My Blog

Posts for: November, 2020

By Enrique C. Escofet, DDS
November 29, 2020
Category: Oral Health
Tags: missing teeth  
PeopleBornwithMissingTeethcanStillGainaBeautifulSmile

When you look at the top row of a normal smile, you'll see symmetrical pairs: the central incisors in the middle, flanked by the lateral incisors and the canine (or eye) teeth on the outside of them.

Sometimes, though, teeth may not form as they should: in fact, it's one of the more common congenital defects with one in five people having missing or deformed teeth, often the upper lateral incisors. In the latter case, it's not uncommon for the eye teeth to drift into the missing lateral incisors' spaces next to the central incisors. This creates a smile even a layperson can tell is off.

There is a way to treat this with orthodontics and cosmetic dentistry that will transform that person's smile while restoring better mouth function too. It's often a long process, however, that's best begun early and must be precisely timed with dental development.

Using braces, we move the drifted teeth back to their proper positions, which will make room for a future dental restoration. It's usually best to begin this treatment during late childhood or early adolescence. The next step is to fill the newly-created space with prosthetic (false) teeth.

Dental implants are an ideal choice since they're durable and life-like, and won't require permanent alteration of adjacent teeth. They do, however, require a certain amount of bone volume at the site to support them; if the volume is insufficient we may have to place a bone graft to stimulate new growth.

It's also best not to install implants until the jaw has finished development, usually in the late teens or early adulthood. In the interim between tooth repositioning and implants we can customize a retainer or other removable appliance with a false tooth to occupy the space. This not only enhances the smile, it also prevents the repositioned teeth from drifting back.

These steps toward achieving a new smile take time and sometimes a team of specialists. But all the effort will be rewarded, as a person born without teeth can have a new smile and improved oral health.

If you would like more information on treating dental development deficiencies, 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 Enrique C. Escofet, DDS
November 19, 2020
Category: Dental Procedures
Tags: tooth loss  
WhyweNeedtoCareforaYoungerPatientsBoneafteraToothLoss

In an instant, an accident could leave you or a loved one with a missing tooth. Thankfully, we can restore it with a dental implant that looks and functions like a real tooth—and the sooner the better.

But if the patient is a teenager or younger, sooner may have to be later. Because their jaws are still developing, an implant placed now could eventually look as if it's sinking into the gums as the jaw continues to grow and the implant doesn't move. It's best to wait until full jaw maturity around early adulthood and in the meantime use a temporary replacement.

But that wait could pose a problem with bone health. As living tissue, bone cells have a life cycle where they form, function and then dissolve (resorption) with new cells taking their place. This cycle continues at a healthy rate thanks to stimulation from forces generated by the teeth during chewing that travel through the roots to the bone.

When a tooth goes missing, however, so does this stimulation. Without it the bone's growth cycle can slow to an unhealthy rate, ultimately reducing bone volume.  Because implants require a certain amount of bone for proper placement and support, this could make it difficult if not impossible to install one.

We can help prevent this by placing a bone graft immediately after the removal of a tooth within the tooth's "socket." The graft serves as a scaffold for new bone cells to form and grow upon. The graft will eventually resorb leaving the newly formed bone in its place.

We can also fine-tune and slow the graft's resorption rate. This may be preferable for a younger patient with years to go before their permanent restoration. In the meantime, you can still proceed with other dental treatments including orthodontics.

By carefully monitoring a young patient's bone health and other aspects of their dental care, we can keep on course for an eventual permanent restoration. With the advances in implantology, the final smile result will be worth the wait.

If you would like more information on dental care for trauma injuries, 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 “Dental Implants for Teenagers: Factors Influencing Treatment Planning in Adolescents.”


WhatYouCanDoAboutBadBreathUnlessYoureaFamousActressPrankingYourCo-Star

Hollywood superstar Jennifer Lawrence is a highly paid actress, Oscar winner, successful producer and…merry prankster. She's the latter, at least with co-star Liam Hemsworth: It seems Lawrence deliberately ate tuna fish, garlic or other malodorous foods right before their kissing scenes while filming The Hunger Games.

It was all in good fun, of course—and her punked co-star seemed to take it in good humor. In most situations, though, our mouth breath isn't something we take lightly. It can definitely be an unpleasant experience being on the receiving end of halitosis (bad breath). And when we're worried about our own breath, it can cause us to be timid and self-conscious around others.

So, here's what you can do if you're concerned about bad breath (unless you're trying to prank your co-star!).

Brush and floss daily. Bad breath often stems from leftover food particles that form a film on teeth called dental plaque. Add in bacteria, which thrive in plaque, and you have the makings for smelly breath. Thorough brushing and flossing can clear away plaque and the potential breath smell. You should also clean your dentures daily if you wear them to avoid similar breath issues.

Scrape your tongue. Some people can build up a bacterial coating on the back surface of the tongue. This coating may then emit volatile sulfur compounds (VSCs) that give breath that distinct rotten egg smell. You can remove this coating by brushing the tongue surface with your toothbrush or using a tongue scraper (we can show you how).

See your dentist. Some cases of chronic bad breath could be related to oral problems like tooth decay, gum disease or broken dental work. Treating these could help curb your bad breath, as can removing the third molars (wisdom teeth) that are prone to trapped food debris. It's also possible for bad breath to be a symptom of a systemic condition like diabetes that may require medical treatment.

Quit smoking. Tobacco can leave your breath smelly all on its own. But a smoking habit could also dry your mouth, creating the optimum conditions for bacteria to multiply. Besides increasing your disease risk, this can also contribute to chronic bad breath. Better breath is just one of the many benefits of quitting the habit.

We didn't mention mouthrinses, mints or other popular ways to freshen breath. While these can help out in a pinch, they may cover up the real causes of halitosis. Following the above suggestions, especially dental visits to uncover and treat dental problems, could solve your breath problem for good.

If you would like more information about ways to treat bad breath, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”