My Blog
By Sathya Medanaga, D.D.S.
May 24, 2022
Category: Dental Procedures
Tags: braces  
3WaysToGetAheadofYourChildsDevelopingBiteProblem

Each year some 4 million teens and pre-teens have their teeth straightened with braces or clear aligners. But there's another facet of bite correction that can take place much earlier in a child's life—and which might reduce or eliminate orthodontic treatment later.

Techniques known as interceptive orthodontics do exactly what the name implies—get ahead of bite problems before they fully develop. Many of these treatments attempt to influence jaw development, a prime factor in many bite problems. Although braces may be a part of interceptive treatment, it often includes other devices.

Here are 3 examples of interventional treatments that can stop a growing bite problem in its tracks.

Palatal expanders. Sometimes, an upper jaw may be growing too narrowly. As a result, incoming permanent teeth don't have enough space and can erupt out of position. A palatal expander device, usually installed around age 7 against the roof of the mouth, puts pressure on the side teeth to "push" the jaw outward. This widens a gap in the center of the pallet, which then fills with new bone. By the time the gap closes in early adolescence, the jaw has gained width and more room for incoming teeth.

Herbst appliances. Supporting muscles and bones can pressure the upper jaw to grow too far forward, which in turn creates an overbite where the upper teeth severely overlap the lower. An orthodontist may attach a Herbst appliance, a device consisting of two metal hinges, to the upper and lower jaws toward the back of the mouth. The hinge action forces the jaw muscles and bones to move the lower jaw forward as it grows, resulting in a better relationship with the upper jaw.

Space maintainers. Not all interceptive techniques involve intricate appliances—a simple looped wire could prevent a later bite problem. Because primary (baby) teeth hold the spaces for future permanent teeth, losing one too early could create an empty space into which surrounding teeth can drift. This, then, reduces the space available for the incoming tooth, causing it to erupt out of position. Placing a looped wire called a space maintainer into the space prevents the teeth around the gap from moving into it.

If you would like more information on various orthodontic treatments, 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 “Interceptive Orthodontics.”

ThisTemporaryRPDCouldSustainYourSmileWhileYouWaitForImplants

Dental implants are often the ideal choice to replace missing teeth. Unfortunately, "ideal" and "affordable" don't always align simultaneously for people. Even if implants are right for you, you may have to put them off to a more financially appropriate season.

In the meantime, though, you're still missing teeth—and perhaps some of them are right square in the middle of your smile. What can you do now, even if temporarily?

The solution might be a flexible removable partial denture (RPD). These newer types of RPD fit somewhere between the lightweight "flipper" and the more traditional rigid plastic appliances often made for permanent use. The flexible RPD is made of nylon plastic (technically known as a super-polyamide), which although lightweight, is highly durable.

Super-polyamides change their shape under high heat, a characteristic dental technicians take advantage of by injection molding heated material into flexible denture bases, to which they then attach the replacement teeth. Like other RPDs, a flexible RPD is custom-designed for the individual patient to match their jaw contours, as well as the types and locations of their missing teeth.

Flexible RPDs also differ from other RPD types in how they stay in place. While the more rigid RPD depends on metal clasps that grip to some of the remaining natural teeth, a flexible RPD uses finger-like extensions of the nylon material to fit around teeth near the gum line where they're difficult to see. As such, the flexible RPD is both comfortable and securely held in place.

A flexible RPD, like their counterparts, does require regular maintenance. Any RPD can accumulate dental plaque, a thin biofilm buildup on teeth that causes dental disease. For this reason, wearers should regularly remove their RPD and clean it thoroughly with an antibacterial soap (never toothpaste). All RPDs should also be removed at night to limit bacterial growth.

With a little care, a flexible RPD could last for several years. It could be just the solution to buy you time while you're waiting to obtain dental implants.

If you would like more information on restoration options for missing 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 “Flexible Partial Dentures.”

VictoriaBeckhamsToothsomeCollection-AllofHerChildrensBabyTeeth

In one respect, celebrities are no different from the rest of us—quite a few famous people love to collect things. Marie Osmond collects dolls (as well as Johnny Depp, reportedly); Leonardo DiCaprio, vintage toys. And, of course, Jay Leno has his famous fleet of cars. But Victoria Beckham's collection is unusually "familial"—she's kept all of her four children's "baby" teeth after they've fallen out.

Best known as Posh Spice of the 1990s group Spice Girls and now a fashion designer and TV personality, Beckham told People Magazine that she has an "entire bucket" of her kids' primary teeth. And, she recently added to it when her nine-year old daughter lost another tooth earlier this year.

You may or may not want to keep your child's baby teeth, but you'll certainly have the opportunity. Children start losing their first set of teeth around age 6 or 7 through early puberty. During the process, each tooth's roots and gum attachment weakens to the point that the tooth becomes noticeably loose. Not long after, it gives way and falls out.

Although a baby tooth doesn't normally need any help with this, children (and sometimes parents) are often eager to accelerate the process. A loose tooth can be annoying—plus there's often a financial incentive via the "Tooth Fairy!"

First off, there's not much harm in a child wiggling a loose tooth—it may even help it come out. It's also possible to help the tooth safely detach sooner by taking a small piece of tissue, folding it over the tooth and giving it a gentle downward squeeze. If it's loose enough, it should pop out.

If it doesn't, don't resort to more forcible measures like the proverbial string and a door—just wait a day or two before trying the gentle squeeze method again. Once the tooth comes out, the empty socket may bleed a bit or not at all. If heavy bleeding does occur, have the child bite down on a piece of clean gauze or a wet tea bag until it stops. You may also have them eat softer foods for a few days to avoid a resumption of bleeding.

Beyond that, there's little else to do but place it under your child's pillow for the Tooth Fairy. And if after their "exchange" with that famous member of the Fae Folk you find yourself in possession of the erstwhile tooth, consider taking a cue from Victoria Beckham and add it to your own collection of family memories.

If you would like more information about losing baby teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Importance of Baby Teeth.”

By Sathya Medanaga, D.D.S.
April 24, 2022
Category: Dental Procedures
HowaRootCanalCouldSaveYourDiseasedTooth

Just a century ago a heavily decayed tooth was most likely a goner, but that all changed in the early 1900s when various treatments finally coalesced into what we now call root canal therapy. The odds have now flip-flopped—you're more likely to preserve a decayed tooth than to lose it.

By decay, we're not referring only to cavities in a tooth's enamel or outer dentin. That's just the start—decay can quickly spread deeper into the dentin close to the pulp, the central portion of a tooth containing bundles of nerves and blood vessels. It can then move into the tooth's pulp chamber, causing the pulp to die and producing infection that will eventually infect the surrounding supporting bone.

Root canal treatments are often a lifeline to a tooth in this perilous condition. After numbing the tooth and surrounding tissues with local anesthesia, we start the procedure by drilling a tiny hole to access the central pulp and root canals. We then use specialized tools to remove all of the infected tissue within these interior spaces.

After thoroughly disinfecting the tooth of any decay, we shape up the root canals for filling. We then inject a rubbery substance known as gutta percha and completely fill the tooth's resulting empty spaces. This filling helps to prevent a recurrence of infection within the tooth.

Once we've filled the tooth, we seal off the access hole to complete the procedure. You may experience a few days of mild discomfort, but it's usually manageable with over-the-counter pain relievers. Later, we'll cement a crown over the tooth: This provides additional protection against infection, as well as adds support to the tooth structure.

One more thing! You may have encountered the notion that undergoing a root canal is painful. We're here to dispel that once and for all—dentists take great care to ensure the tooth and the area around it are completely dead to pain. In fact, if you were experiencing a toothache beforehand, a root canal will alleviate the pain.

To get the best treatment outcome for tooth decay, it's important to uncover it as soon as possible. The earlier we begin treatment, the more likely we can bring your tooth back to good health.

If you would like more information on root canal 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 “A Step-By-Step Guide to Root Canal Treatment.”

InjuryTreatmentforanImmatureToothCouldImpactitsLong-termSurvival

Dental accidents do happen, especially among active tweens and teens. When it does, saving traumatized teeth becomes priority one. It's especially important for these younger age groups whose developing dental structures depend on having a jaw-full of permanent teeth.

But because their permanent teeth are still developing, it's often more difficult to treat them than fully grown teeth. That's because the standard treatment—root canal therapy—isn't advisable for an immature tooth.

During a root canal, a dentist removes the diseased or traumatized tissues inside the pulp and root canals, and subsequently fills the empty spaces to prevent further infection. It's safe to do this, even though we remove much of the pulp's nerve and blood vessel tissue in the process, because these tissues aren't as critical to a fully matured tooth.

But these tissues within the pulp are quite important to a tooth still under development—they help the tooth form strong roots and a normal layer of dentin. Their absence could stunt further growth and lead to future problems with the tooth.

For that and other reasons, we avoid a traditional root canal therapy in immature teeth as much as possible, opting instead for techniques that leave the pulp as intact as possible. The approach we use depends on the condition of the pulp after an injury.

For injuries where the pulp remains unexposed and undamaged within the dentin layer, we might remove as much of the damaged tooth structure as possible, while leaving a small portion of dentin around the pulp. We would then apply an antibacterial agent to this remaining dentin to protect the pulp from infection, and fill the tooth.

If an injury exposes the pulp and partially damages it, we might fully remove any damaged tissues and apply a material to the exposed pulp to stimulate new dentin growth. If successful, the dentin around the pulp will regenerate to restore protective coverage.

The methods we use will depend on the degree of damage to the tooth and pulp tissues, a traditional root canal serving as a last resort. Our aim is to not only save the tooth now, but also give it the best chance for long-term survival.

If you would like more information on dental injury 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 “Saving New Permanent Teeth After Injury.”





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