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Posts for: May, 2021

DrawingImpactedTeethOutoftheGumsCouldHelpNormalizeaSmile

We instinctively know when a smile looks normal—and when it doesn't. It could be that something simply looks out of place like crooked teeth. But we might also notice when something is missing—as with one or both of the canine teeth.

The canine teeth align just under the eyes and are recognizable by their pointed ends. When they're missing, the smile looks “incomplete.” But “missing” in this case could mean “invisible”—the teeth are there, but hidden within the gums because they failed to come in properly and became impacted. This often happens on a smaller jaw where other teeth have crowded into the space intended for them.

Fortunately, we may have a remedy, and not just for appearance's sake—any impacted tooth can cause health problems, from gum abscesses to root damage of neighboring teeth. Although this might necessitate their surgical removal, we might also be able to coax them through the gums into better position in the jaw, if they're in a reasonably good position. This could result in both a boost to a patient's oral health and a more normal looking smile.

First, though, a patient will need to undergo a thorough bite evaluation by an orthodontist. Besides pinpointing the impacted teeth's precise location with x-rays or CT technology, an orthodontist will also want to assess the positions and condition of the rest of the teeth. If the conditions are right and there's enough room in the jaw, the orthodontist may recommend drawing the impacted canines into proper alignment in the jaw.

The process starts when an oral surgeon exposes the impacted teeth by surgically cutting through the gum tissue. They then attach a small bracket to the tooth with a tiny metal chain attached, the other end of which is looped over orthodontic hardware attached to other teeth. The tension on the chain by the hardware gradually nudges the teeth downward out of the gums. This is usually done in coordination with other measures to fully correct the bite.

If the procedure is successful, bringing the canines out of impaction reduces the problems those teeth could cause the person's oral health. But just as important, it can restore normality to their smile.

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.”


By Nathan Gelder DMD
May 18, 2021
Category: Oral Health
Tags: tooth decay  
WhatYouCanDoToHelpYourChildAvoidToothDecay

So, when should you begin taking measures to prevent tooth decay in your child's teeth? When their teeth first begin to show? When all of their primary (baby) teeth are in? Or, wait until their permanent teeth begin erupting?

Actually, tooth decay can be a problem as early as two months of age, before a child's first tooth even comes in. In essence, then, dental disease prevention should be on your radar soon after your child is born. Here's what you can do to prevent the damage of tooth decay to their teeth now and its impact on their dental health in the future.

Start oral hygiene during nursing. Brushing and flossing are lifetime habits that reduce the risk of dental disease. When your children are young, you'll have to perform these tasks for them, ultimately training them to perform them on their own. But even earlier, before their first tooth, you'll want to clean their gums after feedings with a wet cloth to reduce disease-causing bacteria.

Initiate dental visits by age 1. It's appropriate on or before their first birthday, when most children already have a few primary teeth, to begin regular dental visits for cleanings and checkups. Seeing the dentist every six months at an early age will help your child stay well ahead of tooth decay. And starting visits early increases the likelihood it will become a regular part of their lives into adulthood.

Protect against decay. You and your dentist are partners in protecting your child from dental disease. Besides daily oral hygiene, you can also help by providing a dental-friendly diet, and especially restricting sugary snacks and avoiding sweetened liquids in bedtime bottles (including breast milk or formula). In addition to routine care, your dentist can also provide other measures to fight decay, like sealants or topical fluoride.

It's also important for you to set an example for your child to follow. Children soak up what's important to their parents—in this case, watching you take care of your teeth and seeing the dentist as a friend and ally against dental disease. That's your end goal: preventing dental disease now, and instilling the value of dental care that will last your child a lifetime.

If you would like more information on helping your child avoid 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 “Taking the Stress Out of Dentistry for Kids.”


SedationCanHelpanAnxiousChildRelaxDuringDentalTreatment

There are different ways to ease a child's potential nervousness with dental visits, like starting those visits around their first birthday or seeing a pediatric dentist who specializes in children. But even doing those things won't guarantee your child won't develop some form of dental anxiety, which could complicate their dental care.

To help make appointments easier for anxious children, many dentists use conscious sedation as a means of helping them relax. With this technique, the dentist administers a mild sedative to the child to take the edge off their nervousness, while allowing them to remain awake during treatment.

Sedation isn't anesthesia, the means we use to stop pain during treatment (although sedation may be used with anesthesia). Rather, sedation reduces emotional fear and anxiety. And unlike general anesthesia, a sedated child can still breathe without assistance and, depending on the depth of the sedation, respond to physical and verbal stimuli.

In most cases, children are administered sedation medications by mouth, usually as a syrup, although on occasion it might be delivered intravenously with an IV. The dose is usually given some time before their treatment session after the dentist has evaluated them. Dentists mostly use mild sedatives like Midazolam or Hydroxyzine with very little risk of side effects for children.

During the procedure, a designated staff member continually monitors the child's vital signs. Besides heart rate, pulse and respirations, they may also check the child's exhaled carbon dioxide levels to ensure they're breathing normally.

After the treatment session is over, staff will continue to monitor the child until their vital signs return to pre-sedation levels. If the child is of driving age, they'll need someone to drive them home. Children who've been sedated should remain home for the rest of the day, but they can usually return to school the next day depending on what kind of dental work they've undergone.

Dentists follow strict protocols for pediatric sedation adopted by the American Academy of Pediatrics, the American Dental Society, and the American Academy of Pediatric Dentistry. In addition, many states have also established processes for administering sedation therapy. It's a safe and effective method to ease a child's anxiety over their dental visit.

If you would like more information on making dental visits easier for kids, 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 “Sedation Dentistry For Kids.”