Posts for: March, 2014
Thumb or finger sucking is a normal activity for babies and young children — they begin the habit while still in the womb and may continue it well into the toddler stage. Problems with tooth development and alignment could arise, however, if the habit persists for too long.
It’s a good idea, then, to monitor your child’s sucking habits during their early development years. There are also a few things you can do to wean them off the habit before it can cause problems down the road.
- Eliminate your child’s use of pacifiers by eighteen months of age. Studies have shown that the sucking action generated through pacifiers could adversely affect a child’s bite if they are used after the age of 2. Weaning your child off pacifiers by the time they are a year and a half old will reduce the likelihood of that occurring.
- Encourage your child to stop thumb or finger sucking by age 3. Most children tend to stop thumb or finger sucking on their own between the ages of 2 and 4. As with pacifiers, if this habit continues into later childhood it could cause the upper front teeth to erupt out of position and tip toward the lip. The upper jaw also may not develop normally.
- Replace your child’s baby bottle with a training cup around one year of age. Our swallowing mechanism changes as we grow; introducing your child to a training cup at around a year old will encourage them to transition from “sucking” to “sipping,” and make it easier to end the thumb or finger sucking habit.
- Begin regular dental visits for your child by their first birthday. The Age One visit will help you establish a regular habit of long-term dental care. It’s also a great opportunity to evaluate your child’s sucking habits and receive helpful advice on reducing it in time.
While your child’s thumb or finger sucking isn’t something to panic over, it does bear watching. Following these guidelines will help your child leave the habit behind before it causes any problems.
If you would like more information on children’s thumb-sucking and its effect on dental development, 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 “Thumb Sucking in Children.”
Although they may appear inert, teeth are anything but — they grow and change like other bodily tissues until complete maturation. Teeth roots are especially adaptable; teeth with multiple roots develop much like forks in a road as each root takes a different path toward the jawbone.
This fork where they separate is called a furcation. It’s normal for lower molars and premolars to have two furcations, while upper molars traditionally have three. Furcations pose difficulties for teeth cleaning and maintenance. If bone loss has occurred around them, a condition called a furcation invasion has occurred. This loss is most likely due to periodontal (gum) disease, an inflammation arising from bacterial plaque on the teeth that hasn’t been removed through proper oral hygiene.
We identify furcation invasions through x-ray imaging and tactile probing. They’re classified in three stages of development: Class I describes early onset in which marginal bone loss has occurred, exposing a groove that leads to the beginning of the furcation; Class II is moderate bone loss where a space of two or more millimeters has developed horizontally into the furcation; and, Class III, advanced bone loss whereby the bone loss has extended from one side of the tooth to the other, or “through and through furcation.”
Our first step in treatment is to remove any detectable plaque and calculus on the tooth surface, including the roots (known as scaling and root planing). These areas can be difficult to access, especially near furcations, and requires special instruments known as scalers or curettes. We may also employ ultrasonic scalers that use high-frequency vibrations coupled with water to break up and flush out the plaque and calculus.
We then apply antimicrobial or antibiotic medicines to further disinfect the area and inhibit bacterial growth while the affected tissues heal. As the infection and inflammation subsides, we then turn our attention during subsequent visits to address the bone loss around the furcation. This may involve surgical procedures to aid in re-growing gum tissue and bone and to create better access for cleaning and maintaining the area.
Finally, it’s important to establish good oral hygiene habits and regular checkups and cleanings to prevent further complications or a reoccurrence of the disease. Maintaining these habits will help you avoid tooth loss and other problems with your oral health.
If you would like more information on furcations, 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 “What are Furcations?”
Did you know that millions of Americans have some degree of gum recession? Are you one of them?
Gum recession is the loss of the pink gum tissue that surrounds your teeth and can lead to exposure of the root surface of your teeth. In addition to the obvious aesthetic issues, recession can also result in tooth loss in very severe cases.
So, what causes gum recession? Well, first of all, if you are genetically predisposed to having thin gum tissues, your gums will be more prone to receding than those with thick tissues. However, other factors include ineffective oral hygiene, excessive brushing and mal-positioned teeth. In addition, poor fitting appliances, such as partial dentures can also cause gum recession.
If you think you are suffering from gum recession, you should make an appointment with us immediately, so that we can perform a thorough examination to accurately diagnose your condition. We'll look at your teeth and their position within the supporting bone and surrounding gum tissue. Depending upon our diagnosis, we may recommend a technique known as gum or soft tissue grafting, which allows us to regenerate lost or damaged gum tissue. Grafting is the surgical manipulation of tissue, taking it from one site and moving it to another, so that it can attach and grow.
There are two basic gum tissue grafting techniques, the free gingival graft and the connective tissue graft. Here is a description of each:
- Free Gingival Grafting. With this technique, we remove a thin layer of tissue from the roof of your mouth or any other site where the tissues are identical to gum tissue (the donor). We then shape and transplant it to the recipient site to create new gum tissue. Both donor and recipient sites heal within two to three weeks.
- Connective Tissue Grafting. This technique is used to cover exposed roots in the treatment of gum recession. It involves more microsurgical maneuvers to prepare both the donor and recipient sites. We take donor tissue from beneath the surface of the roof of your mouth and then cover it with the gum tissue surrounding the exposed root. Another alternative is to use processed tissue rather than your own tissue as a donor material.
When you visit us for an appointment, we will assess which procedure is best-suited to your needs.
If you would like more information about gum recession and plastic surgery, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Periodontal Plastic Surgery.”
People who fly or scuba dive know firsthand how changes in atmospheric pressure can affect the body: as minor as a popping in the ears, or as life-threatening as decompression sickness. Pressure changes can also cause pain and discomfort in your teeth and sinuses — in fact, severe pain could be a sign of a bigger problem.
Barotrauma (baro – “pressure;” trauma – “injury”), also known as a “squeeze,” occurs when the unequal air pressures outside and inside the body attempt to equalize. Many of the body's organs and structures are filled with air within rigid walls; the force created by equalization presses against these walls and associated nerves, which in turn causes the pain.
The sinus cavities and the middle ear spaces are especially sensitive. Each of these has small openings that help with pressure equalization. However, they can become swollen or blocked with mucous (as when you have a head cold), which slows equalization and contributes to the pain.
It's also possible to experience tooth pain during pressure change. This is because the back teeth in the upper jaw share the same nerve pathways as the upper jaw sinuses — pain originating from the sinuses can be felt in the teeth, and vice-versa. In fact, it's because of this shared pathway that pressure changes can amplify pain from a tooth with a deeper problem, such as a crack, fracture or a defect in dental work.
Besides problems with your teeth, the severe pain could also be related to temporo-mandibular joint dysfunction (TMD), which is pain or discomfort in the small joint that connects your lower jaw to your skull. There are a number of causes for this, but a common one for scuba divers is an ill-fitted regulator mouthpiece that they are biting down on too hard while diving. A custom-fitted mouthpiece could help alleviate the problem.
If you've been experiencing tooth pain during pressure change events, you should see us for an examination before you fly or dive again. There might be more to your pain — and correcting these underlying problems could save you extreme discomfort in the future.
If you would like more information on the effects of atmospheric pressure changes on teeth, 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 “Pressure Changes Can Cause Tooth & Sinus Pain.”