My Blog

Posts for: August, 2018

By Barbara Preussner, DMD
August 29, 2018
Category: Dental Procedures
Tags: braces   tooth extraction  
ExtractingCertainTeethcanBoostOrthodonticEffectiveness

We treat most malocclusions (bad bites) with braces or clear aligners. But not all malocclusions are alike — some can require extra procedures to achieve successful results.

One such example is when incoming teeth crowd other teeth and cause them to erupt abnormally. The crowding also reduces the space needed to move the misaligned teeth to better positions. To make more room we'll often remove some of the teeth before undertaking orthodontics.

The key is to extract the right teeth. The best candidates are those whose absence will have minimal effect on both appearance and dental function. That's commonly the bicuspids, located right on the edge of the “smile zone” (the teeth most visible when we smile) between the cuspid (eye) teeth and the back molars.

Once we choose and remove the teeth our next concern is to protect the bone at the extraction site. The bone in our jaws benefits from the pressure created when we bite or chew. This stimulates new bone cells to form and replace older cells. Without it, as when we have a missing tooth, the amount of bone can diminish over time and affect the success of any future orthodontics.

To prevent this, we take care not to damage the gums and bone removing the tooth. We may also install a graft under the empty socket to encourage bone growth.

If we've removed teeth outside the smile zone, the resulting orthodontics will move teeth into the opened space. In the end, you won't even notice they're gone. Teeth lost or congenitally missing in the smile zone, though, may eventually require a replacement tooth. A dental implant is the best choice, but it should be put on hold for a younger person until their jaw has fully developed.

In the meantime, we can install a spacer or a temporary restoration to hold the empty space and prevent other teeth from drifting into it. This can be incorporated into braces or aligners, or with a removable partial denture or a temporary modified bridge.

Extracting teeth to aid orthodontics first requires a well-laid plan that could encompass several years. The end result, though, can be well worth the time and effort — better function and a new, attractive smile.

If you would like more information on the process of 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 “Tooth Removal for Orthodontic Reasons.”


By Barbara Preussner, DMD
August 19, 2018
Category: Oral Health
SofiaVergaraObsessedWithOralHygiene

A woman as gorgeous and funny as Sofia Vergara surely planned to be a model and actress from the get-go, right? Wrong! Sofia’s first career choice actually was to be… a dentist! That’s right, the sexy star of TV’s Modern Family actually was only two semesters shy of finishing a dental degree in her native Columbia when she traded dental school for the small screen. Still, dental health remains a top priority for the actress and her son, Manolo.

“I’m obsessed,” she recently told People magazine. “My son thinks I’m crazy because I make him do a cleaning every three months. I try to bribe the dentist to make him to do it sooner!”

That’s what we call a healthy obsession (teeth-cleaning, not bribery). And while coming in for a professional cleaning every three months may not be necessary for everyone, some people — especially those who are particularly susceptible to gum disease — may benefit from professional cleanings on a three-month schedule. In fact, there is no one-size-fits-all approach to having professional teeth cleanings — but everyone needs this beneficial procedure on a regular basis.

Even if you are meticulous about your daily oral hygiene routine at home, there are plenty of reasons for regular checkups. They include:

  • Dental exam. Oral health problems such as tooth decay and gum disease are much easier — and less expensive — to treat in the earliest stages. You may not have symptoms of either disease early on, but we can spot the warning signs and take appropriate preventive or restorative measures.
  • Oral cancer screening. Oral cancer is not just a concern of the middle aged and elderly — young adults can be affected as well (even those who do not smoke). The survival rate for this deadly disease goes up tremendously if it is detected quickly, and an oral cancer screening is part of every routine dental visit.
  • Professional teeth cleaning. Calcified (hardened) dental plaque (tartar or calculus) can build up near the gum line over time — even if you brush and floss every day. These deposits can irritate your gums and create favorable conditions for tooth decay. You can’t remove tartar by flossing or brushing, but we can clear it away — and leave you with a bright, fresh-feeling smile!

So take a tip from Sofia Vergara, and don’t skimp on professional cleanings and checkups. If you want to know how often you should come in for routine dental checkups, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor articles “Dental Hygiene Visit” and “Dental Cleanings Using Ultrasonic Scalers.”


By Barbara Preussner, DMD
August 09, 2018
Category: Oral Health
Tags: gum recession  
4ImportantFactsAboutGumRecessionandWhatYoucandoAboutIt

While gum recession is a common occurrence related to aging, it’s not just an “old person’s disease.” It can happen to anyone, even someone with a relatively healthy mouth. And this detachment and shrinking back of the gums from the teeth may not be a minor problem—your dental health is definitely at risk.

Here then are 4 things you should know about gum recession, and what you can do about it.

The most common cause: periodontal (gum) disease. A bacterial infection triggered by built-up dental plaque, gum disease weakens the gums’ attachment to teeth that leads to recession. To help prevent it, clean away plaque with daily brushing and flossing and visit a dentist regularly for more thorough plaque removal. If you already have gum disease, prompt treatment could stop the infection and reduce any resulting damage including recession.

…But not the only one. There are other factors that contribute to recession besides disease. In fact, it could be the result of “too much of a good thing”—brushing too hard and too frequently can damage the gums and lead to recession. You might also be more susceptible to recession if you’ve inherited thin gum tissues from your parents. Thin gums are at increased risk of recession from both disease and over-aggressive hygiene.

Best outcomes result from treating gum disease and/or recession early. The earlier we detect and treat a gum problem, the better the outcome. See your dentist as soon as possible if you see abnormalities like swollen or bleeding gums or teeth that appear larger than before. Depending on your condition there are a number of treatment options like plaque removal or techniques to protect exposed teeth and improve appearance.

Grafting surgery could regenerate lost gum tissue. While with mild cases of gum recession the gums may respond well to treatment and actually rejuvenate on their own, that might not be possible with advanced recession. We may, however, still be able to restore lost tissue through grafting. Using one of a number of techniques, a graft of donor tissue can foster new replacement growth. It’s a meticulous micro-surgical approach, but it could be a viable answer to extreme gum recession.

If you would like more information on gum recession, 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 “Gum Recession.”