Posts for: August, 2017
Major league baseball player Aaron Judge made news in July by breaking Joe DiMaggio's record for most home runs scored by a New York Yankees rookie. Then he made news again, this time for breaking something else. Following their game-winning home run against the Tampa Bay Rays in the 11th inning, the Yanks met for a spontaneous victory celebration at home plate. It was all fun and games… until an errant helmet accidentally slammed into Judge's mouth, breaking off half his left front tooth. Ouch!
Even if you're not playing big-league baseball, accidents sometimes happen. So what's the best dental treatment if you chip or break a tooth? It all depends on how much is broken off.
When a tooth has a small chip in it, dental bonding may be sufficient. Layering on tooth-colored bonding material results in a natural look, and it can be completed in one dental visit. However, bonding material in time will discolor, and it is not as strong as real tooth structure, so eventually it may need re-treatment.
Dental veneers or crowns may be used to restore more seriously damaged teeth. Veneers, thin porcelain shells that cover the front surface of teeth, can be used to restore minor to moderate chips. A crown (“cap”) is used when the damage is greater and more structural support is required. A crown replaces the visible part of the tooth above the gum line.
When the soft pulp tissue inside the tooth is damaged, root canal treatment will be needed to save the tooth. Despite the outdated rumors some people have heard, root canal procedures don't cause pain — they actually relieve it. During the procedure, exposed or infected pulp is removed and the inside of the tooth is sealed. Then a lifelike crown is placed so the tooth looks as good as new.
If the tooth cannot be saved — for example, it breaks off below the gum line — a dental implant may be your best option. Dental implants are small titanium posts that are surgically inserted and then capped with an artificial crown. Implant-supported teeth can last a lifetime and are usually indistinguishable from natural teeth.
So what happened with Judge's tooth? Thanks to a Friday morning visit to the dentist, he was smiling again with a temporary crown — and smiling over the fact that his tooth garnered more attention than the Yankees' dramatic 11th inning win.
If you have questions about cosmetically-pleasing tooth restorations, please contact our office or schedule a consultation. (If you have a dental injury, call us immediately!) You can learn more in the Dear Doctor magazine articles “Dental Implants” and “A Step-by-Step Guide to Root Canal Treatment.”
While crooked teeth are usually responsible for a malocclusion (poor bite), the root cause could go deeper: a malformed maxilla, a composite structure composed of the upper jaw and palate. If that’s the case, it will take more than braces to correct the bite.
The maxilla actually begins as two bones that fit together along a center line in the roof of the mouth called the midline suture, running back to front in the mouth. The suture remains open in young children to allow for jaw growth, but eventually fuses during adolescence.
Problems arise, though, when these bones don’t fully develop. This can cause the jaw to become too narrow and lead to crowding among the erupting teeth and a compromised airway that can lead to obstructive sleep apnea. This can create a cross-bite where the upper back teeth bite inside their lower counterparts, the opposite of normal.
We can remedy this by stimulating more bone growth along the midline suture before it fuses, resulting in a wider maxilla. We do this by installing a palatal expander, an appliance that incrementally widens the suture to encourage bone formation in the gap, which over time will widen the jaw.
An expander is a metal device with “legs” extending out on both sides and whose ends fit along the inside of the teeth. A gear mechanism in the center extends the legs to push against the teeth on both sides of the jaw. Each day the patient or caregiver uses a key to give the gear a quarter turn to extend the legs a little more and widen the suture gap. We remove the expander once the jaw widens to the appropriate distance.
A palatal expander is an effective, cost-efficient way to improve a bite caused by a narrow jaw, but only if attempted before the bones fuse. Widening the jaw after fusion requires surgery to separate the bones — a much more involved and expensive process.
To make sure your child is on the right track with their bite be sure to see an orthodontist for an evaluation around age 6. Doing so will make it easier to intervene at the proper time with treatments like a palatal expander, and perhaps correct bite problems before they become more expensive to treat.
If you would like more information on treating malocclusions, 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.”