You may not always be able to tell if your child's bite isn't developing properly. Â That's why you should have them undergo an orthodontic evaluation around age 6 to uncover any emerging problems with tooth misalignment.
Still, there are some visible signs all's not well with their bite. As the primary (baby) teeth give way, the permanent teeth erupt sequentially around ages 6 to 8. As they come in, you should notice that each tooth fits uniformly next to each other without excessive gaps or, on the other end of the spectrum, not crowded together in crooked fashion. Upper teeth should also fit slightly over the lower teeth when the jaws are shut.
If their teeth appearance deviates from these norms, they may have a bite problem. Here are 4 abnormalities you should watch for.
Underbite or deep bite. As we mentioned, the front teeth should cover the lower teeth with the jaws shut. In an underbite, the reverse happens — the lower teeth are in front of the upper teeth. It's also a problem if the upper teeth cover the lower teeth too much (often referred to as “deeply”).
Open bite. This occurs when there's a gap between the upper and lower front teeth while the jaws are shut together. One possible cause is late thumb sucking, which can put undue pressure on the front teeth and cause them to develop too far forward while forcing the bottom front teeth further backwards.
Crossbites. This kind of bite occurs when some of the teeth don't fit properly over their counterparts, while others do. Crossbites can occur anywhere in the mouth, for example the upper front teeth fitting behind the lower front teeth while the back teeth overlap normally, or the reverse (front normal, back abnormal).
Misalignments and Abnormal Eruptions. Sometimes upper teeth may align too far forward, a situation known as protrusion. Conversely, lower teeth (or the jaw itself) may come in too far back (retrusion). Because a primary tooth might be out of position or not lost in the proper sequence, a permanent tooth might noticeably erupt out of its proper position.
If you notice any of these situations with your child's teeth see your dentist or orthodontist soon for a full examination. If caught early, we may be able to take action that will lessen or even eliminate the problem.
When is the best time to floss your teeth: Morning? Bedtime? How about: whenever and wherever the moment feels right?
For Cam Newton, award-winning NFL quarterback for the Carolina Panthers, the answer is clearly the latter. During the third quarter of the 2016 season-opener between his team and the Denver Broncos, TV cameras focused on Newton as he sat on the bench. The 2015 MVP was clearly seen stretching a string of dental floss between his index fingers and taking care of some dental hygiene business… and thereby creating a minor storm on the internet.
Inappropriate? We don't think so. As dentists, we're always happy when someone comes along to remind people how important it is to floss. And when that person has a million-dollar smile like Cam Newton's — so much the better.
Of course, there has been a lot of discussion lately about flossing. News outlets have gleefully reported that there's a lack of hard evidence at present to show that flossing is effective. But we would like to point out that, as the saying goes, “Absence of evidence is not evidence of absence.” There are a number of reasons why health care organizations like the American Dental Association (ADA) still firmly recommend daily flossing. Here are a few:
- It's well established that when plaque is allowed to build up on teeth, tooth decay and gum disease are bound to follow.
- A tooth brush does a good job of cleaning most tooth surfaces, but it can't reach into spaces between teeth.
- Cleaning between teeth (interdental cleaning) has been shown to remove plaque and food debris from these hard-to-reach spaces.
- Dental floss isn't the only method for interdental cleaning… but it is recognized by dentists as the best way, and is an excellent method for doing this at home — or anywhere else!
Whether you use dental floss or another type of interdental cleaner is up to you. But the ADA stands by its recommendations for maintaining good oral health: Brush twice a day for two minutes with fluoride toothpaste; visit your dentist regularly for professional cleanings and checkups; and clean between teeth once a day with an interdental cleaner like floss. It doesn't matter if you do it in your own home, or on the sidelines of an NFL game… as long as you do it!
If you want to keep that new smile after orthodontic treatment, you’ll need to wear a retainer for awhile. Teeth have a tendency to “rebound” to their old positions and a retainer prevents that from happening.
Most people are familiar with the standard removable retainer. But there’s another option: a bonded retainer. While performing the same function as a removable one, the bonded retainer differs in one important aspect—it’s fixed in place and can’t be removed except by a dentist. It’s especially useful for certain bite repairs like the closure of the gap between the front teeth.
If you’re thinking this retainer sounds a lot like the braces just removed, it’s not. The main part of a bonded retainer is a thin metal wire that we bond with a dental composite material across the back of the affected teeth. While you can definitely feel it with your tongue it can’t be seen by others, which is an advantage over many removable retainers.
The fixed nature of bonded retainers also creates a couple of advantages, especially for younger patients. There’s no compliance issue as with removable retainers—the patient doesn’t have the option of taking it out. That also means it can’t be lost, a frequent and costly occurrence with the removable variety.
But a bonded retainer does have some drawbacks. For one, the wire and composite material make it more difficult to floss. There’s also a possibility of breakage from high biting forces, which if that should occur must be immediately repaired to avoid the teeth rebounding. But while removable retainers have their downsides, it’s much easier with them to keep the teeth clean of plaque—you simply take the appliance out to brush and floss.
With your dentist’s help you can weigh the pros and cons of both types of retainers and decide which is best for you or your child. Whichever one you choose, wearing a retainer will help protect that hard-earned smile for years to come.
If you would like more information on protecting your bite after orthodontic 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 “Bonded Retainers: What are the Pros and Cons?”
Many otherwise attractive smiles have one noticeable blemish — a large gap between the two upper front teeth. If you have such a gap, there’s a solution that could transform your smile.
The most likely reason for the gap is an issue with a bit of muscle tissue between the gums and upper lip known as the frenum, part of the face’s muscular system. The frenum, though, can overdevelop and grow between the two front teeth into the front part of the palate (roof of the mouth). This can keep or push the teeth apart to form a gap.
To correct the issue, it’s first necessary to consult with an orthodontist, a specialist in bites and tooth alignment. It’s possible for there to be other factors contributing to the spacing including tongue thrusting or finger sucking habits, or missing or misaligned teeth. If the examination reveals an overly large frenum, then the treatment usually commences in two stages.
First, we would need to close the gap by the moving the teeth toward each other with some form of orthodontic appliance like braces or clear aligners. Once closed, the next stage would be to surgically remove the excess frenum tissue and cosmetically alter the gums if necessary.
The order of treatment is important — if you remove the frenum tissue first, any resulting scar tissue could prevent closing the gap with orthodontics. Further, cosmetic surgery on the gums beforehand could result in the loss of the papillae, the small triangular gum tissue between teeth, which results in an unattractive “black” hole.
A frenectomy, the procedure to remove the excess frenum, is a relatively minor procedure that can be performed by a periodontist (gum specialist), oral surgeon, or a general dentist with surgical training. The area is numbed with a local anesthetic, the tissue dissected with a small scalpel, and the resulting small wound closed with a few stitches (another option is to use a surgical laser to remove the frenum). Healing should be complete in about a week with only minor discomfort.
Depending on your individual circumstance, full treatment can take time. But in the end these otherwise routine dental procedures can have a huge impact — a more attractive smile without the noticeable gap.
If you would like more information on treating abnormal teeth spacing, 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 “Space between Front Teeth.”
If your teenager is in need of orthodontic treatment, you might automatically think braces. But while this decades-old appliance is quite effective, it isn’t the only “tooth movement” game in town any more. Clear aligners are another choice your teenager might find more appealing.
Clear aligners are a sequential set of computer-generated plastic trays that are worn by a patient one after the other, usually for about two weeks per tray. The trays are fabricated using 3-D computer modeling of the patient’s mouth, each one slightly different from the last to gradually move teeth to the desired new positions.
So, why choose clear aligners over braces?
They’re nearly invisible. Because they’re made of a clear polymer material, they’re not nearly as noticeable as metal braces. In fact, they may go completely unnoticed to the casual observer.
They’re removable. Unlike metal braces, which are fixed in place by an orthodontist, clear aligners can be removed by the wearer. This makes brushing and flossing much easier, and they can also be removed for eating or special occasions. That said, though, they should be worn at least 20 to 22 hours each day to be effective.
They’re becoming more versatile. With some complicated malocclusions (poor bites), braces and other orthodontic appliances may still be necessary. But innovations like added power ridges in clear aligners can more precisely control which teeth move and which don’t. This has greatly increased the number of poor bite scenarios where we can appropriately use clear aligners.
If you’d like to consider clear aligners, just remember they require a bit more self-discipline on the part of the wearer than braces. And once the treatment finishes, they’ll still need to wear a retainer just as with metal braces to help keep the repositioned teeth from reverting to their old positions.
If you think your teen is up to the challenge and their particular situation can be corrected with this innovative technology, then clear aligners could be a great choice.
If you would like more information on clear aligners orthodontic 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 “Clear Aligners for Teens.”
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