Posts for: February, 2019
There are an assortment of techniques and treatments in an orthodontist's toolkit, braces being the most common and best known. Of course, there wouldn't be any tools at all if teeth couldn't move naturally.
Teeth aren't directly connected to the jawbone. An elastic tissue called the periodontal ligament lies between each one, with tiny fibers attaching to the tooth on one side and to the bone on the other. The ligament's elasticity and other qualities allow micro-movements of the teeth as we bite.
The ligament can also adapt to changes in the mouth and teeth by allowing the teeth to move to different positions. That's the basic concept behind braces: we thread a thin wire through brackets attached to the teeth, which we then attach to anchor points (usually back teeth not intended to move) and apply tension to it. Gradually over time, the target teeth move.
But what if your malocclusion (poor bite) is more complicated or the back teeth can't supply enough anchorage for moving the intended teeth? That's where we take advantage of other sources of anchorage.
One such source is the patient's skull, which we can make use of through special headgear worn a few hours a day. The device consists of a strap under tension that runs around the back of the head or neck to a wire housing attached to brackets on the target teeth. If you want to “pull” the teeth forward, the strap would come over the chin, forehead or a combination of both.
We may sometimes want to isolate some teeth to move without moving nearby teeth, such as moving front teeth backward to close a space without affecting teeth further to the rear. We can create a separate anchor point in the jaw with a TAD or temporary anchorage device.
TADs are tiny screws made of stainless steel inserted temporarily into the bone. We loop an elastic band over the TAD on one end and to a bracket or tension wire attached to the target teeth on the other. When we've achieved the teeth's new position we can easily remove the TAD from the bone.
These various tools make it possible to correct difficult or complex malocclusions. They may not always look attractive, but they'll help ensure the final result is.
If you would like more information on available 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 “Orthodontic Headgear & Other Anchorage Appliances.”
Wearing orthodontic braces brings challenges to daily life. During treatment a patient will need to avoid certain foods and habits, take more time to brush and floss properly, and may endure occasional discomfort. But the effect of metal braces on appearance can be especially difficult, especially for peer-conscious teens.
Clear aligners, though, offer an alternative to braces that could make some of these challenges easier, particularly with your appearance. Aligners are clear plastic trays that fit over the teeth to move them. They can be removed by the wearer for easier brushing and flossing or for special occasions. Best of all, they're much less noticeable than metal braces.
Clear aligners were developed thanks to advances in digital technology. An orthodontist uses a computer application incorporating the data from photographs, x-rays or CT scans of a patient's teeth and jaws to produce a series of clear plastic trays. The patient then wears each tray for about two weeks before changing to the next tray in the sequence.
The trays apply pressure much like metal braces to gradually move teeth to the desired position on the jaw. Each tray is slightly smaller in size than the previous tray in the sequence, so that the progression of tooth movement continues with each succeeding tray. The treatment time is about the same as with conventional braces.
This new orthodontic tool works well for many common bite problems, but until recently they've been limited in scope. But new designs in trays and attachments called buttons added to teeth to provide more leverage have greatly increased their use for more complex bite issues.
Clear aligners also have one other disadvantage, ironically due to one of their principal benefits, removability. Although they can be taken out, they must be worn consistently to achieve results. Some younger patients may not have the maturity level and discipline to responsibly wear their aligners as they should.
That's one issue you'll need to discuss with your orthodontist if you're considering clear aligners for your teen. But if they can maintain wearing consistency, and they have a bite problem that can be corrected with aligners, both you and your teen may find this choice more agreeable and attractive than braces.
If you would like more information on clear aligners, 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 “Clear Aligners for Teens.”
A root canal treatment is a common procedure performed by dentists and endodontists (specialists for inner tooth problems). If you're about to undergo this tooth-saving procedure, here's what you need to know.
The goal of a root canal treatment is to stop tooth decay within a tooth's interior and minimize any damage to the tooth and underlying bone. This is done by accessing the tooth's pulp and root canals (tiny passageways traveling through the tooth roots to the bone) by drilling into the biting surface of a back tooth or the "tongue" side of a front tooth.
First, though, we numb the tooth and surrounding area with local anesthesia so you won't feel any pain during the procedure. We'll also place a small sheet of vinyl or rubber called a dental dam that isolates the affected tooth from other teeth to minimize the spread of infection.
After gaining access inside the tooth we use special instruments to remove all of the diseased tissue, often with the help of a dental microscope to view the interior of tiny root canals. Once the pulp and root canals have been cleared, we'll flush the empty spaces with an antibacterial solution.
After any required reshaping, we'll fill the pulp chamber and root canals with a special filling called gutta-percha. This rubberlike, biocompatible substance conforms easily to the shape of these inner tooth structures. The filling preserves the tooth from future infection, with the added protection of adhesive cement to seal it in.
Afterward, you may have a few days of soreness that's often manageable with mild pain relievers. You'll return for a follow-up visit and possibly a more permanent filling for the access hole. It's also likely you'll receive a permanent crown for the tooth to restore it and further protect it from future fracture.
Without this vital treatment, you could very well lose your tooth to the ravages of decay. The time and any minor discomfort you may experience are well worth the outcome.
If you would like more information on treating tooth decay, 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 “Root Canal Treatment: What You Need to Know.”