Correcting a bite problem involves more than applying braces. Orthodontists must consider a wide range of factors, including the type of bite problem involved, complications like impacted or missing teeth, and their patient's overall dental condition.

Orthodontists must also keep in mind the future—how will a treatment implemented now impact a patient's appearance and dental function many years from now? In reality, orthodontists perform these treatments within a dynamic growth environment, especially involving children and teenagers whose mouth and facial structures are still maturing.

And although these growth changes slow in adulthood, they don't stop—orofacial structures continue to change throughout life. For example, a person's lips steadily thicken in size until the mid-teen years, and then slowly thin out over the rest of their lifetime. The distance between the lips both at rest and while smiling may also narrow in later years. Other changes continue to occur in the bones and soft tissues of the mouth and face.

Fortunately, this structural growth follows a fairly consistent track. Although variations do occur, an orthodontist can project the growth changes their patients will undergo as they age, and use that knowledge to plan out bite treatment. With this understanding, orthodontists plan not only what treatments will be needed, but when to perform them, and to what extent.

This may involve a number of treatment stages, spaced out to coincide with regular development. An orthodontist may focus first on general bite correction to bring the teeth and jaws into a reasonable state of alignment. Later, they'll use more refined methods to fine-tune corrections that better align with later adult growth.

More intensive treatments may be necessary to build a foundation for future treatment. For example, orthognathic surgery may be needed to correct a severe case of an over-extended lower jaw. During the procedure, surgeons move the lower jaw to a joint position higher on the skull. This retracts the lower jaw into a more normal alignment with the upper jaw, and can dramatically change the facial profile for the better.

Each orthodontic patient is different, and each requires their own a unique treatment plan. That plan has a greater chance of long-term success by applying knowledge of future growth changes.

If you would like more information on orthodontic treatment, 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 “Understanding Aging Makes Beauty Timeless.”

During election season, you'll often hear celebrities encouraging you to vote. But this year, Kaia Gerber, an up-and-coming model following the career path of her mother Cindy Crawford, made a unique election appeal—while getting her wisdom teeth removed.

With ice packs secured to her jaw, Gerber posted a selfie to social media right after her surgery. The caption read, “We don't need wisdom teeth to vote wisely.”

That's great advice—electing our leaders is one of the most important choices we make as a society. But Gerber's post also highlights another decision that bears careful consideration, whether or not to have your wisdom teeth removed.

Found in the very back of the mouth, wisdom teeth (or “third molars”) are usually the last of the permanent teeth to erupt between ages 17 and 25. But although their name may be a salute to coming of age, in reality wisdom teeth can be a pain. Because they're usually last to the party, they're often erupting in a jaw already crowded with teeth. Such a situation can be a recipe for numerous dental problems.

Crowded wisdom teeth may not erupt properly and remain totally or partially hidden within the gums (impaction). As such, they can impinge on and damage the roots of neighboring teeth, and can make overall hygiene more difficult, increasing the risk of dental disease. They can also help pressure other teeth out of position, resulting in an abnormal bite.

Because of this potential for problems, it's been a common practice in dentistry to remove wisdom teeth preemptively before any problems arise. As a result, wisdom teeth extractions are the top oral surgical procedure performed, with around 10 million of them removed every year.

But that practice is beginning to wane, as many dentists are now adopting more of a “wait and see” approach. If the wisdom teeth show signs of problems—impaction, tooth decay, gum disease or bite influence—removal is usually recommended. If not, though, the wisdom teeth are closely monitored during adolescence and early adulthood. If no problems develop, they may be left intact.

This approach works best if you maintain regular dental cleanings and checkups. During these visits, we'll be able to consistently evaluate the overall health of your mouth, particularly in relation to your wisdom teeth.

Just as getting information on candidates helps you decide your vote, this approach of watchful waiting can help us recommend the best course for your wisdom teeth. Whether you vote your wisdom teeth “in” or “out,” you'll be able to do it wisely.

If you would like more information about what's best to do about wisdom teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth.”

Do you remember your first new car? It purred like a kitten with a brilliant finish you could see a mile away. And my, oh my, the attention you gave it: cleaning, polishing, regularly checking the fluids and other maintenance. That's what comes with pride of ownership—and it's an equally fitting attitude to have with your mouth.

World Oral Health Day is a great opportunity this month to renew your care for your mouth and its primary inhabitants, your teeth and gums. This March 20th, the FDI World Dental Federation wants you to “Be Proud of Your Mouth” for all it makes possible in your life: helping you eat, helping you speak and, of no lesser importance, helping you smile.

So how can you show pride in your mouth?

Keep it clean. Brushing and flossing are the two most important tasks you can do to prevent dental disease and ensure a healthy mouth. It takes only five minutes a day to clear away accumulated dental plaque, a thin film of bacteria most responsible for destructive tooth decay and gum disease. The only catch? To get the most from your oral hygiene efforts, you'll need to brush and floss every day, rain or shine.

Keep it fed. The food your teeth help you eat also benefits them—if they're the right foods. Fresh fruits and vegetables, proteins and dairy items like milk or cheese all contain vitamins and minerals that strengthen teeth against disease. On the flip side, there are foods you should avoid, particularly processed foods and snacks containing added sugar. Sugar feeds the oral bacteria that causes disease.

Keep it maintained. Routine dental visits are just as important for your mouth as routine mechanic visits are for your car. During these regular visits, we'll thoroughly clean your teeth of any missed plaque, especially a hardened version called tartar. It's also a time for us to look more closely at your teeth and gums to uncover any emerging problems that require treatment.

With a little time, effort and discipline, you can protect your teeth and gums from disease, and help them to be as healthy as they can be. The dividends will spill over into the rest of your life, with additional benefits for your physical, mental and social well-being. A healthy mouth is vital to a healthy life.

So, take pride in your mouth and make a commitment today to care for it. And if you haven't seen us in a while, an appointment for a dental cleaning and checkup could be your best move toward healthier teeth and gums.

If you would like more information about best dental care practices, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Daily Oral Hygiene” and “Dental Hygiene Visit.”

It wasn't too many years ago that e-cigarettes were promoted as a healthier alternative to traditional cigarettes. “Vaping” was in and “smoking” was out.

But vaping's recent link with certain lung disorders, especially among younger users, has slowed the promotion train down considerably. And if respiratory health isn't enough, there's another reason to be wary of the practice—it's possible effect on oral health.

An e-cigarette is a handheld device with a reservoir that holds a mixture of water, flavoring, nicotine and other chemicals. The device heats up the liquid to transform it into a vapor that's then inhaled by the user. Technically, the vapor is an aerosol, a gaseous substance containing solid particles from chemical compounds.

Within this aerosol are a number of ingredients that can have a harmful effect on your teeth and gums. Foremost among them is nicotine, a chemical that's also a major ingredient in regular tobacco. Nicotine causes constriction of blood vessels, including those supplying the teeth and gums.

As these vessels constrict, they deliver to the teeth and gums fewer nutrients and antibodies to control infection. As a result, users of nicotine products, whether tobacco or e-cigarettes, will have a compounded risk for dental disease over a non-user.

E-cigarettes may in fact be worse than regular cigarettes in regards to nicotine. Cigarette nicotine is primarily inhaled into the lungs, while e-cigarette nicotine is absorbed by the mouth's mucous membranes, a much more efficient transfer. It's estimated that the amount of nicotine in one e-cigarette cartridge equals the nicotine from 20 cigarettes.

Nicotine isn't the only ingredient in e-cigarettes that could harm your mouth. Chemicals within the flavorings can irritate and dry out the mucous membranes of the mouth, as well as damage tooth enamel. There are a variety of other chemicals present like formaldehyde that could raise your risk for oral cancer.

Rather than a healthy alternative to smoking, e-cigarette users may simply be trading one form of health risk for another—and, in the case of your oral health, just as bad or worse. The best alternative for healthier teeth and gums is to leave both habits—smoking and vaping—far behind.

If you would like more information on vaping and 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 “Vaping and Oral Health.”

Chronic joint pain (temporomandibular joint disorder or TMD) in and of itself can make life miserable. But TMD may not be the only debilitating condition you're contending with—it's quite common for TMD patients to also suffer from fibromyalgia.

Fibromyalgia is a condition with a variety of muscular and neurological symptoms like widespread pain, joint stiffness, headaches and tingling sensations. These symptoms can also give rise to sleep and mood disorder, as well as difficulties with memory. Fibromyalgia can occur in both males and females, but like TMD, it's predominant among women, particularly those in their child-bearing years.

In the past, physicians were mystified by these symptoms of body-wide pain that didn't seem to have an apparent cause such as localized nerve damage. But continuing research has produced a workable theory—that fibromyalgia is related to some defect within the brain or spinal cord (the central nervous system), perhaps even on the genetic level.

This has also led researchers to consider that a simultaneous occurrence of TMD and fibromyalgia may not be coincidental—that the same defect causing fibromyalgia may also be responsible for TMD. If this is true, then the development of new treatments based on this understanding could benefit both conditions.

For example, it's been suggested that drugs which relieve neurotransmitter imbalances in the brain may be effective in relieving fibromyalgia pain. If so, they might also have a similar effect on TMD symptoms.

As the study of conditions like fibromyalgia and TMD continues, researchers are hopeful new therapies will arise that benefit treatment for both. In the meantime, there are effective ways to cope with the symptoms of TMD, among them cold and hot therapy for inflamed jaw joints, physical exercises and stress reduction techniques.

The key is to experiment with these and other proven therapies to find the right combination for an individual patient to find noticeable relief. And perhaps one day in the not too distant future, even better treatments may arise.

If you would like more information on the connection between TMD and other chronic pain conditions, 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 “Fibromyalgia and Temporomandibular Disorders.”