Posts for: December, 2018
A poor bite (malocclusion) could be more than simply teeth out of alignment. There could be complex causes for the malocclusion, possibly involving the facial bone structure.
An example of this is the development of a cross-bite due to problems with the upper jaw and palate (the roof of the mouth), jointly called the maxilla. The maxilla is in fact formed by two bones fused together in the center of the palate in what's called the midline suture. The suture doesn't completely fuse until after puberty.
Sometimes a maxilla's development doesn't follow a normal track. The upper jaw doesn't widen as it should, which leads to the cross-bite where the upper back teeth abnormally bite inside the lower teeth. The upper front teeth continue to bite normally in front of the lower front teeth. This also can have profound influence on breathing, causing sleep apnea.
We can correct this by using an orthodontic appliance called a palatal expander before the midline suture fuses. The expander gradually widens the upper jaw to its normal width and thus eliminates the cross-bite.
Positioned at the roof of the mouth, the expander has metal arms that extend from a central hinge to exert pressure on the inside of the upper teeth. The patient or a caregiver uses a small key to turn a mechanism that extends the arms toward the teeth a tiny amount each day. This gradually widens the jaw, while at the same time stimulating bone growth at the midline suture. Eventually the gap fills with bone to solidify the new width as the suture fuses.
It's important to undertake this treatment before fusion. If you wait until after puberty, you will need to separate the bones first to attempt it. The overall impact and cost is much less if you act promptly in the early years.
Palatal expansion may not be the right treatment in every case, so we'll need to perform a thorough orthodontic exam first. If, however, we do determine it can help, using an expander can improve function, correct future breathing problems and make possible a more attractive future smile.
If you would like more information on orthodontic treatment options, 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 “Palatal Expanders: Orthodontics is more than just Moving Teeth.”
When die-hard music fans hear that their favorite performer is canceling a gig, it’s a big disappointment—especially if the excuse seems less than earth-shaking. Recently, British pop sensation Dua Lipa needed to drop two dates from her world tour with Bruno Mars. However, she had a very good reason.
“I’ve been performing with an awful pain due to my wisdom teeth,” the singer tweeted, “and as advised by my dentist and oral surgeon I have had to have them imminently removed.”
The dental problem Lipa had to deal with, impacted wisdom teeth, is not uncommon in young adults. Also called third molars, wisdom teeth are the last teeth to erupt (emerge from beneath the gums), generally making their appearance between the ages of 18-24. But their debut can cause trouble: Many times, these teeth develop in a way that makes it impossible for them to erupt without negatively affecting the healthy teeth nearby. In this situation, the teeth are called “impacted.”
A number of issues can cause impacted wisdom teeth, including a tooth in an abnormal position, a lack of sufficient space in the jaw, or an obstruction that prevents proper emergence. The most common treatment for impaction is to extract (remove) one or more of the wisdom teeth. This is a routine in-office procedure that may be performed by general dentists or dental specialists.
It’s thought that perhaps 7 out of 10 people ages 20-30 have at least one impacted wisdom tooth. Some cause pain and need to be removed right away; however, this is not always the case. If a wisdom tooth is found to be impacted and is likely to result in future problems, it may be best to have it extracted before symptoms appear. Unfortunately, even with x-rays and other diagnostic tests, it isn’t always possible to predict exactly when—or if—the tooth will actually begin causing trouble. In some situations, the best option may be to carefully monitor the tooth at regular intervals and wait for a clearer sign of whether extraction is necessary.
So if you’re around the age when wisdom teeth are beginning to appear, make sure not to skip your routine dental appointments. That way, you might avoid emergency surgery when you’ve got other plans—like maybe your own world tour!
If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
Around ages 6 to 8, a child's primary teeth will begin to loosen to make way for their permanent teeth. If all goes well, the new set will come in straight with the upper teeth slightly overlapping the bottom.
But sometimes it doesn't go that well: a child may instead develop a poor bite (malocclusion) that interferes with normal function. If we can detect the early signs of a developing malocclusion, however, we may be able to intervene and lessen its impact. You as a parent can play a vital role in this early detection.
The first thing you should be watching for is teeth spacing.Â Normal teeth come in straight with a slight gap between them. But there are two abnormal extremes to look for: teeth having no space between them or crowded together in a crooked, haphazard manner; or they seem to have too much space between them, which indicates a possible discrepancy between the teeth and jaw sizes.
You should also notice how the teeth come together or “bite.” If you notice the lower front teeth biting in front of the upper (the opposite of normal) it may be a developing underbite. If you see a space between the upper and lower teeth when they bite down, this is a sign of an open bite. Or, if the upper front teeth seem to come down too far over the lower, this could mean a deep bite: in extreme cases the lower teeth actually bite into the roof of the mouth behind the upper teeth.
You should also look for crossbites, in which the teeth in one part of the mouth bite abnormally in front or behind their counterparts, while teeth in other parts bite normally. For example, you might notice if the back upper teeth bite inside the lower teeth (abnormal), while the front upper teeth bite outside the lower front teeth (normal).
The important thing is to note anything that doesn't look right or seems inconsistent with how your child's teeth look or how they function. Even if you aren't sure it's an issue, contact us anyway for an examination. If it really is a developing bite problem, starting treatment now may lessen the extent and cost of treatment later.