Posts for: July, 2018
About one American baby in 700 is born with some form of lip or palate cleft—and the percentage is even higher in other parts of the world. At one time this kind of birth defect sentenced a child to a lifetime of social stigma and related health issues. But thanks to a surgical breakthrough over sixty years ago, cleft defects are now routinely treated and repaired.
Oral and facial clefts happen because a child’s facial structure fails to develop normally during pregnancy. This causes gaps or “clefts” to occur in various parts of the mouth or face like the upper lip, the palate (roof of the mouth), the nose or (more rarely) in the cheek or eye region. Clefts can have no tissue fusion at all (a “complete” cleft) or a limited amount (an “incomplete” cleft), and can affect only one side of the face (“unilateral”) or both (“bilateral”).
There was little that could be done up until the early 1950s. That’s when a U.S. Navy surgeon, Dr. Ralph Millard, stationed in Korea noticed after reviewing a series of cleft photos that tissue needed to repair a cleft was most often already present but distorted by the defect. From that discovery, he developed techniques that have since been refined in the ensuing decades to release the distorted tissue and move it to its proper location.
This revolutionary breakthrough has evolved into a multi-stage approach for cleft repair that often requires a team effort from several dental and medical professionals, including oral surgeons, orthodontists and general dentists. The approach may involve successive surgeries over several years with dental care front and center to minimize the threat of decay, maintain proper occlusion (the interaction between the upper and lower teeth, or “bite”), or restore missing teeth with crowns, bridgework or eventually dental implants.
While it’s quite possible this process can span a person’s entire childhood and adolescence, the end result is well worth it. Because of these important surgical advances, a cleft defect is no longer a life sentence of misery.
If you would like more information on treatment for a cleft lip or palate, 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 “Cleft Lip & Cleft Palate.”
Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”
Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.
Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:
A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.
If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.
Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.
Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.
Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.
If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”
What do a teenager with a poor bite, a senior citizen with multiple missing teeth or a middle-aged person with a teeth grinding habit all have in common? They may all depend on a dental appliance for better function or appearance.
There’s a wide variety of removable dental appliances like clear aligners or retainers for orthodontic treatment, dentures for tooth loss or night guards to minimize teeth grinding, just to name a few. But while different, they all share a common need: regular cleaning and maintenance to prevent them from triggering dental disease and to keep them functioning properly.
The first thing to remember about appliance cleaning is that it’s not the same as regular oral hygiene, especially if you have dentures. While they look like real teeth, they’re not. Toothpaste is a no-no because the abrasives in toothpaste designed for tooth enamel can scratch appliance surfaces. These microscopic scratches can develop havens for disease-causing bacteria.
Instead, use liquid dish detergent, hand soap or a specific cleaner for your appliance with a different brush from your regular toothbrush or a specialized tool for your particular appliance. Use warm but not very hot or boiling water: while heat indeed kills bacteria, the hot temperatures can warp the plastic in the appliance and distort its fit. You should also avoid bleach—while also a bacteria killer, it can fade out the gum color of appliance bases.
Be sure you exercise caution while cleaning your appliance. For example, place a towel in the sink basin so if the appliance slips from your hands it’s less likely to break hitting the soft towel rather than the hard sink. And while out of your mouth, be sure you store your appliance out of reach of small children and pets to avoid the chance of damage.
Cleaning and caring for your appliance reduces the risk of disease that might affect your gums or other natural teeth. It will also help keep your appliance working as it was designed for some time to come.