My Blog

Posts for category: Dental Procedures

By Upper East Smiles
June 02, 2021
Category: Dental Procedures
Tags: braces  
LingualBracesAThirdChoiceforMovingTeeth

First, there were braces; then came removable clear aligners—both great ways to straighten teeth. But braces with their metal brackets and wires aren't the most attractive look. And, although nearly invisible aligners improve appearance, they don't work in every bite situation (although their range has improved of late).

But now a third choice has emerged: lingual braces. Like their traditional counterparts, lingual braces are fixed in place—but on the back side of the teeth rather than the front. Instead of "pushing" teeth toward new positions, they "pull" them, arriving at the same "destination" by another path.

This new method came about simultaneously by two different orthodontists a world apart and for different reasons. A Beverly Hills dentist was looking for an invisible form of treatment similar to clear aligners for his appearance-conscious patients. A Japanese dentist wanted an alternative that would reduce the risk of damage or injury posed by traditional braces to his martial arts patients.

Lingual braces (referring to their proximity to the tongue) address both of these concerns. All of the brackets and wiring are positioned out of sight. And because they're shielded by the teeth, they're not as likely to be damaged or cause injury following hard contact to the face—a great benefit for athletes, law enforcement officers and, yes, martial artists.

Even so, lingual braces won't replace the other two methods any time soon. You'll need to consider other factors, such as that lingual braces can cost up to a third more than traditional braces. And although their availability is steadily growing, not all orthodontists have been trained to offer lingual braces, so you may have to widen your search radius for a provider near you.

You may also find it takes a bit of time to get used to the feel of lingual braces. Upper braces can affect speech ability, at least initially, and the lower ones can interfere with tongue comfort. Most people, though, do adjust to them within a week or so.

But by and large, lingual braces do offer a fixed option that's out of sight, out of mind. With this newer orthodontic choice, you now have three good options for achieving a healthier mouth and a more attractive smile.

If you would like more information on methods for straightening 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 “Lingual Braces.”

PorcelainVeneersTransformRealHousewivesStarsSmileSpoiledbyTeethGrinding

Dorit Kemsley isn't shy. Best known to fans as an outspoken and sometimes outrageous cast member of the reality show Real Housewives of Beverly Hills, Kemsley is never reticent about “mixing it up” with fellow castmates or their significant others. Recently, though, she confessed to something that left her less than confident: her smile.

Kemsley has been self-conscious about her smile because her teeth looked noticeably short, worn down from an unconscious habit of grinding her teeth. Although teeth grinding is more common among children (who normally grow out of it by adolescence), it can persist into adulthood, usually from difficulties managing high stress (a likely component in the fashion designer/reality show star's busy life).

Stress-induced teeth grinding can occur during waking hours or, more likely, during deep sleep. The accumulating, long-term effects from the habit can lead not only to worn teeth but to weakened gum support, a high risk of tooth fracture or jaw pain and dysfunction.

So, how do you know if you grind your teeth, especially if it's only happening at night? Typical signs include sore jaws after awaking from sleep, increased tooth pain or sensitivity or, like Kemsley, a noticeable difference in your tooth length. Your family or sleeping partner may also complain about the “skin-crawling” noise you make during the night.

There are ways to lessen the effects of teeth grinding. The first step is to have us verify the underlying cause for the habit. If it's tension from stress, then you might reduce the habit's occurrences by learning better stress management or relaxation techniques through individual counseling, group support or biofeedback therapy. We can also fit you with a mouth guard to wear at night or through the day that reduces the force generated during teeth grinding.

And if you've already experienced accelerated tooth wear like Kemsley with a resultant “small teeth” smile, you might pursue the same solution as the RHOBH star: dental veneers. These thin, life-like wafers of porcelain are custom-made to mask imperfections like chips, staining, slight tooth gaps and, yes, worn teeth.

Veneers are often less expensive and invasive than other cosmetic techniques, yet they can have a transformative effect, as Kemsley's Instagram followers have seen. In conjunction with other dental treatments needed to repair any underlying damage caused by a grinding habit, veneers are an effective fix for the smile you present to the world.

If you suspect you may have a grinding habit, see us for a complete examination. From there, we'll help you protect your teeth and your smile.

If you would like more information on teeth grinding habits and their effects, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Teeth Grinding.”

ThisOrthodonticDeviceCouldStopaPoorBiteFromDeveloping

“Orthodontic treatment” and “braces” almost seem like synonymous terms. But while braces certainly are orthodontic, it isn't the only tool in an orthodontist's toolkit.

A good example is a device is known as a Herbst appliance. It's used in situations where the upper jaw is outpacing the growth and development of the lower jaw during childhood. If not corrected, this could cause the top teeth to protrude abnormally beyond the lower teeth.

The Herbst appliance gently and gradually coaxes the lower jaw to grow in a more forward direction, thus “catching up” with the upper jaw. The top part of the device consists of two metal tubes hinged to small elastic bands, which are cemented to the cheek side of the upper back teeth (molars), one on either side of the jaw.

Two smaller tubes are attached in like fashion to the lower teeth, and then inserted into the larger tubes. As the lower jaw moves, the smaller tubes move within the larger to create pressure that gently pushes the jaw forward. Over time, this can sync the growth progress of both the upper and lower jaws, and reduce the chances of a poor bite.

For best results, a Herbst appliance is usually placed to coincide with a child's most rapid period of jaw growth, usually between 11 and 14. They could be placed as early as 8 or 9, however, in situations where the front teeth are already protruding well beyond the lips. In any event, the goal is to positively influence the growth of the lower jaw to alleviate or at least minimize the need for future orthodontic treatment.

As a fixed device, there's no need for a child or parent to tend to it as with other methods, like orthodontic headwear worn in conjunction with braces. A Herbst appliance can, however, alter the normal sensations associated with eating, swallowing and speaking, which may take a little adjustment time for the child. Wearers will also need to be extra vigilant with daily brushing and flossing because of a higher risk of tooth decay.

These, though, are minor inconveniences compared with the benefit of improved bite development. As such, a Herbst appliance could be a positive investment in your child's dental future.

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 “The Herbst Appliance.”

RemovingTeethMightMakeItEasierToStraightenaSmile

Dentists remove millions of teeth each year, often because of tooth decay or gum disease. But disease isn't the only reason—a tooth extraction might make it easier to straighten a crooked smile.

Realigning teeth for therapeutic or cosmetic reasons is a regular undertaking in dentistry, but the process itself often differs from person to person. Each individual patient requires their own treatment plan taking into account factors like the kind of bite problem involved, the size of the jaw and the space available to move teeth.

This plan could indeed involve removing teeth. For example, an abnormally small jaw could cause crowding. Not only can crowding move teeth out of position, it may also leave little to no room for moving teeth. Although dentists can minimize crowding by influencing jaw development in early childhood, removing teeth for more space is usually the only option available to older adolescents and adults.

Similarly, teeth can fail to erupt properly and remain partially or fully submerged beneath the gums (known as impaction). There is an orthodontic method for pulling an impacted tooth fully onto the jaw, but only if the tooth isn't too far out of alignment. Otherwise, it may be better to remove the impacted tooth and then correct any gaps with braces or a dental implant.

There's also a situation on the opposite side of the spectrum that could benefit from teeth removal—when one or more permanent teeth fail to form, known as congenitally missing teeth. This can cause gaps in the smile or a “lopsided” appearance where a tooth on one side of the jaw is present while its counterpart on the opposite side of the jaw is missing.

The missing tooth can be replaced by an implant, bridge or other restoration. But another option may be to remove the existing counterpart tooth, and then close the gaps. This can result in a much more attractive smile that might be simpler and less costly than replacing the missing tooth.

Again, the decision to remove teeth to improve smile appearance depends on the patient and their particular dental condition. But in the right situation, it could make straightening a smile easier and more effective.

If you would like more information on orthodontic treatments, 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 “Removing Teeth for Orthodontic Treatment.”

TwoGoodOptionsforTemporarilyReplacingaTeenagersMissingTooth

While anyone can lose a permanent tooth, the cause often varies by age group. Adults usually lose their teeth to disease, while those under twenty lose a tooth to accidents.

For adults, a dental implant is usually the best way to replace a missing tooth. Teenagers and younger, on the other hand, must wait to get implants until their jaws fully develop. An implant placed on an immature jaw will eventually look and feel out of place.

For most, their jaws won't reach full maturity until their early twenties. Even so, they still have a couple of good options for restoring their smiles in the meantime, albeit temporarily.

One is a removable partial denture or RPD, a device with the replacement prosthetic (false) tooth or teeth set in a gum-colored acrylic base. Of the various types of RPDs, most teenagers do well with a rigid but lightweight version called a “flipper,” called so because it can be flipped in and out of place with the tongue.

These RPDs are affordable, their fit easily adjusted, and they make cleaning the rest of the teeth easier. But they can break while biting down hard and—because they're dentures—aren't always well accepted among teenagers.

The other option is a bonded bridge. Unlike a traditional bridge secured with crowns cemented to natural teeth, a bonded bridge uses a strip of dental material affixed to the back of the prosthetic tooth with the ends of the strip extending outward horizontally. With the prosthetic tooth inserted into the empty space, these extended ends are bonded to the backs of the natural teeth on either side.

Though not as secure as a traditional bridge, a bonded bridge is more aesthetic and comfortable than an RPG. On the other hand, patients who have a deep bite or a teeth-grinding habit, both of which can generate abnormally high biting forces, run a higher risk of damaging the bridge. A bridge can also make hygiene tasks difficult and time-consuming, requiring a high degree of self-discipline from the patient.

Whichever you choose, both options can effectively replace a teenager's missing tooth while waiting for dental implants. Although temporary, they can make the long wait time for a teenager more bearable.

If you would like more information on restorations for children and teens, please contact us or schedule an appointment for a consultation.