Tag Archives: Orthodontic Experts

Part 2: When Tooth Removal Is The Healthy Choice

In the 2nd series on tooth removal, let’s take a look at the main reasons when tooth removal is the best and wisest option to achieve an optimal treatment outcome.

Reason #1 Crowding.

Imagine a situation where teeth are crowded and poorly aligned. In this situation, the amount of space required is not sufficient to accommodate the teeth. Either the size of the arches must be increased or the number (or size) of teeth reduced.  Or perhaps space preservation with a space maintainer could be utilized.

Up until the age of about 15, if there is mild to moderate crowding, it can be addressed with expanders and braces alone. After the age of 15, the bone structure is well formed and less plastic and expansion may not be possible or healthy to the surrounding supportive tissues.

When there is moderate to severe crowding and limited gum or bone support, permanent teeth will need to be removed to provide the space required. Failure to maintain the teeth with healthy surrounding bone will lead to periodontal problems down the road.

Continue reading Part 2: When Tooth Removal Is The Healthy Choice

Part 1: When Tooth Removal Is The Healthy Choice

Although I prefer not to remove adult teeth, there are exceptions and situations where tooth removal is beneficial. The pendulum has swung from one extreme to another in regards to removal of teeth. In the very early days of orthodontics the approach was never to extract a tooth, later the pendulum swung in the other direction and tooth removal was the norm not the exception. Over the past 25 years the pendulum has headed back in the other direction. So permit me to take a clear eyed and reasoned scientific approach to the subject.

One of the more common concerns I hear during consultation appointments is the following…you don’t have to remove any permanent teeth do you? We strive for perfection in the smile, a healthy bite and teeth that will last for a lifetime. What if, removal of teeth can help achieve these lofty goals and failure to  remove teeth may cause harm. Continue reading Part 1: When Tooth Removal Is The Healthy Choice

Part 2: Baby Teeth and Braces-What Every Parent Needs To Know

What factors are important to consider when determining whether to remove the remaining primary teeth? If a patient’s overall development is delayed, the decision to remove the remaining baby teeth is determined by several factors.

1. I consider the patient’s age. If they are 14 or 15 years of age, I have no hesitation in recommending the remaining baby teeth be removed so that their orthodontic treatment is completed before they graduate from high school.

2. I examine the development of the roots of the unerupted adult teeth. If the root formation of these unerupted teeth is nearing completion but the associated baby teeth are not loose, extractions are advisable.

3. If the 12-year molars are partially or fully erupted but the baby teeth remain, I will usually recommend having the remaining primary teeth removed so that treatment can begin. Continue reading Part 2: Baby Teeth and Braces-What Every Parent Needs To Know

Part 1: Baby Teeth and Braces-What Every Parent Needs To Know

Dental BracesDon’t we have to wait for all the baby teeth to come out? When is the best time for my child to get braces?

These are very common questions that parents ask me. The short answer is no, one does not have to wait for all the baby teeth to come out.

While it is true that a full set of braces is only complete when all the permanent teeth(including 2nd molars) erupt into the mouth (not including 3rd molars/wisdom teeth) that is not necessarily a reason to delay beginning orthodontic treatment. There are certain types of orthodontic problems when early intervention is beneficial; this is referred to as Two Phase treatment.

Two-Phase treatment is recommended in young patients typically between the ages of 7-10 years. When this particular set of problems are not addressed at an early age than the resolution of these problems becomes more challenging and may necessitate more aggressive treatment. At times, a child’s sense of self-esteem is adversely affected by the appearance of their teeth and so they would benefit from early care. Certain bite problems may cause the child’s teeth to be more susceptible to injury, so early treatment is advisable. Continue reading Part 1: Baby Teeth and Braces-What Every Parent Needs To Know

Why Shopping for an Orthodontist is not like Buying a Toaster Oven

Dental HealthThere was a time, not so long ago when purchase decisions were based on quality. There was a good, better and best. Naturally, getting “the best” was more valuable and so commanded a higher price.

Today, we are bombarded with discount frenzy both online and in stores, where the lowest price drives purchasing decisions. Well, this “model” may make sense when it comes to a choice of buying two items that are pretty much the same, like toaster ovens or garden hoses. Buying the least expensive of the two is usually pretty reasonable. Such items that are interchangeable and have what appears to be equal value are called commodities. Continue reading Why Shopping for an Orthodontist is not like Buying a Toaster Oven