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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. Nicola Crichigno and the team at Crichigno 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. Nicola Crichigno 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 Crichigno Orthodontics in Stoney Creek will coordinate a treatment plan to create your best—and healthiest—smile.

It seems like the ads are everywhere these days—repair your enamel and reverse tooth decay with a tube of toothpaste! Are these claims too good to be true? Let’s dive into the science of tooth decay—how decay develops and how (and if!) it can be reversed.

Teeth can stand up to the powerful pressures of biting and chewing because over 95% of our enamel is made up of minerals. Calcium and phosphate ions in our teeth bond to form a crystal structure called hydroxyapatite. Because of the strength of this crystalline design, tooth enamel is the hardest substance in our bodies, even stronger than our bones. 

But bones, like most other parts of our bodies, are living tissue, which means that they can create new cells to replace old or damaged cells. Tooth enamel can’t regenerate new cells to repair itself. This means that when a cavity has made a hole in the tooth, the enamel can’t grow back. And, while enamel structure is very strong, it’s also vulnerable to damage—specifically, damage from acids. 

Our teeth are exposed to acids throughout the day, whether they are acids created by plaque bacteria or the acidic foods and drinks we consume. Acids dissolve mineral bonds, stripping calcium and phosphate minerals from the enamel and leaving weak spots in the tooth surface. This process is called demineralization. Demineralization is the first stage of tooth decay.

The good news? Our bodies are designed with a built-in defense mechanism to prevent demineralization from causing lasting damage. All through the day, saliva helps wash away acids in the mouth and bathes our teeth with new calcium and phosphate ions. These ions bond with the calcium and phosphate in our enamel, restoring enamel strength. This protective repair process is called remineralization. 

Now for the bad news. In the tug of war between demineralization and remineralization, saliva can only do so much. If your diet is heavy with acids, if you don’t brush away acid-producing plaque bacteria regularly, if you eat a lot of the sugars and starches which feed plaque bacteria, the remineralizing effects of saliva can’t keep up with the demineralizing effects of acids.

The first visible sign of demineralization is often a white spot on the tooth where minerals have been stripped from enamel. Studies have shown that enamel-strengthening toothpaste can be effective in this very first stage of tooth decay. Toothpastes which advertise enamel repair generally contain one or more of these ingredients:

• Calcium Phosphate
• Hydroxyapatite
• Fluoride 

Toothpastes with calcium phosphate or hydroxyapatite contain calcium and phosphate minerals, the building blocks of tooth enamel. Studies have suggested that these minerals can replace the calcium and phosphate ions stripped from enamel. These toothpastes may or may not contain fluoride, which is something you should discuss with your dentist before deciding on a specific toothpaste.

Fluoride toothpastes remineralize enamel—and more! Fluoride ions are attracted to the tooth’s surface, and, when fluoride ions join with the calcium and phosphate ions there, they form fluorapatite. Fluorapatite crystals are larger, stronger, and more resistant to acids than hydroxyapatite crystals. And, once bonded with tooth enamel, fluoride attracts the calcium and phosphate ions in saliva to remineralize the teeth more quickly. 

Why consider enamel-repair toothpaste? 

Once enamel is gone, it’s gone for good. If excess demineralization isn’t treated, a weak spot on the tooth surface will continue to erode, growing bigger and deeper until it becomes a hole in the enamel. This is a cavity, and your dentist will need to treat and repair your tooth to prevent the cavity from growing and potentially exposing the tooth’s pulp to bacteria and infection. 

If you wear braces, you want to be especially careful about excess demineralization. Because it can be hard to brush and floss effectively with braces, white spots and discolored patches are a common concern for those with braces, especially on the enamel around brackets.  

Talk to Dr. Nicola Crichigno at our Stoney Creek office about which toothpastes can help restore a healthy balance between the ongoing cycles of demineralization and remineralization when you have braces. While tooth-repair toothpaste can’t fix cavities, these products can often strengthen demineralized enamel and reverse this earliest stage of tooth decay.

Braces and aligners help straighten teeth and create a confident, attractive smile. And those visible benefits are amazing! But orthodontic treatment has an even more important purpose than transforming the appearance of your smile—and that’s protecting and improving your oral health. 

If you’re ready for orthodontic treatment, you know you can look forward to a future of beaming smiles. You can also look forward to healthier teeth and gums and a more comfortable and functional bite. For some people, orthodontic treatment can make speaking and eating easier, and could even contribute to a better night’s sleep.

How can orthodontic treatment from Dr. Nicola Crichigno accomplish these goals? Let’s set the record straight!

Protecting Tooth and Gum Health

• Lowering Your Risk of Cavities

Perfectly aligned teeth are considered aesthetically pleasing, but there’s a more practical reason to appreciate straight teeth. Crooked and overlapping teeth make it easier for food particles and plaque to stick in between the teeth and harder for your brush to remove them. Straight teeth allow you to remove cavity-causing plaque more effectively and with less effort.

• Promoting Healthy Gums

When plaque and tartar build up around the gums, the gum tissue becomes irritated, which is the first stage of gum disease. When teeth are straight and evenly spaced, brushing and flossing are easier and more effective, and your gums reap the benefits.

Creating a More Functional and Comfortable Bite

A malocclusion occurs when the teeth and jaws aren’t properly aligned—they don’t fit together the way they should when you close your mouth. There are different types of bite problems, and these can impact both your oral health and your overall health depending on the type and the severity of the malocclusion. Once a malocclusion is corrected, patients can experience:

• Stronger Teeth and Healthier Gums

Teeth and jaws which don’t fit together properly put extra pressure on your teeth and gums, leading to problems such as worn enamel, cracked teeth, and gum recession. Protect your oral health by creating a well-aligned bite.

• A Pain-Free Bite

Left untreated, malocclusions can cause problems like temporomandibular joint disorder (TMD), headaches, face and neck pain, earaches, limited jaw movement, and painful chewing. Correcting your bite will protect your temporomandibular joint from harm and will relieve the discomfort and pain caused by a malocclusion. 

Other Possible Benefits of Treatment

For those with more serious malocclusions, orthodontic treatment might improve daily life in unexpected ways:

• Improved Speech

It takes a lot of coordination to produce different sounds. The lips, the tongue, the alveolar ridge which holds our teeth, the hard and soft palates, parts of the throat, and, yes, the teeth all play a part in creating speech. Some kinds of malocclusions contribute to speech disorders such as lisps, which orthodontic treatment can help correct.

• Improved Digestion

Digestion starts in the mouth, not the stomach! As we chew, we break down our food into particles which are easier for the stomach to digest. If you can’t chew properly because your teeth are misaligned or a bad bite makes it too painful to chew food as thoroughly as you should, you won’t be getting the full nutritional benefits of your healthy diet. Orthodontic treatment helps you bite down painlessly and break down foods easily for better digestion.

• Improved Sleep

Bite problems can sometimes lead to sleepless nights. More serious malocclusions may cause mouth breathing, which, in turn, can affect the quality of your sleep. If you’re having trouble sleeping, a sleep specialist can help you discover the source of your problems. If your troubled sleep is caused by tooth or jaw misalignment, orthodontic treatment might be the solution.

Orthodontists offer many treatment options designed to align your teeth and jaws for a healthy, attractive smile. Braces or aligners might be all you need to correct a mild malocclusion. Appliances and headgear can influence the growth and position of the jaw if needed. In more severe cases, surgery, together with braces, can create a proportional, healthy bite. 

Whether it’s a confident smile, healthier teeth and gums, a functional, comfortable bite, or any of the other benefits orthodontic treatment can bring, talk to the dental team at Crichigno Orthodontics in Stoney Creek to discover how orthodontic treatment can help you achieve all of your smile goals!

Healthy teeth make you happy to share your smile with the world. But there’s more to your smile than its beauty! There’s a lot of hard work going on, too. 

Teeth Are Designed for Efficient Eating

Because humans are omnivores, we can eat both meat and plants. That’s why our teeth have different shapes—they’re meant to help us process different types of food. 

• Incisors, our front teeth, have sharpish edges to help cut through meats and other firm foods when we bite.
• Canines, the pointed teeth, help tear food into bite-size portions.
• Premolars are flat topped teeth with two cusps, raised points which help us grind food.
• Molars are the flat-topped teeth in the rear of the mouth. They have four cusps to grind and crush food into a paste-like consistency. 

So: Incisors and canines bite and tear food into smaller pieces, which molars and premolars then crush and grind into a paste. Bite, tear, crush, grind—why all this food aggression? Because that’s the key to healthy digestion. 

Successful digestion begins with chewing. Chewing:

• Starts the process of breaking food down into digestible particles.
• Increases saliva production. Saliva binds food particles so that we can swallow easily.
• Expands the surface area of food particles, which allows the digestive system to extract nutrients more efficiently. 

When biting causes you pain, it can be hard to chew food. Swallowing becomes difficult when food particles are too large, and digestion becomes uncomfortable.

Bite pain can occur when there’s a deep cavity or an injured tooth, but it can also be caused when the teeth and jaws don’t fit together the way that they should. This misalignment is called a malocclusion, or bad bite. And while a malocclusion often makes eating more difficult, it can have further damaging effects as well.

Teeth Are Designed to Be Good Partners

While eating is probably the first thing that comes to mind when we think about dental duties, our teeth also work in coordination with other parts of our bodies. A malocclusion can interfere with these normally smooth interactions, affecting:

• Tooth and Jaw Health

Biting, chewing, and clenching put hundreds of pounds of pressure on our teeth and jaws. A misaligned bite misapplies this pressure, which can lead to damaged and unevenly worn teeth, tooth grinding, headaches, jaw pain, and other problems. 

• Speech

Our teeth work with our tongues and lips to form many of the phonetic sounds which make up speech. Try saying the word “teeth,” and see how your tongue and teeth work together! Misaligned teeth and jaws can affect speech development in children and pronunciation in children and adults.

• Face Shape

Our teeth and jaws help give shape to our faces. Alignment problems can affect facial symmetry and self-confidence.

You Can Help Your Teeth Work Their Best

Daily brushing and flossing, eating a healthy diet, and regular visits to your dentist for exams and cleanings help your teeth perform their many daily duties. But if bite problems are causing troubles with eating, tooth or jaw pain, difficulty speaking, or self-consciousness, it’s time to team up with your orthodontist. 

And just like your everyday dental care, orthodontic treatment works best with your active participation. 

• Make sure your teeth are their cleanest with careful brushing and flossing. You may need to brush and floss more often while you’re in treatment.
• If you wear braces, eat a braces-friendly diet. 
• Wear aligners, bands, or appliances for the hours recommended each day.
• Keep up with your orthodontic visits to keep your treatment on schedule.

Talk to your orthodontist to learn more about how to help your teeth work their best for you—and be ready to share that beautiful, hard-working smile!