In any given year, 4 million tweens and teens are in the process of having their teeth straightened with braces or clear aligners. It's so common we tend to consider orthodontic treatment for young people as a rite of passage into adulthood.
But it doesn't necessarily have to be that way—it might be possible to stop or at least minimize a poor bite before it fully develops. That's the goal of interceptive orthodontics—treatments that head off or “intercept” a bite problem early.
The goal isn't necessarily to reposition misaligned teeth, but to correct a problem that can lead to misalignment. Here are some examples.
A narrow jaw. A narrowly developing jaw can crowd incoming teeth out of their normal positions. For the upper jaw, though, we can take advantage of a temporary separation in the bones in the roof of the mouth (palate) with a device called a palatal expander. Placed against the palate, the expander exerts outward pressure on the teeth and jaw to widen this separation. The body fills in the gap with bone to gradually widen the jaw.
Abnormal jaw alignment. It's possible for a jaw to develop abnormally during childhood so that it extends too far beyond the other. Using a hinged device called a Herbst appliance, it's possible to interrupt this abnormal growth pattern and influence the bones and muscles of the jaw to grow in a different way.
Missing primary teeth. An important role for a primary (baby) tooth is to hold a place for the future permanent tooth. But if the primary tooth is lost too soon, other teeth can drift into the space and crowd out the intended permanent tooth. To prevent this, we can insert a space maintainer: This simple looped metal device prevents teeth from drifting and preserves the space for the permanent tooth.
Although these and other interceptive treatments are effective, some like the palatal expander do their best work within a limited age frame. To take advantage of interceptive orthodontics in a timely manner, parents should seek a bite evaluation for their child from an orthodontist around age 6. The earlier we detect a growing bite problem, the greater your chances for successful intervention.
If you would like more information on treating emerging bite problems early, 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 “Interceptive Orthodontics.”
Teenagers can have the same smile-disrupting tooth flaws as adults. But not all cosmetic treatments available to adults are appropriate for teenagers—at least not until they get a little older. Dental veneers fall into that category.
A veneer is a thin porcelain shell custom-made by a dental lab, and bonded by a dentist to the face of a tooth to mask chips, stains, gaps or other imperfections. Because they're less invasive than other measures, veneers are highly popular as a cosmetic dental solution. They do, however, usually require some enamel removal so that they'll appear more natural.
This enamel removal typically won't impact an adult tooth other than it permanently requires it to have veneers or other restorations after alteration. But there is a risk of damage to a teenager's tooth, which hasn't fully developed.
Adolescent teeth usually have a larger pulp chamber (filled with an intricate network of nerves and blood vessels) than adult teeth. And because the enamel and dentin layers may not yet be fully developed, the pulp is much nearer to the tooth's surface.
We must be very careful then in removing enamel and dentin for veneers or we may penetrate the pulp and risk damaging it. Alternatively, there is the possibility of no-prep veneers which are very conservative but often are unable to be done because of the need to often remove tooth structure to make the veneers look natural.
Another cosmetic problem can occur if we place veneers on a patient's teeth whose jaws and mouth structures are still growing. Eventually, the gums could recede and an unsightly gap form between the veneer and the adjacent natural tooth.
Fortunately, there are other techniques we can use to improve a tooth's appearance. Mild chipping can be repaired by bonding composite resin material to the tooth. Some forms of staining may be overcome with teeth whitening. These and other methods can address a teenager's smile appearance until their teeth are mature enough for veneers.
Whether or not a tooth is ready for veneers will depend on its level of development, something that can often be ascertained with x-rays or other diagnostic methods. And if a tooth has already undergone a root canal treatment, there isn't as much concern. In the meantime, though, it may be better for your teen to wait on veneers and try other techniques to enhance their smile.
If you would like more information on dental restoration for teenagers, 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 “Veneers for Teenagers.”
Is a “teeth crush” a thing? According to a recent confession by Lucy Hale, it is. Hale, who has played Aria Montgomery for seven seasons on the hit TV show Pretty Little Liars, admitted her fascination with other people's smiles to Kelly Clarkson during a recent episode of the latter's talk show (Clarkson seems to share her obsession).
Among Hale's favorite “grills”: rappers Cardi B and Post Malone, Julia Roberts, Drake and Madonna. Although some of their smiles aren't picture-perfect, Hale admires how the person makes it work for them: “I love when you embrace what makes you quirky.”
So, how can you make your smile more attractive, but uniquely you? Here are a few ways to gain a smile that other people just might “crush” over.
Keep it clean. Actually, one of the best things you can do to maintain an attractive smile is to brush and floss daily to remove bacterial plaque. Consistent oral hygiene offers a “twofer”: It removes the plaque that can dull your teeth, and it lowers your risk of dental disease that could also foul up your smile. In addition to your daily oral hygiene routine at home, professional teeth cleanings are necessary to get at those hard-to-reach spots you miss with your toothbrush and floss and to remove tartar (calculus) that requires the use of special tools.
Brighten things up. Even with dedicated hygiene, teeth may still yellow from staining and aging. But teeth-whitening techniques can put the dazzle back in your smile. In just one visit to the dental office, it's possible to lighten teeth by up to ten shades for a difference you can see right away. It's also possible to do teeth whitening at home over several weeks using custom-made trays that fit over your teeth and safe whitening solutions that we provide.
Hide tooth flaws. Chipped, stained or slightly gapped teeth can detract from your smile. But bonding or dental veneers, thin layers of porcelain custom-made for your teeth, mask those unsightly blemishes. Minimally invasive, these techniques can turn a lackluster smile into one that gets noticed.
Straighten out your smile. Although the main goal for orthodontically straightening teeth is to improve dental health and function, it can also give you a more attractive smile. And even if you're well past your teen years, it's not too late: As long as you're reasonably healthy, you can straighten a crooked smile with braces or clear aligners at any age.
Sometimes a simple technique or procedure can work wonders, but perhaps your smile could benefit more from a full makeover. If this is your situation, talk to us about a more comprehensive smile renovation. Treatments like dental implants for missing teeth combined with various tooth replacement options, crown lengthening for gummy smiles or tooth extractions to help orthodontics can be combined to completely transform your smile.
There's no need to put up with a smile that's less than you want it to be. Whether a simple cosmetic procedure or a multi-specialty makeover, you can have a smile that puts the “crush” in “teeth crush.”
If you would like more information about cosmetic measures for enhancing your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Porcelain Veneers.”
Over the years, dentists have become quite proficient in treating even the most severe periodontal (gum) disease. Many of these positive outcomes are achieved through manual effort using simple hand instruments called scalars and conventional periodontal surgery.
But that might be changing soon: Periodontists (specialists who care for the gums and other supporting dental structures) are starting to use a different kind of tool for gum disease treatment—surgical lasers.
Although lasers are more commonplace in other fields of medicine, recent developments hint at a more prominent future role for them in dentistry. One of these developments is a laser procedure called Laser Assisted New Attachment Procedure (LANAP®) that treats deep spaces of infection called periodontal pockets, which develop advanced gum disease.
These pockets form as infected gums gradually detach from a tooth as the supporting bone is lost. This widens the normally narrow gap between the teeth and gums. The ensuing pocket fills with infection that must be removed to adequately treat the gum disease. As the pocket extends down to the root, it's often necessary to perform a surgical procedure through the adjacent gum tissue to fully access it.
But with the LANAP® procedure, the dentist can use a laser to access a deep pocket without opening the gums. Moving from above into the gap between the tooth and gums, the light from the laser has the ability to remove diseased tissue without damaging healthy tissue.
The dentist follows this with ultrasonic equipment and manual scalers to further decontaminate the tooth root surface. The laser is then employed once again to facilitate the formation of a blood clot between the teeth and gums to seal the area with a fibrin clot. Once treated, the dentist will monitor the tooth to ensure maximum bone regeneration and gum reattachment.
Although outcomes are the same for the most part, this laser technique for periodontal pockets may have some advantages over conventional surgery. Studies so far show that LANAP® causes less tissue removal and bleeding, less potential for gum recession and less discomfort experienced by patients.
It's not likely that lasers will fully replace conventional gum disease treatments any time soon. But if the encouraging evidence thus far continues, the laser will one day become as commonplace alongside the other tools used for gum disease treatment.
If you would like more information on treatments for 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 “Treating Gum Disease With Lasers.”
If it seems like your teeth are getting longer as you get older, it's unlikely they're magically growing. More likely, your gums are shrinking or receding from your teeth. Besides the negative effect on your appearance, gum recession exposes you and vulnerable tooth areas to harmful bacteria and painful sensitivity.
Although common among older adults, gum recession isn't necessarily a part of aging: It's primarily caused by periodontal (gum) disease, in which infected gum tissues can weaken and detach from the teeth. This, along with bone loss, leads to recession.
But gum disease isn't the only cause—ironically, brushing your teeth to prevent dental disease can also contribute to recession. By brushing too aggressively or too often (more than twice a day), you could eventually damage the gums and cause them to recede. Tobacco use and oral piercings can also lead to weakened or damaged gums susceptible to recession.
You can lower your risk of gum recession by abstaining from unhealthy habits and proper oral hygiene to prevent gum disease. For the latter, your primary defense is gentle but thorough brushing and flossing every day to remove harmful dental plaque. You should also see your dentist at least twice a year for professional dental cleanings and checkups.
If, however, you do experience gum recession, there are a number of ways to restore your gums or at least minimize the recession. To start with, we must treat any gum disease present by thoroughly removing all plaque and tartar (calcified plaque), which fuels the infection. This reduces inflammation and allows the gums to heal.
With mild recession, the gums may rejuvenate enough tissue to recover the teeth during healing. If not, we may be able to treat exposed areas with a tooth-colored material that protects the surface, relieves discomfort and improves appearance.
If the recession is more advanced, we may still be able to stimulate gum regeneration by attaching a tissue graft with a micro-surgical procedure. These types of periodontal surgeries, however, can require a high degree of technical and artistic skill for best results.
In any event, the sooner we detect gum disease or recession, the quicker we can act to minimize the damage. Doing so will ensure your gums are healthy enough to protect your teeth and preserve your smile.
If you would like more information on gum recession, 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 Recession.”
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