Posts for: February, 2018

By Paul D. Bederson, DDS, FAGD
February 27, 2018
Category: Dental Procedures
GetAheadofBiteProblemswithInterceptiveOrthodontics

At any given time some 4 million teens and pre-teens are wearing braces or other orthodontic appliances to correct a malocclusion (poor bite). While most cases are straightforward, some have difficulties that increase treatment time and cost.

But what if you could reduce some of these difficulties before they fully develop? We often can through interceptive orthodontics.

This growing concept involves early orthodontic treatment around 6 to 10 years of age with the goal of guiding the development of a child’s jaws and other mouth structures in the right direction. These early years are often the only time of life when many of these treatments will work.

For example, widening the roof of the mouth (the palate) in an abnormally narrow upper jaw takes advantage of a gap in the bone in the center of the palate that doesn’t fuse until later in adolescence. A device called a palatal expander exerts outward pressure on the back teeth to influence the jawbone to grow out. New bone fills in the gap to permanently expand the jaw.

In cases with a developing overbite (the upper front teeth extending too far over the lower teeth when closed), we can install a hinged device called a Herbst appliance to the jaws in the back of the mouth. The hinge mechanism coaxes the lower jaw to develop further forward, which may help avoid more extensive and expensive jaw surgery later.

Interceptive treatments can also be fairly simple in design like a space retainer, but still have a tremendous impact on bite development. A space maintainer is often used when a primary (“baby”) tooth is lost prematurely, which allows other teeth to drift into the empty space and crowd out the incoming permanent tooth. The wire loop device is placed within the open space to prevent drift and preserve the space for the permanent tooth.

To take advantage of these treatments, it’s best to have your child’s bite evaluated early. Professional organizations like the American Association of Orthodontists (AAO) recommend a screening by age 7. While it may reveal no abnormalities at all, it could also provide the first signs of an emerging problem. With interceptive orthodontics we may be able to correct them now or make them less of a problem for the future.

If you would like more information on orthodontic treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Interceptive Orthodontics.”


By Paul D. Bederson, DDS, FAGD
February 12, 2018
Category: Dental Procedures
YoumayNeedOrthodonticWorkBeforeGettingaDentalImplant

For whatever reason, you’ve put off replacing a missing tooth for awhile. Now you want to fill that empty gap in your smile with a dental implant restoration.

But if your tooth’s been missing for a long time, there could be a problem with space. This is because the teeth on either side of the space may have gradually drifted into it, leaving no room for the implant. You could need orthodontic work first to return these teeth to their proper position.

We could use braces, metal orthodontic devices with wires threaded through brackets bonded to the teeth that are then anchored, usually to back teeth. The orthodontist uses elastics or springs as well as possibly incrementally tightening of the wire against the anchors. These techniques create pressure or tension on the teeth for the desired direction of movement. The teeth’s natural mechanism for movement does the rest.

But while effective, braces can be quite noticeable, an embarrassing thought for many adults having to wear them over several months of treatment. But there may be an alternative: clear aligners, a succession of slightly different plastic trays usually worn in two-week intervals. Sequentially wearing each tray gradually moves the teeth to their desired positions.

Though not appropriate for all bite situations, clear aligners have a number of benefits when they can be used. They’re nearly invisible to others and can be removed for hygiene tasks or rare special occasions. What’s more, the orthodontist may attach a temporary prosthetic (false) tooth to the trays to camouflage the missing space during treatment.

There’s one other issue you may have to deal with: if your tooth loss was related to periodontal (gum) disease, the gums and underlying bone may be in poor condition. In fact, substantial bone loss could rule out an implant altogether. But we may be able to remedy both gum and bone deficiencies through grafting or plastic surgery. It may be possible to regenerate enough bone to support the implant; and surgically repairing your gums will help ensure the implant appears natural.

If you have problems like these, don’t give up on your restoration goal just yet. With some orthodontic and dental work ahead of time, we may still be able to make implants a reality for you.

If you would like more information on restoring your smile after losing teeth, please contact us or schedule an appointment for a consultation.


By Paul D. Bederson, DDS, FAGD
February 04, 2018
Category: Oral Health
HowtoHelpYourChildDevelopGoodOralHygieneHabits

February marks National Children's Dental Health Month. It’s important for children to form daily oral hygiene habits early, but how do you get little ones to take care of their teeth? Try these tips:

Describe your actions. When children are too young to brush on their own, gently brush their teeth for them, narrating as you go so they learn what toothbrushing entails. For example, “Brush, brush, brush, but not too hard,” or “Smile big. Let’s get the front teeth. Now let’s get the teeth in the very back.”

Make learning fun. Around age 3, children can start learning to brush their own teeth. To model proper technique, play follow the leader as you and your child brush teeth side by side, making sure to get all tooth surfaces. Then you both can swish and spit. After brushing together, brush your child’s teeth again to make sure hard-to-reach surfaces are clean. Note that children generally need help brushing until at least age 6.

Encourage ownership and pride. Children feel more invested in their oral health when they get to pick out their own supplies, such as a toothbrush with their favorite character and toothpaste in a kid-friendly flavor. To boost pride in a job well done, reward your child with a sticker or star after they brush their teeth.

Keep your child brushing for two minutes. According to the American Dental Association, toothbrushing should be a two-minute task. To pass the time, play a favorite song or download a tooth-brushing app designed to keep kids brushing the recommended two minutes. For increased motivation, electric toothbrushes for children often have a built-in two-minute timer as well as appealing characters, lights and sounds.

And don’t forget one more key to a lifetime of good oral health—regular dental visits. If you have questions about your child’s dental hygiene or if it’s time to schedule a dental visit, please contact our office. To learn more, read the Dear Doctor magazine articles “Dentistry & Oral Health for Children” and “Top 10 Oral Health Tips for Children.”




Contact Us

Paul D. Bederson, DDS, FAGD

(301) 899-2500
4033 Silver Hill Rd Suitland, MD 20746