Anyone at any age, including older children and teenagers, can lose or be born missing a permanent tooth. And while those missing teeth can be restored, replacing them in patients who haven’t yet reached adulthood can be tricky.
That’s because their dental and facial development isn’t finished. This is especially problematic for dental implants because as the jaws continue to grow, a “non-growing” implant could eventually appear out of alignment with the surrounding natural teeth. That’s why it’s often better to install a temporary restoration until the jaws fully mature in early adulthood. Two great choices are a removable partial denture (RPD) or a bonded (“Maryland”) bridge.
While “dentures” and “teens” don’t seem to go together, an RPD in fact can effectively restore a teen’s lost dental function and appearance. Of the various types of RPDs the one usually recommended for teens has a hard acrylic base colored to resemble the gums, to which we attach prosthetic (“false”) teeth at their appropriate positions on the jaw.
Besides effectiveness, RPDs are easy to clean and maintain. On the downside, though, an RPD can break and—as a removable appliance—become lost. They can also lose their fit due to changes in jaw structure.
The bonded bridge is similar to a traditional fixed bridge. But there’s one big difference: traditional bridges crown the natural teeth on either side of the missing teeth to secure them in place. The supporting teeth must be significantly (and permanently) altered to accommodate the life-like crowns on either end of the bridge.
Instead, a bonded bridge affixes “wings” of dental material extending from the back of the bridge to the back of the natural teeth on either side. While not quite as strong as a regular bridge, the bonded bridge avoids altering any natural teeth.
While a fixed bridge conveniently stays in place, they’re more difficult than an RPD to keep clean. And while less prone to breakage, they aren’t entirely immune to certain stresses from biting and chewing especially in the presence of some poor bites (how the upper and lower teeth come together).
Choosing between the two restorations will depend on these and other factors. But either choice can serve your teen well until they’re able to permanently replace their missing teeth.
Preventing tooth decay is mostly about the basics: daily brushing and flossing followed by regular dental cleanings and checkups. But there’s also a bigger picture: your own personal risk profile for decay based on factors you can modify directly — and those you can’t.
The first type of factor usually involves habits and behavior that either work with your mouth’s natural defenses to fight decay or against it. Besides regular hygiene, your diet is probably the most important of these you can modify for better dental health.
A diet rich in fresh vegetables, protein and dairy products boosts strong, healthy teeth resistant to decay. Conversely, bacteria thrive on the sugar in many snack foods, while sodas, sports or energy drinks elevate acid levels that soften and erode the minerals in your teeth’s enamel.
Lifestyle habits like tobacco use or excessive alcohol consumption also increase your decay risk. Not only do they promote plaque buildup (the thin film of bacteria and food particles that feeds the decay process), but tobacco especially can impede the body’s natural prevention and healing properties.
Conscientious hygiene practices, a dental-friendly diet and modified lifestyle habits all can help you prevent decay. But diligence may not be enough — there are other possible factors you can’t control or may find difficult to change. For example, you may have a genetic propensity toward certain bacteria that cause decay. You may have a condition like gastric reflux that increases the mouth’s acid level. You may also be taking medications that reduce saliva flow, the mouth’s natural acid neutralizer.
But if we know which of these indirect risk factors affect you, we can compensate with extra measures. If enamel strength is a problem we can topically apply fluoride; we can also reduce chronic bacterial levels with prescription rinses. If you have restricted saliva flow, we can attempt to modify your prescriptions through your doctor or prescribe aids that increase saliva.
The key is to investigate your complete risk factor profile through a thorough dental examination. Once we know everything about your mouth, life and health that increases your decay risk, we can put in place a balanced strategy of prevention and treatment just for you. Doing so will greatly increase your chances for keeping your teeth decay-free and healthy.
If you would like more information on preventing and treating dental disease, 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 Decay: How to Assess Your Risk.”
As a parent, you have plenty of questions about your child’s health. One we hear quite often is when dental care should begin for a child.
The short answer is when their first tooth comes in, usually at six months to a year of age: that’s when you should begin brushing at home. But there’s also the matter of when to begin your child’s regular dental visits: we recommend the first visit around the child’s first birthday. Here are 4 reasons why this is the right time to start.
Prevention. First and foremost, starting visits at age one gives your child the best start for preventing tooth decay through cleanings, topical fluoride or, in some cases, sealants. Preventive care for primary teeth may not seem that important since they’ll eventually give way to the permanent teeth. But primary teeth also serve as guides for the next teeth’s ultimate position in the mouth — if a primary tooth is lost prematurely, it could affect your child’s bite in later years.
Development. Early dental visits give us a chance to keep an eye on bite and jaw development. If we notice a developing malocclusion (bad bite) or conditions favorable for it, we can refer you to an orthodontist for consultation or interventional therapy to reduce the possibility or extent of future treatment.
Support. Your child’s regular dental visits can also help you as a parent. We can advise you on all aspects of dental care, including brushing and flossing techniques, nutrition dos and don’ts, and how to handle situations like late thumb sucking.
Familiarization. Dental visits starting at age one will help your child become familiar and comfortable with visiting the dentist that might be more difficult to achieve if they’re older. Dental visit anxiety is a major reason why many people don’t maintain regular visits later in life. Children who come to realize that dental visits are a normal, even pleasant experience are more likely to continue the practice into adulthood.
Caring for your child’s teeth is just as important as other aspects of their health. Getting an early start can head off brewing problems now and set the course for healthy teeth and gums tomorrow.
If you would like more information on pediatric dental 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 “Age One Dental Visit.”
Fans of the legendary rock band Steely Dan received some sad news a few months ago: Co-founder Walter Becker died unexpectedly at the age of 67. The cause of his death was an aggressive form of esophageal cancer. This disease, which is related to oral cancer, may not get as much attention as some others. Yet Becker's name is the latest addition to the list of well-known people whose lives it has cut short—including actor Humphrey Bogart, writer Christopher Hitchens, and TV personality Richard Dawson.
As its name implies, esophageal cancer affects the esophagus: the long, hollow tube that joins the throat to the stomach. Solid and liquid foods taken into the mouth pass through this tube on their way through the digestive system. Worldwide, it is the sixth most common cause of cancer deaths.
Like oral cancer, esophageal cancer generally does not produce obvious symptoms in its early stages. As a result, by the time these diseases are discovered, both types of cancer are most often in their later stages, and often prove difficult to treat successfully. Another similarity is that dentists can play an important role in oral and esophageal cancer detection.
Many people see dentists more often than any other health care professionals—at recommended twice-yearly checkups, for example. During routine examinations, we check the mouth, tongue, neck and throat for possible signs of oral cancer. These may include lumps, swellings, discolorations, and other abnormalities—which, fortunately, are most often harmless. Other symptoms, including persistent coughing or hoarseness, difficulty swallowing, and unexplained weight loss, are common to both oral and esophageal cancer. Chest pain, worsening heartburn or indigestion and gastroesophageal reflux disease (GERD) can also alert us to the possibility of esophageal cancer.
Cancer may be a scary subject—but early detection and treatment can offer many people the best possible outcome. If you have questions about oral or esophageal cancer, call our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Oral Cancer.”
You’ve invested a lot of time and money in orthodontic treatment to improve your smile. If you’re not careful, though, your teeth could actually move back to their old positions. The reason why is related to the same natural tooth-moving mechanism we use to straighten teeth in the first place.
Teeth are held in place by an elastic, fibrous tissue called the periodontal ligament lying between the teeth and the jawbone and attaching to both with tiny collagen fibers. The periodontal ligament allows for incremental tooth movement in response to pressure generated around the teeth, as when we chew (or while wearing braces).
Unfortunately, this process can work in reverse. Out of a kind of “muscle memory,” the teeth can revert to the older positions once there’s no more pressure from the removed braces. You could eventually be right back where you started.
To avoid this, we have to employ measures to hold or “retain” the teeth in their new positions for some time after the braces come off. That’s why we have you wear a dental appliance called a retainer, which maintains tooth position to prevent a relapse. Depending on what’s best for your situation, this could be a removable retainer or one that’s fixed to the teeth.
Patients typically wear a retainer around the clock in the immediate period after braces, and then eventually taper off to just nighttime wear. Younger patients must wear one for several months until the new teeth positions become more secure and the chances of a rebound diminish. For older patients who’ve matured past the jaw development stage, though, wearing a retainer may be a permanent necessity to protect their smile.
Retainer wear can be an annoyance, but it’s an absolute necessity. Think of it as insurance on your investment in a new, more attractive smile.
If you would like more information on improving your smile through orthodontics, 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 Importance of Orthodontic Retainers.”
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