Posts for: November, 2020
Before we begin correcting a malocclusion (poor dental bite), we need to ask a few questions: How extensive is the malocclusion? How far must we move the teeth to correct it? How might the patient's jaw size impact treatment?
Answering these and other questions help us develop an effective treatment plan. And depending on the answers, we might need to look at other procedures before we install braces—like removing one or more of the teeth.
This isn't a subject to approach lightly: All teeth play an important role in dental function and smile appearance, and ordinarily we want to preserve teeth, not remove them. Sometimes, however, it may be a necessary action to achieve our goal of an improved dental bite.
For example, it might be necessary for correcting a malocclusion caused by severe teeth crowding. This occurs when one or both of the jaws hasn't grown to a sufficient size to accommodate all of the teeth erupting on it. As a result, some of the teeth could come in out of their proper alignment.
If caught early before puberty, we may be able to use other techniques to alleviate crowding, like a device called a palatal expander that influences an upper jaw to widen as it grows. If successful, it could provide later teeth more room to erupt in their proper positions.
But even if additional jaw growth occurs, it may not be enough to avoid a malocclusion or treatment with braces. Alleviating further crowding by removing teeth in little noticed areas could help with subsequent orthodontics.
Removing teeth may also be the answer for other problems like an impacted tooth, in which the tooth has not fully erupted and remains submerged in the gums. It's sometimes possible to use a technique to “pull” the tooth down where it should be; but again, that will still require jaw space that may not be available. The more effective course might be to remove the impacted tooth.
Whether or not tooth extraction will be needed can depend on a thorough orthodontic evaluation and full consideration of all the available options. Even though the ideal situation is to correct a bite with all teeth present and accounted for, it may be for the better good to sacrifice some.
If you would like more information on orthodontic techniques, 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 “Removing Teeth for Orthodontic Treatment.”
Thousands of years ago, our ancestors could only expect to live between 30 and 40 years. But steady improvements in lifestyle and medical care have increased human life expectancy to almost 80 years.
Although a welcome development, it does raise a question: Are our teeth up to the added years? Even though quite resilient, it's natural for teeth to wear after years and tens of thousands of meals biting and chewing.
Fortunately, there have also been phenomenal advances in dental restorations that can effectively replace teeth we lose along the way. Even so, the most advanced artificial replacements can't restore the full benefit of natural teeth to oral and general health. The ideal goal is to preserve and protect our natural teeth for as long as possible.
Here are 4 areas worthy of your attention in protecting your teeth throughout your lifetime.
Dental disease. Tooth decay and periodontal (gum) disease are the top causes for poor dental health and tooth loss. They're caused by bacteria living and feeding primarily in dental plaque, a thin biofilm on tooth surfaces. Brushing and flossing daily, along with regular dental cleanings, removes this disease-causing plaque. You should also seek treatment as soon as possible at the first sign of dental disease.
Bite correction. A poor bite is more than a smile problem: Teeth out of alignment and not engaging normally with their counterparts on the other jaw may increase tooth wear and make hygiene more difficult to perform. Orthodontic treatment, even if undertaken later in life, can help maintain your teeth's long-term health and longevity.
Bad habits. Your teeth are tough, but not indestructible. Protect them by avoiding harmful habits or practices like crunching ice, gnawing on pencils, nails or other hard objects, cracking open nuts or using your teeth as tools. Not engaging in these kinds of habits will help reduce wear and help you also avoid chipping and fractures.
Teeth grinding. Involuntarily clenching or grinding your teeth, often while sleeping, can accelerate dental wear. If you suspect you have this habit, take steps first to deal with stress, the number one cause of adult teeth grinding. Your dentist can also fashion a mouth guard that prevents your teeth from making solid contact with each other and thus help reduce wearing to your teeth.
If you would like more information on tooth wear, 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 “How and Why Teeth Wear.”
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.