Should My Child Have Orthodontic Treatment Early?

This blog describes the rationale behind early orthodontic treatment in young children, generally aged 7 to 9. Orthodontic treatment can be divided into two phases:

  • Phase 1 treatment or early orthodontic treatment, which will be discussed in depth in this blog. This treatment is usually for children aged 7 to 9 and has a number of benefits as will be mentioned.
  • Phase 2 treatment or treatment around puberty, once all of the adult teeth are present. 

Every child is different and depending on the severity of the issues, some children may require only phase 1 treatment, other children may require both phase 1 and phase 2 treatment to achieve an ideal result. 

What are the benefits of starting orthodontic treatment early?

There are a number of benefits to starting orthodontic treatment early:

– it gives a better chance of getting a full correction

– it allows us to complete treatment that may avoid surgery

– it allows us to use growth to fix teeth

– it makes it less likely that we will have to extract permanent teeth

– younger children tend to co-operate better than older patients 

– there is a better chance of getting full correction in phase 1, without the need for phase 2 treatment

What does early orthodontic treatment consist of?

The American Orthodontic Association recommends an orthodontic consultation for all kids by the age of 7. Early orthodontic treatment consists of intervention to allow the face and jaws to grow properly. This gives a better chance of full correction of any orthodontic issues as well as prevents relapse of the teeth following treatment. Early orthodontic treatment focuses on addressing any habits and establishing a proper pattern of breathing and swallowing to allow the face and jaws to grow in an ideal way.

Addressing any Habits

The first part of early orthodontic treatment is addressing any habits in order to get a neuromuscular balance to be able to address any orthodontic issues and to prevent relapse of the teeth following treatment. These habits mainly include:

  •  thumb or finger sucking
  •  tongue thrust (which can usually be detected by a child having a lisp with S sounds)
  •  using a pacifier for an extended period of time

All of these habits promote a low forward tongue posture which contributes to malpositioning of the teeth, they can also cause changes in the roof of the mouth. With these habits, frequency is more important than the habit, more than 6 hours will cause malposition of the teeth including a crossbite (where the lower teeth sit in front of the upper teeth), crowding and an open bite (where the front teeth don’t touch). 

With using a pacifier, adverse dental effects may occur after 24 months of pacifier use, the effects are more significant after 48 months. Therefore, pacifier use should be discouraged after four years of age.

Thumb or finger sucking can be addressed with appliances such as a Bluegrass appliance that gets glued into the mouth and stops a child being able to position their thumb on the roof of their mouth.

A tongue thrust can be corrected with a device such as a Myomunchee, which promotes chewing and swallowing with the lips together in order to teach the tongue to position itself correctly (up in the palate instead of forwards) and thus correct the tongue thrust habit.

Correcting Breathing

The next part of treatment is to correct any breathing issues such as mouth breathing. 

There are three main causes of mouth-breathing:

  1. Infantile swallowing pattern that was never out-grown
  2. Thumb sucking, tongue thrusting or use of a pacifier
  3. Airway and breathing problems

The most common cause of airway and breathing problems is enlarged tonsils or adenoids, but other factors such as allergies, asthma, sinus problems and deviated septums can contribute. 

How does Mouth Breathing Cause Orthodontic Issues?

Mouth breathing causes orthodontic issues by promoting a more vertical growth pattern rather than a horizontal growth pattern. When the mouth is open, it drags everything downwards and backwards, resulting in a narrow upper jaw which leads to crowding and can lead to anterior and posterior crossbites (the upper teeth sitting behind the lower teeth). A narrow upper jaw causes restriction to the growth of the lower jaw as well. It also drags the chin downwards and backwards, causing the jaw joint to shift into an incorrect position which leads to bite dysfunction, with symptoms of headaches and facial pain. Finally, your lips are your face’s braces, so open lips encourage the front teeth to flare out. 

What Other Issues Can Mouth Breathing Cause?

Crooked teeth can be a symptom of something larger. Mouth breathing can contribute to more holistic issues such as sleep-disordered breathing (snoring, obstructive sleep apnea) and as these issues can have a significant impact on overall health, it is important that they are treated as early as possible. Sleep-disordered breathing can have a flow-on effect to other areas of a child’s life, poor concentration in school is a significant effect, with children with sleep-disordered breathing will have 10-20 fewer IQ points, on average 5 IQ points per year that this is happening. Other effects can be irritability, bed wetting, hyperactivity and attention deficit disorder

Correcting the Bite and Making Room for the Adult Teeth

Correcting the bite can consist of:

  • Expanding the palate
  • Partial braces 

Expanding the palate is best done early, as at 8 years old, the face is 90% of its adult proportion but by puberty, the face is 100% of its adult proportion. We are able to to get more expansion of the palate (20-25mm) in children 6-8 years, this drops down to less than 12mm in children 12 years old. Expanding the palate helps to make room to move the teeth to correct crowding as well as assists in correcting the bite. 

Expanding the palate is achieved with a device known as a banded or bonded hyrax, which is glued on to the upper teeth. It has a screw across the middle which is turned at regular intervals to slowly expand the palate. Once the palate is expanded to a reasonable amount, the appliance is left in the mouth for a few months to prevent relapse. This phase usually takes 4-5 months. 

The next step is partial braces on the 4 front teeth and 2 back teeth, which usually are worn for 12-18 months. Partial braces can be used to correct any rotated or incorrectly angulated front teeth, closing space between front teeth and correcting any crossbites of the front teeth as well. 

For children with overbites, 2×4 braces will often be combined with a MARA appliance, to encourage the jaw to grow in the correct position and hence correct the overbite.

For children with underbites, facemask headgear will be used in combination with 2×4 braces to encourage the upper jaw to grow whilst simultaneously restricting the growth of the lower jaw. Using facemask headgear can have the added benefit of increasing the airway space to improve breathing. 

Following this treatment, retainers get provided for the child which are worn until all of the adult teeth have come through, at which point, we can assess whether the child will need phase 2 braces. 

Who can provide orthodontic treatment?

Orthodontic treatment can be provided by a general dentist who has undergone extra training to be able to deliver orthodontic treatment. In more difficult cases or cases requiring surgery, your general dentist may refer you to an orthodontist for treatment. 

Are you Addicted to Sugar ?

Yes that is right you can be addicted to sugar just like drugs and alcohol. Sugar is everywhere and in almost every store bought packaged food and drink. It is easily a forgotten nasty that has an effect on your total health and wellbeing.  Many people consume more then there daily intake of sugars without even realising. The World Health Organisation recommends the average daily intake of free sugar for an adult should be reduced to less than 10% of their total energy intake. They say we should be trying to limit our sugar consumption to 6 teaspoons a day. Free sugars include all sugars added to food and drinks as well as natural sugars in fruit etc. 

An Australian Heath survey done in 2011-2012 found that Australians where consuming around about 60g of sugars each day which is equivalent of 13 teaspoons of sugar.  You may think it would be hard to eat that much sugar in a day but if you didn’t already know your average soft drink these days can have up to 10 teaspoons of sugar in them alone.

Sugar Effects on Health and wellbeing 

Sugar can play a major role in our total wellbeing.  People whom consume too much junk food or food with a high sugar content may experience things like fatigue, headaches from withdrawal, bad skin/acne, low energy levels, weight gain/obesity, increased stress, dental caries and some more serious health issues such as heart disease, liver disease and diabetes. Ways in which we can reduce our sugar intake can be by making simple food swaps. These can be as simple as swapping flavoured yoghurt to natural, or a snack bar to a handful of nuts.  Your local GP or Dentist may also have some helpful tips / swaps to help reduce your daily intake of sugar. 

Sugars effects on Teeth 

The deferent types of Bacteria in your mouth form together to create plaque which then uses the energy from the sugar to multiply and grow bigger and faster creating tooth decay. Some Bacteria may turn the sugar into a thick sticky type glue that sticks to the tooth surface which makes it harder for your saliva to wash it away naturally. Making you very reliable / depended on brushing to make sure your teeth are clean. Children and adolescent teens are at higher risk of tooth decay so it is very important to have a healthy balanced diet and practicing good oral hygiene by brushing and having regular check-ups at your dentist. 

Brushing your teeth on the regular

Brushing is very important in preventing decay especially in children, it is recommended that you brush your teeth at least two times a day, the best times to do this would be once in the morning after breakfast and again before bed. The more the better, it can be beneficially if you brush after every main meal when possible. Making sure we are brushing for the whole 2 minutes in circular motions, making sure we are brushing the whole tooth surface including where the tooth meets the gums top and bottom. It is important not to brush to hard as this May causing gum irritation/ damage.  Your Dentist will be able to demonstrate how to correctly brush your teeth and may have some helpful tips with brushing your child’s teeth as well.

Visiting the Dentist

Visiting the dentist for your regular check-up is another way to prevent and stay on top of any tooth decay and oral health issues. With regular scale and cleans and examinations the Dentist can help reduce and prevent the risk of tooth decay by ensuring your teeth are in good condition. They can set up a treatment plan and lead you down the right path for better oral health.

Are You a Teeth Grinder?

Do you grind your teeth or clench your jaw in your sleep? Perhaps you wake up in the morning with a sore jaw or have regular headaches? If this is the case, you may have Bruxism and not even know it!

 

This is very common with many of our patients. Bruxism can go undiagnosed for such a long time that it becomes habitual and just something patients ‘put up with’. At Terrigal Dental, we take a special interest in Bruxism cases. There are many symptoms, causes and treatments available, so why not stop it before it gets worse!

Bruxism can be caused by an array of biological, psychological and external factors. This includes, but is not limited to stress, anxiety, alcohol, or even an abnormal bite or crooked teeth. Alternatively, some clench their teeth as a coping strategy or to assist during deep concentration or to improve focus. It is harmful as it causes excessive wear on your teeth over time, as well as jaw tenderness and discomfort. Some patients grind their teeth so aggressively that their partners can hear it while the person is asleep!

Over an extended period of time, Bruxism can cause the following:

  • your teeth to fracture, loosen or break off
  • teeth sensitivity
  • injury to the joints and muscles in your jaw and/or face
  • ear aches
  • disrupted sleep

It is important to identify Bruxism before it becomes habitual as it will be easier to correct any damage. Here are some tips to stop teeth grinding:

  • Avoid caffeine, alcohol, energy drinks and foods with high levels of sugar in them
  • Avoid chewing gum as it allows your jaw muscles to get used to and comfortable to the clenching action
  • If you notice that you are clenching throughout the day, place the tip of your tongue between your front teeth, training your muscles to relax
  • Engage in relaxing activities before bed and stretching exercises to encourage relaxation of the muscles
  • Try stress management and cognitive behaviour therapy

In addition to the above, our dentists at Terrigal Dental can provide a custom fit mouth guard made to perfectly fit your mouth. This will provide a cushion in between your upper and lower teeth so they don’t directly meet. The guard is strong enough to withstand the pressure of your jaw clenching, but comfortable enough to sleep with it in. It will prevent the erosion of the enamel and should assist with those nasty headaches and pains in your jaw which Bruxism causes.

Through regular dental visits we will be able to monitor how your jaw and teeth change as a result of the mouth guard, and alter it accordingly to get the best result for you.

Wisdom Teeth – All you need to know!

Wisdom teeth; we all have them. Some go a whole lifetime without having any issues, whilst others experience pain, infections and swelling in their late teens and early twenties and need to have one or all of them extracted.

What are wisdom teeth?

Wisdom teeth are the rear third molars that come through at a more mature age than the rest of your teeth. They are located on your upper and lower jaw. Wisdom teeth can appear by:

  • Eruption – coming through with no obstruction
  • Partial eruption
  • Over eruption – coming through but growing too long
  • Impaction – getting suck along the way as a result of the tooth growing at an abnormal angle
Why do wisdom teeth hurt?

Wisdom teeth require removal due to an array of problems they cause, usually due to the lack of space in one’s jaw and mouth. This causes the teeth to erupt at an angle, thereby putting pressure on the surrounding teeth and gums. Further resulting in food and bacteria getting stuck in the difficult to reach places around the wisdom and neighbouring teeth. If the area around the wisdom teeth become infected, it can be extremely painful and may involve swelling of the jaw, pockets of pus developing around the concerned area, difficulty opening the mouth and swallowing and severe pain.

Why do wisdom teeth need to be removed?

Unless the troublesome wisdom teeth are removed by a dentist or oral surgeon, the infection and pain will generally reoccur, progressively get worse and be extremely unpleasant. Tooth decay is also caused by avoiding an extraction of impacted wisdom teeth.

The extraction

There are many misconceptions about the removal of wisdom teeth, often surrounded by the possible complications that can arise for the procedure. However, with the proper after-care and monitoring, it should not be long after the extraction procedure that you can resume your normal day to day activities.

The extraction procedure can range from being a simple ten to twenty minute appointment to an hour appointment. It all depends on how the tooth is growing and how many teeth are required to be removed.

At Terrigal Dental, most commonly a local anaesthetic is applied so you will not feel a thing. There is also the option of happy gas to assist you to relax before the extraction begins.

After care

To ensure you recover as quickly as possible after a wisdom teeth extraction, the following is often suggested:

  • Take pain relieving medication as advised by your dentist or oral surgeon
  • Hold warm salty water in your mouth for a couple of minutes each day – do not gargle
  • Don’t smoke for 48 hours after the surgery and avoid alcohol
  • Consume soft foods until you can open your jaw with ease
My personal experience

Personally, I had all four wisdom extracted in the dental chair. I had been struggling with a swollen jaw and infected third molars for a couple of weeks and tried to put the extraction off as soon as possible, however this only made my symptoms worse. The dentists walked me through the procedure and made me feel extremely comfortable in the chair. After a bit of happy gas and anaesthetic, the extraction commenced and it was over before I knew it. With a couple days of rest, salt water gargles and ice blocks, I recovered in three days. I extremely suggest wisdom teeth removal for anyone struggling with the pain associated with wisdom teeth. An extraction is a couple of minutes of your day that can prevent pain and infections for the rest of your adulthood.

Why are my teeth yellow? Teeth whitening/bleaching

Cleaning your teeth and maintaining their level of whiteness, isn’t as easy as it sounds… and we completely understand! Starting your morning without a warm cup of coffee and winding down without a glass of wine, just doesn’t sound as enjoyable.

To make things worse, it is not just coffee and wine that stain your teeth. There is a wide range of food and lifestyle choices that can inhibit you achieving the perfect level of whiteness.

Causes of yellow teeth:

  • Eating foods with staining properties such as curries, tomato-based sauces and soy sauce. The rich colours and acidic nature of these foods are (no matter how delicious they are) can lead to dental stains due to the level of pigments and sugar in them.
  • Drinking acidic beverages such as soft drink and white wine (red wines aren’t the only type of wine harmful to your teeth). The acidity in these drinks can eat away at the enamel on the surface of your teeth, eventually leading to decay.
  • Eating other pigmented foods, in particular fruits such as blackberries, blueberries and pomegranates. The pigments in these fruits are extremely powerful, and were used to dye clothing not too long ago, so regular intake of these fruits without brushing can cause dental stains.
  • Not drinking enough water. Water is not only important for hydration. It acts as a natural defence against build up and staining! It is recommended to drink water regularly throughout the day to wash away any substances lingering in your mouth, especially after a meal.
  • Smoking. Amongst the endless reasons to quit smoking, dental stains are one of them, along with gum disease and oral cancer.
  • Not brushing or flossing your teeth on a daily basis. As simple as it sounds, avoiding to brush and floss can lead to many dental issues down the track, and is one of the best ways to make sure your maintain your dental hygiene and colour of your teeth until your next dental appointment.

Obviously there are plenty more food and lifestyle choices that can stain your teeth. However, we are not here to advise you that in order to achieve the perfect white teeth you can’t live a normal life. Instead, we propose making the following changes to reduce the effects of the above!

How to stop teeth staining:

  • Diluting your curries and sauces by using some sort of milk or water based addition to the recipe. By ‘watering’ them down, you can reduce the level of pigment in them and therefore reduce the degree of dental staining.
  • Drinking acidic drinks through a straw. We know avoiding soft drinks completely can be difficult, so changing the way through which you consume them can reduce the amount of contact your teeth will have with the acids in the drinks.
  • Drinking enough water before and after meals, as well as throughout the day to ensure you (and your mouth) is not dehydrated.
  • Visit your dentist regularly for check-ups – in the case that there is an issue or concern with your teeth, the sooner it is identified the better.

At Terrigal Dental, we consider each patient part of our community and aim to provide a standard of treatment that we would expect for ourselves. We love educating our patients about their overall dental health as well as the options available to them to achieve the perfect smile – even those that they can incorporate into their daily routines at home.

For those that are finding their teeth to be victims of teeth staining, give us a call today to discuss the teeth whitening treatment we offer, or visit our website to make an appointment online!

Here is some information from the Australian Dental Association as well about aesthetic dentistry. We love making people smile.

Good Start Tumbi Umbi – Tuesday the 6th of September 2018.

On Tuesday the 6th of September, Amber and I went to Good Start at Tumbi Umbi to give the Oral Health presentation about why we have teeth and how to keep them happy and Healthy.

As we arrived, the children were outside playing in the fresh air, in the sand pits and on their bikes. There were so many fun things to play with!

We set up our presentation in front of the big colourful mat. This is where the children sit when they are listening to their teacher speak or read a book.

When we were ready, the very kind teachers brought in the bubbly cute children to sit on the mat. As we saw all the beautiful faces we thought we should get things started with a big smile from everyone. We could see so many bright and happy smiles. The children were so excited to meet Amber the Tooth Fairy and couldn’t wait to ask her some questions. One child noticed Mr Dragon sitting on the table and spotted his big teeth and yellow dots on his tail.

We used Mr Dragon to show everyone how to brush our teeth. We started by brushing the fronts of his teeth with circles and we got the children to make circles with their arms. Next we were brushing the biting areas of Mr Dragons teeth by scrubbing and the children we doing scrubbing movements with their arms. Once we had been through brushing Mr Dragons teeth, he had to spit out all the toothpaste. We explained to the children that it is good to spit out the toothpaste, but not to rinse with water so the important minerals can keep the teeth strong. We passed around Mr Dragon so everyone could have a go at brushing his big teeth.

When I asked why do we clean our teeth, a child told us it is so we do not get cavities. I was blown away with the answer! She was totally correct, we brush our teeth so the sugars from our food don’t eat into our teeth. Another way we can do this is to drink and wash our mouth with water after eating.

Looking around the room, we could see that a couple of the children had missing front teeth. It was so exciting to hear that the tooth fairy had come to their house and taken the tooth but left a little treat for them. They loved that Amber the tooth fairy was here today and wondered where she put all of the children’s teeth she had collected. However, this had to stay a secret.

We got two helpers up the front to show everyone what happens at a dental check up. They Dentist and Patient looked great all dressed up and played their roles very well. The patient had 20 happy teeth and she told us how her bottom front teeth are actually wobbly.

The children loved their gift bags and were so happy with the coloured toothbrushes!

We gave the preschool a Colgate story book with the character Brushalotamus. It talks about different ways we can keep our teeth happy. It tells us why it is important to eat healthy everyday foods, drinking lots of water, brush our teeth 2 times and have regular dental visits. The preschool teacher started reading it while Amber and I were packing up. The children were very interested in the story book.

The children gave us a big cheerful good bye and loved walking us to the door and waving through the fence.

It was really nice seeing so many little happy faces and smiles.

Sam Nowlan (Oral Health Therapist).

Terrigal Dental is now moving to 3/40 Oceanview Drive, Wamberal

Why are we moving?
1. Better parking and no dealing with Terrigal traffic!
2. Level access so no more walking up the stairs!

Having been in our current location for 50 years now it is now time for a new beginning and a new place! Along with our new location we will also be welcoming our amazing Hygienist Sam to the practice, she will be working Mondays and Tuesdays. Sam specialises in children’s dental and also does thorough cleans for adults. We anticipate our move to be completely finished by the 12th of June however we will continue to inform our patients of our location when booking appointments to avoid any confusion.

Our practice name, phone number and opening hours have not changed so all is still as normal!

We look forward to continuing to give our patients the highest possible quality of care at our new location. See you there!

What causes cavities?

Cavities or holes are formed by acid producing bacteria that live on the plaque in your mouth. When sugars and starches aren’t cleaned off your teeth, bacteria quickly begin feeding on them and form plaque. The acids in plaque remove minerals in your tooth’s hard, outer enamel. This erosion causes tiny openings or holes in the enamel — the first stage of cavities.

Brushing and flossing your teeth as well as having them professionally cleaned by our dentists twice a year decreases the level of these damaging bacteria in your mouth. Lack of tooth brushing allows the bacteria to grow producing too much acid which then causes cavities.

Sugary foods feed these bacteria making them produce more acid! So keep brushing and flossing twice a day and keep a healthy, low-sugar diet. These good habits will hopefully lead to a cavity-free visit to Terrigal Dental!

What Toothpaste Should I Use?

Walking down the hygiene care aisle in the supermarket, we’re dazzled with “advanced formulas”, “multi-action” pastes, and even “natural” toothpastes. But all hype aside, what type of toothpaste should you be using?

From pulverised bones and crushed oyster shells to the modern-day pearly white paste, the role of toothpaste has always been to remove plaque and prevent cavities.

At Terrigal Dental we recommend selecting a toothpaste with added fluoride. Any toothpaste that contains fluoride will help to prevent tooth decay, (when used with a daily oral hygiene routine that includes brushing and flossing). Fluoride is an ingredient added to toothpaste to help strengthen and protect teeth against decay. It can also reverse early decay. Most supermarket toothpastes will have fluoride but it is worth checking the ingredients on the back, just to be sure!

Terrigal Primary School Fun Fair

On the weekend our lovely receptionist Sam and Dr Charles participated in the Fun Fair at our local Primary School!

They had guessing competitions, prizes to be won and lots of samples to be given away! It was a beautiful day and they really enjoyed being a part of the day and talking with the community about all things dental.

Thanks for having us!