About one-quarter of people have teeth that never developed. While most of these congenitally missing teeth are wisdom teeth, they can also include premolars or lateral incisors (the teeth right next to the two front teeth, the central incisors).
Missing teeth can have an adverse effect on smile appearance. But that’s not all: because each type of tooth performs a specific function, one or more missing teeth can lead to bite problems and disruption of dental function. In the case of missing lateral incisors, the canines (eye teeth) normally positioned beside and toward the back of the mouth from them may begin to drift into the empty space and grow next to the central incisors. This can result in greater difficulty chewing and a smile that “doesn’t look right.”
To correct this situation, we must often first attempt to orthodontically move any out of place teeth to their normal positions. This re-establishes the space needed for the missing teeth to be replaced, which we can then restore with prosthetic (artificial) teeth. If the permanent restoration of choice involves dental implants, we’ll usually need to wait until the completion of jaw development around early adulthood. In the mean time, we can use a retainer appliance to hold the teeth in their new positions with prosthetic teeth attached to fill the empty space for a better smile appearance in the interim.
The real issue is timing—beginning orthodontic treatment when appropriate to a person’s oral development, as well as completing the implant restoration when the mouth has matured sufficiently. There are other considerations such as bone volume, which may have diminished due to the missing teeth. At some point we may need to consider grafting to build up the bone sufficiently to support dental implants.
This all may entail a team approach by various specialties like orthodontics, periodontics and implantology. Working together and coordinating within a timely schedule, a mouth and smile marred by undeveloped teeth can be transformed.
If you would like more information on treating smiles with underdeveloped permanent 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.”
Shingles is a painful viral infection that could potentially recur in sufferers for years. It causes painful skin rashes, general nerve pain, fever and fatigue. In extreme cases, it can cause blindness if the eyes become infected. And because it’s highly contagious, it could affect your dental treatment.
Formally known as herpes zoster, shingles is a recurrent form of chicken pox. If you contracted chicken pox in childhood, the shingles virus could lay dormant for several years. In fact, most people who contract shingles are over 50.
Because it acutely affects the nerves around the skin, the disease’s most common symptom is a belted or striped rash pattern that often appears on one side of the body and frequently on the head, neck or face. While the severity of symptoms may vary among patients, shingles can be a significant health threat to certain people, especially pregnant women, cancer patients or individuals with compromised immune systems.
In its early stages, the shingles virus can easily pass from person to person, either by direct contact with the rash or by airborne secretions that others can inhale. Because it’s highly contagious, even a routine teeth cleaning could potentially spread the virus to dental staff or other patients. Because of the significant health threat it potentially poses to some people, your dental provider may decline to treat you if you’re showing symptoms of the disease.
To stay ahead of this, let your dentist know you’re experiencing a shingles episode if you have an upcoming dental appointment, in which case you may need to reschedule. In the meantime, you should seek medical attention from your physician who may prescribe antiviral medication. Starting it within 3 days of a shingles outbreak can significantly reduce your pain and discomfort as well as its contagiousness.
And if you’re over sixty or at risk for shingles, consider getting the shingles vaccine. This readily available vaccine has proven effective in preventing the disease and could help you avoid the pain and disruption this viral infection can bring to your life.
Overbites, underbites, crossbites—these are just a few of the possible malocclusions (poor bites) you or a family member might be experiencing. But no matter which one, any malocclusion can cause problems.
Besides an unattractive smile, a malocclusion makes it more difficult to chew and to keep the teeth and gums clean of disease-causing bacterial plaque. Thus correcting a malocclusion improves dental health; a more attractive smile is an added bonus.
This art of correction—moving teeth back to the positions where they belong—is the focus of a dental specialty called orthodontics. And, as it has been for several decades, the workhorse for achieving this correction is traditional braces.
Braces are an assembly of metal brackets affixed to the teeth through which the orthodontist laces a metal wire. The wire is anchored in some way (commonly to the back teeth) and then tightened to apply pressure against the teeth. Over time this constant and targeted pressure gradually moves the teeth to their new desired positions.
The reason why this procedure works is because teeth can and do move naturally. Although it may seem like they’re rigidly set within the jawbone, teeth are actually held in place by an elastic tissue network known as the periodontal ligament. The ligament lies between the tooth and bone and keeps the tooth secure through tiny fibers attached to both it and the bone. But the ligament also allows teeth to continually make micro-movements in response to changes in chewing or other environmental factors.
In a sense, braces harness this tooth-moving capability like a sail captures the wind propelling a sailboat. With the constant gentle pressure from the wires regularly adjusted by the orthodontist, the periodontal ligament does the rest. If all goes according to plan, in time the teeth will move to new positions and correct the malocclusion.
In a way, braces are the original “smile makeover”—once crooked teeth can become straight and more visually appealing. More importantly, though, correcting a poor bite improves how the mouth works, especially while eating, and keeping things clean. A straighter smile isn’t just more attractive—it’s healthier.
If you would like more information on correcting misaligned 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 “Moving Teeth with Orthodontics.”
Everyone loves a concert where there's plenty of audience participation… until it starts to get out of hand.Â Recently, the platinum-selling band Fifth Harmony was playing to a packed house in Atlanta when things went awry for vocalist Camila Cabello. Fans were batting around a big plastic ball, and one unfortunate swing sent the ball hurtling toward the stage — and directly into Cabello's face. Pushing the microphone into her mouth, it left the “Worth It” singer with a chipped front tooth.
Ouch! Cabello finished the show nevertheless, and didn't seem too upset. “Atlanta… u wild… love u,” she tweeted later that night. “Gotta get it fixed now tho lol.” Fortunately, dentistry offers a number of ways to make that chipped tooth look as good as new.
A small chip at the edge of the tooth can sometimes be polished with dental instruments to remove the sharp edges. If it's a little bigger, a procedure called dental bonding may be recommended. Here, the missing part is filled in with a mixture of plastic resin and glass fillers, which are then cured (hardened) with a special light. The tooth-colored bonding material provides a tough, lifelike restoration that's hard to tell apart from your natural teeth. While bonding can be performed in just one office visit, the material can stain over time and may eventually need to be replaced.
Porcelain veneers are a more long-lasting solution. These wafer-thin coverings go over the entire front surface of the tooth, and can resolve a number of defects — including chips, discoloration, and even minor size or spacing irregularities. You can get a single veneer or have your whole smile redone, in shades ranging from a pearly luster to an ultra-bright white; that's why veneers are a favorite of Hollywood stars. Getting veneers is a procedure that takes several office visits, but the beautiful results can last for many years.
If a chip or crack extends into the inner part of a tooth, you'll probably need a crown (or cap) to restore the tooth's function and appearance. As long as the roots are healthy, the entire part of the tooth above the gum line can be replaced with a natural-looking restoration. You may also need a root canal to remove the damaged pulp material and prevent infection if the fracture went too far. While small chips or cracks aren't usually an emergency (unless accompanied by pain), damage to the tooth's pulp requires prompt attention.
If you have questions about smile restoration, please contact us and schedule an appointment. You can read more in the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty As Never Before” and “Porcelain Crowns & Veneers.”
If you suffer from a temporomandibular (“jaw joint”) pain disorder (TMD), you know any activity involving jaw movement can be uncomfortable. That includes eating.
But avoiding eating isn’t an option—which means you may be attempting to minimize discomfort during flare-ups by choosing soft, processed foods that don’t require a lot of jaw force. While this may certainly ease your TMD symptoms, you might also be cheating your health by eating foods not optimally nutritious.
It doesn’t have to be a trade-off: with a few simple techniques you can still eat whole, natural foods while minimizing jaw joint pain. Here are 3 tips for making mealtime less stressful during TMD flare-ups.
Cut food into manageable bite sizes. Preparing your food beforehand will make a big difference in how much effort your jaws exert as you eat. Make sure all your food portions of vegetables, fruits or meats are cut or prepared into small, manageable bite sizes. It also helps to remove the tough outer skin of some fruits and vegetables or to mash other foods like potatoes or beans.
Use cooking liquids to soften food. For foods that aren’t naturally moist, you can add liquids to soften them and make them easier to chew. Incorporate gravies, sauces or marinating liquids into your meal preparation to help soften tougher foods like poultry, meats or some vegetables.
Go easy with your chewing and biting motion. The strategy here is to minimize jaw movement and force as much as possible. While preparing your food as mentioned before will help a lot, how you bite and chew will also make a big difference. Limit your jaw opening to a comfortable degree, take small bites and chew slowly.
Managing a jaw joint disorder is an ongoing process. When practiced together with other treatments like therapy or medication, eating deliberately can help make life with TMD easier.
If you would like more information on coping with jaw joint disorder, 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 “What to Eat When TMJ Pain Flares Up.”
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