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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 Zarrella Dentistry 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 Ashland office to be evaluated.

Part of the charm of your child’s smile is those delicate, diminutive baby teeth. We enjoy those smiles while we can, because soon enough, primary teeth make way for the adult teeth that will last your child a lifetime. So you might be surprised if Dr. John Zarrella and Dr. Peter C. Rider and our team recommend a crown for your child’s baby tooth. Is this procedure necessary when the tooth is going to fall out eventually anyway?

Yes, it really is. If a primary tooth is lost before its normal lifespan, several problems can arise.

• Biting and chewing—a full set of baby teeth is best for proper chewing and digestion. And chewing also helps develop face and jaw muscles.
• Speech development—primary teeth help guide speech production and pronunciation.
• Spacing—a baby tooth serves as a place holder for the adult tooth waiting to replace it. If a primary tooth is lost too early, teeth may drift from their correct location and cause overcrowding or misalignment.

When is a Crown Necessary?

The enamel in a baby tooth is thinner than the enamel found in adult teeth, and a cavity can spread quickly throughout a tooth. Within a short period, the tooth’s structure might be too weak for a regular filling. Sometimes the pulp inside the tooth becomes injured or infected and an endodontic treatment is necessary to remove pulp tissue from inside the tooth. The interior will be filled, but the delicate enamel surrounding it will be fragile. Or an accident can leave a tooth fractured or broken, but still vital.

In each of these cases, a crown will protect the tooth from further decay or damage, and will allow the tooth to function normally until an adult tooth is ready to replace it.

What Types of Crowns are Available?

By far the most common choice for a primary tooth is a stainless steel crown. These crowns are prefabricated and can be fitted snugly to your child’s individual tooth. They are easy to place, less expensive than other crown alternatives, and will last until the tooth is ready to fall out in its proper time. If your child suffers from a metal allergy, or a more natural looking crown is necessary, talk to us about other possible options during your appointment at our Ashland office.

Sure, preserving a baby tooth that was never designed to be permanent seems contradictory. But saving a tooth that helps your child develop proper eating habits, speech production, and correct adult tooth alignment? Those are benefits that will last a lifetime.

Accidents happen. Next time you’ll wear your mouthguard when you skateboard, never use your teeth to open anything, and carefully step away from your grandmother’s hard candy dish. But what to do now for your chipped tooth?

First of all, call Zarrella Dentistry. Dr. John Zarrella and Dr. Peter C. Rider and our team can offer tips on dealing with any pain and how to avoid injuring your tooth further. Make an appointment to see us as soon as possible, where one of the following options might be the best treatment for you:

• Bonding

If the chip is small, you might be a good candidate for bonding. A tooth-colored resin is applied to the damaged area with adhesive, molded to shape, and then hardened with a curing light. It is then polished and, if necessary, further shaped to match your surrounding teeth.

• Porcelain Veneer

A veneer is a thin shell of porcelain individually molded for your tooth. If the chip is too large for bonding, or if you would like a more translucent finish, a veneer might be appropriate. During your first appointment, some of the tooth structure will be gently removed to accommodate the size of the veneer. A mold will be taken and sent to a lab for the creation of the veneer, which will be bonded to your tooth on a later visit. Whether a veneer will be successful depends on several variables, such as the condition of the tooth and enamel, your bite, and whether you grind your teeth. We will take all these factors into consideration in discussing possible treatments.

• Crown

A large chip or pain when eating or drinking might mean that you need a crown. This “cap” will protect your tooth from the pressures of chewing as well as restoring its appearance. On your first visit, some of the tooth structure will probably be removed to make room for the crown, impressions will be taken for the dental lab to make a permanent crown, and a temporary model will be fitted to your tooth. In a following visit the permanent crown will be adhered to your tooth.

If the crack has extended to the pulp of the tooth, you might need a root canal. If this is necessary, we will discuss the procedure during our exam.

No matter the size of the chip, it is important to contact our Ashland office immediately to help avoid infection and prevent further damage. If your tooth is broken below the gumline or otherwise seriously compromised, more intensive care will be necessary. But when a minor accident happens, prompt treatment can quickly restore your smile to health.

You’re an old pro at brushing and flossing by now—after all, you’ve devoted years to looking after your dental health, carefully brushing for two minutes twice each day and flossing daily.

But now, you’ve entered unfamiliar territory—orthodontic treatment. It’s time to level up your brushing game to protect your teeth and gums while you create a more attractive, healthier smile.

Why make changes in your dental routine? Because of plaque. Brackets and wires can make brushing more difficult, allowing plaque to build up around your braces. And plaque which sticks around leads to:

• Demineralization—The bacteria in plaque produce acids, which strip away minerals from tooth enamel. This creates a weak spot in the enamel and can leave a noticeable white stain on your tooth when your braces come off—especially around the places your brackets used to be, because that’s often where plaque accumulates.
• Cavities—Over time, as bacteria continue to attack enamel, a weak spot in the tooth’s surface becomes larger and deeper until it forms a cavity.
• Gingivitis—It only takes a few days for plaque to build up enough to irritate gum tissue and cause tender, inflamed, puffy, or bleeding gums.

Some new skills and new tools will help you keep teeth and gums healthy while you’re wearing braces.

Adapt Your Brushing Strategy

Wearing braces means adapting your brushing and flossing habits. You might need to spend a bit more time cleaning your teeth, but the results will be worth it!

• Brush More Often

Brushing after you eat is generally recommended to remove any food particles and plaque sticking around your brackets and wires. This might mean brushing in the morning, after meals and snacks, and before you go to bed. If you’re unable to brush after eating, be sure to rinse and swish with water to help remove food particles.

• Brush and Floss More Carefully

Brush each tooth surface, outside, inside, and the tops of molars. Angle your brush to clean around brackets and under wires. And while flossing might be more challenging, it’s still essential. Dr. John Zarrella and Dr. Peter C. Rider can show you how to floss when wires get in your way.

Upgrade Your Tools

The right tools make any task easier:

• Toothbrushes— Your teeth and gums might be more sensitive now that you have braces. This is a good time to remember that you never need to scrub your teeth, gums, or braces, and that a soft-bristled brush is the only kind of brush to buy.

There are brushes designed especially for braces which have angled bristles to clean around brackets or smaller heads to fit more comfortably in your mouth. Some people find electric toothbrushes are more effective.

• Interproximal brushes and dental picks—Small cone-shaped brushes and soft picks can clean between your teeth and around your brackets and wires when a brush head is too bulky.
• Floss threaders and braces-friendly floss—Floss threaders are flexible hoops which allow you to maneuver floss under the arch wire and between your teeth. Or try pre-cut floss, which comes with one stiff end to thread easily through your braces and between your teeth.
• Water flossers—A water flosser is a gentle and effective way to help wash away food particles.
• Over the counter or prescription rinses—Dr. John Zarrella and Dr. Peter C. Rider can recommend special rinses which can help prevent cavities.
• Cleaning kit—Put together a kit with toothbrush, travel-size toothpaste, floss or picks, and a small mirror for cleanup on the go.

Because there are so many options, experiment with different tools until you find the best, most efficient way to keep your teeth and braces their cleanest.

Learn from the Experts

Finally, optimize your brushing strategies with help from the experts. The dental team at Zarrella Dentistry in Ashland can teach you new brushing and flossing techniques and suggest the best tools to get the best results. And keep up with your regular dental appointments and cleanings! Regular exams will catch any signs of demineralization before they can lead to stains or cavities, and your hygienist can work around your braces to remove plaque you might have missed.

Take some time each day to level up your brushing game, and, when those braces come off, you’ll celebrate with a winning smile!