Posts for: August, 2018
If you’re about to undergo orthodontic treatment, you’re going to face a challenge keeping your teeth and gums clean wearing braces. That in turn could increase your chances for tooth decay or periodontal (gum) disease, which could diminish your future dental health and disrupt your current orthodontic treatment.
The main hygiene tasks of brushing and flossing are more difficult with braces because of the fixed hardware on the teeth. Your toothbrush or floss can’t always easily maneuver around the wires and brackets, increasing the chances you’ll miss some areas. These neglected areas can then accumulate dental plaque, a thin film of bacteria and food particles that’s most responsible for disease.
But although difficult, effective oral hygiene isn’t impossible. First and foremost, you’ll need to take more time to be thorough with brushing and flossing than you might normally without braces.
Second, there are some specialized hygiene tools to make the job easier. Instead of a regular toothbrush try an interproximal brush. This special brush has a long and thin bristled head (resembling a pipe cleaner) that can maneuver in and around orthodontic hardware much easier than a regular brush.
For flossing, use a floss threader, a device through which you thread floss on one end and then pass the other sharper end between your teeth. Once through, you release the floss from it and floss as usual, repeating the process with the threader for each tooth. Another option is an oral irrigator, a device that emits a pressurized spray of water between teeth to loosen plaque and flush it away. Many orthodontic patients have found this latter option to be quite effective.
Finally, continue seeing your regular dentist for regular appointments in addition to your orthodontist. Besides cleaning those hard to reach areas, your dentist can also provide other preventive measures like topical fluoride for strengthening enamel and prescription mouth rinses that inhibit bacterial growth. You should also see your dentist immediately if you notice signs of disease like spots on the teeth or swollen or bleeding gums.
Keeping your teeth clean while wearing braces is a top priority. Doing so will help ensure your new smile after braces is both an attractive and healthy one.
If you would like more information on dental care during orthodontics, 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 “Caring for Teeth during Orthodontic Treatment.”
About one-quarter of people have teeth that never developed. While most of these congenitally missing teeth are wisdom teeth, they can also include premolars or lateral incisors (the teeth right next to the two front teeth, the central incisors).
Missing teeth can have an adverse effect on smile appearance. But that’s not all: because each type of tooth performs a specific function, one or more missing teeth can lead to bite problems and disruption of dental function. In the case of missing lateral incisors, the canines (eye teeth) normally positioned beside and toward the back of the mouth from them may begin to drift into the empty space and grow next to the central incisors. This can result in greater difficulty chewing and a smile that “doesn’t look right.”
To correct this situation, we must often first attempt to orthodontically move any out of place teeth to their normal positions. This re-establishes the space needed for the missing teeth to be replaced, which we can then restore with prosthetic (artificial) teeth. If the permanent restoration of choice involves dental implants, we’ll usually need to wait until the completion of jaw development around early adulthood. In the mean time, we can use a retainer appliance to hold the teeth in their new positions with prosthetic teeth attached to fill the empty space for a better smile appearance in the interim.
The real issue is timing—beginning orthodontic treatment when appropriate to a person’s oral development, as well as completing the implant restoration when the mouth has matured sufficiently. There are other considerations such as bone volume, which may have diminished due to the missing teeth. At some point we may need to consider grafting to build up the bone sufficiently to support dental implants.
This all may entail a team approach by various specialties like orthodontics, periodontics and implantology. Working together and coordinating within a timely schedule, a mouth and smile marred by undeveloped teeth can be transformed.
If you would like more information on treating smiles with underdeveloped permanent teeth, 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 Permanent Teeth Don’t Grow.”
One of the most effective techniques for saving decayed or injured teeth is the root canal treatment. Yet when many people hear they need it, they become nervous at the prospect.
Much of this stems from a common misunderstanding that undergoing a root canal is painful. It’s not — today’s anesthetics are quite effective in numbing pain during a procedure, and mild pain relievers like ibuprofen are usually sufficient to manage any discomfort afterwards.
In fact, a root canal treatment relieves pain caused by decay within a tooth. As decay progresses, it can enter the interior known as the pulp, which contains bundles of nerves and blood vessels. It attacks these nerves causing pain and infection. If the infection progresses through passageways known as root canals that are in the roots of the tooth, the pain can intensify. More important, the tooth is in danger of loss as the root and connective tissues that hold the tooth in place are injured from the spreading infection.
During a root canal treatment, we access the pulp by drilling a small access hole, usually in the biting surface or in the rear of a front tooth. Once we enter the pulp chamber we remove all the contaminated tissue. Once thoroughly cleansed, we fill the empty chamber and canals with a special filling (usually gutta percha) to prevent future infection. The access hole is then sealed and at a subsequent visit we strongly recommend placing a permanent crown to provide further protection from damage to the tooth.
Root canal treatments are quite common. All general dentists have been trained in endodontic treatment and can perform most types of procedures. More difficult cases (like a complex root canal network that may be hard to access) may require the services of an endodontist, a specialist in root canals. Endodontists use advanced techniques and specialized microscopic equipment to treat complicated situations.
It’s actually good news if we recommend you undergo a root canal treatment — it means your tooth has a good chance of survival once it’s disinfected and the decay is removed. But don’t delay: the sooner we can treat your tooth, the better your chances of a healthy outcome.
If you would like more information on root canal 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 “Common Concerns about Root Canal Treatment.”