We've known for a long time that fluoride strengthens tooth enamel against decay. We've also learned that fluoride consumption early in life pays later dividends with healthier teeth.
But while fluoride has generally proven safe, too much ingested by young children could cause enamel fluorosis. This condition produces a mottled or streaked appearance in teeth ranging from faint white patches to darker, pitted staining. Fluorosis doesn't harm teeth, but it does make them less attractive.
To prevent this, it may be necessary with your dentist's help to monitor your infant's or young child's fluoride intake and keep it in check. That will depend in large part on where you live, as well as your child's hygiene and eating habits.
Like three-quarters of public water systems, your local utility may be adding fluoride to your drinking water. The amount is governed by federal guidelines, which currently recommend fluoride amounts of no more than 0.70 parts per million of water. The fluoride levels in your water could have an impact on your child's total fluoride intake. You can find out for sure how much fluoride is present in your water by contacting your water utility company.
Another major fluoride source is toothpaste and other hygiene products. You can control your child's fluoride exposure by limiting the amount of toothpaste on their brush. Children under two only need a “smear,” while those between two and six need only a pea-sized amount.
Processed foods can contain fluoride if fluoridated water was used in their production. In this case, replace as much of the processed food items in your family's diet as you can with fresh fruits, vegetables and other foods.
Along this line, if you have an infant you want to pay particular attention to feeding formula, especially the powdered form you mix with water. If you're concerned about the amount of fluoride in your water consider other infant feeding options. Besides breast-feeding in lieu of formula, you can also use ready-to-feed pre-mixed with water (usually lower in fluoride) or mix powdered formula with bottled water specifically labeled “de-ionized,” “purified,”Â “demineralized,” or “distilled.”
This can be a lot to keep up with but your dentist can advise you. Fluoride is still a potent weapon against tooth decay and a safeguard on your child's current and future dental health.
If you would like more information on the relationship between fluoride and your child's dental health, 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 Development and Infant Formula.”
Everyone loves a concert where there's plenty of audience participation… until it starts to get out of hand.Â Recently, the platinum-selling band Fifth Harmony was playing to a packed house in Atlanta when things went awry for vocalist Camila Cabello. Fans were batting around a big plastic ball, and one unfortunate swing sent the ball hurtling toward the stage — and directly into Cabello's face. Pushing the microphone into her mouth, it left the “Worth It” singer with a chipped front tooth.
Ouch! Cabello finished the show nevertheless, and didn't seem too upset. “Atlanta… u wild… love u,” she tweeted later that night. “Gotta get it fixed now tho lol.” Fortunately, dentistry offers a number of ways to make that chipped tooth look as good as new.
A small chip at the edge of the tooth can sometimes be polished with dental instruments to remove the sharp edges. If it's a little bigger, a procedure called dental bonding may be recommended. Here, the missing part is filled in with a mixture of plastic resin and glass fillers, which are then cured (hardened) with a special light. The tooth-colored bonding material provides a tough, lifelike restoration that's hard to tell apart from your natural teeth. While bonding can be performed in just one office visit, the material can stain over time and may eventually need to be replaced.
Porcelain veneers are a more long-lasting solution. These wafer-thin coverings go over the entire front surface of the tooth, and can resolve a number of defects — including chips, discoloration, and even minor size or spacing irregularities. You can get a single veneer or have your whole smile redone, in shades ranging from a pearly luster to an ultra-bright white; that's why veneers are a favorite of Hollywood stars. Getting veneers is a procedure that takes several office visits, but the beautiful results can last for many years.
If a chip or crack extends into the inner part of a tooth, you'll probably need a crown (or cap) to restore the tooth's function and appearance. As long as the roots are healthy, the entire part of the tooth above the gum line can be replaced with a natural-looking restoration. You may also need a root canal to remove the damaged pulp material and prevent infection if the fracture went too far. While small chips or cracks aren't usually an emergency (unless accompanied by pain), damage to the tooth's pulp requires prompt attention.
If you have questions about smile restoration, please contact us and schedule an appointment. You can read more in the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty As Never Before” and “Porcelain Crowns & Veneers.”
There are plenty of options today for replacing missing teeth, including dental implants. But if the teeth have been missing for some time, complications can arise that limit your restorative options.
The most consequential possibility is bone loss. Bone has a life cycle: old cells dissolve (resorb), and are then replaced by new cells, stimulated to grow by the forces applied to the teeth during chewing. But the bone won't receive this stimulation if a tooth is missing — so growth slows down, which causes the bone volume to diminish with time.
Another complication can occur involving other teeth around the open space. These teeth will naturally move or “drift” out of their normal position into the missing tooth space. As a result we may not have enough room to place a prosthetic (false) tooth.
If either or both of these complications occur, we'll need to address them before attempting a restoration. Bone loss itself could eliminate dental implants as an option because they require a certain amount of supporting bone for correct placement. Bone loss could also make correcting misaligned teeth difficult if not impossible.
It might be possible, though, to regenerate lost bone with a bone graft. The graft is placed, sometimes along with growth stimulating substances, within the diminished bone area. It then serves as a scaffold upon which new bone can form.
If the bone becomes healthy again, we can then attempt to move any drifted teeth back to where they belong. Besides braces, there's another treatment option especially popular with adults: clear aligners. These are a series of removable, clear plastic trays that, like braces, exert gradual pressure on the teeth to move them. Patients wear each individual tray for about two weeks, and then switch to the next tray in the series to continue the process.
Unlike their traditional counterparts, clear aligners can be removed for cleaning or for special occasions. More importantly, they're much less noticeable than traditional braces.
Once any problems with bone health or bite have been addressed and corrected, you'll have a fuller range of options for replacing your missing teeth. With a little extra time and effort, you'll soon be able to regain a smile you'll be proud to display.
What if you had orthodontic treatments to enhance your smile — and nobody knew about it until it was all done?
That (almost) happened to British singer, cover girl and television personality Cheryl Cole. Since her big break in 2002, on the British reality show Popstars: The Rivals, Cole has had a successful music career, taken turns judging both the British and American versions of The X Factor, and graced the covers of fashion magazines like Elle and Harpers Bazaar.
And somewhere along the way, Cole wore an orthodontic appliance. It very nearly went undetected… until a colleague spilled the beans. That’s when Cole was forced to divulge her secret: For a period of time, she had been wearing clear aligners on her teeth. Until her frenemy’s revelation, only a few people knew — but when you compare the before-and-after pictures, the difference in her smile is clear.
So what exactly are clear aligners? Essentially, they consist of a series of thin plastic trays that are worn over the teeth for 22 hours each day. The trays are custom-made from a computerized model of an individual’s mouth. Each tray is designed to move the teeth a small amount, and each is worn for two weeks before moving on to the next in the series. When the whole series is complete, the teeth will have shifted into their new (and better aligned) positions.
Besides being virtually unnoticeable, aligners are easy to remove. This makes it easy to keep the teeth clean — and can come in handy for important occasions (like cover-photo shoots and acceptance speeches). But don’t remove them too frequently, or they won’t work as planned. If that’s a possibility (with teens, for example), aligners are available with “compliance indicators” to ensure they’re being worn as often as they should be. They can also be made with special tabs to hold a place for teeth that haven’t fully erupted (come in) yet — another feature that’s handy for teens.
So if you need orthodontic work but prefer to stay “under the radar,” ask us whether clear aligners could be right for you. Cheryl Cole did… and the results gave her something more to smile about.
If you would like more information on clear aligners, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Clear Orthodontic Aligners” and “Clear Aligners for Teenagers.”
While most orthodontic treatment doesn’t commence until a child is older or entering adolescence, it’s still a good idea for children as young as 6 to undergo an orthodontic evaluation. An early orthodontic evaluation may reveal emerging problems with the child’s bite and jaw development, and help inform the best course of treatment when the time is right.
A specialty within dentistry, orthodontics focuses on the study and treatment of malocclusions or poor bites. Orthodontists are most concerned with the interaction of the face, jaw and teeth, and whether these structures are developing normally and in the right position.
It’s possible to detect the beginning stages of a malocclusion as a child’s permanent teeth begin to erupt, sometime between ages 6 and 12. Children at this stage may begin to experience crowding of the teeth (or the opposite, too much space between teeth), protruding teeth, extra or missing teeth or problems with jawbone development. While these tend to be congenital (inherited conditions), some problems can be caused by excessive thumb-sucking, mouth breathing, or dental disease stemming from tooth decay. In some cases, “interceptive” orthodontic treatment might be necessary during this early period to improve the chances that future treatment for a malocclusion or poor jaw development will be successful.
An early orthodontic evaluation should be undertaken no later than age 7 to be most effective. It’s also advisable to have regular checkups beginning around the child’s first birthday to spot developing teeth and jaw problems even when only primary teeth are present. The orthodontic evaluation itself takes advantage of an orthodontist’s trained eye to locate more subtle problems with teeth and jaw growth. Knowing this well in advance can make it easier in the long run when orthodontic treatment takes place when they’re older. Waiting until after the full emergence of permanent teeth and further jaw and facial development to evaluate for treatment could make it more difficult or even impossible to correct malocclusion issues found later.
The most effective dental care starts early in life. Not only treating immediate problems but also anticipating those that will require treatment later will help ensure your child will have healthy teeth for life.
If you would like more information on childhood orthodontic evaluations, 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 “Early Orthodontic Evaluation.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.