Posts for: June, 2019
Applying braces or clear aligners to move misaligned teeth is only part of an orthodontist's overall mission to eliminate poor bites (malocclusions). Sometimes a malocclusion isn't caused by the teeth at all—the size of the jaw is the problem!
One type in particular, a cross-bite, often happens because the upper jaw has developed too narrowly. As a result, many of the upper teeth fit inside the lower, the opposite of normal. But a tool called a palatal expander can alleviate the problem if it's applied at an early enough age.
The device works because the upper jawbone initially forms as two halves that fit together along a center line in the roof of the mouth (the palate) running from the back of the mouth to the front. These two bone halves remain separate during childhood to facilitate jaw growth, but eventually fuse around puberty.
Consisting of two sets of wire arms joined together by a hinge mechanism in the middle, the expander device is positioned up against the palate. The orthodontist extends each arm to press against the inside of the back teeth, then adds more outward pressure by turning the mechanism in the middle with a small key. During wear, the patient or caregiver will turn the mechanism in the same way to keep up the pressure on the two sides of the jaw.
This continual pressure keeps the two bones moving away from each other and maintaining a center gap between them. In response, more bone forms on the two halves to fill the gap. In time, the newly formed bone should widen the jaw enough to correct any developing malocclusion.
Timing is everything with a palatal expander—if not used before the jaw bones fuse, the patient will need a surgical procedure to separate the bones to pursue treatment. To catch the problem early enough, children should have an orthodontic evaluation on or before they turn six. An orthodontist may be able to identify this or other emerging bite problems and intervene before it becomes worse. Taking this approach can help save you and your child more expensive orthodontic treatment down the road.
If you would like more information on correcting poor bites, 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.”
Each year, the National Safety Council recognizes June as National Safety Month. It's the perfect time to focus on safety: With summer temperatures heating up, so do sports and outdoor activities—and, unfortunately, the risk of accidents. As the old Boy Scout motto goes, everyone should "be prepared." And while that means watching out for sunburn, poison ivy or traveling hazards, it also means being alert for potential tooth injuries.
Even during casual recreational sports, an unintentional hit to the face or jaw could chip, move or, worse yet, knock a tooth out completely. As with any other aspect of safety, prevention should be at the top of your list when it comes to dental injuries. In that regard, anyone involved in a contact sport or other high-risk activity should wear a mouthguard. This device absorbs much of the force generated during a hard impact to the face or jaw that might otherwise affect the teeth.
Mouthguards fall into two basic categories. The first are retail guards available at sporting goods stores and many pharmacies, most commonly "boil and bite" guards. They're so named because a wearer first softens them with very hot water and then bites down on them to personalize their fit. Once cooled, the mouthguard will maintain its shape. While reducing the severity of impact injuries, these retail mouthguards can be bulky and uncomfortable to wear.
The second category, a custom mouthguard created by a dentist, offers a sleeker, more comfortable fit. These guards are based on a direct impression of the wearer's mouth that we take at the dental office. Although any mouthguard is better than no mouthguard, a 2018 study confirmed that custom-made mouthguards from the dental office perform better than the kind bought in a drug store or sporting goods store.
Summer is prime time for creating cherished family memories. With a little dental injury prevention knowledge, you can help make sure those summer memories are happy ones. If you would like more information about dental injury prevention and treatment, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Athletic Mouthguards” and “Dental Injuries: Field-Side Pocket Guide.”
If you have chronic jaw pain, you may be one of an estimated 10 million Americans suffering from temporomandibular joint disorders (TMD). If so, it's quite possible you're also coping with other health conditions.
TMD is an umbrella term for disorders affecting the temporomandibular (jaw) joints, muscles and adjoining tissues. The most common symptoms are limited jaw function and severe pain. Determining the causes for these disorders can be difficult, but trauma, bite or dental problems, stress and teeth clenching habits seem to be the top factors. Women of childbearing age are most susceptible to these disorders.
In recent years we've also learned that many people with TMD also experience other conditions. In a recent survey of TMD patients, two-thirds reported having three or more other health conditions, the most frequent being fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis or chronic headaches. Researchers are actively exploring if any systemic connections exist between TMD and these other conditions, and how these connections might affect treatment changes and advances for all of them including TMD.
In the meantime, there remain two basic approaches for treating TMD symptoms. The most aggressive and invasive approach is to surgically correct perceived defects in the jaw structure. Unfortunately, the results from this approach have been mixed in their effectiveness, with some patients even reporting worse symptoms afterward.
The more conservative approach is to treat TMD orthopedically, like other joint problems. These less invasive techniques include the use of moist heat or ice to reduce swelling, physical therapy and medication to relieve pain or reduce muscle spasming. Patients are also encouraged to adopt softer diets with foods that are easier to chew. And dentists can also provide custom-fitted bite guards to help ease the stress on the joints and muscles as well as reduce any teeth grinding habits.
As we learn more about TMD and its relationship to other health conditions, we hope to improve diagnosis and treatment. Until then, most dentists and physicians recommend TMD patients try the more conservative treatments first, and only consider surgery if this proves unsatisfactory. It may take some trial and error, but there are ways now to ease the discomfort of TMD.
If you would like more information on the causes and treatments of TMD, 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 “Chronic Jaw Pain and Associated Conditions.”