Posts for: September, 2017
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.
What's an actor's most important feature? According to Vivica A. Fox, whose most recent big-screen role was in Independence Day: Resurgence, it's what you see right up front.
"On screen, your smile and your eyes are the most inviting things that bring the audience in" she said. "Especially if you play the hot chick."
But like lots of people, Vivica reached a point where she felt her smile needed a little help in order to look its best. That's when she turned to a popular cosmetic dental treatment.
"I got veneers years ago," Ms. Fox told Dear Doctor magazine in a recent interview, "just because I had some gapping that probably only I noticed."
What exactly are dental veneers? Essentially, they are thin shells of lustrous porcelain that are permanently attached to the front surfaces of the teeth. Tough, lifelike and stain-resistant, they can cover up a number of defects in your smile — including stains, chips, cracks, and even minor spacing irregularities like the ones Vivica had.
Veneers have become the treatment of choice for Hollywood celebs — and lots of regular folks too — for many reasons. Unlike some treatments that can take many months, it takes just a few appointments to have veneers placed on your teeth. Because they are custom made just for you, they allow you to decide how bright you want your smile to be: anywhere from a natural pearly hue to a brilliant "Hollywood white." Best of all, they are easy to maintain, and can last for many years with only routine care.
To place traditional veneers, it's necessary to prepare the tooth by removing a small amount (a millimeter or two) of its enamel surface. This keeps it from feeling too big — but it also means the treatment can't be reversed, so once you get veneers, you'll always have them. In certain situations, "no-prep" or minimal-prep veneers, which require little or no removal of tooth enamel, may be an option for some people.
Veneers aren't the only way to create a better smile: Teeth whitening, crowns or orthodontic work may also be an alternative. But for many, veneers are the preferred option. What does Vivica think of hers?
"I love my veneers!" she declared, noting that they have held up well for over a decade.
If you’ve lost some teeth you may eventually want to replace them with dental implants. Implants by far are the restoration of choice due to their life-likeness and durability. But those advantages don’t come cheaply — implants can be expensive especially for multiple teeth.
If you’re forced to wait financially for implants, you still have other intermediary options like a removable partial denture (RPD). The conventional RPD has a rigid acrylic base colored to resemble gum tissue supported by a metal frame with attached prosthetic (false) teeth at the missing teeth locations. They’re held secure in the mouth through metal clasps that fit over the remaining teeth.
But these conventional RPDs can sometimes be uncomfortable to wear and don’t always cover the bottom of the gum completely. If this is a concern, you might consider an alternative: flexible RPDs. The base of this RPD is made of a form of flexible nylon rather than acrylic plastic. They’re much more lightweight but still fit securely in the mouth with thin plastic extensions rather than metal clasps. The base can also be more easily formed to cover areas where gum tissue may have receded.
While flexible RPDs hold up better to wear and tear than their conventional counterparts, they must still be maintained like any other appliance. They can accumulate plaque (bacterial biofilm) responsible for tooth decay and periodontal (gum) disease, so daily thorough cleaning is a must. And if there fit becomes loose they can be more difficult to reline or repair than other types of dentures.
They also share a common weakness with other dentures — they can’t prevent and may even stimulate bone loss. As bone ages, old cells dissolve and new ones form to take their place. As we eat and chew our teeth transmit the forces generated through the teeth to the bone to stimulate it to grow. RPDs and other dentures can’t transmit this stimulus, so the bone replaces much slower to the point that the bone volume can diminish.
That’s why it’s best to consider any RPD as a temporary solution until you can obtain an implant for a more permanent and bone-friendly option. In the meantime, though, an RPD can provide you with a great solution for both form and function for missing teeth.
If you would like more information on RPD choices, 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 “Flexible Partial Dentures: An Aesthetic Way to Replace Teeth Temporarily.”