Posts for category: Dental Procedures

By Carol Haddad, DMD
February 18, 2019
Category: Dental Procedures
Tags: bonded retainer  
ABondedRetainerMightbeaBetterChoiceAfterBraces

The braces are finally off! But to keep your new, straighter smile you'll need to wear a retainer for some time. That's because the same structural mechanism used to move your teeth could undo what we've just accomplished.

That mechanism resides in an elastic tissue called the periodontal ligament that lies between the teeth and the bone and attaches to both with tiny fibers. While the ligament holds the teeth securely in place, it also allows for slight movement in response to bite changes. Braces "pull" the teeth in the desired new direction, and the ligament responds.

But with that pressure gone after the braces' removal, a kind of "muscle memory" can set in that moves the teeth back towards their original positions. A retainer, a dental appliance worn on the teeth, exerts just enough pressure to "retain" or keep the teeth from regressing.

Retainers are effective, but the most common type has a feature that poses potential problems: it can be removed by the wearer. Because of this, less disciplined patients might be tempted not to wear their retainer as directed. There's also a higher risk of losing one and incurring additional cost to replace it.

But there is another type, the bonded retainer, which stays permanently in the mouth until removed by an orthodontist. It's composed of a thin piece of metal that's firmly attached to the back of the teeth with dental composite material. Not only does a bonded retainer solve the problems mentioned before, it also can't be seen from the outside like a removable retainer.

A bonded retainer does have one disadvantage: because it can't be removed, it can obstruct the teeth during brushing and flossing and require more effort. You won't have as much difficulty with a removable retainer keeping teeth and gums clean. You can overcome this disadvantage, though, with specialized tools like a water flosser or a floss threader to make hygiene easier.

To choose which type of retainer is best for you or your family member, have a talk with your orthodontist. And if you choose a bonded retainer and later have it removed, be sure to switch immediately to a removable one if your orthodontist advises. With either retainer, you'll be able to preserve that hard-earned smile for years to come.

If you would like more information on bonded retainers, 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 “Bonded Retainers: What are the Pros and Cons.”

By Carol Haddad, DMD
February 08, 2019
Category: Dental Procedures
Tags: toothache  
YourToothacheisTellingyouSomethingsWronginYourMouth

A toothache might mean you have tooth decay—or maybe not. It could also be a sign of other problems that will take a dental exam to uncover. But we can get some initial clues about the underlying cause from how much it hurts, when and for how long it hurts and where you feel the pain most.

Let's say, for instance, you have a sharp pain while consuming something cold or hot, but only for a second or two. This could indicate isolated tooth decay or a loose filling. But it could also mean your gums have receded and exposed some of the tooth's hypersensitive root surface.

While over-aggressive brushing can be the culprit, gum recession is most often caused by periodontal (gum) disease. Untreated, this bacterial infection triggered by accumulated dental plaque could eventually cause tooth and bone loss, so the sooner it's attended to the better.

On the other hand, if the pain seems to linger after encountering hot or cold foods and liquids, or you have a continuous throbbing pain, you could have advanced tooth decay that's entered the inner pulp where infected tooth nerves are reacting painfully. If so, you may need a root canal treatment to remove the diseased pulp tissue and fill the empty pulp and root canals to prevent further infection.

If you have this kind of pain, see a dentist as soon as possible, even if the pain stops. Cessation of pain may only mean the nerves have died and can no longer transmit pain; the infection, on the other hand, is still active and will continue to advance to the roots and bone.

Tooth pain could also indicate other situations: a cracked tooth, an abscess or even a sinus problem where you're feeling the pain radiating through the teeth. So whatever kind of pain you're feeling, it's your body's alarm signal that something's wrong. Promptly seeing your dentist is the best course of action for preserving your health.

If you would like more information on treating tooth pain, 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 Pain? Don't Wait!

By Carol Haddad, DMD
January 29, 2019
Category: Dental Procedures
3WaysOrthodonticTechniquesCouldPreventaPoorBite

While orthodontists can effectively correct most poor bites (malocclusions), some can be quite complex requiring much time and expense. But there's good news—we often don't have to wait on a malocclusion to fully develop if we catch it in time. Thanks to interceptive orthodontics, we may be able to intervene much earlier and eliminate or reduce the degree of difficulty with treatment.

Interceptive orthodontics is a group of techniques and devices used in early childhood to help deter a possible malocclusion. Here are 3 ways this approach could make a difference in your child's bite development.

Guiding jaw growth. On a normal-sized upper jaw, the permanent teeth usually have ample room to erupt. Not so with a smaller jaw: incoming teeth become crowded and may erupt out of alignment or too close to each other. Orthodontists often use a device called a palatal expander to aid an under-sized jaw in its development. The device fits along the roof of the mouth between the teeth and applies gradual outward pressure on them. This encourages the jaw to widen as it grows, thus providing more room for erupting teeth to come in properly and decrease the chances of obstructive sleep apnea in the future.

Reshaping and repositioning jaw bones. An overbite can occur when the jaws aren't properly aligned, often due to poor muscle and bone development. This is where devices like the Herbst appliance are useful. Its hinge mechanism encourages the lower jaw to grow further forward. The jaws can thus develop in a more normal way, minimizing the development of a malocclusion.

Maintaining space. Primary ("baby") teeth are important for dental development because they help guide future permanent teeth to erupt properly; they also keep nearby teeth from drifting into the intended space. But when a primary tooth is lost prematurely due to disease or trauma, the space can become vulnerable to this kind of "drift." With a simple mechanism called a space maintainer we can hold open the space created by a prematurely lost primary tooth until the permanent tooth is ready to erupt.

These and other techniques can help stop bad bites from developing in young children, minimizing or even eliminating the need for future orthodontic treatment. That means a healthier mouth for your child and less impact on your wallet.

If you would like more information on interceptive 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 “Interceptive Orthodontics: Timely Intervention can make Treatment Easier.”

YoumayNeedOrthodonticTreatmentBeforeObtainingImplants

You have a lot of options for replacing missing teeth, from state-of-the-art dental implants to affordable, but effective partial dentures. But if the teeth in question have been missing for a while, you may first have to undergo orthodontic treatment. Here's why.

While they may feel rigid and firm in the jawbone, teeth are actually held in place by periodontal (gum) ligaments. These elastic tissues lie between the teeth and the bone and attach to both with tiny filaments. This mechanism allows the teeth to incrementally move over time in response to biting pressures or other environmental factors.

When a tooth goes missing the teeth on either side of the space naturally move or "drift" into it to help close the gap. This natural occurrence can reduce the space for a restoration if it has gone on for some time. To make room for a new prosthetic (false) tooth, we may have to move the drifted teeth back to where they belong.

If you're thinking metal braces, that is an option—but not the only one. Clear aligners are another way to move teeth if the bite problem (malocclusion) isn't too severe. Aligners are a series of custom-made, clear, plastic trays worn over the teeth. The patient wears each tray, slightly smaller than the previous one in the series, for about two weeks before changing to the next one. The reduction in size gradually moves teeth to their intended target position.

Many adults prefer clear aligners because they're nearly invisible and don't stand out like metal braces. They're removable, so you can take them out for cleaning or for special occasions. And, we can also attach a prosthetic tooth to the tray that temporarily covers the missing tooth space.

Whichever orthodontic treatment you choose, once completed we can then proceed with restoration to permanently replace your missing teeth. While it can be a long process, the end result is a beautiful smile that could last for years to come.

If you would like more information on your dental restoration options, 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 “Straightening a Smile before Replacing Lost Teeth.”

BitewingX-RaysSafelyRevealallAboutBackTeethtoPreventToothDecay

Modern dental care wouldn’t be the same without x-rays. Since dentists began capturing x-ray images a century ago to detect beginning tooth decay, billions of teeth have been preserved.

“Catching it early” is the key to staying ahead of this aggressive bacterial infection. Once it breaks through the protective defenses of tooth enamel, it can advance toward the center of the tooth, the pulp, damaging dentin as it goes. While we can effectively stop it at this point with a root canal treatment, it’s better for the tooth’s long-term health to detect and treat any decay early on with a less-invasive filling or other treatment method.

X-ray imaging helps make that possible, revealing decay much easier than we can see with the unaided eye. And while we can often detect decay in front teeth by visual examination or by using very bright lighting, that’s not as easy with the less accessible back teeth. For those teeth we use a special x-ray technique known as the bitewing.

The name comes from the small frame used to hold the film. It’s held in place in the mouth by the patient biting down on small tabs or “wings” extending from the frame. The x-ray beam travels through the outer cheek and teeth to the film being held in the frame on the back side of the teeth. When exposed, we’ll be able to view the interior of these back teeth: a set of four bitewings gives us a full view of all the upper and lower molars and pre-molars on each side of the jaws.

Like other forms of radiation energy, too much or too frequent exposures to x-rays can lead to serious health problems. But bitewing x-rays carry little risk to health. That’s because they fit well with the ALARA principle, meaning “As Low As Reasonably Achievable,” which helps guide our use of x-rays. Patients receive a fraction of the radiation exposure from routine bitewing x-rays than they receive annually from the natural environment.

Without bitewing x-rays and other diagnostic methods, the chances are high that tooth decay or other dental problems can go undetected in their early stages. Using this important tool can help us head off major damage before it occurs.

If you would like more information on the role of x-rays in dental care, 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 “Bitewing X-Rays: A Routine Part of Your Dental Exam.”



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