Waterbury, CT Family Dentist
John R. Gagné, D.D.S.
808 Highland Ave
Waterbury, CT 06708
(203) 755-9444

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By John R. Gagne, D.D.S
December 03, 2021
Category: Dental Procedures
Tags: wisdom teeth  
DecidingtheFateofWisdomTeethMoreNuancedThaninthePast

If you're of a certain age, there's a good chance you've had your third molars—wisdom teeth—removed. At one time, extracting these particular teeth was a common practice, even if they hadn't shown any signs or symptoms of disease or dysfunction. But now, if you have a son or daughter coming of age, your dentist may recommend leaving theirs right where they are.

So, what's changed?

Wisdom teeth have longed been viewed as problematic. As the last of the permanent teeth, they often erupt on a jaw already crowded with other teeth. This can cause them to come in out of position—or not at all, remaining partially or totally submerged (impacted) beneath the gums.

Misaligned teeth are more difficult to keep clean of bacterial plaque, which in turn raises the risk of tooth decay or gum disease. Impacted teeth can put pressure on the roots of neighboring teeth, which further increases the risk for disease or bite problems.

To avoid these common problems associated with wisdom teeth, dentists often remove them as a preemptive measure. Given their size and possible root complexity, this is no small matter: Removing them usually requires oral surgery, making wisdom teeth extraction one of the top oral surgical procedures performed each year.

Today, however, many dentists are taking a more nuanced approach to wisdom teeth. While they still recommend removal for those displaying signs of disease or other problems, they may advise leaving them in place if the teeth are healthy, not interfering with their neighbors, and not affecting bite development.

That's not necessarily a final decision, especially with younger patients. The dentist will continue to monitor the wisdom teeth for any emerging disease or problems, and may put extraction back on the table if the situation merits it.

The key is to consider each patient and their dental needs regarding wisdom teeth on an individual basis. If warranted, removing the wisdom teeth may still be warranted if will help prevent disease, keep bite development on track and optimize oral health overall.

If you would like more information on wisdom teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Wisdom Teeth: Coming of Age May Come With a Dilemma.”

HeadOffaCrossbiteatthePassWithThisOrthodonticAppliance

At what age should you begin treating a poor bite? Many might say with braces around late childhood or early adolescence. But some bite problems could be addressed earlier—with the possibility of avoiding future orthodontic treatment.

A crossbite is a good example. In a normal bite, all of the upper teeth slightly cover the lower when the jaws are shut. But a crossbite occurs when some of the lower teeth, particularly in back, overlap the upper teeth. This situation often happens when the upper jaw develops too narrowly.

But one feature of a child's mouth structure provides an opportunity to intervene and alter jaw development. During a child's early years, the palate (roof of the mouth) consists of two bones next to each other with an open seam running between them. This seam, which runs through the center of the mouth from front to back, will fuse during puberty to form one continuous palatal bone.

An orthodontist can take advantage of this separation if the jaw isn't growing wide enough with a unique device called a palatal expander. This particular oral appliance consists of four, thin metal legs connected to a central mechanism. The orthodontist places the expander against the palate and then uses the mechanism to extend the legs firmly against the back of the teeth on both sides of the jaw.

The outward pressure exerted by the legs also widens the seam between the two palatal bones. The body will respond to this by adding new bone to the existing palatal bones to fill in the widened gap. At regular intervals, the patient or a caregiver will operate the mechanism with a key that will continue to widen the gap between the bones, causing more expansion of the palatal bones until the jaw has grown to a normal width.

The palatal expander is most effective when it's applied early enough to develop more bone before the seam closes. That's why it's important for children to undergo bite evaluation with an orthodontist around age 6. If it appears a bite problem is developing, early interventions like a palatal expander could slow or stop it before it gets worse.

If you would like more information on interceptive orthodontics, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Palatal Expanders.”

By John R. Gagne, D.D.S
November 13, 2021
Category: Oral Health
Tags: oral hygiene  
5TipsForKeepingYourToothEnamelHealthy

You know what people say: "Protect your tooth enamel, and it will protect your teeth." Then again, maybe you've never heard anyone say that—but it's still true. Super strong enamel protects teeth from oral threats that have the potential to do them in.

Unfortunately, holding the title of "Hardest substance in the human body" doesn't make enamel indestructible. It's especially threatened by oral acid, which can soften its mineral content and lead to erosion.

That doesn't have to happen. Here are 5 things you can do to protect your enamel—and your teeth.

Don't brush too often. Brushing is essential for removing bacterial plaque, the main cause for dental disease. But more isn't always good—brushing too frequently can wear down enamel (and damage your gums, too). So, limit daily brushing to no more than twice a day.

Don't brush too soon. Oral acid normally peaks at mealtime, which can put your enamel into a softer than normal state. No worries, though, because saliva neutralizes acid within about an hour. But brushing before saliva finishes rebuffering could cause tiny bits of softened enamel to flake off—so, wait an hour after eating to brush.

Stop eating—right before turning in for the night, that is. Because saliva flow drops significantly during sleep, the decreased saliva may struggle to buffer acid from that late night snack. To avoid this situation, end your eating or snacking at least an hour before bedtime.

Increase your calcium. This essential mineral that helps us maintain strong bones and teeth can also help our enamel remineralize faster after acid contact. Be sure, then, to include calcium-rich foods and calcium-fortified beverages in your diet.

Limit acidic beverages. Many sodas, sports and energy drinks are high in acid, which can skew your mouth's normal pH. Go with low-acidic beverages like milk or water, or limit acidic drinks to mealtimes when saliva flows more freely. Also, consider using a straw while drinking acidic beverages to lessen their contact with teeth.

Remember, enamel isn't a renewable resource—once it's gone, it's gone. Take care of your enamel, then, so it will continue to take care of you!

If you would like more information on caring for your tooth enamel, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “6 Tips to Help Prevent the Erosion of Tooth Enamel.”

BrieBellaShowsOffHerSix-MonthOldsBabyTeethonInstagram

If you're aiming for adorable camera shots, nothing beats baby photos. Even the tough guys among us can't resist oohing and ahhing over pics of their friends' and families' newest editions. Even celebrities like Brie Bella, WWE wrestler and now activewear entrepreneur, get into the act. She recently posted photos of her six-month old son, Buddy, for Instagramers. The focus—Baby Buddy's new baby teeth.

For many, a baby's first teeth are almost as cute as the baby themselves. Like the tiny humans sporting them, baby (or primary) teeth look like miniature versions of adult teeth. But aside from their inherent cuteness, primary teeth are also critically important for a child's dental function and development.

For most kids, primary teeth come right on time as they begin their transition from mother's milk or formula to solid food that requires chewing. Aside from their importance in nutrition, primary teeth also play a prominent role in a child's speech development and burgeoning social interaction.

They're also fundamental to bite development, with an influence that extends beyond their lifespan. They serve as placeholders for the permanent teeth, "trailblazers" of a sort that guide future teeth toward proper eruption.

So critical is this latter role that losing a baby tooth prematurely can open the door to bite problems. When a baby tooth is lost before its time, the space they're holding for an incoming tooth could be overtaken by neighboring teeth. This in turn could force the intended tooth to erupt out of place, leading to cascading misalignments that could require future orthodontics to correct.

Although facial trauma can cause premature tooth loss, the most common reason is tooth decay. One form of this disease known as early childhood caries (ECC) is especially problematic—it can rapidly develop and spread to other teeth.

Fortunately, there are ways to avoid early primary tooth loss. Here are a few things you can do to prevent that from happening.

  • Clean your baby's teeth daily by brushing and later flossing to remove bacterial plaque, the major cause of tooth decay;
  • Limit your baby's sugar consumption. In particular, avoid bedtime bottles filled with milk, juice or formula;
  • "Child-proof" your child's play areas to lessen their chances of falling on hard surfaces that could injure teeth;
  • Begin regular dental visits around their first birthday for early diagnosis, treatment and the application of other disease prevention measures.

Like Brie Bella, it's a joy for many parents to show off their baby's first teeth. Just be sure to take these common sense steps to protect those primary teeth from an unwelcome early departure.

If you would like more information about children's dental care, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Age One Dental Visit.”

FluorideTreatmentsGiveYourChildAddedProtectionAgainstCavities

When it comes to helping your child avoid tooth decay, it's all hands on deck. Tooth decay can not only harm their current set of primary teeth, but the loss of even one tooth could lead to bite problems later on.

And, even if you're doing all the right things—daily brushing and flossing, limiting sugar consumption and regular dental visits—your child might still develop cavities. If so, it may be necessary to add a boost of prevention with topical fluoride applied by your dentist.

With its enamel-strengthening properties, fluoride plays an important role in dental disease prevention. For decades, manufacturers have added fluoride to toothpaste. And, many water utilities now add tiny amounts of fluoride to their drinking supply.

According to a number of studies, these fluoride applications are effective weapons against tooth decay. But direct applications of fluoride to tooth surfaces can provide even greater benefit to children with a higher susceptibility for decay.

Topical fluoride is usually applied by means of a gel, foam or varnish. In varnish form, it's brushed on the teeth, while dentists apply the foam solution within a tray fitted around the teeth. The gel application can be administered by either method.

Although these topical applications use a higher concentration of fluoride than you find in toothpaste, it poses no serious danger to a child's health. But because high doses of fluoride can lead to staining, topical applications are only administered periodically during childhood.

The only short-term health concern is if the child accidentally swallows some of the mixture during application. This can cause symptoms like an upset stomach, vomiting or headache. Dentists, however, take a number of precautions to prevent accidental ingestion in order to avoid these unpleasant side effects.

The benefits, though, appear to well outweigh this minor risk. In a review of several scientific studies involving nearly 10,000 children, there was an average 28% reduction in decayed, missing or filled teeth in those children that underwent topical fluoride treatments.

If you want to know more about topical fluoride treatments and whether they can help your child avoid tooth decay, talk to your dentist. This fluoride booster could help further protect them from this destructive dental disease.

If you would like more information on helping your child avoid tooth decay, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Fluoride Gels Reduce Decay.”





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John R. Gagné, D.D.S.

John R. Gagné

Dr. Gagné, a member of the American Dental Association and the Academy of Laser Dentistry, is committed to providing his patients with comprehensive dental care.

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