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Posts for: October, 2013

By Gerald D. Gray, DDS
October 28, 2013
Category: Dental Procedures
IntroducingthePalatalExpander

Is there a single orthodontic appliance that can help your child get a wider, better-looking smile, correct problems with the bite, make room in a crowded upper jaw for new teeth to erupt (come in)... and shorten the overall time he or she will need to wear braces? The answer is yes: It's the palatal expander, a device that works with the natural growth patterns of a child's mouth, and offers dramatic results.

What's a palatal expander? Basically, it's a custom-made orthodontic appliance that fits between the rows of back teeth at the top (roof) of the mouth, close to the palate. After it has been put in place, it can be tensioned with a special key. Because it is contained inside the mouth, it's invisible when worn — but its benefits are easy to see.

How does it work? The palatal expander takes advantage of the fact that the left and right halves of a child's upper jaw bone don't completely fuse (knit together) until sometime after puberty. Until that happens, the upper jaw is relatively soft and easy to manipulate. When tension is applied, the palatal expander gently moves the bones apart, just like braces do for teeth. Then new bone tissue naturally fills in the space.

The appliance is tightened daily for a few weeks — while spacing improves dramatically — and then it's left on for several weeks more to stabilize the expansion. The total time a child needs to wear it is generally 3-6 months. After that, a set of braces can be put on if needed. So, what's so great about a palatal expander?

For one thing, the device can correct a crossbite, which occurs when the back top teeth bite inside (instead of outside) the bottom teeth. For another, expanding the upper jaw can relieve the condition known as crowding, which happens when the jaw isn't big enough to accommodate all the teeth. A related situation — impacted teeth — occurs when a tooth that hasn't yet erupted is blocked by another tooth above it. Both these conditions formerly required tooth extraction: an invasive and sometimes complicated procedure. Both can now be remedied by a palatal expander.

But maybe the biggest plus to a youngster — where a month can seem like an age — is the prospect of having to wear braces for less time. And that alone is a good reason to smile.

If you have questions about palatal expanders, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Palatal Expanders” and “The Magic of Orthodontics.”


By Gerald D. Gray, DDS
October 18, 2013
Category: Dental Procedures
ChristieBrinkleysTipsonToothWhitening

Christie Brinkley's world-famous smile has graced the covers of countless magazines for over 30 years. In fact, in her own words from an interview with Dear Doctor magazine, the supermodel said, “I think my smile was really my passport to success in the modeling industry.” And while most of her smile's appeal comes naturally, Christie does give it a boost with good oral hygiene, regular dental checkups and tooth whitening. As Christie says, “When it comes to teeth, keep it as natural as possible. Do not go overboard on whitening. You want your teeth to compliment your face…your friends should not be required to wear sunglasses when you smile!”

Aside from some potential minor side effects such as tooth sensitivity, whitening teeth through bleaching is a relatively inexpensive way to brighten your smile conservatively and successfully. There are three common methods, as described below:

  • An external or vital approach where “vital” (living) teeth are bleached through direct contact to the tooth's surface.
  • An internal or non-vital approach where the tooth is whitened from the inside during a root canal treatment.
  • A combination approach in which both internal and external bleaching techniques are used.

But what causes teeth to become discolored?

Tooth discoloration can be caused by a traumatic blow to your teeth resulting in nerve tissue (pulp) death. However, there can be many other causes: consuming or using products that stain the teeth such as coffee, tea, cola, tobacco products and red wine, to name just a few. Aging is another factor, as it results in changes in the mineral structure of the tooth as the enamel, the outermost layer, loses its beautiful and youthful translucency. Other causes include exposure to high levels of fluoride; tetracycline, an antibiotic, administered during childhood; inherited developmental disorders and jaundice in childhood; and tooth decay.

The good news is that we routinely brighten smiles through tooth whitening. To learn more about brightening your smile, continue reading the Dear Doctor magazine article “Teeth Whitening.” Or if you are ready to have your teeth professionally whitened, contact us today to schedule an appointment so that we can conduct a thorough examination and discuss your whitening treatment options. And if you want to read the entire feature article on Christie Brinkley, continue reading “The Secret Behind Christie Brinkley's Supermodel Smile.”


RestoringHealthandAppearanceThroughPeriodontalPlasticSurgery

The “wear and tear” nature of gingival (gum) tissue enables it to readily handle the chewing and biting actions of eating and still perform its most important function: protecting the roots of your teeth from decay and environmental exposure. But while they're resilient, they're not invincible: it's quite possible for them to lose their attachment to a tooth and begin to recede, leaving the root surfaces exposed.

Gum recession can occur for a number of reasons: poor oral hygiene; over brushing and flossing; malocclusion (a poor bite); personal habits, like biting down on hard foreign objects; or poorly fitted dentures or other appliances. From a genetic point of view, people with thinner gingival tissues are more prone to gum recession than those with thicker tissues. Whatever the cause, the result is the same — the exposed tooth becomes more sensitive to environmental factors (such as heat, cold, abrasion or erosion). More importantly, it now has a higher susceptibility to decay and disease, leading to its possible demise.

But there may be a solution. Although the original tissue may be lost, periodontal plastic surgery can restore a protective layer of tissue to the tooth, and at the same time give you back the smile you once had.

From the Greek word “plastik” for sculpting or modeling clay, plastic surgery procedures restore both form and function to a bodily structure. While the term “plastic surgery” can apply to other procedures in medicine such as rhinoplasty or face lifts, the periodontal procedure particularly involves grafting similar tissue to an area of recession, and then “shaping” it into a natural, life-like form.

To graft means to remove tissue from a donor site and attach it to a recipient site. In the case of periodontal tissue, the recipient patient can also be the donor with the tissue coming from some other area of the same mouth (the graft can also come from another human or an animal). Using advanced techniques and a touch of artistry, the surgeon positions and sutures the graft in place.

The result: not only a new protective covering for your tooth, but a more pleasing appearance when you smile.

If you would like more information on periodontal plastic surgery, 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 “Periodontal Plastic Surgery.”