Posts for: May, 2017
Most children's permanent teeth erupt on a fairly predictable schedule. Sometimes, though, one or more teeth might not develop as they should — or at all.
These absent teeth pose functional problems for chewing and hygiene, which can affect long-term dental health. But they can also have a disruptive effect on an otherwise attractive smile if the missing teeth are the upper lateral incisors in the most visible part of the smile.
You normally find this pair of teeth on either side of the upper central incisors (the two front-most teeth). On the other side of the lateral incisors are the canine or eye teeth, known for their pointed appearance. Without the lateral incisors, the canines tend to drift into the space next to the central incisors. This can produce an odd appearance even a layperson will notice: only four teeth where there should be six!
It's possible to correct this abnormality, but it will take time and expense. The first step is usually to move the teeth in the upper jaw with braces to their correct position. This puts teeth where they should be and also opens space between the canines and central incisors so we can eventually replace the missing teeth with dental implants.
But the key to all this is timing. It's usually appropriate to undertake tooth movement with braces during late childhood or adolescence. But implants shouldn't be installed until the person's jaw fully matures, usually in early adulthood. An implant placed before then could eventually become misaligned.
To accommodate the time between bite correction and implant placement, the patient can wear a retainer appliance that will keep the newly created space open. We can also attach artificial teeth to the retainer to camouflage the empty space.
It usually takes a team of a family dentist, an orthodontist and a surgeon to see this kind of “smile makeover” project through, possibly over several years. But the gains in better aesthetics and health are well worth the time and expense.
If you would like more information on replacing non-developing 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.”
Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.
“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into cavities. How did this happen?
Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.
While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods. Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.
This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”
Here are some other basics of infant dental care that every parent should know:
- Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
- Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
- Start regular dental checkups by the first birthday.
Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.
“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”
If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”