Posts for category: Dental Procedures
Long ago dental work could be painful and stressful—often for both patient and practitioner. Thankfully, that time is long past: today, most procedures are painless in large part due to local anesthesia.
Local anesthetics are numbing substances applied to specific areas of the body like the teeth and gums to temporarily block pain during a procedure. And because they only affect a localized area of the body, you remain conscious and alert throughout the procedure.
To achieve the level of numbing necessary for dental work, we often need to deaden the gums using a needle to deliver the anesthetic. But then this poses a secondary pain concern—the needle stick itself.
Again, topical anesthesia comes to the rescue in the form of a swab, patch or spray applying an anesthetic directly to the top layer of the gums at the injection site. This numbs the area and prevents you from feeling the needle stick. It's highly probable, therefore, that from start to finish you won't feel any discomfort during your dental work except perhaps for a little pressure.
Local anesthesia truly is a game changer for dental care—and not just for the patient. A dentist who's concerned about their patient's comfort level may work hurriedly to complete a procedure. But if their patient is relaxed, the dentist can work calmly and methodically. The result is better, more focused care.
For all its improvements in the patient experience, though, there has been one consistent complaint—the numbness that often lingers for a while after the procedure is over. But there have been advances in recent years that have helped reduce this irritation: new anesthetic agents (even some that can reverse the anesthetic effect) and fine-tuned dosages can help keep residual numbing to a minimum.
Not all procedures like routine teeth cleanings or enamel shaping require anesthesia. But when it's appropriate, local anesthesia can make your next dental visit much more pleasant.
If you would like more information on how anesthesia benefits your 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 “Local Anesthesia for Pain-Free Dentistry.”
While orthodontists can effectively correct most poor bites (malocclusions), some can be quite complex requiring much time and expense. But there's good news—we often don't have to wait on a malocclusion to fully develop if we catch it in time. Thanks to interceptive orthodontics, we may be able to intervene much earlier and eliminate or reduce the degree of difficulty with treatment.
Interceptive orthodontics is a group of techniques and devices used in early childhood to help deter a possible malocclusion. Here are 3 ways this approach could make a difference in your child's bite development.
Guiding jaw growth. On a normal-sized upper jaw, the permanent teeth usually have ample room to erupt. Not so with a smaller jaw: incoming teeth become crowded and may erupt out of alignment or too close to each other. Orthodontists often use a device called a palatal expander to aid an under-sized jaw in its development. The device fits along the roof of the mouth between the teeth and applies gradual outward pressure on them. This encourages the jaw to widen as it grows, thus providing more room for erupting teeth to come in properly and decrease the chances of obstructive sleep apnea in the future.
Reshaping and repositioning jaw bones. An overbite can occur when the jaws aren't properly aligned, often due to poor muscle and bone development. This is where devices like the Herbst appliance are useful. Its hinge mechanism encourages the lower jaw to grow further forward. The jaws can thus develop in a more normal way, minimizing the development of a malocclusion.
Maintaining space. Primary ("baby") teeth are important for dental development because they help guide future permanent teeth to erupt properly; they also keep nearby teeth from drifting into the intended space. But when a primary tooth is lost prematurely due to disease or trauma, the space can become vulnerable to this kind of "drift." With a simple mechanism called a space maintainer we can hold open the space created by a prematurely lost primary tooth until the permanent tooth is ready to erupt.
These and other techniques can help stop bad bites from developing in young children, minimizing or even eliminating the need for future orthodontic treatment. That means a healthier mouth for your child and less impact on your wallet.
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 “Interceptive Orthodontics: Timely Intervention can make Treatment Easier.”
Tooth decay and periodontal (gum) disease pose the most common dangers to dental health. But there are some rare conditions that can also place teeth at risk to be on the lookout for during regular dental checkups.
One such condition is root resorption in an adult tooth, in which the root itself or its surface breaks down and is absorbed by the body. Resorption occurs naturally in a primary (“baby”) tooth so it can loosen and give way for an incoming permanent tooth. Â Resorption still occurs in a limited form with young permanent teeth but should eventually stop.
Sometimes, though, it doesn’t, either from the inside of the tooth out (internal resorption) or more often from the outside in, usually around the neck-like (or “cervical”) portion of the tooth. This more common occurrence, External Cervical Resorption (ECR), can first appear as pink spots on the enamel and then progress into cavity-like areas. If not found and treated promptly, damage can occur quickly and lead to tooth loss.
We don’t fully understand the exact nature and causes for ECR, but we have identified risk factors for its development. Excessive orthodontic force on the teeth or any other trauma can cause damage to the periodontal ligament (which holds teeth in place with the jaw bone). Teeth grinding habits and some dental procedures like internal tooth whitening can also be risk factors.That being said, though, the vast majority of people who experience these issues don’t develop ECR.
Although the causes aren’t fully understood, we can still treat it: the key to success is early detection. You probably won’t notice early signs of ECR, but we can often detect spots from routine x-rays. We can then remove the tissue cells within the lesions causing the damage and restore the area with a tooth-colored filling material. If ECR has extended near the tooth’s interior pulp layer, then a root canal treatment may be needed.
Needless to say, the more extensive ECR occurs in the roots, the less likely the tooth can be saved and may need to be extracted. It’s important, therefore, to maintain regular dental checkups (at least twice a year) to increase your chances of catching a developing problem early.
If you would like more information on root resorption in adult 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 “Root Resorption: An Unusual Phenomenon.”
The movie Bohemian Rhapsody celebrates the iconic rock band Queen and its legendary lead vocalist, Freddie Mercury. But when we see pictures of the flamboyant singer, many fans both old and new may wonder—what made Freddie’s toothy smile look the way it did? Here’s the answer: The singer was born with four extra teeth at the back of his mouth, which caused his front teeth to be pushed forward, giving him a noticeable overbite.
The presence of extra teeth—more than 20 primary (baby) teeth or 32 adult teeth—is a relatively rare condition called hyperdontia. Sometimes this condition causes no trouble, and an extra tooth (or two) isn’t even recognized until the person has an oral examination. In other situations, hyperdontia can create problems in the mouth such as crowding, malocclusion (bad bite) and periodontal disease. That’s when treatment may be recommended.
Exactly what kind of treatment is needed? There’s a different answer for each individual, but in many cases the problem can be successfully resolved with tooth extraction (removal) and orthodontic treatment (such as braces). Some people may be concerned about having teeth removed, whether it’s for this problem or another issue. But in skilled hands, this procedure is routine and relatively painless.
Teeth aren’t set rigidly in the jawbone like posts in cement—they are actually held in place dynamically by a fibrous membrane called the periodontal ligament. With careful manipulation of the tooth, these fibers can be dislodged and the tooth can be easily extracted. Of course, you won’t feel this happening because extraction is done under anesthesia (often via a numbing shot). In addition, you may be given a sedative or anti-anxiety medication to help you relax during the procedure.
After extraction, some bone grafting material may be placed in the tooth socket and gauze may be applied to control bleeding; sutures (stitches) are sometimes used as well. You’ll receive instructions on medication and post-extraction care before you go home. While you will probably feel discomfort in the area right after the procedure, in a week or so the healing process will be well underway.
Sometimes, dental problems like hyperdontia need immediate treatment because they can negatively affect your overall health; at other times, the issue may be mainly cosmetic. Freddie Mercury declined treatment because he was afraid dental work might interfere with his vocal range. But the decision to change the way your smile looks is up to you; after an examination, we can help you determine what treatment options are appropriate for your own situation.
If you have questions about tooth extraction or orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Simple Tooth Extraction” and “The Magic of Orthodontics.”
Children's permanent teeth normally erupt over several years after first forming below the gum line. All their permanent teeth should come in by the time they reach early adolescence.
Unfortunately, this process doesn't always happen as it should. If the erupting teeth become crowded due to a poor bite (malocclusion), teeth still to come in may not have enough room to fully erupt. They become impacted, a condition in which the visible crown remains partially or completely submerged below the gum line.
Impacted teeth create consequences for other teeth and dental health overall. They more readily cause abscesses (a localized infection within the gum tissue) and can damage the roots of nearby teeth. Impacted front canine (eye) teeth can interfere with bite function and their visual absence mars an otherwise attractive smile.
If your child's canine teeth have failed to erupt properly, there is a way to help them fully come in if you act before their mouth structure fully matures. The first step is an orthodontic evaluation of their entire bite. This will determine if there's enough space to move other teeth to make room for the impacted canines.
If so, we would then find the exact position of the impacted teeth using x-rays and possibly cone beam CT scanning for a detailed three-dimensional image. The teeth could be in a variety of positions, such as angled toward the roof of the mouth or cheek or buried high in the jawbone. If the teeth are too far out of position the best course of action may be to remove them and replace them later with a dental implant.
If the impacted teeth, though, are in a feasible position for retrieval, we first expose each tooth through the gums with a minor surgical procedure and bond a small bracket to it. We then attach a small gold chain to the bracket that loops over an orthodontic appliance attached to other teeth. The appliance will exert pressure over several months to pull the tooth into proper position.
If successful, your child will gain the use of these important teeth and a more attractive appearance. But don't delay — this desired outcome will become much harder if not impossible to attain as their teeth and jaws continue to develop.
If you would like more information on treating 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.”