Posts for: December, 2014

By John G. Rutland Family & Cosmetic Dentistry
December 29, 2014
Category: Oral Health
TheImportanceofBabyTeeth

Ah, the baby teeth: those cute little pearl buttons that start to appear in a child’s mouth at around 6 to 9 months of age. Like pacifiers and bedtime stories, they’ll be gone before you know it — the last usually disappear by age 10-13. So if the dentist tells you that your young child needs a root canal, you might wonder why — isn’t that tooth going to be lost anyway?

The answer is yes, it is — but while it’s here, it has some important roles to play in your child’s development. For one thing, baby teeth perform the same functions in kids as they do in adults: Namely, they enable us to chew, bite, and speak properly. The primary teeth also have a valuable social purpose: they allow us to smile properly. If a baby tooth is lost prematurely at age 6, the child may suffer detrimental effects for five years or more — and that’s a long time for someone so young!

Even more important, baby teeth have a critical function in the developing mouth and jaw: Each one holds a space open for the permanent tooth that will eventually replace it — and it doesn’t “let go” until the new tooth is ready to come in. If a primary (baby) tooth is lost too soon, other teeth adjacent to the opening may drift into the empty space. This often means that the permanent teeth may erupt (emerge above the gum line) in the wrong place — or sometimes, not at all.

The condition that occurs when teeth aren’t in their proper positions is called malocclusion (“mal” – bad; “occlusion” – bite). It can cause problems with eating and speaking, and often results in a less-than-perfect-looking smile. It’s the primary reason why kids get orthodontic treatment — which can be expensive and time-consuming. So it makes sense to try and save baby teeth whenever possible.

Procedures like a root canal — or the similar but less-invasive pulpotomy — are often effective at preserving a baby tooth that would otherwise be lost. But if it isn’t possible to save the tooth, an appliance called a space maintainer may help. This is a small metal appliance that is attached to one tooth; its purpose is to keep a space open where the permanent tooth can come in.

If your child is facing the premature loss of a primary tooth, we will be sure to discuss all the options with you. It may turn out that preserving the tooth is the most cost-effective alternative in the long run. If you have questions about your child’s baby teeth, please contact us or schedule an appointment for a consultation.


By John G. Rutland & Kenneth L. Vandervoort, Jr Family & Cosmetic Dentistry
December 26, 2014
Category: Oral Health
Tags: celebrity smiles   orthodontics   gap  
FixingthatGapinyourTeeth

We all know Madonna, Seal, David Letterman, Anna Paquin and Michael Strahan (of the talk show Kelly and Michael). What do all of these celebrities have in common? Each has a “signature gap” between their front teeth. Given that they have been in the public eye for quite some time, it's not likely that these famous faces will choose to change their well-known smile. In fact, Michael Strahan has publically stated that he will never close his gap.

However, it is not uncommon for people to desire to fix a small gap in their teeth, particularly in advance of important events, such as weddings. Often times, fixing this small gap requires relatively simple orthodontic movements or tooth straightening. Since the teeth don't have to be moved very far, we can usually use simple appliances to correct the issue within a few months.

In order for us to determine your course of treatment, you'll need to make an appointment with our office for a thorough examination. When we examine you, we'll be looking for a number of items that will affect our treatment recommendation:

  • Is there enough room to close the space without creating other bite problems?
  • Are the roots of the teeth in reasonably good position to allow for minor tooth movement to close the space? X-rays will be required to make a proper assessment.
  • Is there an involuntary tongue habit that has pushed the teeth forward and created the gap? If so, this could be difficult to fix quickly.
  • Are the surrounding gum tissues and bone healthy?

Based on our assessment and your individual needs, we may recommend one of the following options:

  • Clear retainers, a computer-generated series of clear retainers customized for your bite to move the teeth
  • Removable orthodontic retainers to which we will attach small springs or elastics to facilitate the minor tooth movement
  • Traditional fixed orthodontic appliances (most commonly known as braces), small metal or clear brackets bonded to your teeth through which tiny wires are used to move the teeth

Regardless of the method we choose, once your teeth have moved into the new position, it is important for you to remember that they must be kept in this position until the bone stabilizes around the teeth. We may therefore advise you to wear a retainer for a few months to a few years, depending on your situation.

If you would like more information about orthodontic treatments, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Minor Tooth Movement.”


By John G. Rutland & Kenneth L. Vandervoort, Jr Family & Cosmetic Dentistry
December 11, 2014
Category: Dental Procedures
Tags: wisdom teeth  
ExtractingWisdomTeethNowMayPreventDentalProblemsLater

The reason for extracting a tooth may be all too obvious — the tooth is too decayed or damaged to attempt saving. The reason for extracting a wisdom tooth, on the other hand, may not be so apparent: from the perspective of pain or reduced function, you may not notice a thing. Our recommendation to remove a wisdom tooth is based primarily on what may be occurring out of view below the gum line and its potential threat to adjacent teeth.

Teeth grow and develop below the gum line in the jaw, and then push their way through the gums as they appear in the mouth (eruption). After a normal eruption, the enamel-covered crown is visible above the gum line; the remaining tooth root (about two-thirds of the tooth’s length) resides below the gum line. Because wisdom teeth, or third molars, erupt rather late between ages 17 and 25, they may lack the room to erupt properly due to crowding from other teeth that have already erupted. This can cause the wisdom tooth not to erupt fully through the gums, leaving the crown trapped below the gum line, a condition known as impaction. For the tooth, impaction increases the chances of infection, cyst formation and gum disease around it.

An impacted wisdom tooth can also cause problems for the adjacent teeth as well. The impacted tooth may begin to press against the roots of other teeth; the resulting pressure can damage the other roots, increasing the risk for disease or future tooth loss. A person may not even know they have this problem since there’s often little to no noticeable pain or symptoms.

It may seem counterintuitive, but the best time to remove a wisdom tooth is when it’s not causing immediate problems. There will be, however, signs found during examination (particularly x-rays or CT scan) that future problems are in the making. By extracting an impacted wisdom tooth at the appropriate time, we can avoid more serious problems in the future and improve oral health.

If you would like more information on wisdom teeth and your 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 “Removing Wisdom Teeth.”