Dentist Blog

Posts for tag: orthodontic treatment

WeMayBeAbleToTreatSomeBiteProblemsEarly

In any given year, 4 million tweens and teens are in the process of having their teeth straightened with braces or clear aligners. It's so common we tend to consider orthodontic treatment for young people as a rite of passage into adulthood.

But it doesn't necessarily have to be that way—it might be possible to stop or at least minimize a poor bite before it fully develops. That's the goal of interceptive orthodontics—treatments that head off or “intercept” a bite problem early.

The goal isn't necessarily to reposition misaligned teeth, but to correct a problem that can lead to misalignment. Here are some examples.

A narrow jaw. A narrowly developing jaw can crowd incoming teeth out of their normal positions. For the upper jaw, though, we can take advantage of a temporary separation in the bones in the roof of the mouth (palate) with a device called a palatal expander. Placed against the palate, the expander exerts outward pressure on the teeth and jaw to widen this separation. The body fills in the gap with bone to gradually widen the jaw.

Abnormal jaw alignment. It's possible for a jaw to develop abnormally during childhood so that it extends too far beyond the other. Using a hinged device called a Herbst appliance, it's possible to interrupt this abnormal growth pattern and influence the bones and muscles of the jaw to grow in a different way.

Missing primary teeth. An important role for a primary (baby) tooth is to hold a place for the future permanent tooth. But if the primary tooth is lost too soon, other teeth can drift into the space and crowd out the intended permanent tooth. To prevent this, we can insert a space maintainer: This simple looped metal device prevents teeth from drifting and preserves the space for the permanent tooth.

Although these and other interceptive treatments are effective, some like the palatal expander do their best work within a limited age frame. To take advantage of interceptive orthodontics in a timely manner, parents should seek a bite evaluation for their child from an orthodontist around age 6. The earlier we detect a growing bite problem, the greater your chances for successful intervention.

If you would like more information on treating emerging bite problems early, 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 “Interceptive Orthodontics.”

RemovingTeethMightMakeItEasierToStraightenaSmile

Dentists remove millions of teeth each year, often because of tooth decay or gum disease. But disease isn't the only reason—a tooth extraction might make it easier to straighten a crooked smile.

Realigning teeth for therapeutic or cosmetic reasons is a regular undertaking in dentistry, but the process itself often differs from person to person. Each individual patient requires their own treatment plan taking into account factors like the kind of bite problem involved, the size of the jaw and the space available to move teeth.

This plan could indeed involve removing teeth. For example, an abnormally small jaw could cause crowding. Not only can crowding move teeth out of position, it may also leave little to no room for moving teeth. Although dentists can minimize crowding by influencing jaw development in early childhood, removing teeth for more space is usually the only option available to older adolescents and adults.

Similarly, teeth can fail to erupt properly and remain partially or fully submerged beneath the gums (known as impaction). There is an orthodontic method for pulling an impacted tooth fully onto the jaw, but only if the tooth isn't too far out of alignment. Otherwise, it may be better to remove the impacted tooth and then correct any gaps with braces or a dental implant.

There's also a situation on the opposite side of the spectrum that could benefit from teeth removal—when one or more permanent teeth fail to form, known as congenitally missing teeth. This can cause gaps in the smile or a “lopsided” appearance where a tooth on one side of the jaw is present while its counterpart on the opposite side of the jaw is missing.

The missing tooth can be replaced by an implant, bridge or other restoration. But another option may be to remove the existing counterpart tooth, and then close the gaps. This can result in a much more attractive smile that might be simpler and less costly than replacing the missing tooth.

Again, the decision to remove teeth to improve smile appearance depends on the patient and their particular dental condition. But in the right situation, it could make straightening a smile easier and more effective.

If you would like more information on orthodontic treatments, 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 “Removing Teeth for Orthodontic Treatment.”

SomeBiteProblemsMayRequiretheHelpofOtherToolsinConjunctionWithBraces

If you're into social media, you might have run across the idea that there's nothing to straightening your teeth. According to some SM influencers, you can even do it yourself with a few rubber bands. But the truth is, the mechanics of moving teeth are much more complex—and taking orthodontics into your own hands can cause extensive dental damage.

In reality, all bite problems (malocclusions) require the advanced knowledge and expertise of an orthodontist to correct them safely and effectively. Some, in fact, may require other devices along with braces or clear aligners to achieve the desired outcome for a particular malocclusion.

Here are a few of those additional tools an orthodontist may use and why they may be needed.

Headgear. Some malocclusions result not just from misaligned teeth, but problems with jaw or facial structure development. To accommodate additional factors like this, an orthodontist may include headgear during treatment, usually a strap running around the back of a patient's head or neck and attached in the front to brackets bonded to the teeth (usually the molars). Wearing this headgear for several hours a day can improve jaw and facial development.

Elastics. Unlike basic rubber bands DIYers might use to move their teeth (often with damaging results), elastics are specialized bands designed for targeted tooth movement. They're needed for bite problems that require moving some teeth and not moving others. As such, elastics can be applied in conjunction with braces to perform either intended task—move or prevent movement for specific teeth.

Anchorage. One of the tools often used with elastics for targeted tooth movement are temporary anchorage devices (TADs). These are typically tiny screws imbedded into the jawbone a short distance from fixed braces. An elastic band connected to the braces at a specific point is then attached to the TAD, which serves as an anchor point for the elastic.

These and other devices can help orthodontists achieve a successful correction for certain individual bite problems. And unlike the DIY methods touted on the Internet, these additional tools help them do it safely.

If you would like more information on straightening teeth 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 “Orthodontic Headgear & Other Anchorage Appliances.”

AnchorageDevicesProvideMoreAccuracyLessTreatmentTimeforBraces

Braces are a common part of many teenagers’ life experience — but not every bite problem is alike. Sometimes, there’s a need for accurately moving only a few teeth while making sure others don’t. This is where Temporary Anchorage Devices (TADs) can help streamline that effort and even reduce treatment time.

Orthodontics wouldn’t work at all if we didn’t already have a natural tooth movement mechanism in our mouths. That ability rests with the periodontal ligament, a tough, elastic tissue between the teeth and the bone that firmly attaches to both with tiny collagen fibers. Though quite secure in holding teeth in place, the ligament attachment also allows teeth to move in response to changes in the bone and jaw structure.

Braces are made of brackets cemented to tooth surfaces through which tiny wires pass. The wires are anchored, usually to other teeth or groups of teeth, and tightened to apply pressure against the other teeth. The ligament does the rest: as the teeth are “pressured” to move in a certain direction, new bone, ligament and an anchoring substance known as cementum forms behind it to secure the tooth in its new position.

The anchorage teeth are not intended to move. In some situations, though, it’s difficult to keep them from not moving — much like trying to keep a boat anchor from not dragging through sand on the sea bottom. TADs help alleviate this problem: it’s a mini-screw or mini-implant that’s temporarily placed in the jawbone to which the tension wire can be secured. They’re placed in the best positions for isolating the teeth that need to be moved without compromising the position of nearby teeth that don’t.

With the site numbed with a local anesthetic, we install the TAD through the gum tissue into the bone with a special device; their screw-shaped design holds them securely in place. They’re then removed when the orthodontic treatment is complete.

While a simple procedure, precise placement requires collaboration between the orthodontist and the oral surgeon or dentist who installs them. They also need special attention during daily hygiene to keep them clean. Still, with difficult bite situations they can help bring about the right outcome — a straight and beautiful smile.

If you would like more information on orthodontic 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 “What are TADs?

StopBiteProblemsEarlyWithInterceptiveOrthodontics

Every year many parents learn their “tweenager” or teenager needs their bite corrected, often with specialized orthodontics. Imagine, though, if these families could go back in time to when their child’s poor bite was just developing to stop or slow it from forming.

Time travel may still be science fiction, but the approach suggested isn’t. It’s called interceptive orthodontics, a group of techniques and procedures performed during the early stages of jaw development. The focus is usually on getting abnormal jaw growth back on track, enough so that a poor bite won’t form.

The upper jaw, for example, may be growing too narrow, reducing the amount of available space for tooth eruption. If it isn’t corrected, teeth can erupt out of position. To correct it, an orthodontist places a palatal expander in the roof of the child’s mouth (palate). The appliance applies gentle pressure against the inside of the teeth, which stimulates the jaws to develop wider.

The expander works because of a separation in the bones at the center of the palate, which later fuse around puberty. The pressure applied from the expander keeps this gap slightly open; the body then continues to fill the widening expansion with bone, enough over time to widen the jaw. If you wait until puberty, the gap has already fused, and it would have to be reopened surgically to use this technique. Ideally, then, a palatal expander should be employed at a young age.

Not all interceptive techniques are this extensive—some, like a space maintainer, are quite simple. If a primary (baby) tooth is lost prematurely, teeth next to the empty space tend to drift into it and cause the intended permanent tooth to erupt out of place due to a lack of space. To prevent this an orthodontist places a small wire loop within the space to prevent other teeth from moving into it.

These are but two examples of the many methods for stopping or slowing a developing bite problem. To achieve the best outcome, they need to be well-timed. Be sure, then, to have your child undergo an orthodontic evaluation around age 6. If an interceptive orthodontic approach is needed, it could eliminate the need for more extensive—and expensive—treatment later.

If you would like more information on treatments to get ahead of bite problems, please contact us or schedule an appointment for a consultation.