Anyone at any age, including older children and teenagers, can lose or be born missing a permanent tooth. And while those missing teeth can be restored, replacing them in patients who haven’t yet reached adulthood can be tricky.
That’s because their dental and facial development isn’t finished. This is especially problematic for dental implants because as the jaws continue to grow, a “non-growing” implant could eventually appear out of alignment with the surrounding natural teeth. That’s why it’s often better to install a temporary restoration until the jaws fully mature in early adulthood. Two great choices are a removable partial denture (RPD) or a bonded (“Maryland”) bridge.
While “dentures” and “teens” don’t seem to go together, an RPD in fact can effectively restore a teen’s lost dental function and appearance. Of the various types of RPDs the one usually recommended for teens has a hard acrylic base colored to resemble the gums, to which we attach prosthetic (“false”) teeth at their appropriate positions on the jaw.
Besides effectiveness, RPDs are easy to clean and maintain. On the downside, though, an RPD can break and—as a removable appliance—become lost. They can also lose their fit due to changes in jaw structure.
The bonded bridge is similar to a traditional fixed bridge. But there’s one big difference: traditional bridges crown the natural teeth on either side of the missing teeth to secure them in place. The supporting teeth must be significantly (and permanently) altered to accommodate the life-like crowns on either end of the bridge.
Instead, a bonded bridge affixes “wings” of dental material extending from the back of the bridge to the back of the natural teeth on either side. While not quite as strong as a regular bridge, the bonded bridge avoids altering any natural teeth.
While a fixed bridge conveniently stays in place, they’re more difficult than an RPD to keep clean. And while less prone to breakage, they aren’t entirely immune to certain stresses from biting and chewing especially in the presence of some poor bites (how the upper and lower teeth come together).
Choosing between the two restorations will depend on these and other factors. But either choice can serve your teen well until they’re able to permanently replace their missing teeth.
Saliva is a true workhorse among bodily fluids — it breaks down food for digestion, keeps harmful bacteria in check and neutralizes acid that is destructive to tooth surfaces. So when saliva flow is chronically diminished, it’s more serious than the uncomfortable feeling of “dry mouth” — it can have a detrimental effect on your overall health.
It’s normal to experience temporary mouth dryness: in the morning (because saliva flow slows during sleep), when we’re under stress, or after smoking or consuming certain foods and beverages like onions or coffee. But chronic dry mouth (“xerostomia”) is different — the mouth remains dry for extended periods, leading to problems like tooth decay caused by inadequate acid neutralization.
Medications are one of the most common causes for xerostomia. According to the Surgeon General, there are over 500 medications — both prescription and over-the-counter — that can cause it, including antihistamines, diuretics and antidepressants. Radiation or chemotherapy used for cancer treatment may also cause dry mouth, sometimes permanently. There are also systemic conditions that affect saliva flow like diabetes, Parkinson’s disease, cystic fibrosis, and many autoimmune diseases.
Treating chronic dry mouth will of course depend on the underlying cause. If drug-related the first approach should be to find a substitute medication that won’t as readily cause reduced saliva flow. If that’s not possible, then it’s helpful to drink more water when taking the medication (a few sips before and a full glass afterward). You can also cut back on caffeinated, acidic or sugary foods and drinks as well as alcohol, and refrain from tobacco use.
A saliva stimulant might also help. Besides prescription medication, there are other products like xylitol, a natural alcohol sugar found in chewing gum, toothpaste or rinses, that help increase saliva flow — and xylitol also inhibits the growth of decay-causing bacteria.
The most important thing for chronic dry mouth is maintaining consistent daily hygiene through brushing and flossing and regular dental cleanings and checkups. Helping to increase your saliva flow and making every effort to prevent dental disease will help keep this condition from harming your teeth and gums.
If you would like more information on the causes and treatment of dry mouth, 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 “Dry Mouth.”
It's no secret that many of Hollywood's brightest stars didn't start out with perfectly aligned, pearly-white teeth. And these days, plenty of celebs are willing to share their stories, showing how dentists help those megawatt smiles shine. In a recent interview with W magazine, Emma Stone, the stunning 28-year-old star of critically-acclaimed films like La La Land and Birdman, explained how orthodontic appliances helped her overcome problems caused by a harmful habit: persistent thumb sucking in childhood.
“I sucked my thumb until I was 11 years old,” she admitted, mischievously adding “It's still so soothing to do it.” Although it may have been comforting, the habit spelled trouble for her bite. “The roof of my mouth is so high-pitched that I had this huge overbite,” she said. “I got this gate when I was in second grade… I had braces, and then they put a gate.”
While her technical terminology isn't quite accurate, Stone is referring to a type of appliance worn in the mouth which dentists call a “tongue crib” or “thumb/finger appliance.” The purpose of these devices is to stop children from engaging in “parafunctional habits” — that is, behaviors like thumb sucking or tongue thrusting, which are unrelated to the normal function of the mouth and can cause serious bite problems. (Other parafunctional habits include nail biting, pencil chewing and teeth grinding.)
When kids develop the habit of regularly pushing the tongue against the front teeth (tongue thrusting) or sucking on an object placed inside the mouth (thumb sucking), the behavior can cause the front teeth to be pushed out of alignment. When the top teeth move forward, the condition is commonly referred to as an overbite. In some cases a more serious situation called an “open bite” may develop, which can be difficult to correct. Here, the top and bottom front teeth do not meet or overlap when the mouth is closed; instead, a vertical gap is left in between.
Orthodontic appliances are often recommended to stop harmful oral habits from causing further misalignment. Most appliances are designed with a block (or gate) that prevents the tongue or finger from pushing on the teeth; this is what the actress mentioned. Normally, when the appliance is worn for a period of months it can be expected to modify the child's behavior. Once the habit has been broken, other appliances like traditional braces or clear aligners can be used to bring the teeth into better alignment.
But in Stone's case, things didn't go so smoothly. “I'd take the gate down and suck my thumb underneath the mouth appliance,” she admitted, “because I was totally ignoring the rule to not suck your thumb while you're trying to straighten out your teeth.” That rule-breaking ended up costing the aspiring star lots of time: she spent a total of 7 years wearing braces.
Fortunately, things worked out for the best for Emma Stone: She now has a brilliant smile and a stellar career — plus a shiny new Golden Globe award! Does your child have a thumb sucking problem or another harmful oral habit? For more information about how to correct it, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”
There's a burning sensation in your mouth even though you haven't had anything hot to eat or drink. It's an experience you've had for years, often accompanied by mouth dryness, tingling or numbness that leaves you irritable, anxious or depressed.
The root causes for Burning Mouth Syndrome (BMS) remain elusive, although there appear to be links to diabetes, acid reflux, menopausal hormonal changes or even psychological issues. Although we may not be able to pinpoint the root cause we can identify contributing factors to BMS through a detailed oral examination and medical history (including drugs you're taking).
Mouth dryness is one of the most common factors for BMS. The lack of lubrication from adequate saliva flow can contribute substantially to the irritating burning sensation. There are a number of causes for mouth dryness, including as a side effect from many medications or other treatments.
We must also consider whether an allergic reaction — the body's over-reaction to a foreign substance — may have a role in your symptoms. Some people react to sodium lauryl sulfate, a foaming agent found in many types of toothpaste, along with whitening substances or flavorings like cinnamon; denture wearers can become allergic to the plastic materials used to construct the denture. These, as well as spicy foods, smoking or alcohol, can irritate or cause the tissues lining the inside of the mouth to peel.
Determining what factors contribute to your symptoms allows us to develop a treatment approach tailored to your situation. If, for example, we've determined your BMS stems from dry mouth as a side effect to medication, we can ask your doctor to prescribe an alternative, increase your water intake when taking pills or stimulate saliva flow. If we identify an allergen as a factor, you can eliminate the substance to reduce symptoms.
You may also need to make changes to your eating and lifestyle habits: stop smoking, reduce your alcohol or coffee consumption and avoid very hot or spicy foods. And look for ways to reduce stress, another contributing factor, through relaxation techniques, exercise or support groups.
It's possible that BMS will resolve itself over time. In the meantime, though, we can help you find ways to alleviate the irritation.
If you would like more information on diagnosing and treating BMS, 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 “Burning Mouth Syndrome.”
National Fresh Breath Day is celebrated in August, but who doesn’t want fresh breath every day? Everyone has bad breath once in a while, so here are some tips to fight it.
1. Step up your oral hygiene routine.
Good oral hygiene is the first line of defense against bad breath. Brush your teeth morning and night and floss daily to remove much of the tiny food debris and plaque (colonies of oral bacteria) that can cause bad breath.
2. Don’t neglect your tongue.
A coated tongue can be a source of bad breath, so brush your tongue as well as your teeth or use a tongue scraper, which can be purchased in the oral health aisle of your local pharmacy.
3. Clean around your braces.
If you have braces, use an interdental brush or a water flosser to free trapped food particles.
4. Pay attention to your oral appliances.
If you wear dentures, be sure to clean them thoroughly every day, and brush your gums and the inside of your mouth as well. Bridgework also needs special attention: Clean carefully around the bridge and under the false tooth, as food can get stuck there.
5. Tackle dry mouth.
Dry mouth, a major cause of bad breath, can result from numerous medications, salivary gland problems, or breathing through the mouth instead of the nose due to sinus problems, sleep apnea, or other conditions. If your mouth is chronically dry, chew sugarless gum to stimulate saliva production, or ask about an over-the-counter or prescription saliva substitute.
6. Avoid extreme dieting.
Weight loss diets that advocate a stringent reduction in carbohydrates can lead to “keto breath.” This foul-smelling breath happens when the body burns fat instead of glucose for fuel.
7. Quit smoking.
In addition to smelling like cigarettes, people who smoke have less—as well as lower quality—saliva, which contributes to bad breath and poor oral health. If you need help quitting, talk with us or call (800) QUIT-NOW.
8. Be aware that some foods and beverages can leave stinky breath.
These include garlic, onions, strong spices, coffee, alcohol, cheese, and canned fish.
9. Keep up with regular dental visits.
Professional dental cleanings are necessary to get rid of hardened plaque (tartar) that can’t be removed by your brushing and flossing routine at home. We also check for gum disease, another cause of bad breath.
10. See your doctor.
Certain medical conditions like acid reflux, diabetes, and respiratory infections can cause bad breath. If you have an untreated health condition, make an appointment with your medical doctor.
If you are concerned about bad breath, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”
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