Posts for category: Dental Procedures
The monarchs of the world experience the same health issues as their subjects—but they often tend to be hush-hush about it. Recently, though, the normally reticent Queen Elizabeth II let some young dental patients in on a lesser known fact about Her Majesty's teeth.
While touring a new dental hospital, the queen told some children being fitted for braces that she too “had wires” once upon a time. She also said, “I think it's worth it in the end.”
The queen isn't the only member of the House of Windsor to need help with a poor bite. Both Princes William and Harry have worn braces, as have other members of the royal family. A propensity for overbites, underbites and other malocclusions (poor bites) can indeed pass down through families, whether of noble or common lineage.
Fortunately, there are many ways to correct congenital malocclusions, depending on their type and severity. Here are 3 of them.
Braces and clear aligners. Braces are the tried and true way to straighten misaligned teeth, while the clear aligner method—removable plastic mouth trays—is the relative “new kid on the block.” Braces are indeed effective for a wide range of malocclusions, but their wires and brackets make it difficult to brush and floss, and they're not particularly attractive. Clear aligners solve both of these issues, though they may not handle more complex malocclusions as well as braces.
Palatal expanders. When the upper jaw develops too narrowly, a malocclusion may result from teeth crowding into too small a space. But before the upper jaw bones fuse together in late childhood, orthodontists can fit a device called a palatal expander inside the upper teeth, which exerts gentle outward pressure on the teeth. This encourages more bone growth in the center to widen the jaw and help prevent a difficult malocclusion from forming.
Specialized braces for impacted teeth. An impacted tooth, which remains partially or completely hidden in the gums, can impede dental health, function and appearance. But we may be able to coax some impacted teeth like the front canines into full eruption. This requires a special orthodontic technique in which a bracket is surgically attached to the impacted tooth's crown. A chain connected to the bracket is then looped over other orthodontic hardware to gradually pull the tooth down where it should be.
Although some techniques like palatal expanders are best undertaken in early dental development, people of any age and reasonably good health can have a problem bite corrected with other methods. If you are among those who benefit from orthodontics, you'll have something in common with the Sovereign of the British Isles: a healthy, attractive and straighter smile.
If all goes normally, we have most of our permanent teeth as we enter puberty. Except, though, when it doesn't—sometimes incoming permanent teeth don't fully erupt, often because there's not enough room for them on the jaw. This can leave all or part of a tooth still up inside the gum and bones.
This condition is known as impaction, and it can cause problems with a person's bite and their smile. This is especially true of the upper canines, those pointed teeth located just under the eyes. Without them present, a person's smile can look oddly different. Moreover, it can worsen their bite and increase the risk of trauma and disease for nearby teeth.
Fortunately, there may be a way to coax impacted canines into erupting into their proper position on the jaw. It will involve, though, some minor surgery and orthodontic intervention to accomplish that feat.
First, though, a patient with missing canines should undergo a thorough orthodontic evaluation. This exam will reveal not only what may be going on with the missing teeth, but how the whole bite has been affected. Knowing the big picture will help direct the next treatment steps.
After pinpointing the impacted teeth's exact position (usually through x-rays or cone beam CT scanning), we then decide whether it's feasible to attempt to expose the teeth. Sometimes, a tooth's position is so out of place that it may be best to remove it and consider a dental implant or other restorative measures.
If it is in a workable position, then the impacted teeth would be exposed surgically (usually by an oral surgeon or periodontist). The surgeon would then bond a small bracket to the exposed tooth and then attach a small chain.
After suturing the incised gum tissues back in place, the chain extending outward from the gums would then be looped over orthodontic hardware attached to other teeth. This will place downward pressure on the upper canine tooth, and over several months prod it to fully erupt.
This may sound like an elaborate procedure, but it's fairly routine and predictable. As a result, a patient can finally get the full benefit of all their teeth, enhance their dental health and transform their smile.
If you would like more information on dealing with 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.”
If you have a less than attractive smile due to some moderate imperfections, dental veneers may be the answer. This relatively inexpensive dental restoration may be the key to transforming your smile.
If you're thinking of veneers as a “thin covering,” you're on the right track. Just like construction veneers used to cover wall surfaces, dental veneers are thin wafers of material (usually porcelain) that cover the front of tooth surfaces. Made uniquely for the individual patient, veneers provide a life-like covering that can mask a variety of dental imperfections.
Veneers are mildly invasive, meaning some of the enamel layer of the teeth to which they're bonded will need to be removed. If this alteration occurs, it's permanent, so the teeth will require a veneer or other restoration from then on. It's usually necessary, though, so that the veneer doesn't appear too bulky. Even so, veneers are still less invasive than other restorations.
The list of appearance problems veneers can address is quite varied. One of their more common uses is to correct certain structural flaws in teeth: chips, abnormal tooth shape from wear or teeth that are congenitally smaller than normal.
They're also a remedy for heavy staining. While teeth whitening can temporarily brighten a dull, dingy smile, veneers provide a permanent solution for the problem of staining. They're also a practical option for internal tooth staining, which can't be addressed by either home or professional external teeth whitening procedures.
Finally, veneers may be used to close small gaps and other mild forms of dental misalignment. And although they may not be able to correct larger gaps by themselves, they're sometimes used in conjunction with orthodontic treatment.
Veneers can address many dental flaws, but not all. To see if your dental situation could benefit from a veneer application, you'll need to undergo a complete dental examination. If it seems veneers aren't a good fit for you, your dentist will discuss other types of cosmetic treatments to improve your smile.
If, on the other hand, veneers do appear to be a viable option for you, you're just a few visits away from a completely new look. Veneers can change your smile—and your life!
If you would like more information on porcelain veneers, 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 “Porcelain Veneers: Strength & Beauty as Never Before.”
Bite problems are quite common—as many as 75% of adults may have some form of orthodontic issue. Unfortunately, there's also something else just as common: that many people believe they're too old to correct it.
This belief is a myth—while there are factors that could prevent orthodontic treatment, age isn't necessarily one of them. If your teeth, gums and bone are sound and you're in reasonably good general health, you most likely can have a bite problem corrected even beyond middle age.
Why worry about it, though, if you've lived this long with misaligned teeth? For one thing, straightening teeth with braces or clear aligners can boost your dental health. Teeth that are in normal alignment are easier to keep clean of disease-causing bacterial plaque. You'll also find it easier to chew than if your bite is out of line.
A more attractive, straighter smile can also impact your social and professional life. Having a smile you're not embarrassed to show can boost your self-confidence and image. Research on people who've undergone orthodontic treatment in adulthood have found improvements in social connection and even expanded career opportunities.
Orthodontic treatment can make a difference with your health and life, no matter your age. But while the number of years you've lived won't necessarily make a difference, what those years have brought could rule it out.
If, for example, you've lost significant bone structure due to diseases like periodontal (gum) disease, your teeth may not be able to sustain the new position created by braces or aligners without a form of permanent fixation. If you have systemic conditions like severe cardiovascular disease, bleeding problems, leukemia or uncontrolled diabetes, orthodontic treatment could worsen those conditions. And certain prescription drugs may pose similar problems as well.
That's why you'll need to undergo a thorough dental exam, as well as provide a complete medical history to your orthodontist. If nothing prevents you from treatment, though, you may be able to regain a new smile, better health and a new confidence in life.
If you would like more information on adult 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 “Orthodontics for the Older Adult.”
Chronic jaw pain can be an unnerving experience that drains the joy out of life. And because of the difficulty in controlling it patients desperate for relief may tread into less-tested treatment waters.
Temporomandibular disorders (TMDs) are a group of conditions affecting the joints connecting the lower jaw to the skull and their associated muscles and tendons. The exact causes are difficult to pinpoint, but stress, hormones or teeth grinding habits all seem to be critical factors for TMD.
The most common way to treat TMD is with therapies used for other joint-related problems, like exercise, thermal (hot and cold) applications, physical therapy or medication. Patients can also make diet changes to ease jaw function or, if appropriate, wear a night guard to reduce teeth grinding.
These conservative, non-invasive therapies seem to provide the widest relief for the most people. But this approach may have limited success with some patients, causing them to consider a more radical treatment path like jaw surgery. Unfortunately, surgical results haven't been as impressive as the traditional approach.
In recent years, another treatment candidate has emerged outside of traditional physical therapy, but also not as invasive as surgery: Botox injections. Botox is a drug containing botulinum toxin type A, which can cause muscle paralysis. Mostly used in tiny doses to cosmetically soften wrinkles, Botox injections have been proposed to paralyze certain jaw muscles to ease TMD symptoms.
Although this sounds like a plausible approach, Botox injections have some issues that should give prospective patients pause. First, Botox can only relieve symptoms temporarily, requiring repeated injections with increasingly stronger doses. Injection sites can become painful, bruised or swollen, and patients can suffer headaches. At worst, muscles that are repeatedly paralyzed may atrophy, causing among other things facial deformity.
The most troubling issue, though, is a lack of strong evidence (outside of a few anecdotal accounts) that Botox injections can effectively relieve TMD symptoms. As such, the federal Food and Drug Administration (FDA) has yet to approve its use for TMD treatment.
The treatment route most promising for managing TMD remains traditional physical and drug therapies, coupled with diet and lifestyle changes. It can be a long process of trial and error, but your chances for true jaw pain relief are most likely down this well-attested road.
If you would like more information on treating jaw disorders, 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 “Botox Treatment for TMJ Pain.”