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YouMayNeedOrthodonticsBeforeReplacingaMissingTooth

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.

If you would like more information on dental solutions for improving your smile, please contact us or schedule an appointment for a consultation.

HaveYourLooseToothExaminedasSoonasPossible

A loose permanent tooth is not a good thing—and not something you should put off having examined. That’s because a loose tooth could soon become a lost tooth.

How we treat it depends on its underlying cause, which could be one of two types. One is primary occlusal trauma, meaning the affected tooth has experienced accidental trauma or higher biting forces than it normally encounters. This usually happens because of teeth grinding habits.

It could also be secondary occlusal trauma. Unlike primary trauma where the supporting gums and bone may be reasonably healthy, secondary trauma occurs because these structures have been severely damaged by periodontal (gum) disease. As the gums begin to detach from a tooth and its underlying bone deteriorates, even normal biting forces can loosen it.

If gum disease is present, our first priority is to bring it under control. We do this primarily by removing all dental plaque (a thin film of bacteria and food particles that triggers the infection and sustains it) and calculus or tartar (calcified plaque). This can take several sessions and, in the case of deep infection, may require a surgical procedure.

On the other hand, if teeth grinding is the primary cause, we’ll focus on minimizing the habit and its effects. One way is to create a custom-fitted guard worn to prevent upper and lower teeth from making solid contact. You may also need to improve your management of stress—another factor in teeth grinding—through medication, therapy or biofeedback.

In either case, improved periodontal health will help the gums naturally regain their strong attachment with help, if necessary, from gum tissue or bone grafting surgery. But this healing process can take time, so we may need to secure a loose tooth in the interim by splinting it to neighboring stable teeth. This usually requires bonding rigid material or metal across the back of all involved teeth or in a channel cut along the teeth’s biting surfaces. In this way the more stable teeth support the loose one.

Splinting may be temporary as the mouth heals from disease or trauma and the teeth regain their stability. In some cases, though, it may be permanent. Either way, dealing promptly with a loose tooth can help ensure it’ll survive—so see your dentist as soon as possible.

If you would like more information on treating loose 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 “Treatment for Loose Teeth.”

RemovingOneorMoreTeethCouldImproveOrthodonticOutcomes

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.”

WhatYouCanDoAboutBadBreathUnlessYoureaFamousActressPrankingYourCo-Star

Hollywood superstar Jennifer Lawrence is a highly paid actress, Oscar winner, successful producer and…merry prankster. She's the latter, at least with co-star Liam Hemsworth: It seems Lawrence deliberately ate tuna fish, garlic or other malodorous foods right before their kissing scenes while filming The Hunger Games.

It was all in good fun, of course—and her punked co-star seemed to take it in good humor. In most situations, though, our mouth breath isn't something we take lightly. It can definitely be an unpleasant experience being on the receiving end of halitosis (bad breath). And when we're worried about our own breath, it can cause us to be timid and self-conscious around others.

So, here's what you can do if you're concerned about bad breath (unless you're trying to prank your co-star!).

Brush and floss daily. Bad breath often stems from leftover food particles that form a film on teeth called dental plaque. Add in bacteria, which thrive in plaque, and you have the makings for smelly breath. Thorough brushing and flossing can clear away plaque and the potential breath smell. You should also clean your dentures daily if you wear them to avoid similar breath issues.

Scrape your tongue. Some people can build up a bacterial coating on the back surface of the tongue. This coating may then emit volatile sulfur compounds (VSCs) that give breath that distinct rotten egg smell. You can remove this coating by brushing the tongue surface with your toothbrush or using a tongue scraper (we can show you how).

See your dentist. Some cases of chronic bad breath could be related to oral problems like tooth decay, gum disease or broken dental work. Treating these could help curb your bad breath, as can removing the third molars (wisdom teeth) that are prone to trapped food debris. It's also possible for bad breath to be a symptom of a systemic condition like diabetes that may require medical treatment.

Quit smoking. Tobacco can leave your breath smelly all on its own. But a smoking habit could also dry your mouth, creating the optimum conditions for bacteria to multiply. Besides increasing your disease risk, this can also contribute to chronic bad breath. Better breath is just one of the many benefits of quitting the habit.

We didn't mention mouthrinses, mints or other popular ways to freshen breath. While these can help out in a pinch, they may cover up the real causes of halitosis. Following the above suggestions, especially dental visits to uncover and treat dental problems, could solve your breath problem for good.

If you would like more information about ways to treat bad breath, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”

These4HabitsCouldHelpYouAvoidGumDisease

Here’s the bad news about periodontal (gum) disease: It’s a leading cause for tooth loss. Even worse: Half of adults over 30 will have some form of it during their lifetime.

But here’s the good news: If caught early, we can often treat and stop gum disease before it can do substantial harm to your mouth. And the best news of all—you may be able to avoid a gum infection altogether by adopting a few healthy habits.

Here are 4 habits you can practice to prevent a gum infection from happening.

Practice daily brushing and flossing. Gum disease is a bacterial infection most often arising from dental plaque, a thin film of bacteria and food particles that accumulates on teeth. Removing plaque daily with brushing and flossing will reduce your chances of a gum infection. And be sure it’s daily—missing just a few days is enough for gum inflammation to get started.

Get regular dental cleanings and checkups. Even the most diligent personal hygiene can miss plaque, which may then harden into a calcified form impossible to remove with brushing and flossing called calculus (tartar). At least twice-a-year professional dental cleanings will clear away any remnant plaque and tartar, which can greatly reduce your risk for dental disease.

Make gum-friendly lifestyle changes. Smoking more than doubles your chances of gum disease. Likewise, a sugar-heavy diet, which feeds disease-causing bacteria, also makes you more susceptible to infection. Quitting smoking, cutting back on alcohol consumption and following a dental-friendly diet could boost your teeth and gum health and avoid infection.

Watch for signs of infection. Although you can greatly reduce your risk of gum disease, you can’t always bring that risk to zero. So, be aware of the signs of gum disease: sometimes painful, swollen, reddened or bleeding gums. If you notice any of these signs, make a dental appointment—the sooner you’re diagnosed and begin treatment, the less likely gum disease will ruin your dental health.

If you would like more information on preventing gum disease, please contact us or schedule an appointment for a consultation.





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