My Blog
By Tom Casey DDS, & Erin Haugen DDS
September 18, 2020
Category: Dental Procedures
WisdomTeethCanStillbeaProblemfortheWorldsYoungestBillionaire

According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.

At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.

And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.

As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.

Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.

Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.

Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.

If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?

By Tom Casey DDS, & Erin Haugen DDS
September 08, 2020
Category: Dental Procedures
Tags: missing teeth  
3WaysWeCanImproveaSmileAffectedbyUnformedTeeth

On the way to adulthood, permanent teeth steadily erupt until, if all goes normally, you have a full set of teeth. Sometimes, though, one or more teeth may fail to form. This not only can affect your dental health, but it could also diminish your smile.

For example, if the lateral incisors on either side of the central incisors (the two teeth front and center) don't develop, it could create a smile that's “not quite right.” But we can vastly improve such a smile in one of three unique ways.

The first is to fill the resulting gap through canine substitution. This is an orthodontic method in which we use braces to move the pointed canine teeth, which normally position on the other side of the missing laterals, closer to the central incisors. This choice is determined by the size of the canine teeth. If they are slim in width, they can be re-shaped to make them appear more like a lateral incisor, and the gums possibly reshaped as well around them through cosmetic surgery.

We can also install a dental bridge, an appliance that fills the missing lateral space with prosthetic teeth. A traditional bridge requires the teeth on either side of the gap to be reduced in size, which becomes a permanent alteration to accommodate these crowns. This is a disadvantage in a young person.  We can also use a “bonded bridge” which uses adhesives to attach extended pieces (or “wings”) of dental material from either side of the prosthetic tooth to one or more supporting teeth.  These wings are behind the permanent teeth.  Though not as durable as a traditional bridge, it does avoid altering the support teeth.

Finally, we can replace the missing teeth with dental implants. In this method, we install titanium metal posts into the jawbone at the missing tooth locations and then attach a life-like crown to each one. Implants may be more costly than other restorative methods and can take several months to complete. But they are life-like, highly durable, and don't require any alteration to other teeth. A disadvantage is that you should wait until at least 19 years of age to consider this option.  What many people do is use a temporary solution until the proper age to do a dental implant.

Each of these methods have their advantages and disadvantages, which should be thoroughly reviewed in consultation with your dentist. And each may also require other dental work, such as initial orthodontics to open adequate space for a restoration. But any of these methods for correcting a missing lateral tooth can be effective and help restore both a healthier mouth and a more attractive smile.

If you would like more information on treating congenital dental defects, 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 “When Permanent Teeth Don't Grow.”

By Tom Casey DDS, & Erin Haugen DDS
August 29, 2020
Category: Dental Procedures
Tags: loose tooth  
WeNeedtoActQuicklytoSaveYourLooseTooth

If you're an adult, your teeth shouldn't wiggle—not even a little bit. If you have a loose tooth, you need to see your dentist as soon as possible to avoid losing it permanently.

Loose teeth usually happen because of one of two kinds of bite-related trauma. One is known as primary occlusal, which usually happens when the periodontal (gum) structures that help secure teeth encounter higher than normal biting forces. This is usually due to a clenching or grinding habit.

The other and more common kind is secondary occlusal: This happens when the periodontal structures and supporting bone are in a weakened state, usually because of gum disease. In this condition, even normal biting forces can cause damage to a tooth's gum attachment and result in looseness.

To stop a loose tooth from becoming a lost tooth, we'll need to take these immediate steps.

Treat any underlying disease. If a gum infection is the culprit, our first priority is to stop it from doing any more damage. The main treatment for gum disease is to remove dental plaque, a thin film of bacteria and food particles that's the usual cause for the infection. Depending on how much the infection has advanced, this could take several sessions to bring it under control.

Reduce abnormal biting forces. If teeth are loose from abnormally high bite forces, there are a few things we can do. One is to selectively reshape the biting surfaces of teeth so that they receive less force while biting. Another approach is to minimize the effect of teeth grinding with an occlusal guard worn in the mouth: Its slick plastic surface prevents teeth from making solid contact while biting.

Splint loose teeth to secure them. We can secure loose teeth by splinting them to more stable teeth with metal strips or other means. Splinting is often done in conjunction with the aforementioned treatments, and is usually temporary until the tooth regains its periodontal attachments. Sometimes, though, it may be necessary to permanently splint a weakened tooth.

A loose tooth isn't necessarily destined to be lost. But we'll have to act quickly—if you have a loose tooth see us as soon as possible to determine how best to save it.

If you would like more information on saving loose 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 article “Treatment for Loose Teeth.”

By Tom Casey DDS, & Erin Haugen DDS
August 19, 2020
Category: Oral Health
Tags: gum disease   smoking  
SmokingIncreasesYourRiskforGumDisease

There are important reasons not to smoke, like minimizing your risk for deadly diseases like heart disease or lung cancer. But here's another good reason: Smoking increases your risk of gum disease and possible tooth loss. And although not necessarily life-threatening, losing your teeth can have a negative effect on your overall health.

According to the U.S. Centers for Disease Control, individuals who smoke cigarettes, cigars, pipes or e-cigarettes are twice as likely as non-smokers to develop gum disease, and four times as likely the infection will become advanced. Your risk may also increase if you're regularly exposed to second-hand smoke.

There are a number of reasons for this increased risk. For one, smokers are less likely than non-smokers to recognize they have gum disease, at least initially, because they may not display classic symptoms of an infection like red, swollen or bleeding gums. This happens because the nicotine in tobacco smoke interferes with normal blood circulation. As a result, their gums may appear healthy when they're not.

That same circulation interference can also inhibit the production and supply of antibodies to fight infection. Not only can this intensify the infection, it can also slow healing and complicate treatment. In fact, smokers are more likely to have repeated episodes of infection, a condition called refractory periodontitis.

But there is good news—smoking's effect on your gum health doesn't have to be permanent. As soon as you stop, your body will begin to repair the damage; the longer you abstain from the habit, the more your gum health will improve. For example, one national study found that former smokers who had not smoked for at least eleven years were able to achieve an equal risk of gum disease with someone who had never smoked.

Quitting smoking isn't easy, but it can be done. If abrupt cessation (“cold turkey”) is too much for you, there are medically-supported cessation programs using drugs or other techniques that can help you kick the habit. And while it may be a long road, leaving smoking behind is an important step toward improving and maintaining good dental health.

If you would like more information on protecting your gum health, 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 “Smoking and Gum Disease.”

By Tom Casey DDS, & Erin Haugen DDS
August 09, 2020
Category: Dental Procedures
MileyCyrussLittleSecretStraighteningHerSmileWithLingualBraces

Miley Cyrus's rise to fame began when she was cast in the Disney series Hannah Montana. She played the title character, Hannah Montana, a famous singing star hiding her true identity, ordinary girl, Miley Stewart. In her real life at the time, Miley Cyrus had her own little secret—she was undergoing orthodontic treatment to straighten her smile.

Like many teenagers (as well as many adults), Cyrus's dental bite wasn't in proper alignment. She could have gone the traditional way by straightening her smile with braces fixed to the front of her teeth. It's an effective treatment, but the metallic hardware can overwhelm a person's appearance.

With her various roles in the public spotlight, Cyrus and her family wanted an effective but out-of-sight method for moving her teeth. They chose a relatively new one called lingual braces. Unlike traditional braces, the hardware for lingual braces is fixed on the back of the teeth (or the tongue side, hence the term “lingual”).

Lingual braces can correct any bite problem labial (“lip”) braces can, just through different mechanics of movement. Its main appeal is that the hardware is hidden behind the teeth, so only you and your orthodontist need know you're wearing braces.

There is also less risk of damage to the mouth or the braces themselves if you're in a sport or profession where you're at high risk for facial blows. And unlike patients with traditional braces, you'll have an unobstructed view of your progress over the course of treatment.

Lingual braces do tend to cost more than traditional braces. Some patients also have difficulty at first with speaking and tongue comfort, though most grow accustomed to the braces within a couple of weeks. Because lingual braces are relatively new, there's been a limited number of orthodontists offering it.

But lingual braces are just one of the ways to straighten teeth. Modern dentistry offers several ways to give you your dream smile. If you have dental problems or would like to improve the look of your smile, please contact us or schedule a consultation, and we can discuss your options. To learn more, read the Dear Doctor magazine articles “Lingual Braces” and “The Magic of Orthodontics.”





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