Best Age for Rapid Palatal Expansion?

Many times when your child is getting braces, the orthodontist recommends a palatal expander. The reason for the expander is The Department of Orthodontics at the University of Ferrera, Italy performed a study recognizing that the most appropriate timing for treatment appears to be before the eruption of the permanent lateral incisors. That is the upper permanent incisors because the palatal expander is placed on the upper teeth. As you notice from the chart, the upper permanent lateral incisors generally erupt between ages 8 and 9.

The British Journal of Othodontics describes a study, with pictures, showing a technique which combines the use of rapid maxillary expansion and fixed appliance in growing patients, which covers certain circumstances. Even though the study is a number of years old, it still covers the basics.

As most of the air we breathe passes the lower nasal floor, an improvement in nasal breathing is likely after rapid palatal expansion, according to NCBI, National Center for Biotechnology Information.

These are just a few reasons for the palatal expander, in case it is something that your orthodontist recommends for your child.

Do First Signs of a Disease Shows Up in Your Mouth?

Your mouth is not just a bunch of teeth and a tongue, your mouth may be the first place where many diseases show up. If your have a healthy mouth, that is if your gums are healthy, bacteria will have a more difficult time entering your bloodstream. If you have gum disease, the bacteria has an entry point into your bloodstream, your infected gums. Sometimes medications that reduce saliva flow and cause a dry mouth can also allow bacteria to enter your bloodstream.

Diseases such as cardiovascular disease, adult diabetes, Type 1 diabetes mellitus in children, cocaine use, HIV/AIDS and osteoporosis may be linked to oral health. Let's first start with cardiovascular disease and go through each of the items above one by one.

There is a bit of controversy over good oral care and cardiovasular disease. A study documented by NCBI, National Center for Biotechnology Information, confirms that a lower frequency of daily teeth brushing is related to high prevalence of cardiovascular risk factors. JACC, Journal of American College of Cardiology reports that self-reported periodontal disease is not an independent predictor of subsequent cardiovascular
disease in middle-aged to elderly men. JADA, Journal of the
American Dental Association states that recommending periodontal treatment for the prevention of atherosclerotic cardiovascular disease is not warranted based on scientific evidence. Some of the results are a bit unclear on whether periodontal disease is a predictor of subsequent cardiovascular disease or if people with cardiovascular disease are likely to have periodontal disease. JACC recognizes other sources which indicate that acute myocardial infarction patients are more likely to have periodontal disease than a comparable control population without coronary artery disease.

The ADA, American Dental Association, points out that diabetic individuals are at least two to three times more likely to develop periodontal disease than non-diabetics. Diabetes is found to aggravate periodontal disease and diminish the capacity to form new bone. This may make it more difficult for diabetics in particular to repair the loss of tissue that occurs in periodontal diseases.

Children with Type 1 Diabetes seem to have a higher amount of calculus formation than children without diabetes despite the same oral hygiene care, according to a study done at the Kaunas University of Medicine in Lithuania in 2008. This study was first done at the Clinic of Dental and Oral Diseases at the same University noting that children with Type 1 Diabetes generally consumed less sweetened drinks and sweetened snacks.

A study published in the National Association of Biotechnology Information suggests that cocaine use is a concern because recent use of cocaine increases the risk of a medical emergency during dental treatment, especially when epinephrine-containing local anaesthetics or retraction cords are used. Therefore, dental treatment should be postponed for 6 to 24 hours after the use of cocaine.

It is fairly commonly known that oral lesions are among the early signs of HIV infection and can predict its progression to acquired immunodeficiency syndrome (AIDS). While oral lesions are an early symptom of AIDS, a sore throat and swollen lymph glands may or may not be an early symptom.

It has been proven that it is possible to use dental panoramic radiographs to identify post-menopausal women with low skeletal bone mineral density (BMD) or osteoporosis.

It is possible that any changes in your mouth can allow bacteria to enter your bloodstream, so keeping this all in mind, it is very important to keep your gums and teeth clean and healthy.

Should We Be Concerned With Sports Dentistry?

The American Dental Association promotes the use of mouthguards for sporting activities, particularly any sporting activity that could result in a blow to the mouth. This does not exclude any sport. The NCBI, National Center for Biotechnological Information has numerous studies on different sports and how the use of a mouth guard is becoming more and more a necessity. Those sports include:

acrobatics, football, skiing, volleyball, kickboxing, lacrosse,
basketball, gymnastics, racquetball, skydiving, water polo,
boxing, handball, rugby, soccer, weight lifting, baseball, inline skating,
discus throwing, ice hockey, shot putting, squash, wrestling, field hockey,
skate boarding, surfing, martial arts, basic military training

The NYSSF, National Youth Sports Safety Foundation, encourages the use of safety equipment, including mouthguards, to reduce injuries. "Even though a mouth protector is worn, it is still possible for a tooth to be knocked out; however, the wearing of a protector will reduce tooth injuries to a minimum. It is recommended that mouth guards be worn by all athletes during practice and competition of contact and collision sorts." quotes the NYSSF.

The ASTM, American Society of Testing and Materials, reports that the use of mouth protectors reduces forces which cause concussions, neck injuries, and jaw fractures.

There are three types of mouthguards, no-boil, boil and bite, and custom fitted fabricated by your dentist. Some work well with braces and are necessary to avoid tissue injuries. According to JADA, the Journal of the American Dental Association, the most effective mouth guard should be resilient, tear resistant, and comfortable. A few are noted below.

No Boil

Masel Doublegard

Boil and Bite

Shock Doctor by Dentech
Ultimate Athletic sold by resellers

Custom Fitted, dentist fabricated

Playsafe by Glidewell Laboratories

White or Silver Fillings, That is the Question?

Within the last fifteen years or so, biological dentists, dentists practicing holistic dentistry and people supporting holistic medicine claim that mercury in ordinary fillings can escape, travel to distant organs, and contribute to the development of diseases, including cancer. They claim that replacing metal fillings with synthetic, nontoxic compounds will eliminate toxins from the body and increase resistance to disease. This brought up numerous concerns and numerous studies throughout the dental and medical field. I could not find a specific website noting these concerns, but I could find that the Centre for Biological Medicine in Canada studies the effects that homotoxins have on the body and mercury fillings in teeth being one of their concerns. The concern may also continue to include psychological effects the silver fillings might have on children.

The NCBI, National Center for Biotechnological Information, states that the dental profession has been criticized on the effects of mercury in amalgam or silver filling and the impact of mercury on the environment and human health as early as 1998 and as late as 2004.

The Council on Scientific Affairs is a committee of the American Medical Association that provides information and recommendations on medical and public health issues. The Council on Scientific Affairs concluded in 1998 that amalgam continues to be a safe and effective restorative material. The American Dental Association has their council which is called the American Dental Association Council on Scientific Affairs. The ADA Council on Scientific Affairs concludes that, based on available scientific information, amalgam continues to be a safe and effective restorative material. The Council’s report also states, "There currently appears to be no justification for discontinuing the use of dental amalgam."

The ACS, American Cancer Society stated in 1998, that typical dental fillings contain metals such as mercury, copper, and silver, but there is no solid evidence showing that the presence of these metals in teeth causes disease in other parts of the body. There have also been studies with children and these studies, according to the NCBI, have found no evidence that exposure to mercury from dental amalgams was associated with adverse psychosocial outcomes in children.

JADA, in 1998, the Journal of the American Dental Association, did not support resin or white fillings on stress related teeth, such as posterior teeth.

In 2002, the NCAHF, National Council Against Health Fraud, believes that amalgam fillings are safe, that anti-amalgam activities endanger public welfare, and that so-called "mercury-free dentistry" is substandard practice.

In 2005, the NCBI reports that their findings do not support the hypothesis that exposure to amalgam produces adverse, clinically evident neurological effects.

WebMD, an online tool that provides valuable health information, tools for managing your health, and support to those who seek information supports the issue that there is no harm found in amalgam fillings as late as 2006.

The Mayo Clinic mentions that there is no need to replace metal dental fillings for aesthetic reasons. In fact, replacing metal dental fillings purely for looks should only be done if the dentist feels it wouldn't compromise the long-term health of the tooth. Likewise, there's no need to replace metal dental fillings due to concerns about mercury in the fillings.

Some of this information was studied in 1998 and some a bit later in 2006. This issue has been one of the oldest controversies in medicine and may never be completely solved. The FDA, U.S. Food and Drug Administration, has not been able to completely solve this issue. Remember, the FDA is engaged in a rulemaking that may lead to revised labeling. It is also reviewing evidence about safe use, particularly in sensitive subpopulations. If you are concerned about the possible health effects of amalgam fillings, you should talk with your qualified health care practitioner. Dental amalgam fillings are very strong and durable, they last longer than most other types of fillings, and they are relatively inexpensive. The FDA does not recommend that you have your amalgam fillings removed.

In 2008, the European Commission Health & Consumer Protection Directorate-General, concludes that there is no scientific evidence for risks of adverse systemic effects exist and the current use of dental amalgam does not pose a risk of systemic disease.

Are Lasers Safe for Dental Surgery?

Oral Surgery includes a wide array of dental procedures, including removing soft tissue from the lips and mouth. The reason for the removal of the soft tissue may be because of extra tissue connecting the cheek to the gums. There are two specific areas in the mouth; the lingual frenum connecting the tongue to the floor of the mouth and the maxillary frenum connecting the upper
lip to the mouth. Another reason for the removal of
soft tissue may be to remove mucoceles,
which may be caused by lip biting or removing a mole on the lip or even removing excess gum tissue. This list does not include all the possible reasons to remove soft tissue, but gives you an idea of them.

Most of these surgeries have traditionally been performed with a scalpel or electrosurgery. Lasers have become a simple and safe alternative for both children and adults, according to the National Center for Biotechnology Information, NCBI. Using a laser has proven to be quicker and safer oral surgical method, as well as, a method that reduces the chances of infection, swelling, discomfort, scaring and is even less invasive.

So, what makes using lasers for oral surgery quicker and more non-invasive? For one, many times there is no need to anesthetise the area where the surgery is to be performed. There is no pain or discomfort from the laser. A laser is non-invasive because there is little or no bleeding from the procedure. Another benefit to the laser surgery is a general dentist can do some laser surgeries, so there may be no need to visit an oral surgeon.

The Journal of Clinical Laser Medicine & Surgery also supports using the laser for oral surgeries. There are many more possibilities in using lasers in dentistry. I have only touched on a few.