My Blog

By George R. Shepley, DDS
February 20, 2021
Category: Dental Procedures
WeMayBeAbleToTreatSomeBiteProblemsEarly

In any given year, 4 million tweens and teens are in the process of having their teeth straightened with braces or clear aligners. It's so common we tend to consider orthodontic treatment for young people as a rite of passage into adulthood.

But it doesn't necessarily have to be that way—it might be possible to stop or at least minimize a poor bite before it fully develops. That's the goal of interceptive orthodontics—treatments that head off or “intercept” a bite problem early.

The goal isn't necessarily to reposition misaligned teeth, but to correct a problem that can lead to misalignment. Here are some examples.

A narrow jaw. A narrowly developing jaw can crowd incoming teeth out of their normal positions. For the upper jaw, though, we can take advantage of a temporary separation in the bones in the roof of the mouth (palate) with a device called a palatal expander. Placed against the palate, the expander exerts outward pressure on the teeth and jaw to widen this separation. The body fills in the gap with bone to gradually widen the jaw.

Abnormal jaw alignment. It's possible for a jaw to develop abnormally during childhood so that it extends too far beyond the other. Using a hinged device called a Herbst appliance, it's possible to interrupt this abnormal growth pattern and influence the bones and muscles of the jaw to grow in a different way.

Missing primary teeth. An important role for a primary (baby) tooth is to hold a place for the future permanent tooth. But if the primary tooth is lost too soon, other teeth can drift into the space and crowd out the intended permanent tooth. To prevent this, we can insert a space maintainer: This simple looped metal device prevents teeth from drifting and preserves the space for the permanent tooth.

Although these and other interceptive treatments are effective, some like the palatal expander do their best work within a limited age frame. To take advantage of interceptive orthodontics in a timely manner, parents should seek a bite evaluation for their child from an orthodontist around age 6. The earlier we detect a growing bite problem, the greater your chances for successful intervention.

If you would like more information on treating emerging bite problems early, 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 “Interceptive Orthodontics.”

By George R. Shepley, DDS
February 10, 2021
Category: Oral Health
Tags: oral hygiene   oral health  
4GuidelinestoHelpMakeSureYourChildsOralHealthStaysonTrack

As they mature, your child's teeth, gums and jaws develop—if all goes well, they'll all be healthy and functioning normally when they enter adulthood. But tooth decay and other problems could derail that development and cause lingering oral health issues later in life.

Following these 4 guidelines now during your child's early years will help ensure their teeth and gums have a healthy future.

Start oral hygiene early. There's no need to wait for their first teeth to come in to begin your child's regular oral hygiene. Start with wiping their gums right after feeding with a clean wet cloth to minimize bacterial development. Then, start brushing as soon as teeth appear—to begin with, use a slight smear of toothpaste on the brush. As they mature, teach them to brush and later floss for themselves.

Check your water. Most utilities add tiny traces of fluoride to their drinking water supply. If your water supplier does, it can make a big difference (along with fluoride toothpaste) in helping your child avoid tooth decay. If your system doesn't, then speak to your dentist about whether your child could benefit from topical fluoride applied directly to their teeth.

Keep a check on sugar. Decay-causing bacteria thrive on the sugar added to processed foods, candies and many beverages. Even milder forms of sugar like lactose found in milk or formula can stimulate bacterial growth. So, in addition to daily brushing and flossing, do your best to minimize sugar in your child's diet. And don't put infants or toddlers to bed with a bottle filled with any liquid other than water.

See the dentist. Starting around their first birthday, regular dental visits can help keep your child's dental development on track. Dental visits are also an opportunity for preventive treatments against decay like sealants or topical fluoride. Your dentist may also detect the early signs of bite problems that if addressed now, could lessen their impact later in life.

Your child's dental health could get off course before you even realize it. But partnering with your dentist, you can help make sure your child's teeth and gums have a bright and healthy future.

If you would like more information on how best to care for your child's oral 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 “Top 10 Oral Health Tips for Children.”

By George R. Shepley, DDS
January 31, 2021
Category: Oral Health
Tags: toothache   oral health  
WhatToDoandNotDoforThese3CommonChildhoodDentalProblems

Knowing what to do—and what not to do—when your child is sick can greatly affect their health and well-being. That's especially true with dental problems.

Here then are some Dos and Don'ts for 3 common problems children experience with their teeth and gums.

Teething. An infant's first teeth breaking through the gums is a normal but often unpleasant experience. Fortunately, teething episodes only last a few days. And, there's usually no need to see the dentist unless they have a fever or diarrhea while teething. In the meantime:

  • Do: provide them chilled (not frozen) cloth or plastic items to bite and gnaw, and massage their gums to relieve painful pressure. You can also give them an age-appropriate dose of a mild pain reliever.
  • Don't: rub any medication on their gums, which can irritate them and other soft tissues. Never use alcohol or aspirin to alleviate teething discomfort. And avoid using anything with benzocaine, a numbing agent which can be hazardous to young children.

Toothache. Whether a momentary sensitivity to hot or cold or a sharp, throbbing pain, a child's toothache often signals tooth decay, a bacterial disease which could eventually lead to tooth loss.

  • Do: make a dental appointment at your child's first complaint of a toothache. Ease the pain with a warm-water rinse, a cold compress to the outside of the jaw, or a mild pain reliever.
  • Don't: rub medication on the teeth or gums (for similar reasons as with teething). Don't apply ice or heat directly to the affected tooth or gums, which can burn them.

Bleeding gums. Gum bleeding from normal brushing or flossing, along with red or swollen gums, may indicate periodontal (gum) disease. Although rare in children, it can still happen—and it can put an affected tooth in danger.

  • Do: see your dentist if bleeding continues for a few days. Continue to brush gently with a soft-bristled toothbrush around the gums to remove plaque, a thin-biofilm most responsible for gum infection.
  • Don't: brush aggressively or more than twice a day, which could unnecessarily irritate and damage the gums. And don't stop brushing—it's important to remove plaque buildup daily to lessen the gum infection.

If you would like more information on dental care for children, please contact us or schedule an appointment for a consultation.

By George R. Shepley, DDS
January 21, 2021
Category: Oral Health
PrettyLittleLiarsLucyHaleCrushesonSmiles

Is a “teeth crush” a thing? According to a recent confession by Lucy Hale, it is. Hale, who has played Aria Montgomery for seven seasons on the hit TV show Pretty Little Liars, admitted her fascination with other people's smiles to Kelly Clarkson during a recent episode of the latter's talk show (Clarkson seems to share her obsession).

Among Hale's favorite “grills”: rappers Cardi B and Post Malone, Julia Roberts, Drake and Madonna. Although some of their smiles aren't picture-perfect, Hale admires how the person makes it work for them: “I love when you embrace what makes you quirky.”

So, how can you make your smile more attractive, but uniquely you? Here are a few ways to gain a smile that other people just might “crush” over.

Keep it clean. Actually, one of the best things you can do to maintain an attractive smile is to brush and floss daily to remove bacterial plaque. Consistent oral hygiene offers a “twofer”: It removes the plaque that can dull your teeth, and it lowers your risk of dental disease that could also foul up your smile. In addition to your daily oral hygiene routine at home, professional teeth cleanings are necessary to get at those hard-to-reach spots you miss with your toothbrush and floss and to remove tartar (calculus) that requires the use of special tools.

Brighten things up. Even with dedicated hygiene, teeth may still yellow from staining and aging. But teeth-whitening techniques can put the dazzle back in your smile. In just one visit to the dental office, it's possible to lighten teeth by up to ten shades for a difference you can see right away. It's also possible to do teeth whitening at home over several weeks using custom-made trays that fit over your teeth and safe whitening solutions that we provide.

Hide tooth flaws. Chipped, stained or slightly gapped teeth can detract from your smile. But bonding or dental veneers, thin layers of porcelain custom-made for your teeth, mask those unsightly blemishes. Minimally invasive, these techniques can turn a lackluster smile into one that gets noticed.

Straighten out your smile. Although the main goal for orthodontically straightening teeth is to improve dental health and function, it can also give you a more attractive smile. And even if you're well past your teen years, it's not too late: As long as you're reasonably healthy, you can straighten a crooked smile with braces or clear aligners at any age.

Sometimes a simple technique or procedure can work wonders, but perhaps your smile could benefit more from a full makeover. If this is your situation, talk to us about a more comprehensive smile renovation.  Treatments like dental implants for missing teeth combined with various tooth replacement options, crown lengthening for gummy smiles or tooth extractions to help orthodontics can be combined to completely transform your smile.

There's no need to put up with a smile that's less than you want it to be. Whether a simple cosmetic procedure or a multi-specialty makeover, you can have a smile that puts the “crush” in “teeth crush.”

If you would like more information about cosmetic measures for enhancing your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Porcelain Veneers.”

By George R. Shepley, DDS
January 11, 2021
Category: Dental Procedures
Tags: partial denture   bridge  
TwoGoodOptionsforTemporarilyReplacingaTeenagersMissingTooth

While anyone can lose a permanent tooth, the cause often varies by age group. Adults usually lose their teeth to disease, while those under twenty lose a tooth to accidents.

For adults, a dental implant is usually the best way to replace a missing tooth. Teenagers and younger, on the other hand, must wait to get implants until their jaws fully develop. An implant placed on an immature jaw will eventually look and feel out of place.

For most, their jaws won't reach full maturity until their early twenties. Even so, they still have a couple of good options for restoring their smiles in the meantime, albeit temporarily.

One is a removable partial denture or RPD, a device with the replacement prosthetic (false) tooth or teeth set in a gum-colored acrylic base. Of the various types of RPDs, most teenagers do well with a rigid but lightweight version called a “flipper,” called so because it can be flipped in and out of place with the tongue.

These RPDs are affordable, their fit easily adjusted, and they make cleaning the rest of the teeth easier. But they can break while biting down hard and—because they're dentures—aren't always well accepted among teenagers.

The other option is a bonded bridge. Unlike a traditional bridge secured with crowns cemented to natural teeth, a bonded bridge uses a strip of dental material affixed to the back of the prosthetic tooth with the ends of the strip extending outward horizontally. With the prosthetic tooth inserted into the empty space, these extended ends are bonded to the backs of the natural teeth on either side.

Though not as secure as a traditional bridge, a bonded bridge is more aesthetic and comfortable than an RPG. On the other hand, patients who have a deep bite or a teeth-grinding habit, both of which can generate abnormally high biting forces, run a higher risk of damaging the bridge. A bridge can also make hygiene tasks difficult and time-consuming, requiring a high degree of self-discipline from the patient.

Whichever you choose, both options can effectively replace a teenager's missing tooth while waiting for dental implants. Although temporary, they can make the long wait time for a teenager more bearable.

If you would like more information on restorations for children and teens, please contact us or schedule an appointment for a consultation.





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