My Blog
By Carl H. Tegtmeier, DMD
November 11, 2018
Category: Dental Procedures
4SignsYourChildMayHaveaPoorBite

Although tooth decay is a major problem to watch for in your child’s teeth, it isn’t the only one. As their teeth transition from primary (“baby”) to permanent, you should also be on the lookout for a developing poor bite or malocclusion.

Although the signs can be subtle, you may be able to detect an emerging malocclusion, starting usually around age 6, if you know what to look for. Here are 4 signs your child may be developing a poor bite.

Excessive spacing. This is something that might be noticeable while the child still has their primary teeth. If you notice an excessive amount of space around the front teeth, the sizes of the jaws and the teeth may be disproportional.

Abnormal overlapping. The upper teeth normally just cover the bottom teeth when the jaws are closed. But a malocclusion may be forming if the lower teeth cover the upper (underbite), the upper teeth extend too far over the lower (deep bite) or there’s space between the upper and lower front teeth (open bite).

Different overlapping patterns. Watch as well for some of the teeth overlapping normally while others don’t, a sign of a cross bite. For example, the back upper teeth may cover their counterparts in a normal fashion while the lower front teeth abnormally overlap the top front. The roles here between front and back teeth can also be reversed.

Abnormal eruptions. Permanent teeth normally follow a pattern when erupting, but certain factors could disrupt the process. For example, a jaw that’s developed too small can cause crowding as incoming teeth vie for space; as a result, some permanent teeth may erupt out of their proper position. Likewise, if a baby tooth is out of its normal position or prematurely lost, the permanent tooth may erupt out of position too.

The good news with each of these developing bite problems is that we can correct them or at least minimize their future effect if caught early. So if you notice any of these signs or anything else out of the ordinary, see an orthodontist as soon as possible. It’s also a good idea to have your child undergo a thorough orthodontic evaluation around age 6.

If you would like more information on bite problems in children, 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 “Problems to watch for in Children Ages 6 to 8.”

By Carl H. Tegtmeier, DMD
November 01, 2018
Category: Dental Procedures
Tags: cleft lip  
CleftRepaircanRestoreaSmileChangeaLife

Oral and facial clefts are among the most common and heartbreaking of birth defects. Clefts make feeding or even breathing difficult and can affect speech development.

But there's one other profound effect: an “abnormal” face caused by a cleft can have devastating consequences for a person's self-image and social relationships.

About 1 in 700 U.S. babies are born with some type of visible gap or “cleft.” It can occur in their upper lip, soft and hard palate, nose or occasionally extending to the cheek or eye region. We typically classify clefts as “unilateral” (affecting only one side of the face) or “bilateral” (affecting both sides).  We're not completely sure on the root causes, but research so far has uncovered links with the mother's possible exposure to toxic substances, nutrient or vitamin deficiencies, or infections during fetal development.

Taking steps during pregnancy to minimize these exposures is certainly helpful. But what can be done for children born with a cleft?

A great deal, thanks to the development of surgical repair techniques over the last century. The surgical approach relies on the fact that the tissues required to repair the cleft already exist. They're simply distorted by the cleft break.

Even so, the road to restoration is a long and arduous one. Lip repairs usually take place at 3-6 months of age; palate (roof of the mouth) clefts are undertaken at 6-12 months. As the child's jaw and mouth structure develops, further surgeries may be needed to match earlier repairs with development.

Cleft repairs also require a team of specialists including a maxillofacial (oral) surgeon, orthodontist and general dentist. The latter plays an important role during the process, ensuring the child maintains good dental health through prevention and treatment of disease and dental work for at risk teeth.

The road to a normal life is difficult — but well worth it. A repaired cleft vastly improves a child's health and well-being. Moreover, it restores to them something the rest of us might take for granted — a normal face and smile.

If you would like more information on cleft defects and how to treat them, please contact us or schedule an appointment for a consultation.

By Carl H. Tegtmeier, DMD
October 22, 2018
Category: Dental Procedures
Tags: gum recession  
GraftingcanHelpRegenerateGumTissueLostThroughRecession

Gum recession — when the gum tissue covering teeth wears away — is a serious matter. If the roots become exposed you'll not only have increased sensitivity and possible discomfort, your teeth can become more susceptible to decay.

There are a number of reasons for gum recession, including overaggressive brushing and flossing, poor fitting appliances like dentures or braces, or genetics (inheriting a thin gum tissue type or poor tooth position). Perhaps the most common reason, though, is periodontal (gum) disease. Caused by bacterial plaque, a thin film of food particles that builds up on tooth surfaces, the disease weakens the gum tissues around teeth, causing them ultimately to detach and “roll up” toward the roots.

Treating the gum infection by removing the built-up plaque and calculus (hardened plaque deposits) will help stop recession or even reverse it.  As we remove plaque the infection subsides and the gums cease to be inflamed. If they haven't receded too far they may re-grow and renew their attachment to the teeth.

In other cases, though, the recession may have progressed too far and too rapidly toward root exposure. Gums in this condition may require tissue grafts to the recessed area to create or regenerate new tissue.

Most grafting techniques fall into one of two categories. The first is known as free gingival grafting where a thin layer of skin is removed or "freed" from the roof of the patient's mouth (the palate), shaped and then stitched to the recession site.

The second category is called connective tissue grafting, most often used to cover exposed roots. In this case the donor material is transplanted from the donor site to the recipient site, but the recipient site's tissue covers the donor connective tissue graft as it still maintains a physical attachment to the original location. The recipient site can thus maintain a blood supply, which can result in quicker, more comfortable healing than with free gingival grafting.

Connective tissue grafting does, however, require sophisticated microsurgical techniques, along with the surgeon's in-depth skill and art, to prepare both the donor and recipient sites. Allografts (donor skin from another person) may also be used as a donor tissue and placed beneath the recipient site tissue thereby avoiding a second surgical site.

Gum tissue grafting can be an intense undertaking, but the results can be astounding. Not only will restoring recessed gum tissues give your teeth a new lease on life, it will revitalize your smile.

If you would like more information on treatment for gum recession, 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 “Periodontal Plastic Surgery.”

By Carl H. Tegtmeier, DMD
October 12, 2018
Category: Dental Procedures
AToothlessTiger

Let’s say you’re traveling to Italy to surprise your girlfriend, who is competing in an alpine ski race… and when you lower the scarf that’s covering your face, you reveal to the assembled paparazzi that one of your front teeth is missing. What will you do about this dental dilemma?

Sound far-fetched? It recently happened to one of the most recognized figures in sports — Tiger Woods. There’s still some uncertainty about exactly how this tooth was taken out: Was it a collision with a cameraman, as Woods’ agent reported… or did Woods already have some problems with the tooth, as others have speculated? We still don’t know for sure, but the big question is: What happens next?

Fortunately, contemporary dentistry offers several good solutions for the problem of missing teeth. Which one is best? It depends on each individual’s particular situation.

Let’s say that the visible part of the tooth (the crown) has been damaged by a dental trauma (such as a collision or a blow to the face), but the tooth still has healthy roots. In this case, it’s often possible to keep the roots and replace the tooth above the gum line with a crown restoration (also called a cap). Crowns are generally made to order in a dental lab, and are placed on a prepared tooth in a procedure that requires two office visits: one to prepare the tooth for restoration and to make a model of the mouth and the second to place the custom-manufactured crown and complete the restoration. However, in some cases, crowns can be made on special machinery right in the dental office, and placed during the same visit.

But what happens if the root isn’t viable — for example, if the tooth is deeply fractured, or completely knocked out and unable to be successfully re-implanted?

In that case, a dental implant is probably the best option for tooth replacement. An implant consists of a screw-like post of titanium metal that is inserted into the jawbone during a minor surgical procedure. Titanium has a unique property: It can fuse with living bone tissue, allowing it to act as a secure anchor for the replacement tooth system. The crown of the implant is similar to the one mentioned above, except that it’s made to attach to the titanium implant instead of the natural tooth.

Dental implants look, function and “feel” just like natural teeth — and with proper care, they can last a lifetime. Although they may be initially expensive, their quality and longevity makes them a good value over the long term. A less-costly alternative is traditional bridgework — but this method requires some dental work on the adjacent, healthy teeth; plus, it isn’t expected to last as long as an implant, and it may make the teeth more prone to problems down the road.

What will the acclaimed golfer do? No doubt Tiger’s dentist will help him make the right tooth-replacement decision.

If you have a gap in your grin — whatever the cause — contact us or schedule an appointment for a consultation, and find out which tooth-replacement system is right for you. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Crowns & Bridgework.”

By CARL H. TEGTMEIER, DMD
October 02, 2018
Category: Dental Procedures

Multiple Dental implantsDo You Need Dental Implants?

There are several restorative procedures that can help rejuvenate and strengthen your smile, but dental implants are the best. If you're interested, Dr. Carl Tegtmeier can provide dental implants in Mount Kisco, NY.

The Dental Implant Procedure

Dental implants are one of many restorative procedures, like dentures and bridges. Dental implants consist of several parts:

  1. A titanium post inserted into the jawbone
  2. A screw that secures an abutment
  3. A crown matching the rest of your teeth

Your Mount Kisco dentist surgically inserts a titanium post into your jaws to replace your missing tooth root. It provides stability and strength while preventing any weakening or shrinkage of the jawbone. After inserting the titanium post, the dentist seals your gums and allows 3 to 6 months for osseointegration (connection) to occur. Following this period, your dentist re-opens the area above the titanium post, inserts a screw, places an abutment above the screw and secures a crown on top that matches the rest of your teeth.

The Advantages to Dental Implants:

  • They restore bite and chewing function
  • They restore cracks, chips, or fractures one tooth, a few teeth or all of your teeth
  • Dental implants don't move while you're eating or speaking
  • Dental implants can last a lifetime
  • They fill gaps to give you a wider, fuller smile

Preserving Your Implants:

You need to take proper care of your dental implants. Here are some things preventative measures:

  • Receiving fluoride treatment and using fluoride-containing products like toothpaste and mouthwash
  • Avoiding tobacco, smoking, and drinking too much coffee and tea
  • Drinking fluoride-containing water, to prevent issues like gum disease and tooth decay
  • Getting professional dental cleanings and checkups every six months to remove hardened plaque
  • Flossing at least once before bed
  • Brushing your teeth for at least two minutes twice a day, while holding the brush at a 40-degree angle

If you have more questions or concerns about dental implants, call your Dr. Carl Tegtmeier's office in Mount Kisco, NY, at (914) 241-2069.





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