Children's permanent teeth normally erupt over several years after first forming below the gum line. All their permanent teeth should come in by the time they reach early adolescence.
Unfortunately, this process doesn't always happen as it should. If the erupting teeth become crowded due to a poor bite (malocclusion), teeth still to come in may not have enough room to fully erupt. They become impacted, a condition in which the visible crown remains partially or completely submerged below the gum line.
Impacted teeth create consequences for other teeth and dental health overall. They more readily cause abscesses (a localized infection within the gum tissue) and can damage the roots of nearby teeth. Impacted front canine (eye) teeth can interfere with bite function and their visual absence mars an otherwise attractive smile.
If your child's canine teeth have failed to erupt properly, there is a way to help them fully come in if you act before their mouth structure fully matures. The first step is an orthodontic evaluation of their entire bite. This will determine if there's enough space to move other teeth to make room for the impacted canines.
If so, we would then find the exact position of the impacted teeth using x-rays and possibly cone beam CT scanning for a detailed three-dimensional image. The teeth could be in a variety of positions, such as angled toward the roof of the mouth or cheek or buried high in the jawbone. If the teeth are too far out of position the best course of action may be to remove them and replace them later with a dental implant.
If the impacted teeth, though, are in a feasible position for retrieval, we first expose each tooth through the gums with a minor surgical procedure and bond a small bracket to it. We then attach a small gold chain to the bracket that loops over an orthodontic appliance attached to other teeth. The appliance will exert pressure over several months to pull the tooth into proper position.
If successful, your child will gain the use of these important teeth and a more attractive appearance. But don't delay — this desired outcome will become much harder if not impossible to attain as their teeth and jaws continue to develop.
If you would like more information on treating impacted 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 “Exposing Impacted Canines.”
In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.
When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”
Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.
There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.
By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.
So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.
There are plenty of options today for replacing missing teeth, including dental implants. But if the teeth have been missing for some time, complications can arise that limit your restorative options.
The most consequential possibility is bone loss. Bone has a life cycle: old cells dissolve (resorb), and are then replaced by new cells, stimulated to grow by the forces applied to the teeth during chewing. But the bone won't receive this stimulation if a tooth is missing — so growth slows down, which causes the bone volume to diminish with time.
Another complication can occur involving other teeth around the open space. These teeth will naturally move or “drift” out of their normal position into the missing tooth space. As a result we may not have enough room to place a prosthetic (false) tooth.
If either or both of these complications occur, we'll need to address them before attempting a restoration. Bone loss itself could eliminate dental implants as an option because they require a certain amount of supporting bone for correct placement. Bone loss could also make correcting misaligned teeth difficult if not impossible.
It might be possible, though, to regenerate lost bone with a bone graft. The graft is placed, sometimes along with growth stimulating substances, within the diminished bone area. It then serves as a scaffold upon which new bone can form.
If the bone becomes healthy again, we can then attempt to move any drifted teeth back to where they belong. Besides braces, there's another treatment option especially popular with adults: clear aligners. These are a series of removable, clear plastic trays that, like braces, exert gradual pressure on the teeth to move them. Patients wear each individual tray for about two weeks, and then switch to the next tray in the series to continue the process.
Unlike their traditional counterparts, clear aligners can be removed for cleaning or for special occasions. More importantly, they're much less noticeable than traditional braces.
Once any problems with bone health or bite have been addressed and corrected, you'll have a fuller range of options for replacing your missing teeth. With a little extra time and effort, you'll soon be able to regain a smile you'll be proud to display.
Temporomandibular joint disorder (TMJ) pain can make it difficult to eat and sleep. Luckily, several treatment options can ease your pain. Greenville, SC, dentist Dr. Jeff Johnson discusses the condition and shares information on treatments.
What is TMJ?
Problems with the bones, ligaments and tendons in the hinge joints in your jaw can cause TMJ symptoms, including pain in your jaw, head, neck and shoulders. The condition can occur if you've experienced an injury to your head or neck, but may also be triggered by grinding your teeth, arthritis, bite issues or stress. In some cases, it may not be possible to determine the cause of your TMJ.
In addition to pain, TMJ causes a variety of unpleasant symptoms, including:
- Difficulty opening or closing your mouth
- Locking jaw
- Change in your bite
- Jaw stiffness
- Clicking or popping sounds when you open or close your mouth
- Ear pain or ringing in the ears
- Neck and shoulder muscle stiffness
- Facial swelling
What treatments are available?
Before you begin treatment for your TMJ symptoms, it's important to determine a cause, if possible. During your visit to Dr. Johnson's Greenville office, he'll perform a thorough examination of your mouth and jaw, which may involve X-rays or other tests.
Mild pain can often be treated with ice, over-the-counter pain medications and exercises designed to relax your jaw. If the pain is severe, prescription pain relievers, muscle relaxants, antidepressants or steroid injections may help. No matter what the cause of your pain, you may benefit from stress reduction techniques, such as meditation.
TMJ can sometimes occur due to a bite problem or jaw misalignment. Braces can realign your teeth and reduce your symptoms, although you may also need surgery if you have a jaw misalignment.
Occlusal splints, devices worn at night that decrease pressure on your jaw, realign it and prevent grinding, may also be helpful. In some cases, surgery may be needed to remove debris or even replace the joint.
There's no need to suffer from TMJ symptoms when effective treatment is available. If you're tired of dealing with the pain, schedule an appointment with Greenville, SC, dentist Dr. Jeff Johnson by calling (864) 271-3463.
Is having good oral hygiene important to kissing? Who's better to answer that question than Vivica A. Fox? Among her other achievements, the versatile actress won the “Best Kiss” honor at the MTV Movie Awards, for a memorable scene with Will Smith in the 1996 blockbuster Independence Day. When Dear Doctor magazine asked her, Ms. Fox said that proper oral hygiene was indeed essential. Actually, she said:
"Ooooh, yes, yes, yes, Honey, 'cause Baby, if you kiss somebody with a dragon mouth, my God, it's the worst experience ever as an actor to try to act like you enjoy it!"
And even if you're not on stage, it's no fun to kiss someone whose oral hygiene isn't what it should be. So what's the best way to step up your game? Here's how Vivica does it:
“I visit my dentist every three months and get my teeth cleaned, I floss, I brush, I just spent two hundred bucks on an electronic toothbrush — I'm into dental hygiene for sure.”
Well, we might add that you don't need to spend tons of money on a toothbrush — after all, it's not the brush that keeps your mouth healthy, but the hand that holds it. And not everyone needs to come in as often every three months. But her tips are generally right on.
For proper at-home oral care, nothing beats brushing twice a day for two minutes each time, and flossing once a day. Brushing removes the sticky, bacteria-laden plaque that clings to your teeth and causes tooth decay and gum disease — not to mention malodorous breath. Don't forget to brush your tongue as well — it can also harbor those bad-breath bacteria.
While brushing is effective, it can't reach the tiny spaces in between teeth and under gums where plaque bacteria can hide. But floss can: That's what makes it so important to getting your mouth really clean.
Finally, regular professional checkups and cleanings are an essential part of good oral hygiene. Why? Because even the most dutiful brushing and flossing can't remove the hardened coating called tartar that eventually forms on tooth surfaces. Only a trained health care provider with the right dental tools can! And when you come in for a routine office visit, you'll also get a thorough checkup that can detect tooth decay, gum disease, and other threats to your oral health.
Bad breath isn't just a turn-off for kissing — It can indicate a possible problem in your mouth. So listen to what award-winning kisser Vivica Fox says: Paying attention to your oral hygiene can really pay off! For more information, contact us or schedule an appointment for a consultation. You can read the entire interview with Vivica A. Fox in Dear Doctor's latest issue.
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