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Westminster, MD 21157
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Posts for category: Dental Procedures

By Dr. Patrick Gallagher, D.D.S.
March 18, 2014
Category: Dental Procedures
Tags: braces   orthodontics  
ExtraCareisRequiredWhenTreatingTeenagersWithLostTeeth

Permanent tooth loss at any age greatly affects long-term oral health. But because their jaw and facial structures are still developing, it’s particularly consequential for adolescents. Add to that any planned orthodontic treatment, and a little extra care is warranted when a teenager loses a tooth.

The biggest concern is potential bone loss caused by the missing tooth. Because the mouth structures are still developing, bone loss can be especially problematic for any future restorations of missing teeth. One of the best ways to slow or stop bone loss is to surgically insert bone-grafting material at the time of an extraction. Bone grafts act as scaffolds that the body builds natural bone upon; eventually the natural bone completely replaces the graft material.

When it comes to the matter of orthodontics, the treatment plan will be to either close the space so that future tooth replacement isn’t necessary or maintain the space for future tooth replacement. If the choice is the latter, the orthodontist will maintain enough space during installation of the braces for future replacement. In the meantime, the orthodontist can install temporary, color-matched tooth replacements within the braces to cover the gap. After the braces have been removed, artificial crowns may also be incorporated into the retainers for a more natural appearance until receiving a permanent replacement.

The best choice for that permanent replacement is a dental implant, a “stand-alone” system that encourages bone maintenance and doesn’t interfere or impact adjacent teeth. The only real question for adolescents is when to install the implants.

The mouth’s structural development doesn’t conclude until early adulthood: in males around ages 20, and in females typically a year or so earlier. Your dentist will evaluate your adolescent’s growth and development to determine if he or she is ahead or behind the growth curve. Natural teeth grow and develop along with the corresponding bone growth, but implants are artificial devices that don’t “grow” with the natural bone. It’s important, therefore, to postpone an implant installation until the jaw structure has fully developed — if done too early, the implant crown’s length won’t appear to be proportionally right (especially in relation to natural teeth) as the jaw continues to grow.

If you would like more information on dental implants for teenagers, 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 “Dental Implants for Teenagers.”

EarlyOrthodonticCareHelpedChildStarNolanGouldGetReadyforPrimeTime

Nolan Gould, who plays Luke on the popular TV comedy Modern Family, has beautiful, straight teeth. But in an exclusive interview with Dear Doctor magazine, the young actor said it wasn't always that way.

“My teeth used to be pretty messed up,” Nolan said. “I had two extra teeth when I was born. They hadn't come out (erupted) yet. And all the other teeth that were already there were starting to point backwards because it was getting so crowded in my mouth. At about the age of 7, I started going to the orthodontist to get my teeth checked.”

Age 7 may sound early for a visit to the orthodontist, but in fact that's exactly the age we recommend for a first orthodontic evaluation. Malocclusions (bad bites) often become noticeable around this time, as the child's permanent (adult) teeth erupt. We might already be able to see evidence of the following problems: crowding, too much space between teeth, protruding teeth, extra or missing teeth, and sometimes problems with jaw growth. So even if your child is too young for braces, it is not necessarily too early for an orthodontic evaluation.

This type of exam can spot subtle problems with jaw growth and emerging teeth while some baby teeth are still present. Early detection of orthodontic problems makes it easier to correct those problems in the long run. Waiting until all of the permanent teeth are in, or until facial growth is nearly complete, may make correction more difficult or even impossible. That's why the American Association of Orthodontists recommends that all children get a check-up with an orthodontist no later than age 7.

Orthodontic treatment itself usually begins between ages 7 and 14. Therapy that begins while a child is still growing, often referred to as “interceptive orthodontics,” helps produce optimal results. In Nolan's case, an early orthodontic evaluation allowed his orthodontist enough time to plan the most effective treatment. Nolan's two extra teeth were removed before they had a chance to push his other teeth even further out of alignment, and he was given orthodontic appliances which fit behind the teeth.

“You can remove them, which is really good for acting, especially because you can't see them. I can wear them 24/7 and nobody will ever notice.”

One thing that is noticeable, however, is Nolan's perfectly aligned smile!

If you would like to learn more about improving tooth alignment with orthodontics, please contact us to schedule an appointment for a consultation. To read Dear Doctor's entire interview with Nolan Gould, please see “Nolan Gould.” Dear Doctor also has more on an “Early Orthodontic Evaluation.”

By Dr. Patrick Gallagher, D.D.S.
January 23, 2014
Category: Dental Procedures
HughJackmansShockingTeeth

Australian heartthrob Hugh Jackman has won international recognition for his work on stage, screen and television, including his long-running portrayal of Wolverine in the X-Men film series, and his Academy-Award-nominated starring role in Les Miserables. Oh, and did we mention he was named the “sexiest man alive” by People magazine in 2008? So when Jackman once said “I have shocking teeth”… what did he mean?

“[My dentist] looked at my teeth and went, ‘Oh, my God, you've got gray teeth,’” the actor stated. The proposed cure: tooth whitening. But what if the action hero's teeth were brightened too much — would his look still convey his trademark rugged charm? To see how that issue was resolved, let's look a little closer at various methods of tooth whitening.

All Whitening Isn't the Same
Everyone has seen the kind of over-the-counter tooth whitening strips advertised in magazines and sold in drug stores. Most dentists agree that, given enough time, they can work in many cases. But there may be problems, too.

One is that unless you know what's actually causing the darkening, you can't be sure if there is an underlying issue that needs treatment — a root-canal problem, for example. Bleaching a diseased tooth is like painting over a rusty car: it camouflages the problem, but doesn't fix it. That's one reason why, before any whitening treatment is attempted, it's important to have a complete dental examination, with x-rays.

Another is that without professional supervision, it's more difficult to control the degree of whitening you will end up with. For safety reasons, over-the-counter whitening products have the least concentrated bleaching agent, and will probably require weeks of use to produce noticeable results. The next step up — a custom-designed, at-home bleaching kit from our office — will likely produce results twice as fast.

The Professional Advantage
At-home bleaching done under our supervision uses stronger whitening agents with a flexible plastic tray that's custom-made to fit your teeth. It's a cost-effective way to achieve several shades of whitening in a relatively short time. Plus, with the advantage of our experience and guidance, you can get excellent results safely and efficiently.

If you want the fastest and most controllable whitening, however, in-office whitening treatments are the best way to go. According to one study, using the most concentrated whiteners in a safe clinical setting produced a six-shade improvement in just three office visits! This would have required a week or more of at-home bleaching, or upwards of 16 daily applications of the over-the-counter whitening products!

In-office whitening also offers the greatest degree of control over the outcome. That's why it was the method Hugh Jackman chose for his treatments. By adjusting the concentration of the bleaching solution and the treatment time, Jackman's dentist made sure his teeth were pleasingly light — but still looked completely natural. And in our office, we can do the same for you.

So whether you're looking for a dazzlingly bright smile or a more subtle enhancement, the best way to start is to call our office for a consultation. For more information, see the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “Teeth Whitening.”

By Dr. Patrick Gallagher, D.D.S.
November 15, 2013
Category: Dental Procedures
WhatyoucandotoReduceComplicationsAfterGumSurgery

Today's periodontal (gum) surgical procedures are less painful and have fewer complications than ever before. Nevertheless, the best outcome still depends on how well you care for yourself as you recuperate. Here are some things you can do after surgery to lessen its effect.

In the first twenty-four hours after surgery, your primary objective is to prevent swelling, the major source of post-operative discomfort. You can accomplish this by applying an ice or cold pack to the outside of your face in the area of the surgery. It's best to alternate five minutes on and off with the pack for the outside, and ice chips, cold water or ice cream inside your mouth as often as possible. Your aim is to surround the surgical site with cold as much as you can with the five-minute on and off strategy.

You should eat only foods that are cold and soft (Jell-O™, applesauce, yogurt, ice cream, etc.), to help ease any swelling. The next day switch to hotter foods like soup, mashed potatoes or buttered pasta, as well as hot, salt water rinses as often as convenient. Avoid crumbly foods like chips, cookies or popcorn for a few days to help keep the incision site particle-free.

We typically prescribe a number of medications during recuperation: analgesics (usually of the aspirin or ibuprofen family) for swelling and pain, and antibiotics and antibacterial rinses to inhibit bacterial growth. Be sure to follow directions with each prescribed medication, taking the correct dosage and for the specified duration.

There is a possibility of post-operative bleeding — but don't panic. You should first attempt to locate the bleeding area, clean it, and then apply gentle pressure with moist, sterile gauze for ten to fifteen minutes. If the bleeding doesn't stop, give us a call.

You should keep the wound site as clean as possible to help avoid infection. However, don't brush, floss or rinse during the first twenty-four hours to avoid bleeding, and limit hygiene activities to antibacterial mouthrinses like chlorhexidine near the wound site for several days to weeks. During the first few days to a week after surgery avoid activities like strenuous exercise, drinking alcohol, sucking through a straw, or blowing up a balloon, as these can also increase your risk for bleeding. You should also avoid tobacco products during this time as these can inhibit the healing process. Each surgery is different and you should make sure you follow the specific instructions your surgeon will provide for you.

Taking these precautions will help keep discomfort and complications to a minimum. They will also help you recover quickly so that you can get back to your normal life.

If you would like more information on periodontal surgery and what to expect, 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 “Instructions Following Periodontal Surgery.”

By Dr. Patrick Gallagher, D.D.S.
October 31, 2013
Category: Dental Procedures
Tags: celebrity smiles   braces  
KristiYamaguchisBracesHelpedGiveHeraWinningSmile

If Kristi Yamaguchi's kids inherit her figure skating ability, they might just be headed for the Olympics — after all, their mom won the gold medal for figure skating in the 1992 games. When it comes to teeth, however, she wouldn't mind if they inherited her spouse's instead. “My husband [fellow Olympian turned pro hockey player Bret Hedican] never had braces,” she recently told an interviewer. “I'm hoping they get his teeth.”

When you look at the elegant skating star's pearly smile, you'd never suspect she had dental problems. In fact, Kristi had four permanent teeth extracted to relieve the crowding in her mouth. She also wore braces to correct irregularities in both upper and lower teeth. Could orthodontics work the same “magic” for your kids — or yourself?

It just might. The first step toward finding out is having an orthodontic evaluation. For kids, the right time for an initial evaluation is no later than age 7. By then, the first molars are usually present and your child's bite pattern is establishing. Even though treatment may not begin for several more years, it's helpful to know what problems may arise in your child's individual situation — and to start treating them at just the right time.

Orthodontics has progressed a great deal in the two decades since Yamaguchi's braces came off. Today, small devices called palatal expanders are often used to create more space in the mouth, as an alternative to tooth extraction. There are also many new options for orthodontic appliances, in addition to standard metal braces. These include unobtrusive tooth-colored braces and lingual braces, which are applied to the tongue side of the teeth and can't be seen. In some cases, clear plastic aligners can be used instead of braces, for a look that's almost invisible.

Adolescence is often the preferred time to do orthodontic treatment. By then, the permanent teeth have mostly come in, but there's still some growing left to do. But age isn't a factor that should stop you from getting the smile you've always wanted. About one in five orthodontic patients today is an adult — and those less-visible appliances can fit in well with the more “professional” image of an older person.

Orthodontics can't help make someone an Olympic athlete — only lots of talent and practice can do that. But it can make a big difference in a person's appearance. “Once my braces came off, it was like — Wow! That looks so much nicer,” Yamaguchi recollected. And today, the mother of two, author, and philanthropist sports the same appealing smile she had on the podium at the Albertville Olympic Games.

If you would like more information on how orthodontics could help you get the smile you've dreamed about, 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 “Early Orthodontic Evaluation” and “The Magic of Orthodontics.”