blog

Our Blog

Early Orthodontics

December 5th, 2018

Perhaps you are already planning for the years when your teenager will need orthodontic work. But hearing that your seven-year-old would benefit from orthodontic treatment? That might come as a complete surprise! It’s a recommendation with real benefits, though—early intervention can save children from tooth and bite problems now, and even simplify their future orthodontic care.

Treating young children for orthodontic problems is called “interceptive orthodontics.” When the permanent teeth start arriving, there might be problems with spacing, bite or protruding teeth. Often, treatment while the bones are still growing is the best way to prevent more serious problems later.

We recommend that your child have an orthodontic consultation with Dr. Ralph around the age of seven. This exam is especially important for children who may have been thumb suckers or used a pacifier after the age of three, or if you notice obvious teeth, speech or bite issues.

  • Crowding and Spacing Issues

Teeth are arranged in two crescent shapes called arches. When the arch of your child’s mouth is small, the permanent teeth can become very crowded as they erupt. Formerly, teeth were removed to make more room. Now, early use of a palatal expander can enlarge the upper dental arch in order to help the permanent teeth come in without crowding. The need for future tooth extraction is reduced, and there is a better chance for correct spacing and alignment with early treatment.

On the other hand, when a child loses a tooth too soon, too much space left between baby teeth can also be a problem. The remaining teeth can shift, leaving the wrong place open for the adult tooth to come in. We might recommend a space maintainer so that there is no shifting of the teeth and there is room for the proper adult tooth to erupt in its proper spot.

  • Malocclusions (Bite Problems)

Some malocclusions, like a crossbite, can be caused by problems with jaw and facial structure. Again, we might recommend a palatal expander to help the upper arch of the teeth to fit properly with the lower jaw. Problems with overbite, open bite and other bite issues can also be addressed at this age if necessary. Early care can discourage TMJ (temporomandibular joint) disorders, reduce speech problems, and improve facial symmetry. 

  • Protruding Front Teeth

Teeth that protrude are much more likely to be damaged when playing or after a fall. Methods such as braces or appliances can reposition them and protect them from breaking or fracturing.

Many children will not need early intervention, and many can wait until they are older for orthodontic work. But if your young child has orthodontic problems that should be addressed, early intervention can do more than set the stage for successful orthodontics in the teen years. Talk to our Liberty Lake or Spokane, WA team about what we can do for your child. Interceptive orthodontics can protect teeth, guide jaw and speech development, modify harmful oral habits and help to adjust bite problems before they become serious—when it comes to your child’s dental health, the best solutions are early ones!

What is a palatal expander?

November 28th, 2018

Orthodontists like Dr. Ralph recommend a first orthodontic visit and evaluation for your child around the age of seven. We will evaluate your child’s jaw and facial development and make sure that there is enough room in the mouth for the permanent teeth when they arrive. One of the recommendations we might make for early treatment is the use of a palatal expander. If you are unfamiliar with this device, let’s take a closer look at why it’s necessary and what exactly it does.

Why do we recommend the palatal expander?

There are two dental arches, composed of the upper and the lower teeth, in your child’s mouth. This arch-shaped design is meant to accommodate all the permanent teeth. Further, when the upper and lower teeth meet, they should result in a healthy occlusion, or bite.

Sometimes, the upper dental arch is simply too small to accommodate all of your child’s permanent teeth, leading to crowding, extractions, and impacted teeth. Also, a too-narrow arch can result in a crossbite, where some of the upper teeth bite inside the lower ones. An improper bite can lead to problems such as TMJ (temporomandibular joint) disorder, improper wear and stress on teeth, certain speech difficulties, and other potential complications. The palatal expander was designed to prevent these problems from occurring.

What is a palatal expander and how does it work?

The expander itself is a device that increases the size of the upper dental arch. Before your child’s bones are finished growing, the space between the two bones of the upper palate is filled with cartilage. This tissue is flexible when children are young, but gradually fuses solidly into place by the time they are finished growing (usually in the early to mid-teens). If the arch can be widened to accommodate the emerging permanent teeth, or to reduce malocclusions, this improvement can also affect the need for, and length of, future dental work.

There are several types of expanders available at our Liberty Lake or Spokane, WA office. These are custom-made appliances, commonly attached between the upper teeth on each side of the jaw. The two halves of the device are connected with a screw-type mechanism that can be adjusted to widen the upper palate and dental arch with gentle pressure. This is a gradual process, with small adjustments usually made once or twice a day to slowly move the bones further apart. As weeks go by, you will notice a successful change in the spacing of the teeth. Your child might even develop a gap in the front teeth, which is normal and will generally close on its own.

If you would like more detailed information, talk to Dr. Ralph about the palate expander. We can tell you what to expect from this treatment if we think it is best for your child’s unique needs, and how to make it as easy as possible for your child. Our goal is to provide your child with the healthiest teeth and bite possible, always making use of treatments that are both gentle and effective.

Does my child need two-phase treatment?

November 21st, 2018

You might be surprised to see one of your second grader’s friends with a dental appliance. Isn’t orthodontic work just for teenagers? And, if not, should your seven-year-old be sporting braces right now? The answer to both of those questions is “Not necessarily.” Two-phase treatment is a process designed to correct issues that arise during different times in your child’s life.

First Phase Treatment

We recommend that every child have an orthodontic evaluation around the age of seven to determine if there is a problem that would benefit from early treatment. First phase orthodontics is not the same as orthodontics for older patients. The focus here is on the developing bone and muscle structures which form your child’s bite and provide space for the permanent teeth when they arrive.

There are some clear-cut orthodontic goals that are much easier to attain when children’s bones are still growing.

  • Reducing Crowding

If your child’s mouth is small, the permanent teeth will have little room to fit in when they arrive. We may recommend gently enlarging the upper dental arch with the use of a palatal expander. This device will provide room for the adult teeth, and could potentially shorten second phase treatment time. Sometimes the extractions necessary to create more room for permanent teeth in later years can be avoided, as well as the possibility of an impacted tooth—one which doesn’t erupt because it is blocked by other teeth.

  • Dealing with Jaw and Bite Concerns

Bones and muscles do not always develop properly, leading to problems with jaw and facial structure. Your younger child still has growing bones, so this is a great time to gently re-form the jaw into a healthy shape. Problems caused by crossbites, underbites, open bites, and other malocclusions can be reduced with early treatment.  

  • Protecting Teeth

If your child has protruding front teeth, these teeth are more likely to be damaged in falls, at play, or while participating in sports. We can gently reposition them.

Second Phase Treatment

Second phase treatment is designed for your older child. After a resting period, when the permanent teeth finish erupting, we should see your child to evaluate any further orthodontic needs. This is the time to finish the process of straightening the teeth and making sure that each tooth fits together properly for a comfortable and healthy bite. This phase usually makes use of braces or aligners, and can take approximately 12-24 months.

Two-phase treatment is not necessary for every child. But there are some unique reasons that early orthodontics might be recommended for your child, even if it’s clear that more orthodontic work will be needed later. Make an appointment with Dr. Ralph at our Liberty Lake or Spokane, WA office, and let’s evaluate your child’s orthodontic needs, whether now or in the future, for a lifetime of beautiful smiles.

Safety of Dental X-Ray Radiation

November 14th, 2018

We all want to live our healthiest lives. We know that part of keeping ourselves healthy is regular visits to our Liberty Lake or Spokane, WA office for checkups and necessary dental work. And that dental work might require an X-ray. Should the amount of radiation in an X-ray concern us?

First, it is helpful to know that the radiation you are exposed to from a dental X-ray is very small. A set of most bitewing X-rays, for example, produces an amount of exposure about equal to the amount of background radiation we get from our normal surroundings in a typical day. We also take care to minimize your exposure even further by using specially designed equipment and protective shielding, and taking only necessary X-rays. If your child is very young, if you are pregnant, or if you have other health concerns, talk to us about the advisability of X-rays and whether they are essential to treatment.

Second, much of our careful general examination will be done visually. Dr. Ralph can check for cavities and other problems and assess tooth and gum health. But sometimes, there are conditions which can’t be detected without an X-ray.

  • Decay that isn’t visible in an oral exam—if a small cavity develops between teeth, or is hidden underneath a filling, an X-ray will catch it before more damage can take place.
  • Infection—An X-ray will reveal infections such as abscesses that can damage both bone and tooth, and gum disease that has harmed bone and connective tissue.
  • Orthodontic and periodontal issues—We might need an X-ray to determine the spacing and development of your child’s incoming teeth and maturing jaw structure, to properly create braces for adults or children, or to place an implant within the jawbone.
  • If you are a new patient, it is helpful to have complete X-rays taken as a baseline of your current dental health and previous dental work. This baseline allows us to track tooth and jaw development, if necessary, and to evaluate any future changes that might be a concern. (If you have had X-rays taken in another office, we can help you have them transferred so we have a background of your dental history.)

Even though the radiation from a dental X-ray is minimal, be assured that we will never request any unnecessary procedure. When we recommend an X-ray, we do so to make sure there is no decay or infection threatening the health of your gums and teeth, and that we have the essential knowledge we need to treat any dental, periodontal, or orthodontic condition. Because we all want to live our healthiest lives—and part of that healthy life is both active and proactive dental care.