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TeensMayNeedaTemporaryReplacementforMissingTeeth

Tooth replacement at any age is a challenge, but especially for teenagers. Dental implants in particular may not be possible yet for teens or young adults whose jaws are still developing. Because it’s imbedded directly into bone, the implant will not move with the jaw as jaw growth occurs, making it look potentially unattractive.

The best solution could be a temporary replacement until their jaw reaches maturity. One such option is a removable partial denture (RPD), an artificial tooth set in an acrylic base that resembles gum tissue. Although we associate dentures with older adults, an RPD works well for teens as a temporary measure. Perhaps the best version for a younger person utilizes metal clips that fit over adjacent teeth and hold the RPD in place. Although quite resilient, the wearer needs to be careful when biting into something hard (like an apple or similar firm fruit) or the artificial tooth may break off.

Another option, a bonded bridge, is a fixed solution similar to a traditional bridge. Whereas a traditional bridge is supported by crowns affixed to the teeth on either side of the empty socket (and requiring extensive alteration of the teeth to accommodate them), a bonded bridge attaches to the supporting teeth with wing-like projections of dental material that attaches to the backs of the adjacent teeth, hidden from view. Although not as secure as a traditional bridge, they can conceivably endure until the teen’s jaw structure is ready for an implant or other permanent solution.

Choosing between an RPD and a bonded bridge will depend on a number of factors, including the teen’s individual bite, clenching or biting habits and the health and strength of supporting bone and gums. Regardless of the type of solution chosen, it’s important to maintain good oral hygiene, especially around a bridge. If bacterial plaque is allowed to build up on tooth surfaces, it could result in an infection that can damage both gums and bone, and reduce the chances of a successful implant in the future.

All these and other considerations should be discussed after a thorough examination. From there, we can advise you on the best course of action to restore both appearance and function until it’s time for a permanent restoration.

If you would like more information on temporary tooth replacements for teens, please contact us or schedule an appointment for a consultation.

By John Sartorio, D.M.D.
May 10, 2020
Category: Oral Health
Tags: oral hygiene   flossing  
IsTraditionalFlossingtooDifficultConsiderWaterFlossing

A critical part of effective, daily oral hygiene, flossing removes bacterial plaque from between teeth that can’t be accessed with brushing. Unfortunately, it’s often neglected — string flossing requires a bit more dexterity than brushing and can be difficult to do properly.

It can be even more difficult for people with implants or who wear orthodontic appliances. For brace wearers in particular, getting access to areas between teeth with string floss is next to impossible; the metal brackets and tension wire also have a tendency to catch and retain food debris that’s difficult to remove with brushing alone.

Water flossing, using a device called an oral irrigator, is an effective alternative that addresses many of these difficulties. First available for home use in the 1960s, an oral irrigator delivers pulsating water at high pressure through a handheld applicator that forcefully flushes material from between teeth.

There’s no question that string flossing is effective in plaque removal between teeth — but what about oral irrigators? A 2008 study looked at a group of orthodontic patients with braces who used oral irrigators and compared them with a similar group that only brushed. The study found that five times as much plaque was removed in the group using the oral irrigators as opposed to the group only brushing.

Oral irrigators may also be effective for people who’ve developed periodontal (gum) disease. In fact, oral irrigators coupled with ultra-sound devices are routinely used by dental hygienists to remove plaque and calculus (hardened plaque deposits) in periodontal patients. As with regular oral hygiene, though, it’s important for patients with gum disease to include water flossing with daily brushing (at least twice a day) and regular cleaning sessions at the dentist to ensure removal of all plaque and calculus.

If you’re interested in using an oral irrigator, be sure to consult with us at your next appointment. Not only can we recommend features to look for in equipment, but we can also instruct you on the techniques to make water flossing an effective plaque remover.

If you would like more information on water flossing, 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 “Cleaning Between Your Teeth.”

By John Sartorio, D.M.D.
April 30, 2020
Category: Oral Health
Tags: oral health   nutrition  
BestDietaryPracticesforHealthyTeethandGums

Your diet can play as important a role in your dental health as brushing and flossing. What you eat (particularly sugar) could increase your risk of tooth decay despite your hygiene habits. And vice-versa: a nutritious diet may help boost your preventive efforts even more.

Let’s look at two very different approaches to diet and see how your dental health is likely to fare under each.

A High Sugar/Low Fiber Diet. Modern western diets heavy with processed foods are inundated with two particular types of refined sugars. The first is sucrose, which comes mainly from either beets or sugar cane. Foods (and beverages) may also contain a refined sugar from corn known as high fructose corn syrup. Refined sugars are added for taste to thousands of products like cake, candy, soft drinks or even condiments like catsup. These “free” sugars are easily processed by bacteria into acid. Combine that with fewer fibrous vegetables in the diet and you have a recipe not only for obesity and other health issues, but tooth decay as well.

A High Fiber/Low Sugar Diet. Fruits and vegetables make up a large part of this kind of diet, while added free sugars much less so. That doesn’t make this diet sugar-free: all plant products contain simple sugars produced by photosynthesis. The difference, though, is that these sugars — glucose, fructose and sucrose (natural, not the refined versions) — are more slowly absorbed into the bloodstream during digestion because of the fiber content of fruits and vegetables. You’ll also receive other nutrients like vitamins and minerals necessary for good health. Eating this kind of diet will help decrease the risk of tooth decay.

So there you have it: eat more fresh fruits and vegetables and restrict your intake of processed foods and sweets. You may also want to fine-tune a few items to maximize decay prevention: for example, eat starches in their natural form (whole grains, beans or certain fruits) as much as possible rather than refined or in combination with added sugar (cakes, cookies, etc.). And while fresh fruits with their naturally occurring sugars aren’t a significant factor in tooth decay, dried fruits (especially with added sugar) might.

Bon appétit!

If you would like more information on proper diets for better oral health, 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 “Nutrition & Oral Health.”

YouCanHaveaStraighterSmile-JustLiketheQueenofEngland

The monarchs of the world experience the same health issues as their subjects—but they often tend to be hush-hush about it. Recently, though, the normally reticent Queen Elizabeth II let some young dental patients in on a lesser known fact about Her Majesty's teeth.

While touring a new dental hospital, the queen told some children being fitted for braces that she too “had wires” once upon a time. She also said, “I think it's worth it in the end.”

The queen isn't the only member of the House of Windsor to need help with a poor bite. Both Princes William and Harry have worn braces, as have other members of the royal family. A propensity for overbites, underbites and other malocclusions (poor bites) can indeed pass down through families, whether of noble or common lineage.

Fortunately, there are many ways to correct congenital malocclusions, depending on their type and severity. Here are 3 of them.

Braces and clear aligners. Braces are the tried and true way to straighten misaligned teeth, while the clear aligner method—removable plastic mouth trays—is the relative “new kid on the block.” Braces are indeed effective for a wide range of malocclusions, but their wires and brackets make it difficult to brush and floss, and they're not particularly attractive. Clear aligners solve both of these issues, though they may not handle more complex malocclusions as well as braces.

Palatal expanders. When the upper jaw develops too narrowly, a malocclusion may result from teeth crowding into too small a space. But before the upper jaw bones fuse together in late childhood, orthodontists can fit a device called a palatal expander inside the upper teeth, which exerts gentle outward pressure on the teeth. This encourages more bone growth in the center to widen the jaw and help prevent a difficult malocclusion from forming.

Specialized braces for impacted teeth. An impacted tooth, which remains partially or completely hidden in the gums, can impede dental health, function and appearance. But we may be able to coax some impacted teeth like the front canines into full eruption. This requires a special orthodontic technique in which a bracket is surgically attached to the impacted tooth's crown. A chain connected to the bracket is then looped over other orthodontic hardware to gradually pull the tooth down where it should be.

Although some techniques like palatal expanders are best undertaken in early dental development, people of any age and reasonably good health can have a problem bite corrected with other methods. If you are among those who benefit from orthodontics, you'll have something in common with the Sovereign of the British Isles: a healthy, attractive and straighter smile.

If you would like more information about orthodontic treatment options, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Magic of Orthodontics.”

By John Sartorio, D.M.D.
April 10, 2020
Category: Oral Health
Tags: gum recession  
4ThingsYouCanDotoAvoidDamageFromGumRecession

Gum recession is a serious oral condition in which the gums shrink back or “recede” from their normal position around the teeth. Because they're the primary protection for teeth below the enamel, this can expose the teeth to infection or cause painful sensitivity. And receded gums most certainly can diminish your smile.

But there are preventive measures you can adopt that might help you avoid this unpleasant condition. Here are 4 things you can do to minimize your risk for gum recession.

Practice daily oral hygiene. The main cause for recession is gum disease, a bacterial infection that weakens gum attachment to teeth. Gum disease usually arises from dental plaque, a thin bacterial film that builds up on teeth. Removing it every day with brushing and flossing minimizes the risk of gum disease and gum recession.

But don't overdo it. Although brushing is key to keeping your mouth healthy, too hard and too often can damage your gums and lead to recession. A little “elbow grease” may be appropriate for other cleaning tasks, but not your teeth—use gentle strokes and let the mild abrasives in your toothpaste do the main removal work. And avoid brushing more than twice a day.

See your dentist regularly. Your personal care efforts are a major part of preventing gum recession, but you can greatly increase the effect with professional dental care. That's because with even the best hygiene practice infections and other gum problems can still arise. You may also have inherited thinner gum tissues from your parents that increase your disease risk and bear closer monitoring.

Act quickly at the first signs of disease. Gum disease is a progressive disease, and it doesn't take long for it to become intrenched. The sooner it can be treated, the less likely you'll experience recession. So, make a dental appointment as soon as possible if you notice your gums are swollen, red or painful, or if they bleed easily after brushing.

There are ways to reverse gum recession. But many treatments like grafting surgery to regenerate new gum tissues can be quite involved and expensive. Following these tips can help you avoid gum recession altogether or stop it before it goes that far.

If you would like more information on how to avoid gum recession, 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 “Gum Recession: Getting Long in the Tooth.”





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