Posts for tag: orthodontics
Normally, teeth erupt and grow in a symmetrical alignment: on the top palate, for example, the two central incisors take center stage; on either side are the lateral incisors, and then beside these the canines (cuspids).
But what happens when teeth don’t grow in? The result can be a smile that just doesn’t quite look right; more importantly, normal function is impaired because the person can’t grasp and chew food correctly.
These missing teeth are the result of a congenital (“from birth”) defect. It’s estimated that almost a quarter of all people are missing one or more wisdom teeth, and more than 5% are missing one or more second premolars or upper lateral incisors.
In a normal arch (the upper or lower set of teeth), each tooth type performs a particular role during eating. A missing tooth causes the remaining teeth to compensate, but beyond their capacity. The remaining teeth also tend to move to fill in any gaps left by the missing teeth, as when the eye teeth move toward the central incisors in the absence of the lateral incisors. This puts them out of position, so they can’t cover (“occlude”) their counterparts on the other arch and grasp food properly.
To improve the smile and restore proper chewing function it’s necessary to first move these “out of position” teeth to their correct position through orthodontics. We would then fill the gaps that result with life-like restorations (preferably dental implants with crowns) that resemble the type of tooth that should be there.
The restoration needs to be timed carefully, especially for young patients whose jaw structure has not fully developed. If implants are installed before the jaw’s full maturity (usually late teens or early twenties), the implant crowns may not appear to be the right length as the jawbone continues to grow. Since bone growth depends on the normal pressures exerted by the teeth, there may also be insufficient bone mass in the gap area to support a dental implant. Growing bone with bone-grafting material may be necessary before installing implants.
The total process could take many months or even years, depending on age and other conditions. In the end, though, the results can be astounding — better function and a vibrant, new smile.
If you would like more information on developmental problems with 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.”
Not only can orthodontic treatment transform your smile, it can also restore function to your teeth and mouth that will improve both your oral and general health. But any treatment to straighten misaligned teeth requires careful planning. Depending on the exact nature of your misalignment, there may be some additional steps we would need to perform before undertaking orthodontic treatment.
One common need is space to help relieve overcrowding. To make room for tooth movement, often a tooth may need to be removed if the crowding is excessive. The most likely candidates are the first bicuspids, teeth located between the cuspids (or eyeteeth, located in line under the eyes) and the second premolar located in front of the molar teeth. The removal of these first premolars won't have a great effect on future form or function. Under the gentle pressure exerted by the braces, neighboring teeth will move and fill in the open space. Today's orthodontist goes to great lengths to avoid removing any teeth; in severe overcrowding, though, this is an acceptable way to create needed space.
Damaged teeth in need of replacement may also be removed before orthodontics and certainly more desirable — if any tooth needed to be removed, you would always choose a damaged tooth first. The object is to first preserve the underlying bone and close the space to avoid replacing that tooth or, if not possible, maintain the correct amount of space for any future restoration.
As living tissue, bone constantly reshapes in response to its environment. If it no longer senses a tooth (or the forces exerted by a tooth when biting or chewing), the bone will slowly disappear through a process known as bone resorption. To counteract this process, we may graft material (like processed donor bone) into the socket to encourage and maintain bone growth. This creates a platform for future tooth replacements like implants or bridgework after orthodontic treatment.
After orthodontics, it may also be necessary to install some type of “placeholder” (temporary bridgework or partial denture) in the area of missing teeth. Keeping the teeth from migrating into the space will improve the chances that any permanent restoration like an implant or fixed bridgework will look natural — as if it belonged there the entire time.
A complete dental examination will indicate whether any teeth need to be removed before undergoing orthodontic treatment. If necessary, taking this strategic step will help ensure we achieve the best result — a winning smile.
If you would like more information on tooth removal and other options to enhance orthodontics, 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.”
The perception that orthodontics is mainly for children or teenagers is changing rapidly. The number of adults seeking treatment for misaligned teeth is on the rise, especially with the development of less intrusive treatments like clear aligners.
Still, as an adult you may be wondering if having your teeth straightened is really worth the effort. There are good reasons to consider orthodontic treatment even when your teen years are well in your rear view mirror — and improving your smile is only just one of them.
To be sure, smile enhancement is an important reason. We place a high value on presenting our best appearance; indeed, our self-assurance and esteem suffers if we feel we have a less than pleasing smile. Adults who improve their smiles through orthodontics typically see a rise in confidence and an improvement in life attitudes that can have a positive impact on their social, career and financial development.
But there is another reason: as a general rule, misaligned teeth do not function as well. Biting, chewing and speaking may be more difficult. Over the long-term misaligned teeth and the resulting poor bite can have an adverse effect on nutrition, social skills and normal tooth wear.
What's more, misaligned teeth are more difficult to clean even with conscientious daily hygiene. Despite your best efforts, this can lead to increased plaque that causes tooth decay and periodontal (gum) disease. In regard to gums, misaligned teeth may be more prone to receding gums which further exposes teeth to harmful bacteria. Realigning teeth can vastly improve dental hygiene.
As with considering any dental procedure, the first step is a complete dental examination to measure the level of misalignment, as well as the current health of your teeth and gums. After that, we can discuss your orthodontic options for not only correcting your smile, but improving your oral hygiene which can have a pronounced improvement in your oral health as well.
If you would like more information on the benefits of orthodontic 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 “Why Straighten Teeth.”
Compared to traditional braces, orthodontic clear aligners seem miraculous in many ways, almost too good to be true. You may be wondering if they really work. The answer is yes — but they are not for everyone.
What are orthodontic aligners and how do they work?
Clear orthodontic aligners are an alternative to traditional braces that are used to move your teeth and transform your smile without much interference to your daily life. They are removable trays made of a clear plastic material that is essentially invisible.
When using aligners, a sequence of slightly different trays is custom-made to fit over your teeth. You must wear each one 20 hours a day for two weeks before changing to the next in the series. The aligners are computer generated, designed by state-of-the-art techniques based on models and images of your own teeth. They work because slight changes in the sequential aligners gradually shift your teeth. If they are worn consistently, the process takes from six months to two or three years.
Advantages over traditional braces are:
- The aligners can be removed for eating, drinking, brushing, flossing and social occasions.
- They have no rough edges or wires, making them more comfortable.
- Changes become visible quickly as your teeth move into their new, better positions.
Clear aligners are a good solution for correcting mild to moderately crowded or incorrectly spaced teeth. They are most effective if your back teeth already fit together properly. Clear aligners are usually effective in correcting simpler or tipping movements of teeth in two dimensions. For more complex movements, traditional braces may be required. Clear aligners are usually recommended for adults whose teeth and jaws are fully developed, and not for children.
When do you need traditional fixed braces?
Traditional braces are fixed brackets attached to the teeth through which narrow, flexible wires are threaded. They may be necessary if your teeth do not meet properly, creating too much overbite or underbite. Closing spaces where teeth are missing, rotating teeth, or other complicated situations probably make you a better candidate for traditional braces.
Each particular situation is unique. To find out if clear aligners are right for you, make an appointment with us for an assessment and diagnosis of your own situation. For more information see the Dear Doctor magazine article “Clear Orthodontic Aligners.”
For adults with a reasonably well fitting bite, but mild to moderate crowding or spaces between your teeth, clear orthodontic aligners can be an ideal solution for straightening your teeth. This is why we offer this treatment option to our patients experiencing these issues. However, for those of you who are unfamiliar with what they are or how they work, this will give you a brief understanding.
Clear orthodontic aligners consist of a series of clear “trays” that fit snuggly over all teeth to slowly shift them into alignment. Patients are typically required to wear them 20 hours per day for about 2 weeks before progressing to the next tray. With each new tray, you are one step closer to achieving your goal of perfectly aligned teeth. The entire process usually lasts 6-18 months depending on how much movement is required to achieve the goals.
Each aligner is individually made from very precise molds of the patient's teeth to ensure proper fit. And we map out the entire alignment process using computer generation from each patient's initial molds so that we can identify the number of trays required. But best of all, clear orthodontic aligners are perfectly smooth with no rough edges like traditional braces, and you can remove them for eating, brushing, and flossing teeth as well as for brief social events.