One of the biggest concerns we hear from parents is about their child's thumb sucking habit. Our advice: if they're under age 4, there's no need for concern — yet. If they're older, though, you should be concerned about the possible effect on their bite.
Thumb sucking is a universal habit among infants and toddlers and is related to their swallowing pattern during feeding. As they swallow, their tongue thrusts forward to create a seal with the lips around the breast or a bottle nipple. Many pediatricians believe thumb sucking replicates nursing and so has a comforting effect on infants.
Around age 4, though, this swallowing pattern begins to change to accommodate solid food. The tongue now begins to rest at the back of the top front teeth during swallowing (try swallowing now and you'll see). For most children, their thumb sucking habit also fades during this time and eventually stops.
But for whatever reason, some children don't stop. As the habit persists, the tongue continues to thrust forward rather than toward the back of the top front teeth. Over time this can place undue pressure on both upper and lower front teeth and contribute to the development of an open bite, a slight gap between the upper and lower teeth when the jaws are shut.
While late childhood thumb sucking isn't the only cause for an open bite (abnormal bone growth in one jaw is another), the habit is still a prominent factor. That's why it's important that you start encouraging your child to stop thumb sucking around age 3 and no later than 4. This is best accomplished with positive reinforcement like rewards or praise.
If they've continued the habit a few years after they should have stopped, we may also need to check to see if their swallowing mechanism has become stunted. If so, we may need to use certain exercises to retrain their tongue to take the proper position during swallowing.
While you shouldn't panic, it's important to take action to stop thumb sucking before it becomes a long-term problem. A positive, proactive approach will help avoid costly orthodontic problems later in their lives.
If you would like more information about thumb or finger sucking, 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.”
For over three decades, veneers have helped mask dental imperfections like chipping, staining or gaps and improve the appearance of millions of teeth. As the name implies, this thin layer of porcelain covers a tooth's visible surface and accurately mimics the texture, color and translucence of natural teeth.
Veneers could be just the solution you need for a more attractive smile. But before you begin treatment, be sure you have these 3 essentials in place to ensure a successful outcome.
True expectations. While the transformation of a tooth's appearance with a veneer can be astounding, veneers in general do have their limitations. You need an adequate amount of the tooth's structure present for a veneer to properly adhere — if not, you may need to consider a porcelain crown instead. Likewise, gaps and other misalignments may be too great for a veneer to cover: in that case, you should consider orthodontics. A thorough examination beforehand will determine if veneers are the best option for you.
An artisan team. Every veneer is custom made to match an individual patient's tooth shape and color, handcrafted by a skilled dental technician. There's also an art to the dentist preparing the tooth beforehand and then properly positioning the veneer for bonding to achieve the most attractive result. Be sure, then, that your veneer "team" comes highly recommended by others.
The best materials. The first porcelains were powdered glass ceramics mixed with water to form a paste. Technicians shaped the paste in successive layers and as it oven-cured it took on the beautiful translucence of natural teeth. Unfortunately, this type of porcelain could be brittle and prone to shattering when subjected to heavy biting forces. In recent years, though, we've begun to use ceramics reinforced with other materials like Leucite for added strength. Today, the materials dentists use have much better durability.
If you would like more information on porcelain veneers, 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 “Porcelain Veneers.”
Thanks to treatments like chemotherapy and radiation, your chances of surviving cancer are greater than ever. These treatments, however, often produce unwelcome side effects. Treating throat or oral cancer, for example, could damage your mouth's salivary glands or bone.
Saliva is essential to oral health, providing antibodies to curb the growth of disease-causing bacteria and neutralizing acid, which can erode enamel. But salivary glands damaged during cancer treatment may not be able to produce enough saliva. The resulting “dry mouth” creates an environment conducive to bacterial growth and elevated acid levels.
You can help reduce the effects of dry mouth during your treatment (and after, if the damage is permanent) by drinking more water or by using substances that stimulate saliva. Cutting back on acidic foods and beverages will also help lower your mouth's acidity. And be sure to keep up daily oral hygiene and regular dental visits.
The more ominous threat to oral health during cancer treatment, though, is osteoradionecrosis. This occurs when radiation targets specific areas of bone. The bone can lose blood supply and living cellular tissue, which inhibit its ability to heal or replenish itself. If this occurs in the jawbone of teeth that may be lost, the bone tissue could be adversely affected during healing.
Depending on your treatment needs, your risk for osteoradionecrosis might be unavoidable if teeth are to be lost. It's important we discuss that risk because it could impact future dental treatment. In the worst case, before cancer treatment, we may not be able to save affected teeth and your restorative options might be limited.
If your risk of osteoradionecrosis is minimal, though, we may be able to restore any resulting damaged or missing teeth with a wide range of options like dental implants or crowns before or after your cancer treatment.
As with other aspects of health, taking care of your teeth and gums while undergoing cancer treatment can be challenging; some problems may be unavoidable. But with a proper dental treatment plan during and after chemotherapy and radiation, we can minimize those problems and help to eventually restore your smile.
Digital computer technology has made a big impact on cosmetic dentistry. We can now simulate on a monitor display of your face how your new smile will appear after dental work, thanks to a graphics program specifically designed for cosmetic dentistry.
While that's an amazing development, we can also take it a step further by creating the look of a new smile on your actual teeth during an office visit. We call it a “trial smile.”
To create a trial smile, we begin with composite resin, a tooth-colored bonding material, and fashion it into temporary veneers or crowns that we then temporarily place over your teeth. This gives us the chance to see what your new smile will look like in all three spatial dimensions (rather than the two-dimensional view on a computer monitor) and while your face is in motion as you talk and smile. This can give us a great deal more detail to help better evaluate your proposed look.
A trial smile also helps us in planning your new look. Like you, we want the best result possible: a trial smile allows us to see how your jaw movement interacts with your updated look and if everything works together as it should. It will also give us a better idea how much tooth structure we'll need to remove to accommodate your permanent veneers or crowns — the less, of course, the better.
Although you won't be able to take your trial smile with you when you leave, we can take a photograph you can review later, as well as show friends and family for their opinion. Trial smiles do add some cost to treatment, but the proportion of expense to the benefit of actually viewing your smile in this fashion is well worth it. It's one more way we can ensure your final new smile meets your expectations.
If you would like more information on “trial smiles,” 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 “Testing Your Smile Makeover.”
What makes a beautiful smile? The teeth, of course: bright, evenly shaped and precisely aligned with each other. But your teeth can be as perfect as can be and your smile will still appear unattractive.
The reason? Your gums show more than they should when you smile.
What's considered a gummy smile is largely a matter of perception that can vary from person to person. As a rule of thumb, though, we consider a smile “gummy” if four millimeters (mm) or more of the gums show.
Fortunately, we can minimize the gums' prominence and make your smile more attractive. But what methods we use will depend on why your gums stand out. And it's not always because of the gums themselves.
It could be your teeth didn't erupt normally during dental development. Mature crown (the visible part of the tooth) length is normally about 10 mm with a width about 75-85% of that. But an abnormal eruption could result in teeth that appear too short, which can make the gums stand out more. We can correct this with a surgical procedure called crown lengthening in which we remove excess gum tissue and, if necessary, reshape the underlying bone to expose more of the tooth crown.
Another potential cause is how far your upper lip rises when you smile. Normally the lip rises only enough to reveal about 4 mm of teeth. In some cases, though, it may rise too high and show more of the gums. We can modify lip movement in a number of ways, including Botox injections to temporarily paralyze the lip. A more permanent solution is a lip stabilization procedure. It sounds bad, but it's a fairly simple procedure to surgically reposition the muscle attachments to restrict movement.
Your gummy smile may also result from an upper jaw too long for your facial structure. We can correct this with orthognathic (“ortho” – straighten, “gnathos” – jaw) surgery. During the procedure the surgeon permanently positions the jaw further up in the skull; this will reduce the amount of teeth and gums displayed when you smile.
Discovering the true cause of your gummy smile will determine how we treat it. After a complete oral examination, we can then discuss your options to transform your smile into a more attractive one.
If you would like more information on treating gummy smiles and other cosmetic problems, 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 “Gummy Smiles.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.