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If you're currently undergoing orthodontic treatment, you're no doubt looking forward to the day your braces come off. But that won't end your treatment just yet — you'll need to wear a retainer.
Teeth are held secure in the bone of the jaw by an elastic tissue known as the periodontal ligament. As the braces “pull” the teeth to their new position, the ligament stretches and the bone remodels around the teeth. But the ligament also has a tendency to rebound as the tension eases when the braces are removed. The teeth could then return to their original position, especially during the first few months.
To prevent this patients wear an orthodontic appliance known as a retainer. It maintains some of the tension once supplied by the braces to help keep or “retain” the teeth in their new position. Depending on your age and other factors, you'll have to wear one for at least eighteen months; some patients, especially adults, may have to wear one indefinitely.
You may be familiar with a removable retainer, one you can take in and out of your mouth. But there's another type called a bonded retainer that's fixed to the teeth and can only be removed by a dentist. With this retainer a dentist bonds a thin piece of wire to the back of the teeth where it can't be seen. You can feel it, though, with the tongue: an unusual sensation at first, but one easily grown accustomed to.
Unlike their removable counterparts, bonded retainers aren't noticeable, either to others or the wearer. They're especially appropriate for patients who may not be as diligent in wearing a removable retainer.
It does, though, have some disadvantages. The position of the wire running horizontally across several teeth can make flossing difficult. And as with any retainer, removing it could increase the risk of the teeth moving out of alignment.
There are a number of factors to discuss with your orthodontist about which type of retainer is best for your situation. If you do choose a bonded retainer, be sure you work with the dental hygienist on how best to floss the affected teeth. And if you do have it removed, have a removable retainer prepared so you can preserve that smile you've invested so much into obtaining.
A recent episode of “America’s Got Talent” featured an engaging 93-year-old strongman called The Mighty Atom Jr. The mature muscleman’s stunt: moving a full-sized car (laden with his octogenarian “kid brother,” his brother’s wife, plus Atom’s “lady friend”) using just his teeth. Grinning for host Howie Mandel, Atom proudly told the TV audience that his teeth were all his own; then he grasped a leather strap in his mouth, and successfully pulled the car from a standstill.
We’re pleased to see that the Atom has kept his natural teeth in good shape: He must have found time for brushing and flossing in between stunts. Needless to say, his “talent” isn’t one we’d recommend trying at home. But aside from pulling vehicles, teeth can also be chipped or fractured by more mundane (yet still risky) activities — playing sports, nibbling on pencils, or biting too hard on ice. What can you do if that happens to your teeth?
Fortunately, we have a number of ways to repair cracked or chipped teeth. One of the easiest and fastest is cosmetic bonding with tooth-colored resins. Bonding can be used to fill in small chips, cracks and discolorations in the teeth. The bonding material is a high-tech mixture of plastic and glass components that’s extremely lifelike, and can last for several years. Plus, it’s a procedure that can be done right in the office, with minimal preparation or discomfort. However, it may not be suitable for larger chips, and it isn’t the longest-lasting type of restoration.
When more of the tooth structure is missing, a crown (or cap) might be needed to restore the tooth’s appearance and function. This involves creating a replacement for the entire visible part of the tooth in a dental lab — or in some cases, right in the office. It typically involves making a model of the damaged tooth and its neighbors, then fabricating a replica, which will fit perfectly into the bite. Finally, the replacement crown is permanently cemented to the damaged tooth. A crown replacement can last for many years if the tooth’s roots are in good shape. But what if the roots have been dislodged?
In some cases it’s possible to re-implant a tooth that has been knocked out — especially if it has been carefully preserved, and receives immediate professional attention. But if a tooth can’t be saved (due to a deeply fractured root, for example) a dental implant offers today’s best option for tooth replacement. This procedure has a success rate of over 95 percent, and gives you a natural looking replacement tooth that can last for the rest of your life.
So what have we learned? If you take care of your teeth, like strongman Atom, they can last a long time — but if you need to move your car, go get the keys.
If you would like more information about tooth restoration, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Crowns & Bridgework.”
If you have periodontal (gum) disease, it's important for you to know its effects aren't limited to your mouth. A number of studies demonstrate gum disease can affect the rest of your body — and what may be going on elsewhere could likewise stimulate gum disease.
Here are 3 diseases or conditions that seem to share a link with gum disease.
Diabetes. This chronic disease results from the body's inability to interact properly with insulin, the hormone necessary for turning glucose (sugar) into energy, or producing enough of it. There's clear evidence that having diabetes increases your risk of gum disease and vice-versa. If you have diabetes, it's important that you keep it under control for your gum's sake as much as for your overall health.
Cardiovascular disease. Like diabetes, this group of heart and blood vessel diseases has a related characteristic with gum disease: inflammation. This natural function of the immune system limits tissue damage caused by disease or injury. But in both CVD and gum disease, inflammation can become chronic and itself cause damage. Further, some types of bacteria associated with gum disease can contribute to a higher risk of CVD. Minimizing gum disease occurrence with good oral hygiene could positively impact your risk of CVD.
Pregnancy. While certainly not a disease, pregnancy does trigger hormonal changes in the mother that in turn could elevate her risk of gum disease, particularly pregnancy gingivitis. Not only does this pose problems for the mother's teeth and gums, some studies connect gum disease to the increased possibility of early, pre-term birth. A sharper focus on dental care during pregnancy not only benefits the mother but may also be important for the health of the baby.
These aren't the only conditions that can be affected by gum disease: others like osteoporosis, respiratory disease or rheumatoid arthritis also share links with the disease. If you have any systemic condition like these, it pays to be extra vigilant in preventing and treating gum disease.
If you would like more information on periodontal (gum) disease, 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 “Good Oral Health Leads to Better Health Overall.”
For anyone else, having a tooth accidentally knocked out while practicing a dance routine would be a very big deal. But not for Dancing With The Stars contestant Noah Galloway. Galloway, an Iraq War veteran and a double amputee, took a kick to the face from his partner during a recent practice session, which knocked out a front tooth. As his horrified partner looked on, Galloway picked the missing tooth up from the floor, rinsed out his mouth, and quickly assessed his injury. “No big deal,” he told a cameraman capturing the scene.
Of course, not everyone would have the training — or the presence of mind — to do what Galloway did in that situation. But if you’re facing a serious dental trauma, such as a knocked out tooth, minutes count. Would you know what to do under those circumstances? Here’s a basic guide.
If a permanent tooth is completely knocked out of its socket, you need to act quickly. Once the injured person is stable, recover the tooth and gently clean it with water — but avoid grasping it by its roots! Next, if possible, place the tooth back in its socket in the jaw, making sure it is facing the correct way. Hold it in place with a damp cloth or gauze, and rush to the dental office, or to the emergency room if it’s after hours or if there appear to be other injuries.
If it isn’t possible to put the tooth back, you can place it between the cheek and gum, or in a plastic bag with the patient’s saliva, or in the special tooth-preserving liquid found in some first-aid kits. Either way, the sooner medical attention is received, the better the chances that the tooth can be saved.
When a tooth is loosened or displaced but not knocked out, you should receive dental attention within six hours of the accident. In the meantime, you can rinse the mouth with water and take over-the-counter anti-inflammatory medication (such as ibuprofen) to ease pain. A cold pack temporarily applied to the outside of the face can also help relieve discomfort.
When teeth are broken or chipped, you have up to 12 hours to get dental treatment.Â Follow the guidelines above for pain relief, but don’t forget to come in to the office even if the pain isn’t severe. Of course, if you experience bleeding that can’t be controlled after five minutes, dizziness, loss of consciousness or intense pain, seek emergency medical help right away.
And as for Noah Galloway:Â In an interview a few days later, he showed off his new smile, with the temporary bridge his dentist provided… and he even continued to dance with the same partner!
If you would like more information about dental trauma, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Trauma & Nerve Damage to Teeth” and “The Field-Side Guide to Dental Injuries.”
Like any parent you want your child to grow up healthy and strong. So be sure you don't neglect their dental care, a crucial part of overall health and well-being.
The most important part of this care is prevention — stopping dental disease and other problems before they do harm. Proactive prevention is the best way to keep their teeth and gum growth on the right track.
Prevention starts at home with a daily habit of brushing and later flossing. In the beginning, you'll have to brush for them, with just a smear of toothpaste on the toothbrush. As they get older, you can teach them to brush for themselves, graduating to a pea-sized dose of toothpaste.
It's also important to begin regular dental visits around their first birthday. Many of their primary (baby) teeth are coming in, so regular cleanings and checkups will help keep tooth decay in check. Early visits will also get them used to seeing the dentist and hopefully help stimulate a lifelong habit.
These visits have a number of purposes. First and foremost is to monitor dental development and early detection of any emerging problems, like a poor bite. Catching problems early could help reduce or even eliminate future treatment.
Some children are also at greater risk for tooth decay and could benefit from applications of topical fluoride, a mineral that strengthens tooth enamel, or a sealant to help protect the teeth. This is especially helpful in preserving primary (baby) teeth: early loss of a primary tooth could disrupt the permanent tooth's eruption and cause a poor bite.
Your child's dental visits could also benefit you as their caregiver. You receive regular feedback on how well your child's teeth and gums are developing, and the effectiveness of their oral hygiene. You also get answers to your questions about their oral health: the dentist's office is your best source for advice on teething, diet and other issues.
Together, you and your dentist can provide and maintain the best conditions for your child's dental development. The result will be the healthiest mouth they can have as they enter their adult years.
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