Posts for: December, 2017
If you’ve ever looked at younger photos of yourself, you’re sure to notice differences with your present appearance. Of course, your basic features might appear much the same. But maybe your lips seemed a little thicker back then, or your nose a bit less prominent.
This is because your facial features don’t stop growing when you reach adulthood—they continue to change throughout your life. For example, lips reach their maximum thickness by around age 14 for girls or age 16 for boys; they’ll remain at that level of thickness for a few years before gradually thinning throughout adulthood. The nose will also continue to grow, becoming more prominent especially as changes in the lower part of the face can make the chin appear shorter.
Although each of us ages at different rates and in different ways, these general physical trends are somewhat predictable. That’s why we can use the knowledge of how our facial physiology changes with age to fine tune orthodontic or other cosmetic dental treatments. The most optimum approach is to consider treatment in the early stages of bite development during childhood or early adolescence.
This means we’re doing more than correcting a patient’s current bite: we’re also taking into account how tooth movement now might affect the jaw and facial structures later in life. By incorporating our understanding of age-related changes into our treatment we might be able to provide some hedge against the effects of aging.
This approach starts with early comprehensive dental care, preferably before a child’s first birthday, and an orthodontic evaluation at around age 6 to assess bite development. It may also be necessary to initiate interceptive treatment at an early age to lessen or even eliminate a growing bite problem to help ease the extent of future treatment. And if a bite requires correction, early evaluation can help create a timetable for effective treatment in later years.
Taking this approach can correct problems now affecting both dental health and appearance. But by acknowledging the aging process in our treatments, we can build the foundation for a beautiful smile well into the future.
Soon after the primary (baby) teeth begin to give way, the teeth a child will have the rest of their lives start erupting into the mouth. But while they’re permanent, they’re not as strong and developed as they will be in adulthood.
That’s why we treat young permanent teeth differently from older adult teeth. For example, a decayed adult tooth may need a root canal treatment; but this standard treatment would often be the wrong choice for a child’s tooth.
The reason why involves the pulp, the innermost layer of a tooth, which plays a critical role in early development. Young permanent teeth continue to grow in sync with the jaws and facial structure. Most of this growth is in the dentin, the layer between the enamel and pulp, which increases proportionally to the other layers as the tooth matures. The pulp generates this new dentin.
A root canal treatment completely removes the diseased tissue of the pulp. This isn’t a major issue for a mature tooth because it no longer needs to generate more dentin. But it can have long-term consequences for an immature tooth whose growth may become stunted and the roots not fully formed. The tooth may thus become brittle and darkened, and might eventually require removal.
Because of these potential consequences, a root canal treatment is a last resort for a young permanent tooth. But there are modified alternatives, depending on the degree of pulp exposure or infection. For example, if the pulp is intact, we may be able to remove as much soft decayed dentin as we can, place an antibacterial agent and then fill the tooth to seal it without disturbing the pulp. If the pulp is partially affected, we can remove that part and place substances that encourage dentin growth and repair.
Our main goal is to treat a young tooth with as little contact with the pulp as possible, so as not to diminish its capacity to generate new dentin. Avoiding a full root canal treatment if at all possible by using these and other techniques will help ensure the tooth continues to develop to full maturity.
If you would like more information on dental care for 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 “Saving New Permanent Teeth after Injury.”