Besides fracturing immature adult teeth, the aforementioned dislodging or knocking out completely are some things that young people have to endure sometimes, unfortunately. However, modern dentistry has so much more to offer now than it ever did, thanks to science, technology and really, really smart people; so the level of treatment, restoration, or therapy only depends on the severity of damage done. The good news is that something can always be done.
If a young adult tooth were to be minorly dislodged (which means moved out of its natural position, remember?), extensive treatment may not even be necessary. The tooth may be only monitored over a period of time, possibly with minor adjustments made here and there, to ensure it continues to grow and develop normally. A tooth severely dislodged, surgery may have to be performed to restore stability and strength. In both of these cases, though, the tooth’s natural potential for strength will never be reached because of the injury, no matter what kind of treatment is performed.
If this immature tooth has been knocked out completely, if it can be put back into its socket and stabilized within one hour and watched closely by a dentist for a few weeks, chances are good that it can be saved. Changes in the tooth’s appearance and feeling will be monitored as well, and if any signs of decay or infection arise, then measures — particularly apexification — may have to be taken to keep it alive and well. If the tooth has been out for longer than an hour, it has probably dried out and must be filled with medication, put back into the socket, and re-stabilized as a “dead” tooth.
In either of those cases, the tooth is likely to not last as long as the others, in which case other options (say, an implant) will have to be discussed with the endodontist.
Dr. Boyajian, West Los Angeles
www.dentalwellnessarts.com
Occlusal Correction: Reshaping of Teeth
This is probably the first solution one might think of when wondering how a malocclusion will be corrected. The teeth are grinding together, so just move them around so they don’t. Right?
Well, I think we’ve learned that it’s a little bit more complex than that; but in some cases, the solution is as “simple” as moving teeth around. If the jaw, surrounding muscles and tissues, and everything else seems to be functioning well, selective reshaping can take place, and your teeth will fit together correctly when you bite down. This will halt and prevent further wear-and-tear on teeth that are perhaps showing signs of cracking, wearing, chipping, or breaking.
Dr. Boyajian, West Los Angeles
www.dentalwellnessarts.com
Dental Malocclusion
A malocclusion is a “bad bite.” Easy enough, right?
If a good occlusion is defined as a bite where all components of the chewing system work together harmoniously, then a bad occlusion — a malocclusion — means that the teeth do not match up and fit together when you bite down. One or more of the components involved in the chewing system may not be functioning properly, and is most likely what is causing the teeth to come down abnormally.
The funny thing is that most of us don’t realize that we have a malocclusion until we go in for an occlusal analysis. After a while, we unconsciously train our muscles to chew in a certain way, to move in a certain direction repeatedly, so that it does seem like our teeth fit together fine. But you can’t really tell the difference between what’s “normal” and what’s “really normal” until you’ve had adjustments made because you’ve been doing it a certain way for so long.
Having a malocclusion almost guarantees wear and tear on your teeth, facial muscle fatigue, and long-term damage and/or disease throughout your whole mouth and jaw area. Having your malocclusion corrected is absolutely necessary for your mouth’s health and ultimately your whole body.
Dr. Boyajian, West Los Angeles
www.dentalwellnessarts.com
Dental Occlusion
An occlusion is basically the noun form of the word “occlusal,” which we already know is a term describing your bite. An occlusion is the way your bite is uniquely designed, how your teeth come down on each other and fit into specific grooves to properly chew.
However, an occlusion does not merely describe how the teeth fit together because — what have we learned? — the chewing system involves the TMJ (temporo-mandibular joints… your jaw joints), jaw bones, muscles, ligaments, and all other soft tissues in your mouth. With the ideal occlusion, every one of these elements works with the others to create comfort, harmony, and efficiency in your chewing. If any of these elements is not functioning to its best potential, however, even the smallest hindrance can cause pain, injury, disease, and other problems. This is called a malocclusion and will be covered in tomorrow’s post.
Dr. Boyajian, West Los Angeles
www.dentalwellnessarts.com
Dental Bite Analysis Overview
How is an occlusal analysis performed, exactly, and what is involved in the process?
Well, first, a mold of your teeth is taken so an accurate plaster or stone model of your bite can be examined. Using what’s called a facebow transfer, the dentist will find the center of your jaw joint’s rotation, and then take measurements to see how it relates to your upper jaw.
Imprints of your teeth are then taken for a bite registration. A bite registration shows the dentist how your teeth come together when you are biting down completely. Also, the pattern of your jaw’s movement when chewing is unique to every individual. This pattern is also recorded.
There is a device called an articulator that a dentist uses to view your exact bite without having to use your head (which translates into countless hours in a dentist’s chair for you, the patient). It looks like this. The models previously made of your teeth are installed into the articulator, along with all the measurements of your jaw’s exact movements and how your teeth come together when you bite down.
After some examination (and long after your appointment is finished and you’ve driven home in time for dinner, don’t worry), the dentist will do some analyzing and will determine what is causing problems with your bite. Is it a TMJ disorder? Are crowns that were formed years ago getting in the way of proper chewing? What needs to be done in order to make the next procedure(s) successful?
Your dentist will be able to tinker with the articulator and find the ideal form of chewing system for you. A wax model will be made, and your dentist will move towards making these changes before moving on to the aforesaid procedure(s).
And, voila! Not only will you have some super treatment coming your way, but you’ll be comfortable knowing that your entire chewing system will be working the way it is supposed to.
Dr. Boyajian, West Los Angeles
www.dentalwellnessarts.com
When Should An Occlusal Analysis Be Done?
The occlusal analysis, when getting ready to perform any kind of orthodontic surgery, is crucial for a dentist or orthodontist to make the best possible choices for your oral health; a substantial number of problems are avoided when we know to not move a tooth in a certain direction, or design a mouthguard that will tire the jaw in an unhealthy manner. This is comprehensive dentistry; everything works together, and everything is related! An occlusal analysis is absolutely necessary before any of the following procedures:
As a small side note, gum disease can, in fact, be evidence of a poor bite. But that’s a topic for another day.
Dr. Boyajian, West Los Angeles
Dental Occlusal Analysis
“Occlusal” is basically a fancy, dental-scientific word for “bite.” I have mentioned occlusal (bite) analysis in an earlier post, but if you don’t remember it, I shall reiterate:
Occlusal analysis takes a look at your bite, your entire chewing system, comprehensively observing, recording, and adjusting small areas where your bite can reach its full effective, comfortable, and long-lasting potential. This approach — analyzing the whole mouth, jaw, teeth, and their movements — is far superior to adjusting each individual tooth. Adjusting the individual teeth can lead to painful jaw malfunctions and TMJ disorders over time because of prolonged crooked movement (slight though it may be) and repetitive clenching or grinding.
Does your dentist give occlusal analyses? Should you go in for one?
Dr. Boyajian, West Los Angeles
Apexification Procedure
Apexification is the procedure needed when apexogenesis fails to restore the health of an injured, immature tooth.
The first part of the process includes removal of all tooth pulp tissue. A medication is placed in the apex to seal off the opening; the root is then filled back up with a hardening material and sealed off, and any damage to the crown is also restored. The pulp will never be restored, but the natural tooth is saved and light monitoring will ensure it stays healthy in your mouth.
Because the tooth is filled with synthetic material and has not yet been as strongly established as the other adult teeth will become, the tooth will be more susceptible to fractures later. But apexification treatment done properly and carefully will lessen this possibility.
Dr. Boyajian, West Los Angeles
www.dentalwellnessarts.com
Apexogenesis Procedure
Apexowhat?! Yes, this is definitely quite a new word to wrap our heads around. What can I say? It’s a two-for-one deal: learning a little bit about dentistry while simultaneously sharpening your vocabulary skills. How convenient, right?
Anyway, in the previous post, I introduced the concepts of apexogenesis and apexification. Apexogenesis will be briefly discussed in this post.
Apexogenesis is a procedure performed after an injury that helps a young adult tooth root to continue growing and the the pulp to heal correctly. Medication is used on the surrounding soft tissues to prevent infection and ensure proper recovery. If the procedure is successful, the apex (remember, the root’s tip which has a slight opening) continues to close as the tooth grows, and the root canal walls thicken. A successful operation also relieves the patient of any further endodontic treatment, provided the pulp heals completely and the tooth’s life is fully preserved.
If, however, the apexogenesis therapy did not prove to be successful, apexification may be required. Details coming!
Dr. Boyajian, West Los Angeles
www.dentalwellnessarts.com
Traumatic Dental Injuries: Children’s Cases
Dealing with injuries in children’s teeth is a little different than with grown adults; their incoming adult teeth have not fully come through and developed a strong, established root.
The apex, or tip of the root (way down/up in the gums), in a tooth that has not yet matured in a child’s mouth, has a far larger opening than a mature tooth. The reason why this opening is wider during the young stages is so that nutrients can more easily enter the tooth to help it develop strength and health as the child grows up. Compare it to an ice cream waffle cone, where the crown of the tooth is where the scoop of ice cream goes, and the apex is the pointy part at the bottom. If you were to bite a hole in the bottom of the cone, it would leave an opening… and ice cream would drip out.
Well, the anatomy of a tooth is similar. In a still-developing adult tooth, the hole is just much wider, and the walls of the root canal are thinner. As the child and his teeth mature, the apex opening grows smaller, the walls thicker, and the tooth becomes nice and sturdy.
If an injury were to occur to these young adult teeth, special care is needed if the health of the tooth is to be preserved to its full potential. One of two kinds of procedures may be needed: apexogenesis or apexification. I will cover these in future posts.
Dr. Boyajian, West Los Angeles
www.dentalwellnessarts.com
Traumatic Dental Injuries: Further Treatment
Besides fracturing immature adult teeth, the aforementioned dislodging or knocking out completely are some things that young people have to endure sometimes, unfortunately. However, modern dentistry has so much more to offer now than it ever did, thanks to science, technology and really, really smart people; so the level of treatment, restoration, or therapy only depends on the severity of damage done. The good news is that something can always be done.
If a young adult tooth were to be minorly dislodged (which means moved out of its natural position, remember?), extensive treatment may not even be necessary. The tooth may be only monitored over a period of time, possibly with minor adjustments made here and there, to ensure it continues to grow and develop normally. A tooth severely dislodged, surgery may have to be performed to restore stability and strength. In both of these cases, though, the tooth’s natural potential for strength will never be reached because of the injury, no matter what kind of treatment is performed.
If this immature tooth has been knocked out completely, if it can be put back into its socket and stabilized within one hour and watched closely by a dentist for a few weeks, chances are good that it can be saved. Changes in the tooth’s appearance and feeling will be monitored as well, and if any signs of decay or infection arise, then measures — particularly apexification — may have to be taken to keep it alive and well. If the tooth has been out for longer than an hour, it has probably dried out and must be filled with medication, put back into the socket, and re-stabilized as a “dead” tooth.
In either of those cases, the tooth is likely to not last as long as the others, in which case other options (say, an implant) will have to be discussed with the endodontist.
Dr. Boyajian, West Los Angeles
www.dentalwellnessarts.com