Posts for: March, 2018
You don’t have to be a dental professional to appreciate a beautiful smile. Likewise, you’ll also know when something’s not quite right with one.
Such can be the case when a tooth fails to erupt properly, causing most or all of the crown to remain below the gum line, a condition known as impaction. Upper canines (or “eyeteeth,” for their location in the arch under the eyes) are especially susceptible to impaction: located on either side of the lateral incisors, which are on either side of the central incisors (the two center front teeth).
The upper canines are important both for function and appearance. Working with their lower counterparts they help cut through food as we chew, so you lose some of that efficiency when they don’t erupt properly. Impacted teeth are susceptible to abscesses and cysts, and can impinge upon and damage the roots of other teeth. And just as importantly, their absence also disrupts the smile as nearby teeth tend to move or “drift” toward the open space.
Rather than remove the impacted canines as is often done with back teeth, it may be more advantageous for both function and appearance to “coax” them into full eruption. This requires first pinpointing their exact location below the gums using x-rays or cone beam 3-D imaging.
If the teeth are in reasonably good position we must first prepare them for orthodontic treatment by surgically exposing the crown from the gums and bonding a small bracket to it. We then attach a small gold chain to the bracket that extends outside of the gums when we suture them back into place. The chain is attached to orthodontic hardware that exerts pressure on the impacted tooth for several months to “pull” it out into the arch.
This procedure has the best chance of success if undertaken before the end of jaw development in early adulthood. Otherwise, it may be better to remove the impacted canines and replace them with dental implants, followed by orthodontic treatment of other teeth to restore their proper position and bite relationships. In either case, your impacted upper canines don’t have to be a problem — we can restore both your mouth function and your smile.
If you would like more information on impacted teeth and 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 “Exposing Impacted Canines.”
Fluoride is an important weapon in the fight against tooth decay. Fluoride consumption and other applications are especially beneficial during children's dental development for building strong teeth long-term.
But the truism "too much of a good thing" could aptly apply to fluoride. If a child consumes too much fluoride over an extended period of time, it could cause a condition called enamel fluorosis in which the enamel surface develops mottled or streaked staining. It's not harmful to the tooth's health, but it can greatly diminish a person's smile appearance.
To avoid fluorosis, it's important with the help of your dentist to know and regulate as much as possible the amount of fluoride your child receives. Here are 3 fluoride sources you should manage.
Toothpaste. Many manufacturers add fluoride to their toothpaste formula, usually an important way to receive this tooth-strengthening chemical. But younger children tend to swallow more toothpaste than older children or adults. Because the chemical builds up in the body over time, swallowing toothpaste every day could potentially elevate your child's fluoride levels. To avoid this, just use a "smear" of toothpaste on the brush for children under age 2, and a pea-sized amount for older children.
Your water system. About three-quarters of all public water utilities add fluoride to their water as an added measure for tooth decay prevention. The amount can vary from system to system, although the maximum amount recommended by the U.S. Government is 0.70 parts per million (PPM). You can ask your local water system how much fluoride, if any, is present or they add to your drinking water.
Bottled water. Any type of bottled beverage (water, juices, sodas, etc.) could contain various levels of fluoride. Unfortunately there are no labeling requirements regarding its presence, so the most prudent course is to carefully manage the beverages your child drinks, or stay with bottled water marked "de-ionized," "purified," "demineralized" or "distilled," which typically have lower fluoride levels. For babies feeding on milk, you can use the aforementioned bottled waters to mix powder, use ready-to-feed formula (also low in fluoride) or breast-feed.
If you would like more information on fluoride and your baby, 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 “Tooth Development and Infant Formula.”