In dentistry, the alignment or relation of the upper and lower teeth when a person bites down is called occlusion, or more commonly, “bite”. Malocclusion, or misalignment of the upper and lower dental arches results in a “bad bite” and when a bad bite negatively affects a person’s oral and overall health, a bite disorder is present.
An improperly functioning bite puts strain on a person’s jaw bones and facial muscles and causes problems with chewing, talking, and swallowing. A bad bite can contribute to a host of problems, including: receding gums; teeth grinding/clenching; broken teeth; tooth erosion; maxillofacial pain; and sleep apnea.
Bite disorders are caused by: deviations in tooth development; ill-fitting dental prostheses; an underdeveloped jaw; injury; or dysfunctions of the TMJ (temporomandibular jaw) joints. They can also develop as a result of habits such as thumb-sucking and tongue thrusting which put constant pressure on the teeth causing them to shift.
Types of bite disorders
Teeth in the lower dental arch tilt inward or outward more than the corresponding teeth in the upper dental arch.
The upper teeth overlap or protrude over the lower teeth.
The lower teeth overlap or protrude over the upper teeth.
The upper and lower teeth do not quite come together when the person bites down leaving a space between the dental arches.
Bite disorders are treated by dentists using a mixture of bite occlusion dentistry and TMJ therapy. Tooth reshaping, orthodontic treatment (e.g. braces), dental prostheses, and tooth extractions may be used to correct the patient’s bite, while bite splints/mouth guards are used to treat malocclusion-related teeth clenching and sleep apnea. Jaw surgery may also be required to fix bad bites and reduce maxillofacial pain.
Dentists have long understood that pathogenic bacteria play a central role in oral pathologies. Various kinds of bacteria in the mouth are associated with tooth decay, periodontal diseases, oral mucosal diseases, endodontic diseases, and even oral cancer. Early detection and monitoring of pathogenic bacteria is thus a critical component of oral disease prevention, diagnosis, and treatment.
Traditionally, dental practitioners have relied on microbiological tests to detect, diagnose and monitor oral health conditions that have pathogenic bacteria as an underlying cause or factor. These conventional tests however, are limited for a number of reasons. For one, many conventional microbiological tests do not pick up on bacterial agents that have a very low infectious dose (the amount of bacterial cells required to start an infection). Also, conventional microbiological testing requires collecting oral specimens and performing culture analyses in a laboratory. This process is technically complicated and the cultures can be difficult to interpret. Also, the need to wait for test results delays treatment.
New advances in oral microbiological testing hold promise for faster and more accurate detection and diagnosis of bacterial oral conditions. Recently, a wireless oral sensor has been developed that is able to measure and report levels and types of pathogenic bacteria in the mouth. The sensor is an ultra-thin film that is pressed onto the surface of a tooth, hence the name ‘tooth tattoo’. The sensor’s detection ability rests in its layer of specially designed peptides which bond with specific bacteria. An antenna built into the sensor powers the device and transmits data to a handheld reading device.
Compared to traditional oral disease detection and diagnostic methods, tooth tattoo sensors provide onsite detection and monitoring without the need for time-consuming laboratory testing. They are faster and more accurate at detecting even very low levels of pathogenic bacteria, and allow for better, more customized treatment of oral pathologies. Tooth tattoo sensors are still being developed and tested but may eventually become a regular feature of general dental care.
Restorative dentistry is a specialized field of dentistry that deals with rehabilitating damaged, missing, or diseased teeth to restore the functional and cosmetic quality of a person’s dentition. Because teeth cannot be restored without considering the health and integrity of the structures and tissues that support them, restorative dentistry is typically an integrative approach which brings together prosthodontic, endodontic, and periodontal treatment.
Prosthodontics, which involves designing and fitting dental prostheses, is the mainstay of restorative dentistry. Dental prostheses are devices designed to replace missing or defective teeth or other mouth structures. These artificial devices mimic the look, and restore the function, of natural mouth structures. Dental prostheses used in restorative dentistry include the following:
A dental crown is a protective cap or covering that is cemented onto a tooth that is cracked, chipped, or otherwise damaged. Crowns match the color and look of the patient’s natural teeth and also strengthen the tooth’s structure.
Bridges are artificial teeth designed to fill a gap between healthy teeth. Bridges are bonded to the adjacent natural teeth to hold them in place. Bridges prevent the teeth from shifting thereby preserving the alignment of the teeth.
Dentures are removable artificial teeth that can be designed to restore a person’s full dental arch (complete dentures) or several missing teeth (partial dentures).
Dental implants are artificial teeth that are singly screwed into the jawbone, after which, a crown in placed on top. Implants mimic the appearance and function of natural teeth.
The process of restoring teeth may sometimes require that the pulp chamber and tissues surrounding the roots of the teeth be treated. In such cases, restorative dentistry may also involve endodontic treatments such as root canal therapy or root end surgery.
In many cases, the presence of a periodontal disease or defect is the reason why teeth need to be restored in the first place. The gum, jawbone, or periodontal ligament often needs to be treated before dental prostheses can be fitted. As such, restorative dentistry often involves periodontal treatments such as bone grafts to replace atrophied jaw bone, or crown lengthening to expose enough natural tooth structure for the placement of a dental crown.
Taking children to the dentist can be tricky, and this is especially true for a child’s first dental visit. Some children find it hard to sit still at the dentist and may behave disruptively, running around or touching things in the dentist’s office. Alternatively, some children can feel anxious or intimidated in new situations or interacting with strangers and will not immediately warm up to the person in the white coat. Furthermore, sharp-looking, noisy dental instruments can be frightening to children who have been known to throw tantrums or have meltdowns once seated in the dental chair.
If you are a caregiver who is planning to take a youngster to the dentist for the first time, here are some things you can do to ensure that your child gets the best out of his or her treatment and the visit goes as smoothly as possible.
1) Choose a kid-friendly dentist
Some dental practices are more kid-friendly than others. You can call beforehand to find out what amenities the dental practice offers for kids, e.g. kids waiting room/play area, stickers, child-sized dental chairs etc. Taking your child to a pediatric dentist rather than to a general dentist is recommended since pediatric dental facilities provide child-friendly environments, and the dental staff is trained to work with children.
2) Orient the child beforehand
Calmly discuss the upcoming visit with your child. This will satisfy your child’s curiosity and also help them to feel prepared. During a first visit, the dentist will usually do a physical examination, take x-rays, and perhaps do a dental cleaning. Let your child know what will be expected of them. Also, prepare your child to like the dental practitioner by painting the dentist as a nice person who likes children. Build up positive associations in your child’s mind so that dental visits don’t seem scary or even that big of a deal. Some dental practices offer office tours and taking the child on one beforehand is a good way to orient them to the new environment.
3) Communicate with the dentist
Let the dental staff know up front of any allergies your child has, as well as any habits that might affect their oral health e.g. thumb sucking. You should let the dentist know of any concerns you have regarding your child’s ability to receive dental care.
4) Stay with your child
It’s important for parents to stay in the examining room with younger children. This allows you to offer moral support and be a comforting presence for your child. By staying in the examining room, you’re also able to observe the dental staff in action and make sure you are comfortable with the way care is being delivered.
Cavities or dental caries are a relatively common development in the life cycle of human teeth. These holes or eroded areas in the surface of the teeth occur when plaque and tartar buildup on the teeth triggers acidic processes that cause the tooth’s enamel layer to decay. Without treatment, the decay may progress to the dentine layer of the tooth and eventually to the pulp chamber, exposing the sensitive nerves and blood vessels inside the teeth. Without the protective outer layer, food and bacteria can enter the teeth making it vulnerable to infection. Also, by depleting the tooth structure, cavities undermine tooth strength, making the affected teeth prone to fractures.
Dental cavities can form on any part of a tooth depending on where the acid attacks. Dental cavities are classified as follows.
1) Root cavities
Cavities that form below the gum line, on the surface of the teeth roots, are known as root cavities. This is the least common type of dental decay, occurring mostly in people with receding gums, for example, elderly people.
2) Pit and fissure cavities
Pit and fissure cavities occur on the chewing surfaces of the teeth. These cavities form on the grooves and valleys (the pits and fissures) that characterize the top surfaces of the molars (the back teeth). Pit and fissure cavities are the most common type of dental decay. They are also usually the most severe and painful.
3) Smooth surface cavities
Cavities that form between the teeth, or on the flat inner or outer surface of the teeth, are called smooth surface cavities. In the beginning, these cavities appear as white, chalky spots on the flat surfaces of the teeth, rather than as holes in the teeth; because of this, many people do not realize they have a cavity. Smooth surface cavities are considered the least threatening type of cavity since they grow more slowly than other types of cavities and can be reversed with fluoride therapy.
Regardless of the type, cavities require immediate treatment since they can have potentially serious, even life-threatening consequences when left untreated. A dental filling, which involves closing up the hole in the tooth, or root canal therapy to remove damaged pulp, can curb the escalating harmful effects of dental cavities.
From enjoying outdoor activities to getting the perfect tan, most people value time spent in the sun. Moreover, most of us have heard that moderate sun exposure has a host of health benefits including reducing the risk of certain cancers, fostering bone health, and boosting the immune system. One less well-known reason for treasuring the sun’s rays has to do with your teeth.
Sunshine aids in tooth health by helping the body produce vitamin D, which in turn helps the body to absorb calcium, one of the building blocks of healthy teeth. Calcium is crucial for healthy tooth development in the early stages of a person’s life since this mineral is central to the molecular structure of tooth enamel. Calcium is also necessary to maintain strong, healthy teeth over the course of a person’s lifetime. This is because teeth are subject to ongoing calcium ion loss on the molecular level through the lifelong process of tooth demineralization. If the calcium in teeth is not constantly replenished, enamel erosion, tooth decay, and eventually cavities arise, the dental problems behind costly fillings and tooth extractions. Thus, tooth enamel needs to be constantly remineralized with calcium ions to prevent destruction of the teeth structure.
Most of the calcium found in the body is stored in the teeth and bones, however the body requires calcium for other important tasks such as blood clotting, nerve functioning, and heart regulation. Low levels of vitamin D can impede the absorption of calcium on the cellular level, result in calcium being leeched from the teeth and directed toward other bodily functions, a process that weakens the teeth.
Moderate sun exposure is one of the best ways to maximize vitamin D production and thereby maximize the calcium absorption needed for strong teeth. Sunshine, through its positive effect on vitamin D and calcium levels in the body, also helps combat infection and inflammation, the underlying mechanisms of most periodontal diseases. For all of the above reasons, sunshine should be considered an important component of a good oral care regimen.
Amalgam fillings, more commonly known as metal fillings, have long been the subject of debate. These older types of fillings are made from a blend of copper, silver and mercury and for decades, were the standard type of tooth filling used in dentistry. Since the 1970s however, research into the effects of metal toxicity on the human body has brought the safety of metal fillings into question. Several studies have linked metal fillings to gastrointestinal problems, neurological problems, sleep disturbances, Alzheimer’s disease, kidney damage, oral pathologies, and immune system disorders. In light of the controversy surrounding amalgam fillings, many dental practices now offer filling replacement services.
Dentists who remove mercury fillings carefully follow a set of protocols to ensure that the fillings are removed safely. During removal of mercury fillings, as the dentist drills out the filling, the patient is exposed to harmful mercury, copper, and silver vapors; thus, precautions are taken to minimize the effects of heavy metal ingestion on the patient. Usually, the patient will be given a high oral dose of vitamin C, an antioxidant that works to removes or detoxify the body of heavy metals. The patient will also be given an oxygen mask with a built-in filter; this way, the patient is breathing in clean air, rather than airborne heavy metal particles.
During filling removal, the dental assistant will also use a suction hose, air-water syringe, and another tool called a high volume evacuator to constantly vacuum away debris and keep the mouth clean and dry. This is done to keep the patient from swallowing pieces of metal and to reduce the possibility of infection. Once the metal filling is out and the patient has rinsed with water to clean the mouth of any remaining metal fragments, the next step is re-plugging the tooth with a composite filling. These non-metal fillings are non-toxic and match the color of the teeth so that they appear natural. After the procedure, the patient is typically given activated charcoal pills to take which further detox the body of heavy metals.
One of the surest ways to avoid the harmful effects of tooth decay is to maintain good oral hygiene habits. Another way is to detect cavities early and nip them in the bud before they progress into full-blown health problems like abscesses, tooth loss, and even nerve damage. While most cavities can be treated easily with fillings, the process of filling a tooth weakens the tooth, making it prone to fractures, and sometimes, infection. The bigger the cavity, the more damage is done to the tooth structure. By detecting cavities early, when they are smaller and less complicated to treat, tooth integrity can be preserved and dental disasters can be averted.
Once upon a time, patients had to rely solely on a dentist’s manual examination, x-rays, or on their own subjective symptoms, to ascertain the presence of cavities; however, not all cavities are discernible by the human eye and in the early stages, not all cavities produce noticeable symptoms. Also, by the time cavities show up on x-rays, the decay has already progressed to a considerable portion of the tooth.
Nowadays, FDA-approved laser technology is the cutting edge of cavity detection. A laser light is beamed onto the teeth and areas of the teeth where decay is present show fluorescence (glow brightly). The laser detector also produces an audible signal when passed over suspicious areas. Additionally, these devices register a number on a scale which gives an idea of whether the area requires immediate treatment or is simply a vulnerable area that should be actively monitored.
Lasers detectors have a 90 percent accuracy rate at detecting cavities. These instruments expose pin prick-sized cavities that are just starting to form, i.e., cavities that require only a small filling. Small fillings mean less damage to the tooth structure, and they also reduce the risk of complications like abscesses, fracturing, and tooth loss further down the road, complications that can be quite expensive to treat. Laser cavity detection also aids in cavity prevention since it exposes vulnerable areas that can be treated with fluoride therapy or dental sealants before cavities form.
Lingual frenectomy and lingual frenuloplasty are both dental procedures used to correct a condition called ankyloglossia. Ankylogloassia, more commonly known as ‘tied tongue’, is an abnormality of the lingual frenulum. The lingual frenulum, the band of tissue that connects the tongue to the floor of the mouth, is abnormally short, thick, and tight in individuals with ankyloglossia. This affects the movement of the tongue and can cause eating, speech, tooth development, oral health, and psycho-social problems. Ankyloglossia is a condition some people are born with, whether due to hereditary or environmental factors.
Lingual frenectomy is a surgical procedure that involves completely removing the lingual frenulum. It is performed by an oral surgeon with the help of local anesthesia. The procedure takes 10 to 15 minutes to complete and the patient is left with a short row of stitches on the underside of the tongue. Serious side-effects are not typically seen with lingual frenectomy; however, potential complications include bleeding, infection, and in some cases, temporary or permanent nerve damage.
Lingual frenuloplasty differs from lingual frenectomy in that the frenulum is not completely removed, but only altered. The goal of lingual frenuloplasty is to snip the lingual frenulum just enough to loosen it and increase the mobility of the tongue. In terms of procedure length and post- operative expectations, lingual frenuloplasty is very similar to lingual frenectomy.
Lingual frenectomy and frenuloplasty may be performed using a scalpel (surgical knife) or a soft tissue laser. Laser dental surgery has several advantages compared to dental surgery done with a scalpel. Ankyloglossia treated with a laser does not require stitches, and also results in less pain and bleeding.
It is often said that it’s the little things we do in life that make a real difference. Well, that same principle applies to oral hygiene. By paying attention to seemingly trivial details like time spent brushing or the type of toothbrush you use, you can significantly boost your oral health and even add years to your life. Here are a few tricks to help you make those small changes that produce drastic oral health results.
Toothbrush replacement reminder
You probably know that your toothbrush should be replaced every3 to 4 months, but if you’re like a lot of people, then you probably forget when you got your toothbrush in the first place. A toothbrush that is more than 4 months old is not an effective brushing tool since the bristles would have become frayed and stiff. Fortunately, there are toothbrushes that actually remind you when it’s time to replace your brush. These toothbrushes have a timestrip inside the handle of the toothbrush that changes color when it’s time for a replacement, or the bristles themselves may change color. Whether you buy a toothbrush with a built-in reminder or set up a reminder alert on your smart phone, consistently changing your toothbrush on time can go a long way in maximizing your oral hygiene.
Dentists recommended that 2 minutes is the minimum amount of time a person should spend brushing their teeth, yet in the hustle and bustle of daily life it’s easy to give brushing time short shrift. In a study published by the American Dental Hygienists Association, people who used a timer while brushing brushed longer; moreover, plaque removal significantly increased in proportion to brushing time. Brushing timers, once thought of as only for kids, are thus good devices for adults to use as well. Another trick is to use an electric toothbrush with a built-in timer.
Choose the right toothbrush
It is a well-known fact that some toothbrushes are better than others, yet many people don’t know how to choose a good toothbrush. Toothbrushes with wide handles are more comfortable to hold and make brushing easier. A good trick is to place a rubber pen grip on the toothbrush handle for better grasping. Choose a toothbrush that fits the size of your mouth, and remember that soft bristled brushes are better than hard bristled ones. If you have orthodontic exposures or braces, you should invest in inexpensive interdental brushes which are specially designed to fit under orthodontic wires. By using the right toothbrush, you can significantly enhance your brushing results and boost your overall oral health.
A fairly common occurrence in the mouth is the existence of extra bone development along the outside or inside of the jawline near the teeth, or in the roof of…
Sedation dentistry is a wonderful option for many people who would not or cannot tolerate dentistry in a traditional dental setting. Many people have a fear of visiting the dentist,…
Lingual frenectomy and lingual frenuloplasty are both dental procedures used to correct a condition called ankyloglossia. Ankylogloassia, more commonly known as ‘tied tongue’, is an abnormality of the lingual frenulum….