Advances in technology often lead to greater choices for things like automobiles or smartphones. In recent decades, advances in orthodontics have given families another choice besides braces for straightening teeth: clear aligners.
Clear aligners are a series of computer-generated mouth trays of clear plastic that are custom made for an individual patient's teeth. Like braces, these trays worn in the mouth put pressure on the teeth to move in a desired direction. Patients wear an individual tray for about two weeks and then change it out for the next tray in the series. Each subsequent tray is designed to pick up where the former tray left off in the progress of tooth movement.
Although treatment takes about as along as braces, clear aligners have some distinct advantages. First and foremost, their clear plastic construction makes them nearly invisible to outside observers. This makes them ideal for appearance-conscious teens (or adults) who may be embarrassed by the look of metallic braces.
And unlike their fixed counterpart, clear aligners can be removed by the wearer for meals, hygiene and the rare special occasion. As a result, patients with aligners aren't as restricted with food items and have an easier time keeping their teeth clean and avoiding dental disease than braces wearers.
But although definitely a benefit, removability can be potentially problematic depending on the maturity level of the patient. To be effective, an aligner tray must remain in the mouth for the majority of the time—too much time out negates the effect. Patients, then, must be responsible with wearing aligners as directed.
Clear aligners may also not work for treating difficult bites, especially those that require targeted movement (or non-movement) of select teeth. In those cases, braces may be the necessary treatment. But this situation has changed in recent years with the development of new devices and techniques that increase the range of bite problems clear aligners can treat.
Depending then on the bite problem and a patient's level of personal responsibility, clear aligners can be a viable orthodontic choice. And just like braces, they too can improve both dental function and appearance.
If you would like more information on orthodontic options for teens, 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.”
In the realm of dental restorations, not all crowns are alike. And, one type isn't necessarily superior to the others. One type of crown may work better for a particular tooth, while a different crown is better suited to another.
Therefore, knowing your options can help you make a more informed choice with your dentist regarding the best crown for your needs. Here, then, is a quick primer on the main types of dental crowns used today.
Metal crowns. Early in the last century, crowns made of gold, silver or other metals were the go-to dental restoration. Because of their strength and durability, metal crowns are still used today, mainly in back teeth that encounter heavy biting forces. Their drawback: They're decidedly not the color of natural teeth and so can stand out if they're placed in the visible "smile zone."
PFM crowns. The first crowns made with dental porcelain solved the appearance problem, but couldn't adequately handle biting forces as well as metal. Out of this came the porcelain fused to metal (PFM) crown, which contains an inner core of metal overlaid with tooth-colored porcelain. Providing both strength and life-likeness, PFM crowns were immensely popular until the mid-2000s.
All-Ceramic crowns. The development of porcelains more durable than earlier versions eventually dethroned the PFM (although the latter is still used today). Sixty percent of the crowns installed in recent years are all-ceramic, many reinforced with a strength material known as Lucite. Many all-ceramic crowns reaching the 15-year mark are still in place and functioning.
All of these crowns continue to be viable options for dental patients. The biggest factor in choosing one particular crown over another is the type of tooth involved and its location. As mentioned before, metal or PFM crowns are usually better for back teeth where durability is a higher priority than aesthetics. All-ceramics work well in high-visibility front teeth that normally encounter lighter biting forces than back teeth.
Regardless of which kind eventually caps your tooth, any of today's modern crowns will function as intended. But the best crown for you will be the one that both protects your tooth and enhances your smile.
If you would like more information on dental crown restorations, 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 Dental Crowns.”
Some things in life are almost guaranteed to make you go, "Uh, oh"—your car won't start, your a/c goes out, or, worse yet, you get an unexpected letter from the IRS.
Here's another: One of your teeth is loose. And, if you don't act quickly, that loose tooth may soon become a lost tooth.
But first, we need to find out why it's loose. It's usually due to one of two types of injury related to your bite. One type is called primary occlusal trauma. This results from your teeth encountering higher than normal biting forces. This often happens if you habitually gnash or grind your teeth together outside of normal functions like eating or speaking.
The other type is secondary occlusal trauma. In this case, the supporting gum tissues and bone have been weakened or lost by disease, with the gum tissues possibly becoming detached. Without this support, even normal biting forces could loosen a tooth.
Our treatment approach for a loose tooth may differ depending on which of these is the cause. For primary occlusal trauma, we want to reduce the biting forces that have contributed to loosening the tooth. One way to do this is to create a mouthguard that when worn prevents teeth from making solid contact during grinding episodes.
For secondary trauma, we want to first focus on treating any gum disease responsible for weakening the gum tissues. Once we have it under control, the gums and bone tissues can heal and possibly regain and strengthen their attachment with the tooth.
At the same time, we may also need to stabilize a loose tooth to prevent its loss. This usually involves splinting, whereby we use neighboring healthy teeth to support the loose tooth. One way to do this is to attach a metal strip across the backs of the loose tooth and its more stable neighbors, or by way of a channel cut through the top biting surfaces of the teeth.
If a loose tooth regains its attachment with the gums and bone, it may stabilize and any splinting can be removed. If not, splinting may become a permanent solution. Either way, prompt treatment can help us save your loose tooth.
If you would like more information on treating loose 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 “Loose Teeth: Biting Forces Can Loosen Teeth.”
There are plenty of hilarious videos of groggy patients coming out of wisdom teeth surgery to keep you occupied for hours. While many of these have turned everyday people into viral video stars, every now and then it really is someone famous. Recently, that someone was Seattle Seahawks quarterback Russell Wilson.
The NFL star underwent oral surgery to remove all four of his third molars (aka wisdom teeth). His wife, performer and supermodel, Ciara, caught him on video as he was wheeled to recovery and later uploaded the clip to Instagram. As post-wisdom teeth videos go, Wilson didn't say anything too embarrassing other than, "My lips hurt."
Funny videos aside, though, removing wisdom teeth is a serious matter. Typically, the third molars are the last permanent teeth to erupt, and commonly arrive late onto a jaw already crowded with other teeth. This increases their chances of erupting out of alignment or not erupting at all, remaining completely or partially submerged within the gums.
This latter condition, impaction, can put pressure on the roots of adjacent teeth, can cause abnormal tooth movement resulting in a poor bite, or can increase the risk of dental disease. For that reason, it has been a common practice to remove wisdom teeth preemptively, even if they aren't showing any obvious signs of disease.
In recent years, though, dentists have become increasingly nuanced in making that decision. Many will now leave wisdom teeth be if they have erupted fully and are in proper alignment, and they don't appear to be diseased or causing problems for other teeth.
The best way to make the right decision is to closely monitor the development of wisdom teeth throughout childhood and adolescence. If signs of any problems begin to emerge, it may become prudent to remove them, usually between the ages of 16 and 25. Because of their location and root system, wisdom teeth are usually removed by an oral surgeon through one of the most common surgeries performed each year.
This underscores the need for children to see a dentist regularly, beginning no later than their first birthday. It's also a good idea for a child to undergo an orthodontic evaluation around age 6. Both of these types of exams can prove helpful in deciding on what to do about the wisdom teeth, depending on the individual case.
After careful monitoring throughout childhood and adolescence, the best decision might be to remove them. If so, take it from Russell Wilson: It's worth becoming the star of a funny video to protect both current and future dental health.
At what age should you begin treating a poor bite? Many might say with braces around late childhood or early adolescence. But some bite problems could be addressed earlier—with the possibility of avoiding future orthodontic treatment.
A crossbite is a good example. In a normal bite, all of the upper teeth slightly cover the lower when the jaws are shut. But a crossbite occurs when some of the lower teeth, particularly in back, overlap the upper teeth. This situation often happens when the upper jaw develops too narrowly.
But one feature of a child's mouth structure provides an opportunity to intervene and alter jaw development. During a child's early years, the palate (roof of the mouth) consists of two bones next to each other with an open seam running between them. This seam, which runs through the center of the mouth from front to back, will fuse during puberty to form one continuous palatal bone.
An orthodontist can take advantage of this separation if the jaw isn't growing wide enough with a unique device called a palatal expander. This particular oral appliance consists of four, thin metal legs connected to a central mechanism. The orthodontist places the expander against the palate and then uses the mechanism to extend the legs firmly against the back of the teeth on both sides of the jaw.
The outward pressure exerted by the legs also widens the seam between the two palatal bones. The body will respond to this by adding new bone to the existing palatal bones to fill in the widened gap. At regular intervals, the patient or a caregiver will operate the mechanism with a key that will continue to widen the gap between the bones, causing more expansion of the palatal bones until the jaw has grown to a normal width.
The palatal expander is most effective when it's applied early enough to develop more bone before the seam closes. That's why it's important for children to undergo bite evaluation with an orthodontist around age 6. If it appears a bite problem is developing, early interventions like a palatal expander could slow or stop it before it gets worse.
If you would like more information on interceptive 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 “Palatal Expanders.”
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