My Blog

By Dr. J Douglas McDonald, DDS
October 13, 2017
Category: Oral Health
Tags: thumb sucking  
MonitoringYourChildsThumbSuckingCouldHelpAvoidFutureBiteProblems

Although distressing to many parents, infants and toddlers sucking their thumb is a common if not universal habit. Most children phase out of it by around age 4, usually with no ill effects. But thumb-sucking continuing into late childhood could prove problematic for a child’s bite.

Thumb sucking is related to how young children swallow. All babies are born with what is called an infantile swallowing pattern, in which they thrust their tongues forward while swallowing to ensure their lips seal around a breast or bottle nipple when they nurse. Thumb-sucking mimics this action, which most experts believe serves as a source of comfort when they’re not nursing.

Around 3 or 4, their swallowing transitions to a permanent adult swallowing pattern: the tip of the tongue now positions itself against the back of the top front teeth (you can notice it yourself when you swallow). This is also when thumb sucking normally fades.

If a child, however, has problems transitioning to an adult pattern, they may continue to thrust their tongue forward and/or prolong their thumb-sucking habit. Either can put undue pressure on the front teeth causing them to move and develop too far forward. This can create what’s known as an open bite: a slight gap still remains between the upper and lower teeth when the jaws are shut rather than the normal overlapping of the upper teeth over the lower.

While we can orthodontically treat an open bite, we can minimize the extent of any treatments if we detect the problem early and intervene with therapies to correct an abnormal swallowing pattern or prolonged thumb sucking. For the former we can assist a child in performing certain exercises that help retrain oral and facial muscles to encourage a proper swallowing pattern. This may also help diminish thumb sucking, but we may in addition need to use positive reinforcement techniques to further discourage the habit.

To stay ahead of possible problems with thumb sucking or the swallowing pattern you should begin regularly taking them to the dentist around their first birthday. It’s also a good idea to have an orthodontic evaluation around age 6 for any emerging bite problems. Taking these positive steps could help you avoid undue concern over this common habit.

If you would like more information on managing your child’s thumb-sucking habit, 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 “How Thumb Sucking Affects the Bite.”

By Dr. J Douglas McDonald, DDS
September 28, 2017
Category: Dental Procedures
Tags: celebrity smiles   crowns  
DentalCrownsfortheKingofMagic

You might think David Copperfield leads a charmed life:  He can escape from ropes, chains, and prison cells, make a Learjet or a railroad car disappear, and even appear to fly above the stage. But the illustrious illusionist will be the first to admit that making all that magic takes a lot of hard work. And he recently told Dear Doctor magazine that his brilliant smile has benefitted from plenty of behind-the-scenes dental work as well.

“When I was a kid, I had every kind of [treatment]. I had braces, I had headgear, I had rubber bands, and a retainer afterward,” Copperfield said. And then, just when his orthodontic treatment was finally complete, disaster struck. “I was at a mall, running down this concrete alleyway, and there was a little ledge… and I went BOOM!”

Copperfield’s two front teeth were badly injured by the impact. “My front teeth became nice little points,” he said. Yet, although they had lost a great deal of their structure, his dentist was able to restore those damaged teeth in a very natural-looking way. What kind of “magic” did the dentist use?

In Copperfield’s case, the teeth were repaired using crown restorations. Crowns (also called caps) are suitable when a tooth has lost part of its visible structure, but still has healthy roots beneath the gum line. To perform a crown restoration, the first step is to make a precise model of your teeth, often called an impression. This allows a replacement for the visible part of the tooth to be fabricated, and ensures it will fit precisely into your smile. In its exact shape and shade, a well-made crown matches your natural teeth so well that it’s virtually impossible to tell them apart. Subsequently, the crown restoration is permanently attached to the damaged tooth.

There’s a blend of technology and art in making high quality crowns — just as there is in some stage-crafted illusions. But the difference is that the replacement tooth is not just an illusion: It looks, functions and “feels” like your natural teeth… and with proper care it can last for many years to come.  Besides crowns, there are several other types of tooth restorations that are suitable in different situations. We can recommend the right kind of “magic” for you.

If you would like more information about crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Crowns & Bridgework” and “Porcelain Crowns & Veneers.”

By Dr. J Douglas McDonald, DDS
September 13, 2017
Category: Oral Health
Tags: oral hygiene   gum disease  
StayVigilantwithOralHygienetoAvoidAnotherBoutofGumDisease

Treating advanced periodontal (gum) disease takes time. If you have this destructive disease, it wouldn’t be uncommon for you to undergo several cleaning sessions to remove plaque from tooth and gum surfaces. This built-up film of bacteria and food particles is primarily responsible for triggering and fueling gum disease.

These cleaning sessions, which might also involve surgery and other advanced techniques to access deep pockets of infection, are necessary not only to heal your gums but to preserve the teeth they support. With these intense efforts, however, we can help rescue your teeth and return your reddened and swollen gums to a healthy, pink hue.

But what then — is your gum disease a thing of the past?

The hard reality is that once you’ve experienced gum disease your risk of another occurrence remains. From now on, you must remain vigilant and disciplined with your oral hygiene regimen to minimize the chances of another infection. You can’t afford to slack in this area.

Besides daily brushing and flossing as often as your dentist directs, you should also visit your dentist for periodontal maintenance (PM) on a regular basis. For people who’ve experienced gum disease, PM visits are more than a routine teeth cleaning. For one, your dentist may recommend more than the typical two visits a year: depending on the severity of your disease or your genetic vulnerability, you may need to increase the frequency of maintenance appointments by visiting the dentist every two to three months.

Besides plaque and calculus (tartar) removal, these visits could include applications of topical antibiotics or other anti-bacterial substances to curb the growth of disease-causing bacteria in your mouth. You may also need to undergo surgical procedures to make particular areas prone to plaque buildup easier to clean.

The main point, though, is that although you’ve won your battle with gum disease, the war isn’t over. But with your own daily hygiene maintenance coupled with your dentist’s professional attention, you’ll have a much better chance of avoiding a future infection.

If you would like more information on preventing and treating gum disease, 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 “Periodontal Cleanings.”

By Dr. J Douglas McDonald, DDS
August 29, 2017
Category: Oral Health
ActressEmmaStoneRevealsHowThumbSuckingAffectedHerTeeth

It's no secret that many of Hollywood's brightest stars didn't start out with perfectly aligned, pearly-white teeth. And these days, plenty of celebs are willing to share their stories, showing how dentists help those megawatt smiles shine. In a recent interview with W magazine, Emma Stone, the stunning 28-year-old star of critically-acclaimed films like La La Land and Birdman, explained how orthodontic appliances helped her overcome problems caused by a harmful habit: persistent thumb sucking in childhood.

“I sucked my thumb until I was 11 years old,” she admitted, mischievously adding “It's still so soothing to do it.” Although it may have been comforting, the habit spelled trouble for her bite. “The roof of my mouth is so high-pitched that I had this huge overbite,” she said. “I got this gate when I was in second grade… I had braces, and then they put a gate.”

While her technical terminology isn't quite accurate, Stone is referring to a type of appliance worn in the mouth which dentists call a “tongue crib” or “thumb/finger appliance.” The purpose of these devices is to stop children from engaging in “parafunctional habits” — that is, behaviors like thumb sucking or tongue thrusting, which are unrelated to the normal function of the mouth and can cause serious bite problems. (Other parafunctional habits include nail biting, pencil chewing and teeth grinding.)

When kids develop the habit of regularly pushing the tongue against the front teeth (tongue thrusting) or sucking on an object placed inside the mouth (thumb sucking), the behavior can cause the front teeth to be pushed out of alignment. When the top teeth move forward, the condition is commonly referred to as an overbite. In some cases a more serious situation called an “open bite” may develop, which can be difficult to correct. Here, the top and bottom front teeth do not meet or overlap when the mouth is closed; instead, a vertical gap is left in between.

Orthodontic appliances are often recommended to stop harmful oral habits from causing further misalignment. Most appliances are designed with a block (or gate) that prevents the tongue or finger from pushing on the teeth; this is what the actress mentioned. Normally, when the appliance is worn for a period of months it can be expected to modify the child's behavior. Once the habit has been broken, other appliances like traditional braces or clear aligners can be used to bring the teeth into better alignment.

But in Stone's case, things didn't go so smoothly. “I'd take the gate down and suck my thumb underneath the mouth appliance,” she admitted, “because I was totally ignoring the rule to not suck your thumb while you're trying to straighten out your teeth.” That rule-breaking ended up costing the aspiring star lots of time: she spent a total of 7 years wearing braces.

Fortunately, things worked out for the best for Emma Stone: She now has a brilliant smile and a stellar career — plus a shiny new Golden Globe award! Does your child have a thumb sucking problem or another harmful oral habit? For more information about how to correct it, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”

By Dr. J Douglas McDonald, DDS
August 14, 2017
Category: Dental Procedures
AnswerstoCommonQuestionsAboutRootCanalTreatments

A root canal treatment is a commonly known but often misunderstood procedure. Contrary to popular belief, these treatments aren't painful — in fact, they often stop a toothache. More importantly, a “root canal” can give a tooth on the verge of loss another lease on life.

Still, if you've never experienced a root canal treatment before, you probably have questions. Here are the answers to a few of the most common.

Why do they call it a “root canal”? This is the popular shorthand term for a procedure that removes diseased tissue from a decay-infected pulp, the innermost part of a tooth and the actual root canals themselves. Root canals are the narrow, hollow channels that run from the tip of the root to the pulp and are also involved in the procedure.

Why do I need one? Once infected, the pulp's bundles of blood vessels, nerves and other tissues become diseased. This often results in a painful toothache that can also suddenly disappear once the nerves within the pulp die. But there's still a problem: If we don't clean out the diseased and dead pulp tissue, the infection could spread through the root canals to the bone and endanger the tooth's survival.

What happens during the procedure? After deadening the tooth and surrounding gums with local anesthesia, we enter the pulp through an access hole we create. Using special instruments we remove the diseased tissue and shape the root canals to seal them with a filling material called gutta percha. Sealing the access hole is then necessary to prevent re-infection. Later we'll cap the tooth with a porcelain crown to restore its appearance and add further protection against fracture or cracking of the tooth.

Who can perform a root canal treatment? In many cases a general dentist can perform the procedure. There are some complex situations, however, that require a root canal specialist with additional training, expertise and equipment to handle these more difficult cases. If your tooth is just such a case it's more than likely your general dentist will refer you to an endodontist to make sure you get the right kind of care to save it.

If you would like more information on root canal treatment, 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 “Root Canal Treatment: What You Need to Know.”





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