My Blog

Posts for: September, 2017

ATeenwithaMissingToothMayNeedtoWaitonaDentalImplant

There’s a lot to like about replacing a missing tooth with a dental implant. This state-of-the-art restoration is by far the most durable and life-like option available. And unlike other replacement options implants stimulate bone growth, a major concern after tooth loss.

For that reason we encourage getting an implant as soon as possible — for adults, that is. We don’t recommend implants for younger patients because even a teenager’s jaws haven’t yet reached full maturity. Because it attaches to the jaw differently, an implant can’t move with the growing jaw as real teeth do. It would eventually look as if it were sinking into the jaw below the gum line or being left behind as the rest of the jaw grows.

It’s best, then, to postpone placing an implant until the jaw fully matures, usually in a patient’s early twenties. In the meantime, there are some things we can do to prepare for a future implant while also restoring the tooth with a temporary replacement.

As previously mentioned, our biggest concern is bone health. Like other living tissue, bone has a growth cycle of older cells dissolving and newer ones forming in their place. The teeth transmit the pressure produced when we chew to the bone to stimulate this growth. With the absence of a tooth, the adjacent bone no longer receives this stimulation — the growth cycle slows and may eventually lead to bone loss.

We can help this situation by placing a bone graft in the missing tooth socket at the time of extraction. The graft serves as a scaffold that’s eventually taken over and replaced by new bone growth. We can also try to control how fast the graft is replaced by using grafting material that’s slowly removed and lasts longer — often a preferable situation if an implant is years away.

As for appearance, we can create a custom partial denture or even a type of bridge that bonds a prosthetic tooth to neighboring teeth without significantly altering them. If the patient undergoes orthodontic treatment it’s also possible to add prosthetic teeth to an orthodontic appliance.

Eventually, we’ll be able to provide the permanent solution of a dental implant. With careful planning and measures to preserve bone health, there’s a good chance the outcome will be worth the wait.

If you would like more information on treatments for lost teeth in children and teenagers, 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 “Dental Implants for Teenagers.”


HowKathyBatesRetainsHerMovie-StarSmile

In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.

When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”

Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.

There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.

By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.

So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.

If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.