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Posts for tag: orthodontic treatment

By Ravenel Family Dentistry
February 12, 2020
Category: Dental Procedures
StopBiteProblemsEarlyWithInterceptiveOrthodontics

Every year many parents learn their “tweenager” or teenager needs their bite corrected, often with specialized orthodontics. Imagine, though, if these families could go back in time to when their child’s poor bite was just developing to stop or slow it from forming.

Time travel may still be science fiction, but the approach suggested isn’t. It’s called interceptive orthodontics, a group of techniques and procedures performed during the early stages of jaw development. The focus is usually on getting abnormal jaw growth back on track, enough so that a poor bite won’t form.

The upper jaw, for example, may be growing too narrow, reducing the amount of available space for tooth eruption. If it isn’t corrected, teeth can erupt out of position. To correct it, an orthodontist places a palatal expander in the roof of the child’s mouth (palate). The appliance applies gentle pressure against the inside of the teeth, which stimulates the jaws to develop wider.

The expander works because of a separation in the bones at the center of the palate, which later fuse around puberty. The pressure applied from the expander keeps this gap slightly open; the body then continues to fill the widening expansion with bone, enough over time to widen the jaw. If you wait until puberty, the gap has already fused, and it would have to be reopened surgically to use this technique. Ideally, then, a palatal expander should be employed at a young age.

Not all interceptive techniques are this extensive—some, like a space maintainer, are quite simple. If a primary (baby) tooth is lost prematurely, teeth next to the empty space tend to drift into it and cause the intended permanent tooth to erupt out of place due to a lack of space. To prevent this an orthodontist places a small wire loop within the space to prevent other teeth from moving into it.

These are but two examples of the many methods for stopping or slowing a developing bite problem. To achieve the best outcome, they need to be well-timed. Be sure, then, to have your child undergo an orthodontic evaluation around age 6. If an interceptive orthodontic approach is needed, it could eliminate the need for more extensive—and expensive—treatment later.

If you would like more information on treatments to get ahead of bite problems, please contact us or schedule an appointment for a consultation.

DakotaJohnsonandHerMissingToothGapSparksOnlineDebate

Celebrities’ controversial actions and opinions frequently spark fiery debates on social media. But actress Dakota Johnson lit a match to online platforms in a seemingly innocent way—through orthodontics.

This summer she appeared at the premier of her film The Peanut Butter Falcon missing the trademark gap between her front teeth. Interestingly, it happened a little differently than you might think: Her orthodontist removed a permanent retainer attached to the back of her teeth, and the gap closed on its own.

Tooth gaps are otherwise routinely closed with braces or other forms of orthodontics. But, as the back and forth that ensued over Johnson’s new look shows, a number of people don’t think that’s a good idea: It’s not just a gap—it’s your gap, a part of your own uniqueness.

Someone who might be sympathetic to that viewpoint is Michael Strahan, a host on Good Morning America. Right after the former football star began his NFL career, he strongly considered closing the noticeable gap between his two front teeth. In the end, though, he opted to keep it, deciding it was a defining part of his appearance.

But consider another point of view: If it truly is your gap (or whatever other quirky smile “defect” you may have), you can do whatever you want with it—it really is your choice. And, on that score, you have options.

You can have a significant gap closed with orthodontics or, if it’s only a slight gap or other defect, you can improve your appearance with the help of porcelain veneers or crowns. You can also preserve a perceived flaw even while undergoing cosmetic enhancements or restorations. Implant-supported replacement teeth, for example, can be fashioned to retain unique features of your former smile like a tooth gap.

If you’re considering a “smile makeover,” we’ll blend your expectations and desires into the design plans for your future smile. In the case of something unique like a tooth gap, we’ll work closely with dental technicians to create restorations that either include or exclude the gap or other characteristics as you wish.

Regardless of the debate raging on social media, the final arbiter of what a smile should look like is the person wearing it. Our goal is to make sure your new smile reflects the real you.

If you would like more information about cosmetically enhancing your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Space Between Front Teeth” and “The Impact of a Smile Makeover.”

By Ravenel Family Dentistry
September 05, 2019
Category: Dental Procedures
ALittleOrthodonticMagicCouldHelpanImpactedToothErupt

Bite problems aren't limited to teeth simply out of position. The problem could be some teeth aren't there—visibly, that is. They still exist below the gums and bone, but they've been crowded out and blocked from erupting. We call this condition impaction.

Any tooth can become impacted and affect the bite, but a person's smile suffers more if it involves visible front teeth. This is especially so if the teeth in question are upper canines or "eye teeth"—the smile doesn't look normal without these pointed teeth on either side of the central and lateral incisors.

Impacted teeth can also contribute to more than a cosmetic problem: they're more susceptible to abscesses (pockets of infection) or root damage both to themselves or neighboring teeth. To minimize these potential health issues, we'll often remove impacted teeth surgically (as is often done with wisdom teeth).

But because of their important role in not only appearance but also bite function, we may first try to assist impacted canines to fully erupt before considering extraction. It takes a bit of orthodontic "magic," but it can be done.

Before we can make that decision, though, we want to precisely locate the impacted teeth's positions and how it may affect other teeth. This initial evaluation, often with advanced diagnostics like CT scanning or digital x-rays, helps us determine if the impacted teeth are in a workable position to save. If they're not, we may then need to consider removing them and ultimately replacing them with a dental implant or similar restoration.

But if their position is workable and there are no other impediments, we can proceed with helping them erupt. To do this we'll have to first expose them by creating a small opening in the gums through minor surgery. We then bond a small bracket to the tooth, to which we'll attach a small chain that we then attach to orthodontic braces. This enables us to exert continuous pressure on the tooth.

Over time, the pressure coaxes the tooth to erupt. We may still need to apply other forms of orthodontics and cosmetic procedures, but using this procedure to rescue impacted canines can produce a healthier and more attractive smile.

If you would like more information on treating complex bite problems, 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 “Exposing Impacted Canines.”

By Ravenel Family Dentistry
August 16, 2019
Category: Dental Procedures
LingualBracesAnInvisibleWaytoMoveYourTeeth

Once upon a time, braces were the way to straighten a smile. They were—and continue to be—an effective orthodontic treatment especially for younger patients. But braces do have a few drawbacks, one of the biggest being appearance: when you're wearing braces, everyone can see you're wearing them.

That changed a couple of decades ago with the introduction of clear aligners. Removable plastic trays that incrementally move teeth, aligners have quickly become popular for a number of reasons. Perhaps their biggest attraction is that they're barely noticeable.

There's now a third option for correcting crooked teeth: lingual braces. They're similar to the traditional version, but with one big difference: all of the hardware is on the back side of the teeth.

Ironically, two orthodontists an ocean apart developed the idea, and for different reasons. A Beverly Hills orthodontist was looking for an invisible tooth-moving method that would appeal to his image-conscious patients. The other in Japan wanted to offer his martial arts patients, who risked injury from facial blows with traditional braces, a safer alternative.

These two motivations illustrate the two biggest advantages to lingual braces. The brackets and other hardware are attached to the back of the teeth (on the tongue side, hence the term "lingual") and exert the tooth-moving force by pulling, in contrast to the pushing motion of labial ("lip-side") braces. They're thus invisible (even to the wearer) and they won't damage the soft tissues of the cheeks, lips and gums if a wearer encounters blunt force trauma to the mouth.

They do, however, have their disadvantages. For one, they're often 15-35 percent more expensive than traditional braces. They're also a little more difficult to get used to—they can affect speech and cause tongue discomfort. Most patients, though, get used to them within a week. And, being a relatively new approach, not all orthodontists offer them as a treatment option yet.

If you're interested in this approach to teeth straightening, speak with your orthodontist to see if they're right for you. But if you do take this route, you may have a more pleasing and safe experience.

If you would like more information on orthodontic treatment with lingual braces, 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: A Truly Invisible Way to Straighten Teeth.”

By Ravenel Family Dentistry
July 17, 2019
Category: Dental Procedures
CrazyLittleThingCalledHyperdontia

The movie Bohemian Rhapsody celebrates the iconic rock band Queen and its legendary lead vocalist, Freddie Mercury. But when we see pictures of the flamboyant singer, many fans both old and new may wonder—what made Freddie’s toothy smile look the way it did? Here’s the answer: The singer was born with four extra teeth at the back of his mouth, which caused his front teeth to be pushed forward, giving him a noticeable overbite.

The presence of extra teeth—more than 20 primary (baby) teeth or 32 adult teeth—is a relatively rare condition called hyperdontia. Sometimes this condition causes no trouble, and an extra tooth (or two) isn’t even recognized until the person has an oral examination. In other situations, hyperdontia can create problems in the mouth such as crowding, malocclusion (bad bite) and periodontal disease. That’s when treatment may be recommended.

Exactly what kind of treatment is needed? There’s a different answer for each individual, but in many cases the problem can be successfully resolved with tooth extraction (removal) and orthodontic treatment (such as braces).┬áSome people may be concerned about having teeth removed, whether it’s for this problem or another issue. But in skilled hands, this procedure is routine and relatively painless.

Teeth aren’t set rigidly in the jawbone like posts in cement—they are actually held in place dynamically by a fibrous membrane called the periodontal ligament. With careful manipulation of the tooth, these fibers can be dislodged and the tooth can be easily extracted. Of course, you won’t feel this happening because extraction is done under anesthesia (often via a numbing shot). In addition, you may be given a sedative or anti-anxiety medication to help you relax during the procedure.

After extraction, some bone grafting material may be placed in the tooth socket and gauze may be applied to control bleeding; sutures (stitches) are sometimes used as well. You’ll receive instructions on medication and post-extraction care before you go home. While you will probably feel discomfort in the area right after the procedure, in a week or so the healing process will be well underway.

Sometimes, dental problems like hyperdontia need immediate treatment because they can negatively affect your overall health; at other times, the issue may be mainly cosmetic. Freddie Mercury declined treatment because he was afraid dental work might interfere with his vocal range. But the decision to change the way your smile looks is up to you; after an examination, we can help you determine what treatment options are appropriate for your own situation.

If you have questions about tooth extraction or orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Simple Tooth Extraction” and “The Magic of Orthodontics.”