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Posts for: August, 2018

HowtoTreattheProblemofTeeththatNeverDeveloped

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.”


5CausesofBadBreathandWhatYouCanDoAboutIt

Unlike the months on either side, August isn't known for major holidays. But it does have one cause for celebration: National Fresh Breath Day! True, this observance will probably never achieve big-time recognition. Yet everyone would agree that fresh breath is something to appreciate! Unfortunately, bad breath is a persistent problem for many people. The first step in treating it is to identify the cause. Here are 5 common causes of bad breath:

1. Poor oral hygiene. Certain types of oral bacteria cause bad breath, and the mouth provides a perfect environment for them—especially when dental plaque and food debris is not well cleansed. So to keep your breath fresh, maintain a diligent oral hygiene routine. This includes brushing your teeth twice a day with fluoride toothpaste and flossing at least once a day. For an extra-clean mouth, use a tongue scraper—a plastic tool about the size of a toothbrush that's available in most drug stores. This will remove bacteria and food debris from your tongue for extra freshness.

2. Oral diseases. Bad odors in your mouth may also be caused by infections—which is what tooth decay and gum disease actually are. Sometimes old fillings wear out, allowing bacteria to re-infect a tooth that was once treated for decay. Other signs of these common oral diseases include tooth pain and bleeding or puffy gums. If you notice any of these, don't ignore it—make a dental appointment today!

3. Diet. Smelly foods will give you smelly breath; it's that simple. And the odors may linger after you have eaten them. When onion, garlic and other pungent foods are digested, their odor-producing substances enter your bloodstream and proceed to your lungs—which can affect how your breath smells. If you suspect your dietary habits are causing bad breath, try eliminating certain foods (at least temporarily) and see if that helps.

4. Dry mouth. Saliva helps cleanse your mouth, so reduced saliva flow can lead to bad breath. This accounts for "morning breath," which is caused when the mouth dries out during sleep (especially if you are a mouth-breather). However, some people don't produce enough saliva throughout the day. Sometimes it's just that they don't drink enough water. But a very common cause of chronic dry mouth is regular use of medications, both prescription and over-the-counter. If you notice that medication is drying out your mouth, let your doctor know. And stay hydrated!

5. Smoking. Given that smoking increases your risk for many serious diseases, including oral cancer, the fact that it can lead to bad breath seems almost trivial. Still, it's worth noting that smoking causes mouth odor both directly and indirectly by reducing the flow of saliva and promoting gum disease. In fact, tobacco in all forms is a hazard to your health.

If you'd like more information on bad breath, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Warning Signs of Periodontal (Gum) Disease” and “Dry Mouth.”


ChrissyTeigensTeeth-GrindingTroubles

It might seem that supermodels have a fairly easy life — except for the fact that they are expected to look perfect whenever they’re in front of a camera. Sometimes that’s easy — but other times, it can be pretty difficult. Just ask Chrissy Teigen: Recently, she was in Bangkok, Thailand, filming a restaurant scene for the TV travel series The Getaway, when some temporary restorations (bonding) on her teeth ended up in her food.

As she recounted in an interview, “I was… like, ‘Oh my god, is my tooth going to fall out on camera?’ This is going to be horrible.” Yet despite the mishap, Teigen managed to finish the scene — and to keep looking flawless. What caused her dental dilemma? “I had chipped my front tooth so I had temporaries in,” she explained. “I’m a grinder. I grind like crazy at night time. I had temporary teeth in that I actually ground off on the flight to Thailand.”

Like stress, teeth grinding is a problem that can affect anyone, supermodel or not. In fact, the two conditions are often related. Sometimes, the habit of bruxism (teeth clenching and grinding) occurs during the day, when you’re trying to cope with a stressful situation. Other times, it can occur at night — even while you’re asleep, so you retain no memory of it in the morning. Either way, it’s a behavior that can seriously damage your teeth.

When teeth are constantly subjected to the extreme forces produced by clenching and grinding, their hard outer covering (enamel) can quickly start to wear away. In time, teeth can become chipped, worn down — even loose! Any dental work on those teeth, such as fillings, bonded areas and crowns, may also be damaged, start to crumble or fall out. Your teeth may become extremely sensitive to hot and cold because of the lack of sufficient enamel. Bruxism can also result in headaches and jaw pain, due in part to the stress placed on muscles of the jaw and face.

You may not be aware of your own teeth-grinding behavior — but if you notice these symptoms, you might have a grinding problem. Likewise, after your routine dental exam, we may alert you to the possibility that you’re a “bruxer.” So what can you do about teeth clenching and grinding?

We can suggest a number of treatments, ranging from lifestyle changes to dental appliances or procedures. Becoming aware of the behavior is a good first step; in some cases, that may be all that’s needed to start controlling the habit. Finding healthy ways to relieve stress — meditation, relaxation, a warm bath and a soothing environment — may also help. If nighttime grinding keeps occurring, an “occlusal guard” (nightguard) may be recommended. This comfortable device is worn in the mouth at night, to protect teeth from damage. If a minor bite problem exists, it can sometimes be remedied with a simple procedure; in more complex situations, orthodontic work might be recommended.

Teeth grinding at night can damage your smile — but you don’t have to take it lying down! If you have questions about bruxism, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Stress & Tooth Habits” and “When Children Grind Their Teeth.”