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?”
While retainers are often viewed as a nuisance, they’re crucial to protect the gains made with bite correction. Without them, all of the progress achieved through braces or clear aligners could be lost.
Here’s why: The same elastic gum tissue called the periodontal ligament that holds teeth in place also allows them to move incrementally in response to changes in the mouth. That’s why we can move teeth with braces or aligners, which put pressure on the teeth toward a desired direction of movement while the periodontal ligament does the rest.
But the mechanics can also work in reverse: With pressure relieved when the braces are removed, the teeth could revert to their original positions through a kind of “muscle memory.” The light pressure provided by a retainer is enough to keep or “retain” teeth in their new positions.
The best known retainer is a removable appliance. Initially, a patient wears it continuously and only takes it out during oral hygiene. Wear duration may later be reduced to night time only and eventually not at all, depending on a patient’s individual needs.
While effective, removable retainers do have some downsides. Like braces, they’re visible to others. And because they’re removable, they’re frequently misplaced or lost, leading to the added expense of a new one.
An alternative is a bonded retainer, a thin piece of wire attached to the back of the newly moved teeth to keep them in place. Because it’s behind the teeth it’s not visible—and there’s no misplacing it because only a dentist can take it out.
A bonded retainer is a good option, especially if a patient is immature and not as diligent about wearing or keeping up with their appliance. But it can make flossing difficult to perform, and if they’re removed or broken prematurely, the teeth could revert to their former positions.
If you decide to go with a bonded retainer, be sure you get some tips from your dental hygienist on how to floss with it. And if you decide later to have it removed early, be sure to replace it with a removable retainer. Either of these two options can help you keep your new and improved smile.
If you would like more information on bonded retainers, 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.”
So…you faithfully brush and floss your teeth every day. Kudos to you! Along with regular dental visits, daily hygiene is the best thing you can do to keep your teeth and gums disease-free.
Dental plaque, that thin film of bacteria and food particles that builds up on teeth, is the number one cause for tooth decay and periodontal (gum) disease. Thoroughly removing it daily through brushing and flossing drastically reduces your chances for disease.
But just the acts of brushing and flossing aren’t enough—both are skills requiring some level of mastery for truly effective plaque removal. Otherwise, any leftover plaque could be an invitation for infection.
So, how can you tell if you’re getting the job done? One way is a quick swipe of the tongue across your teeth after brushing: If they still feel gritty rather than smooth, chances are you left some plaque behind.
A more comprehensive method, though, is with a plaque disclosing agent, a product found in stores that sell dental care items. These kits contain liquids, tablets or swabs that when applied to the teeth right after brushing or flossing temporarily dye any leftover plaque a particular color. You’ll be able to see the results for yourself in the mirror.
A plaque disclosing agent can also reveal patterns of remaining plaque that indicate where you need to improve your hygiene efforts. For example, a scalloping effect along the gum line could mean you’re not adequately reaching high enough in these areas with your brush as well as your floss.
The dye effect is temporary, but it might take a few hours for the staining to fade away. You should also avoid swallowing any solution and avoid getting it on your clothes. And while disclosing agents can help improve your hygiene skills, your dentist or hygienist is still your best resource for dental care advice—so keep up those regular dental visits.
If you would like more information on best hygiene practices, 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 “Plaque Disclosing Agents.”
The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!
That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.
If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.
For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.
If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.
When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement
If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”
Your child could hit a speed bump on their road to dental maturity—tooth decay. In fact, children are susceptible to an aggressive form of decay known as Early Childhood Caries (ECC) that can lead to tooth loss and possible bite issues for other teeth.
But dentists have a few weapons in their arsenal for helping children avoid tooth decay. One of these used for many years now is the application of sealants to the biting surfaces of both primary and permanent teeth. Now, two major research studies have produced evidence that sealant applications help reduce children's tooth decay.
Applying sealant is a quick and painless procedure that doesn't require drilling or anesthesia. A dentist brushes the sealant in liquid form to the nooks and crannies of a tooth's biting surfaces, which tend to accumulate decay-causing bacterial plaque. They then use a curing light to harden the sealant.
The studies previously mentioned that involved thousands of patients over a number of years, found that pediatric patients without dental sealants were more than three times likely to get cavities compared to those who had sealants applied to their teeth. The studies also found the beneficial effect of a sealant could last four years or more after its application.
The American Dental Association and the American Academy of Pediatric Dentistry recommend sealants for children, especially those at high risk for decay. It's common practice now for children to first get sealants when their first permanent molars erupt (teeth that are highly susceptible to decay), usually between the ages of 5 and 7, and then later as additional molars come in.
There is a modest cost for sealant applications, but far less than the potential costs for decay treatment and later bite issues. Having your child undergo sealant treatment is a worthwhile investment: It could prevent decay and tooth loss in the near-term, and also help your child avoid more extensive dental problems in the future.
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.