Posts for: June, 2020
If all goes normally, we have most of our permanent teeth as we enter puberty. Except, though, when it doesn't—sometimes incoming permanent teeth don't fully erupt, often because there's not enough room for them on the jaw. This can leave all or part of a tooth still up inside the gum and bones.
This condition is known as impaction, and it can cause problems with a person's bite and their smile. This is especially true of the upper canines, those pointed teeth located just under the eyes. Without them present, a person's smile can look oddly different. Moreover, it can worsen their bite and increase the risk of trauma and disease for nearby teeth.
Fortunately, there may be a way to coax impacted canines into erupting into their proper position on the jaw. It will involve, though, some minor surgery and orthodontic intervention to accomplish that feat.
First, though, a patient with missing canines should undergo a thorough orthodontic evaluation. This exam will reveal not only what may be going on with the missing teeth, but how the whole bite has been affected. Knowing the big picture will help direct the next treatment steps.
After pinpointing the impacted teeth's exact position (usually through x-rays or cone beam CT scanning), we then decide whether it's feasible to attempt to expose the teeth. Sometimes, a tooth's position is so out of place that it may be best to remove it and consider a dental implant or other restorative measures.
If it is in a workable position, then the impacted teeth would be exposed surgically (usually by an oral surgeon or periodontist). The surgeon would then bond a small bracket to the exposed tooth and then attach a small chain.
After suturing the incised gum tissues back in place, the chain extending outward from the gums would then be looped over orthodontic hardware attached to other teeth. This will place downward pressure on the upper canine tooth, and over several months prod it to fully erupt.
This may sound like an elaborate procedure, but it's fairly routine and predictable. As a result, a patient can finally get the full benefit of all their teeth, enhance their dental health and transform their smile.
If you would like more information on dealing with impacted 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 “Exposing Impacted Canines.”
Half of all children will injure at least one tooth before adulthood. That's why we're joining with other health professionals this June to promote National Safety Month. As dentists, we want to call particular attention to potential dental injuries and what parents and caregivers can do to help their child avoid them.
The source for a dental injury usually depends on a child's age and development level. Younger children learning to walk and run are more apt to fall, and may hit their mouth on hard or sharp surfaces. Later on, most dental injuries tend to come from contact during sports play or other physical activities.
Your prevention strategy should therefore adjust to your child's age and activity level. If you have an infant starting to walk, for example, don't allow them to move around carrying a bottle, cup or other hard object that could be a source of injury if they fall. Also, keep an eye out for hard furniture or sharp-edged surfaces as they toddle around.
If you have a highly mobile toddler, discourage them from climbing and jumping on furniture, tables or other hard surfaces. If feasible, pad these surfaces and sharp edges to minimize the force of impact from a collision.
To prevent sports-related mouth injuries in older children and teens, your primary defense is an athletic mouthguard. Mouthguards cushion and absorb much of the force generated during hard sports contact. They should be worn for any physical activity with a potential risk for mouth injury, including practice sessions and informal play like a pick-up basketball game.
A type of athletic mouthguard known as “boil and bite” is readily available in retail sporting goods stores. After purchase, it is softened in very hot water; the wearer then places it in their mouth and bites down to form a permanent impression. Boil and bite mouthguards offer protection, but they can be bulky and uncomfortable to wear.
For a higher level of protection along with a more accurate and comfortable fit, a custom mouthguard created by a dentist is a more desirable option. These are based on a detailed impression of the wearer's bite, so the fit can't be beat. Both types of mouthguard need upgrading periodically in young wearers to accommodate dental development as they age.
Accidents can happen, but there's much you can do to reduce the likelihood of injury to your child's teeth. Protective measures and equipment—as well as a watchful eye—can go far to help them emerge from these active, early years dentally unscathed.
If you would like more information about dental safety, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Top 10 Oral Health Tips for Children” and “Athletic Mouthguards.”
Your child could hit a speed bump on their road to dental maturity—tooth decay. In fact, children are susceptible to an aggressive form of decay known as Early Childhood Caries (ECC) that can lead to tooth loss and possible bite issues for other teeth.
But dentists have a few weapons in their arsenal for helping children avoid tooth decay. One of these used for many years now is the application of sealants to the biting surfaces of both primary and permanent teeth. Now, two major research studies have produced evidence that sealant applications help reduce children's tooth decay.
Applying sealant is a quick and painless procedure that doesn't require drilling or anesthesia. A dentist brushes the sealant in liquid form to the nooks and crannies of a tooth's biting surfaces, which tend to accumulate decay-causing bacterial plaque. They then use a curing light to harden the sealant.
The studies previously mentioned that involved thousands of patients over a number of years, found that pediatric patients without dental sealants were more than three times likely to get cavities compared to those who had sealants applied to their teeth. The studies also found the beneficial effect of a sealant could last four years or more after its application.
The American Dental Association and the American Academy of Pediatric Dentistry recommend sealants for children, especially those at high risk for decay. It's common practice now for children to first get sealants when their first permanent molars erupt (teeth that are highly susceptible to decay), usually between the ages of 5 and 7, and then later as additional molars come in.
There is a modest cost for sealant applications, but far less than the potential costs for decay treatment and later bite issues. Having your child undergo sealant treatment is a worthwhile investment: It could prevent decay and tooth loss in the near-term, and also help your child avoid more extensive dental problems in the future.