Craig S. Karriker, DMD, P.A.- 400 South Granard Street, Gaffney, SC 29341, (864) 487-0710

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By Craig S. Karriker, DMD, PA
May 12, 2017
Category: Oral Health
TakeStepstoSaveanIncomingToothsPlacetoAvoidaPoorBite

At your child's latest dental visit, you found out one of their primary (“baby”) teeth has become decayed and in danger of loss. Of course, you may think, it's only a primary tooth — it's going to come out sooner or later.

But a primary tooth lost “sooner” rather than “later” can create long-term negative consequences for your child's dental health. For the sake of the future permanent tooth, the best treatment strategy could be to put forth the effort and expense to save it.

Besides its role in eating and chewing, a primary tooth's most important function is as a “trailblazer” for the permanent tooth developing below it. A primary tooth doesn't normally loosen and let go until the new permanent tooth is ready to erupt. Until then they hold the new tooth's space in the jaw.

But if the primary tooth is lost prematurely, nearby teeth can drift into and crowd the space so that the permanent tooth comes in out of position. This can result in a malocclusion, or poor bite.

Depending on the state of your child's jaw development, it may be advisable to attempt saving the tooth through a filling or, in the case of deep decay, a modified root canal treatment. If the tooth can't be saved, then placing an orthodontic appliance known as a space maintainer might be necessary. Cemented to a tooth next to the empty space, this appliance has a looped band of metal that butts against the tooth on the other side of the gap, and prevents both teeth from drifting into the space.

Intervening for a decayed primary tooth can seem a waste of time and money since it has a limited lifespan to begin with. But for the health of its companion permanent tooth, as well as possibly avoiding orthodontic treatment, it could be well worth it for your child's long-term dental health.

If you would like more information on dental care for your child, 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 “Importance of Baby Teeth.”

By Craig S. Karriker, DMD, PA
September 08, 2015
Category: Dental Procedures
Tags: orthodontics   oral surgery  
ExposingandPreservingImpactedCanineTeeth

The final emergence of permanent teeth in late adolescence marks the end of a long process beginning in the womb with the formation of our primary or “baby” teeth. Permanent teeth form in a similar way as buds high in the jaw, continuing to grow until the primary teeth ahead of them fall away. The crowns of the new adult teeth eventually break through the gum tissue and emerge (erupt) into view.

At least, that’s normally what should happen; sometimes, though, a tooth may only erupt partially or not at all, a condition known as impaction. The crown remains partially or fully submerged below the gum line, causing the tooth to press against other teeth, potentially damaging them. It can also make periodontal (gum) tissues adjacent to the area more susceptible to disease. Wisdom teeth are especially prone to this kind of impaction, to the extent they’re often surgically removed (extracted) to avoid future problems to adjacent teeth or the bite.

Upper canines (the “eye teeth” normally located directly below the eyes) are also subject to impaction. But because of their highly visible position, extracting them could have an adverse impact on the patient’s smile. In this case, we often attempt instead to expose and ultimately save the tooth.

Before taking any action, however, an orthodontic examination is conducted first to pinpoint the exact position of the impacted tooth and determine how that position might affect moving teeth into a more desired alignment. If we find the impacted canine is in a workable position, the next step is to surgically uncover the tooth from the gum tissue (a minor procedure usually performed by an oral surgeon or periodontist). Once exposed, an orthodontic bracket with a small attached gold chain is bonded to the tooth. The gums are then sutured back into place with the chain exposed and allowed to heal.

At some future point an orthodontist will attach the chain to orthodontic hardware that will pull the impacted tooth into proper position over several months. As a result, the upper canine becomes “un-impacted”; the dangers to surrounding teeth and tissues are also reduced. And, just as important, we can preserve the tooth and with orthodontics achieve an attractive, normal smile.

If you would like more information on the effects and treatment of impacted teeth, 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 “Exposing Impacted Canines.”

SolvingtheProblemofMissingTeethWithOrthodonticsandRestorations

Normally, teeth erupt and grow in a symmetrical alignment: on the top palate, for example, the two central incisors take center stage; on either side are the lateral incisors, and then beside these the canines (cuspids).

But what happens when teeth don’t grow in? The result can be a smile that just doesn’t quite look right; more importantly, normal function is impaired because the person can’t grasp and chew food correctly.

These missing teeth are the result of a congenital (“from birth”) defect. It’s estimated that almost a quarter of all people are missing one or more wisdom teeth, and more than 5% are missing one or more second premolars or upper lateral incisors.

In a normal arch (the upper or lower set of teeth), each tooth type performs a particular role during eating. A missing tooth causes the remaining teeth to compensate, but beyond their capacity. The remaining teeth also tend to move to fill in any gaps left by the missing teeth, as when the eye teeth move toward the central incisors in the absence of the lateral incisors. This puts them out of position, so they can’t cover (“occlude”) their counterparts on the other arch and grasp food properly.

To improve the smile and restore proper chewing function it’s necessary to first move these “out of position” teeth to their correct position through orthodontics. We would then fill the gaps that result with life-like restorations (preferably dental implants with crowns) that resemble the type of tooth that should be there.

The restoration needs to be timed carefully, especially for young patients whose jaw structure has not fully developed. If implants are installed before the jaw’s full maturity (usually late teens or early twenties), the implant crowns may not appear to be the right length as the jawbone continues to grow. Since bone growth depends on the normal pressures exerted by the teeth, there may also be insufficient bone mass in the gap area to support a dental implant. Growing bone with bone-grafting material may be necessary before installing implants.

The total process could take many months or even years, depending on age and other conditions. In the end, though, the results can be astounding — better function and a vibrant, new smile.

If you would like more information on developmental problems with teeth, 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 “When Permanent Teeth Don’t Grow.”

By Craig S. Karriker, DMD, PA
April 01, 2014
Category: Oral Health
Tags: orthodontics  
TreatingBiteProblemsEarlyCouldMakeLaterTreatmentEasierorUnnecessary

When most people think of orthodontic treatment, they may think of braces worn during the teenage years. But there are some types of malocclusions (bad bites) that may benefit from intervention much earlier than adolescence. A cross-bite is one example.

A cross-bite occurs when the front teeth of the lower arch bite in front of the upper teeth rather than behind them. The condition can have an adverse effect on any of the six front teeth of either arch. This type of malocclusion can develop quite early in childhood.

Orthodontists have developed a two-phase treatment for a cross-bite, with the possibility that the first phase may be all that’s needed. If your child has a cross-bite, your orthodontist may first recommend he or she wear a specially-designed retainer for a few months. The retainer could stop and correct an existing problem before it becomes worse, or it could prevent a deeper problem from developing in the first place. The retainer could also help guide jawbone development during these formative years, even as early as age 7, for children at risk.

Even if this first phase doesn’t fully correct the cross-bite and the second phase (most likely braces or a similar orthodontic device) becomes necessary, it could still help to make the second phase easier and less costly. On the other hand, if orthodontic treatment is postponed until adolescence when the mouth structures are more fully formed it may become quite difficult or even impossible to correct the problems that have developed.

As a result, early intervention for this or similar orthodontic conditions is the most efficient strategy, even when later treatment is necessary. As part of your child’s regular dental care (which should begin ideally around their first birthday), we can advise you on any need for an orthodontic evaluation based on our observations. An orthodontist can then best advise whether waiting until later for treatment is best, or whether intervention now could lessen problems later.

If you would like more information on preventative orthodontics, 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 “Preventative & Cost Saving Orthodontics.”

By Craig S. Karriker, DMD, PA
August 29, 2013
Category: Dental Procedures
Tags: orthodontics   braces  
StraighteningYourChildsTeethWhenisthebesttimetostart

All parents want their child to have an attractive smile and good strong healthy teeth; but it may be difficult for parents to know if their young children's teeth are coming in the way they should. Parents may not know that it is also important that the upper and lower jaws need to be in proper alignment for a properly functioning bite.

As a child's permanent teeth come in, the teeth may be too crowded, or they may have spaces between them that are too large. They can have protruding teeth, extra or missing teeth, or problems with jaw growth. Sometimes children have malocclusions (“mal” – bad; “occlusion” – bite) that were caused by thumb sucking or other problems. If you wait to seek treatment until all of the child's permanent teeth have come in, and facial and jaw growth are nearly complete, correction of problems will be more difficult and the potential to encourage jaw growth in a positive direction may be lost.

When a little can go a long way

Whether a malocclusion is obvious or not it is important to have an orthodontic evaluation at an early age. Experts advise having an orthodontic evaluation some time before the age of 7. At 7, a child's permanent (adult) teeth have begun to come in but they still have some primary (baby) teeth left. If necessary, it's a good time to intercept and make a big difference for a little treatment.

Treatment that begins while a child's teeth are erupting or coming in, is called “interceptive orthodontics.” It provides an opportunity for the best results in orthodontic treatment. It can also include working with the child's facial growth and jaw development to assure that the upper and lower jaws align together effectively. It can often be done with simple removable appliances rather than full braces.

Orthodontics (“ortho” – straight; “odont” – tooth) is a sub-specialty of dentistry that is devoted to the study and treatment of malocclusions. Your general or pediatric dentist may recommend that our child consult with an orthodontist. Orthodontists are dentists who specialize in the growth and development of the teeth and jaws, as well as directing proper growth by moving the teeth into correct position.

Come to see us early for an orthodontic evaluation, while it's still easy to make a big improvement in your child's future smile.

Contact us today to schedule an appointment or to discuss your questions about orthodontia in children. You can also learn more by reading the Dear Doctor magazine article “Early Orthodontic Evaluation.” Or the article “The Magic of Orthodontics.”