On the way to adulthood, permanent teeth steadily erupt until, if all goes normally, you have a full set of teeth. Sometimes, though, one or more teeth may fail to form. This not only can affect your dental health, but it could also diminish your smile.
For example, if the lateral incisors on either side of the central incisors (the two teeth front and center) don't develop, it could create a smile that's “not quite right.” But we can vastly improve such a smile in one of three unique ways.
The first is to fill the resulting gap through canine substitution. This is an orthodontic method in which we use braces to move the pointed canine teeth, which normally position on the other side of the missing laterals, closer to the central incisors. This choice is determined by the size of the canine teeth. If they are slim in width, they can be re-shaped to make them appear more like a lateral incisor, and the gums possibly reshaped as well around them through cosmetic surgery.
We can also install a dental bridge, an appliance that fills the missing lateral space with prosthetic teeth. A traditional bridge requires the teeth on either side of the gap to be reduced in size, which becomes a permanent alteration to accommodate these crowns. This is a disadvantage in a young person. We can also use a “bonded bridge” which uses adhesives to attach extended pieces (or “wings”) of dental material from either side of the prosthetic tooth to one or more supporting teeth. These wings are behind the permanent teeth. Though not as durable as a traditional bridge, it does avoid altering the support teeth.
Finally, we can replace the missing teeth with dental implants. In this method, we install titanium metal posts into the jawbone at the missing tooth locations and then attach a life-like crown to each one. Implants may be more costly than other restorative methods and can take several months to complete. But they are life-like, highly durable, and don't require any alteration to other teeth. A disadvantage is that you should wait until at least 19 years of age to consider this option. What many people do is use a temporary solution until the proper age to do a dental implant.
Each of these methods have their advantages and disadvantages, which should be thoroughly reviewed in consultation with your dentist. And each may also require other dental work, such as initial orthodontics to open adequate space for a restoration. But any of these methods for correcting a missing lateral tooth can be effective and help restore both a healthier mouth and a more attractive smile.
If you would like more information on treating congenital dental defects, 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.”
If you're well past your teen years, you probably have several reasons for not straightening your crooked smile: the expense, the time and the embarrassment of being a 30-, 40- or 50+- something wearing braces. But we have five reasons why adult orthodontic treatment can be a smart choice: Tom Cruise, Kathy Bates, Carrie Underwood, Danny Glover and Faith Hill.
That's right: Each of these well-known entertainers and performers—and quite a few more—underwent treatment to improve a poor dental bite. And not as teenage unknowns: Each on our list wore braces or clear aligners as famous adults (the paparazzi don't lie!).
Here are a few of the reasons why these celebrities chose to change their smile through orthodontics—and why you can, too.
Age isn't a factor. Straightening misaligned teeth isn't reserved only for tweens and teens—there are a growing number of adults well into their middle and senior years undergoing orthodontic treatment. As long as your teeth are relatively sound and your gums are healthy, it's altogether appropriate to undergo bite correction at any age.
A boost to your dental health. Gaining a more attractive smile through orthodontics is in some ways an added benefit. The biggest gain by far is the improvement straightening your teeth can bring to your long-term health. Misaligned teeth are more difficult to keep clean of dental plaque, which can increase your disease risk. They also may not function as well as they should while chewing food, which can affect your digestion.
Traditional braces aren't the only way. If the thought of displaying all that hardware makes you cringe, it's not your only option. One of the most popular alternatives is clear aligners, custom plastic trays that are nearly invisible on your teeth—and you can take them out, too. Another method growing in popularity are lingual braces: All the hardware is behind the teeth and thus out of sight. And you can, of course, opt for traditional braces—just ask Tom Cruise!
Oh, yes—a new smile! Orthodontics was truly the first “smile makeover.” It can improve your appearance all by itself, or it can be part of a comprehensive plan to give you an entirely new look. While the gains to your health are primary, don't discount what a more attractive smile could do for you in every area of your life.
The best way to find out if orthodontics will work for you is to visit us for an initial exam and consultation. Just like our A-list celebrities, you may find that orthodontics could be a sound investment in your health and self-confidence.
If you would like more information about orthodontic treatments, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “The Magic of Orthodontics: The Original Smile Makeover.”
Ever have a paper cut or an irritated hangnail? They're not considered major health problems, but, boy, can they sting!
Something similar can occur in the corners of your mouth called angular cheilitis. It's also known as perleche, from the French word “to lick” (a common habit with this type of sore). It can occur at any age, with children or young adults developing it from drooling during sleep or orthodontic treatment.
Older adults, though, are more prone than younger people for a variety of reasons. Age-related wrinkling is a major factor, especially “marionette lines” that run from the mouth to the chin. Dried or thinned out skin due to exposure from cold, windy weather may also contribute to perleche.
Perleche can also develop from within the mouth, particularly if a person is experiencing restricted salivary flow leading to reduced lubrication around the lips. Poorly cleaned dentures, weakened facial supporting structure due to missing teeth, vitamin deficiencies and some systemic diseases can all lead to perleche. And if an oral yeast infection occurs around the cracked mouth corners, the irritation can worsen and prolong the healing process.
To clear up a case of cracked mouth corners, you should promptly see your dentist for treatment. Treatment will typically include some form of antifungal ointment or lozenge applied over a few days to clear up the sores and prevent or stop any infection. You might also need to apply a steroid ointment for inflammation and other ointments to facilitate healing.
To prevent future episodes, your dentist may ask you to use a chlorhexidine mouthrinse to curb yeast growth. If you wear dentures, you'll need to adopt a regular cleaning routine (as well as leaving them out at night). You might also wish to consider updated dental restorations or orthodontics to improve dental support, and help from a dermatologist if wrinkling might be a potential cause.
Cracked mouth corners won't harm you, but they can make for a miserable experience. Take steps to relieve the irritation and any future occurrence.
If you would like more information on angular cheilitis or similar oral conditions, 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 “Cracked Corners of the Mouth.”
We Americans love our sports, whether as participants or spectators. But there's also a downside to contact sports like soccer, football or basketball: a higher risk of injury, particularly to the mouth and face. One of the most severe of these is a knocked out tooth.
Fortunately, that doesn't necessarily mean it's lost: The tooth can be reinserted into the empty socket and eventually return to normal functionality. But it must be done as soon as possible after injury. The more time elapses, the lower the chances of long-term survival.
That's because of how teeth are held in place in the jaw, secured by an elastic, fibrous tissue known as the periodontal ligament. When a tooth is knocked out some of the ligament's periodontal cells remain on the tooth's root. If these cells are alive when the tooth is reinserted, they can regenerate and reestablish attachment between the ligament and the tooth.
Eventually, though, the cells can dry out and die. If that has already happened before reinsertion, the tooth's root will fuse instead with the underlying bone. The tooth may survive for a short time, but its roots can eventually dissolve and the tooth will be lost.
Your window of opportunity for taking advantage of these live periodontal cells is only 5-20 minutes with the best chances in those earlier minutes. You should, therefore, take these steps immediately after an injury:
- Find the tooth, hold it by the crown (not the root end), and rinse off any debris with clean water;
- Reinsert the root end into the empty socket with firm pressure;
- Place clean gauze or cloth in the person's mouth between the tooth and the other jaw, and ask them to bite down gently and hold their bite;
- Seek dental or emergency medical care immediately;
- If you're unable to reinsert the tooth, place it quickly in a container with milk and see a dentist immediately.
You can also obtain an Android or IOS smartphone app developed by the International Association of Dental Traumatology called ToothSOS, which will guide you through this process, as well as for other dental emergencies. The quicker you act, the better the chances that the injured person's knocked out tooth can be rescued.
If you would like more information on what to do in a dental emergency, 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 a Tooth is Knocked Out.”
As far as your appearance goes, the most important teeth you have are those in the “smile zone.” These are the teeth most visible when you smile—and the ones that awkwardly stand out if they're chipped, worn or otherwise flawed. More than any other teeth, they determine how inviting your smile is to others.
You might think you'll need extensive cosmetic dental work to fix these kinds of dental defects. But that may not be necessary: We may be able to use a dental material known as composite resin to repair the defects in your “smile zone” teeth in one office visit.
Composite resins are a combination of ceramics and plastics that have been around for some time. They've only recently come into wide use, though, with the development of new techniques to bond them to tooth surfaces. They're ideal for chips, cracks, or decayed areas where front teeth make contact with one another. They may also be used occasionally to reshape irregular or misaligned teeth.
You'll first need a complete dental examination to determine if composite resin bonding is an appropriate approach for your situation. If so, we'll begin by preparing the tooth surface to better accept the resin material. We'll then apply the liquid form of the material in layers, along with other agents to increase the material's strength. Each layer is cured (hardened) before applying the next layer.
As the layers build up, we shape the material to achieve a normal tooth appearance. We'll also incorporate your individual color shadings, so that the prepared tooth blends well with surrounding natural teeth. In effect, the procedure requires as much artistry as technical skill to create a natural look.
Though not as strong as porcelain veneers or crowns, composite resins are durable if not subjected to heavy biting forces. And for a few hours in the dentist's chair with minimal tooth preparation, a composite resin treatment can create a dramatic and exciting change in your appearance.
If you would like more information on composite resin bonding, 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 “Artistic Repair of Front Teeth With Composite Resin.”
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