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RemovingOneorMoreTeethCouldImproveOrthodonticOutcomes

Moving teeth through orthodontics may involve more than simply wearing braces. There are many bite conditions that require extra measures before, during or after traditional orthodontic treatment to improve the outcome.

One such measure is extracting one or more teeth. Whether or not we should will depend on the causes behind a patient's poor dental bite.

Here, then, are 4 situations where tooth extraction before orthodontics might be necessary.

Crowding. This happens when the jaw isn't large enough to accommodate all the teeth coming in. As a result, later erupting teeth could erupt out of position. We can often prevent this in younger children with space maintainers or a palatal expander, a device which helps widen the jaw. Where crowding has already occurred, though, it may be necessary to remove selected teeth first to open up jaw space for desired tooth movement.

Impacted teeth. Sometimes an incoming tooth becomes blocked and remains partially or fully submerged beneath the gums. Special orthodontic hardware can often be used to pull an impacted tooth down where it should be, but not always. It may be better to remove the impacted tooth completely, as well as its matching tooth on the other side of the jaw to maintain smile balance before orthodontically correcting the bite.

Front teeth protrusion. This bite problem involves front teeth that stick out at a more horizontal angle. Orthodontics can return the teeth to their proper alignment, but other teeth may be blocking that movement. To open up space for movement, it may be necessary to remove one or more of these obstructing teeth.

Congenitally missing teeth. The absence of permanent teeth that failed to develop can disrupt dental appearance and function, especially if they're near the front of the mouth. They're often replaced with a dental implant or other type of restoration. If only one tooth is missing, though, another option would be to remove the similar tooth on the other side of the jaw, and then close any resulting gaps with braces.

Extracting teeth in these and other situations can help improve the chances of a successful orthodontic outcome. The key is to accurately assess the bite condition and plan accordingly.

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

WhatTaraLipinskiDoestoProtectOneofHerMostValuableAssets-HerSmile

Tara Lipinski loves to smile. And for good reason: The Olympic-gold medalist has enjoyed a spectacular career in ladies' figure skating. Besides also winning gold in the U.S. Nationals and the Grand Prix Final, in 1997 Lipinski became the youngest skater ever to win a World Figure Skating title. Now a sports commentator and television producer, Lipinski still loves to show her smile—and counts it as one of her most important assets. She also knows the importance of protecting her smile with daily hygiene habits and regular dental care.

Our teeth endure a lot over our lifetime. Tough as they are, though, they're still vulnerable to disease, trauma and the effects of aging. To protect them, it's essential that we brush and floss every day to remove bacterial plaque—that thin accumulating film on teeth most responsible for tooth decay and gum disease.

To keep her smile in top shape and reduce her chances of dental disease, Lipinski flosses and brushes daily, the latter at least twice a day. She also uses a tongue scraper, a small handheld device about the size of a toothbrush, to remove odor-causing bacteria and debris from the tongue.

Lipinski is also diligent about visiting the dentist for professional cleanings and checkups at least twice a year because even a dedicated brusher and flosser like her can still miss dental plaque that can then harden into tartar. Dental hygienists have the training and tools to clear away any lingering plaque and tartar that could increase your disease risk. It's also a good time for the dentist to check your teeth and gums for any developing problems.

The high pressure world of competitive figure skating and now her media career may also have contributed to another threat to Lipinski's smile: a teeth-grinding habit. Teeth grinding is the unconscious action—often while asleep—of clenching the jaws together and producing abnormally high biting forces. Often a result of chronic stress, teeth grinding can accelerate tooth wear and damage the gum ligaments attached to teeth. To help minimize these effects, Lipinski's dentist created a custom mouthguard to wear at night. The slick plastic surface of the guard prevents the teeth from generating any damaging biting forces when they clench together.

The importance of an attractive smile isn't unique to celebrities and media stars like Tara Lipinski. A great smile breeds confidence for anyone—and it can enhance your career, family and social relationships. Protect this invaluable asset with daily oral hygiene, regular dental visits and prompt treatment for disease or trauma.

If you would like more information about protecting your smile, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine articles “Tooth Decay” and “Teeth Grinding.”

By Ely M. Lun-Chial, DDS
March 03, 2020
Category: Dental Procedures
Tags: tooth extractions  
ExtractingaToothisaRoutineProcedure

Dentists around the world routinely remove diseased or damaged teeth every day. While some extractions require surgery, many don't: Your family dentist can perform these simple extractions, usually with little complication.

The term simple doesn't necessarily mean easy—as we'll note in a moment, it takes a deft and experienced hand to perform this type of extraction. The term in this case refers more to the type and condition of the tooth: The tooth roots are relatively straight and reside in the bone at an accessible angle. There are otherwise no meaningful impediments to removing it straight out.

The idea of “pulling a tooth” out of the jaw isn't the most accurate way to describe the procedure. A tooth is actually held in place within its bony socket by the periodontal ligament, a tough, elastic tissue between the tooth root and the bone that attaches to both through tiny fibrous extensions. The best method is to first loosen the tooth from the ligament's tiny attachments, for which experienced dentists can develop a certain feel. Once released from the ligament, the tooth will usually come free easily from its socket.

Not all teeth, though, can be removed in this manner. Teeth with multiple roots like back molars, and without a straight trajectory out of the socket, can have a complicated removal. Other dental conditions could also prove problematic for simple extraction, such as brittle roots that might fragment during removal.

For these and other complications, your general dentist may refer you to an oral surgeon for the tooth extraction. But even with the surgical component, these more complicated extractions are relatively minor and routine—millions of wisdom teeth, for example, are removed every year in this manner.

If you have a tooth that needs to be removed due to disease or injury, your dentist will first determine the best way to remove it and will refer you, if necessary, for surgical extraction. And whatever kind of extraction you undergo, the dentist performing it will make sure you remain pain-free during the procedure.

While tooth preservation is usually the best course for long-term dental health, it's sometimes best to remove a tooth. If that should happen, your dentist will make sure it's done with as little discomfort to you as possible.

If you would like more information on dental extraction methods, 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 “Simple Tooth Extraction?

By Ely M. Lun-Chial, DDS
February 22, 2020
Category: Oral Health
Tags: oral hygiene  
ItsBesttoAvoidThisOnlineTrendforYourEnamelsSake

The Internet is truly amazing: It takes only a few seconds to tap into a vast store of knowledge to find information that once took people hours or days. But amidst all that helpful data, there's also some not so helpful information—in fact, some can be downright harmful, including to your dental health.

One particular Internet trend is brushing teeth with black, gooey substances containing activated charcoal. Scores of online videos featuring people doing this are getting viral views, perhaps more for the “gross” factor than the claimed health benefits.

So, why do it? Advocates of using activated charcoal for oral hygiene claim the ingredient kills harmful microorganisms in your mouth. The charcoal is also supposed to whiten your teeth.

But clinical studies of the practice, including one recently published in the Journal of the American Dental Association have been unable to substantiate these claims. There's simply no evidence that activated charcoal does what its advocates say it can do.

Unfortunately, there is evidence the practice can actually harm your teeth. This is because activated charcoal is an abrasive substance that over time could damage your teeth's enamel. Eroded enamel doesn't regrow, so eventually the more vulnerable dentin, the tooth layer just beneath the protective enamel, becomes exposed. It's not only darker and less attractive than enamel, its more susceptible to tooth decay and cavities.

The best way to care for your teeth, brushing and flossing daily, may seem boring compared to videos of brushing with charcoal, but it is effective—and safe. You should also see your dentist for more thorough cleanings at least every six months to round out your dental care.

And if you want a brighter smile, your dentist can perform a tooth whitening procedure that can give you months or even years of satisfaction. Professional tooth whitening (or even home whitening kits applied properly) also won't harm your enamel.

If you would like more information on the best ways to clean and care for your teeth and gums, please contact us or schedule an appointment for a consultation.

By Ely M. Lun-Chial, DDS
February 12, 2020
Category: Oral Health
4ThingstoDotoKeepYourChildsDentalDevelopmentonTrack

When you’re expecting a new baby, there’s a lot to prepare: outfitting the nursery, stocking up on diapers or choosing a pediatrician. It’s also not too early to consider how to protect your new child’s dental development.

From birth through adolescence, a child’s mouth goes through a whirlwind of growth. Hopefully, it all follows a normal track, but detours can arise like tooth decay or bite problems.

Here are 4 things you can do to keep your child’s dental development on track.

Start oral hygiene before teeth. Daily oral hygiene is essential toward helping your child avoid tooth decay. And don’t wait for teeth to come in—begin wiping their gums with a clean, damp cloth right after nursing. When teeth do appear, switch to brushing with just a smear of toothpaste and then add flossing as more teeth come in.

Begin regular dental visits. The American Dental Association recommends pediatric dental visits around the first birthday. The possibility of tooth decay becomes a concern around this time as the primary teeth are steadily erupting. Starting earlier rather than later may also help your child adjust to the routine of dental visits that they’ll most likely carry on as they get older.

Control their sugar consumption. Because sugar is a prime food source for disease-causing bacteria, you should keep your child’s sugar consumption as controlled as possible. For example, don’t put a baby to bed with a bottle filled with a sugary liquid (including juice and breast milk)—the constant presence of the liquid during nap time encourages bacterial growth and acid production.

Get an orthodontic evaluation. While we often associate orthodontic treatment with the teen years, it may be possible to head off bite problems earlier. So, see an orthodontist for a bite evaluation when your child is around age 6. If there are signs of a developing problem, certain techniques could help stop or slow them from getting worse, helping you avoid extensive and expensive treatment later.

With a newborn coming, you and your family have a lot on your plate. Be sure, though, not to forget making plans for keeping their teeth and gums healthy.

If you would like more information on dental care for your child, 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.”





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