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Posts for: December, 2016

CorrectaCross-BitebyWideningtheUpperJawwithanExpander

A poor bite (malocclusion) could be more than simply teeth out of alignment. There could be complex causes for the malocclusion, possibly involving the facial bone structure.

An example of this is the development of a cross-bite due to problems with the upper jaw and palate (the roof of the mouth), jointly called the maxilla. The maxilla is in fact formed by two bones fused together in the center of the palate in what's called the midline suture. The suture doesn't completely fuse until after puberty.

Sometimes a maxilla's development doesn't follow a normal track. The upper jaw doesn't widen as it should, which leads to the cross-bite where the upper back teeth abnormally bite inside the lower teeth. The upper front teeth continue to bite normally in front of the lower front teeth. This also can have profound influence on breathing, causing sleep apnea.

We can correct this by using an orthodontic appliance called a palatal expander before the midline suture fuses. The expander gradually widens the upper jaw to its normal width and thus eliminates the cross-bite.

Positioned at the roof of the mouth, the expander has metal arms that extend from a central hinge to exert pressure on the inside of the upper teeth. The patient or a caregiver uses a small key to turn a mechanism that extends the arms toward the teeth a tiny amount each day. This gradually widens the jaw, while at the same time stimulating bone growth at the midline suture. Eventually the gap fills with bone to solidify the new width as the suture fuses.

It's important to undertake this treatment before fusion. If you wait until after puberty, you will need to separate the bones first to attempt it. The overall impact and cost is much less if you act promptly in the early years.

Palatal expansion may not be the right treatment in every case, so we'll need to perform a thorough orthodontic exam first. If, however, we do determine it can help, using an expander can improve function, correct future breathing problems and make possible a more attractive future smile.

If you would like more information on orthodontic treatment 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 “Palatal Expanders: Orthodontics is more than just Moving Teeth.”


By Stewart Dental
December 18, 2016
Category: Oral Health
NoahGallowaysDentallyDangerousDancing

For anyone else, having a tooth accidentally knocked out while practicing a dance routine would be a very big deal. But not for Dancing With The Stars contestant Noah Galloway. Galloway, an Iraq War veteran and a double amputee, took a kick to the face from his partner during a recent practice session, which knocked out a front tooth. As his horrified partner looked on, Galloway picked the missing tooth up from the floor, rinsed out his mouth, and quickly assessed his injury. “No big deal,” he told a cameraman capturing the scene.

Of course, not everyone would have the training — or the presence of mind — to do what Galloway did in that situation. But if you’re facing a serious dental trauma, such as a knocked out tooth, minutes count. Would you know what to do under those circumstances? Here’s a basic guide.

If a permanent tooth is completely knocked out of its socket, you need to act quickly. Once the injured person is stable, recover the tooth and gently clean it with water — but avoid grasping it by its roots! Next, if possible, place the tooth back in its socket in the jaw, making sure it is facing the correct way. Hold it in place with a damp cloth or gauze, and rush to the dental office, or to the emergency room if it’s after hours or if there appear to be other injuries.

If it isn’t possible to put the tooth back, you can place it between the cheek and gum, or in a plastic bag with the patient’s saliva, or in the special tooth-preserving liquid found in some first-aid kits. Either way, the sooner medical attention is received, the better the chances that the tooth can be saved.

When a tooth is loosened or displaced but not knocked out, you should receive dental attention within six hours of the accident. In the meantime, you can rinse the mouth with water and take over-the-counter anti-inflammatory medication (such as ibuprofen) to ease pain. A cold pack temporarily applied to the outside of the face can also help relieve discomfort.

When teeth are broken or chipped, you have up to 12 hours to get dental treatment. Follow the guidelines above for pain relief, but don’t forget to come in to the office even if the pain isn’t severe. Of course, if you experience bleeding that can’t be controlled after five minutes, dizziness, loss of consciousness or intense pain, seek emergency medical help right away.

And as for Noah Galloway:  In an interview a few days later, he showed off his new smile, with the temporary bridge his dentist provided… and he even continued to dance with the same partner!

If you would like more information about dental trauma, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Trauma & Nerve Damage to Teeth” and “The Field-Side Guide to Dental Injuries.”


By Stewart Dental
December 03, 2016
Category: Oral Health
HelpDe-StressYourChildsDentalVisitswiththeseTips

Regular dental visits are just as important for healthy teeth and gums as daily brushing and flossing. Not only will these visits reduce the amount of hidden or hard to reach bacterial plaque (the main source of dental disease), but they'll also boost the chances problems with teeth and gums are caught early and treated.

A lifetime habit of dental visits should begin around your child's first birthday, but children can be stressed or even frightened by trips to the dentist. This could stick with them, causing them to avoid regular dental visits when they become adults. The absence of professional dental care could prove hazardous to their dental health.

Here then are some things you can do to “de-stress” your child's dental visits.

Begin and sustain regular visits early. By not waiting a few years after age one, your child has a better chance of viewing it and subsequent visits as a normal part of life.

Choose a “kid-friendly” dentist. A pediatric dentist is trained not only for dental issues specific to children, but also in creating a comfortable environment for them. Some general dentists are also skilled with children, taking the time to talk and play with them first to ease any anxiety.

Stay calm yourself. Perhaps you've discovered, often in an embarrassing fashion, that your children are watching you and taking cues on how to act and react. Be sure then to project a sense of ease and a “nothing to this” attitude, rather than nervousness or anxiety. Your child will follow your lead.

Set the example. Speaking of following your lead, your children will intuitively pick up whether you're serious about your own dental health, which could influence them. So be sure you practice what you preach: daily oral hygiene, a dental-friendly diet and, of course, your own regular visits to the dentist. Your actions about your own dental care really will speak louder than words.

If you would like more information on effective dental care for your child, 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.”