The movie Bohemian Rhapsody celebrates the iconic rock band Queen and its legendary lead vocalist, Freddie Mercury. But when we see pictures of the flamboyant singer, many fans both old and new may wonder—what made Freddie’s toothy smile look the way it did? Here’s the answer: The singer was born with four extra teeth at the back of his mouth, which caused his front teeth to be pushed forward, giving him a noticeable overbite.
The presence of extra teeth—more than 20 primary (baby) teeth or 32 adult teeth—is a relatively rare condition called hyperdontia. Sometimes this condition causes no trouble, and an extra tooth (or two) isn’t even recognized until the person has an oral examination. In other situations, hyperdontia can create problems in the mouth such as crowding, malocclusion (bad bite) and periodontal disease. That’s when treatment may be recommended.
Exactly what kind of treatment is needed? There’s a different answer for each individual, but in many cases the problem can be successfully resolved with tooth extraction (removal) and orthodontic treatment (such as braces). Some people may be concerned about having teeth removed, whether it’s for this problem or another issue. But in skilled hands, this procedure is routine and relatively painless.
Teeth aren’t set rigidly in the jawbone like posts in cement—they are actually held in place dynamically by a fibrous membrane called the periodontal ligament. With careful manipulation of the tooth, these fibers can be dislodged and the tooth can be easily extracted. Of course, you won’t feel this happening because extraction is done under anesthesia (often via a numbing shot). In addition, you may be given a sedative or anti-anxiety medication to help you relax during the procedure.
After extraction, some bone grafting material may be placed in the tooth socket and gauze may be applied to control bleeding; sutures (stitches) are sometimes used as well. You’ll receive instructions on medication and post-extraction care before you go home. While you will probably feel discomfort in the area right after the procedure, in a week or so the healing process will be well underway.
Sometimes, dental problems like hyperdontia need immediate treatment because they can negatively affect your overall health; at other times, the issue may be mainly cosmetic. Freddie Mercury declined treatment because he was afraid dental work might interfere with his vocal range. But the decision to change the way your smile looks is up to you; after an examination, we can help you determine what treatment options are appropriate for your own situation.
If you have questions about tooth extraction or orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Simple Tooth Extraction” and “The Magic of Orthodontics.”
The change from primary teeth to permanent is an announcement to the world that a boy or girl is "growing up." "Growing up," though, is still not "grown"—the new teeth are still in a period of development that can affect how we treat them if they're injured or diseased.
While a new tooth erupts with all its anatomical layers, the middle dentin is somewhat thinner than it will be after it matures. The pulp, the tooth's innermost layer, produces new dentin and gradually increases the dentin layer during this early development period. While the pulp continues to produce dentin over a tooth's lifetime, most of it occurs in these early years.
To prevent or stop any infection, we would normally perform a root canal treatment in which we remove the pulp tissue and fill the empty pulp chamber and root canals. This poses no real issue in an older tooth with mature dentin. Removing the pulp from an immature tooth, though, could interrupt dentin development and interfere with the tooth's root growth. Besides a higher risk of discoloration, the tooth could become more brittle and prone to fracture.
That's why we place a high priority on preserving a younger tooth's pulp. Rather than a root canal treatment, we may treat it instead with one of a number of modified techniques that interact less with the pulp. Which of these we use will depend on the extent of the pulp's involvement with the injury or disease.
If it's unexposed, we may use a procedure called indirect pulp therapy, where we remove most of the tooth's damaged dentin but leave some of the harder portion intact next to the pulp to avoid exposure. If, though, some but not all of the pulp is damaged, we may perform a pulpotomy: here we remove the damaged pulp tissue while leaving the healthier portion intact. We may then apply a stimulant substance to encourage more dentin production to seal the exposure.
These and other techniques can help repair an injured young tooth while preserving most or all of its vital pulp. Although we can't always use them, when we can they could give the tooth its best chance for a full life.
If you would like more information on caring for your child's 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 “Saving New Permanent Teeth after Injury.”
If you're one of the millions of people wearing an oral appliance, you already know how important it is to your dental health. Whatever the purpose—replacing teeth, stopping teeth grinding or guarding against injury—you want to get the most and longest service from it. That means showing your appliance some tender loving care on a regular basis.
It doesn't require a lot of time and effort to clean and maintain your oral appliance. But there are some pitfalls that could lead to greater wear and tear and just outright damage. Here are 3 things you should be on the alert for to keep your appliance doing its job for you.
Be careful how you clean it. Your appliance might resemble natural oral tissue, but it's not—so don't use toothpaste. Toothpaste contains abrasives, which are fine for tooth enamel but damaging to materials in your appliance. Instead, use dish detergent, hand soap or a specialized cleaner. Don't use hot or boiling water, which could soften any plastic and distort the appliance's mouth fit. Nix the bleach too, which can fade colored portions of the appliance that mimic gum tissue.
Don't wear them 24/7 unless your dentist advises. Depending on the type and function of your appliance, you shouldn't wear them around the clock unless your dentist advises otherwise. Dentures are usually removed at night while you sleep to help prevent bacterial growth. Keeping them out at night -and keeping them clean—will help lower your risk of dental disease. One caveat, though: there are some concerns today about the effect of keeping dentures out of the mouth at night on sleep apnea. It's a good idea, then, to discuss the issue with your dentist regarding taking dentures out at night.
Prevent accidental drops on hard surfaces. Chewing forces are considerable, but your appliance is designed to take it. The same can't be said, though, if they accidentally fall on a hard surface—the fall could crack or break them. To protect against this, be sure to put a soft towel or cloth in your sink basin while you're cleaning your appliance. And don't place it on a night stand or low surface where it could be knocked off accidentally by a child, a pet or you. A sudden accident like this could be costly.
If you would like more information on extending the life of your oral appliance, 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 “10 Tips for Cleaning Your Oral Appliance.”
Dairy foods have played a role in human diets for thousands of years. More than one kid—whether millennia ago on the Mesopotamian plains or today in an American suburb—has been told to drink their milk to grow strong. This is because milk and other dairy products contain vitamins and minerals that are essential for a healthy body, including healthy teeth and gums. In honor of National Dairy Month in June, here are four ways dairy boosts your oral health:
Dental-friendly vitamins, minerals and proteins. Dairy products are an excellent source of many vitamins and minerals that are important for good dental health. They are packed with calcium and phosphorus, two minerals that work together to strengthen tooth enamel. In addition to the vitamins they contain naturally, milk and yogurt are fortified with vitamin D, which aids in calcium and phosphorus absorption; cheese contains a small amount of vitamin D naturally. What's more, dairy proteins have been shown to prevent or reduce the erosion of tooth enamel and strengthen the connective tissues that hold teeth in place.
Lactose: a more tooth-friendly sugar. Sugars like sucrose or high fructose corn syrup, which are routinely added to processed foods, are a primary trigger for tooth decay. This is because certain oral bacteria consume sugar, producing acid as a by-product. The acid weakens tooth enamel, eventually resulting in cavities. Dairy products—at least those without added sugar—are naturally low in sugar, and the sugar they contain, lactose, results in less acid production than other common sugars.
The decay-busting power of cheese. We know that high acidity in the mouth is a major factor in decay development. But cheese is low in acidity, and a quick bite of it right after eating a sugary snack could help raise the mouth's pH out of the danger zone. Cheeses are also rich in calcium, which could help preserve that important mineral's balance in tooth enamel.
Dairy for gum health. A study published in the Journal of Periodontology found that people who regularly consumed dairy products had a lower incidence of gum disease than those who did not. And since gum health is related to the overall health, it's important to do all we can to prevent and manage gum disease.
For those who cannot or choose not to consume dairy products, there are other foods that supply calcium naturally, such as beans, nuts and leafy greens—and many other foods are fortified with calcium, vitamin D and other nutrients. It may be wise to take a multivitamin or calcium with vitamin D as a supplement as well.
If you would like more information about nutrition and oral health, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Nutrition & Oral Health” and “How to Help Your Child Develop the Best Habits for Oral Health.”
For anyone else, having a tooth accidentally knocked out while practicing a dance routine would be a very big deal. But not for Dancing With The Stars contestant Noah Galloway. Galloway, an Iraq War veteran and a double amputee, took a kick to the face from his partner during a recent practice session, which knocked out a front tooth. As his horrified partner looked on, Galloway picked the missing tooth up from the floor, rinsed out his mouth, and quickly assessed his injury. “No big deal,” he told a cameraman capturing the scene.
Of course, not everyone would have the training — or the presence of mind — to do what Galloway did in that situation. But if you’re facing a serious dental trauma, such as a knocked out tooth, minutes count. Would you know what to do under those circumstances? Here’s a basic guide.
If a permanent tooth is completely knocked out of its socket, you need to act quickly. Once the injured person is stable, recover the tooth and gently clean it with water — but avoid grasping it by its roots! Next, if possible, place the tooth back in its socket in the jaw, making sure it is facing the correct way. Hold it in place with a damp cloth or gauze, and rush to the dental office, or to the emergency room if it’s after hours or if there appear to be other injuries.
If it isn’t possible to put the tooth back, you can place it between the cheek and gum, or in a plastic bag with the patient’s saliva, or in the special tooth-preserving liquid found in some first-aid kits. Either way, the sooner medical attention is received, the better the chances that the tooth can be saved.
When a tooth is loosened or displaced but not knocked out, you should receive dental attention within six hours of the accident. In the meantime, you can rinse the mouth with water and take over-the-counter anti-inflammatory medication (such as ibuprofen) to ease pain. A cold pack temporarily applied to the outside of the face can also help relieve discomfort.
When teeth are broken or chipped, you have up to 12 hours to get dental treatment.Â Follow the guidelines above for pain relief, but don’t forget to come in to the office even if the pain isn’t severe. Of course, if you experience bleeding that can’t be controlled after five minutes, dizziness, loss of consciousness or intense pain, seek emergency medical help right away.
And as for Noah Galloway:Â In an interview a few days later, he showed off his new smile, with the temporary bridge his dentist provided… and he even continued to dance with the same partner!
If you would like more information about dental trauma, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Trauma & Nerve Damage to Teeth” and “The Field-Side Guide to Dental Injuries.”
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