Referrals
Years ago, dental braces were only thought to be appropriate for pre-teens and teens having problems with their bite (malocclusion). Today, adults commonly choose orthodontic treatments as well. Close to 30% of all orthodontic patients in the United States are adults. However, it pays to start early for maximum effectiveness and the American Dental Association recommends that children receive an orthodontic evaluation by age seven. Stewart Family Dentistry serves both children and adults.
A malocclusion is usually a restorative issue, since it may interfere with eating and speaking. It may also be an esthetic issue that involves cosmetic dentistry since a malocclusion may prevent the development of a well-aligned smile or facial jaw lines.
No matter what your age, orthodontics can protect your bite (occlusion), maximize your teeth's effectiveness in performing their functions, and enhance the smile that gives you confidence. In orthodontics today, teeth and underlying roots are repositioned, providing better support for the crown of the tooth. Orthodontic treatment can also rejuvenate your facial appearance by reshaping the jaw, neck, and lips, especially when combined with surgical procedures. Finally, well-aligned teeth make oral hygiene easier.
The Orthodontic Evaluation
If you are a candidate for orthodontics, you will be referred by Stewart Family Dentistry to an orthodontist for evaluation of your bite. During the first visit, your orthodontist may use several methods to develop an individualized treatment plan, including:
- Oral, facial and functional evaluation
- Intraoral and facial photographs
- Panoramic and cephalometric x-rays
- Impressions for models of the teeth and bite
The orthodontist will review your dental records, perform a clinical assessment, take x-rays of your mouth and head as well as make models of the teeth by creating an accurate impression of the teeth — all of which is studied in order to formulate the best plan. During the second visit, your orthodontist will typically review the treatment plan and estimate the number of months for the active phase of treatment. The standard treatment phase is two years. After this, you may be required to wear a retainer for a while.
The treatment time to make the changes required to produce a satisfactory outcome can vary, based on age and how closely you follow your treatment plan. For example, younger patients may respond more quickly to treatment than adult patients because the bones supporting young teeth are more pliable than older bones. But adults tend to follow treatment instructions more consistently than children, which shortens treatment time. In some cases the treatment time is longer. For example, oral surgery and recovery may be necessary before or during the braces treatment.
Periodontics
Periodontics is the branch of dentistry that treats the structures that support the teeth — gums, bones and ligaments. Periodontal or gum diseases, including gingivitis and periodontitis, are serious infections that, if left untreated, can lead to tooth loss. They begin when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes gums to become inflamed. More than 75% of North Americans over 35 years of age have some form of periodontal disease. Although many are infected, few know they actually have the disease. In a recent study, 8 out of 10 people surveyed believed they did not have periodontal disease.
To test for periodontal diseases, your hygienist at Stewart Dentistry will examine your gums for color and firmness. Your teeth will be tested for looseness and checked for the way they fit together when you bite. In addition, x-rays may be taken to evaluate the bone supporting your teeth. The hygienist will use a technique called periodontal probing. In this procedure, a small measuring instrument is gently placed between your tooth and gum to measure the depth of the pocket.
As the hygienist will tell you, in order to keep your teeth and gums healthy daily cleaning is required in the form of brushing and flossing. If the plaque is not removed, it hardens into a rough, porous deposit called tartar. Toxins produced by the bacteria in the plaque irritate the gums. The toxins destroy supporting tissues around the teeth. Gums then pull away from the teeth, forming deeper pockets, which then fill up with more plaque.
When gum disease progresses, the pockets continue to become deeper and plaque continues to move further down the roots of the teeth damaging the bone that supports them. Unless treated, the affected teeth can become loose and eventually may be lost. If Dr. Stewart and your hygienist have determined that the tissues around your teeth are unhealthy and cannot be repaired with non-surgical therapy, you will be referred to a periodontal specialist.
Oral Surgery
Dr. Stewart may refer you to an oral surgeon for a variety of reasons. Oral surgeons care for patients with problem wisdom teeth, facial pain, and misaligned jaws. They treat accident victims suffering facial injuries, place dental implants, care for patients with oral cancer, tumors and cysts of the jaws, and perform facial cosmetic surgery.
The most common reason Dr. Stewart will refer you to an oral surgeon is removal of wisdom teeth. Wisdom teeth, also known as third molars, are the last teeth to erupt in your mouth. This generally occurs between the ages of 17 and 25, a time of life that has been called the "Age of Wisdom."
A wisdom tooth can become impacted when there is lack of space in the dental arch and its growth and eruption are prevented by overlying gum, bone or another tooth. Impacted teeth can be painful and lead to infection. They may also crowd out or damage adjacent teeth. Dr. Stewart will determine whether or not a wisdom tooth must come out, even if it has not caused any problems yet. Since not all problems related to third molars are painful or visible, damage may occur without your being aware of it. As wisdom teeth grow, their roots become longer, the teeth become more difficult to remove and complications become more likely. In addition, impacted wisdom teeth are more likely to cause problems as patients age and it is estimated that about 85% of third molars will eventually need to be removed. Dr. Stewart recommends that wisdom teeth be removed by the time the patient is a young adult in order to prevent future problems and to ensure optimal healing.