Moving teeth through orthodontics may involve more than simply wearing braces. There are many bite conditions that require extra measures before, during or after traditional orthodontic treatment to improve the outcome.
One such measure is extracting one or more teeth. Whether or not we should will depend on the causes behind a patient's poor dental bite.
Here, then, are 4 situations where tooth extraction before orthodontics might be necessary.
Crowding. This happens when the jaw isn't large enough to accommodate all the teeth coming in. As a result, later erupting teeth could erupt out of position. We can often prevent this in younger children with space maintainers or a palatal expander, a device which helps widen the jaw. Where crowding has already occurred, though, it may be necessary to remove selected teeth first to open up jaw space for desired tooth movement.
Impacted teeth. Sometimes an incoming tooth becomes blocked and remains partially or fully submerged beneath the gums. Special orthodontic hardware can often be used to pull an impacted tooth down where it should be, but not always. It may be better to remove the impacted tooth completely, as well as its matching tooth on the other side of the jaw to maintain smile balance before orthodontically correcting the bite.
Front teeth protrusion. This bite problem involves front teeth that stick out at a more horizontal angle. Orthodontics can return the teeth to their proper alignment, but other teeth may be blocking that movement. To open up space for movement, it may be necessary to remove one or more of these obstructing teeth.
Congenitally missing teeth. The absence of permanent teeth that failed to develop can disrupt dental appearance and function, especially if they're near the front of the mouth. They're often replaced with a dental implant or other type of restoration. If only one tooth is missing, though, another option would be to remove the similar tooth on the other side of the jaw, and then close any resulting gaps with braces.
Extracting teeth in these and other situations can help improve the chances of a successful orthodontic outcome. The key is to accurately assess the bite condition and plan accordingly.
If you would like more information on orthodontic options, 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.”
Periodontal (gum) disease can weaken gum attachment and cause bone deterioration that eventually leads to tooth loss. But its detrimental effects can also extend beyond the mouth and worsen other health problems like heart disease or diabetes.
While the relationship between gum disease and other health conditions isn't fully understood, there does seem to be a common denominator: chronic inflammation. Inflammation is a natural defense mechanism the body uses to isolate damaged or diseased tissues from healthier ones. But if the infection and inflammation become locked in constant battle, often the case with gum disease, then the now chronic inflammation can actually damage tissue.
Inflammation is also a key factor in conditions like heart disease and diabetes, as well as rheumatoid arthritis or osteoporosis. Inflammation contributes to plaque buildup in blood vessels that impedes circulation and endangers the heart. Diabetes-related inflammation can contribute to slower wound healing and blindness.
Advanced gum disease can stimulate the body's overall inflammatory response. Furthermore, the breakdown of gum tissues makes it easier for bacteria and other toxins from the mouth to enter the bloodstream and spread throughout the body to trigger further inflammation. These reactions could make it more difficult to control any inflammatory condition like diabetes or heart disease, or increase your risk for developing one.
To minimize this outcome, you should see a dentist as soon as possible if you notice reddened, swollen or bleeding gums. The sooner you begin treatment, the less impact it may have on your overall health. And because gum disease can be hard to notice in its early stages, be sure you visit the dentist regularly for cleanings and checkups.
The most important thing you can do, though, is to try to prevent gum disease from occurring in the first place. You can do this by brushing twice and flossing once every day to keep dental plaque, the main trigger for gum disease, from accumulating on tooth surfaces.
Guarding against gum disease will certainly help you maintain healthy teeth and gums. But it could also help protect you from—or lessen the severity of—other serious health conditions.
If you would like more information on preventing and treating gum disease, 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 “Good Oral Health Leads to Better Health Overall.”
If there's anything that makes Alfonso Ribeiro happier than his long-running gig as host of America's Funniest Home Videos, it's the time he gets to spend with his family: his wife Angela, their two young sons, and Alfonso's teenaged daughter. As the proud dad told Dear Doctor–Dentistry & Oral Health magazine, "The best part of being a father is the smiles and the warmth you get from your children."
Because Alfonso and Angela want to make sure those little smiles stay healthy, they are careful to keep on top of their kids' oral health at home—and with regular checkups at the dental office. If you, too, want to help your children get on the road to good oral health, here are five tips:
- Start off Right—Even before teeth emerge, gently wipe baby's gums with a clean, moist washcloth. When the first teeth appear, brush them with a tiny dab of fluoride on a soft-bristled toothbrush. Schedule an age-one dental visit for a complete evaluation, and to help your child get accustomed to the dental office.
- Teach Them Well—When they're first learning how to take care of their teeth, most kids need a lot of help. Be patient as you demonstrate the proper way to brush and floss…over and over again. When they're ready, let them try it themselves—but keep an eye on their progress, and offer help when it's needed.
- Watch What They Eat & Drink—Consuming foods high in sugar or starch may give kids momentary satisfaction…but these substances also feed the harmful bacteria that cause tooth decay. The same goes for sodas, juices and acidic drinks—the major sources of sugar in many children's diets. If you allow sugary snacks, limit them to around mealtimes—that gives the mouth a chance to recover its natural balance.
- Keep Up the Good Work—That means brushing twice a day and flossing at least once a day, every single day. If motivation is an issue, encourage your kids by letting them pick out a special brush, toothpaste or floss. You can also give stickers, or use a chart to show progress and provide a reward after a certain period of time. And don't forget to give them a good example to follow!
- Get Regular Dental Checkups—This applies to both kids and adults, but it's especially important during the years when they are rapidly growing! Timely treatment with sealants, topical fluoride applications or fillings can often help keep a small problem from turning into a major headache.
Bringing your kids to the dental office early—and regularly—is the best way to set them up for a lifetime of good checkups…even if they're a little nervous at first. Speaking of his youngest child, Alfonso Ribeiro said "I think the first time he was really frightened, but then the dentist made him feel better—and so since then, going back, it's actually a nice experience." Our goal is to provide this experience for every patient.
If you have questions about your child's dental hygiene routine, call the office or schedule a consultation. You can learn more in the Dear Doctor magazine article “How to Help Your Child Develop the Best Habits for Oral Health.”
Your child’s current dental care sets the stage for good oral health later in life. It’s essential, therefore, that you know how best to protect their teeth and gums. In recognition of February as National Children’s Dental Health Month, here’s a short true or false quiz to test your knowledge of proper dental care for your child.
- Your child’s dental hygiene begins when their first teeth appear.
False: The bacteria that cause dental disease can take up residence in an infant’s mouth before their first teeth come in. To help curb this bacterial growth, wipe your baby’s gums with a clean, wet cloth after nursing or bottle-feeding.
- Kissing your newborn on the mouth could lead to tooth decay.
True. Any mouth-to-mouth contact with your infant could transfer oral bacteria from you to them. Their immune system isn’t mature enough to handle these “new arrivals,” which can increase their risk for tooth decay. Instead, kiss your child on the cheek or forehead or use other ways to show affection.
- Primary (baby) teeth don’t need the same care from disease as permanent teeth.
False: Although they have a limited lifespan, primary teeth play a huge role in a child’s dental development by protecting the space intended for the incoming permanent teeth. If primary teeth are lost prematurely due to dental disease, it could lead to incoming teeth erupting out of position.
- It’s best to start your child’s regular dental visits around their first birthday.
True: By age one, children already have a few teeth that need preventive or therapeutic care by a dentist. Starting early also gets them used to seeing the dentist and reduces their chances of developing dental visit anxiety.
- Your infant or toddler sucking their thumb isn’t a cause for concern.
True: Thumb-sucking is a nearly universal habit among infants that typically begins to fade around ages 3 or 4. If the habit continues, though, it could begin affecting their bite. It’s recommended that you encourage your child to quit thumb-sucking around age 3.
- The best time to consider your child’s bite health is right before puberty.
False: Signs of an emerging bite problem can begin appearing even before a child starts school. It’s a good idea, then, to have your child undergo an orthodontic evaluation around age 6. If the orthodontist finds a problem, it may be possible to intervene to correct or minimize it before it goes too far.
One last thing: Your child’s dental care isn’t entirely on your shoulders. We’re here to partner with you, not only providing preventive and therapeutic treatment for your child, but also advising you on their day-to-day dental care and hygiene. Together, we’ll help ensure your child’s dental development stays on track.
If you would like more information about dental care for children, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Dentistry & Oral Health for Children.”
Sometimes you need only a single solution to improve your smile: teeth whitening to brighten stained teeth; porcelain veneers or crowns to mask dental flaws; or a life-like dental implant to replace a missing tooth. But not all dental situations are that simple and sometimes require a combination of treatments.
A case in point: restoring a missing tooth within a poor bite. The absent tooth itself may be the cause of the bite problem if it’s been missing for some time: The nearby teeth tend to move or “drift” into the empty space, leaving no room for implant placement.
When this happens, you’ll first need orthodontic treatment to correct the bite problem. Not only will this open the space for the implant, it also comes with its own benefits. It obviously improves your smile appearance—but straighter teeth are also easier to keep clean of bacterial plaque, which reduces your disease risk. You may also experience better digestion after your teeth are properly aligned and able to function as they should during eating.
The traditional way to improve a bite is through metal braces. But there are some downsides: For one, braces can make it difficult to keep teeth adequately clean, making wearers more susceptible to tooth decay and gum disease. Braces are also quite visible and can detract from a person’s appearance (even more so if a missing tooth is involved).
Unless your situation requires braces, you can choose clear aligners as an alternative. These clear, computer-generated plastic trays are worn in sequence to gradually move teeth to their desired positions. Unlike braces, you can remove aligners for eating, cleaning or rare special occasions. And, they’re barely noticeable to others.
If you also have a missing tooth, you can have a temporary prosthetic (“false”) tooth built into your aligner trays. In this way you can still enhance your smile while undergoing aligner treatment.
Once your bite has been corrected, we can then proceed with restoring your missing tooth permanently with a dental implant. Although orthodontics adds to the time and expense of restoration, its often necessary to achieve the best result. Your future smile will be the better for it.
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