Correcting a bite problem involves more than applying braces. Orthodontists must consider a wide range of factors, including the type of bite problem involved, complications like impacted or missing teeth, and their patient's overall dental condition.
Orthodontists must also keep in mind the future—how will a treatment implemented now impact a patient's appearance and dental function many years from now? In reality, orthodontists perform these treatments within a dynamic growth environment, especially involving children and teenagers whose mouth and facial structures are still maturing.
And although these growth changes slow in adulthood, they don't stop—orofacial structures continue to change throughout life. For example, a person's lips steadily thicken in size until the mid-teen years, and then slowly thin out over the rest of their lifetime. The distance between the lips both at rest and while smiling may also narrow in later years. Other changes continue to occur in the bones and soft tissues of the mouth and face.
Fortunately, this structural growth follows a fairly consistent track. Although variations do occur, an orthodontist can project the growth changes their patients will undergo as they age, and use that knowledge to plan out bite treatment. With this understanding, orthodontists plan not only what treatments will be needed, but when to perform them, and to what extent.
This may involve a number of treatment stages, spaced out to coincide with regular development. An orthodontist may focus first on general bite correction to bring the teeth and jaws into a reasonable state of alignment. Later, they'll use more refined methods to fine-tune corrections that better align with later adult growth.
More intensive treatments may be necessary to build a foundation for future treatment. For example, orthognathic surgery may be needed to correct a severe case of an over-extended lower jaw. During the procedure, surgeons move the lower jaw to a joint position higher on the skull. This retracts the lower jaw into a more normal alignment with the upper jaw, and can dramatically change the facial profile for the better.
Each orthodontic patient is different, and each requires their own a unique treatment plan. That plan has a greater chance of long-term success by applying knowledge of future growth changes.
If you would like more information on orthodontic treatment, 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 “Understanding Aging Makes Beauty Timeless.”
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.
There are different ways to ease a child's potential nervousness with dental visits, like starting those visits around their first birthday or seeing a pediatric dentist who specializes in children. But even doing those things won't guarantee your child won't develop some form of dental anxiety, which could complicate their dental care.
To help make appointments easier for anxious children, many dentists use conscious sedation as a means of helping them relax. With this technique, the dentist administers a mild sedative to the child to take the edge off their nervousness, while allowing them to remain awake during treatment.
Sedation isn't anesthesia, the means we use to stop pain during treatment (although sedation may be used with anesthesia). Rather, sedation reduces emotional fear and anxiety. And unlike general anesthesia, a sedated child can still breathe without assistance and, depending on the depth of the sedation, respond to physical and verbal stimuli.
In most cases, children are administered sedation medications by mouth, usually as a syrup, although on occasion it might be delivered intravenously with an IV. The dose is usually given some time before their treatment session after the dentist has evaluated them. Dentists mostly use mild sedatives like Midazolam or Hydroxyzine with very little risk of side effects for children.
During the procedure, a designated staff member continually monitors the child's vital signs. Besides heart rate, pulse and respirations, they may also check the child's exhaled carbon dioxide levels to ensure they're breathing normally.
After the treatment session is over, staff will continue to monitor the child until their vital signs return to pre-sedation levels. If the child is of driving age, they'll need someone to drive them home. Children who've been sedated should remain home for the rest of the day, but they can usually return to school the next day depending on what kind of dental work they've undergone.
Dentists follow strict protocols for pediatric sedation adopted by the American Academy of Pediatrics, the American Dental Society, and the American Academy of Pediatric Dentistry. In addition, many states have also established processes for administering sedation therapy. It's a safe and effective method to ease a child's anxiety over their dental visit.
If you would like more information on making dental visits easier for kids, 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 “Sedation Dentistry For Kids.”
If you suffer frequent sinus infections, you might want to see a dentist. No, really—your recurring sinusitis might stem from a decayed tooth.
Tooth decay can start as a cavity, but left untreated can advance within the tooth and infect the pulp and root canals. If it reaches the end of the root, it can cause the root tip and surrounding bone to break down.
A severe toothache is often a good indicator that you have advanced tooth decay, which can usually be stopped with a root canal treatment. But a decayed tooth doesn't always produce pain or other symptoms—you could have a “silent” infection that's less likely to be detected.
A symptomless, and thus untreated, infection in an upper back tooth could eventually impact the maxillary sinus, a hollow air-filled space located just above your back jaw. This is especially true for people whose tooth roots extend close to or even poke through the sinus floor.
That “silent” infection in your tooth, could therefore become a “loud” one in the sinuses causing chronic post-nasal drip, congestion and, of course, pain. Fortunately, a physician or an ear, nose and throat (ENT) specialist might suspect a dental origin for a case of recurring sinusitis, a condition known as maxillary sinusitis of endodontic origin (MSEO).
Antibiotic treatment can clear up sinusitis symptoms short-term. It's unlikely, though, it will do the same for a dental infection, which may continue to trigger subsequent rounds of sinusitis. The best approach is for a dentist, particularly a specialist in interior tooth disease called an endodontist, to investigate and, if a decayed tooth is found, treat the source of the infection.
As mentioned earlier, the solution is usually a root canal treatment. During this procedure, the dentist completely removes all infected tissue within the pulp and root canals, and then fills the empty spaces to prevent future infection. In one study, root canal therapy had a positive effect on alleviating sinusitis in about half of patients who were diagnosed with a decayed tooth.
If your sinusitis keeps coming back, speak with your doctor about the possibility of a dental cause. You may find treating a subsequently diagnosed decayed tooth could alleviate your sinus problem.
If you would like more information on how your dental health could affect the rest of your body, 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 “Sinusitis and Tooth Infections.”
There's a lot to like about porcelain veneers, especially as you get older. For one, they can be less expensive and invasive than other cosmetic restorations. More importantly, though, they're versatile—they can solve a variety of dental appearance problems.
Veneers are thin shells of porcelain that are bonded to the front of teeth to alter their appearance—a work of custom art crafted by a dental technician to fit an individual patient's dental needs. They can turn back the clock on a less than attractive smile, and, with a little care, could last for years.
Here are some dental appearance problems you might encounter in your later years that veneers may help you improve.
Discoloration. As we get older, our teeth color can change—and not for the better. Teeth whitening temporarily brightens dull and dingy teeth, but the effect will fade over time. Additionally, there are some forms of staining, particularly those arising from within a tooth, for which external whitening can't help. Veneers can mask discoloration and give a new, permanent shine to teeth.
Unattractive shape. As we age, wearing on teeth can cause them to appear shorter and create sharper angles around the edges. Veneers can be used to restore length and soften the shape of teeth. Because veneers can be customized, we can actually create a tooth shape that you believe will improve your appearance.
Dental flaws. A lifetime of biting and chewing, not to mention a chance injury, can lead to chips, cracks or other dental defects. But veneers can cover over unsightly flaws that cause you to be less confident in your smile. Veneers can give you back the smile you once had or, if you were born with dental flaws, the smile you never had.
Misalignments. The biting forces we encounter throughout our lifetime can move teeth out of alignment, or widen gaps between them. You can undergo orthodontic treatment to correct these misalignments problems, but if they're relatively minor, we may be able to use veneers to “straighten” your smile.
If you're concerned about the effects of aging on your smile, veneers could help you look younger. Visit us for a full dental evaluation to see if a veneer restoration is right for you.
If you would like more information on porcelain veneers, 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 “Porcelain Veneers: Strength & Beauty as Never Before.”
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