Posts for tag: orthodontic treatment
You’re ready to have that missing tooth replaced with a dental implant or other life-like restoration. But we may first have to address another problem — moving the teeth around the missing tooth space back to where they should be.
That empty space is the primary reason those teeth are no longer in the right position. Through their attachment to the periodontal ligament that lies between them and the bone, teeth are able to move slightly over time in response to mouth changes. This same mechanism, however, may also cause teeth to “drift” toward each other across the empty space left by a missing tooth; too much drift and there won’t be enough room for the replacement tooth.
A fairly straightforward orthodontic treatment can restore drifted teeth to their original position to make room for the replacement. There is one situation, however, that can complicate this treatment — if you also have periodontal (gum) disease, a plaque-induced bacterial infection. During normal tooth movement bone dissolves (resorbs) in front of the tooth in the direction of movement, while new bone forms behind it to help stabilize the tooth in its new position. Gum disease, however, can weaken the bone around these teeth, inhibiting the natural rebuilding process of bone and connective tissue that could jeopardize the success of the orthodontic treatment.
It’s important, then, to first treat and bring the gum disease under control to restore health to both the gums and bone. It’s also just as important during orthodontic treatment to prevent another infection flare-up through renewed brushing and flossing and regular office cleanings and checkups. Choosing clear aligners over traditional braces to move the teeth could also help — unlike fixed braces that often make oral hygiene difficult, clear aligners can be removed to allow easier cleaning of teeth and gums.
Depending on your situation, the process for preparing your mouth for a tooth replacement can involve several procedures and healing time. But the end result — a brand new tooth that looks amazing — will be something to smile about.
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.”
Have you heard about interceptive orthodontics? This type of early intervention could benefit perhaps 10â??20% of children who need orthodontic treatment, making a positive impact on tooth and jaw development, facial symmetry, and overall self esteem. In case you’re not familiar with it, here are the answers to some common questions about interceptive orthodontic treatment.
Q: What’s the difference between interceptive orthodontics and regular orthodontics?
A: Standard orthodontic treatment typically involves moving teeth into better positions (usually with braces or aligners), and can be done at any age. Interceptive orthodontics uses a variety of techniques to influence the growth and development of teeth and jaws, with the aim of improving their function and appearance. Because it works with the body’s natural growth processes, interceptive treatment is most effective before the onset of puberty (around age 10-14), when growth begins to stop. It is generally not appropriate for adults.
Q: What are the advantages of early treatment with interceptive orthodontics?
A: When it’s done at the right time, interceptive treatment offers results that would be difficult or impossible to achieve at an older age without using more complex or invasive methods — for example, tooth extraction or jaw surgery. That’s why the American Association of Orthodontists, among other professional organizations, recommends that all kids have their first orthodontic screening at age 7.
Q: What are some common issues that can be treated with interceptive orthodontics?
A: One is crowding, where there is not enough room in the jaw to accommodate all the permanent teeth with proper spacing in between. A palatal expander can be used to create more room in the jaw and avoid the need for tooth extraction. Another is a situation where the top and bottom jaws don’t develop at the same rate, resulting in a serious malocclusion (bad bite). A number of special appliances may be used to promote or restrict jaw growth, which can help resolve these problems.
Q: How long does interceptive orthodontic treatment take?
A: Depending on what’s needed, a child might wear a device like a palatal expander or another type of appliance for 6-12 months, followed by a retainer for a period of time. Or, a space maintainer may be left in place for a period of months to hold a place for a permanent tooth to erupt (emerge from the gums). Interceptive treatment ends when a child’s jaw stops growing.
Q: Will braces still be needed after interceptive treatment?
A: Often, but not always, the answer is yes. However, interceptive treatment may shorten the period of time where braces need to be worn, and can help prevent many problems later on.
If you have additional questions about interceptive orthodontics, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Early Orthodontic Evaluation.”
In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.
When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”
Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.
There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.
By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.
So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.