Posts for: May, 2018
It’s true — thumb sucking beyond age 4 can cause bite problems for permanent teeth. But prolonged thumb sucking is just one of a number of possible contributing factors for a bad bite (malocclusion). A dentist must identify all the factors involved when a bad bite is present — their involvement is essential for a successful treatment outcome.
A fairly benign habit for infants and toddlers, thumb sucking is related to an “infantile swallowing pattern” young children use by thrusting their tongues forward between the upper and lower teeth when they swallow. Around age 4, though, they usually transition to an adult swallowing pattern in which the tongue rests on the roof of the mouth just behind the front teeth. Thumb sucking stops for most children around the same time.
Thumb sucking beyond this age, though, can put increased pressure on incoming permanent teeth pushing them forward. This could lead to an “open bite” in which the upper and lower teeth don’t meet when the jaws are closed. The tongue may also continue to thrust forward when swallowing to seal the resulting gap, which further reinforces the open bite.
Before treating the bite with braces, we must first address the thumb sucking and improper tongue placement when swallowing — if either isn’t corrected the teeth could gradually revert to their previous positions after the braces come off. Besides behavioral incentives, we can also employ a thin metal appliance called a “tongue crib” placed behind the upper and lower incisors. A tongue crib discourages thumb sucking and makes it more difficult for the tongue to rest within the open bite gap when swallowing, which helps retrain it to a more normal position.
An open bite can also occur if the jaws develop with too much vertical growth. Like thumb sucking and improper tongue placement, abnormal jaw growth could ultimately cause orthodontic treatment to fail. In this case, though, surgery may be necessary to correct the jaw structure.
With all these possible variables, our first step needs to be a thorough orthodontic exam that identifies all the cause factors for your child’s specific malocclusion. Knowing if and how thumb sucking may have contributed to the poor bite will help us design a treatment strategy that’s successful.
If you would like more information on the causes of poor tooth position, 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 “How Thumb Sucking Affects the Bite.”
It’s likely you depend on your regular dentist for the lion’s share of your dental care. But in cases of advanced disease or trauma, you may need the services of a dental specialist.
This could be the case with periodontal (gum) disease, a bacterial infection triggered by a thin biofilm on tooth surfaces called dental plaque that isn’t adequately removed through daily oral hygiene practices. While your regular dentist can effectively treat many forms of gum disease, there are times when you should see a periodontist who specializes in the gum, supporting bone and connective tissues.
So, when should you see a periodontist for gum disease treatment? Here are 3 situations that may call for this important dental specialist.
If your dentist refers you. Your dentist may be quite proficient in treating gum disease, mainly by removing the dental plaque and tartar sustaining the infection. But if the infection has advanced deep within the gum tissues especially around the roots and bone, you may need more advanced measures, including surgery, performed by a periodontist.
If you’d like a second opinion. Of course, you don’t need a referral to see a periodontist. You can make an appointment with one for another opinion about your diagnosis and recommended treatment plan. If you choose to see a periodontist, make sure they have access to all your dental and medical records, as well as your past health history.
If you have other health issues. Gum disease often doesn’t occur in a vacuum – it may exist and even influence (or be influenced by) other inflammatory medical conditions. If you have such a condition like diabetes or cardiovascular disease, you may opt to see a periodontist first for a more comprehensive evaluation.
In the meantime, keep an eye out for the first signs of disease including red, swollen or bleeding gums (if you smoke, be aware smoking hides these signs of disease). And practice daily brushing and flossing as well as obtaining regular dental cleanings to keep plaque accumulation to minimum. Preventing gum disease and getting treatment as early as possible may help you avoid more invasive treatments later.
If you would like more information on treating gum disease, 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 “When to See a Periodontist.”
You brush and floss every day to rid your teeth and gums of disease-causing plaque. But while “showing up” is most of the battle, the effectiveness of your technique will win the war.
So, how good are you at removing plaque? One quick way to find out is the “tongue test”—simply rub your tongue along your teeth: they should feel smooth and “squeaky” clean. Surfaces that feel rough and gritty probably still contain plaque.
For a more thorough evaluation, your dental hygienist may use a product during your regular dental visit called a plaque disclosing agent. It’s a solution applied to your teeth that dyes any bacterial plaque present on tooth surfaces a certain color while leaving clean surfaces un-dyed. The disclosing agent shows you where you’re effectively removing plaque and where you’re not.
These products aren’t exclusive to the dental office—you can use something similar at home if you’d like to know how well you’re doing with your hygiene before your next visit. You can find them over-the-counter as tablets, swabs or solutions. You may even find some that have two dye colors, one that reveals older plaque deposits and the other newer plaque.
You simply follow the product’s directions by first brushing and flossing as usual, then chewing the tablet, daubing the swab on all tooth and gum surfaces, or swishing the solution in your mouth like mouthwash for about 30 seconds before spitting it out. You can then use a mirror to observe any dye staining. Pay attention to patterns: for example, dyed plaque scalloping along the gum line means you’ll need to work your brush a little more in those areas.
The dye could color your gums, lips and tongue as well as your teeth, but it only lasts a few hours. And while plaque disclosing agents are FDA-approved for oral use, you should still check the ingredients for any to which you may be allergic.
All in all, a plaque disclosing agent is a good way to occasionally check the effectiveness of your plaque removal efforts. By improving your technique you may further lower your risk of dental disease.
If you would like more information on learning how effective your oral hygiene really is, 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 “Plaque Disclosing Agents.”