One of the key elements in a child’s development is their first set of teeth. Although primary (“baby”) teeth last only a few years, they’re critically important for enabling a child to eat solid foods, speak and smile.
But they also provide one more important benefit—they hold the space in the jaw reserved for the permanent teeth developing just under the gums until they erupt. But if a child loses a primary tooth prematurely because of disease or injury, other teeth may drift into the vacant space and crowd it out for the intended permanent tooth. It may then come in misaligned or remain stuck within the gums (impaction).
To avoid this, we try to treat and preserve a diseased primary tooth if at all practical. For a primary molar, one of the large teeth in the back of the mouth, this might include capping it with a stainless steel crown.
Why a metal crown? Primary molars normally don’t fall out until around ages 10-12, so it may be years for a younger child before their permanent molars erupt. All during that time these particular teeth will encounter heavier biting forces than teeth in the front.
A steel crown is often the best solution for a molar given their longer lifespans and encountered biting forces. The crown’s metal construction can stand up to these forces while still protecting the tooth from re-infection from decay. And because molars are typically outside of the “smile zone” occupied by more visible front teeth, the crown’s metal appearance isn’t usually an aesthetic issue.
Crowning a molar usually takes one visit, a dentist typically performing the procedure with local anesthesia and possibly a mild sedative like nitrous oxide gas (“laughing gas”). After removing any decayed structure from the tooth, the dentist will then fit a pre-formed crown over the remaining structure, sized and shaped to match the original tooth as close as possible.
A stainless steel crown is a cost-effective way to added needed years to a primary molar that could otherwise be lost prematurely. Preserving it may help a child avoid bite problems and expensive future treatments.
If you would like more information on dental care for primary 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 “Stainless Steel Crowns for Kids: A Safe and Effective Way to Restore Primary Molars.”
True or false: there’s no cause for concern about tooth decay until your child’s permanent teeth erupt.
False—decayed primary teeth can lead to potentially serious consequences later in life.
Although “baby” teeth last only a few years, they’re essential to future dental health because they act as placeholders and guides for the incoming permanent teeth. If they’re lost prematurely due to decay, other teeth may drift into the empty space intended for the emerging permanent tooth. Because of this, inadequate space will crowd the out of proper alignment.
And because they have thinner enamel than permanent teeth, primary teeth are more susceptible to decay. Once decay sets in, it can spread rapidly in a matter of months.
Fortunately, we may be able to prevent this from happening to your child’s primary teeth with a few simple guidelines. It all begins with understanding the underlying causes of tooth decay.
Tooth decay begins with bacteria: As a result of their digestion, these microorganisms secrete acid that at high levels can erode tooth enamel. The higher the population of bacteria in the mouth, the higher the acidity and potential threat to the teeth.
The first objective then in preventing decay is to remove dental plaque, the thin film of bacteria and food particles on tooth surfaces, through daily brushing and flossing. And because bacteria feed on sugar as a primary food source, you should reduce your child’s sugar consumption by restricting it to only meal times and not sending your child to bed with a bottle filled with a sugary liquid (including formula or breast milk).
To help boost your child’s protection, we can also apply sealants and fluoride to teeth to help protect and strengthen their enamel from acid attack. Because we’ll also monitor for signs of decay, it’s important to begin regular dental visits beginning around age one. If we do detect decay, we can then treat it and make every effort to preserve your child’s primary teeth until they’ve completed their normal life cycle.
By taking these steps, we can help make sure your child’s early teeth go the distance. Their current and future dental health will certainly benefit.
If you would like more information on prevention and treatment of tooth decay, 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 “Do Babies Get Tooth Decay?”
Once upon a time, braces were the way to straighten a smile. They were—and continue to be—an effective orthodontic treatment especially for younger patients. But braces do have a few drawbacks, one of the biggest being appearance: when you're wearing braces, everyone can see you're wearing them.
That changed a couple of decades ago with the introduction of clear aligners. Removable plastic trays that incrementally move teeth, aligners have quickly become popular for a number of reasons. Perhaps their biggest attraction is that they're barely noticeable.
There's now a third option for correcting crooked teeth: lingual braces. They're similar to the traditional version, but with one big difference: all of the hardware is on the back side of the teeth.
Ironically, two orthodontists an ocean apart developed the idea, and for different reasons. A Beverly Hills orthodontist was looking for an invisible tooth-moving method that would appeal to his image-conscious patients. The other in Japan wanted to offer his martial arts patients, who risked injury from facial blows with traditional braces, a safer alternative.
These two motivations illustrate the two biggest advantages to lingual braces. The brackets and other hardware are attached to the back of the teeth (on the tongue side, hence the term "lingual") and exert the tooth-moving force by pulling, in contrast to the pushing motion of labial ("lip-side") braces. They're thus invisible (even to the wearer) and they won't damage the soft tissues of the cheeks, lips and gums if a wearer encounters blunt force trauma to the mouth.
They do, however, have their disadvantages. For one, they're often 15-35 percent more expensive than traditional braces. They're also a little more difficult to get used to—they can affect speech and cause tongue discomfort. Most patients, though, get used to them within a week. And, being a relatively new approach, not all orthodontists offer them as a treatment option yet.
If you're interested in this approach to teeth straightening, speak with your orthodontist to see if they're right for you. But if you do take this route, you may have a more pleasing and safe experience.
If you would like more information on orthodontic treatment with lingual braces, 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 “Lingual Braces: A Truly Invisible Way to Straighten Teeth.”
Some moviegoers have been known to crunch popcorn, bite their fingers or grab their neighbor’s hands during the intense scenes of a thriller. But for one fan, the on-screen action in the new superhero film Black Panther led to a different reaction.
Sophia Robb, an 18-year-old Californian, had to make an emergency visit to the orthodontic office because she snapped the steel wire on her retainer while watching a battle scene featuring her Hollywood crush, Michael B. Jordan. Her jaw-clenching mishap went viral and even prompted an unexpected reply from the actor himself!
Meanwhile, Sophia got her retainer fixed pronto—which was exactly the right thing to do. The retention phase is a very important part of orthodontic treatment: If you don’t wear a retainer, the beautiful new smile you’re enjoying could become crooked again. That’s because if the teeth are not held in their new positions, they will naturally begin to drift back into their former locations—and you may have to start treatment all over again…
While it’s much more common to lose a removable retainer than to damage one, it is possible for even sturdy retainers to wear out or break. This includes traditional plastic-and-wire types (also called Hawley retainers), clear plastic retainers that are molded to fit your teeth (sometimes called Essix retainers), and bonded retainers: the kind that consists of a wire that’s permanently attached to the back side of your teeth. So whichever kind you use, do what Sophia did if you feel that anything is amiss—have it looked at right away!
When Black Panther co-star Michael B. Jordan heard about the retainer mishap, he sent a message to the teen: “Since I feel partly responsible for breaking your retainers let me know if I can replace them.” His young fan was grateful for the offer—but even more thrilled to have a celebrity twitter follower.
If you have questions about orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Bonded Retainers.”
While pregnancy is an exciting time for expectant mothers, it can pose extra health challenges. This is especially true regarding dental health.
Because of hormonal changes that naturally occur during pregnancy, your teeth and gums are at higher risk for dental disease. These changes can increase cravings for carbohydrates, particularly sugar. Increased sugar consumption feeds bacteria found in dental plaque, which is most responsible for tooth decay and periodontal (gum) disease.
Hormonal changes can also make your gums more susceptible to infection. Conditions may be favorable for a form of gum disease called pregnancy gingivitis, which can begin as an infection in the surface layers of the gums. But like other forms of gum disease, pregnancy gingivitis can advance below the gum line and lead to serious health consequences.
Because of this "pregnancy effect" on your teeth and gums, there are some things to which you should pay heed while you're expecting. First and foremost, keep up a daily regimen of brushing and flossing to remove accumulated dental plaque. You should also control your sugar intake to minimize bacterial growth that can cause disease.
It's also important for you to continue regular dental visits during your pregnancy. Your dentist will monitor your dental health and initiate treatment if you begin to show signs of disease. Besides professional cleanings, your dentist may also prescribe antibacterial mouthrinses to combat bacteria.
As far as dental procedures, essential treatments like fillings, root canals or extractions are usually considered safe to perform during pregnancy. But elective treatments of a cosmetic nature are best postponed until after your baby's delivery.
One last tip: because of the higher risk of tooth decay or gum disease, be on the lookout for any abnormal signs in your mouth. This includes spots on the teeth, tooth pain or swollen, reddened or bleeding gums. If you see any of these signs, see your dentist as soon as possible.
Your teeth and gums are indeed at risk for disease during pregnancy. But daily hygiene, regular dental care and attention to signs of disease can help keep that danger at bay.
If you would like more information on prenatal dental care, 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 “Dental Care During Pregnancy.”
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