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Posts for: November, 2014

KristinCavallarisSpaghettiCatcher-FirstStepToAWinningSmile

Kristin Cavallari's flawless smile has been featured on TV, film and magazine covers. But the 25-year-old actress and reality-show personality didn't always have a perfect set of teeth. In fact, she told Dear Doctor magazine — where readers recently voted to crown her with the “Smile of the Year” award — that her dental treatments began the same way many do: with orthodontics in sixth grade.

“I had the ‘spaghetti catcher,’ which is what everyone used to call it,” she reminisced. But by that, she didn't mean a strainer — she's talking about what dentists call a “palatal expander.”

In case you're not familiar with this orthodontic device, a palatal expander takes advantage of the natural growth patterns of a child's upper jaw to create additional space for the top set of teeth. How does it work? Basically, it's similar to braces: By applying gentle pressure, the appliance creates changes in the jaw. Unlike braces, however, it's invisible — it fits between the upper teeth, close to the roof of the mouth.

During the three to six months a child wears the palatal expander, it pushes the left and right halves of the upper jawbone apart, and then maintains and stabilizes the new, wider spacing. Since the palatal bones don't fuse until after puberty, tightening it a little bit each day for the first few weeks provides a quick and painless method of making the upper jaw a bit roomier. And that can be a very good thing. Why?

There are lots of reasons. For one, it can relieve the condition called “crowding,” when there is not enough space in the upper jaw to accommodate the proper alignment of the permanent teeth. In the past, teeth often had to be extracted in that situation. It may even allow “impacted” teeth — ones which are blocked from erupting by other teeth — to come in normally.

It can help treat a “crossbite,” when the back top teeth come down to bite inside (instead of outside) the lower back teeth. It also generally shortens the total time a child needs for orthodontic treatment. That's good news for any teenager — even if their own day-to-day “reality show” isn't featured on TV!

If you would like more information about palatal expanders, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Palatal Expanders” and “Early Orthodontic Evaluation.”


By Keith Mellovitz, DDS
November 11, 2014
Category: Dental Procedures
Tags: osteoporosis   oral surgery  
CertainTreatmentsforOsteoporosisCouldComplicateOralSurgery

Although periodontal (gum) disease is the most common cause of bone loss in the mouth, women at or past menopause face another condition that could cause complications with their oral bone health — osteoporosis.

While normal bone goes through a balanced cycle of resorption (the dissolving of bone tissue) and re-growth, osteoporosis, a hormone-induced disease, tips the scale toward resorption. This reduces bone density, which weakens the bone and makes them more susceptible to fracture.

Some studies have shown a link between osteoporosis and existing gum disease; however, the greater concern at present from an oral health standpoint regards the side effects of a certain class of drugs called bisphosphonates used in the treatment of osteoporosis. Bisphosphonates slow excessive bone resorption, which helps restore normal balance to the bone growth cycle.

Some long-term users of bisphosphonates, however, may develop a complication in their jaw bone known as osteonecrosis in which isolated areas of the bone lose vitality and die. This can complicate certain types of oral surgery, particularly to install dental implants (which rely on stable bone for a successful outcome). While research is still ongoing, it does appear individuals at the highest risk of osteonecrosis are those with underlying cancers who receive high-dose intravenous bisphosphonate treatment every month for an extended period of time.

It’s important then that you let us know before any dental procedure if you’ve been diagnosed with osteoporosis and what treatment you’re receiving for it. If you’ve been taking a bisphosphonate for an extended period of time, we may recommend that you stop that treatment for three months (if possible) before undergoing oral surgery. While your risk of complications from osteonecrosis is relatively small, adding this extra precaution will further reduce that risk and help ensure a successful outcome for your scheduled dental procedure.

If you would like more information on osteoporosis and oral health, 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 “Osteoporosis & Dental Implants” and “Good Oral Health Leads to Better Health Overall.”