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CorrectingaPoorBiteWithBraces-aTrueWonder

Braces are so common that we often view them as "ho-hum." But there are aspects about braces that make them remarkable. For one, the fact that we can move teeth at all is a wonder of nature.

We normally experience our teeth as firmly set in the jaw, which can easily lead to assuming they're permanently fixed to the bone. They're not. Teeth are actually held in place by a fibrous gum tissue called the periodontal ligament that lies between them and the jawbone. The ligament anchors to both with tiny fibers, which on the tooth side affixes within a thin substance called cementum deposited on the tooth root.

As we said, we don't normally notice teeth moving. But the periodontal ligament does allow movement on a miniscule scale as a response to normal pressures that accompany biting and chewing. Although we're unaware of it, this movement takes place as the bone and cementum ahead of the direction of movement begin to dissolve. Simultaneously, new bone and cementum develops on the other side of the tooth to stabilize the movement.

Orthodontic treatment takes advantage of this natural process. The anchored wires of braces through attached brackets place pressure on the teeth in the intended direction for tooth movement. The natural mechanism described earlier does the rest. Over time, orthodontists have developed an amazing amount of precision working within this mechanism.

Another aspect about braces and other methods we may take for granted is our motive for even trying to move teeth in the first place. It may seem we're only realigning teeth to produce a more attractive smile—which they can do and why we often refer to braces as the "original smile makeover." But there's an even greater desire—straightening teeth can improve dental health.

Poor bites in turn cause other problems. Misaligned teeth are more difficult to keep clean of bacterial plaque, which increases the risk of disease. A poor bite can also accelerate teeth wear and contribute to gum problems like recession. We can eliminate or minimize these problems through bite correction.

Whatever your age, braces or other means can vastly benefit your health and your appearance. They may not always seem so, but braces are one of the true wonders of dental care.

If you would like more information on bite correction through orthodontics, 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 “Moving Teeth With Orthodontics.”

YouNeedtoActFasttoSaveaLooseTooth

Some things in life are almost guaranteed to make you go, "Uh, oh"—your car won't start, your a/c goes out, or, worse yet, you get an unexpected letter from the IRS.

Here's another: One of your teeth is loose. And, if you don't act quickly, that loose tooth may soon become a lost tooth.

But first, we need to find out why it's loose. It's usually due to one of two types of injury related to your bite. One type is called primary occlusal trauma. This results from your teeth encountering higher than normal biting forces. This often happens if you habitually gnash or grind your teeth together outside of normal functions like eating or speaking.

The other type is secondary occlusal trauma. In this case, the supporting gum tissues and bone have been weakened or lost by disease, with the gum tissues possibly becoming detached. Without this support, even normal biting forces could loosen a tooth.

Our treatment approach for a loose tooth may differ depending on which of these is the cause. For primary occlusal trauma, we want to reduce the biting forces that have contributed to loosening the tooth. One way to do this is to create a mouthguard that when worn prevents teeth from making solid contact during grinding episodes.

For secondary trauma, we want to first focus on treating any gum disease responsible for weakening the gum tissues. Once we have it under control, the gums and bone tissues can heal and possibly regain and strengthen their attachment with the tooth.

At the same time, we may also need to stabilize a loose tooth to prevent its loss. This usually involves splinting, whereby we use neighboring healthy teeth to support the loose tooth. One way to do this is to attach a metal strip across the backs of the loose tooth and its more stable neighbors, or by way of a channel cut through the top biting surfaces of the teeth.

If a loose tooth regains its attachment with the gums and bone, it may stabilize and any splinting can be removed. If not, splinting may become a permanent solution. Either way, prompt treatment can help us save your loose tooth.

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 “Loose Teeth: Biting Forces Can Loosen Teeth.”

IfYouFindFlossingTooDifficultTryaWaterFlosser

Dental plaque, that gritty bacterial film coating your teeth, is the top cause for tooth decay and periodontal (gum) disease. You can see and feel a lot of it—but not all of it. Some deposits can lodge snugly between your teeth, and can cause dental disease just as much as what's out in the open.

The problem with between-teeth plaque is that even a solid brushing habit might not effectively remove it. That's why you flossing should also be part of your daily oral hygiene.

If the thought of flossing, however, causes you to let out an audible sigh, we understand. Flossing typically engenders less enthusiasm than brushing, mainly because many find flossing time consuming and difficult to do.

If traditional flossing isn't your bag, we may have a reasonable alternative. Oral irrigation is a hygiene method for removing plaque between teeth using a pressurized water spray. You direct the water spray between your teeth using a handheld wand (which somewhat resembles a power toothbrush) and small hose attached to a countertop pump appliance.

A mainstay in dental offices, oral irrigators (or water flossers) have been available for home use since the 1960s. They're ideal for people who have problems with manual dexterity or who may not want to contend with flossing thread. They also make it easier for patients wearing braces to clean between their teeth, a monumental task using regular floss.

As to effectiveness, oral irrigation appears to match that of regular flossing, especially for orthodontic patients. Clinical studies in the early 2000s compared patients with braces using oral irrigation with those who were brushing only. Those using irrigation were able to remove five times as much plaque as the other group.

There are a number of comparable oral irrigation brands on the market from which to choose, and your dentist can advise you on features to look for when purchasing one. Just be sure you're using some method, oral irrigation or traditional flossing, to remove disease-causing plaque from between your teeth—either will go a long way in keeping your teeth and gums healthy.

If you would like more information on flossing methods, 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 “Cleaning Between Your Teeth.”

LoveandHipHopHostsNo-GapSmileandHowYouCanHaveOneToo

Nina Parker, the host of Love & Hip Hop for six seasons, is now busy with the new game show Blockbusters and her own talk show The Nina Parker Show. But even with a full plate, she took time recently for some personal care—getting a new smile.

Parker's fans are familiar with her noticeable tooth gap. But a video on TikTok in February changed all that: In the video, she teasingly pulls away a mask she's wearing to reveal her smile—without the gap.

Parker and other celebrities like Madonna, Michael Strahan and David Letterman are not alone. Teeth gaps are a common smile feature, dating back millennia (even in fiction: Chaucer described the Wife of Bath as being "gap-toothed" in The Canterbury Tales).

So, what causes a tooth gap? Actually, a lot of possibilities. The muscle between the teeth (the frenum) may be overly large and pushing the teeth apart. There may be too much room on the jaw, so the teeth spread apart as they develop. It might also have resulted from tongue thrusting or late thumb sucking as a child, influencing the front teeth to develop forward and outward.

A tooth gap can be embarrassing because they're often front and center for all the world to see, but they can also cause oral health problems like complicating oral hygiene and increasing your risk for tooth decay. They can also contribute to misalignment of other teeth.

Fortunately, there are ways to alleviate a gap. One way is to move the teeth closer together with either braces or removable clear aligners. This may be the best approach if the gap is wide and it's contributing to misalignment of other teeth. You may also need surgery to alter the frenum.

You can also reduce less-pronounced gaps cosmetically with dental bonding or porcelain veneers. Bonding involves applying a type of resin material to the teeth on either side of the gap. After some sculpting to make it appear life-like, we harden the material with a curing light. The result is a durable, tooth-like appearance that closes the gap.

A veneer is a thin wafer of porcelain, custom-made to fit an individual patient's tooth. Bonded to the front of teeth, veneers mask various dental flaws like chips, deformed teeth, heavy staining and, yes, mild to moderate tooth gaps. They do require removing a small amount of enamel on the teeth they cover, but the results can be stunning—completely transformed teeth without the gap.

Getting rid of a tooth gap can be a wise move, both for your smile and your health. You may or may not take to social media to show it off like Nina Parker, but you can feel confident to show the world your new, perfect smile.

If you would like more information about treating teeth gaps and other dental flaws, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Space Between Front Teeth.”

TakeCareofYourGums-AndYourGumsWillTakeCareofYourTeeth

Even masterpiece paintings need an appropriate frame. Likewise, our gums help bring out our teeth's beauty.

But gums are more than enhancements for our smile appearance—they're also critical to good oral health. In recognition of National Gum Care Month, there are a couple of reasons why you should look after your gums just like you do your teeth.

For one, the gums are primarily responsible for holding teeth in place. With healthy gums, the teeth won't budge even under chewing stress (although this attachment does allow for micro-movements). Diseased gums, however, are another story: Advancing gum disease weakens gum attachment, causing teeth to loosen and eventually give way.

The gums also protect the root end of teeth from pathogens and oral acid, just as enamel protects the crown. Gum disease can also foul up this protective mechanism as infected gums have a tendency to shrink away from the teeth (also known as gum recession). This exposes the roots to an increased risk for disease.

So, taking care of your gums is an essential part of taking care of your teeth. And, the basic care for them is the same as for your pearly whites: daily brushing and flossing and regular dental cleanings. These habits remove the buildup of dental plaque, a thin film of food and bacteria that cause gum disease.

It's also important to keep a watchful eye for any signs of gum abnormalities. Be on the alert for unusual gum redness, swelling and bleeding. Because these may be indicators of an infection already underway, you should see us for an examination as soon as possible.

If we find gum disease, we can begin immediate treatment in the form of comprehensive plaque removal. If the disease has advanced to the root, we may need to access this area surgically to remove any infection. So, the sooner we're able to diagnose and treat an infection, the less likely that scenario will occur.

Ironically, something meant to protect your gums could also damage them. You can do this with excessive and overly aggressive brushing. Putting too much "elbow grease" into brushing, as well as doing it more than a couple of times a day, could eventually cause the gums to recede. Instead, apply only the same degree of pressure to brushing as you would while writing with a pencil.

As we like to tell our patients, take care of your mouth, and your mouth will take care of you. Something similar could be said about your gums: Take care of these essential soft tissues, and they'll continue to support and protect your teeth.

If you would like more information about periodontal gum care, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Daily Oral Hygiene.”





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