When a child is born, he or she will have 20 primary teeth and 32 permanent teeth. But sometimes kids are born with additional teeth, and our team at Convivial Dental calls this oral condition "hyperdontia." Primary teeth are the first set of teeth that erupt in your child's mouth, typically by the time they are 36 months old, and are shed by the time your child reaches the age of 12. Permanent teeth then take the place of the primary teeth and are usually fully-erupted by the time your son or daughter reaches 21 years of age. Anyone who develops more than 20 primary teeth or more than 32 permanent teeth has hyperdontia, and the additional teeth are referred to as supernumerary teeth.

While the cause of hyperdontia is not entirely clear, it is believed that there may be a genetic factor. Oral professionals have found that patients with extra teeth often have syndromes like cleidocranial dysplasia, Ehler-Danlos syndrome, Gardner syndrome, or cleft lip and palate. The prevalence of hyperdontia affects between one and four percent of the population in the United States, and the majority of cases are limited to a single tooth.

So, what is the best way to deal with hyperdontia? It really depends on the case. The treatment plan your doctor suggests varies according to the potential problem posed by the supernumerary teeth, as well as their type. Orthodontic treatment may certainly may help, but extraction can also be a good option. We recommend that children receive an oral evaluation or checkup no later than the age of seven. In addition to hygiene evaluation, this helps ensure your child does not experience hyperdontia problems.

If you suspect you or your child may be suffering from hyperdontia, please give us a call to schedule an appointment at our convenient Chestnut Hill, Massachusetts office to be evaluated.

Even though it’s called a “permanent retainer,” your fixed retainer isn’t necessarily meant to last a lifetime. But with care, it should last just as long as you need it, keeping your teeth perfectly aligned after your orthodontic treatment is complete. Why is this retainer the one to choose for challenging alignments?

A fixed retainer is often used for teeth which were very crowded or had large gaps before treatment, especially along the bottom teeth, which tend to shift more. With a permanent retainer, a custom fitted wire is attached with a bonding adhesive to the back of each of the selected teeth. This design makes sure that the teeth can’t shift out of place while your bones and ligaments strengthen around them.

Occasionally, though, your permanent retainer isn’t quite as permanent as it should be. If you think your fixed retainer is becoming “unfixed,” what clues should you look for?

• Broken wire

A clearly broken wire can be obvious, or you might discover it when you notice pain or irritation caused by the end of a wire poking around your tongue or mouth.

• Loose bond

The orthodontic adhesive used to bond the wire to each tooth can come loose as the result of an accident, an unfortunately chewy treat, or simply with the passage of time.

• Shifting teeth

You might not notice anything wrong with your retainer, but what you do notice is that your once-straight teeth have started shifting back to their old positions. If you see any movement in your teeth, your retainer might need repair.

What should you do?

• Give our Chestnut Hill, Massachusetts orthodontic office a call! It’s important to act promptly to prevent further retainer damage, oral discomfort, and tooth misalignment.
• Rinse with warm water if your mouth is irritated.
• If a wire is poking you, call us for advice on gently pushing it back into place.
• Orthodontic wax can protect your teeth and tissue from detached wires.
• If you have a clear retainer, wear it until you can come in. If you don’t have one, and you can’t see us immediately, ask if an over the counter moldable retainer is a good idea to help keep your teeth aligned in the meantime.

One benefit of a fixed retainer is that it’s almost invisible because it’s behind your teeth. But this hidden location can also make it difficult to notice potential problems. Fortunately, there are some proactive steps you can take to help your permanent retainer—and your bite—stay healthy:

• Avoid foods which are sticky, hard, or chewy. If a food can damage traditional braces, it can damage your retainer.
• Wear protective gear like mouthguards and helmets when you’re active—they protect more than just your retainer!
• Ask your dentist to examine your retainer adhesive’s staying power whenever you have a checkup.

If you notice a detached wire or loose adhesive or see your teeth shifting, give Drs. Cartsos and Zavras a call. It’s important to act promptly to fix a fixed retainer, because your teeth and bite alignment are in jeopardy when you delay. And always bring your retainer (or retainer pieces) with you in case we can repair it.

Permanent retainers don’t necessarily last forever. But whether your fixed retainer is going to be with you long-term, or whether you’re going to transition to a removable retainer in the future, let’s make sure your permanent retainer is just as “permanent” as it needs to be!

Time to brush! So, you make sure you gently brush the plaque off the outside surfaces of your teeth. You want to present a gleaming smile to the world, after all. And you make sure to brush the inside surfaces as well, because who wants to feel a fuzzy patch of plaque every time their tongue hits their teeth? And, naturally, you remember to clean the tops of your molars, because those crevices make them more cavity-prone than any other surface.

Done? Not quite!

You might be surprised to learn that no matter how well you’ve brushed all the visible surfaces of your teeth, you’ve left quite a bit of enamel untouched—the adjoining, or touching, surfaces of the teeth that sit next to each other.

You’ve probably noticed that your bristles can’t . . . quite . . . reach all the enamel between your teeth (especially between your molars!) when you’re brushing. This means that food particles and plaque have an easier time sticking around. And when the bacteria in plaque are left undisturbed, especially with a banquet of food particles available, they produce acids which gradually eat away at the enamel covering our teeth, creating a cavity.

Here’s where we work in some specific dental vocabulary. “Interproximal” means between the adjoining, or touching, surfaces of the teeth. And an interproximal cavity is a cavity that develops on one of those side surfaces of your teeth.

• Preventing Interproximal Cavities

Fortunately, prevention is about as basic as it can be—brushing and flossing effectively. Dentists recommend brushing for two minutes at least twice a day and flossing once each day. While most of us are good about keeping up with brushing, sometimes that daily flossing is more a goal than a reality.

But it’s flossing which really does the trick when it comes to interproximal cleaning. If you floss correctly, food particles and plaque are removed from between the teeth and around the gum line—places where bristles just can’t reach.

When you wear braces, though, flossing isn’t quite so basic. Getting that floss just where it needs to be in between brackets and wires and in between teeth can be a challenge!

The good news is there are many products designed just to make flossing easier while you’re in orthodontic treatment:

• Floss threaders are flexible hoops that help you thread floss behind your wires easily.
• Precut floss strands use a stiff tip at one end for threading floss through wires.
• Interproximal brushes are tiny, cone-shaped brushes which can fit between your teeth and braces for precise cleaning.
• Water flossers eliminate floss altogether, using a pulsing stream of water to clean between and around teeth and braces.

During your next visit to our Chestnut Hill, Massachusetts office, Drs. Cartsos and Zavras can give you tips on how to use any of these tools effectively for cleaner teeth and cleaner braces.

Preventing cavities on the exterior surfaces of your teeth is probably pretty much automatic by now, but don’t forget the potential for stealth decay! If we find signs of erosion on the sides of your teeth, or if your hygienist lets you know that you’ve got a lot of interproximal plaque buildup, work with your dental team to make sure “interproximal cavity” doesn’t become a working part of your dental vocabulary.

Braces can straighten your teeth to give you a more attractive smile for life. The process can take 18 months to two years or more, and this amount of time can seem unending when you first get your braces. Counting down your brace time can help the time pass more quickly and build the excitement for when you finally get your braces removed.

Make a Wall Calendar

Crossing out each day on a calendar is a standard way of counting down time. You can make this more personal by designing your own calendar to help you count down. Use an online customization service to upload photos or designs for each month. Each month’s picture can also display the number of months remaining until you expect your braces to come off.

Schedule Rewards

When you receive regular rewards for continuing to wear your braces, they can seem less burdensome. Plan to buy yourself a reward every month that you wear your braces for the duration of the treatment. The time will pass much faster when you feel you are earning rewards for your patience.

Lengthen a Paper Chain

Use strips of paper to make the links of your chain, and add a new link each week to lengthen the chain. Before sealing each new strip of paper into a circle, write on it a reason why you are getting your teeth straightened, or an event in the future when you will appreciate your straight teeth as you smile.

Use a Wall Hanging

Purchase a large pad of blank white paper. Write a “0” on the bottom sheet and a “1” on the next, and continue until you reach the number of days remaining in your treatment. Rip off the top sheet each day to see how many days are left and remind yourself of the progress you are making.

Find a Buddy

If any of your friends get braces around the same time as you, share the experience. Make a pact to celebrate each trip to Convivial Dental when one of you receives news about your progress.