Every year many parents learn their “tweenager” or teenager needs their bite corrected, often with specialized orthodontics. Imagine, though, if these families could go back in time to when their child’s poor bite was just developing to stop or slow it from forming.
Time travel may still be science fiction, but the approach suggested isn’t. It’s called interceptive orthodontics, a group of techniques and procedures performed during the early stages of jaw development. The focus is usually on getting abnormal jaw growth back on track, enough so that a poor bite won’t form.
The upper jaw, for example, may be growing too narrow, reducing the amount of available space for tooth eruption. If it isn’t corrected, teeth can erupt out of position. To correct it, an orthodontist places a palatal expander in the roof of the child’s mouth (palate). The appliance applies gentle pressure against the inside of the teeth, which stimulates the jaws to develop wider.
The expander works because of a separation in the bones at the center of the palate, which later fuse around puberty. The pressure applied from the expander keeps this gap slightly open; the body then continues to fill the widening expansion with bone, enough over time to widen the jaw. If you wait until puberty, the gap has already fused, and it would have to be reopened surgically to use this technique. Ideally, then, a palatal expander should be employed at a young age.
Not all interceptive techniques are this extensive—some, like a space maintainer, are quite simple. If a primary (baby) tooth is lost prematurely, teeth next to the empty space tend to drift into it and cause the intended permanent tooth to erupt out of place due to a lack of space. To prevent this an orthodontist places a small wire loop within the space to prevent other teeth from moving into it.
These are but two examples of the many methods for stopping or slowing a developing bite problem. To achieve the best outcome, they need to be well-timed. Be sure, then, to have your child undergo an orthodontic evaluation around age 6. If an interceptive orthodontic approach is needed, it could eliminate the need for more extensive—and expensive—treatment later.
While a relatively minor health issue, cracked mouth corners (medically known as angular cheilitis) can certainly be irritating. Fortunately, you don't have to live with it—we can help reduce the discomfort and even make it less likely to happen in the future.
Angular cheilitis is most characterized by redness and fissures (or cracks) in the skin at the corners of the lips. It commonly happens in younger ages (children to younger adults) because of drooling or complications from wearing braces. Older adults can also develop cracked mouth corners due to wrinkling around the mouth. The immediate causes are usually localized to the mouth and lip region, but it can sometimes arise from systemic conditions.
A case of angular cheilitis can also become infected, usually with a strain of yeast known as “candida albicans,” which then intensifies inflammation and discomfort. This is usually due to interaction between saliva and the open fissures, helped along by people's tendency to habitually lick these cracks (hence the other name for cracked mouth corners, perleche, from the French “to lick”).
The best way to treat angular cheilitis is with a series of applications of oral or topical antifungal medication. These may also be combined with steroid ointments that help retard redness and inflammation. If the infection involves the inside of the mouth, you may also need to use an antibacterial rinse until it clears up.
There are also things you can do to minimize future occurrences. Be sure to have missing teeth replaced or loose dentures refitted, and stay vigilant with daily brushing and flossing. You might also consult with a dermatologist about ways to treat wrinkling around the mouth. And easing those wrinkles could not only minimize your chances of developing angular cheilitis, but also give you a more youthful appearance.
Cracked mouth corners can be unnerving. But with a few simple steps we can help relieve any current discomfort and help you reduce the chances of another occurrence.
If you would like more information on cracked mouth corners and other oral irritations, 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 “Cracked Corners of the Mouth.”
Today’s technologically advanced dentures aren’t your grandparents’ “false teeth.” Now made with superior materials and processes, you could almost forget you’re wearing them. But don’t let that cause you to leave them in for the night: While it may seem like a harmless thing to do, wearing dentures 24/7 may not be good for them or your health.
For one thing, around the clock denture wearing could worsen bone loss, already a concern with dentures and missing teeth. The forces generated when we chew on natural teeth stimulate new bone growth to replace older bone cells. When teeth go missing, though, so does this stimulus. Even the best dentures can’t restore this stimulation, so bone loss remains a risk.
And, dentures can accelerate bone loss because of the added pressure they bring to the bony gum ridges that support them. Wearing them all the time deprives the gums of any rest, further speeding up the pace of bone loss. Losing bone volume not only affects your overall oral health, it will gradually loosen your dentures’ fit and make them uncomfortable to wear.
Another problem: You may clean your dentures less frequently if you don’t take them out at night. Lack of cleaning can encourage bacterial growth and lead to disease. Studies show that people who don’t take their dentures out at night have more dental plaque accumulation, gum inflammation and higher blood counts of the protein interleukin 6, indicating the body is fighting infection.
And that’s not just a problem for your mouth. Continuous denture wearing could make you twice as likely to develop life-threatening pneumonia as someone who routinely takes their dentures out.
These and other concerns make nightly denture removal a good practice for your health’s sake. While they’re out, it’s also a good time to clean them: Manually brush them for best results (be sure you’re only using regular soap or denture cleanser—toothpaste is too abrasive for them). You can then store them in clean water or a solution designed for dentures.
Having said all that, though, there may be one reason why wearing dentures at night might be beneficial—it may help prevent obstructive sleep apnea. If you have this condition, talk to your dentist about whether wearing your dentures at night has more advantages than disadvantages. And, if bone loss created by wearing dentures is a concern, it could be resolved by having implants support your dentures. Again, discuss this with your dentist.
Taking care of your dentures will help increase their life and fit, and protect your health. And part of that may be taking them out to give your gums a rest while you’re resting.
If you would like more information on denture 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 “Sleeping in Dentures.”
Some moviegoers have been known to crunch popcorn, bite their fingers or grab their neighbor’s hands during the intense scenes of a thriller. But for one fan, the on-screen action in the new superhero film Black Panther led to a different reaction.
Sophia Robb, an 18-year-old Californian, had to make an emergency visit to the orthodontic office because she snapped the steel wire on her retainer while watching a battle scene featuring her Hollywood crush, Michael B. Jordan. Her jaw-clenching mishap went viral and even prompted an unexpected reply from the actor himself!
Meanwhile, Sophia got her retainer fixed pronto—which was exactly the right thing to do. The retention phase is a very important part of orthodontic treatment: If you don’t wear a retainer, the beautiful new smile you’re enjoying could become crooked again. That’s because if the teeth are not held in their new positions, they will naturally begin to drift back into their former locations—and you may have to start treatment all over again…
While it’s much more common to lose a removable retainer than to damage one, it is possible for even sturdy retainers to wear out or break. This includes traditional plastic-and-wire types (also called Hawley retainers), clear plastic retainers that are molded to fit your teeth (sometimes called Essix retainers), and bonded retainers: the kind that consists of a wire that’s permanently attached to the back side of your teeth. So whichever kind you use, do what Sophia did if you feel that anything is amiss—have it looked at right away!
When Black Panther co-star Michael B. Jordan heard about the retainer mishap, he sent a message to the teen: “Since I feel partly responsible for breaking your retainers let me know if I can replace them.” His young fan was grateful for the offer—but even more thrilled to have a celebrity twitter follower.
If you have questions about orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Bonded Retainers.”
Your teeth face a hostile environment populated by disease-causing bacteria. But your teeth also have some “armor” against these microscopic foes: enamel. This hard outer tooth layer forms a barrier between harmful bacteria and the tooth’s more vulnerable layers of dentin and the inner pulp.
But although it’s tough stuff, enamel can erode when it comes into contact with high concentrations of mouth acid. Losing substantial amounts of enamel could leave your teeth exposed to disease.
So, here are 3 things you can do to help protect your enamel so it can keep on protecting you.
Careful on the brushing. Brushing removes dental plaque, a thin bacterial film on teeth most responsible for dental disease. But be careful not to brush too often, too hard and too quickly after eating. Brushing more than twice a day can cause gum recession and enamel wear; likewise, brushing too aggressively. You should also wait at least 30 minutes after eating to brush to give your saliva sufficient time to neutralize any acid. You could lose tiny bits of softened enamel brushing too soon.
Cut back on acidic foods and beverages. Spicy foods, sodas and, yes, sports and energy drinks all contain high amounts of acid that can increase your mouth’s acidity. It’s a good idea, then, to reduce acidic foods and beverages in your diet. Instead, eat less spicy foods and drink primarily water or milk. Also, look for foods and beverages with calcium, which helps increase your enamel’s ability to remineralize after acid contact.
Don’t eat right before bedtime. There are a lot of reasons not to eat just before you hit the hay—and one of them is for protecting your tooth enamel. Saliva normally neutralizes acid within a half hour to an hour after eating. While you’re sleeping, though, saliva production decreases significantly. This in turn slows its neutralizing effect, giving acid more contact time with enamel. So, end your eating a few hours before you turn in to avoid too much acid remaining on your teeth.
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