Posts for category: Dental Procedures

ARetainer-LikeDevicecanPreservetheSpaceLeftbyaLostPrimaryTooth

Children losing their primary (“baby”) teeth is both natural and necessary. So, is it really that much of a concern if they lose one early?

The answer is yes — premature primary tooth loss could have long-term consequences for the permanent teeth as they develop within the jaw before eruption. Primary teeth play a crucial role in this development: as the permanent teeth form and grow the primary teeth serve as placeholders until they’re ready to erupt. A natural process then takes place in which the primary tooth’s roots dissolve (resorb) to allow them to fall out. Once they’re out of the way, the permanent teeth can then erupt.

If, however, they’re lost before the permanent teeth are ready, it leaves a space in the child’s bite. The dynamic mechanism between teeth and the periodontal ligament causes adjacent teeth to move or “drift” into the space. This can crowd out the permanent tooth intended for the space, causing it to come in improperly forming a malocclusion (bad bite), or it may become impacted and remain partially or fully below the surface of the gums.

This poor dental development could lead to extensive orthodontic treatment later in life, which is why we seek to preserve even decayed primary teeth for their entire natural lifespan. If the tooth is lost, however, we need to take action to preserve the space for the permanent tooth and avoid costly treatment later.

This usually calls for a “space maintenance” appliance — a type of orthodontic “retainer” — worn by the child to prevent other teeth from drifting into the space. Designed by your orthodontist, the appliance can also perform a cosmetic and social function by causing the space to appear unnoticeable.

Maintaining that space requires monitoring — especially by an orthodontist — and continued dental hygiene and care both at home and at the dentist’s office. The extra care preserving the space caused by premature tooth loss will help to ensure your child’s dental structure develops properly and their future smile will be an attractive one.

If you would like more information on the care and treatment of primary teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Early Loss of Baby Teeth” and “Losing a Baby Tooth.”

By Carey & Aylward, DDS, PC
June 25, 2015
Category: Dental Procedures
EdenSherandtheLostRetainer

Fans of the primetime TV show The Middle were delighted to see that high school senior Sue, played by Eden Sher, finally got her braces off at the start of Season 6. But since this popular sitcom wouldn’t be complete without some slapstick comedy, this happy event is not without its trials and tribulations: The episode ends with Sue’s whole family diving into a dumpster in search of the teen’s lost retainer. Sue finds it in the garbage and immediately pops it in her mouth. But wait — it doesn’t fit, it’s not even hers!

If you think this scenario is far-fetched, guess again. OK, maybe the part about Sue not washing the retainer upon reclaiming it was just a gag (literally and figuratively), but lost retainers are all too common. Unfortunately, they’re also expensive to replace — so they need to be handled with care. What’s the best way to do that? Retainers should be brushed daily with a soft toothbrush and liquid soap (dish soap works well), and then placed immediately back in your mouth or into the case that came with the retainer. When you are eating a meal at a restaurant, do not wrap your retainer in a napkin and leave it on the table — this is a great way to lose it! Instead, take the case with you, and keep the retainer in it while you’re eating. When you get home, brush your teeth and then put the retainer back in your mouth.

If you do lose your retainer though, let us know right away. Retention is the last step of your orthodontic treatment, and it’s extremely important. You’ve worked hard to get a beautiful smile, and no one wants to see that effort wasted. Yet if you neglect to wear your retainer as instructed, your teeth are likely to shift out of position. Why does this happen?

As you’ve seen firsthand, teeth aren’t rigidly fixed in the jaw — they can be moved in response to light and continuous force. That’s what orthodontic appliances do: apply the right amount of force in a carefully controlled manner. But there are other forces at work on your teeth that can move them in less predictable ways. For example, normal biting and chewing can, over time, cause your teeth to shift position. To get teeth to stay where they’ve been moved orthodontically, new bone needs to form around them and anchor them where they are. That will happen over time, but only if they are held in place with a retainer. That’s why it is so important to wear yours as directed — and notify us immediately if it gets lost.

And if ever you do have to dig your retainer out of a dumpster… be sure to wash it before putting in in your mouth!

If you would like more information on retainers, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Why Orthodontic Retainers?

By Carey & Aylward, DDS, PC
June 10, 2015
Category: Dental Procedures
Tags: gummy smile  
ImprovingaGummySmileDependsonitsCause

A “gummy” smile, in which the upper gums are too prominent, is a common condition. There are several causes for gummy smiles — determining which one is the first step to having your appearance changed.

Although perceptions vary from person to person, most dentists agree a gummy smile shows 4 mm or more of gum tissue, and the amount is out of proportion with the length of the crown (the visible tooth). Teeth normally erupt through the gums during childhood and continue development until early adulthood, shrinking back from the tooth until stabilizing in place.

This typically produces a crown length of about 10 mm, with a “width to length” ratio of about 75-85%. But variations can produce differences in the relationship between teeth and gums and the width to length ratio of the teeth. The teeth may appear shorter and the gums more prominent. Worn teeth, caused by aging or grinding habits, may also appear shorter.

If tooth to gum proportionality is normal, then the cause may be upper lip movement. When we smile, muscles cause our lips to retract 6-8 mm from the lip’s resting position. If the amount of movement is greater (meaning the lip is hypermobile), it may show too much of the gums. The upper jaw can also extend too far forward and cause the gums to appear too prominent.

There are a number of ways to improve gummy smiles, depending on the cause. Periodontal plastic surgery known as crown lengthening removes and reshapes excess gum tissue to reveal more of the tooth. Lip hypermobility can be reduced with Botox injections (to paralyze the muscles) or in some cases with surgery to reposition the muscle attachments. Orthognathic surgery can be used to surgically reposition an overextended upper jaw. Other cosmetic enhancements such as orthodontics, bonding or porcelain restorations can also prove effective.

The first step is to obtain an accurate diagnosis for your gummy smile. From there, we can devise the best treatment approach to bring your smile back into a more attractive proportion.

If you would like more information on minimizing a gummy smile, 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 “Gummy Smiles.”

By Carey & Aylward, DDS, PC
May 11, 2015
Category: Dental Procedures
Tags: veneers  
PreplessVeneerscanTransformYourSmileWithoutAlteringYourTeeth

Porcelain veneers represent one of the best values in cosmetic dentistry, capable of radically changing a person’s smile with little tooth surface preparation. Still, the small amount of tooth enamel usually removed to accommodate them will permanently alter the affected teeth, to the point they will require a veneer or other restoration from then on.

The traditional veneer has remarkable versatility for solving a number of minor cosmetic problems, correcting mild tooth positioning problems and replacing lost or damaged enamel. But to avoid an unnatural bulky appearance, a portion of the tooth enamel must be permanently removed to accommodate them.

In recent years, though, a new concept known as “prepless veneers” has emerged in the field of cosmetic dentistry. Understandably, this new, “drill-free” veneer application has caused a lot of debate among dentists and patients alike, with concerns of bulky, overly-contoured teeth resulting from the technique. But the concept is growing as many well-regarded dentists have incorporated both minimal prep and prepless veneers into their service offerings.

The prepless veneer offers a cosmetic solution that doesn’t alter the tooth permanently. Using techniques such as feathering, which tapers and blends the veneer seamlessly with the tooth at the gum line, we can avoid an unnatural appearance while offering patients a much less invasive outcome.

The main disadvantage of prepless veneers at this time is that they’re not appropriate in every case. In fact, careful patient selection is a key to a successful outcome. For example, relatively large teeth or teeth positioned too far forward don’t work well with an added layer of thickness.

If, on the other hand, you have small, short or worn teeth, or teeth overshadowed by your lips — just to name a few likely scenarios — then you may benefit immensely from prepless veneers without permanent alteration to your teeth. A detailed examination is your first step to finding out if this new technique could provide you with a less-invasive smile makeover.

If you would like more information on drill-free porcelain veneers, 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 “Porcelain Veneers without the Drill.”

By Carey & Aylward, DDS, PC
April 23, 2015
Category: Dental Procedures
Tags: Teeth Whitening  

Teeth WhiteningIf you're thinking about whitening your teeth, you'd be joining the 100 million Americans who have tried a dental bleaching product or procedure. Needless to say, whitening now leads the cosmetic industry; the products are easily obtained and very affordable. But are they safe? Because the dentists at Carey & Aylward in Westland know that it's important to make an informed decision about your health, here are some facts about the safety of dental whitening.

More isn't better

It may seem like a good idea to extend the time you wear whitening strips or trays to achieve a brighter smile in faster time. However, your Westland dentist advises against going "off-label" for several reasons.

First, the overuse of whitening chemicals can actually bring on the opposite effect - your teeth can become mottled and unevenly colored if the trays or strips are left in place too long. They can even permanently dull the finish on your enamel.

Leaving whitening products on longer than instructed can also have painful consequences. The gum tissue can become very irritated from exposure to the chemicals. If the enamel is compromised, the teeth can become extremely sensitive to hot and cold stimuli (coffee, ice cream, and so on). If you have an untreated cavity or fracture, the whitening chemicals can edge into these spaces, potentially causing internal nerve damage.

Expert opinion

It may ease your mind to know that the American Dental Association has placed their Seal of Acceptance on many whitening systems and procedures, including some that can be purchased at pharmacies or grocery stores. However, these industry experts caution that a dental professional should be consulted before beginning any treatment. Checking for the ADA's seal and talking with your southeastern Michigan dentist about the product will help put you on the right track for whiter teeth.

Leave it to the pros

For those who want quick but safe results, a visit to your Westland dental office would be your best option. In-office whitening treatments usually only take as long as a lunch break - between 30 and 60 minutes. Upon completion, the results are immediately visible. In-office whitening can last up to a year, much longer than over-the-counter systems, and with your dentist at the helm, your safety and satisfaction is the ultimate goal.

Don't let discolored teeth keep you from smiling. Contact the team at Carey & Aylward DDS in Westland today for a consultation.