Posts for: February, 2018
Congenitally missing teeth or hypodontia is a condition where some of the adult teeth do not develop. Although it can also affect the primary teeth, this is quite rare, unless there is an underlying genetic disorder (see ectodermal dysplasia discussed below).
What teeth are usually affected?
Third molars (wisdom teeth) are the most commonly missing but are not included in the definition of hypodontia. This is because it is considered a variation of normal to have missing wisdom teeth. The other most commonly missing teeth are lower second premolars and the upper lateral incisors.
Genetic disorders causing missing teeth:
Ectodermal dysplasia- This is a term that includes many genetic disorders that affect the hair, nails, skin, glands, and teeth of those born with it. Teeth may be missing, malformed (cone-shaped) and more prone to decay. Those with ectodermal dysplasia have a normal life expectancy, and most do not have developmental delays. Dentists may be one of the first health professionals to suspect ectodermal dysplasia due to the differences in tooth development.
How will I know if I have missing teeth?
Your dental professional will be able to tell if you have any missing teeth. Usually, they will need an x-ray to confirm this. Gaps between your teeth, losing a baby tooth with no adult tooth taking its place or having a baby tooth longer than normal are all signs of having congenitally missing teeth.
I don't have an adult tooth yet, how long will my baby tooth last?
In the case of having no adult tooth to replace a baby tooth, sometimes the baby tooth remains in the mouth longer than it is meant to. There are cases where they can last well into adulthood, depending on the condition of the tooth and how long the roots are. At some point, the baby tooth may need to be extracted, and it is a good idea to have a treatment plan ready for how to fill the space.
Implants- Usually the best option since they act the most like natural teeth and have the best patient satisfaction and comfort. This treatment may need to be delayed until adulthood and after orthodontic treatment, if it is necessary. Implants are relatively easy to care for and keep healthy with good daily oral hygiene.
Bridge- A bridge can be used to fill a space left by a missing tooth. It involves two crowns on either side of the space with an artificial tooth in between. This is a permanent and non-removable solution but requires thorough cleaning under the bridge to maintain tissue and tooth health.
Orthodontics- Sometimes gaps can be closed with orthodontics and do not require having the space filled. Orthodontics may also need to be done in addition to other treatment options.
Dentures- Partial dentures may be an option to replace missing teeth. Sometimes they are used as short-term solutions until a more permanent treatment such as implants can be done. Implant retained dentures may also be an option. These are more secure dentures that are held in place by implants.
Missing teeth can affect many things including the ability to eat, speak and smile properly. You can work with your dental professional to come up with an individualized treatment plan that will work best for you. Call us to schedule your appointment today: 905-286-1569
In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.
When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”
Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.
There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.
By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.
So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.
A lot of time and effort goes into straightening your smile. But there’s a possibility it might not stay that way—and all that hard work could be lost. The same natural mechanism that enables your teeth to move with braces could cause them to revert to their old, undesirable positions.
So for a little while (or longer for some people) you’ll need to wear a retainer, an appliance designed to keep or “retain” your teeth where they are now. And while the removable type is perhaps the best known, there’s at least one other choice you might want to consider: a bonded retainer.
Just as its name implies, this retainer consists of a thin metal wire bonded to the back of the teeth with a composite material. Unlike the removable appliance, a bonded retainer is fixed and can only be removed by an orthodontist.
Bonded retainers have several advantages. Perhaps the most important one is cosmetic—unlike the removable version, others can’t see a bonded retainer since it’s hidden behind the teeth. There’s also no keeping up with it—or losing it—since it’s fixed in place, which might be helpful with some younger patients who need reminding about keeping their retainer in their mouth.
There are, however, a few disadvantages. It’s much harder to floss with a bonded retainer, which could increase the risks of dental disease. It’s also possible for it to break, in which case it will need to be repaired by an orthodontist and as soon as possible. Without it in place for any length of time the teeth could move out of alignment.
If you or a family member is about to have braces removed, you’ll soon need to make a decision on which retainer to use. We’ll discuss these options with you and help you choose the one—removable or bonded—that’s right for you.
If you would like more information on bonded retainers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Bonded Retainers: What are the Pros and Cons?”