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.”
What makes an attractive smile? Of course, shiny, straight and defect-free teeth are a big factor. But there’s another equally important element: all your teeth have come in.
Sometimes, though, they don’t: one or more teeth may remain up in the gums, a condition known as impaction. And if they’re in the front like the upper canines (the pointed teeth on either side of the front four incisors) your smile’s natural balance and symmetry can suffer.
Impaction usually happens due to lack of space on a small jaw. Previously erupted teeth crowd into the space of teeth yet to come in, preventing them from doing so. As a result the latter remain hidden within the gums.
While impaction can interfere with the smile appearance, it can cause health problems too. Impacted teeth are at higher risk for abscesses (localized areas of infection) and can damage the roots of other teeth they may be pressing against. That’s why it’s desirable for both form and function to treat them.
We begin first with an orthodontic examination to fully assess the situation. At some point we’ll want to pinpoint the impacted teeth’s precise location and position. While x-rays are useful for locating impacted teeth, many specialists use cone beam CT (CBCT) technology that produces highly detailed three-dimensional images viewable from different vantage points.
If the tooth is in too extreme a position, it might be best to remove it and later replace it with a dental impact or similar restoration once we’ve completed other necessary orthodontic treatment. But if the tooth is in a reasonable position, we might be able to “move” the tooth into its proper place in the jaw in coordination with these other tooth-movement efforts to make room for it.
To begin this process, an oral surgeon or periodontist surgically exposes the tooth crown (the normally visible portion) through the gums. They then bond a small bracket to the crown and attach a small gold chain. An orthodontist will attach the other end to orthodontic hardware that will exert downward pressure on the tooth to gradually bring it into normal position.
Dealing with impacted teeth of this nature is often part of a comprehensive effort to correct the bite. If we’re successful, it could permanently transform both the smile and overall dental health.
If you would like more information on treating impacted teeth, 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 “Exposing Impacted Canines.”
While it may not be one of your favorite features in the dental office, the dental drill is nevertheless necessary for treating problem teeth. It’s used primarily for removing decayed or damaged structure and preparing a tooth for fillings or other restorations.
Dental drills have been used for decades and are quite effective — but they have their drawbacks. Their rotating burrs often remove portions of healthy tooth structure along with decayed material. Friction from the drill action can cause discomfort, so local anesthesia is usually needed. Drills can also emit a high-pitched machine noise that’s unsettling to many patients.
There’s a growing alternative to the drill, known as air abrasion. Although the technology has been around since the 1950s, the development of new suction pumps that capture the resulting dust from its use has made it more palatable as an option to the traditional drill.
Also known as particle abrasion, the technique uses a pressurized stream of fine particles (usually aluminum oxide, an abrasive powder) directed at teeth to wear away (abrade) the tooth’s structural surface. We can be quite precise in the amount of surface material removed, so it’s useful for diminishing stains or roughing the surface for bonding materials like composite resin. We’re also able to remove decayed material with very little impact on surrounding healthy structure, and you may not need anesthesia during the procedure.
While this quiet alternative to the noisier drill is quite versatile, it does have its limitations. It’s not that efficient for preparing larger cavities for restoration or for removing older amalgam fillings. The teeth to be treated must be carefully isolated to prevent the fine particle dust produced from being swallowed by the patient or spread into the air. High-volume suction equipment is a must or the procedure will create a “sandstorm” of particles in the room.
Still, for situations suited to it and with proper isolation measures, air abrasion can be effective and comfortable. If the technology continues to improve, the dental drill may soon become a relic of the past.
If you would like more information on procedures using air abrasion, 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 “Air Abrasion Technology.”
Teething is a normal part of your baby’s dental development. That doesn’t make it less stressful, though, for you or your baby.
This natural process occurs as your child’s primary teeth sequentially erupt through the gums over a period of two or three years. The first are usually the two lower front teeth followed by the two upper front ones, beginning (give or take a couple of months) between six and nine months. By the age of three, most children have all twenty of their primary teeth.
The disruption to the gum tissues can cause a number of unpleasant side effects including gum swelling, facial rash, drooling, disrupted sleep patterns and decreased appetite. As a result a child can become irritable, bite and gnaw to relieve gum discomfort or rub their ears. Every child’s experience is different as well as their degree of pain and discomfort.
As a tooth is about to erupt, you may notice symptoms increasing a few days before and after. The symptoms will then subside until the next tooth begins to erupt. In a way, teething is much like a storm—you mostly have to ride it out. However, that doesn’t mean you can’t lessen your child’s discomfort during the teething episode.
For one thing, cold, soft items like teething rings, pacifiers or even a clean, wet washcloth your child can gnaw on will help relieve gum pressure. Chilling the item can have a pain-numbing effect—but avoid freezing temperatures, which can burn the tissues. You can also massage the gums with a clean finger to relieve pain. But don’t rub alcohol on their gums and only use numbing agents (like Benzocaine) for children older than two, and only with the advice and supervision of your healthcare provider. The use of acetaminophen or ibuprofen might also be used under the advice of your doctor.
If you notice your child has diarrhea, extensive rashes or fever, contact your physician immediately—these aren’t normal teething symptoms and may indicate something more serious. And be sure to consult with us if you have any other questions or concerns.
Teething can be a difficult time for your baby and family. But with these tips and a little “TLC” you can keep their discomfort to a minimum.
If you would like more information on caring for your baby’s developing teeth, 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 “Teething Troubles: How to Help Your Baby be Comfortable.”
It's no secret that many of Hollywood's brightest stars didn't start out with perfectly aligned, pearly-white teeth. And these days, plenty of celebs are willing to share their stories, showing how dentists help those megawatt smiles shine. In a recent interview with W magazine, Emma Stone, the stunning 28-year-old star of critically-acclaimed films like La La Land and Birdman, explained how orthodontic appliances helped her overcome problems caused by a harmful habit: persistent thumb sucking in childhood.
“I sucked my thumb until I was 11 years old,” she admitted, mischievously adding “It's still so soothing to do it.” Although it may have been comforting, the habit spelled trouble for her bite. “The roof of my mouth is so high-pitched that I had this huge overbite,” she said. “I got this gate when I was in second grade… I had braces, and then they put a gate.”
While her technical terminology isn't quite accurate, Stone is referring to a type of appliance worn in the mouth which dentists call a “tongue crib” or “thumb/finger appliance.” The purpose of these devices is to stop children from engaging in “parafunctional habits” — that is, behaviors like thumb sucking or tongue thrusting, which are unrelated to the normal function of the mouth and can cause serious bite problems. (Other parafunctional habits include nail biting, pencil chewing and teeth grinding.)
When kids develop the habit of regularly pushing the tongue against the front teeth (tongue thrusting) or sucking on an object placed inside the mouth (thumb sucking), the behavior can cause the front teeth to be pushed out of alignment. When the top teeth move forward, the condition is commonly referred to as an overbite. In some cases a more serious situation called an “open bite” may develop, which can be difficult to correct. Here, the top and bottom front teeth do not meet or overlap when the mouth is closed; instead, a vertical gap is left in between.
Orthodontic appliances are often recommended to stop harmful oral habits from causing further misalignment. Most appliances are designed with a block (or gate) that prevents the tongue or finger from pushing on the teeth; this is what the actress mentioned. Normally, when the appliance is worn for a period of months it can be expected to modify the child's behavior. Once the habit has been broken, other appliances like traditional braces or clear aligners can be used to bring the teeth into better alignment.
But in Stone's case, things didn't go so smoothly. “I'd take the gate down and suck my thumb underneath the mouth appliance,” she admitted, “because I was totally ignoring the rule to not suck your thumb while you're trying to straighten out your teeth.” That rule-breaking ended up costing the aspiring star lots of time: she spent a total of 7 years wearing braces.
Fortunately, things worked out for the best for Emma Stone: She now has a brilliant smile and a stellar career — plus a shiny new Golden Globe award! Does your child have a thumb sucking problem or another harmful oral habit? For more information about how to correct it, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”
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