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Posts for category: Dental Procedures

By DeMarco Family Dental
May 11, 2021
Category: Dental Procedures
Tags: aging  
KnowingHowtheMouthandFaceGrowCanImproveBiteTreatment

Correcting a bite problem involves more than applying braces. Orthodontists must consider a wide range of factors, including the type of bite problem involved, complications like impacted or missing teeth, and their patient's overall dental condition.

Orthodontists must also keep in mind the future—how will a treatment implemented now impact a patient's appearance and dental function many years from now? In reality, orthodontists perform these treatments within a dynamic growth environment, especially involving children and teenagers whose mouth and facial structures are still maturing.

And although these growth changes slow in adulthood, they don't stop—orofacial structures continue to change throughout life. For example, a person's lips steadily thicken in size until the mid-teen years, and then slowly thin out over the rest of their lifetime. The distance between the lips both at rest and while smiling may also narrow in later years. Other changes continue to occur in the bones and soft tissues of the mouth and face.

Fortunately, this structural growth follows a fairly consistent track. Although variations do occur, an orthodontist can project the growth changes their patients will undergo as they age, and use that knowledge to plan out bite treatment. With this understanding, orthodontists plan not only what treatments will be needed, but when to perform them, and to what extent.

This may involve a number of treatment stages, spaced out to coincide with regular development. An orthodontist may focus first on general bite correction to bring the teeth and jaws into a reasonable state of alignment. Later, they'll use more refined methods to fine-tune corrections that better align with later adult growth.

More intensive treatments may be necessary to build a foundation for future treatment. For example, orthognathic surgery may be needed to correct a severe case of an over-extended lower jaw. During the procedure, surgeons move the lower jaw to a joint position higher on the skull. This retracts the lower jaw into a more normal alignment with the upper jaw, and can dramatically change the facial profile for the better.

Each orthodontic patient is different, and each requires their own a unique treatment plan. That plan has a greater chance of long-term success by applying knowledge of future growth changes.

If you would like more information on orthodontic treatment, 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 “Understanding Aging Makes Beauty Timeless.”

CTImagingTechnologyCanImproveOutcomesforComplexDentalProblems

The mouth is a crowded place with nerves, blood vessels and sinus cavities sharing common space with the teeth and gums. Although important in their own right, these structures can also hinder treatment for complex dental situations like dental implant surgery or impacted teeth.

Treating these and similar situations depends on getting an accurate depiction of “what lies beneath.” Conventional x-rays help, but their two-dimensional images don't always give the full picture. There's another way—cone beam computed tomography (CBCT).

Similar to CT scanning, CBCT uses x-ray energy to take hundreds of “sliced” images that are then re-assembled with special software to create a three-dimensional model viewable on a computer screen. CBCT is different, though, in that it employs a scanning device that revolves around a patient's head, which emits a cone-shaped beam of x-rays to capture the images.

A dentist can manipulate the resulting 3-D model on screen to study revealed oral structures from various angles to pinpoint potential obstacles like nerves or blood vessels. The detailed model may also aid in uncovering the underlying causes of a jaw joint disorder or sleep apnea.

CT technology isn't the only advanced imaging system used in healthcare. Another is magnetic resonance imaging (MRI), which excites hydrogen atoms in water molecules. This produces different vibration rates in individual tissue structures, which are then translated into detailed images of these structures. Unlike CT or CBCT, MRI doesn't use x-ray energy, but rather a magnetic field and radio waves to produce the atomic vibrations.

But while providing good detail of soft tissues, MRI imaging doesn't perform as well as CBCT with harder tissues like bone or teeth. As to the potential risks of CBCT involving x-ray radiation exposure, dentists follow much the same safety protocols as they do with conventional x-rays. As such, they utilize CBCT only when the benefits far outweigh the potential x-ray exposure risks.

And, CBCT won't be replacing conventional x-rays any time soon—the older technology is often the more practical diagnostic tool for less invasive dental situations. But when a situation requires the most detailed and comprehensive image possible, CBCT can make a big difference.

If you would like more information on advanced dental diagnostics, 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 “Getting the Full Picture With Cone Beam Dental Scans.”

WisdomTeethCanStillbeaProblemfortheWorldsYoungestBillionaire

According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.

At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.

And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.

As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.

Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.

Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.

Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.

If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?

TopicalFluorideCouldBoostYourChildsAvoidanceofToothDecay

Tooth decay is perhaps the biggest danger your child's teeth can face. Not only can it rob them of primary teeth now, but the loss of teeth at this early age could also lead to future bite problems.

That's why it's important to reduce the risk of tooth decay through daily brushing and flossing and regular dental cleanings. You child may also benefit from another measure that enhances those other hygiene efforts—topical fluoride applied directly to tooth surfaces.

Fluoride is a naturally occurring chemical that's been demonstrated to strengthen tooth enamel against contact with acid, the main cause of tooth decay. Today, fluoride is added not only to toothpastes and other dental hygiene products, but also in minute amounts to drinking water supplies across the country.

Even if your child takes in fluoride through one or more of these sources, there may still be a benefit to a topical application. For one, topical applications are usually stronger than fluoride toothpaste or fluoridated water supplies and can have greater effect. And because fluoridated water is ingested first before traveling through the bloodstream to the teeth, directly applied fluoride can strengthen them much faster.

But are these stronger concentrations of topical fluoride safe? Studies have shown no long-term health risk, but there can be temporary side effects like stomach pain, vomiting or headaches if the patient accidently swallows too much of the solution during the application. These side effects, however, can be minimized through safety measures dentists put in place during the procedure.

One study by the Cochrane Oral Health Research Group seems to show that the long-term benefit of topical fluoride is well worth this minor risk of side effects. After reviewing several scientific studies involving thousands of patients, the group found an overall 28% reduction in decayed, filled or missing teeth over a number of years among those who received a topical fluoride treatment.

Because of these and other forms of evidence, fluoride applications in either gel, foam or varnish forms have become a routine part of preventive care for children. Discussing it with your dentist, you may find it could be an extra weapon for your child in fighting tooth decay.

If you would like more information on how to protect your child's teeth from decay, 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 “Fluoride Gels Reduce Decay.”

TakeItFromTaylorSwift-LosingYourOrthodonticRetainerisNoFun

For nearly two decades, singer-songwriter Taylor Swift has dominated the pop and country charts. In December she launched her ninth studio album, called evermore, and in January she delighted fans by releasing two bonus tracks. And although her immense fame earns her plenty of celebrity gossip coverage, she's managed to avoid scandals that plague other superstars. She did, however, run into a bit of trouble a few years ago—and there's video to prove it. It seems Taylor once had a bad habit of losing her orthodontic retainer on the road.

She's not alone! Anyone who's had to wear a retainer knows how easy it is to misplace one. No, you won't need rehab—although you might get a mild scolding from your dentist like Taylor did in her tongue-in-cheek YouTube video. You do, though, face a bigger problem if you don't replace it: Not wearing a retainer could undo all the time and effort it took to acquire that straight, beautiful smile. That's because the same natural mechanism that makes moving teeth orthodontically possible can also work in reverse once the braces or clear aligners are removed and no longer exerting pressure on the teeth. Without that pressure, the ligaments that hold your teeth in place can “remember” where the teeth were originally and gradually move them back.

A retainer prevents this by applying just enough pressure to keep or “retain” the teeth in their new position. And it's really not the end of the world if you lose or break your retainer. You can have it replaced with a new one, but that's an unwelcome, added expense.

You do have another option other than the removable (and easily misplaced) kind: a bonded retainer, a thin wire bonded to the back of the teeth. You can't lose it because it's always with you—fixed in place until the orthodontist removes it. And because it's hidden behind the teeth, no one but you and your orthodontist need to know you're wearing it—something you can't always say about a removable one.

Bonded retainers do have a few disadvantages. The wire can feel odd to your tongue and may take a little time to get used to it. It can make flossing difficult, which can increase the risk of dental disease. However, interdental floss picks can help here. ¬†And although you can't lose it, a bonded retainer can break if it encounters too much biting force—although that's rare.

Your choice of bonded or removable retainer depends mainly on your individual situation and what your orthodontist recommends. But, if losing a retainer is a concern, a bonded retainer may be the way to go. And take if from Taylor: It's better to keep your retainer than to lose it.

If you would like more information about protecting your smile after orthodontics, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Importance of Orthodontic Retainers.”