Posts for: May, 2019
The primary goal of dental care is to preserve teeth. But there are circumstances in which removing a tooth, even a relatively healthy one, could prove best in the long run.
A malocclusion (poor bite) related to crowding might fit such a circumstance. Crowding occurs when the size of the jaw is too small for the teeth coming in. With not enough space, some teeth could erupt out of their proper positions. Removing certain teeth frees up space to eventually allow braces or other orthodontic devices to re-align the teeth.
The teeth most frequently removed are the first bicuspids, located between the cuspid (the "eyeteeth" directly under the eyes) and the back teeth, and the second premolar. Removing these won't normally affect appearance or functionality once orthodontic or cosmetic treatments are complete.
Because of the mechanics of jaw development it might be necessary to perform these extractions several years before orthodontic treatment. This could create another potential problem: the time lag could adversely affect bone health.
This is because bone, as living tissue, has a life cycle with cells forming, functioning and then dissolving, and new cells taking their place. When teeth are chewing or in contact with each other they generate force that travels through the tooth roots to the bone and stimulates cell growth at a healthy replacement rate.
But when a tooth is missing, so is this stimulation. This slows the replacement rate and eventually leads to decreased bone volume. Too much bone loss could create obstacles for orthodontic treatment or a future dental implant.
To avoid this, the dentist will often place a bone graft with processed bone mineral within the empty tooth socket right after extraction. The graft serves as a scaffold for bone cells to grow upon. The graft (plus any other added growth boosters) can help maintain a healthy level of bone volume to facilitate future orthodontic or restorative treatments.
Since targeted extraction for orthodontics is time-sensitive, you should have your child's bite evaluated by an orthodontist by age 7 to see if any action is necessary. The earlier a malocclusion is detected, the more likely a more attractive and healthy smile will be the ultimate outcome.
If you would like more information on correcting poor bites, 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 Removal for Orthodontic Reasons.”
If you have a few missing teeth but can't afford dental implants or fixed bridgework, consider a removal partial denture (RPD). Although implants may be the superior choice aesthetically and functionally, an RPD can still effectively give you back your teeth.
RPDs are designed to replace one or more missing teeth but not a full arch like a full denture. Considered a permanent restoration, RPDs are also more durable than transitional "flippers," denture appliances that are flexible and light enough to be flipped out of the mouth with a flick of the tongue.
The key to both their affordability and durability is vitallium, a strong but lightweight metal alloy most often used in their frame construction. To it we attach artificial teeth usually made of porcelain or glass-filled resins that occupy the precise location of the missing teeth on the gum ridge. The artificial teeth and frame are surrounded by gum-colored plastic for a more natural look.
Each RPD is custom-made depending on the number and location of the missing teeth. Its construction will focus on minimizing any rocking movement of the RPD during chewing or biting. Too much of this movement could damage the adjacent teeth it's attaching to and cause the appliance to be uncomfortable to wear. We can stabilize the frame by precisely fitting it between teeth to buttress it. We also insert small rests or clasps made of vitallium at strategic points to grip teeth and minimize movement.
RPDs do have some downsides: their unique attachment with teeth encourages the accumulation of dental plaque, the thin bacterial film that's the leading cause of tooth decay and periodontal (gum) disease. These diseases can affect your remaining teeth's health and stability, which could in turn disrupt the fit of the RPD. Also, too much movement of the appliance can make the teeth to which it's attached become more mobile. It's important, then, if you wear a RPD to remove it daily for cleaning (and to thoroughly brush and floss your natural teeth), and to remove it at night to give the attaching teeth a rest.
A RPD can give you back the teeth you've lost for many years to come—if you take care of it. Maintaining both your RPD and the rest of your teeth and gums will help extend the life and use of this effective and affordable replacement restoration.
If you would like more information on teeth replacement 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 “Removable Partial Dentures: Still a Viable Tooth-Replacement Alternative.”
Teeth whitening or bleaching is one of the most affordable and least invasive ways of improving your smile. Although the effect fades with time, whitening can make dull and dingy teeth more attractive in short order.
Teeth whitening is also unique among cosmetic dental procedures in that you can do it yourself at home. While professional bleaching solutions are stronger and capable of greater brightness and longevity, you can still achieve good results with a DIY kit.
If you decide to whiten at home, though, there are a few things to keep mind for a desirable and safe outcome. Here are 3 tips for successful DIY teeth whitening.
Follow the directions. It's not a good idea, both for a successful and safe outcome, to stray away from a kit manufacturer's recommended directions. FDA-approved home kits usually contain 10% or less of carbamide peroxide (one of the more common bleaching agents). That may not seem very strong but it's adequate within the recommended time it remains on your teeth to achieve an effective whitening effect. Exceeding those directions could permanently damage your tooth enamel.
Make sure a home kit will work on your staining. Home whitening kits only affect outer staining on tooth enamel. But dental discoloration can also arise from inside a tooth, often because of trauma, tetracycline use, or as a side effect of a root canal treatment. This kind of internal staining requires a special procedure usually performed by an endodontist to reduce it. So, see your dentist first to make sure your teeth are healthy enough for whitening and that a home kit will work for you.
Get your dentist's advice on home kits. There are a number of whitening applications on the market you can choose, so ask your dentist for recommendations. They can also give you some helpful tips on the whitening process to ensure you'll be safe and successful in your efforts.
Here's a couple of other things to remember to enhance your teeth whitening experience: whether you whiten your teeth at home or with the dentist, be sure you continue to care for your teeth with daily brushing and flossing. And, if you limit your consumption of foods and beverages known to stain teeth, you'll help extend the duration of your brighter smile.
If you would like more information on teeth whitening procedures, 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 Whitening Safety Tips.”