Posts for category: Dental Procedures
There are an assortment of techniques and treatments in an orthodontist's toolkit, braces being the most common and best known. Of course, there wouldn't be any tools at all if teeth couldn't move naturally.
Teeth aren't directly connected to the jawbone. An elastic tissue called the periodontal ligament lies between each one, with tiny fibers attaching to the tooth on one side and to the bone on the other. The ligament's elasticity and other qualities allow micro-movements of the teeth as we bite.
The ligament can also adapt to changes in the mouth and teeth by allowing the teeth to move to different positions. That's the basic concept behind braces: we thread a thin wire through brackets attached to the teeth, which we then attach to anchor points (usually back teeth not intended to move) and apply tension to it. Gradually over time, the target teeth move.
But what if your malocclusion (poor bite) is more complicated or the back teeth can't supply enough anchorage for moving the intended teeth? That's where we take advantage of other sources of anchorage.
One such source is the patient's skull, which we can make use of through special headgear worn a few hours a day. The device consists of a strap under tension that runs around the back of the head or neck to a wire housing attached to brackets on the target teeth. If you want to “pull” the teeth forward, the strap would come over the chin, forehead or a combination of both.
We may sometimes want to isolate some teeth to move without moving nearby teeth, such as moving front teeth backward to close a space without affecting teeth further to the rear. We can create a separate anchor point in the jaw with a TAD or temporary anchorage device.
TADs are tiny screws made of stainless steel inserted temporarily into the bone. We loop an elastic band over the TAD on one end and to a bracket or tension wire attached to the target teeth on the other. When we've achieved the teeth's new position we can easily remove the TAD from the bone.
These various tools make it possible to correct difficult or complex malocclusions. They may not always look attractive, but they'll help ensure the final result is.
If you would like more information on available orthodontic treatments, 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 “Orthodontic Headgear & Other Anchorage Appliances.”
A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.”
How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future.
The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time.
If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body.
If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring.
If you would like more information about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”