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3WaystoCorrectaSmileWithMissingIncisors

In the classic holiday film, It's a Wonderful Life, George Bailey sees what life would be like if he'd never been born. In a variation on the theme, imagine your life if your teeth had never formed.

That's actually a reality for some—they're born without teeth, albeit usually only one or two. But even then, they're often more susceptible to problems with their bite, speech development and nutrition.

And if their missing teeth affects their appearance, their self-image could also take a hit. In particular, the maxillary lateral incisors on either side of the central incisors (those in the very front) can create an odd smile if missing.

Fortunately, we can correct the problem of missing lateral incisors with three possible solutions. The first is canine substitution, involving the pair of pointed teeth next in line to the missing incisors. In effect, we use orthodontic appliances like braces to move them toward the frontmost teeth and close the missing teeth gap.

It's a minimally invasive way to improve smile appearance. But because of their size and sharp edges, it's often necessary to alter the canines, perhaps even crown them. Some people may also need gum surgery to "blend" the gums with the repositioned teeth.

A second method is a fixed bridge, a series of fused crowns. Those in the middle replace the missing teeth, while those on the ends are bonded to the natural teeth on either side of the gap to support the bridge.

Bridges can function well for many years, but it does require permanently altering the supporting teeth for crowning. An alternative Maryland or bonded bridge doesn't require this alteration, but it's also less durable than a traditional bridge.

Finally, we could replace the missing teeth with dental implants, a titanium post imbedded into the jawbone with an attached life-like crown. An implant tooth can last for decades, and don't require alterations to other teeth. However, they're not suitable for younger patients who are still undergoing jaw development—a temporary restoration may thus be in order until the jaw matures.

Being born without certain teeth is something you can't do anything about. But you can change how it affects your appearance and life with one of these options for a new smile.

If you would like more information on correcting a smile with missing 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 “When Permanent Teeth Don't Grow.”

VictoriaBeckhamsToothsomeCollection-AllofHerChildrensBabyTeeth

In one respect, celebrities are no different from the rest of us—quite a few famous people love to collect things. Marie Osmond collects dolls (as well as Johnny Depp, reportedly); Leonardo DiCaprio, vintage toys. And, of course, Jay Leno has his famous fleet of cars. But Victoria Beckham's collection is unusually "familial"—she's kept all of her four children's "baby" teeth after they've fallen out.

Best known as Posh Spice of the 1990s group Spice Girls and now a fashion designer and TV personality, Beckham told People Magazine that she has an "entire bucket" of her kids' primary teeth. And, she recently added to it when her nine-year old daughter lost another tooth earlier this year.

You may or may not want to keep your child's baby teeth, but you'll certainly have the opportunity. Children start losing their first set of teeth around age 6 or 7 through early puberty. During the process, each tooth's roots and gum attachment weakens to the point that the tooth becomes noticeably loose. Not long after, it gives way and falls out.

Although a baby tooth doesn't normally need any help with this, children (and sometimes parents) are often eager to accelerate the process. A loose tooth can be annoying—plus there's often a financial incentive via the "Tooth Fairy!"

First off, there's not much harm in a child wiggling a loose tooth—it may even help it come out. It's also possible to help the tooth safely detach sooner by taking a small piece of tissue, folding it over the tooth and giving it a gentle downward squeeze. If it's loose enough, it should pop out.

If it doesn't, don't resort to more forcible measures like the proverbial string and a door—just wait a day or two before trying the gentle squeeze method again. Once the tooth comes out, the empty socket may bleed a bit or not at all. If heavy bleeding does occur, have the child bite down on a piece of clean gauze or a wet tea bag until it stops. You may also have them eat softer foods for a few days to avoid a resumption of bleeding.

Beyond that, there's little else to do but place it under your child's pillow for the Tooth Fairy. And if after their "exchange" with that famous member of the Fae Folk you find yourself in possession of the erstwhile tooth, consider taking a cue from Victoria Beckham and add it to your own collection of family memories.

If you would like more information about losing baby teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Importance of Baby Teeth.”

BothToothDecayorGumDiseaseCouldBecomeSomethingFarWorse

While mouth pain can certainly get your attention, what exactly hurts may be difficult to identify. It might seem to emanate from a single tooth, or a group of teeth. Then again, it might not be clear whether it's coming from teeth or from the gums.

Still, it's important to pinpoint the cause as much as possible to treat it correctly. One of the main questions we often want to answer is whether the cause originates from within a tooth or without.

In the first case, tooth decay may have entered the pulp at the center of the tooth. The pulp contains nerve bundles that can come under attack from decay and transmit pain signals. Incidentally, if the pain suddenly goes away, it may simply mean the nerves have died and not the infection.

The decay can also spread into the root canals leading to the root and supporting bone, and then make the jump into the gum tissues. One possible sign of this is the one mentioned earlier—you can't quite tell if the pain is from the tooth or the surrounding gums.

The root canals could also serve as a transportation medium for infection in the other direction. In that case, gum disease has advanced into the bone tissues around a tooth near its roots. The infection can then cross into the tooth. Again, both a tooth and the gum tissue around it can become diseased.

We have effective treatments for individual occurrences of interior tooth decay or gum disease: The former usually requires a root canal treatment to remove infected tissue and fill and seal the tooth from future infection; we alleviate gum disease by removing the dental plaque causing it and helping the gum tissues to heal. But combined tooth and gum infection scenarios are more difficult to treat, have a poorer prognosis and may require specialists.

To reduce the risk of either tooth decay or gum disease developing into this greater problem, it's best to take action at the first sign of trouble. So, see your dentist as soon as possible when you encounter oral pain or if you notice swollen or bleeding gums. The earlier we treat the initial outbreak of disease, be it tooth decay or gum disease, the better your chances of a successful and happy outcome.

If you would like more information on tooth pain, 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 “Confusing Tooth Pain.”

HeresWhatToDofor4KindsofDentalInjuries

Although kids are resilient, they're not indestructible. They're prone to their share of injuries, both major and minor—including dental injuries.

It's common for physically active children to suffer injuries to their mouth, teeth and gums. With a little know-how, however, you can reduce their suffering and minimize any consequences to their long-term oral health.

Here are 4 types of dental injuries, and what to do if they occur.

Chipped tooth. Trauma or simply biting down on something hard can result in part of the tooth breaking off, while the rest of it remains intact. If this happens, try to retrieve and save the chipped pieces—a dentist may be able to re-bond them to the tooth. Even if you can't collect the chipped pieces, you should still see your dentist for a full examination of the tooth for any underlying injury.

Cracked tooth. A child can experience intense pain or an inability to bite or close their teeth normally if a tooth is cracked (fractured), First, call the dentist to see if you need to come in immediately or wait a day. You can also give the child something appropriate to their age for pain and to help them sleep if you're advised to wait overnight.

Displaced tooth. If a child's tooth appears loose, out of place or pushed deeper into the jaw after an accident, you should definitely see a dentist as soon as possible—all of these indicate a serious dental injury. If they're unavailable or it's after hours, your dentist may tell you to visit an emergency room for initial treatment.

Knocked-out tooth. Minutes count when a tooth is knocked completely out. Quickly locate the tooth and, holding it only by the crown and not the root, rinse off any debris with clean water. Place it in a glass of milk or attempt to place it back into the socket. If you attempt to place it back into the socket, it will require pressure to seat the tooth into position. You should then see a dentist or ER immediately.

A dental injury can be stressful for both you and your child. But following these common-sense guidelines can help you keep your wits and ensure your child gets the care they need.

If you would like more information on pediatric dental treatment, please contact us or schedule an appointment for a consultation.

SeeYourDentistFirstBeforeUsingaHomeTeethWhiteningKit

Are your stained teeth bumming you out? There's good news—you can transform that dull and dingy smile yourself with a tooth whitening product.

There are dozens of over-the-counter whitening kits that allow you to brighten your own smile. Although not as controlled and long-lasting as a dentist's professional whitening, these DIY kits can still give you effective results.

But since these products involve chemical solutions that bleach tooth enamel, there's a common concern about their safety. Could you be harming your teeth by using a home whitening kit?

The answer is no—as long as you follow the manufacturer's directions for using the product. These kits have been formulated with a lower percentage of bleaching agent (usually 10% carbamide peroxide) than whitening solutions used by dentists. They've also been subjected to several clinical studies gauging both their effectiveness and safety.

That said, though, exceeding a product's recommended directions and frequency of use could cause you problems. If not used properly, a bleaching solution can erode tooth enamel—and this protective tooth layer doesn't grow back! As long as you whiten "within the lines," so to speak, you shouldn't encounter this kind of situation.

With that said, though, there are good reasons to consult your dentist before using a whitening product, or have them perform the whitening for you.

For one thing, an over-the-counter whitening product won't work if the staining originates from inside a tooth. It's wise, then, to have a dental examination first before using a whitening product to uncover this or any other underlying dental problems that should be addressed first.

You may also find a professional whitening will give you a more desirable result. A stronger professional bleaching solution under a dentist's expert control can produce a brighter, longer lasting smile than a home use product. A dentist may also be able to control the level of brightness better to help you achieve the smile effect you desire, from subtle white to ultra-bright.

Whichever way you go, your dentist can advise you on your options and make sure your teeth are in good shape for whitening. The end result can be a brighter smile—and a brighter mood.

If you would like more information on teeth whitening, 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.”





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