Posts for: September, 2020
Infancy is perhaps the only time in a person's life where a smile with just a few tiny teeth is still endearing. More will come—and then each will gradually depart, succeeded by permanent replacements.
That short lifespan, though, doesn't diminish their importance. Primary teeth not only provide children the ability to eat solid food and develop speech, but they set the stage for future dental health.
The latter arises from primary teeth's role as placeholders for incoming permanent teeth. Because permanent teeth eruption occurs in stages, primary teeth prevent earlier erupted teeth from drifting into the space intended for a later tooth. If they're lost prematurely and other teeth crowd into the space, the intended tooth may not have enough room to erupt properly, cascading from there into a poor bite (malocclusion).
The most common reason for premature loss is an aggressive form of tooth decay in children under 6 called early childhood caries (ECC). About one in four U.S. children encounter ECC, with those in poverty at higher risk. Infection in one tooth can spread to others, including newly erupted permanent teeth.
The goal then is to prevent ECC as much as possible, and initiate prompt treatment should it still occur. A good prevention strategy has two prongs: the actions and habits of parents or caregivers; and the prevention and treatment measures taken by dental providers.
At home, it's important that you wipe your newborn's gums with a clean, damp cloth after each feeding to reduce bacterial growth. As teeth erupt, switch then to gentle brushing with a rice grain-sized amount of baby toothpaste. You should also limit their sugar consumption, including not allowing them to sleep with a bedtime bottle of any liquid other than water.
It's also important that you start your child's regular dental visits around their first birthday. This allows us to detect any developing cavities, as well as apply sealants and topical fluoride to help prevent decay. And should a cavity develop, regular visits help ensure prompt treatment to preserve the tooth.
Your child's set of primary teeth only last a few short years, but their contribution echoes for a lifetime. Taking these measures to protect them from tooth decay ensures they'll fully make that contribution.
If you would like more information on dental care for children, 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 “Do Babies Get Tooth Decay?”
The monarchs of the world experience the same health issues as their subjects—but they often tend to be hush-hush about it. Recently, though, the normally reticent Queen Elizabeth II let some young dental patients in on a lesser known fact about Her Majesty's teeth.
While touring a new dental hospital, the queen told some children being fitted for braces that she too “had wires” once upon a time. She also said, “I think it's worth it in the end.”
The queen isn't the only member of the House of Windsor to need help with a poor bite. Both Princes William and Harry have worn braces, as have other members of the royal family. A propensity for overbites, underbites and other malocclusions (poor bites) can indeed pass down through families, whether of noble or common lineage.
Fortunately, there are many ways to correct congenital malocclusions, depending on their type and severity. Here are 3 of them.
Braces and clear aligners. Braces are the tried and true way to straighten misaligned teeth, while the clear aligner method—removable plastic mouth trays—is the relative “new kid on the block.” Braces are indeed effective for a wide range of malocclusions, but their wires and brackets make it difficult to brush and floss, and they're not particularly attractive. Clear aligners solve both of these issues, though they may not handle more complex malocclusions as well as braces.
Palatal expanders. When the upper jaw develops too narrowly, a malocclusion may result from teeth crowding into too small a space. But before the upper jaw bones fuse together in late childhood, orthodontists can fit a device called a palatal expander inside the upper teeth, which exerts gentle outward pressure on the teeth. This encourages more bone growth in the center to widen the jaw and help prevent a difficult malocclusion from forming.
Specialized braces for impacted teeth. An impacted tooth, which remains partially or completely hidden in the gums, can impede dental health, function and appearance. But we may be able to coax some impacted teeth like the front canines into full eruption. This requires a special orthodontic technique in which a bracket is surgically attached to the impacted tooth's crown. A chain connected to the bracket is then looped over other orthodontic hardware to gradually pull the tooth down where it should be.
Although some techniques like palatal expanders are best undertaken in early dental development, people of any age and reasonably good health can have a problem bite corrected with other methods. If you are among those who benefit from orthodontics, you'll have something in common with the Sovereign of the British Isles: a healthy, attractive and straighter smile.
One of the major signs that a young person's dental development is nearing completion is the eruption of the last four permanent teeth: the third molars, located rear-most on either side of both the upper and lower jaws. But the advent of these molars, also called wisdom teeth, isn't always a cause for celebration: They can give rise to serious dental problems.
Wisdom teeth often arrive on an already crowded jaw, making them subject to erupting out of position or becoming impacted, totally or partially submerged in the gums. This can cause harm not only to themselves, but also to other teeth: They can impinge on and damage the roots of their neighbors; impede brushing and flossing and increase the risk of disease; and skew the alignment of other teeth to create poor bites that affect dental health and function.
Wisdom teeth are considered so prone to these problems (an estimated 70% between ages 20 and 30 have at least one impacted molar) that it's been a common practice to remove them before they show signs of disease or poor bite development. As a result, third molar extractions are the most common surgical procedure performed by oral surgeons.
But the dental profession is now reevaluating this practice of early removal. On the whole, it's difficult to predict if the eruption of wisdom teeth in a particular person will actually lead to problems. It may be premature, then, to remove wisdom teeth before there's sufficient evidence of its necessity.
As a result, many dentists now follow a more nuanced approach to wisdom teeth management. An impacted wisdom tooth that's diseased or contributing to disease is an obvious candidate for removal. But if the eruption is proceeding without signs of impaction, disease or poor bite development, many providers recommend not removing them early. Instead, their development is allowed to continue, although monitored closely.
If signs of problems do begin to emerge, then removal may again be an option. Until then, a more long-term watchful approach toward wisdom teeth may be the best strategy for helping a young person achieve optimal dental health.
If you would like more information on managing wisdom teeth treatment, 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 “Wisdom Teeth: Coming of Age May Come With a Dilemma.”