“Orthodontic treatment” and “braces” almost seem like synonymous terms. But while braces certainly are orthodontic, it isn't the only tool in an orthodontist's toolkit.
A good example is a device is known as a Herbst appliance. It's used in situations where the upper jaw is outpacing the growth and development of the lower jaw during childhood. If not corrected, this could cause the top teeth to protrude abnormally beyond the lower teeth.
The Herbst appliance gently and gradually coaxes the lower jaw to grow in a more forward direction, thus “catching up” with the upper jaw. The top part of the device consists of two metal tubes hinged to small elastic bands, which are cemented to the cheek side of the upper back teeth (molars), one on either side of the jaw.
Two smaller tubes are attached in like fashion to the lower teeth, and then inserted into the larger tubes. As the lower jaw moves, the smaller tubes move within the larger to create pressure that gently pushes the jaw forward. Over time, this can sync the growth progress of both the upper and lower jaws, and reduce the chances of a poor bite.
For best results, a Herbst appliance is usually placed to coincide with a child's most rapid period of jaw growth, usually between 11 and 14. They could be placed as early as 8 or 9, however, in situations where the front teeth are already protruding well beyond the lips. In any event, the goal is to positively influence the growth of the lower jaw to alleviate or at least minimize the need for future orthodontic treatment.
As a fixed device, there's no need for a child or parent to tend to it as with other methods, like orthodontic headwear worn in conjunction with braces. A Herbst appliance can, however, alter the normal sensations associated with eating, swallowing and speaking, which may take a little adjustment time for the child. Wearers will also need to be extra vigilant with daily brushing and flossing because of a higher risk of tooth decay.
These, though, are minor inconveniences compared with the benefit of improved bite development. As such, a Herbst appliance could be a positive investment in your child's dental future.
If you would like more information on interceptive orthodontics, 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 “The Herbst Appliance.”
Your tooth enamel is often under assault from oral acid produced by bacteria and certain foods. Unless neutralized, acid can erode your enamel, and lead to destructive tooth decay.
But there's another type of acid that may be even more destructive—the acid produced in your stomach. Although important for food digestion, stomach acid outside of its normal environment can be destructive. That includes your teeth, if stomach acid finds its way into your mouth. And that can happen if you have gastroesophageal reflux disease (GERD).
GERD, a chronic condition affecting 1 in 5 adults, is caused by the weakening of the lower esophageal sphincter, a ring of muscle at the intersection of the esophagus and the stomach that prevents stomach acid from traveling back into the digestive tract and damaging the esophageal liner.
It's also possible for stomach acid to travel as far up as the mouth. With a pH of 2.0 or less, stomach acid can lower the mouth's normal pH level of 7.0 well below the 5.5 pH threshold for enamel softening and erosion. This can cause your teeth, primarily the inside surfaces of the upper teeth, to become thin, pitted or yellowed. Your teeth's sensitivity may also increase.
If you have GERD, you can take precautions to avoid tooth damage and the extensive dental work that may follow.
- Boost acid buffering by rinsing with water (or a cup of water mixed with a ½ teaspoon of baking soda) or chewing on an antacid tablet.
- Wait about an hour to brush your teeth following a reflux episode so that your saliva has time to neutralize acid and re-mineralize enamel.
- If you have chronic dry mouth, stimulate saliva production by drinking more water, chewing xylitol gum or using a saliva supplement.
You can also seek to minimize GERD by avoiding tobacco and limiting your consumption of alcohol, caffeine or spicy and acidic foods. Your doctor may also prescribe medication to control your GERD symptoms.
Preventing tooth decay or gum disease from the normal occurrences of oral acid is a daily hygiene battle. Don't let GERD-related acid add to the burden.
If you would like more information on protecting your teeth from acid reflux, 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 “GERD and Oral Health.”
Osteoporosis is a serious bone weakening disease in older adults that can turn a minor fall into a major bone fracture. But the condition could also impact dental treatment—triggered ironically by the drugs used to treat osteoporosis rather than the disease itself.
From the Latin for “porous bone,” osteoporosis causes bone to gradually lose mineral structure. Over time the naturally-occurring spaces between mineralized portions of the bone enlarge, leaving it weaker as a result.
Although there's no definitive cure for osteoporosis, a number of drugs developed over the last couple of decades can inhibit its progress. Most fall into two major categories, bisphosphonates and RANKL inhibitors.
These drugs work by inhibiting the normal growth cycle of bone. Living bone constantly changes as cells called osteoblasts produce new bone. A different type, osteoclasts, clear away older bone to make room for these newer cells. The drugs selectively destroy osteoclasts so that the older bone, which would have been removed by them, remains for a longer period of time.
Retaining older cells longer initially slows the disease process. But there is a downside: in time, this older bone kept in place continues to weaken and lose vitality. In rare instances it may eventually become detached from its blood supply and die, resulting in what is known as osteonecrosis.
Osteonecrosis mostly affects two particular bones in the body: the femur (the long bone in the upper leg) and the jawbone. In regard to the latter, even the stress of chewing could cause osteonecrosis in someone being treated for osteoporosis. It can also occur after tooth extractions or similar invasive procedures.
If you're taking a bisphosphonate or RANKL inhibitor, you'll want to inform your dentist so that the necessary precautions can be taken before undergoing dental work more invasive than routine cleanings or getting a filling or crown. If you need major dental work, your dentist or you will also need to speak with your physician about stopping the drug for a few months before and after a dental procedure to minimize the risk of osteonecrosis.
Fortunately, the risk for dental problems while undergoing treatment for osteoporosis is fairly low. Still, you'll want to be as prepared as possible so that the management of your osteoporosis doesn't harm your dental health.
If you would like more information on osteoporosis and dental health, 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 “Osteoporosis Drugs & Dental Treatment.”
Do you remember your first new car? It purred like a kitten with a brilliant finish you could see a mile away. And my, oh my, the attention you gave it: cleaning, polishing, regularly checking the fluids and other maintenance. That's what comes with pride of ownership—and it's an equally fitting attitude to have with your mouth.
World Oral Health Day is a great opportunity this month to renew your care for your mouth and its primary inhabitants, your teeth and gums. This March 20th, the FDI World Dental Federation wants you to “Be Proud of Your Mouth” for all it makes possible in your life: helping you eat, helping you speak and, of no lesser importance, helping you smile.
So how can you show pride in your mouth?
Keep it clean. Brushing and flossing are the two most important tasks you can do to prevent dental disease and ensure a healthy mouth. It takes only five minutes a day to clear away accumulated dental plaque, a thin film of bacteria most responsible for destructive tooth decay and gum disease. The only catch? To get the most from your oral hygiene efforts, you'll need to brush and floss every day, rain or shine.
Keep it fed. The food your teeth help you eat also benefits them—if they're the right foods. Fresh fruits and vegetables, proteins and dairy items like milk or cheese all contain vitamins and minerals that strengthen teeth against disease. On the flip side, there are foods you should avoid, particularly processed foods and snacks containing added sugar. Sugar feeds the oral bacteria that causes disease.
Keep it maintained. Routine dental visits are just as important for your mouth as routine mechanic visits are for your car. During these regular visits, we'll thoroughly clean your teeth of any missed plaque, especially a hardened version called tartar. It's also a time for us to look more closely at your teeth and gums to uncover any emerging problems that require treatment.
With a little time, effort and discipline, you can protect your teeth and gums from disease, and help them to be as healthy as they can be. The dividends will spill over into the rest of your life, with additional benefits for your physical, mental and social well-being. A healthy mouth is vital to a healthy life.
So, take pride in your mouth and make a commitment today to care for it. And if you haven't seen us in a while, an appointment for a dental cleaning and checkup could be your best move toward healthier teeth and gums.
If you would like more information about best dental care practices, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Daily Oral Hygiene” and “Dental Hygiene Visit.”
Enamel is the hardest substance in the human body, and for good reason—it's your teeth's first line of defense against wearing and harmful oral bacteria. But although enamel can “take a licking and keep on ticking,” it can lose its mineral content, soften and eventually erode to expose the teeth to bacteria.
Here are 4 tips for protecting your enamel so it keeps on protecting you.
Practice sound brushing techniques. Brushing is necessary for removing bacterial plaque that can trigger dental disease. But how you brush could prove not only ineffective, but also harmful to your enamel. So, be sure you're brushing all tooth surfaces, but not too forcefully or too often (twice a day is enough)—otherwise, you could wear down enamel and damage your gums.
Wait to brush after eating. The acid levels in the mouth go up during eating, causing an immediate softening of enamel. But saliva then goes to work neutralizing acid and helping to restore enamel's mineral content. Since it takes saliva about thirty minutes to an hour to complete this task, wait on brushing at least that long. Otherwise, you might remove tiny traces of temporarily softened enamel.
Avoid eating right before bed. While we sleep, our saliva flow decreases until we wake up. If you eat just before bed, you may not be giving your saliva enough time to neutralize acid before it “goes to sleep” with you for the night. So, give your saliva ample time to neutralize any remaining acid by not eating anymore at least an hour before you turn in.
Limit drinking acidic beverages. Some of our favorite drinks—sodas, energy and sports drinks, and even some juices—can be high in acid. To protect your enamel, reduce your consumption of these types of beverages in favor of water or milk (the calcium in the latter will also benefit your enamel). When you do drink acidic beverages, use a straw to minimize contact of the fluid with your enamel.
Healthy and strong enamel is the key to healthy and strong teeth. It's worth taking these steps to protect this important defense against destructive tooth decay.
If you would like more information on personal dental care, 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 “6 Tips to Help Prevent the Erosion of Tooth Enamel.”
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