For decades, dental x-rays have helped us accurately diagnose and treat a wide array of dental diseases and conditions. But even with recent advances in digital imaging, the traditional x-ray does have one drawback: its two-dimensional view doesn’t always provide the “big picture” that a three-dimensional viewpoint can provide.
But a new type of x-ray technology can do just that: known as cone beam computed tomography (CBCT), these machines record hundreds of digital images as a cone-shaped beam of x-ray energy is projected through a device that rotates around a person’s head. A computer then assembles the images into a single three-dimensional image that can be manipulated on screen to view from various angles. Not only does this provide greater context and detail, it does so with no more radiation exposure than a standard 20-film digital full-mouth x-ray series.
While CBCT hasn’t replaced the traditional x-ray, it’s making its mark in a number of specialized areas of dentistry. The following are just a few of the ways CBCT is improving both accuracy and treatment outcomes.
Orthodontics. CBCT can provide a much more detailed view of the entire jaw; this can help us determine the best locations for realigning teeth safely and effectively.
Dental Implants. With a CBCT scan we can precisely locate nerve canals, sinuses and adjacent teeth before implant surgery to locate the best position for the implant.
TMD Treatment. To help develop the best treatment approach for alleviating the pain and dysfunction of temporo-mandibular joint disease (TMD), a CBCT scan can provide us detailed information on how the disease is affecting a patient’s joints, teeth, sinuses and airway.
Impactions. An impacted tooth can exert damaging pressure against the roots of neighboring teeth. A CBCT scan allows us to observe the impacted tooth from various vantage points to determine the best treatment approach for neighboring teeth, nerve canals and sinuses.
If you would like more information on CBCT technology, 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 “Getting the Full Picture With Cone Beam Dental Scans.”
Braces are a common experience among teens and pre-teens. And although the treatment can be a major financial undertaking, more and more families pursue it to help their child attain a straighter, more attractive smile.
But orthodontics isn’t first and foremost a cosmetic treatment. Although an improved appearance is a benefit, the main reason for treatment is therapeutic—it can improve your child’s current and future dental health.
The teeth’s relationship to the jaws and gums makes moving them possible. Rather than simply being fixed within their jawbone socket, teeth are actually held in place by a strong, elastic tissue called the periodontal ligament. The ligament lies between the teeth and jawbone and attaches to both with tiny extending fibers. This attachment secures the teeth in place.
But the ligament also has a dynamic quality—it can reshape itself when necessary and allow teeth to move gradually into new positions. This is most necessary during the early years of mouth and jaw development, but it can also occur throughout life. Orthodontics takes advantage of this mechanism by applying precise pressure to the teeth in the direction of desired movement. The periodontal ligament does the rest by reshaping and allowing the teeth to move in response to this pressure.
The result is straighter teeth and a more normal bite. With the teeth now where they should be, it’s also easier to clean them of disease-causing dental plaque, whereas misaligned teeth are more prone to plaque accumulation that can be difficult to remove. And because the whole mouth including teeth are involved when we talk, teeth positioned in a more normal bite will improve speech.
Orthodontics is a long-term process, often encompassing more than the actual time wearing braces. Both orthodontists and pediatric dentists recommend a bite evaluation by an orthodontist around the age of 6. If it does appear an abnormal bite is forming, it may be possible to intervene and stop or at least slow the development. This could have a more positive impact on any future treatment.
Braces and other treatments can make a difference in your child’s self-image and social relationships. But the main beneficiary will be their dental health.
If you would like more information on orthodontic treatment, 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 “Moving Teeth With Orthodontics.”
Although tooth decay is a major problem to watch for in your child’s teeth, it isn’t the only one. As their teeth transition from primary (“baby”) to permanent, you should also be on the lookout for a developing poor bite or malocclusion.
Although the signs can be subtle, you may be able to detect an emerging malocclusion, starting usually around age 6, if you know what to look for. Here are 4 signs your child may be developing a poor bite.
Excessive spacing. This is something that might be noticeable while the child still has their primary teeth. If you notice an excessive amount of space around the front teeth, the sizes of the jaws and the teeth may be disproportional.
Abnormal overlapping. The upper teeth normally just cover the bottom teeth when the jaws are closed. But a malocclusion may be forming if the lower teeth cover the upper (underbite), the upper teeth extend too far over the lower (deep bite) or there’s space between the upper and lower front teeth (open bite).
Different overlapping patterns. Watch as well for some of the teeth overlapping normally while others don’t, a sign of a cross bite. For example, the back upper teeth may cover their counterparts in a normal fashion while the lower front teeth abnormally overlap the top front. The roles here between front and back teeth can also be reversed.
Abnormal eruptions. Permanent teeth normally follow a pattern when erupting, but certain factors could disrupt the process. For example, a jaw that’s developed too small can cause crowding as incoming teeth vie for space; as a result, some permanent teeth may erupt out of their proper position. Likewise, if a baby tooth is out of its normal position or prematurely lost, the permanent tooth may erupt out of position too.
The good news with each of these developing bite problems is that we can correct them or at least minimize their future effect if caught early. So if you notice any of these signs or anything else out of the ordinary, see an orthodontist as soon as possible. It’s also a good idea to have your child undergo a thorough orthodontic evaluation around age 6.
If you would like more information on bite problems in children, 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.”
The fast-paced world of sports and entertainment isn’t all glitz and glamour. These high-profile industries create a unique kind of emotional and mental stress on celebrities. For many of them, a way to “let off steam” is an oral habit known as teeth grinding.
Teeth grinding is an involuntary habit in which a person bites and grinds their teeth outside of normal activities like eating or speaking. It’s common among young children, who usually grow out of it, but it can also affect adults, especially those who deal with chronic stress. If not addressed, teeth grinding can eventually wear down teeth, damage gum attachments or fracture weaker teeth. It can even contribute to tooth loss.
A number of well-known personalities in the spotlight struggle with teeth grinding, including actress Vivica Fox, model and TV host Chrissy Teigen, and star athletes Tara Lipinski and Milos Raonic of ice skating and tennis fame, respectively. The habit represents not only a threat to their dental health, but also to one of their most important career assets: an attractive and inviting smile. Fortunately, though, they each use a similar device to manage their teeth grinding.
Besides seeking ways to better manage life stress, individuals with a teeth-grinding habit can protect their teeth with a custom mouthguard from their dentist. Made of slick plastic, this device is worn over the teeth, usually while sleeping, to minimize dental damage. During a grinding episode, the teeth can’t make contact with each other due to the guard’s glossy surface—they simply slide away from each other. This reduces the biting forces and eliminates the potential for wear, the main sources of dental damage.
Chrissy Teigen, co-host with LL Cool J on the game show Lip Sync Battle, wears her custom-made guard regularly at night. She even showed off her guard to her fans once during a selfie-video posted on Snapchat and Twitter. Vivica Fox, best known for her role in Independence Day, also wears her guard at night, and for an additional reason: The guard helps protect her porcelain veneers, which could be damaged if they encounter too much biting force.
Mouthguards are a prominent part of sports, usually to protect the teeth and gums from injury. Some athletes, though, wear them because of their teeth grinding habit. Tara Lipinski, world renowned figure skater and media personality, keeps hers on hand to wear at night even when she travels. And Milos Raonic, one of the world’s top professional tennis players, wears his during matches—the heat of competition tends to trigger his own teeth-grinding habit.
These kinds of mouthguards aren’t exclusive to celebrities. If you or a family member contends with this bothersome habit, we may be able to create a custom mouthguard for you. It won’t stop teeth grinding, but it could help protect your teeth—and your smile.
If you would like more information about protecting your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Grinding” and “When Children Grind Their Teeth.”
When designing your new smile, we have a lot of options for changing how individual teeth look: from whitening discolored teeth to replacing missing teeth with life-like dental implants. But the problem may not be how your teeth look — in fact, individually they may look perfect. If they’re not straight, though, your smile won’t be as attractive as it could be.
We can address a poor bite (malocclusion) through the dental specialty of orthodontics. By moving misaligned teeth we may be able to transform your smile without any other dental work, or it could serve as a more solid foundation for other cosmetic enhancements. To find out if orthodontics can make a difference for you, you should begin with an initial visit to your general dentist. A thorough dental examination will enable them to tell you if correcting your bite could be a good option for you. If it is, they’ll most likely refer you to an orthodontist, a specialist in treating malocclusions.
The orthodontist will also perform an evaluation and get as complete a picture as possible of your particular bite problems. This examination will also include checking jaw growth and development in younger patients, how the affected teeth align with other teeth, and if your current bite is having any effect on the jaw joints. This will provide a good overview of not only the malocclusion but how it affects the rest of your mouth.
With this detailed analysis, they can then advise you on the best course of treatment. Most malocclusions can be corrected with braces or, increasingly, clear aligner trays. In certain situations, though, more specialized approaches may be needed, such as isolating only certain teeth for movement.
While orthodontic treatment takes time and can be expensive, the end result can be amazing: an improved bite that not only enhances your appearance but improves function and long-term health. Along with other cosmetic enhancements to your teeth and gums, orthodontics can give you a new sense of confidence in your smile.
If you would like more information on improving your smile with orthodontic treatment, 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 “The Magic of Orthodontics.”
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