There are usually two moments when primary (“baby”) teeth generate excitement in your family: when you first notice them in your child’s mouth, and when they come out (and are headed for a rendezvous with the “tooth fairy”!).
Between these two moments, you might not give them much thought. But you should—although primary teeth don’t last long, they play a pivotal role in the replacing permanent teeth’s long-term health.
This is because a primary tooth is a kind of guide for the permanent one under development in the gums. It serves first as a “space saver,” preventing nearby teeth from drifting into where the permanent tooth would properly erupt; and, it provides a pathway for the permanent tooth to travel during eruption. If it’s lost prematurely (from injury or, more likely, disease) the permanent tooth may erupt out of position because the other teeth have crowded the space.
That’s why we try to make every reasonable effort to save a problem primary tooth. If decay, for example, has advanced deep within the tooth pulp, we may perform a modified root canal treatment to remove the diseased tissue and seal the remaining pulp from further infection. In some circumstances we may cap the tooth with a stainless steel crown (or possibly a white crown alternative) to protect the remaining structure of the tooth.
Of course, even the best efforts can fall short. If the tooth must be removed, we would then consider preserving the empty space with a space maintainer. This orthodontic device usually takes the form of a metal band that’s cemented to a tooth on one side of the empty space with a stiff wire loop soldered to it that crosses the space to rest against the tooth on the other side. The wire loop prevents other teeth from crowding in, effectively “maintaining” the space for the permanent tooth.
Regular dental visits, plus your child’s daily brushing and flossing, are also crucial in preventing primary teeth from an “early departure.” Keeping them for their full lifespan will help prevent problems that could impact your child’s dental health future.
If you would like more information on the right care approach for primary 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 “Importance of Baby Teeth.”
Although tooth decay is a major problem to watch for in your child’s teeth, it isn’t the only one. As their teeth transition from primary (“baby”) to permanent, you should also be on the lookout for a developing poor bite or malocclusion.
Although the signs can be subtle, you may be able to detect an emerging malocclusion, starting usually around age 6, if you know what to look for. Here are 4 signs your child may be developing a poor bite.
Excessive spacing. This is something that might be noticeable while the child still has their primary teeth. If you notice an excessive amount of space around the front teeth, the sizes of the jaws and the teeth may be disproportional.
Abnormal overlapping. The upper teeth normally just cover the bottom teeth when the jaws are closed. But a malocclusion may be forming if the lower teeth cover the upper (underbite), the upper teeth extend too far over the lower (deep bite) or there’s space between the upper and lower front teeth (open bite).
Different overlapping patterns. Watch as well for some of the teeth overlapping normally while others don’t, a sign of a cross bite. For example, the back upper teeth may cover their counterparts in a normal fashion while the lower front teeth abnormally overlap the top front. The roles here between front and back teeth can also be reversed.
Abnormal eruptions. Permanent teeth normally follow a pattern when erupting, but certain factors could disrupt the process. For example, a jaw that’s developed too small can cause crowding as incoming teeth vie for space; as a result, some permanent teeth may erupt out of their proper position. Likewise, if a baby tooth is out of its normal position or prematurely lost, the permanent tooth may erupt out of position too.
The good news with each of these developing bite problems is that we can correct them or at least minimize their future effect if caught early. So if you notice any of these signs or anything else out of the ordinary, see an orthodontist as soon as possible. It’s also a good idea to have your child undergo a thorough orthodontic evaluation around age 6.
If you would like more information on bite problems in children, 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 “Problems to watch for in Children Ages 6 to 8.”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
We breathe every moment of every day and we’re hardly aware of it most of the time. But if you take the time to focus, you’ll find two possible pathways for your breath: through the nose or through the mouth.
While either pathway provides the air exchange needed to live, nose breathing offers better health benefits. Air passes through the nasal passages, which filter out many harmful particles and allergens. The mucous membranes in the nose also humidify the air and help produce heart-friendly nitric oxide.
Nose breathing also plays a role in your child’s facial and jaw development: the tongue rests on the roof of the mouth (the palate) and becomes a kind of mold around which the developing upper jaw can form. With chronic mouth breathing, however, the tongue rests just behind the lower teeth, depriving the upper jaw of its normal support. This could result in the development of a poor bite (malocclusion).
To avoid this and other undesirable outcomes, you should have your child examined if you notice them breathing mostly through the mouth, particularly at rest. Since chronic mouth breathing usually occurs because of an anatomical obstruction making nose breathing more difficult, it’s usually best to see a physician or an ear, nose and throat (ENT) specialist first for evaluation and treatment.
It’s also a good idea to obtain an orthodontic evaluation of any effects on their bite development, such as the upper jaw growing too narrowly. If caught early enough, an orthodontist can correct this with a palatal expander, a device that exerts gradual outward pressure on the jaw and stimulating it to grow wider.
Another bite problem associated with chronic mouth breathing is misalignment of the jaws when closed. An orthodontist can address this with a set of removable plates worn in the mouth. As the jaws work the angled plates force the lower jaw forward, thus encouraging it to grow in the direction that best aligns with the upper jaw.
Any efforts to correct a child’s breathing habits can pay great dividends in their overall health. It could likewise head off possible bite problems that can be both extensive and costly to treat in the future.
While tooth decay seems to get most of the “media attention,” there’s another oral infection just as common and destructive: periodontal (gum) disease. In fact, nearly half of adults over 30 have some form of it.
And like tooth decay, it begins with bacteria: while most are benign or even beneficial, a few strains of these micro-organisms can cause gum disease. They thrive and multiply in a thin, sticky film of food particles on tooth surfaces called plaque. Though not always apparent early on, you may notice symptoms like swollen, reddened or bleeding gums.
The real threat, though, is that untreated gum disease will advance deeper below the gum line, infecting the connective gum tissues, tooth roots and supporting bone. If it’s not stopped, affected teeth can lose support from these structures and become loose or out of position. Ultimately, you could lose them.
We can stop this disease by removing accumulated plaque and calculus (calcified plaque, also known as tartar) from the teeth, which continues to feed the infection. To reach plaque deposits deep below the gum line, we may need to surgically access them through the gums. Even without surgery, it may still take several cleaning sessions to remove all of the plaque and calculus found.
These treatments are effective for stopping gum disease and allowing the gums to heal. But there’s a better way: preventing gum disease before it begins through daily oral hygiene. In most cases, plaque builds up due to a lack of brushing and flossing. It takes only a few days without practicing these important hygiene tasks for early gingivitis to set in.
You should also visit the dentist at least twice a year for professional cleanings and checkups. A dental cleaning removes plaque and calculus from difficult to reach places. Your dentist also uses the visit to evaluate how well you’re doing with your hygiene efforts, and offer advice on how you can improve.
Like tooth decay, gum disease can rob you of your dental health. But it can be stopped—both you and your dentist can keep this infection from ruining your smile.
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.