When your braces finally come off, you’ll hopefully be astounded by what you see –once-crooked teeth replaced by a more attractive smile. But you might also see something you didn’t expect: noticeable white spots on some of your teeth.
These spots called white spot lesions (WSLs) appear lighter than the surrounding tooth enamel due to mineral loss just beneath the surface. This happens because bacterial or food acids have contacted the enamel surface for too long and dissolved the underlying calcium and other minerals. This results in a small discolored and chalky-like area in the enamel.
WSLs are common during orthodontics because wires and brackets create hard to reach places for brushing and flossing, which can accumulate bacterial plaque. The bacteria produce acid, which weakens the enamel at these places. The tiny white spots that result are more than just unattractive—they can become entry points into the tooth for decay. That’s why they should be dealt with as soon as possible—and preferably before they’re created.
To that end, you’ll need to do as thorough a job as possible brushing and flossing while undergoing orthodontic treatment. To improve your thoroughness try using an interproximal toothbrush that can maneuver more closely around braces hardware than a regular brush. You can also improve your flossing with a floss threader or a water flosser, a device that sprays pressurized water to loosen and flush away plaque.
If you do develop WSLs, there are some things we can do to treat them. We can attempt to re-mineralize the affected enamel with the help of topical fluoride (either pastes or gels for home use or with an office application) or a re-mineralizing agent. We can also use techniques like microabrasion, which restores damaged areas beneath the surface, or inject a liquid, tooth-colored resin beneath the WSL’s surface to improve appearance and protect against decay.
If while wearing braces you do notice any white spots or other tooth discoloration let your dentist or orthodontist know right away. The sooner your dental providers can begin dealing with potential WSLs the better your chances for a healthy and beautiful outcome after braces.
If you would like more information on oral hygiene while wearing braces, 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 “White Spots on Teeth During Orthodontic Treatment.”
Regular dental visits are just as important for healthy teeth and gums as daily brushing and flossing. Not only will these visits reduce the amount of hidden or hard to reach bacterial plaque (the main source of dental disease), but they'll also boost the chances problems with teeth and gums are caught early and treated.
A lifetime habit of dental visits should begin around your child's first birthday, but children can be stressed or even frightened by trips to the dentist. This could stick with them, causing them to avoid regular dental visits when they become adults. The absence of professional dental care could prove hazardous to their dental health.
Here then are some things you can do to “de-stress” your child's dental visits.
Begin and sustain regular visits early. By not waiting a few years after age one, your child has a better chance of viewing it and subsequent visits as a normal part of life.
Choose a “kid-friendly” dentist. A pediatric dentist is trained not only for dental issues specific to children, but also in creating a comfortable environment for them. Some general dentists are also skilled with children, taking the time to talk and play with them first to ease any anxiety.
Stay calm yourself. Perhaps you've discovered, often in an embarrassing fashion, that your children are watching you and taking cues on how to act and react. Be sure then to project a sense of ease and a “nothing to this” attitude, rather than nervousness or anxiety. Your child will follow your lead.
Set the example. Speaking of following your lead, your children will intuitively pick up whether you're serious about your own dental health, which could influence them. So be sure you practice what you preach: daily oral hygiene, a dental-friendly diet and, of course, your own regular visits to the dentist. Your actions about your own dental care really will speak louder than words.
If you would like more information on effective dental care for your child, 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 “Taking the Stress out of Dentistry for Kids.”
Summer is the time for many children to experience the fun and freedom of sleepaway camp. Along with greater independence, camp brings increased responsibility for kids to take care of themselves, including taking care of their oral health.
Two keys to dental health are a balanced diet and good oral hygiene, but camp life may tempt kids to overdo the kinds of food they don’t often indulge in at home. For most campers, enjoying s’mores around the fire is a given, but these marshmallowy treats pack a punch in the sugar department. In fact, a single s’more has half the daily limit of sugar recommended by the World Health Organization—and if the sweet treat’s name is any indication, no one stops at just one! Because sticky marshmallows are a central ingredient, they are worse for the teeth than many other sweets; the goo adheres to the surface of the teeth and gets stuck between teeth and braces, increasing the potential for tooth decay. Add in plenty of opportunities to consume sugary drinks and other treats throughout the week, and sleepaway camp can be a less-than-ideal environment to maintain good oral health, especially since brushing and flossing may not be a high priority with so much else going on.
You can help your camper feel more invested in their oral hygiene routine by involving them in as many preparations as possible, such as making a list of items to pack and shopping together for dental supplies. These can include a travel toothbrush with a case and a travel-sized tube of fluoride toothpaste—or a package of pre-pasted disposable toothbrushes. And don’t forget dental floss! You may also wish to include gum sweetened with xylitol, a natural sweetener that helps fight cavities. This could come in handy for those times your child gets too busy to brush.
Consider scheduling a teeth cleaning for the downtime after your child gets home from camp and before the start of the new school year, just in case your child wasn’t the most diligent about oral hygiene while away—and to ensure that they begin the new school year in the best oral health.
If you would like more information about how your child can maintain good oral health, please call our office to schedule a consultation. You can learn more in the Dear Doctor magazine articles “How to Help Your Child Develop the Best Habits for Oral Health” and “The Bitter Truth About Sugar.”
While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.
“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.
Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.
Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).
For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.
Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.
If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”
About one American baby in 700 is born with some form of lip or palate cleft—and the percentage is even higher in other parts of the world. At one time this kind of birth defect sentenced a child to a lifetime of social stigma and related health issues. But thanks to a surgical breakthrough over sixty years ago, cleft defects are now routinely treated and repaired.
Oral and facial clefts happen because a child’s facial structure fails to develop normally during pregnancy. This causes gaps or “clefts” to occur in various parts of the mouth or face like the upper lip, the palate (roof of the mouth), the nose or (more rarely) in the cheek or eye region. Clefts can have no tissue fusion at all (a “complete” cleft) or a limited amount (an “incomplete” cleft), and can affect only one side of the face (“unilateral”) or both (“bilateral”).
There was little that could be done up until the early 1950s. That’s when a U.S. Navy surgeon, Dr. Ralph Millard, stationed in Korea noticed after reviewing a series of cleft photos that tissue needed to repair a cleft was most often already present but distorted by the defect. From that discovery, he developed techniques that have since been refined in the ensuing decades to release the distorted tissue and move it to its proper location.
This revolutionary breakthrough has evolved into a multi-stage approach for cleft repair that often requires a team effort from several dental and medical professionals, including oral surgeons, orthodontists and general dentists. The approach may involve successive surgeries over several years with dental care front and center to minimize the threat of decay, maintain proper occlusion (the interaction between the upper and lower teeth, or “bite”), or restore missing teeth with crowns, bridgework or eventually dental implants.
While it’s quite possible this process can span a person’s entire childhood and adolescence, the end result is well worth it. Because of these important surgical advances, a cleft defect is no longer a life sentence of misery.
If you would like more information on treatment for a cleft lip or palate, 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 “Cleft Lip & Cleft Palate.”
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