Posts for: May, 2018
Poor bites, also known as “malocclusions,” can have a dramatic impact on mouth function and appearance. Moving teeth to better positions will solve most of these bite problems — but not all.
A case in point is a malformed maxilla, the skeletal structure formed by the union of the upper jaw and the roof of the mouth (the palate). If the rear portion of the maxilla develops too narrowly, the back teeth will bite abnormally inside the lower teeth while the front teeth bite normally, creating what’s known as a crossbite. People with this kind of malocclusion often shift their lower jaw to one side to bite down completely.
This can be corrected without too much intervention if the problem is diagnosed while the person is young. This is because the maxilla is actually formed from two bones that don’t completely fuse together in the center of the palate until just after puberty. An orthodontic appliance known as a palatal expander takes advantage of this slight gap. The metal appliance is placed along the narrowed portion of the palate in the rear of the mouth: four metal “arms,” two on each side, attach to the inside of the back teeth with a tension device between them that extends the arms outward to put pressure against the teeth.
Every day the patient or a parent uses a special key to turn the tension device and cause it to expand slightly, placing additional outward pressure on the jaw. This will widen the gap in the center of the palate and new bone will grow to fill in the increased space. Over time this will cause the rear portion of maxilla to widen.
While effective, a palatal expander may not work in every case, and it must be done before the two bones fuse permanently. When it can be used, though, it’s a proven treatment that can restore proper bite function, as well as improve your child’s smile.
If you would like more information on palatal expanders to correct certain bite problems, 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 “Palatal Expanders.”
There’s more to teeth than meets the eye. Hidden beneath the visible crown are the tooth’s roots set within the jawbone, secured and protected by the gums from bacteria and infection. But if the gums shrink back (recede), the roots become exposed and susceptible to disease, especially at the points where multiple roots branch from each other, areas called furcations.
It all begins with periodontal (gum) disease caused by built-up bacterial plaque from insufficient brushing and flossing. The infection triggers inflammation that over time weakens gum tissues. They begin to detach from the teeth, which can eventually lead to gum recession and root exposure.
This also causes bone loss, especially at the furcations. We can detect any loss (known as a furcation invasion) and how far along it may be with x-ray imaging or by manually probing with an instrument called a periodontal probe.
There are three general classes measuring furcation invasions. In the earliest, Class I, we can feel the invasion as a slight groove; in Class II, it increases to two or more millimeters across. In Class III the bone loss extends from one side of the root all the way to the other (a “through and through”).
At this stage a patient is in danger of losing the tooth, so we’ll have to act promptly. This means first removing accumulated dental plaque and calculus (tartar) to stop the infection and allow the gums to heal. With severe damage, we may need to assist healing with bone and gum tissue grafting, in which we place donor grafts to serve as scaffolding for the appropriate tissue to grow upon.
You can help prevent this situation by practicing effective daily hygiene and visiting your dentist for thorough cleanings at least twice a year (or more if recommended). And at the first signs of a gum infection—swollen, reddened or bleeding gums—make an appointment as soon as possible to have it checked. The sooner we can detect and treat gum disease, the less likely a furcation invasion or worse will be in your future.
Teething is a normal part of your baby’s dental development. That doesn’t make it less stressful, though, for you or your baby.
This natural process occurs as your child’s primary teeth sequentially erupt through the gums over a period of two or three years. The first are usually the two lower front teeth followed by the two upper front ones, beginning (give or take a couple of months) between six and nine months. By the age of three, most children have all twenty of their primary teeth.
The disruption to the gum tissues can cause a number of unpleasant side effects including gum swelling, facial rash, drooling, disrupted sleep patterns and decreased appetite. As a result a child can become irritable, bite and gnaw to relieve gum discomfort or rub their ears. Every child’s experience is different as well as their degree of pain and discomfort.
As a tooth is about to erupt, you may notice symptoms increasing a few days before and after. The symptoms will then subside until the next tooth begins to erupt. In a way, teething is much like a storm—you mostly have to ride it out. However, that doesn’t mean you can’t lessen your child’s discomfort during the teething episode.
For one thing, cold, soft items like teething rings, pacifiers or even a clean, wet washcloth your child can gnaw on will help relieve gum pressure. Chilling the item can have a pain-numbing effect—but avoid freezing temperatures, which can burn the tissues. You can also massage the gums with a clean finger to relieve pain. But don’t rub alcohol on their gums and only use numbing agents (like Benzocaine) for children older than two, and only with the advice and supervision of your healthcare provider. The use of acetaminophen or ibuprofen might also be used under the advice of your doctor.
If you notice your child has diarrhea, extensive rashes or fever, contact your physician immediately—these aren’t normal teething symptoms and may indicate something more serious. And be sure to consult with us if you have any other questions or concerns.
Teething can be a difficult time for your baby and family. But with these tips and a little “TLC” you can keep their discomfort to a minimum.
If you would like more information on caring for your baby’s developing 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 “Teething Troubles: How to Help Your Baby be Comfortable.”