My Blog

Posts for tag: orthodontic treatment

WemayNeedtoRemoveoneorMoreTeethBeforeApplyingBraces

“To gain something, sometimes you have to give up something else.”

No, that isn't the latest viral meme on the Internet. It's actually a practical consideration that could arise in orthodontics.

In this case, the “something” to gain is a straighter, more attractive smile; the “something” you may have to part with is a few teeth. This may be necessary if there are too many teeth on a dental arch for its capacity, a situation called crowding. A lack of space is the main reason teeth come in misaligned.

Before we can correct this, we'll need to free up space to allow for tooth movement by removing one or more of the existing teeth. The ideal candidates are those that are near to the teeth we wish to move but not highly visible. The first bicuspids are the most frequent choices for removal: they're located behind the cuspids or eyeteeth (the pointed teeth right under the eyes).

Ideally, we'll remove the target teeth some time before we apply braces to give the gums a chance to heal. At the same time we want to preserve the bone that once supported the teeth we've extracted. This is because when we chew the forces generated by the teeth stimulates bone replacement growth. When a tooth is no longer there the supporting bone doesn't receive this stimulation and may ultimately reduce in volume.

We may try to prevent this by placing a bone graft in the empty socket immediately after removing the tooth. The graft serves as a scaffold to encourage new bone to grow. Hopefully when we're ready to apply braces, the bone will be strong and healthy to handle the movement of the teeth.

As the teeth move under the influence of braces, they'll begin to fill up the space created by tooth removal. Once it's completed, the extracted teeth won't be missed — the other teeth now straightened will completely fill out the smile.

The different steps in this process must be carefully planned and executed precisely, and it will take months or even years to complete. In the end, though, this complicated bite problem can be corrected and replaced with an attractive, straight smile.

If you would like more information on correcting a poor bite, 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 Modern Touch Dentistry
January 09, 2017
Category: Dental Procedures
HowKathyBatesRetainsHerMovie-StarSmile

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.

ClosingtheGapBetweenFrontTeethCanCreateaMoreAttractiveSmile

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.”