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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. Kathleen Tavarez and the team at Tavarez 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. Kathleen Tavarez 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 Tavarez Orthodontics in Menlo Park or San Carlos, CA will coordinate a treatment plan to create your best—and healthiest—smile.

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. Kathleen Tavarez 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 Menlo Park or San Carlos, CA 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!

School’s out. The barbecue’s fired up. T-shirts and shorts are back in style. Sandy beaches and sidewalks are sizzling. Summer’s officially here, and it’s time to get back into hot weather mode. This means getting back into some healthy summer habits.

Be Ready to Hydrate!

Warm weather can lead to dehydration before you know it. And water does more than hydrate—it rinses away food particles after eating or snacking, neutralizes enamel-eroding acids in the mouth, and helps us keep up healthy levels of saliva. 

• A reusable water bottle is a summer shopping list must. When you’re out walking, hiking, exercising, or camping, you can’t always be sure you’ll have fresh water available. Fill your water bottle before you leave home—you’ll help yourself stay hydrated, save money, and protect the environment, too!
• When you’re on the go, rinse with water after snacking to help remove food particles from teeth and braces.
• Go light on the sports drinks and sodas when planning your summer menus. They’re often filled with sugars and acids—two very unhealthy ingredients for your teeth. 

Restock Your Sunscreen

Sunscreen helps protect skin of all shades and all ages. Exposure to ultraviolet rays is known to cause skin cancer and premature aging. Lip tissue is thin and delicate, especially at risk from the sun’s damaging UV rays. 

• Check your sunscreen for its expiration date. Protective sunscreens and lip balms lose effectiveness once that date has passed.
• Some sunscreens are designed for use on lips. If yours isn’t, look for a protective lip balm. All of your sunscreens and balms should have an SPF (Sun Protection Factor) of 30 or higher.
• Bring your sunscreen and balm with you when you’re out and about, and reapply every two hours, or sooner if you’re eating, drinking, or getting wet.

Prep for Summer Adventures

If you’re travelling this summer, make sure the right dental and orthodontic supplies are part of your gear. A travel size toothbrush and toothpaste, a well-ventilated toothbrush case, and your orthodontist’s and dentist’s emergency contact information are basic necessities. If you wear braces, add dental wax and extra rubber bands. If you have aligners or a retainer, don’t forget your case.

Once you have the basics, you can tailor your kit to your summer plans:

• Flying? Make sure every liquid, gel, or aerosol you’ll need is the proper size for carry-on flight rules, 3.4 oz (100 ml) or less. Toothpaste and mouthwash are included in these categories, so look for travel sizes in your favorites. 
• Going overseas? Don’t forget plug adaptors or voltage converters if needed for your electric toothbrush.
• Camping? An emergency kit with cotton rolls, over-the counter pain relief, oral pain relief gel, dental wax (for damaged braces or a broken tooth), and even temporary fillings and a tooth preservation kit can be crucial in case of unexpected dental injuries.

Make Sure Dental Care Is on Your Summer Calendar

Laid-back summer days are the best, but laid-back dental care really isn’t! Follow your healthy dental routine even during the lazy days of summer.

• Keep up with your brushing and flossing. Brush two minutes twice each day with a fluoride toothpaste, and floss at least once a day—or more often as your orthodontist recommends.
• If you’re planning a trip, don’t ignore warning signs. If you have tooth pain or sensitivity, see your dentist to treat any problems before you’re cruising at 30,000 feet or enjoying a remote campout miles from anywhere.
• See your orthodontist as scheduled, and make sure to let the office know if you have travel plans which might disrupt your regular treatment schedule.
• Keep your appointments for dental exams and cleanings to ensure year-round dental health.

Whether you’re basking in the warm outdoor weather, relaxing in the shade with a cool drink and a good book, on the road to adventure, or wherever your summer plans take you, we hope these easy tips will help you create a summer filled with bright, healthy smiles.

TMJ is the quick way of referring to your Temporomandibular Joint. Pardon the pun, but that’s quite a mouthful! What is this joint, what does it do, and, if your Dr. Kathleen Tavarez and our team have told you that you have a TMJ disorder, what can we do to help?

The Temporomandibular Joint

Your two temporomandibular joints are amazing works of anatomical design. These are the joints where the temporal bone in the skull meets the mandible bone of the jaw, and allow our mouths to open and close, move back and forth, and slide from side to side. Muscle, bone, and cartilage work together to provide easy movement and to cushion the joint. But sometimes, the joint doesn’t work as smoothly as it should, and this can lead to Temporomandibular Joint Disorder, or TMD.

When Should You Suspect You Have TMD?

You might have TMD if you experience any of these symptoms:

• Painful chewing
• Pain around your TMJ, or in your face or neck
• Earaches
• Changes in your bite
• Jaws that are limited in movement or lock open or shut
• Clicking, popping or grating noises when you open and shut your jaw

There are many conditions linked to TMD. If you grind your teeth at night, have arthritis in the jaw, have suffered an injury or infection in the area, or have problems with your bite, for example, you might be more likely to have TMJ problems. If you suspect you have TMD, or suffer from any of the symptoms listed above for an extended period, give us a call.

Treating TMD

During your visit to our Menlo Park or San Carlos, CA office, we will check your medical history, and examine your head and neck. We can take an X-ray or scan if needed for further examination of the joint. Because there is no real scientific agreement yet about the best way to treat TMJ disorders, a conservative treatment plan is often best. If you do show signs of TMD, we might first suggest relaxation techniques, over-the-counter pain relievers, or the use of ice packs or moist heat compresses. A change to a softer diet can help, and you should stop chewing gum and making any exaggerated jaw movements.

If these self-care practices aren’t effective, we might suggest a nightguard. This appliance is a comfortable and flexible mouthguard custom fitted for you, and will bring relief from teeth grinding when worn at night. If this treatment is not effective, talk to us about other options.

Luckily, most cases of TMD are temporary and don’t become worse over time. But any persistent discomfort is a good reason to visit us. Whether you have TMD, or any other problem causing you pain in the head or jaw, we want to help.