Sounds a bit off, I know. In reality, several minor tooth movement appliances can double as a final retainer. The prime example would be a patient who you have identified as having minor anterior crowding, (maybe post-orthodontic relapse but not necessarily).  This can easily be fixed with a Spring Hawley Retainer or an Inman Aligner. 

Here’s how it works: You take a set of traditional or digital upper and lower impressions. The lab will use these to do a computerized space analysis which allows them to set the teeth into an ideal position and fabricate an appliance to that correction which will slowly move the teeth and correct the crowding.

The computer analysis will also allow the lab to provide you with a template on where you will need to interproximally recontour the teeth upon delivery of the appliance.   After the teeth are where they should be, the patient can often wear the appliance as a final retainer.

Is there ever a time when you should recommend stainless steel crowns to your patient?

If the child’s teeth are seriously decayed to the point where filling with lesser material will fail – especially true when the patient has received a pulpectomy – then Stainless Steel Crowns are likely the order of the day.

 A stainless steel crown can prevent further decay and allow the child to eat, chew, and speak normally until the permanent teeth erupt. There are certainly more esthetic pediatric crown options, e.g. Pedo Jackets or Strip Crowns. These options are, however, more expensive. For those patients that require basic care, a stainless steel crown is certainly better than extraction therapy or no treatment at all.  

Excepting most notable Pizza and Ice Cream, there are pros and cons connected with most life choices. Agreeing that final retention is indefinite, you have to decide what is going to work best for you and your patient.  To begin, we have classified retention appliances into three categories: Fixed, Removable and Active Retention.

Let’s walk through a few options in the fixed category. 

Fixed appliances are either cemented or bonded in place. The best reason for a fixed approach is that compliance isn’t an issue. The biggest negative is that the patients needs to learn how to floss and properly clean around their appliances. .If a patient is not vigilant, periodontal problems can occur.

Another problem with a fixed approach is that, at times, cement or bonding can fail, which means the patient might have to come back into your office to get the appliance re-cemented or re-bonded. 

At the risk of overdoing it in the “glib” department, “Shift Happens”.  As discussed in our last series, “Grace’s Airway Adventures,” the human mouth was originally designed to comfortably house all 32 teeth. For a number of reasons, over the years we have lost that spacing – evolved (or devolved) to a point where we require various forms of assistance to achieve that genetic potential. 

Hence, Orthodontics.

The esthetics of broad smiles and straight teeth are what your patients most desire --either for themselves or their kids. Healthy, uncompromised airways are the major consideration prior, during and after treatment.

But shift happens.  Patients, forget to wear their retainer. They lose it. They break it. Over a period of time many suffer relapse – and it’s often the lower anteriors that first begin to crowd. 

Your child’s baby teeth, known in the dental world as their primary dentition, have come in…and they’re crooked! Does this mean that their adult teeth will be crooked too?

Not necessarily. It depends on what caused the misalignment (s) in your child’s primary dentition. As children grow and develop, if there is not enough room for the adult dentition then teeth can crowd as they erupt.  It is important that there be room for all 32 teeth, so as children grow providing optimal conditions for this to happen is imperative not only for “straight teeth” but also proper development and function.  That is something that will probably reoccur with adult teeth…but once corrected, alignment can be maintained.

Try thinking about dentures without visualizing an elderly person putting in their teeth in the morning or taking them out and dropping them into a glass of water at night. Go ahead.

The truth is, dentures may become necessary at any age.

A bad fall, a violent hit during a sporting game, excessive tooth decay or entire host of accidental trauma scenarios…all could potentially create the need for tooth replacement. And yes, even young children may need dentures or pediatric partial dentures.

This might well raise the question of whether a pediatric partial denture is even necessary, given that the child’s adult teeth will eventually grow in. While this is true, your child needs the use of his or her teeth in the meantime. Missing multiple teeth can make it difficult for a child to chew or learn to articulate words correctly. The partial denture also acts as a space maintainer, which will minimize potential crowding of the adult teeth when they erupt.

The following is a series of blogs to explain the situation of pediatic airways disorders and my Daughter Graces' journey through the process of diagnosis and treatment.

GRACE’S JOURNEY: THE WAY TO AN OPEN AIRWAY, PART II

GRACE’S JOURNEY: THE WAY TO AN OPEN AIRWAY, PART I

TONSILS AND ADENOIDS REDUX: SAVING GRACE

AIRWAY AND ENVIRONMENT: GRACE’S BATTLE TO BREATHE

SNORING AND SLEEP APNEA: OBSERVATIONS, OVERLOOKS AND MY GIRL GRACE

PEDIATRIC AIRWAY DISORDERS: SNORE WARS

SLEEP, HEALTH AND PEDIATRIC AIRWAY DISORDERS: MY EYES ON GRACE

THIS IS THE FACE OF A PEDIATRIC AIRWAY PROBLEM

GRACE’S JOURNEY: THE SEARCH FOR “AIRWAY FIRST”

You’re a dentist…but you must also be a savvy business owner. After all, you can be the best dentist in the world, but if you can’t pay the bills, your dental skills won’t matter one bit. A smart dentist knows that one key to increasing profit is to cut back on unnecessary chair time.

There are many ways to do this. Your assistants can handle the lion’s share of standard cleaning and prep work, yet many procedures require you at the helm. In these instances, saving time on procedures – without lowering the quality of the outcome – can save you money and make your practice more profitable.

If you have something wrong with your teeth, you may wonder whether to call an orthodontist or a dentist. Both work with teeth, so it can sometimes be a little confusing.

So let’s keep it simple.  A dentist is a generalist, like your primary care doctor. Dentists help you keep your teeth clean and healthy -- preventing tooth decay; performing root canals; detecting gum disease; placing crowns, bridges, and veneers; even professionally whitening your teeth.

An orthodontist is a specialist, like a cardiologist.