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Orthodontists and dentists use advanced procedures to treat and save teeth. But sometimes, a tooth just can’t be saved and needs to be extracted. Sometimes it’s due to extensive decay, or infection, or serious injury. Or sometimes, to create a healthy bite, an extraction is necessary during orthodontic treatment.

When does an orthodontist recommend an extraction? Conditions which call for extraction include:

• Incoming Wisdom Teeth

Not many people have enough space in their mouths for four wisdom teeth! And when there’s no room to erupt properly, wisdom teeth can become decayed or infected, push your other teeth out of place, and damage the roots of nearby molars. Extracting wisdom teeth protects your teeth and your bite alignment.

Usually, orthodontic treatment takes place before the wisdom teeth begin to erupt. But if yours start to make an appearance during treatment, your orthodontist and dentist will work together to schedule extraction without interfering too much with your orthodontic treatment plan.

• Tooth and Jaw Structure

Dr. Viney Saini and the team at Viney P. Saini Orthodontics carefully plan your treatment based on examinations, X-rays, and/or 3D imaging. The goal is to align your teeth and jaws for an attractive smile and a healthy, functional bite. When overcrowding is severe, or if there is a serious malocclusion (bite problem), or if a particular tooth is unusually large or misshapen, your orthodontist might recommend an extraction.

Sometimes more room can be made for teeth with appliances such as palatal expanders or, in other cases, with the help of oral surgery. Extractions are only recommended when they are absolutely necessary.

• Baby Teeth Which Aren’t Coming Out 

Baby teeth normally fall out in a predictable pattern. Front teeth first, canines and molars last. Baby teeth have small roots, and these roots begin to break down when the adult teeth underneath put pressure on them as they start to erupt. As the root gets smaller and smaller, the baby tooth gets looser and looser—until it falls out. 

Sometimes, though, the roots of primary teeth don’t break down, and the baby teeth stay right where they are. This means that the permanent teeth have to erupt someplace else—usually behind those baby teeth. This creates a double row of teeth, and your permanent teeth can become crooked or overlap as they try to fit in. Extracting stubborn baby teeth allows your adult teeth to come in just where they’re supposed to. Because of their small roots, extracting primary teeth is usually simple and straightforward, and can be done in your dentist’s office. 

• Too Many Teeth

Most of us have 32 adult teeth, including wisdom teeth. It’s rare, but sometimes an extra, or supernumerary, tooth develops. Your jaw is most probably not equipped to accommodate any extras, so, in this case, the extra tooth or teeth are removed to give the rest of the teeth the space they need to avoid overlapping or crowding.

When your orthodontist recommends an extraction, it’s because it’s important for your dental health. Dr. Viney Saini will refer you to a dentist or a specialist like a periodontist or oral surgeon, who will: 

• discuss the extraction procedure with you, including sedation options
• numb the area 
• gently loosen and then extract the tooth
• provide options for pain management after the procedure
• give you detailed instructions for aftercare
• work with your orthodontist to keep your treatment on schedule

Extraction is never your first choice, or your orthodontist’s! But when an extraction is necessary for tooth and bite alignment, everyone at Viney P. Saini Orthodontics in Clarksburg, MD and Frederick, MD will coordinate a treatment plan to create your best—and healthiest—smile.

August 22 is National Tooth Fairy Day! If the Tooth Fairy is a treasured part of your child’s life, you’re just in time to celebrate! But what to do when the Tooth Fairy doesn’t arrive on schedule—when baby teeth stay longer than expected or are lost too soon? 

A baby’s 20 baby teeth tend to come in within a fairly predictable time frame. The bottom central incisors in the very front of your baby’s mouth typically make their appearance first, when your baby is around six to ten months old. Over the next few years, the remaining incisors, canines, and first molars arrive. Last on the scene are the second molars, which usually show up between the ages of 23-33 months. 

Just as baby teeth follow a pattern coming in, they tend to follow the same pattern falling out. The front teeth begin to wiggle and loosen around age six or seven, while the last of the baby teeth, the canines and second molars, are often lost between the ages of ten and 12. 

Baby teeth fall out as the adult teeth below them push up as they erupt. The top of the new tooth puts pressure on the root of the baby tooth, gradually dissolving it. As the root grows smaller and can’t anchor the tooth, the tooth begins to wiggle and eventually becomes loose enough to fall out. This leaves the adult tooth perfectly placed to grow into its proper position.

Sometimes, though, teeth linger far past their fall-out date. Sometimes, because of decay or trauma, they are lost much too early. In either case, Dr. Viney Saini can provide treatment to protect little smiles now and to ensure that there’s space for the permanent teeth to erupt and align correctly.

Teeth Which Overstay Their Welcome

If that baby tooth never gets wiggly, the team at Viney P. Saini Orthodontics can help! When baby teeth stubbornly hang on, adult teeth can erupt behind them, creating a double row of teeth commonly known as “shark teeth.” These permanent teeth can become crowded or misaligned as they try to fit in any space available. Or a baby tooth can block an adult tooth from erupting at all. When that baby tooth just isn’t budging, an extraction will create space for the permanent tooth to erupt.

Extracting a baby tooth is generally a straightforward procedure because primary teeth have very small roots. Your child’s dental team at Viney P. Saini Orthodontics are experts in helping you prepare your child for the procedure in a gentle, reassuring, and age-appropriate way. 

Often, a local anesthetic is all that’s necessary for a simple extraction, but if you feel sedation would better fit your child’s needs, discuss sedation options with your dentist. After the extraction, you’ll be given clear information on how to deal with pain and swelling, which foods and drinks are best while the extraction site heals, and how to protect the area.

Teeth Which Exit Too Early

In the case of decay or trauma, Dr. Viney Saini will do everything possible to save the tooth. When decay is so extensive that there’s not enough structure left to hold a filling or crown, or when there’s an infection in or around the tooth, or when an accident or injury has caused serious damage, extraction might be the healthiest option. Depending on your child’s age, further treatment might be needed afterward to protect future smiles. 

Besides their roles in eating and speaking, baby teeth save space for permanent teeth. Whenever a child loses a primary tooth too soon, the family dentist will be on the lookout for potential future orthodontic problems. If remaining baby teeth shift, taking up part of the empty space left behind by the lost tooth, the adult teeth below won’t have the space they need to erupt properly. Permanent teeth might come in at an awkward angle or in the wrong place. 

In this case, Dr. Viney Saini might recommend a space maintainer. Space maintainers are small, custom-designed appliances which prevent the remaining baby teeth from shifting position while holding space open for the permanent tooth to arrive right on schedule and right where it belongs. 

It’s comforting to have charts which let us know when little teeth will typically come in and when they will typically fall out. But unexpected events might mean teeth overstay their welcome or depart too soon. When the Tooth Fairy can’t keep to her schedule, schedule an appointment at Viney P. Saini Orthodontics in Clarksburg, MD and Frederick, MD as soon as possible to make sure your child is on track for a future of healthy smiles.

You’re constantly playing defense. Your child spends two minutes in the morning and two minutes at night carefully brushing and flossing with a fluoride toothpaste. You make sure sugary and acidic foods are not a major part of your diets. Your child visits our Clarksburg, MD and Frederick, MD office for regular exams and cleanings. Really, how can a cavity get past all that?

But even with the best defensive practices, you don’t have a level playing field—literally. The tops of our molars and premolars don’t have the smooth, easy-to-clean surfaces that our other teeth have. If you look at the chewing surfaces, you will notice deep grooves which toothbrush bristles have a much harder time reaching.  

Plaque and food particles can become trapped in these grooves (known as pits and fissures), providing perfect conditions for a cavity to develop. That is why cavities are so common in newly erupted molars. Dental sealants protect these teeth from cavities by providing a barrier which smooths out the surface of the tooth and prevents food and bacteria from reaching the molar’s crevices.

Most sealants are invisible plastic resin coatings which we apply in our Clarksburg, MD and Frederick, MD office. Usually the procedure is so quick and easy that no dental anesthetic is required. Each tooth will be examined first. If we find any signs of early decay, we will gently treat that area before beginning.

When the tooth is ready, it will be cleaned and dried. An etching solution will be brushed on to the dry surface to roughen the area a bit so that the sealant will hold to the tooth more effectively. A thin coat of the sealant is then painted on and hardened under a curing light. And that’s it!

Once teeth are sealed, they should be cleaned and flossed just as carefully as before. Regular exams and cleanings are still very important, and we can monitor the condition of the sealant and the sealed teeth. Properly applied, sealants can last from three to five years, or even longer.

Who should consider sealants? Sealants are typically recommended when the permanent molars first erupt. Children’s enamel takes a while to become its strongest, and so these just-erupted teeth are more at risk for cavities. Sometimes Dr. Viney Saini will recommend sealants for primary (baby) teeth if needed. But even adults can benefit—talk to us if you are interested and we will let you know if sealants might be right for you.

Sealants are a simple, safe, and minimally invasive way to prevent cavities. Studies of sealed molars and premolars show a dramatic reduction in cavities compared to untreated teeth. Sealants are one of the most effective ways to defend your teeth or your children’s teeth from tooth decay. And as we’ve all heard—defense wins championships!

We get it. You’re working out and could use a boost. It’s 2 a.m. and that essay won’t write itself (darn it). You’re in the middle of a rehearsal that goes on and on and . . . 

It’s easy to reach for an energy drink when you’re feeling a bit low on, well, energy. These drinks are loaded with caffeine, and, like coffee or tea, can help you feel more alert. But before you pop that top, let’s look at how energy drinks affect your dental health.

• Energy drinks are very acidic.

Acid levels are measured using the pH scale, which ranges from 0 (most acidic) to 14 (most alkaline). Saliva has a normal pH somewhere between 6.2 and 7.6, which helps neutralize any acidic conditions in the mouth and promotes a healthy oral environment. But saliva’s neutralizing effect can be overwhelmed by highly acidic foods and drinks.

Why are higher levels of acids bad for our teeth? Acids strip away minerals like calcium from tooth enamel, minerals which make enamel the strongest substance in the body. This demineralization weakens the enamel’s protective outer structure and can lead to enamel loss, sensitivity, tooth discoloration, and decay.

Many energy drinks are among the most acidic beverages on the market. Mineral loss in your enamel starts to occur when the pH balance in the mouth falls to 5.5 or less. Lemon juice has a pH between 2 and 3. White vinegar has a pH of 2.5. Energy drinks can range from 1.5 to 3.5 on the pH scale! Studies show that regular consumption of energy drinks greatly increases the risk and severity of dental erosion.

• Most energy drinks are full of sugar.

Sugar is easily metabolized, or broken down, by the body. When our bodies break down food, energy is released. That’s why companies add sugar as well as caffeine to their energy drinks. 

The plaque bacteria which create cavities also use sugars in these drinks as an energy source, converting sugars into acids. Just like acidic foods and drinks, bacterial acids break down the mineral structure in tooth enamel. You might notice small white spots when the enamel starts to erode—and a cavity starts to develop. 

• Energy drinks aren’t just bad for your dental health. 

The temporary burst of energy you get from all the sugar in energy drinks is followed by a sugar crash when blood sugar levels go down again, and you can feel tired, weak, or shaky. 

Even worse, one energy drink might contain three to four times the amount of caffeine found in a cup of coffee. Excess caffeine interferes with healthy sleep. It can cause changes in heart rate, blood pressure, and anxiety levels. 

Children and teens are especially vulnerable to the effects of large amounts of caffeine while their brains and bodies are still developing. That’s why the American Academy of Pediatrics recommend no energy drinks at all for children and teenagers. The FDA suggests that adults should not take in more than 400 milligrams per day of caffeine, while energy drinks can range from around 80 to 400 mg per can. 

If you do have the occasional energy drink, what’s the best way to protect your teeth and gums?

• Don’t linger over your drink. Sipping slowly over time just bathes your teeth and gums in sugar and acids over a longer period. 
• Drink water when you’re done. Water helps wash away sugars and acids, hydrates, and promotes healthy saliva production.
• If the team at Viney P. Saini Orthodontics gives gum a thumbs up, chew a piece of sugarless gum after downing an energy drink to increase saliva flow and help neutralize acids in the mouth. 
• Wait at least 30-60 minutes to brush after finishing an energy drink. Acids in the drink weaken enamel, and brushing immediately can be abrasive to the tooth surface.
• Eat a healthy diet rich in proteins, complex carbs, vitamins, and minerals to feel more energetic.
• Keep up with good dental hygiene. Brush twice each day for two minutes and floss daily, or more often as recommended by Dr. Viney Saini.

If you notice signs of enamel erosion—sensitivity, front teeth which are becoming transparent or rough around the edges, yellowish discoloration, or white or brown spots on your enamel—it’s time for a talk with your dentist. When caught early enough, treatment is available which can stop further erosion from harming your teeth.

It can be harder to brush and floss as effectively when you wear braces, so it’s more important than ever to make healthy choices in your diet and to keep up with your dental hygiene. The team at Viney P. Saini Orthodontics in Clarksburg, MD and Frederick, MD is always happy to give hygiene tips! Talk to your dentist or doctor to discover healthy ways to stay focused and energetic. Your workout, your essay, your rehearsal, and, above all, your healthy body and healthy smile will thank you!