of the crown (the visible part of a tooth), as well as remove excess gum tissues and reshape them and the underlying bone for a more proportional appearance.
A hypermobile upper lip can be treated with Botox, a cosmetic injection that temporarily paralyzes the lip muscles and restricts their movement. But for a permanent solution, we could consider a surgical procedure to limit upper lip movement.
Surgery may also be necessary for an abnormal jaw structure to reposition it in relation to the skull. If, on the other hand it’s the teeth’s position and not the jaw causing gum prominence, we may be able to correct it with orthodontics.
As you can see, there are several ways varying in complexity to correct a gummy smile. To know what will work best for you, you’ll need to undergo an orofacial examination to determine the underlying cause. It’s quite possible there’s a way to improve your smile and regain your self-confidence.
If you would like more information on improving a gummy smile, 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 “Gummy Smiles.”
Your child has had braces for a few months and making good progress with correcting a poor bite (malocclusion), but you’ve also noticed something else: his gums are becoming red and swollen.
These are symptoms of gingivitis, a periodontal (gum) disease. It’s an infection that arises when plaque, a thin film of bacteria and food particles, isn’t adequately removed from teeth with daily brushing and flossing. The braces increase the risk for gingivitis.
This is because the hardware — metal or plastic brackets cemented to the teeth and joined together by metal bands — makes it more difficult to reach many areas of the teeth with a brush or floss string. The plaque left behind can trigger an infection that causes inflammation (swelling) and bleeding.
To exacerbate the situation, gums don’t always take well to braces and can react by overgrowing. Wearing braces may also coincide with a teenager’s surge in hormones that can accelerate the infection. Untreated, gingivitis can develop into advanced stages of disease that may eventually cause tooth loss. The effect is also heightened as we’re orthodontically putting stress on teeth to move them.
You can stay ahead of gingivitis through extra diligence with daily hygiene, especially taking a little more time to adequately get to all tooth surfaces with your brush and floss. It may also help to switch to a motorized brush or one designed to work around braces. You can make flossing easier by using special threaders to get around the wires or a water flosser that removes plaque with a pulsating water stream.
And don’t forget regular dental visits while wearing braces: we can monitor and treat overgrowth, perform thorough dental cleanings and treat occurrences of gingivitis. In some cases you may need to visit a periodontist, a specialist in gums and supporting teeth structures, for more advanced treatment. And if the disease becomes extensive, the braces may need to be removed temporarily to treat the gums and allow them to heal.
Orthodontic treatment is important for not only creating a new smile but also improving your teeth’s function. Keeping a close eye out for gum disease will make sure it doesn’t sidetrack your efforts in gaining straighter teeth.
If you would like more information on dental care during 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 “Gum Swelling During Orthodontics.”