Posts for: February, 2016
It’s true — thumb sucking beyond age 4 can cause bite problems for permanent teeth. But prolonged thumb sucking is just one of a number of possible contributing factors for a bad bite (malocclusion). A dentist must identify all the factors involved when a bad bite is present — their involvement is essential for a successful treatment outcome.
A fairly benign habit for infants and toddlers, thumb sucking is related to an “infantile swallowing pattern” young children use by thrusting their tongues forward between the upper and lower teeth when they swallow. Around age 4, though, they usually transition to an adult swallowing pattern in which the tongue rests on the roof of the mouth just behind the front teeth. Thumb sucking stops for most children around the same time.
Thumb sucking beyond this age, though, can put increased pressure on incoming permanent teeth pushing them forward. This could lead to an “open bite” in which the upper and lower teeth don’t meet when the jaws are closed. The tongue may also continue to thrust forward when swallowing to seal the resulting gap, which further reinforces the open bite.
Before treating the bite with braces, we must first address the thumb sucking and improper tongue placement when swallowing — if either isn’t corrected the teeth could gradually revert to their previous positions after the braces come off. Besides behavioral incentives, we can also employ a thin metal appliance called a “tongue crib” placed behind the upper and lower incisors. A tongue crib discourages thumb sucking and makes it more difficult for the tongue to rest within the open bite gap when swallowing, which helps retrain it to a more normal position.
An open bite can also occur if the jaws develop with too much vertical growth. Like thumb sucking and improper tongue placement, abnormal jaw growth could ultimately cause orthodontic treatment to fail. In this case, though, surgery may be necessary to correct the jaw structure.
With all these possible variables, our first step needs to be a thorough orthodontic exam that identifies all the cause factors for your child’s specific malocclusion. Knowing if and how thumb sucking may have contributed to the poor bite will help us design a treatment strategy that’s successful.
If you would like more information on the causes of poor tooth position, 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 “How Thumb Sucking Affects the Bite.”
Did you see the move Cast Away starring Tom Hanks? If so, you probably remember the scene where Hanks, stranded on a remote island, knocks out his own abscessed tooth — with an ice skate, no less — to stop the pain. Recently, Dear Doctor TV interviewed Gary Archer, the dental technician who created that special effect and many others.
“They wanted to have an abscess above the tooth with all sorts of gunk and pus and stuff coming out of it,” Archer explained. “I met with Tom and I took impressions [of his mouth] and we came up with this wonderful little piece. It just slipped over his own natural teeth.” The actor could flick it out with his lower tooth when the time was right during the scene. It ended up looking so real that, as Archer said, “it was not for the easily squeamish!”
That’s for sure. But neither is a real abscess, which is an infection that becomes sealed off beneath the gum line. An abscess may result from a trapped piece of food, uncontrolled periodontal (gum) disease, or even an infection deep inside a tooth that has spread to adjacent periodontal tissues. In any case, the condition can cause intense pain due to the pressure that builds up in the pus-filled sac. Prompt treatment is required to relieve the pain, keep the infection from spreading to other areas of the face (or even elsewhere in the body), and prevent tooth loss.
Treatment involves draining the abscess, which usually stops the pain immediately, and then controlling the infection and removing its cause. This may require antibiotics and any of several in-office dental procedures, including gum surgery, a root canal, or a tooth extraction. But if you do have a tooth that can’t be saved, we promise we won’t remove it with an ice skate!
The best way to prevent an abscess from forming in the first place is to practice conscientious oral hygiene. By brushing your teeth twice each day for two minutes, and flossing at least once a day, you will go a long way towards keeping harmful oral bacteria from thriving in your mouth.
If you have any questions about gum disease or abscesses, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Periodontal (Gum) Abscesses” and “Confusing Tooth Pain.”