To get your child on the right track for lifelong dental health we recommend you begin their dental visits around their first birthday. You can certainly visit your family dentist, especially if you and your family feel comfortable with them. But you also might want to consider a pediatric dentist for your child's dental needs.
What's the difference between a family dentist and a pediatric dentist? Both offer the same kind of prevention and treatment services like cleanings, fluoride applications or fillings. But like their counterparts in medicine — the family practice physician and pediatrician — the family dentist sees patients of all ages; the pediatric dentist specializes in care for children and teens only.
In this regard, pediatric dentists undergo additional training to address dental issues specifically involving children. Furthermore, their practices are geared toward children, from toys and child-sized chairs in the waiting room to “kid-friendly” exam rooms decorated to appeal to children.
While your family dentist could certainly do the same, pediatric dentists are also skilled in reducing the anxiety level that's natural for children visiting the dental office. This can be especially helpful if you have a special needs child with behavioral or developmental disorders like autism or ADHD. A pediatric dentist's soothing manner and the calm, happy environment of the office can go a long way in minimizing any related anxiety issues.
Your child may have other needs related to their oral health that could benefit from a pediatric dentist. Some children have a very aggressive form of dental caries disease (tooth decay) called early childhood caries (ECC).Â If not treated promptly, many of their teeth can become severely decayed and prematurely lost, leading to possible bite problems later in life. Pediatric dentists are well-suited to treat ECC and to recognize other developmental issues.
Again, there's certainly nothing wrong with taking your child to your family dentist, especially if a long-term relationship is important to you (your child will eventually “age out” with a pediatric dentist and no longer see them). It's best to weigh this and other factors such as your child's emotional, physical and dental needs before making a decision.
During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.
Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.
For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.
When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.
But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.
Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.
So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…
If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”
With college, a full-time job and an upcoming wedding to plan, Brooke Vitense had the hectic life of an average young woman in her twenties. But a chance discovery one morning would completely upend her normal life.
That morning Brook noticed white spots on the underside of her tongue while brushing her teeth. Not long after, she pointed out the spots to her dentist during her regular dental checkup. He recommended having the spots biopsied, just to be safe. She needed a wisdom tooth removed, so she scheduled the biopsy with her oral surgeon to coincide with the tooth extraction.
She soon forgot about the biopsy — until her dentist contacted her about the results. The lesions were pre-cancerous: he recommended she have them and a portion of her tongue removed surgically as soon as possible.
She underwent the procedure, but that wasn't the end of her ordeal. The follow-up pathology report indicated cancerous cells in the tissue excised during the procedure. To ensure elimination of any remaining cancerous cells they would need to remove more of her tongue as well as the lymph nodes from her neck.
Brooke survived her cancer experience and has since resumed her life. Her story, though, highlights some important facts about oral cancer.
Oral cancer is life-threatening. Although cases of oral cancer are rarer than other types of malignancies, the survival rate is low (50%). This is because lesions or other abnormalities are often dismissed as simple sores. Like any cancer, the earlier it's detected and treated, the better the chances for survival.
Anyone of any age can develop oral cancer. While most cases occur in older adults, young and otherwise healthy people like Brooke are not immune. It's important for everyone to make healthy lifestyle choices (good oral hygiene and nutrition, moderate alcohol use and avoidance of tobacco) and see a dentist whenever you see an abnormal sore or spot in your mouth.
Regular dental checkups are crucial for early detection. Had Brooke not seen her dentist soon after discovering the spots on her tongue, her survivability could have been drastically lower. Regular dental visits (and cancer screenings if you're at high risk) could mean all the difference in the world.
If you would like more information on the signs and treatment of oral cancer, please contact us or schedule an appointment for a consultation. You can watch Brooke's interview by visiting How a Routine Dental Visit Saved My Life
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
Braces utilize the mouth’s existing teeth-moving mechanism by applying pressure in the direction of the desired movement. This is done with a wire laced through metal brackets affixed to the outside of the teeth that’s then usually anchored to brackets on the back teeth to maintain constant tension.
This anchorage set-up alone, however, may not work effectively with all bite situations, which might require other points of anchorage. That’s where these other tools in the orthodontist’s toolkit can come in handy.
Headgear. These appliances not only aid with moving teeth but they also help influence the proper growth of facial structures (as when one of the jaws is too far forward or too far back). Because of this influence on jaw growth you’ll only find them used with pre-teens. The most typical application is a strap running around the back of the head or neck (or sometimes over the chin or forehead) that attaches in the front to brackets usually bonded to the molars. In this case the back of the patient’s skull serves as the anchor point.
Temporary anchorage devices (TADs). Orthodontists sometimes wish to isolate the teeth to be moved from nearby teeth that shouldn’t be. For example, they may want to move front teeth back to close a space without the back teeth moving forward. In this case, it may be necessary to create a separate anchorage point in the jaw. This can be done with TADs, which are made of either biotolerant (stainless steel, chromiumâ??cobalt alloy), bioinert (titanium, carbon), or bioactive (hydroxyapatite, ceramic oxidized aluminum) materials and shaped like mini-screws. Orthodontists insert them into the bone and then attach them to the braces using elastics (rubber bands). After completing orthodontic treatment they’re easily removed.
Elastics. We’ve already mentioned them, but elastics deserve their own category because they can be used in various kinds of anchorage. They play an important role, for example, in cross-arch anchorage that maintains tension between the upper and lower jaws. They can also be used to help move one or more groups of teeth — or isolate certain teeth from moving. They truly are flexible (no pun intended) in their uses for fine-tuned tooth movement.
All these devices can be used in various combinations to match and correct whatever bite situation a patient may have. The end result is straighter and better-functioning teeth — and a more attractive smile.
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 “Orthodontic Headgear & Other Anchorage Appliances.”
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