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Does My Child Really Need Dental Arch Expansion?

Arch expansion, or the expansion of the upper jaw, is a form of orthodontic treatment often used to correct a narrow upper arch or crowded upper teeth. Expanding the upper jaw is a potential first step in early orthodontics – if your child’s smile is demonstrating a constructed maxillary arch, he or she will need orthopedic forces to expand the maxilla. By expanding your child’s arch, or the circumference of his or her palate, his or her smile will have more space for permanent teeth to move and grow.

The best age for arch expansion patients is, ideally, as young as possible, but no earlier than the age of five. Upper jaw expansion is most successful when it is performed in children under the age of sixteen, because your child’s baby teeth will be replaced by permanent teeth between the ages of six and thirteen.

Benefits of Arch Expansion

  • Correction of Cross Bites – If your child’s upper teeth actually fit inside his or her lower teeth, he or she may have a cross bite. A cross bite can result in asymmetrical growth of the lower jaw, which can lead to facial asymmetry.
  • Reduction of Overcrowding – Once his or her upper arch is expanded, your child’s smile will have more room to accommodate the development of teeth.
  • Improvement in Breathing Abilities – Does your child experience difficulty breathing through his or her nose? This may be the issue! In fact, dental arch expansion can develop the airway and influence breathing in a number of positive ways, including lessening a patient’s risk of developing sleep apnea and treating existing sleeping and breathing disorders. Continuous mouth-breathing can result in unhealthy inhalation of unfiltered bacteria, dry mouth, and potential halitosis.

Don’t hesitate to look into improving your child’s airway and dental issues!

The Processes of Arch Expansion

  • Fixed Appliance – A fixed appliance, also referred to as a Rapid Palatal Expander (RPE), sits in the top of your child’s mouth at all times. It is traditionally attached to the molars with metal rings, but some appliances may be removable in certain cases. This appliance stretches the bone and cartilage of the palate, forcing it to expand. The appliance comes with a “key” that can be used to tighten the device, therefore, placing outward pressure on the two halves of your child’s upper jaw. Your dentist will recommend a set tightening schedule, and you can simply tighten your child’s RPE in the comfort of your own home on a daily basis. Slowly but surely, your child’s upper jaw will expand.
  • Removable Appliances – Similar to a fixed appliance, removable appliances use slow, gentle pressures to mold your child’s arch form, moving teeth and allowing new bone to grow. Some options for removable appliances include OcclusoGuards, positioners, Bionators, Myobrase, Schwartz plates, and sagittal appliances.

FAQs

  • Does it hurt?
    • There may be some initial discomfort once the application is placed, but typically, no. Patients report a feeling of pressure on the teeth, roof of the mouth, behind the nose, and even between the eyes, but no pain. This pressure fades away within minutes of adjusting the application.
  • How can I help my child through the process?
    • To make the first couple of days more comfortable for your child, you may want to find some fun foods that do not require a ton of chewing. This can include yogurt, pudding, mashed potatoes, ice cream, etc. A day or two after the device is placed, eating should feel normal again. Because food can be easily trapped in the device, be sure to encourage and monitor your child’s oral hygiene regimen. Always make sure your child’s application is clean. Guide your child to stay away from sticky foods, like jelly beans or caramel.
  • How long does my child have to wear the device?  
    • An average timeframe for arch expansion is 6-9 months.
  • How is the device fastened to my child’s mouth?
    • Expanders are typically glued or bonded to your child’s teeth. There are removable expanders, however, fixed ones have the advantage of never being lost or forgotten.
  • Is the device noticeable?
    • Outwardly, no. When the device is initially placed, your child may produce more saliva and have a harder time speaking and eating than usual. After a few days, these symptoms should subside.

Your child’s smile depends on his or her “big kid teeth” fitting into a little mouth! By aligning the upper and lower jaws to meet properly, your child’s arch will have plenty of room for tooth growth.

What Dental X-rays Does My Child Need? Are They Safe?

girl with dentist and x-raysDental x-rays are necessary for determining the present status of a patient’s oral health, along with identifying a patient-specific treatment plan. A request for x-rays can depend on several different factors, including how much dental work has been previously done, the current condition of that dental work, dental hygiene, a patient’s age, a patient’s risk for disease, and any signs or symptoms of dental decay or gum disease. For example, children may need x-rays more often than adults, because their teeth and jaws are continually developing and are more likely to be affected by tooth decay. Each intraoral x-ray shows several teeth, from the upper surface to the supporting bone. Dentists can order multiple images in order to learn more about a specific area of concern.

Dental x-rays are safe. However, they do require extremely low levels of radiation exposure, which makes the risk of potentially harmful effects very minimal. In other words, any level of radiation poses a potential risk to patients. For this reason, team members want to minimize a patient’s exposure as much as possible.

In most dental offices, every precaution is taken to ensure radiation exposure is As Low As Reasonably Achievable, also known as following the ALARA principle. Thanks to advanced dental technology, dental teams operate dental x-ray tools and utilize techniques designed to limit your body’s exposure to radiation. A leaded apron minimizes radiation exposure to your child’s abdomen, while a leaded thyroid collar protects the thyroid from radiation.

Here are 5 different types of dental x-rays your child may need, depending on his or her oral health:

  • Bitewing X-rays (also called cavity-detecting x-rays): These x-rays are used to view the areas between teeth that cannot be easily seen. These X-rays are needed only after the teeth in the back of the mouth are touching each other, as they show where cavities may be forming. In some children, this doesn’t happen until the first permanent molar (also called the 6-year molar) has erupted.
  • Periapical X-rays: These x-rays are used to view the entire crowns and roots of one, two or three teeth that sit next to each other. They also show the supporting bone structure of the teeth, allowing the dentist see your child’s permanent teeth developing below the baby teeth. They are also used to look for abscesses and gum disease.
  • Panoramic X-rays: These x-rays are used to obtain a comprehensive view of all of the teeth on one film, displaying the upper and lower jaws, the temporomandibular joints (TMJs) and the sinuses above the upper teeth. They are often used if a child has hurt his or her face, has orthodontic problems, or is mentally or physically disabled. Panoramic X-rays, unlike other types, do not require a film to be put in the child’s mouth. This is helpful for children who gag easily or have small mouths. This X-ray must be exposed for 12-18 seconds, and the patient must be able to sit or stand still for that whole time.
  • Occlusal X-rays: These are used to view most of the upper or lower teeth on one film. This is useful when the dentist does not have a panoramic X-ray machine or when the child has difficulty in taking bitewing or periapical X-rays.
  • Orthodontic X-rays (also called cephalometric or lateral skull): This type of X-ray shows the head from a side view. It is used to evaluate growth of the jaws and the relationship of bones in the skull. It also helps an orthodontist make an accurate diagnosis and develop a treatment plan.

If you have any questions or concerns regarding dental x-rays, please do not hesitate to contact us!

Be Wise about Your Teen’s Wisdom Teeth

male dentist with woman patient at clinicWisdom teeth, otherwise known as third molars, normally push through the gums between ages 17 to 25. The nickname “wisdom teeth” dates all the way back to the 17th century, implying a person may not be truly wise until he or she receives third molars. These are the last teeth to erupt through the gums for adults. Have your wisdom teeth already arrived?

Here are some symptoms to watch for:

  • Red, inflamed or tender gums behind your molars
  • Discomfort toward the back of the mouth when chewing food or drinking
  • Jaw pain and tenderness
  • Bad breath
  • Unpleasant taste upon chewing food

But what about these symptoms occurring for “tweens”, those from ages 11 to 15? This age range is the time that  second (or 12-year) molars are typically coming into the mouth behind the first (or six-year) molars. The same conditions can occur as the second molars erupt into the mouth as when third molars erupt. Typically there is less room for third molar than second molars so these problems are more common with the third molars. When pain and inflammation is present, a dentist will usually not remove the tooth that is a second molar. He or she will likely clean and medicate the area with an antibacterial rinse and in a few cases perform a simple surgical procedure to remove the inflamed tissue that covers the top of the erupting tooth. Thankfully in most cases there is no need for any treatment as the tooth continues to grow into place and the pain goes away all by itself. Not sure if they’re second molars or wisdom teeth? Ask your dentist. He or she can take a quick look and tell you in a second and save you a lot of worrying and second-guessing.

Dental professionals typically recommend removing wisdom teeth through surgery, due to the common problems associated with their arrival. If the alignment in a patient’s teeth is extremely straight, he or she may not need wisdom teeth removal. However, perfect alignment is rare, and extraction is necessary when wisdom teeth do not grow in properly.

If a smile is already a bit crowded, the arrival of wisdom teeth can make things even more complicated. Overcrowding can lead to problems in the gums and bone, cavities and shifting of existing teeth. If a wisdom tooth only partially breaks through the surface of the gums, an unhealthy amount of bacteria tends to grow, causing infection resulting in swelling, stiffness, pain and other illnesses. When your dentist sees this problem the diagnosis is called pericoronitis and the suggestion is typically that the teeth be removed.

Many wisdom teeth become impacted, which means they cannot erupt through the gums because they grew in facing the wrong angle. Impacted wisdom teeth do not have an open connection to the mouth, which may lead to pain, inflammation, infection or damage to adjacent teeth.

To avoid these risks, early removal is strongly recommended. By waiting until an older age, the risk of the procedure and healing time significantly increase. It is preferable to have wisdom teeth removed before they cause problems in overall oral health.

If you are considering wisdom tooth removal, the biggest variable of the surgery is how you want to be medicated. Options include one or more of the following:

  • Local anesthesiaThis type of on-site injection is used for other dental procedures to numb the area.
  • Laughing gas (nitrous oxide)Laughing gas can be used in conjunction with local anesthesia to “take the edge off”.
  • Oral Conscious sedation—A combination of medications keep the patient in a groggy state for the procedure. You may have heard that this technique is called Chill with the Pill.
  • Oral medications for anxiety—Anti-anxiety medications are used to combat fear and anxiety before and during a procedure.
  • I.V. Sedation—A combination of medications that temporarily put the patient under so that the procedure can be done and they are not aware of it. This is done in many dental practices.
  • General anesthesia —In rare, complex situations, a patient may be “put under” for oral surgery. This type of anesthesia requires advanced training and typically does not take place in a dental clinic setting.

Thankfully, there are many options for making wisdom tooth extractions relatively simple and painless. We know not all wisdom teeth may need to be removed, but if you suspect you may need to have your wisdom teeth taken out, feel free to schedule an appointment with your dentist for further consultation.

Pediatric vs. General Dentistry: Is There a Difference?

Girl in dentists chair toothbrushing a modelThe choice between pediatric dentistry and general dentistry is a dilemma parents have been facing for years. So, what are the benefits of a pediatric dentist, rather than a general dentist?

The main difference between a pediatric dentist and general dentist is education. General dentists must complete at least three or more years of undergraduate education, plus four more years of dental school. On the other hand, pediatric dentists must complete the same schooling as a general dentist, plus an additional two to three years of specialty training following dental school. General dentists do not uniformly receive training regarding the oral care of kids, although some may pursue additional training after dental school individually.

During their training, pediatric dentists learn about kid-specific oral health issues, such as sedatives for children, dental developmental difficulties, and root canals on adult teeth that have not fully formed. Pediatric dentists are also more likely to have affiliations with hospitals and established relationships with pediatricians and other child specialists, which creates a network of health professionals dedicated to finding the best solution for your child’s oral health needs.

In a pediatric dental office, doctors and team members normally have a better understanding of how visual and emotional factors can influence a child’s behavior throughout a visit. Oftentimes, pediatric dentists are better equipped to foster a more soothing, kid-friendly atmosphere for your children. Environment is extremely important when it comes to the relationship kids have with their dentists. Pediatric dental offices usually have brightly-colored walls and interactive toys or videos. These details may just seem like unnecessary bells and whistles, but an environment completely dedicated to kids easily gains a child’s trust.

Pediatric dentists are also trained in the behavior and interactions with children. In other words, pediatric dentists typically have the right personality for treating children. They do not become discouraged or irritated with kids who may cry or have anxiety about visiting the dentist, as they are trained to operate in these kinds of scenarios.

Despite these advantages of having a pediatric dentist, most children are treated by general dentists. A general dentist often has an existing relationship with the entire family, and therefore has a great deal of family history knowledge, which may apply to the diagnosis or treatment of a dental issue with a child.

If your child has abnormal oral health issues or severe dental anxiety, seeing a pediatric dentist may be a great option for you and your family. On the other hand, if your family has a standing relationship with a general dentist, and your child needs a regular checkup, seeing a general dentist would suffice. There are some general dentists who have received advanced training in children’s dentistry, even though they are not pediatric dentists. In this situation, it is up to the family to decide what is best for their child.

Should My Child See a Pediatric Dentist?

Children's dentistAs adults, we all know the importance of oral health and maintaining an oral care regimen. But, what about your children? When should they see a dentist, and does it matter what type of dentist they see? Most babies get their first teeth around the age of 6 months. The ideal time to begin seeing a dentist is about 6 months after the first tooth erupts, so about 1 year of age. Many parents have the misconception that because baby teeth will eventually fall out, they don’t need to be properly cared for. This is false. Baby teeth, or milk teeth as they are often referred to, are important to take care of because they pave the way for healthy adult, or permanent, teeth.

In the dental industry today, there are many different types of dentists who specialize in certain areas. In fact, there are dentists who are specially educated to care for children. Pediatric dentists are the pediatricians of dentistry. A pediatric dentist has 2-3 years of training after dental school that is geared towards caring for children’s teeth and dental issues as they relate to children. They learn about kid-specific entities such as sedatives for children, treating children under general anesthesia and behavior guidance, which allows the dentist to adapt their behavior to fit the needs of a child. This behavior guidance training also gives dentists the ability to learn about caring for those with special needs. Pediatric dentists are able to offer suggestions to parents on hygiene, diet and nursing factors that could cause or prevent oral health issues in children. Often, a pediatric dentists’ office environments are even geared towards children. They will see children from their very first dental appointment through the teenage years.

Is it necessary that your child see a pediatric dentist, though? It’s best to consult your family pediatrician or your family dentist. They can offer guidance in the best treatment for your child. If your child has abnormal oral health issues or severe dental anxiety, seeing a pediatric dentist may be a great option for you and your family. On the other hand, if your family has a standing relationship with a general dentist, and your child needs a regular checkup, seeing a general dentist would suffice. There are some general dentists who have received advanced training in children’s dentistry, even though they are not pediatric dentists. In this situation, it is up to the family to decide what is best for their child.

Bring My 7 Year Old to an Orthodontist? Why??

Little boy with retainerAccording to the American Association of Orthodontics, children should receive their first orthodontic screening by the age of 7. Not every orthodontic problem can be treated by age 7, but most of them can be identified. Most adult first molars and front teeth are erupted by this age allowing the orthodontist to assess growth patterns and development. While this may seem early to some, in reality early orthodontic treatment prevents more serious problems from arising.

Orthodontic treatment in young children is known as interceptive orthodontics or Phase 1 orthodontics. Since teeth are still developing and the jaw is still growing, certain conditions may be easier to address. The goal of interceptive orthodontics is to create adequate space for permanent teeth to grow and ensure the proper development of the upper and lower jaws. Interceptive orthodontics is necessary to:

  • Guide growth of the permanent and jaws
  • Lower the risk of trauma to protruded front teeth
  • Correct harmful oral habits
  • Improve facial appearance

While early orthodontics may not be the answer, it is the best solution. Most children who undergo any form of interceptive orthodontics will need further treatment later on in life. There are many benefits, however. The most important is that later treatment will often be shorter, less complicated and less extensive. Other benefits of orthodontic treatment include:

  • Fewer extractions
  • Better profile/facial esthetics
  • Influence jaw growth versus correcting jaw alignment

The only way to know for sure if your child needs interceptive orthodontic treatment is to schedule a visit with your orthodontist. Some of the most common early signs are:

  • Early or late tooth loss
  • Difficulty chewing or biting
  • Crowded or misplaced teeth
  • Current or previous thumb sucker
  • Misaligned jaws

If you think your child may need interceptive orthodontic treatment, consult an orthodontist. X-rays, impressions and photographs may be taken to determine ideal treatment.

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