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Posts for: October, 2013

TreatingThumbSuckingNowCouldReduceOrthodonticTreatmentLater

One of the most common parental concerns is the habit of many children, even late into childhood, to suck their thumbs or fingers. Many parents have asked us, “Could this affect their teeth?”

The answer, unfortunately, is yes — thumb sucking can contribute to a malocclusion (bad bite) that could eventually require orthodontic treatment. Before making any assumptions, however, we need to understand the bigger picture.

To begin with, infants have a different swallowing mechanism than adults and older children. When you as an adult swallow, you'll notice the tip of your tongue positions itself just above the back of the top front teeth. An infant, however, will thrust their tongue between their upper and lower jaw as they swallow (also known as an infantile swallowing pattern or primary tongue thrust). The infant normally begins changing to an adult swallowing pattern when their primary (baby) teeth begin to erupt.

However, if a child's swallowing transition is slower than normal and the tongue rests between the jaws for a longer duration, it can inhibit the full eruption of teeth, believed to be the main cause of an open bite (a gap between the upper and lower teeth when the jaws are shut). The thumb during sucking resting between the teeth can have the same effect.

Thumb sucking may not necessarily lead to a malocclusion — for example, an abnormally developing jawbone could be the culprit. If prolonged thumb sucking does become a concern, however, there are steps we can take to reduce the impact of the habit. We can install a thin metal “tongue crib” behind the upper and lower incisors that will not only discourage thumb sucking, but also help retrain the tongue not to rest between the upper and lower teeth. There are also exercise routines known as orofacial myofunctional therapy (OMT) that can retrain specific muscles in the mouth to encourage more normal chewing and swallowing patterns.

These steps may not prevent future orthodontic treatment, but they could reduce its extent. The key is regular dental checkups and consultation to ensure your child's teeth and bite are developing normally.

If you would like more information on the effects of chronic thumb sucking on the mouth, 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 “How Thumb Sucking Affects the Bite.”


By Tamara Simons, DDS
October 21, 2013
Category: Oral Health
Tags: oral health   dry mouth  
KnowtheCausesandTreatmentsforChronicDryMouth

You hardly notice the moist environment of your mouth — unless it becomes uncomfortably dry. Some instances of dry mouth are quite normal — when you first wake in the morning after reduced saliva flow during sleep, when you're stressed, or when you're dehydrated and need fluids. But some are not normal — millions of people, in fact, suffer from a chronic inadequacy of saliva production and flow.

Chronic dry mouth (or xerostomia) can have a greater effect on your oral health than discomfort. Saliva performs a number of tasks for the body: its enzymes help break down food before digestion; its antimicrobial properties help reduce harmful bacteria and its buffering ability helps neutralize acid, both of which reduce the risk of tooth decay.

There are a number of causes for chronic dry mouth. One of the most common arises as a side effect of over 500 medications, both prescription and over-the-counter. The major contributors to dry mouth fall into three main types: antihistamines, used to treat allergies; diuretics, prescribed to cardiac patients to drain excess fluid; and antidepressants. Diseases like Diabetes, Parkinson's disease, or AIDS can also cause dry mouth. Some treatments can too — persons undergoing head or neck radiation or chemotherapy may experience dry mouth.

If you've noticed dry mouth over several days, it's a good idea to visit us for an exam. Our first step is to try to determine the extent and cause of the condition. Depending on what we find, we can then recommend a treatment path that includes some changes in habit and prescribed medications. For example, if lack of hydration is contributing to dry mouth, we would recommend drinking an adequate amount of water, as well as cutting back on caffeinated or acidic beverages. We might also prescribe medication to stimulate saliva flow. Consuming foods that contain xylitol, a natural sugar substitute, may also do the same.

It's also important that you maintain a good oral hygiene regimen and regular dental checkups and cleanings. Good oral hygiene and the proper treatment for chronic dry mouth will greatly reduce your risk of tooth decay and other diseases.

If you would like more information on the causes and treatment of dry mouth, 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 “Dry Mouth.”


By Tamara Simons, DDS
October 18, 2013
Category: Oral Health
CatCoras6WaystoKeepKidsOffJunkFood

Junk food and between-meal sweets are a habit for many of us, even though we know it is bad for our bodies and our teeth. As adults, we are responsible for our own choices. As parents, we are also responsible for our children's choices, and for teaching them to choose wisely.

Celebrity Chef Cat Cora offers the following six suggestions for leading children to a healthy lifestyle. Cora is a star of Iron Chef America and author of Cat Cora's Classics with a Twist: Fresh Takes on Favorite Dishes, in which she reveals healthier versions of classic recipes. In her remakes she shows how to cook with a lot of flavor while reducing fat and sugar. Cora has four young sons, so her methods are not just theories — they have been practiced in real life.

1. Remember who's the boss.

“My kids have never had fast food,” Cora said in a recent interview with Dear Doctor magazine. “The parents have a choice to do that or not,” she said. “The kids are not going to the grocery store to shop; the kids are not driving themselves through fast food chains.”

2. Make your rules clear and stick to them.

“Right now my 7-year-old tries to be picky, but it's really about us being consistent as parents,” Cat said. For example, in her household pizza is served only at the weekly pizza and movie night. The kids get a healthier version of what they want, so they don't feel deprived. The evening includes air-popped popcorn without butter — and no soda, which is bad for teeth because of its sugar and other chemical ingredients.

3. Offer your children a variety of foods and tastes.

Cora made sure her children tried different foods and spices from infancy, so they are open to trying new things. It's easier to get all the nutrition you need if you eat a wide variety of foods.

4. Learn to make tasty substitutions for sugar.

When her children were babies, Cora stopped relying on bottles and sippy cups as soon as possible, reducing her children's likelihood of developing tooth decay due to sugary residues remaining in their mouths. Now that they are older, she uses tasty substitutes for sugar such as fruit purees and the natural sugar substitute Stevia.

5. Include the children in meal planning.

Kids are more likely to eat a meal they are involved in planning and cooking. For example, ask them which vegetable they would like to have (not whether they want to have a vegetable).

6. Model healthy behavior for your kids.

Parents are the best role models. This is true not only for food choices, but also for exercise and maintaining a healthy lifestyle.

Contact us today to schedule an appointment to discuss your questions about oral health. You can also learn more by reading the Dear Doctor magazine article “Cat Cora.”


Non-VitalBleachingRemovesUnsightlyToothDiscolorationFromWithin

Root canal treatments are an important method for stopping the disease process within an infected tooth and ultimately saving it. However, one of the few side effects could have an aesthetic impact on your smile. Leftover blood pigments or the filling materials themselves can cause a darkening of the tooth — the tooth could eventually stand out in an unsightly way from surrounding teeth.

There is, however, one possible solution: a whitening technique known as internal or non-vital bleaching can lighten a darkened, non-vital tooth. For this procedure, we would insert a bleaching mix (usually sodium perborate mixed with hydrogen peroxide) into the pulp chamber of the darkened tooth for a short period of time. The chemical reaction of the mix whitens the tooth from within.

Our first step is to make sure by x-rays that the root canal filling in the tooth is still intact and still has a good seal. We then create a small opening in the rear of the tooth just above the root canal filling, irrigate it with water to remove any debris, and then add a special cement at the point where the root canal filling begins to seal it from any leakage of the bleaching solution into the root canal filling.

We then insert the bleaching solution into the empty pulp chamber. This is covered with a cotton pellet, which is then sealed in with a temporary filling. We repeat this application over a number of days until we see a noticeable change in the tooth color (normally after one to four visits). At this point, we would remove any residual solution and apply a permanent filling to seal the tooth.

This procedure can be performed instead of more extensive procedures such as veneers and crowns as a cover for the discolored tooth, or as a way to lighten teeth before applying a veneer or crown to help prevent discoloration from showing through. Either way, non-vital bleaching can help remove unsightly discoloration and restore vibrancy to your smile.

If you would like more information on internal or non-vital bleaching, 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 “Whitening Traumatized Teeth.”


By Tamara Simons, DDS
October 03, 2013
Category: Oral Health
Tags: braces   retainers  
RetainersMakingYourNewSmilePermanent

Finally: Your braces are off! Break out the taffy, bubble gum, corn on the cob... and... whoa!!... the retainer?

Yes, the retainer. As the name implies, this simple device will ensure that your pearly whites remain in the new, desired position you've worked so diligently to achieve. Here's why:

The same physiological properties that allow your teeth to move when you're wearing braces are always at work — braces simply direct that movability in controlled ways. Teeth are not set into your jaw bone like posts fixed in concrete; rather, the root portion is attached to the bone by elastic periodontal (peri – around; odont – tooth) ligaments that permit micromovement of teeth all the time. The periodontal tissues are living; therefore, they are always changing and “remodeling” (just as hair grows, skin peels, etc.) When a light orthodontic force is placed on a tooth the following processes occur:

  • on the pulling or tension side, the periodontal ligament will activate bone-forming cells (osteoblasts) to deposit new bone to fill in the area from where the tooth was previously, and
  • on the pressure side, the periodontal ligament will activate bone-resorbing cells (osteoclasts) to remove bone allowing the tooth to move in that direction.

Visualize drawing your hand forward through water: The water parts in front of your hand and fills in behind it.

Once your teeth are in their desired position and your braces are removed, your teeth will tend to return to their old position if they are not stabilized or “retained” in their new one long enough for the bone and ligament to re-form and mature around them. This can take several months. In addition, orthodontic treatment stretches collagen fibers in gum tissues to some extent, contributing to the forces that tend to shift teeth back in the direction from which they came. The gum tissues will continue to exert this pressure until these tissues remodel. This can take longer than the bone and ligament stabilization, as collagen cells reorganize at a much slower rate.

Types of Retainers

The type of retainer you will use, how frequently and for how long will depend on your unique situation. The most familiar type of retainer is removable and one you may not have to wear all the time, at least after the first couple of months. In cases where the retainer is going to be needed for a long-term period, a common alternative is to have thin retainer wires bonded to the inside surfaces of the front teeth so they don't show.

Considering how much time, effort, and sometimes expense is required in improving your smile, the retainer is your assurance that it was all well spent. Even people getting a comparatively simple pedicure/manicure don't leave the salon without letting the polish dry!

If you would like more information about orthodontics and retainers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.”