Posts for: July, 2021
We instinctively know when a smile looks normal—and when it doesn't. It could be that something simply looks out of place like crooked teeth. But we might also notice when something is missing—as with one or both of the canine teeth.
The canine teeth align just under the eyes and are recognizable by their pointed ends. When they're missing, the smile looks “incomplete.” But “missing” in this case could mean “invisible”—the teeth are there, but hidden within the gums because they failed to come in properly and became impacted. This often happens on a smaller jaw where other teeth have crowded into the space intended for them.
Fortunately, we may have a remedy, and not just for appearance's sake—any impacted tooth can cause health problems, from gum abscesses to root damage of neighboring teeth. Although this might necessitate their surgical removal, we might also be able to coax them through the gums into better position in the jaw, if they're in a reasonably good position. This could result in both a boost to a patient's oral health and a more normal looking smile.
First, though, a patient will need to undergo a thorough bite evaluation by an orthodontist. Besides pinpointing the impacted teeth's precise location with x-rays or CT technology, an orthodontist will also want to assess the positions and condition of the rest of the teeth. If the conditions are right and there's enough room in the jaw, the orthodontist may recommend drawing the impacted canines into proper alignment in the jaw.
The process starts when an oral surgeon exposes the impacted teeth by surgically cutting through the gum tissue. They then attach a small bracket to the tooth with a tiny metal chain attached, the other end of which is looped over orthodontic hardware attached to other teeth. The tension on the chain by the hardware gradually nudges the teeth downward out of the gums. This is usually done in coordination with other measures to fully correct the bite.
If the procedure is successful, bringing the canines out of impaction reduces the problems those teeth could cause the person's oral health. But just as important, it can restore normality to their smile.
If you would like more information on treating impacted 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 “Exposing Impacted Canines.”
A few months into wearing braces you may notice your gums are swollen. It's likely you've developed periodontal (gum) disease.
Gum disease is a bacterial infection that usually begins with dental plaque. This thin, accumulated biofilm on teeth is filled with bacteria that cause dental disease. The more of it that remains on your teeth, the higher your risk for a gum infection.
In addition to regular dental cleanings, the best way for a person to reduce their gum disease risk is to remove plaque on a daily basis through brushing and flossing. Unfortunately, wearing braces complicates this: The brackets and wires affixed to your teeth can get in the way of your toothbrush and regular dental floss. As a result, you can easily miss plaque hidden around these bits of hardware.
Aside from gum disease, the braces themselves can irritate your gums. This irritation inflames the gums and may even cause more tissue to grow. Compound this overgrowth with a possible gum infection and it's no wonder your gums are severely swollen.
To lessen the chances of swollen gums with braces, you'll need to beef up your daily hygiene efforts. Simply put, it will typically take more time than normal to thoroughly clean around your braces. A few specialized tools, though, might make it easier.
An interproximal brush with a narrower head than a regular toothbrush is useful for accessing tight places around brackets. And a floss threader or a water flosser (which uses pressurized water to loosen and remove plaque) may help you better maneuver around wires to remove plaque between teeth.
Keeping your teeth clean as possible will certainly help you avoid gum swelling due to disease. But swelling from tissue overgrowth may not be resolved until your braces come off. In severe cases, it may even be necessary to remove the braces to treat the gums before resuming orthodontic treatment.
In any case, be as thorough as possible with your oral hygiene efforts during orthodontics and see your regular dentist for cleanings every six months. When you have completed orthodontic treatment, cleanings every six months are usually recommended. It's the best way to keep your gums healthy while you're wearing braces.
If you would like more information on dental care while wearing braces, 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 “Gum Swelling During Orthodontics.”
During this year's baseball spring training, Minnesota Twins center fielder Byron Buxton got into a row with a steak dinner—and the beefsteak got the better of it. During his meal, the Gold Glove winner cracked a tooth.
Fortunately, he didn't lose it. Buxton's dentist rescued the tooth with a dental procedure that's been around for over a century—a root canal treatment. The dependable root canal is responsible for saving millions of teeth each year.
Dentists turn to root canal treatments for a number of reasons: a permanent tooth's roots are dissolving (a condition called resorption); chronic inflammation of the innermost tooth pulp due to repeated fillings; or a fractured or cracked tooth, like Buxton's, in which the pulp becomes exposed to bacteria.
One of the biggest reasons, though, is advanced tooth decay. Triggered by acid, a by-product of bacteria, a tooth's enamel softens and erodes, allowing decay into the underlying dentin. In its initial stages, we can often treat decay with a filling. But if the decay continues to advance, it can infect the pulp and root canals and eventually reach the bone.
Decay of this magnitude seriously jeopardizes a tooth's survival. But we can still stop it before that point with a root canal. The basic procedure is fairly straightforward. We begin first by drilling a small hole into the tooth to access the inner pulp and root canals. Using special instruments, we then remove all of the infected tissue within the tooth.
After disinfecting the now empty spaces and reshaping the root canals, we fill the tooth with a rubber-like substance called gutta percha. This, along with filling the access hole, seals the tooth's interior from future infection. In most cases, we'll return sometime later and bond a life-like crown to the tooth (as Buxton's dentist did for him) for added protection and support.
You would think such a procedure would get its own ticker tape parade. Unfortunately, there's a cultural apprehension that root canals are painful. But here's the truth—because your tooth and surrounding gums are numbed by local anesthesia, a root canal procedure doesn't hurt. Actually, if your tooth has been throbbing from tooth decay's attack on its nerves, a root canal treatment will alleviate that pain.
After some time on the disabled list, Buxton was back in the lineup in time to hit his longest homer to date at 456 feet on the Twins' Opening Day. You may not have that kind of moment after a root canal, but repairing a bothersome tooth with this important procedure will certainly get you back on your feet again.
If you would like more information about root canal therapy, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “A Step-By-Step Guide to Root Canal Treatment.”