Other than tooth decay, children don't encounter dental disease to the extent adults do. But injuries are another story: More than 5 million teeth are knocked loose each year, and a high percentage involve children. Roughly a third of these and similar children's injuries are sports-related.
April is National Facial Protection Month: Several oral and facial health organizations, including the American Association of Orthodontists, have joined together to raise awareness about the risks of injury to the face and mouth, especially among children. Many of these injuries have long-term consequences with lifetime treatment costs in the thousands of dollars.
But as the name implies, this awareness month is also about protection—what you can do to help your child avoid a costly and devastating dental injury. Top of the list: Have your child wear an athletic mouthguard during all contact sports activities (including practices).
The National Federation of State High School Associations mandates mouthguard wear for football, lacrosse, and ice and field hockey. But those aren't the only sporting activities where a mouthguard should be standard equipment: In fact, basketball has more orofacial injuries each year than any other sport. Generally, mouthguards should be worn for any sports activity that involves potential contact with other players or objects.
There is a variety of mouthguard choices, but most fall into two basic categories, “boil and bite” and custom-made. The former, readily available in retail sports stores, get their name from the procedure employed when first purchased to adjust their fit to an individual player. Out of the package, they should be soaked in hot or boiling water until softened, and then placed in the wearer's mouth to bite down on. After they cool, they'll retain that bite pattern.
Boil and bite guards are relatively inexpensive, but the fit isn't as precise as a mouthguard that is custom-made by a dentist. This can lead to comfort issues—and players are less likely to wear an uncomfortable mouthguard.
Custom mouthguards, on the other hand, have a more accurate fit, allowing them to be thinner and more comfortable. They also provide the highest level of protection against blows to the face and mouth. These are more costly than boil and bite guards, and younger athletes may need a replacement every few years to accommodate jaw growth development. But compared to the physical, emotional and financial cost of a dental injury, custom mouthguards are worth the investment.
A mouth or face injury can happen in an instant and result in damage that can have lingering effects for years. For the best protection, see that your star athlete has and wears a custom mouthguard.
Many things can affect your child’s future dental health: oral hygiene, diet, or habits like thumb sucking or teeth grinding. But there’s one you might not have considered: how they breathe.
Specifically, we mean whether they breathe primarily through their mouth rather than through their nose. The latter could have an adverse impact on both oral and general health. If you’ve noticed your child snoring, their mouth falling open while awake and at rest, fatigue or irritability you should seek definite diagnosis and treatment.
Chronic mouth breathing can cause dry mouth, which in turn increases the risk of dental disease. It deprives the body of air filtration (which occurs with nose breathing) that reduces possible allergens. There’s also a reduction in nitric oxide production, stimulated by nose breathing, which benefits overall health.
Mouth breathing could also hurt your child’s jaw structure development. When breathing through the nose, a child’s tongue rests on the palate (roof of the mouth). This allows it to become a mold for the palate and upper jaw to form around. Conversely with mouth breathers the tongue rests behind the bottom teeth, which deprives the developing upper jaw of its tongue mold.
The general reason why a person breathes through the mouth is because breathing through the nose is uncomfortable or difficult. This difficulty, though, could arise for a number of reasons: allergy problems, for example, or enlarged tonsils or adenoids pressing against the nasal cavity and interfering with breathing. Abnormal tissue growth could also obstruct the tongue or lip during breathing.
Treatment for mouth breathing will depend on its particular cause. For example, problems with tonsils and adenoids and sinuses are often treated by an Ear, Nose and Throat (ENT) specialist. Cases where the mandible (upper jaw and palate) has developed too narrowly due to mouth breathing may require an orthodontist to apply a palatal expander, which gradually widens the jaw. The latter treatment could also influence the airway size, further making it easier to breathe through the nose.
The best time for many of these treatments is early in a child’s growth development. So to avoid long-term issues with facial structure and overall dental health, you should see your dentist as soon as possible if you suspect mouth breathing.
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?”
The movie Bohemian Rhapsody celebrates the iconic rock band Queen and its legendary lead vocalist, Freddie Mercury. But when we see pictures of the flamboyant singer, many fans both old and new may wonder—what made Freddie’s toothy smile look the way it did? Here’s the answer: The singer was born with four extra teeth at the back of his mouth, which caused his front teeth to be pushed forward, giving him a noticeable overbite.
The presence of extra teeth—more than 20 primary (baby) teeth or 32 adult teeth—is a relatively rare condition called hyperdontia. Sometimes this condition causes no trouble, and an extra tooth (or two) isn’t even recognized until the person has an oral examination. In other situations, hyperdontia can create problems in the mouth such as crowding, malocclusion (bad bite) and periodontal disease. That’s when treatment may be recommended.
Exactly what kind of treatment is needed? There’s a different answer for each individual, but in many cases the problem can be successfully resolved with tooth extraction (removal) and orthodontic treatment (such as braces). Some people may be concerned about having teeth removed, whether it’s for this problem or another issue. But in skilled hands, this procedure is routine and relatively painless.
Teeth aren’t set rigidly in the jawbone like posts in cement—they are actually held in place dynamically by a fibrous membrane called the periodontal ligament. With careful manipulation of the tooth, these fibers can be dislodged and the tooth can be easily extracted. Of course, you won’t feel this happening because extraction is done under anesthesia (often via a numbing shot). In addition, you may be given a sedative or anti-anxiety medication to help you relax during the procedure.
After extraction, some bone grafting material may be placed in the tooth socket and gauze may be applied to control bleeding; sutures (stitches) are sometimes used as well. You’ll receive instructions on medication and post-extraction care before you go home. While you will probably feel discomfort in the area right after the procedure, in a week or so the healing process will be well underway.
Sometimes, dental problems like hyperdontia need immediate treatment because they can negatively affect your overall health; at other times, the issue may be mainly cosmetic. Freddie Mercury declined treatment because he was afraid dental work might interfere with his vocal range. But the decision to change the way your smile looks is up to you; after an examination, we can help you determine what treatment options are appropriate for your own situation.
If you have questions about tooth extraction or orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Simple Tooth Extraction” and “The Magic of Orthodontics.”
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.”
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