Posts for: September, 2018
People mainly identify orthodontics with braces. But while they’re a major part of it, braces aren’t the only way this important dental specialty can make a difference in a person’s bite.
For example, orthodontics can help guide the development of a younger patient’s facial structure that could head off future upper teeth misalignment. The area of focus is the upper jaw and palate (the roof of the mouth) that jointly make up a structure called the maxilla. The maxilla is actually formed by two bones fused together in the center of the palate along what is known as the midline suture running from front to back in the mouth.
The two bones remain separated until puberty, which helps accommodate rapid structural growth during childhood. But problems can arise if the upper jaw is too narrow, causing a “cross-bite” where the lower back teeth bite abnormally outside the upper ones. This can crowd upper permanent teeth and cause them to erupt improperly.
Using a technique called palatal expansion we can correct this abnormality if we act before the maxillary bones fuse. The technique employs a custom-made appliance called a palatal expander that attaches to the posterior teeth of the upper arch. Expanders have two halves joined by a small screw device to increase tension against the teeth to widen the jaw. A parent or the patient (if old enough) increases the tension by using a special key to turn the adjustment screw a tiny amount each day. This may cause minor discomfort that normally eases in a few minutes.
The patient wears the device until the jaw expands to the desired width and then allows the bones to stabilize in the new position. This can sometimes create a small gap between the upper front teeth, but it often closes on its own or it may require braces to close it.
While palatal expanders are not for every case, they can help normalize development and improve the bite, and thus preclude more extensive orthodontic treatment later. But time is of the essence: after the maxilla has fused, surgery will be necessary to separate them and widen the palate. It’s important then not to delay if your child could benefit from this effective treatment.
If you would like more information on palatal expanders and other orthodontic treatments, 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.”
We breathe every moment of every day and we’re hardly aware of it most of the time. But if you take the time to focus, you’ll find two possible pathways for your breath: through the nose or through the mouth.
While either pathway provides the air exchange needed to live, nose breathing offers better health benefits. Air passes through the nasal passages, which filter out many harmful particles and allergens. The mucous membranes in the nose also humidify the air and help produce heart-friendly nitric oxide.
Nose breathing also plays a role in your child’s facial and jaw development: the tongue rests on the roof of the mouth (the palate) and becomes a kind of mold around which the developing upper jaw can form. With chronic mouth breathing, however, the tongue rests just behind the lower teeth, depriving the upper jaw of its normal support. This could result in the development of a poor bite (malocclusion).
To avoid this and other undesirable outcomes, you should have your child examined if you notice them breathing mostly through the mouth, particularly at rest. Since chronic mouth breathing usually occurs because of an anatomical obstruction making nose breathing more difficult, it’s usually best to see a physician or an ear, nose and throat (ENT) specialist first for evaluation and treatment.
It’s also a good idea to obtain an orthodontic evaluation of any effects on their bite development, such as the upper jaw growing too narrowly. If caught early enough, an orthodontist can correct this with a palatal expander, a device that exerts gradual outward pressure on the jaw and stimulating it to grow wider.
Another bite problem associated with chronic mouth breathing is misalignment of the jaws when closed. An orthodontist can address this with a set of removable plates worn in the mouth. As the jaws work the angled plates force the lower jaw forward, thus encouraging it to grow in the direction that best aligns with the upper jaw.
Any efforts to correct a child’s breathing habits can pay great dividends in their overall health. It could likewise head off possible bite problems that can be both extensive and costly to treat in the future.
The basics for treating tooth decay have changed little since the father of modern dentistry Dr. G.V. Black developed them in the early 20th Century. Even though technical advances have streamlined treatment, our objectives are the same: remove any decayed material, prepare the cavity and then fill it.
This approach has endured because it works—dentists practicing it have preserved billions of teeth. But it has had one principle drawback: we often lose healthy tooth structure while removing decay. Although we preserve the tooth, its overall structure may be weaker.
But thanks to recent diagnostic and treatment advances we’re now preserving more of the tooth structure during treatment than ever before. On the diagnostic front enhanced x-ray technology and new magnification techniques are helping us find decay earlier when there’s less damaged material to remove and less risk to healthy structure.
Treating cavities has likewise improved with the increased use of air abrasion, an alternative to drilling. Emitting a concentrated stream of fine abrasive particles, air abrasion is mostly limited to treating small cavities. Even so, dentists using it say they’re removing less healthy tooth structure than with drilling.
While these current advances have already had a noticeable impact on decay treatment, there’s more to come. One in particular could dwarf every other advance with its impact: a tooth repairing itself through dentin regeneration.
This futuristic idea stems from a discovery by researchers at King’s College, London experimenting with Tideglusib, a medication for treating Alzheimer’s disease. The researchers placed tiny sponges soaked with the drug into holes drilled into mouse teeth. After a few weeks the holes had filled with dentin, produced by the teeth themselves.
Dentin regeneration isn’t new, but methods to date haven’t been able to produce enough dentin to repair a typical cavity. Tideglusib has proven more promising, and it’s already being used in clinical trials. If its development continues to progress, patients’ teeth may one day repair their own cavities without a filling.
Dr. Black’s enduring concepts continue to define tooth decay treatment. But developments now and on the horizon are transforming how we treat this disease in ways the father of modern dentistry couldn’t imagine.