Before we begin correcting a malocclusion (poor dental bite), we need to ask a few questions: How extensive is the malocclusion? How far must we move the teeth to correct it? How might the patient's jaw size impact treatment?
Answering these and other questions help us develop an effective treatment plan. And depending on the answers, we might need to look at other procedures before we install braces—like removing one or more of the teeth.
This isn't a subject to approach lightly: All teeth play an important role in dental function and smile appearance, and ordinarily we want to preserve teeth, not remove them. Sometimes, however, it may be a necessary action to achieve our goal of an improved dental bite.
For example, it might be necessary for correcting a malocclusion caused by severe teeth crowding. This occurs when one or both of the jaws hasn't grown to a sufficient size to accommodate all of the teeth erupting on it. As a result, some of the teeth could come in out of their proper alignment.
If caught early before puberty, we may be able to use other techniques to alleviate crowding, like a device called a palatal expander that influences an upper jaw to widen as it grows. If successful, it could provide later teeth more room to erupt in their proper positions.
But even if additional jaw growth occurs, it may not be enough to avoid a malocclusion or treatment with braces. Alleviating further crowding by removing teeth in little noticed areas could help with subsequent orthodontics.
Removing teeth may also be the answer for other problems like an impacted tooth, in which the tooth has not fully erupted and remains submerged in the gums. It's sometimes possible to use a technique to “pull” the tooth down where it should be; but again, that will still require jaw space that may not be available. The more effective course might be to remove the impacted tooth.
Whether or not tooth extraction will be needed can depend on a thorough orthodontic evaluation and full consideration of all the available options. Even though the ideal situation is to correct a bite with all teeth present and accounted for, it may be for the better good to sacrifice some.
If you would like more information on orthodontic techniques, 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.”
The humble squirrel—darlings to some, bird feeder-robbing nuisances to others—has its own month. Since 1995, the Squirrel Lovers Club of Chicago has celebrated October as Squirrel Awareness Month to pay tribute to this diverse family of rodents with over 270 species. It's also an opportunity to indulge in our favorite “squirrelly” fact: Squirrels' teeth don't stop growing.
And we do mean grow. A squirrel's four front incisors increase about 6 inches a year—a good thing since squirrels put those teeth through their paces gnawing through hard-shelled nuts and seeds. If they didn't keep growing, you'd see plenty of squirrels with worn-to-nothing front teeth.
We humans have some cause to be envious because, unlike squirrels, our permanent teeth stop growing by the time we reach adulthood. That could be a problem since nearly all of us encounter tooth wear as we age.
And it could be even worse. Bad habits like crunching ice, biting into hard foods or using our teeth as tools can contribute to accelerated wear. Some people also involuntarily clench or grind their teeth, creating higher than normal pressure that can wear down teeth.
Suffice it to say, it's worth the effort to quit conscious bad dental practices to prevent your teeth from wearing faster than normal. A teeth-grinding habit, though, may require more than willpower: We'll need to look at other ways to reduce its effect on your teeth.
First, you may want to try to reduce chronic stress, the top contributor to adult teeth grinding. Better stress management with the help of counseling, relaxation techniques, biofeedback or group therapy can all help reduce the occurrence of this destructive habit.
Such efforts, though, can take time. In the meantime, we may be able to help you reduce the effect of a grinding habit with a custom-made mouth guard. This plastic guard worn in the mouth prevents teeth from making hard contact with each other during grinding, and so it reduces the damaging forces that can wear down teeth.
By the way, if you've already experienced excessive tooth wear, not all hope is lost. We may be able to restore your teeth to normal length with the help of bonded porcelain veneers or crowns. After a thorough evaluation, we can give you options for turning back the “age clock” on your smile.
Our teeth may not continuously grow like squirrels', but we can still protect them from the effects of excessive wear. Good dental practices and habits—and restorative measures when necessary—can keep your smile looking as young as ever.
The top cause for adult tooth loss isn't decay or trauma—it's periodontal (gum) disease. The disease may begin with the gums, but it can ultimately damage underlying bone enough to weaken its support of teeth, causing them to loosen and fall out.
But that's not the end of the havoc gum disease can wreak. The consequences of an uncontrolled infection can ripple beyond the mouth and worsen other health problems like diabetes, heart disease or arthritis.
The common link between gum disease and these other conditions is the inflammatory response, a natural mechanism to fight infection caused by disease or trauma. This mechanism changes blood vessels to increase blood flow to hasten the travel of protective white blood cells to the injury or disease location.
But if this mechanism that supports healing becomes chronic, it can actually do harm. The chronic inflammation that occurs with gum disease can damage mouth structures, just as inflammation from diabetes or arthritis can damage other parts of the body. And any form of chronic inflammation, even that found in gum disease, can worsen other inflammatory diseases.
You can lessen this link between gum disease and other conditions—as well as improve your oral health—by preventing or seeking prompt treatment for any periodontal infection in the following ways:
- Practice daily brushing and flossing to clear away bacterial dental plaque, the main cause of gum disease;
- See your dentist regularly for more thorough dental cleanings and checkups;
- See your dentist promptly if you notice red, swollen or bleeding gums, common signs of a gum infection;
- Stop smoking to lower your risk for both gum disease and tooth decay;
- Adopt a healthy diet, which can help you lose weight (a factor in diabetes and other inflammatory diseases) and strengthen your immune system;
- Manage other inflammatory conditions to lessen their effect on your gum disease risk.
Taking these steps can help you avoid the inflammation caused by gum disease that might also affect the rest your body. Seeking prompt treatment at the first sign of an infection will also minimize the damage to your teeth and gums and the effect it could have on the rest of your health.
If you would like more information on prevention and treatment of gum disease, 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 “Gum Disease & Systemic Health.”
To anyone immersed in the “X-Men Universe” Hugh Jackman will always be Wolverine, a role he played in seven movies. But there’s more to this Australian actor than mutant bone claws and mutton chops that would make Elvis envious. Jackman has also starred in over 20 non-superhero films, including Les Misérables, for which he won a Golden Globe. He is also a Tony award-winning Broadway performer—with a winning smile.
With his famed character Logan/Wolverine fading in the rearview mirror, Jackman has returned to his musical roots. He will play Harold Hill in the Broadway revival of The Music Man, set to open in Fall 2020. And since May 2019 he’s been on world tour with Hugh Jackman: The Man. The Music. The Show., featuring Jackman and a supporting cast performing songs from favorite shows and films, including Les Misérables and the 2017 hit The Greatest Showman.
The Show, with 90 planned stops throughout Europe, North America and Oceania, is a decidedly different “universe” from the X-Men. As Wolverine, Jackman could get away with a scruffier look. But performing as Jean Valjean or the bigger-than-life P.T. Barnum, he has to bring a vastly different look to the role, which brings us to Jackman’s teeth…
Once upon a time, Jackman’s teeth were an unflattering gray—definitely not a good look for stage or film. So with the help of his dentist, Jackman set about upgrading his smile with teeth whitening. Teeth whitening is a great way to take a dull, stained smile and turn up the volume on its brightness—and attractiveness—a notch or two. A dentist applies a bleaching solution that stays in contact with the teeth for a few minutes. The process is often aided by special lighting.
A professional application is especially desirable if, like Jackman, you want “Goldilocks” brightness: not too little, not too much, but just right for you. Dentists can precisely control the tint level to get a brighter but more naturally looking white. Of course, you can also get a dazzling “Hollywood” smile if you so desire.
And although the effect of teeth whitening isn’t permanent, a dental application can last a while, depending on how well you manage foods and beverages that stain teeth. With a touchup now and then, you may be able to keep your brighter smile for years before undergoing the full procedure again.
One important note, though: This technique only works with outer enamel staining. If the discoloration originates from within the tooth, the bleaching agent will have to be placed internally, requiring access to the inside of the tooth. An alternative would be porcelain veneers to mask the discoloration, an option that also works when there is ultra-heavy enamel staining.
If you’re tired of your dull smile, talk with us about putting some pizzazz back into it. Teeth whitening could be your way to get a smile worthy of Broadway.
If you would like more information about teeth whitening, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Whitening Traumatized Teeth.”
A full night's sleep isn't a luxury—we all need it for a healthy mind and body. But 50-70 million people in the U.S. aren't getting enough sleep because of a chronic sleep disorder like obstructive sleep apnea (OSA).
OSA happens when a sleeper's airway becomes blocked (most commonly by the tongue), cutting off oxygen to the brain. The body rouses from sleep to overcome the blockage. This awakening could last only a few seconds, after which the person immediately goes back to sleep. But it can occur hundreds of times a night and interrupt deeper sleep needed for a good night's rest.
Sleep disorders like OSA are a significant medical problem that could contribute to serious health issues like high blood pressure or cardiovascular disease. If you're experiencing fatigue, irritability or your family's complaints of you snoring, you should see a physician for diagnosis and treatment options.
You should also consider another health professional who could be helpful in dealing with OSA—and may even be able to provide a treatment option: your dentist. Here's how.
A dentist could discover your OSA. Because of twice-a-year dental visits, dentists often see patients more frequently than other healthcare providers. A properly trained dentist could pick up on signs and symptoms of sleep disorder, including patients falling asleep and even snoring while in the dentist's chair.
Dentists are familiar with the mouth. Few healthcare providers focus on the oral cavity like dentists. Besides the teeth and gums, dentists also have extensive knowledge of the tonsils, uvula and tongue that often play a role in sleep disorders. As such, a dentist may notice abnormalities during routine exams that might contribute to airway obstruction during sleep.
Dentists provide a treatment option. Many OSA patients use a CPAP mask to maintain an open airway during sleep. But CPAP therapy can be uncomfortable for some. For mild to moderate cases of OSA, dentists can create an oral appliance based on the patient's mouth dimensions that prevents the tongue from sinking back into the throat.
If you believe you may have OSA or a similar sleep disorder, by all means speak with your doctor. But also mention it to your dentist—your dental provider might hold the key to a better night's sleep.
If you would like more information on how we could help with your sleep apnea symptoms, 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 “Sleep Disorders & Dentistry.”
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