Your mouth is a lot like the Wild West — home to millions of bacteria and other microbes, some of which are definitely not “the good guys.” But your teeth are well-protected from these hostile forces and their acidic waste products: with enamel shielding the visible part of your tooth, your gums protect the parts you can’t see.
As effective as they are, though, your gums aren’t invincible: their greatest threat is periodontal (gum) disease. This bacterial infection arises from plaque, a thin film of bacteria and food particles accumulating on teeth due to inadequate brushing and flossing.
The infected tissues soon become inflamed (red and swollen), a natural defensive response from the immune system. The longer they’re inflamed, however, the more likely they’ll begin detaching from the teeth. The gums may eventually shrink back or recede from the teeth, often causing them to appear “longer” because more of the tooth is now exposed to view.
Gum recession doesn’t bode well for your teeth’s survival: the exposed tooth and underlying bone can become even more susceptible to infection and damage. In the end, you could lose your tooth and portions of the supporting bone.
Treatment depends on the severity of the gum recession. In mild to moderate cases, we may only need to perform the standard gum disease treatment of removing plaque and calculus from all gum and tooth surfaces (including below the gum line) with special instruments. This helps reduce the infection and allow the gums to heal and re-establish attachment with the tooth. In more advanced cases, though, the recession may be so extensive we’ll need to graft donor tissue to the area using one of a variety of surgical techniques.
Although the right treatment plan can help restore your gum health, there’s another approach that’s even better — preventing gum disease in the first place. You can reduce your disease risk by practicing daily brushing and flossing and visiting your dentist regularly or when you see symptoms like gum swelling or bleeding. Taking care of your gums won’t just save your smile — it might also save your teeth.
If you would like more information on diagnosing and treating gum disease, 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 Recession.”
“Less is more” is a truism for much of life. It’s also an important feature of an emerging approach to treating tooth decay known as minimally invasive dentistry (MID).
MID updates another revolution in dental care that occurred in the early 1900s. Treating decay took a quantum leap thanks to techniques developed by Dr. G. V. Black, considered the father of modern dentistry. Dr. Black’s approach (known as “extension for prevention”) involved not only removing decayed tooth structure, but also adjacent areas deemed vulnerable to decay, which made them easier to clean. On the downside, though, it also created larger than normal fillings.
As the practice prevailed through much of the Twentieth Century another weakness became apparent—the approach could not guarantee a treated tooth would not experience decay again. This became the real impetus toward MID—to find more comprehensive ways to treat decay with as little impact on the tooth structure as possible.
These efforts received a real boost from emerging technology. This was especially true in diagnostics with the rise of new devices like intraoral cameras and techniques like laser fluorescence that can enable dentists to detect decay much earlier. It’s now possible to catch the disease at an earlier stage before substantial damage to the tooth occurs.
MID has also led to new treatments that preserve more of the tooth structure. Traditional drilling is increasingly giving way to air abrasion, the use of a fine particle stream of aluminum oxide, glass beads or baking soda directed precisely at decayed structure and minimizing damage to healthy structure. We’re also using new filling materials like composite resin for restorations after treatment that are strong yet still life-like and attractive.
We also can’t forget the role of the twin daily hygiene practices brushing and flossing to remove bacterial plaque, the main source of dental disease. And regular dental cleanings and checkups round out the MID approach, helping to ensure that decay doesn’t get too far. The end result of this revolutionary approach: your teeth can experience less impact from treatment and remain healthier and more attractive in the long-run.
If you would like more information on minimally invasive 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 “Minimally Invasive Dentistry: When Less Care is more.”
When Entertainment Tonight host Nancy O’Dell set out to teach her young daughter Ashby how to brush her teeth, she knew the surest path to success would be to make it fun for the toddler.
“The best thing with kids is you have to make everything a game,” Nancy recently said in an interview with Dear Doctor TV. She bought Ashby a timer in the shape of a tooth that ticks for two minutes — the recommended amount of time that should be spent on brushing — and the little girl loved it. “She thought that was super fun, that she would turn the timer on and she would brush her teeth for that long,” Nancy said.
Ashby was also treated to a shopping trip for oral-hygiene supplies with Mom. “She got to go with me and choose the toothpaste that she wanted,” Nancy recalled. “They had some SpongeBob toothpaste that she really liked, so we made it into a fun activity.”
Seems like this savvy mom is on to something! Just because good oral hygiene is a must for your child’s health and dental development, that doesn’t mean it has to feel like a chore. Equally important to making oral-hygiene instruction fun is that it start as early as possible. It’s best to begin cleaning your child’s teeth as soon as they start to appear in infancy. Use a small, soft-bristled, child-sized brush or a clean, damp washcloth and just a thin smear of fluoride toothpaste, about the size of a grain of rice.
Once your child is old enough to hold the toothbrush and understand what the goal is, you can let him or her have a turn at brushing; but make sure you also take your turn, so that every tooth gets brushed — front, back and all chewing surfaces. After your child turns 3 and is capable of spitting out the toothpaste, you can increase the toothpaste amount to the size of a pea. Kids can usually take over the task of brushing by themselves around age 6, but may still need help with flossing.
Another great way to teach your children the best oral-hygiene practices is to model them yourself. If you brush and floss every day, and have regular cleanings and exams at the dental office, your child will come to understand what a normal, healthy and important routine this is. Ashby will certainly get this message from her mom.
“I’m very adamant about seeing the dentist regularly,” Nancy O’Dell said in her Dear Doctor interview. “I make sure that I go when I’m supposed to go.”
It’s no wonder that Nancy has such a beautiful, healthy-looking smile. And from the looks of things, her daughter is on track to have one, too. We would like to see every child get off to an equally good start!
If you have questions about your child’s oral health, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Taking the Stress Out of Dentistry for Kids” and “Top 10 Oral Health Tips for Children.”
Your teenager is about to take a big step toward better health and a more attractive appearance — orthodontic treatment. You both know the benefits: better chewing function, lower risk of dental disease, and, of course, a straighter and more beautiful smile.
But your teen might also dread the next couple of years of wearing braces. And it's hard to blame them: although they're effective, wearing braces restricts eating certain snacks and foods, they require extra time and effort for brushing and flossing, and they're often uncomfortable to wear. And of high importance to a teenager, they may feel embarrassed to wear them.
But over the last couple of decades a braces alternative has emerged: clear aligners. This form of bite correction requires fewer food restrictions, allows greater ease in hygiene, and is considered more attractive than braces. In fact, most observers won't notice them when a wearer smiles.
Clear aligners are a series of clear plastic trays created by computer that are worn in a certain sequence. During wear each tray exerts pressure on the teeth to gradually move them in the desired direction. The patient wears a single tray for two weeks and then changes to the next tray in the sequence, which will be slightly different than the previous tray. At the end of the process, the teeth will have been moved to their new positions.
Clear aligners aren't appropriate for all bite problems. When they are, though, they offer a couple of advantages over braces. Unlike braces, a wearer can remove the aligner to brush and floss their teeth or for rare, special or important social occasions. And, of course, their appearance makes them less likely to cause embarrassment while wearing them.
In recent years, design improvements have increased the kinds of bites aligners can be used to correct. For example, they now often include “power ridges,” tiny features that precisely control the amount and direction of pressure applied to the teeth. They've also become thinner and more comfortable to wear.
If you're interested in clear aligners as a treatment option, talk with your orthodontist about whether your teen is a good candidate. If so, they could make orthodontic treatment for achieving a more attractive and healthy smile less of an ordeal.
If you would like more information on clear aligners as an orthodontic option, 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 “Clear Aligners for Teens.”
When you think orthodontics, you may instantly picture braces or clear aligners worn by teenagers or adults. But there’s more to orthodontics than correcting fully developed malocclusions (poor bites). It’s also possible to intervene and potentially reduce a malocclusion’s future severity and cost well beforehand.
Known as interceptive orthodontics, these treatments help guide jaw growth in children while mouth structures are still developing and more pliable. But timing is critical: waiting until late childhood or puberty could be too late.
For example, we can influence an upper jaw developing too narrowly (which can cause erupting teeth to crowd each other) with an expander appliance placed in the roof of the mouth. The expander exerts slight, outward pressure on the upper jaw bones. Because the bones haven’t yet fused as they will later, the pressure maintains a gap between them that fills with additional bone that eventually widens the jaw.
Functional appliances like the Herbst appliance influence muscle and bone development in the jaws to eventually reshape and reposition them. The Herbst appliance utilizes a set of metal hinges connected to the top and bottom jaws; when the patient opens and closes their jaws the hinges encourage the lower jaw to move (and eventually grow) forward. If successful, it could help a patient avoid more invasive treatments like tooth extraction or jaw surgery.
Some interceptive objectives are quite simple in comparison like preserving the space created by a prematurely lost primary tooth. If a child loses a primary tooth before the incoming permanent tooth is ready to erupt, the nearby teeth can drift into the empty space. Without enough room, the permanent tooth could erupt out of position. We can hold the space with a simple loop device known as a space maintainer: usually made of acrylic or metal, the device fits between adjacent teeth and prevents them from drifting into the space until the permanent tooth is ready to come in.
Interceptive orthodontics can have a positive impact on your child’s jaw development, now and in the future. For these techniques to be effective, though, they must begin early, so be sure your child has a complete orthodontic evaluation beginning around age 7. You may be able to head off future bite problems before they happen.
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