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Posts for: June, 2020

By Dr. Stephanie ML Wong, DMD, Inc.
June 29, 2020
Category: Oral Health
HowtoHelpYourChildBeattheOddsforGettingaToothInjury

Half of all children will injure at least one tooth before adulthood. That's why we're joining with other health professionals this June to promote National Safety Month. As dentists, we want to call particular attention to potential dental injuries and what parents and caregivers can do to help their child avoid them.

The source for a dental injury usually depends on a child's age and development level. Younger children learning to walk and run are more apt to fall, and may hit their mouth on hard or sharp surfaces. Later on, most dental injuries tend to come from contact during sports play or other physical activities.

Your prevention strategy should therefore adjust to your child's age and activity level. If you have an infant starting to walk, for example, don't allow them to move around carrying a bottle, cup or other hard object that could be a source of injury if they fall. Also, keep an eye out for hard furniture or sharp-edged surfaces as they toddle around.

If you have a highly mobile toddler, discourage them from climbing and jumping on furniture, tables or other hard surfaces. If feasible, pad these surfaces and sharp edges to minimize the force of impact from a collision.

To prevent sports-related mouth injuries in older children and teens, your primary defense is an athletic mouthguard. Mouthguards cushion and absorb much of the force generated during hard sports contact. They should be worn for any physical activity with a potential risk for mouth injury, including practice sessions and informal play like a pick-up basketball game.

A type of athletic mouthguard known as “boil and bite” is readily available in retail sporting goods stores. After purchase, it is softened in very hot water; the wearer then places it in their mouth and bites down to form a permanent impression. Boil and bite mouthguards offer protection, but they can be bulky and uncomfortable to wear.

For a higher level of protection along with a more accurate and comfortable fit, a custom mouthguard created by a dentist is a more desirable option. These are based on a detailed impression of the wearer's bite, so the fit can't be beat. Both types of mouthguard need upgrading periodically in young wearers to accommodate dental development as they age.

Accidents can happen, but there's much you can do to reduce the likelihood of injury to your child's teeth. Protective measures and equipment—as well as a watchful eye—can go far to help them emerge from these active, early years dentally unscathed.

If you would like more information about dental safety, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Top 10 Oral Health Tips for Children” and “Athletic Mouthguards.”


By Dr. Stephanie ML Wong, DMD, Inc.
June 19, 2020
Category: Dental Procedures
Tags: wisdom teeth  
HereIsHowWeMayBeAbletoBringanImpactedToothWhereItShouldBe

If all goes normally, we have most of our permanent teeth as we enter puberty. Except, though, when it doesn't—sometimes incoming permanent teeth don't fully erupt, often because there's not enough room for them on the jaw. This can leave all or part of a tooth still up inside the gum and bones.

This condition is known as impaction, and it can cause problems with a person's bite and their smile. This is especially true of the upper canines, those pointed teeth located just under the eyes. Without them present, a person's smile can look oddly different. Moreover, it can worsen their bite and increase the risk of trauma and disease for nearby teeth.

Fortunately, there may be a way to coax impacted canines into erupting into their proper position on the jaw. It will involve, though, some minor surgery and orthodontic intervention to accomplish that feat.

First, though, a patient with missing canines should undergo a thorough orthodontic evaluation. This exam will reveal not only what may be going on with the missing teeth, but how the whole bite has been affected. Knowing the big picture will help direct the next treatment steps.

After pinpointing the impacted teeth's exact position (usually through x-rays or cone beam CT scanning), we then decide whether it's feasible to attempt to expose the teeth. Sometimes, a tooth's position is so out of place that it may be best to remove it and consider a dental implant or other restorative measures.

If it is in a workable position, then the impacted teeth would be exposed surgically (usually by an oral surgeon or periodontist). The surgeon would then bond a small bracket to the exposed tooth and then attach a small chain.

After suturing the incised gum tissues back in place, the chain extending outward from the gums would then be looped over orthodontic hardware attached to other teeth. This will place downward pressure on the upper canine tooth, and over several months prod it to fully erupt.

This may sound like an elaborate procedure, but it's fairly routine and predictable. As a result, a patient can finally get the full benefit of all their teeth, enhance their dental health and transform their smile.

If you would like more information on dealing with impacted 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 “Exposing Impacted Canines.”


By Dr. Stephanie ML Wong, DMD, Inc.
June 09, 2020
Category: Oral Health
Tags: gummy smile  
WhyIsYourSmileGummyHereAre4Possibilities

What makes a beautiful smile? Beautiful teeth, for sure. But there's also another component that can make or break your smile, regardless of your teeth's condition: your gums. Although their primary function is to protect and stabilize the teeth, your gums also enhance them aesthetically by providing an attractive frame.

But just as a painting displayed in an oversized frame can lose some of its appeal, so can your smile if the size of your gums appears out of proportion with your teeth. Normally, a smile that displays more than four millimeters of gum tissue is considered “gummy.”

There are some things we can do to improve your gum to teeth ratios. What we do will depend on which of the following is the actual cause for your gummy smile.

Excess gum tissue. We'll start with the obvious: you have excess gum tissue that obscures some of the visible tooth crown. We can often correct this with a surgical procedure called “crown lengthening,” which removes some of the excess tissue and then reshapes the gums and bone to expose more teeth length.

Teeth that appear too short. The problem may not be your gums — it could be your teeth appear too short. This can happen if the teeth didn't erupt fully, or if they've worn down due to aging or a grinding habit. One option here is to “lengthen” the tooth cosmetically with veneers, crowns or other bonding techniques.

Higher lip movement. Rather than your teeth and gums being out of size proportion, your upper lip may be rising too high when you smile, a condition known as hypermobility. One temporary fix is through Botox injections that paralyze the lip muscles and prevent their movement from overextending. We could also use periodontal surgery to perform a lip stabilization procedure that permanently corrects the upper lip movement.

Overextended jaw. Your gums may seem more prominent if your upper jaw extends too far down and forward. In this case, orthognathic (jaw straightening) surgery might be used to reposition the jaw relative to its connection with the skull. Setting the jaw up and back in this way would reduce the prominence of the gums when you smile.

As you can see, treatments range from cosmetic techniques to moderate surgical procedures. A full dental exam will help determine which if any of these measures could reduce gumminess and improve your smile.

If you would like more information on correcting gummy smiles, 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 “Gummy Smiles.”




Stephanie Wong

Dr. Stephanie Wong is unlike any other dentist you've ever been to.  The reason she became a dentist was her yearning to help and heal her patients.  Her goal was to "Create Life Changing Experiences".  She is also well regarded...

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