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Posts for category: Dental Procedures

By Wortham Dental
November 21, 2021
Category: Dental Procedures
5SignsYourChildMayBeDevelopingaPoorBite

A Malocclusion—better known as a poor bite—can have far-ranging consequences that could follow a child into adulthood. Bite abnormalities make it more difficult to chew and digest food. And, misaligned teeth are also harder to keep clean, increasing the risk of dental disease.

But the good news is that we can often curb these long-term effects by discovering and treating a malocclusion early. A poor bite generally develops slowly with signs emerging as early as age 6. If you can pick up on such a sign, interventional treatment might even prevent a malocclusion altogether.

Here are 5 possible signs that might indicate your child is developing a poor bite.

Excessive spacing or crowding. A poor bite may be developing if the gaps between teeth seem unusually wide or, at the opposite spectrum, the teeth appear crooked or "bunched up" from crowding.

Underbite. In a normal bite the teeth on the upper jaw arch slightly cover the lower. If the opposite is true—the lower teeth are in front of the upper—then an underbite could be forming.

Open bite. Normally, when the jaws are shut, there is no open space between them. But if you notice a space still present between the upper and lower teeth when the jaws are shut, it may indicate an open bite.

Crossbite. This abnormal bite occurs when some of the lower teeth bite in front of the upper, while the remaining lower teeth are properly aligned behind the upper. Crossbites can occur with either the front or the back teeth.

Front teeth abnormalities. Front teeth especially can indicate a number of problems. In a deep bite, the upper front teeth extend too far over the lower teeth. Protrusion occurs when the upper teeth jut too far forward; in retrusion, the lower teeth seem to be farther back than normal.

See your dentist if you notice these signs or anything else unusual with your child's bite. Better yet, schedule a bite evaluation with an orthodontist when your child reaches age 6. Getting a head start on treating an emerging malocclusion can save them bigger problems down the road.

If you would like more information on malocclusions and their impact on your child's oral health, 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 “Problems to Watch For in Children Ages 6 to 8.”

LikeJohnnyManzielYouMayNeedanOralSurgeonforaMajorDentalProblem

QB sensation Johnny Manziel has had a varied career in professional football. After playing two seasons for the NFL Cleveland Browns, he quarterbacked for a number of teams in the Canadian Football League. More recently, he joined the Zappers in the new Fan Controlled Football league (FCF). But then with only a few games under his belt, he was waylaid by an emergency dental situation.

It's unclear what the situation was, but it was serious enough to involve oral surgery. As a result, he was forced to miss the Zappers' final regular-season game. His experience is a reminder that some dental problems can't wait—you have to attend to them immediately or risk severe long-term consequences.

Manziel's recent dental problem also highlights a very important specialty of dentistry—oral surgery. Oral surgeons are uniquely trained and qualified to treat and correct a number of oral problems.

Tooth extraction. Although some teeth can be removed by a general dentist, some have complications like multiple roots or impaction that make regular extractions problematic. An oral surgeon may be needed to surgically remove these kinds of problem teeth.

Disease. Oral surgeons often intervene with diseases attacking areas involving the jaws or face. This includes serious infections that could become life-threatening if they're not promptly treated by surgical means.

Bite improvement. Some poor bites (malocclusions) arise from a mismatch in the sizes of the jaws.  An oral surgeon may be able to correct this through orthognathic surgery to reposition the jaw to the skull. This may compensate for the difference in jaw sizes and reduce the bite problem.

Implants. Dental implants are one of the best ways to replace teeth, either as a standalone tooth or as support for a fixed dental bridge or a removable denture.  In some cases, it may be better for an oral surgeon to place the implants into a patient's jawbone.

Reconstruction. Injuries or birth defects like a cleft lip or palate can alter the appearance and function of the face, jaws or mouth. An oral surgeon may be able to perform procedures that repair the damage and correct oral or facial deformities.

Sleep apnea. Obstructive sleep apnea is usually caused by the tongue relaxing against the back of the throat during sleep and blocking the airway. But other anatomical structures like tonsils or adenoids can do the same thing. An oral surgeon could address this situation by surgically altering obstructing tissues.

It's likely most of your dental care won't require the services of an oral surgeon. But when you do need surgical treatment, like Johnny Manziel, these dental specialists can make a big difference in your oral health.

If you would like more information about oral surgery, please contact us or schedule a consultation.

YourDecayedToothMightNeedaDifferentKindofRootCanalTreatment

Advanced decay doesn't necessarily mean it's curtains for an infected tooth. Millions of teeth in that condition have been saved by a tried and true procedure called root canal therapy.

Although they may vary according to the complexity of a case, all root canal procedures share some similarities. After numbing the tooth and gum areas with local anesthesia, the procedure begins with a small hole drilled into the tooth to access the infected pulp and root canals, tiny passageways inside the root.

The dentist then uses special instruments to clear out infected tissue from the pulp and canals, followed by thoroughly sanitizing the resulting empty spaces. This is followed with filling the pulp chamber and root canals with a rubber-like substance (gutta percha) to seal the interior of the tooth from further infection. Later, the dentist typically crowns the tooth for further protection and support.

Root canals have become the standard treatment for teeth with advanced decay. There are, however, some circumstances where performing a root canal isn't a good idea. For example, a previously root-canaled tooth with a crown and supporting post. A dentist would need to fully disassemble the restoration to gain access into the tooth, which could significantly weaken it.

But there may be another option if a standard root canal is out of the picture: a surgical procedure performed by an endodontist (a specialist in interior tooth treatment) called an apicoectomy. Instead of drilling through the tooth crown, the endodontist accesses the tooth root through the adjacent gum tissue.

Like a traditional root canal, the procedure begins by anesthetizing the tooth and surrounding gums. The endodontist then makes a small incision through the gums to expose the diseased tissues at the tooth's root. After removing the infected tissue and a few millimeters of the root tip, they place a small filling to seal the end of the root canal against infection and suture the gum incision.

This is a specialized procedure that requires the state-of-the-art equipment and advanced techniques of an endodontist. But it does provide another possible option for saving a diseased tooth that might otherwise be lost.

If you would like more information on treatments for tooth decay, 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 “Apicoectomy: A surgical Option When Root Canal Treatment Fails.”

DoThese2ThingsForYourHealthsSakeIfYouWearDentures

Today's dentures are more comfortable, more functional and more life-like than ever before—so much so that you might forget you have them in. Even so, dentures do have some downsides, and constant wear only amplifies those.

Our biggest concern is the effect dentures can have on bone health. Older bone is constantly replaced by newer bone, and the forces generated while chewing help stimulate this new growth. When a tooth is lost, however, this growth stimulus vanishes with it for that area of the bone. This may result in a slower growth rate, which can eventually lead to lost bone volume and density.

Dentures can't restore this lost stimulus, and may even make the situation worse. That's because traditional dentures rest on the bony ridges of the gums where the teeth once were. This can put pressure on the underlying bone, which can accelerate bone loss—and even more so when wearers leave their dentures in continuously.

Dentures can also contribute to disease if they're not regularly removed and cleaned. Besides oral yeast infections, bacteria-laden dentures can contribute to the production of a protein called interleukin-6 produced by the white blood cells. If a significant amount of this protein passes into the blood stream, it can increase body-wide inflammation and foster a systemic environment conducive to serious diseases like pneumonia.

If you wear dentures, then, it's good for your health (oral and otherwise) to incorporate two practices into your daily life. The first is to remove your dentures at night while you sleep. Not only will this help slow the progression of bone loss, it will also give your gums a chance to rest and recover from denture wear.

It's also important to regularly clean your dentures, either with an antibacterial soap or a special denture cleanser. During storage, keep your dentures in clean water or a peroxide-based solution designed for dentures. This will reduce the accumulation of bacteria on your dentures that can cause disease.

Dentures restore the dental function and smile appearance that a person loses with their teeth. Taking care of your dentures (and giving your mouth a daily rest from them) will help promote good oral and general health for you and a longer life for your dentures.

If you would like more information on denture care, 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 “Sleeping in Dentures.”

WhatChrissyTeigensInaugurationNightCapMishapCouldMeanForYou

Inauguration night is usually a lavish, Washington, D.C., affair with hundreds attending inaugural balls throughout the city. And when you're an A-List celebrity whose husband is a headliner at one of the events, it's sure to be a memorable night. As it was for super model Chrissy Teigen—but for a slightly different reason. During the festivities in January, Teigen lost a tooth.

Actually, it was a crown, but once she told a Twitter follower that she loved it “like he was a real tooth.” The incident happened while she was snacking on a Fruit Roll-Up (those sticky devils!), and for a while there, husband and performer John Legend had to yield center stage to the forlorn cap.

But here's something to consider: If not for the roll-up (and Teigen's tweets on the accident) all of us except Teigen, her dentist and her inner circle, would never have known she had a capped tooth. That's because today's porcelain crowns are altogether life-like. You don't have to sacrifice appearance to protect a tooth, especially one that's visible when you smile (in the “Smile Zone”).

It wasn't always like that. Although there have been tooth-colored materials for decades, they weren't as durable as the crown of choice for most of the 20th Century, one made of metal. But while gold or silver crowns held up well against the daily grind of biting forces, their metallic appearance was anything but tooth-like.

Later, dentists developed a hybrid of sorts—a metal crown fused within a tooth-colored porcelain shell. These PFM (porcelain-fused-to-metal) crowns offered both strength and a life-like appearance. They were so effective on both counts that PFMs were the most widely used crowns by dentists until the early 2000s.

But PFMs today make up only 40% of currently placed crowns, down from a high of 83% in 2005. What dethroned them? The all-ceramic porcelain crown—but composed of different materials from years past. Today's all-ceramic crowns are made of more durable materials like lithium disilicate or zirconium oxide (the strongest known porcelain) that make them nearly as strong as metal or PFM crowns.

What's more, coupled with advanced techniques to produce them, all-ceramic crowns are incredibly life-like. You may still need a traditional crown on a back tooth where biting forces are much higher and visibility isn't an issue. But for a tooth in the “Smile Zone”, an all-ceramic crown is more than suitable.

If you need a new crown (hopefully not by way of a sticky snack) or you want to upgrade your existing dental work, see us for a complete exam. A modern all-ceramic crown can protect your tooth and enhance your smile.

If you would like more information about crowns or other kinds of dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Crowns & Veneers.”