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Posts for: March, 2020

RemovingTeethCouldImprovetheOutcomeforaCrowdedBite

The primary goal of dental care is to preserve teeth. But there are circumstances in which removing a tooth, even a relatively healthy one, could prove best in the long run.

A malocclusion (poor bite) related to crowding might fit such a circumstance. Crowding occurs when the size of the jaw is too small for the teeth coming in. With not enough space, some teeth could erupt out of their proper positions. Removing certain teeth frees up space to eventually allow braces or other orthodontic devices to re-align the teeth.

The teeth most frequently removed are the first bicuspids, located between the cuspid (the "eyeteeth" directly under the eyes) and the back teeth, and the second premolar. Removing these won't normally affect appearance or functionality once orthodontic or cosmetic treatments are complete.

Because of the mechanics of jaw development it might be necessary to perform these extractions several years before orthodontic treatment. This could create another potential problem: the time lag could adversely affect bone health.

This is because bone, as living tissue, has a life cycle with cells forming, functioning and then dissolving, and new cells taking their place. When teeth are chewing or in contact with each other they generate force that travels through the tooth roots to the bone and stimulates cell growth at a healthy replacement rate.

But when a tooth is missing, so is this stimulation. This slows the replacement rate and eventually leads to decreased bone volume. Too much bone loss could create obstacles for orthodontic treatment or a future dental implant.

To avoid this, the dentist will often place a bone graft with processed bone mineral within the empty tooth socket right after extraction. The graft serves as a scaffold for bone cells to grow upon. The graft (plus any other added growth boosters) can help maintain a healthy level of bone volume to facilitate future orthodontic or restorative treatments.

Since targeted extraction for orthodontics is time-sensitive, you should have your child's bite evaluated by an orthodontist by age 7 to see if any action is necessary. The earlier a malocclusion is detected, the more likely a more attractive and healthy smile will be the ultimate outcome.

If you would like more information on correcting poor bites, 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 “Tooth Removal for Orthodontic Reasons.”


By Warren General Dentistry
March 19, 2020
Category: Oral Health
OralHygieneisntEasywithBraces-butitsStillDoable

If you’re about to undergo orthodontic treatment, you’re going to face a challenge keeping your teeth and gums clean wearing braces. That in turn could increase your chances for tooth decay or periodontal (gum) disease, which could diminish your future dental health and disrupt your current orthodontic treatment.

The main hygiene tasks of brushing and flossing are more difficult with braces because of the fixed hardware on the teeth. Your toothbrush or floss can’t always easily maneuver around the wires and brackets, increasing the chances you’ll miss some areas. These neglected areas can then accumulate dental plaque, a thin film of bacteria and food particles that’s most responsible for disease.

But although difficult, effective oral hygiene isn’t impossible.  First and foremost, you’ll need to take more time to be thorough with brushing and flossing than you might normally without braces.

Second, there are some specialized hygiene tools to make the job easier. Instead of a regular toothbrush try an interproximal brush. This special brush has a long and thin bristled head (resembling a pipe cleaner) that can maneuver in and around orthodontic hardware much easier than a regular brush.

For flossing, use a floss threader, a device through which you thread floss on one end and then pass the other sharper end between your teeth. Once through, you release the floss from it and floss as usual, repeating the process with the threader for each tooth. Another option is an oral irrigator, a device that emits a pressurized spray of water between teeth to loosen plaque and flush it away. Many orthodontic patients have found this latter option to be quite effective.

Finally, continue seeing your regular dentist for regular appointments in addition to your orthodontist. Besides cleaning those hard to reach areas, your dentist can also provide other preventive measures like topical fluoride for strengthening enamel and prescription mouth rinses that inhibit bacterial growth. You should also see your dentist immediately if you notice signs of disease like spots on the teeth or swollen or bleeding gums.

Keeping your teeth clean while wearing braces is a top priority. Doing so will help ensure your new smile after braces is both an attractive and healthy one.

If you would like more information on dental care during 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 “Caring for Teeth during Orthodontic Treatment.”


By Warren General Dentistry
March 09, 2020
Category: Dental Procedures
Tags: chipped tooth  
OneVisitMayBeAllYouNeedtoRestoreaChippedTooth

As tough as teeth are, life can take its toll on them and sometimes lead to parts of them chipping off. Although it might not affect a tooth's overall health, it can certainly downgrade its appearance.

But we can restore a chipped tooth like new, and it may not require extensive dental work. Thanks to a versatile dental material called composite resin, we can often bring back a tooth's natural appearance in just one visit.

Tooth-colored resins have been around for decades, but their application has been limited due to issues with durability. Recently developed bonding techniques, though, have made them a workable option for restoring mild to moderate tooth defects.

We do this by applying and bonding the composite resin to a tooth to “fill in” the missing portion. While it's often a short process, it does require a thorough understanding of tooth anatomy, function and aesthetics.

We begin with a comprehensive exam to assess the true condition of a chipped tooth. Some dental defects might be better served with a porcelain restoration like a veneer or crown for best results. Still, there are a wide range of defects for which composite resins is a solid repair choice.

Once we've determined bonding is appropriate, we prepare the tooth by first roughening its outer surface and then etching it with an acid solution to increase bonding strength. We then apply a luting agent, a kind of dental cement, also to aid with bonding.

We then begin applying the composite resin in liquid form, one layer at a time. This layering process helps simulate the color depth and shape of the tooth, and to further incorporate strength into the restoration. We're also careful at this point to match the variations of color with those of the surrounding teeth so that it looks as natural as possible.

As we finish each layer, we apply a curing light to harden the resin. We can then polish the finished product and make adjustments for the bite. The end result is a tooth that not only looks whole, but natural and blended with the rest of your teeth. Bonding could truly change your smile in just one visit.

If you would like more information on cosmetic dental restorations, 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 “Artistic Repair of Front Teeth With Composite Resin.”