My Blog

Posts for: September, 2020

YouCanHaveaStraighterSmile-JustLiketheQueenofEngland

The monarchs of the world experience the same health issues as their subjects—but they often tend to be hush-hush about it. Recently, though, the normally reticent Queen Elizabeth II let some young dental patients in on a lesser known fact about Her Majesty's teeth.

While touring a new dental hospital, the queen told some children being fitted for braces that she too “had wires” once upon a time. She also said, “I think it's worth it in the end.”

The queen isn't the only member of the House of Windsor to need help with a poor bite. Both Princes William and Harry have worn braces, as have other members of the royal family. A propensity for overbites, underbites and other malocclusions (poor bites) can indeed pass down through families, whether of noble or common lineage.

Fortunately, there are many ways to correct congenital malocclusions, depending on their type and severity. Here are 3 of them.

Braces and clear aligners. Braces are the tried and true way to straighten misaligned teeth, while the clear aligner method—removable plastic mouth trays—is the relative “new kid on the block.” Braces are indeed effective for a wide range of malocclusions, but their wires and brackets make it difficult to brush and floss, and they're not particularly attractive. Clear aligners solve both of these issues, though they may not handle more complex malocclusions as well as braces.

Palatal expanders. When the upper jaw develops too narrowly, a malocclusion may result from teeth crowding into too small a space. But before the upper jaw bones fuse together in late childhood, orthodontists can fit a device called a palatal expander inside the upper teeth, which exerts gentle outward pressure on the teeth. This encourages more bone growth in the center to widen the jaw and help prevent a difficult malocclusion from forming.

Specialized braces for impacted teeth. An impacted tooth, which remains partially or completely hidden in the gums, can impede dental health, function and appearance. But we may be able to coax some impacted teeth like the front canines into full eruption. This requires a special orthodontic technique in which a bracket is surgically attached to the impacted tooth's crown. A chain connected to the bracket is then looped over other orthodontic hardware to gradually pull the tooth down where it should be.

Although some techniques like palatal expanders are best undertaken in early dental development, people of any age and reasonably good health can have a problem bite corrected with other methods. If you are among those who benefit from orthodontics, you'll have something in common with the Sovereign of the British Isles: a healthy, attractive and straighter smile.

If you would like more information about orthodontic treatment options, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Magic of Orthodontics.”


ActQuicklyWithaKnockedOutToothtoEnsureItsLong-TermSurvival

We Americans love our sports, whether as participants or spectators. But there's also a downside to contact sports like soccer, football or basketball: a higher risk of injury, particularly to the mouth and face. One of the most severe of these is a knocked out tooth.

Fortunately, that doesn't necessarily mean it's lost: The tooth can be reinserted into the empty socket and eventually return to normal functionality. But it must be done as soon as possible after injury. The more time elapses, the lower the chances of long-term survival.

That's because of how teeth are held in place in the jaw, secured by an elastic, fibrous tissue known as the periodontal ligament. When a tooth is knocked out some of the ligament's periodontal cells remain on the tooth's root. If these cells are alive when the tooth is reinserted, they can regenerate and reestablish attachment between the ligament and the tooth.

Eventually, though, the cells can dry out and die. If that has already happened before reinsertion, the tooth's root will fuse instead with the underlying bone. The tooth may survive for a short time, but its roots can eventually dissolve and the tooth will be lost.

Your window of opportunity for taking advantage of these live periodontal cells is only 5-20 minutes with the best chances in those earlier minutes. You should, therefore, take these steps immediately after an injury:

  1. Find the tooth, hold it by the crown (not the root end), and rinse off any debris with clean water;
  2. Reinsert the root end into the empty socket with firm pressure;
  3. Place clean gauze or cloth in the person's mouth between the tooth and the other jaw, and ask them to bite down gently and hold their bite;
  4. Seek dental or emergency medical care immediately;
  5. If you're unable to reinsert the tooth, place it quickly in a container with milk and see a dentist immediately.

You can also obtain an Android or IOS smartphone app developed by the International Association of Dental Traumatology called ToothSOS, which will guide you through this process, as well as for other dental emergencies. The quicker you act, the better the chances that the injured person's knocked out tooth can be rescued.

If you would like more information on what to do in a dental emergency, 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 “When a Tooth is Knocked Out.”


MouthBreathingCanLeadtoSeriousOralProblemsEspeciallyforChildren

It's normal for people to breathe through their nose. And for good reason: Nasal breathing filters contaminants, warms and humidifies incoming air, and helps generate beneficial nitric oxide. Chronic mouth breathing, on the other hand, can trigger a number of harmful effects, especially for the teeth and gums.

Because our survival depends on continuous respiration, our bodies automatically seek out the air flow path of least resistance, normally through the nose. But if our nasal passages become obstructed, as with enlarged adenoids or sinus congestion, we may involuntarily breathe through the mouth.

This can lead to oral problems like chronic dry mouth, which not only creates an unpleasant mouth feel, it also produces the ideal environment for dental disease. And, it could cause an even more serious problem for children during jaw and teeth development.

This is because the tongue rests along the roof of the mouth (palate) while breathing through the nose. In this position, the tongue serves as a mold for the upper jaw and teeth while they're growing during childhood. During mouth breathing, however, the tongue moves away from the palate, depriving the jaw and teeth of this molding effect, and possibly resulting in a poor bite.

You can prevent these and other oral problems by seeing a healthcare professional as soon as you notice your child regularly breathing through their mouth. The best professional for this is an ENT, a medical specialist for conditions involving the ears, nose and throat. ENTs provide treatment for diagnosed obstructions involving the tonsils, adenoids and sinuses.

Even so, persistent mouth breathing may already have affected your child's bite. It may be prudent, then, to also have their bite evaluated by an orthodontist. There are interventional measures that can help get jaw development back on track and minimize future orthodontic treatment.

Finally, a child who has undergone treatment to remove nasal breathing obstructions usually reverts to nasal breathing automatically. But sometimes not: To “relearn” normal breathing, a child may need to undergo orofacial myofunctional therapy (OMT) with a certified therapist to retrain their facial muscles and tendons to breathe through the nose.

Your child's tendency to mouth breathing may not seem like a major problem. But prompt attention and treatment could prevent it from interrupting their dental development.

If you would like more information on correcting mouth breathing, 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 “The Trouble With Mouth Breathing.”