My Blog

Posts for: September, 2020

By Courtney Camp Highsmith, DMD
September 26, 2020
Category: Dental Procedures
YouCanHaveaStraighterSmile-JustLiketheQueenofEngland

The monarchs of the world experience the same health issues as their subjects—but they often tend to be hush-hush about it. Recently, though, the normally reticent Queen Elizabeth II let some young dental patients in on a lesser known fact about Her Majesty's teeth.

While touring a new dental hospital, the queen told some children being fitted for braces that she too “had wires” once upon a time. She also said, “I think it's worth it in the end.”

The queen isn't the only member of the House of Windsor to need help with a poor bite. Both Princes William and Harry have worn braces, as have other members of the royal family. A propensity for overbites, underbites and other malocclusions (poor bites) can indeed pass down through families, whether of noble or common lineage.

Fortunately, there are many ways to correct congenital malocclusions, depending on their type and severity. Here are 3 of them.

Braces and clear aligners. Braces are the tried and true way to straighten misaligned teeth, while the clear aligner method—removable plastic mouth trays—is the relative “new kid on the block.” Braces are indeed effective for a wide range of malocclusions, but their wires and brackets make it difficult to brush and floss, and they're not particularly attractive. Clear aligners solve both of these issues, though they may not handle more complex malocclusions as well as braces.

Palatal expanders. When the upper jaw develops too narrowly, a malocclusion may result from teeth crowding into too small a space. But before the upper jaw bones fuse together in late childhood, orthodontists can fit a device called a palatal expander inside the upper teeth, which exerts gentle outward pressure on the teeth. This encourages more bone growth in the center to widen the jaw and help prevent a difficult malocclusion from forming.

Specialized braces for impacted teeth. An impacted tooth, which remains partially or completely hidden in the gums, can impede dental health, function and appearance. But we may be able to coax some impacted teeth like the front canines into full eruption. This requires a special orthodontic technique in which a bracket is surgically attached to the impacted tooth's crown. A chain connected to the bracket is then looped over other orthodontic hardware to gradually pull the tooth down where it should be.

Although some techniques like palatal expanders are best undertaken in early dental development, people of any age and reasonably good health can have a problem bite corrected with other methods. If you are among those who benefit from orthodontics, you'll have something in common with the Sovereign of the British Isles: a healthy, attractive and straighter smile.

If you would like more information about orthodontic treatment options, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Magic of Orthodontics.”


By Courtney Camp Highsmith, DMD
September 16, 2020
Category: Oral Health
Tags: mouthguards  
ItsTimeforFootballIsYourFavoritePlayersMouthFullyProtected

It's September—and that means football season is underway. Whether you're playing, spectating or managing a fantasy team, the action is about to ramp up. Unfortunately, increased “action” also includes injury risk, especially for a player's teeth, mouth and jaws.

Injury prevention is a top priority for all players, whether the pros or the little guys in Pee Wee league. For oral injuries, the single best way to avoid them is by wearing an athletic mouthguard. This soft but durable plastic appliance helps cushion the force of a direct blow to the face or mouth. Wearing one can help prevent tooth and gum damage, as well as lessen the risk for jaw or facial bone fractures.

Mouthguard use is fairly straightforward—a player should wear one anytime there's player-to-player contact. That's not only during game time, but also during practice and informal play. But what's not always straightforward is which type of mouthguard to purchase. That's right: You'll have to decide from among a variety of mouthguards on the market.

Actually, though, most fall into one of two categories: the “Boil and Bite” found in most retail stores with a sports gear department; or the custom mouthguard fashioned by a dentist.

The first are called Boil and Bite because the mouthguard must first be softened with hot water and then placed in the intended wearer's mouth to bite down on in its softened state. When the mouthguard cools and re-hardens, it will retain the bite impression to give it somewhat of an individual fit. These retail guards are relatively inexpensive and reasonably effective in cushioning hard contact, but they can also be on the bulky side and uncomfortable to wear.

In contrast, custom mouthguards are formed from an accurate impression of the wearer's bite taken in the dental office. Because of the individualized fit, we can create a guard with less bulk, greater comfort and, due to their precision, better effectiveness in preventing injury.

A custom guard is more expensive than a retail mouthguard, and younger players may need a new upgrade after a few seasons to accommodate fit changes due to jaw development. But even so, with its higher level of protection and comfort (making it more likely to be worn during play), a custom mouthguard is a worthwhile investment that costs far less than a devastating dental injury.

So, if you or a family member will be hitting the gridiron this fall (or, for that matter, the basketball court or baseball diamond later in the year), be sure you invest in a mouthguard. It's a wise way to ensure this football season will be a happy one.

If you would like more information about dental safety and sports, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Athletic Mouthguards.”


By Courtney Camp Highsmith, DMD
September 06, 2020
Category: Dental Procedures
Tags: missing teeth  
3WaysWeCanImproveaSmileAffectedbyUnformedTeeth

On the way to adulthood, permanent teeth steadily erupt until, if all goes normally, you have a full set of teeth. Sometimes, though, one or more teeth may fail to form. This not only can affect your dental health, but it could also diminish your smile.

For example, if the lateral incisors on either side of the central incisors (the two teeth front and center) don't develop, it could create a smile that's “not quite right.” But we can vastly improve such a smile in one of three unique ways.

The first is to fill the resulting gap through canine substitution. This is an orthodontic method in which we use braces to move the pointed canine teeth, which normally position on the other side of the missing laterals, closer to the central incisors. This choice is determined by the size of the canine teeth. If they are slim in width, they can be re-shaped to make them appear more like a lateral incisor, and the gums possibly reshaped as well around them through cosmetic surgery.

We can also install a dental bridge, an appliance that fills the missing lateral space with prosthetic teeth. A traditional bridge requires the teeth on either side of the gap to be reduced in size, which becomes a permanent alteration to accommodate these crowns. This is a disadvantage in a young person.  We can also use a “bonded bridge” which uses adhesives to attach extended pieces (or “wings”) of dental material from either side of the prosthetic tooth to one or more supporting teeth.  These wings are behind the permanent teeth.  Though not as durable as a traditional bridge, it does avoid altering the support teeth.

Finally, we can replace the missing teeth with dental implants. In this method, we install titanium metal posts into the jawbone at the missing tooth locations and then attach a life-like crown to each one. Implants may be more costly than other restorative methods and can take several months to complete. But they are life-like, highly durable, and don't require any alteration to other teeth. A disadvantage is that you should wait until at least 19 years of age to consider this option.  What many people do is use a temporary solution until the proper age to do a dental implant.

Each of these methods have their advantages and disadvantages, which should be thoroughly reviewed in consultation with your dentist. And each may also require other dental work, such as initial orthodontics to open adequate space for a restoration. But any of these methods for correcting a missing lateral tooth can be effective and help restore both a healthier mouth and a more attractive smile.

If you would like more information on treating congenital dental defects, 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 Permanent Teeth Don't Grow.”




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