Bite problems aren't limited to teeth simply out of position. The problem could be some teeth aren't there—visibly, that is. They still exist below the gums and bone, but they've been crowded out and blocked from erupting. We call this condition impaction.
Any tooth can become impacted and affect the bite, but a person's smile suffers more if it involves visible front teeth. This is especially so if the teeth in question are upper canines or "eye teeth"—the smile doesn't look normal without these pointed teeth on either side of the central and lateral incisors.
Impacted teeth can also contribute to more than a cosmetic problem: they're more susceptible to abscesses (pockets of infection) or root damage both to themselves or neighboring teeth. To minimize these potential health issues, we'll often remove impacted teeth surgically (as is often done with wisdom teeth).
But because of their important role in not only appearance but also bite function, we may first try to assist impacted canines to fully erupt before considering extraction. It takes a bit of orthodontic "magic," but it can be done.
Before we can make that decision, though, we want to precisely locate the impacted teeth's positions and how it may affect other teeth. This initial evaluation, often with advanced diagnostics like CT scanning or digital x-rays, helps us determine if the impacted teeth are in a workable position to save. If they're not, we may then need to consider removing them and ultimately replacing them with a dental implant or similar restoration.
But if their position is workable and there are no other impediments, we can proceed with helping them erupt. To do this we'll have to first expose them by creating a small opening in the gums through minor surgery. We then bond a small bracket to the tooth, to which we'll attach a small chain that we then attach to orthodontic braces. This enables us to exert continuous pressure on the tooth.
Over time, the pressure coaxes the tooth to erupt. We may still need to apply other forms of orthodontics and cosmetic procedures, but using this procedure to rescue impacted canines can produce a healthier and more attractive smile.
If you would like more information on treating complex bite problems, 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 “Exposing Impacted Canines.”
If you think “vaping” electronic cigarettes (e-cigarettes for short) is healthier for your teeth and gums than smoking cigarettes, you might be disappointed with the latest research. A number of studies seem to indicate e-cigarettes could be just as damaging to your mouth as traditional cigarettes.
An e-cigarette is a device containing a chamber for liquids and a means to heat the liquid into a vapor. The user then inhales or “vapes” the vapor, which contains nicotine and flavorings. The heat also pressurizes the vapor causing it to expel as an aerosol into the mouth.
Researchers have found the ingredients and aerosol effect could lead to potential health problems. An Ohio State University researcher found that vaping disrupted the normal balance of microorganisms in the mouth known as the oral microbiome. This imbalance could make it easier for disease-causing bacteria to proliferate, particularly those most responsible for periodontal (gum) disease.
Another study coming out of the University of Rochester and Stony Brook University in New York detected cell damage in gum tissue caused by e-cigarette vapor similar to that caused by regular cigarette smoke. Some of this damage seemed to result from the flavoring agents used in the e-cigarette liquid, as well as nicotine.
Another study from Quebec, Canada appears to concur with the New York study. These researchers found the damage caused by e-cigarette vapor might substantially increase the rate of cell death in oral tissues by as much as 50% over a short period of time. This kind of damage can lead to higher risks of dental diseases like gum disease or tooth decay.
While we don’t know the long-term effect of using e-cigarettes on both oral and general health, these studies are alarming: They seem to show vaping may cause some of the same problems as smoking. With the jury still out, the prudent thing to do is limit or avoid vaping altogether to protect your mouth from these unhealthy outcomes.
Multi-platinum recording artist Janet Jackson has long been known for her dazzling smile. And yet, Jackson admitted to InStyle Magazine that her trademark smile was once a major source of insecurity. The entertainer said, “To me, I looked like the Joker!” It was only after age 30 that the pop icon came to accept her unique look.
Jackson is not alone. A study commissioned by the American Association of Orthodontists found that more than one third of U.S. adults are dissatisfied with their smile. But there’s good news—modern dentistry can correct many flaws that can keep you from loving your smile, whether you’re unhappy with the color, size, or shape of your teeth. Here are some popular treatments:
Professional teeth whitening: Sometimes a professional teeth whitening will give you the boost you need. In-office whitening can dramatically brighten your smile in just one visit.
Tooth-colored fillings: If you have silver-colored fillings on teeth that show when you smile, consider replacing them with unnoticeable tooth-colored fillings.
Dental bonding: If you have chipped, cracked, or misshapen teeth, cosmetic bonding may be the fix you’re looking for. In this procedure, tooth colored material is applied to the tooth’s surface, sculpted into the desired shape, hardened with a special light, and polished for a smooth finish.
Porcelain veneers: Dental veneers provide a natural-looking, long-lasting solution to many dental problems. These very thin shells fit over your teeth, essentially replacing your tooth enamel to give you the smile you desire.
Replacement teeth: Is a missing tooth affecting your self-confidence? There are several options for replacing missing teeth, from a removable partial denture to a traditional fixed bridge to a state-of-the-art implant-supported replacement tooth. Removable partial dentures are an inexpensive way to replace one or more missing teeth, but they are less stable than non-removable options. Dental bridges, as the name implies, span the gap where a tooth is missing by attaching an artificial tooth to the teeth on either side of the space. In this procedure, the teeth on both sides of the gap must be filed down in order to support the bridgework. Dental implants, considered the gold standard in tooth replacement technology, anchor long-lasting, lifelike replacements that function like natural teeth.
After coming to embrace her smile, Jackson asserted, “Beautiful comes in all shapes, sizes, and colors." If you don’t feel that your smile expresses the beauty you have inside, call our office to schedule a consultation. It’s possible to love your smile. We can help.
For more information, read Dear Doctor magazine article “How Your Dentist Can Help You Look Younger.”
While pregnancy is an exciting time for expectant mothers, it can pose extra health challenges. This is especially true regarding dental health.
Because of hormonal changes that naturally occur during pregnancy, your teeth and gums are at higher risk for dental disease. These changes can increase cravings for carbohydrates, particularly sugar. Increased sugar consumption feeds bacteria found in dental plaque, which is most responsible for tooth decay and periodontal (gum) disease.
Hormonal changes can also make your gums more susceptible to infection. Conditions may be favorable for a form of gum disease called pregnancy gingivitis, which can begin as an infection in the surface layers of the gums. But like other forms of gum disease, pregnancy gingivitis can advance below the gum line and lead to serious health consequences.
Because of this "pregnancy effect" on your teeth and gums, there are some things to which you should pay heed while you're expecting. First and foremost, keep up a daily regimen of brushing and flossing to remove accumulated dental plaque. You should also control your sugar intake to minimize bacterial growth that can cause disease.
It's also important for you to continue regular dental visits during your pregnancy. Your dentist will monitor your dental health and initiate treatment if you begin to show signs of disease. Besides professional cleanings, your dentist may also prescribe antibacterial mouthrinses to combat bacteria.
As far as dental procedures, essential treatments like fillings, root canals or extractions are usually considered safe to perform during pregnancy. But elective treatments of a cosmetic nature are best postponed until after your baby's delivery.
One last tip: because of the higher risk of tooth decay or gum disease, be on the lookout for any abnormal signs in your mouth. This includes spots on the teeth, tooth pain or swollen, reddened or bleeding gums. If you see any of these signs, see your dentist as soon as possible.
Your teeth and gums are indeed at risk for disease during pregnancy. But daily hygiene, regular dental care and attention to signs of disease can help keep that danger at bay.
If you would like more information on prenatal dental care, 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 “Dental Care During Pregnancy.”
Tooth decay is a destructive oral disease, which along with periodontal (gum) disease is most responsible for tooth loss. And as you age, your disease risk goes up.
One form of decay older people often experience is root cavities. Unlike those occurring in the visible crown, root cavities often occur below the gum line and are especially destructive to tooth structure.
That's because, unlike the crown protected by ultra-hard enamel, the roots are covered by a thin, mineralized material called cementum. Although cementum offers some protection, it can't compare with the decay-resistant capacity of enamel.
The roots also depend on gum coverage for protection. But unfortunately, the gums can shrink back or recede, usually due to gum disease or over-aggressive brushing, and expose some of the root surface. With only the cementum to protect them, the roots can become highly susceptible to decay. If a cavity forms here, it can rapidly advance into the tooth's interior, the pulp, weakening the tooth and increasing its risk of loss.
To stop the decay, we must treat root cavities much like we do with crown cavities: by removing any decayed structure and then filling the cavity. But root cavities are often more difficult to access depending on how far below the gum line they extend. We may need to perform minor gum surgery to expose the cavity to treat it.
But as with any form of tooth decay, the best strategy is to prevent root cavities in the first place. Your first line of defense is a daily hygiene habit of brushing and flossing to remove dental plaque, the main cause for tooth decay. You should also visit your dentist at least twice a year (or more, if recommended) for more thorough cleanings and checkups. Your dentist can also recommend or prescribe preventive rinses, or apply fluoride to at-risk tooth surfaces to strengthen them.
You should also be on the lookout for any signs of gum disease. If you see swollen, reddened or bleeding gums, see your dentist as soon as possible. Stopping possible gum recession will further reduce your risk of root cavities.
If you would like more information on the prevention and treatment of tooth decay, 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 “Root Cavities: Tooth Decay Near the Gum Line Affects Many Older Adults.”
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