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So what’s the deal with wisdom teeth?

Before I place braces on any patient, I take a panoramic x-ray to assess the teeth and jaws. And almost always, I discover wisdom teeth developing beneath the gums, behind the other molars. When I tell patients that they have wisdom teeth, I often see a look of dismay on their parents’ faces. Perhaps they remember having their own wisdom teeth removed – or more likely they remember being swollen and eating mush for 3 days. They assume that because their children have wisdom teeth, they will need to get them removed. And this isn’t always true!

In the old days, wisdom teeth were a lot like tonsils – doctors removed them because they were there. But the thinking has changed about wisdom teeth over the past few decades, just as it has for tonsils. These days, we only recommend removing wisdom teeth if we see a problem associated with them or if we believe a problem is imminent. Such problems include infections of the teeth or gums, or damage to the adjacent molars.

“But won’t my wisdom teeth push my other teeth crooked?” you may ask.

And the answer is that they are unlikely to do so, because when braces are finished every patient gets a set of retainers to keep the teeth straight. As long as you are wearing your retainers, your teeth should remain straight, regardless of your wisdom teeth. Of course, if you aren’t wearing your retainer, your teeth may go crooked with or without the influence of your wisdom teeth.
So, the fact that your child has wisdom teeth developing does not necessarily mean that those teeth will need to be pulled, nor does it mean that the teeth will go crooked again unless you have them removed. Rather, the best thing to do is to see your orthodontist for yearly retainer checks, and have a panoramic x-ray done at age 16. Hopefully the x-ray will show healthy teeth developing normally, and extractions won’t be necessary. And if it turns out that the wisdom teeth have to be removed don’t worry…..they may remove the teeth, but your child can keep the wisdom ☺

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Gummy Smiles, and how to fix them.

According to the orthodontic literature, a gummy smile is defined as showing more than 1-2 millimeters of gum tissue when smiling naturally. Of course, showing slightly more than 2mm of gum is not necessarily a problem, but when people show much more than that, they are often unhappy with the appearance of their smiles.

Interestingly, gummy smiles often have nothing to do with the gums. Instead, they are usually caused by excessive growth of the upper jaw. In orthodontic lingo, we call this “vertical maxillary excess.”

This can be caused by genetics, or sometimes by habits such as chronic mouth breathing or thumb sucking. The issue is not that the gums themselves have over-grown, but rather that the upper jaw itself has grown too far downward, carrying the teeth and gums along with them.

The following brief animation demonstrates how orthodontics can correct a gummy smile.  For more videos, please be sure to visit our youtube channel or visit our before and after gallery here to see more examples of smile transformations with orthodontics.

 

The treatment of gummy smiles depends on the severity of the problem. Mild to moderate gummy smiles can often be treated with braces. We place braces on the teeth, and apply an upward force to the upper incisors. This force does not push the teeth into the gums, but rather it causes the teeth and gums to move upward together, causing the upper jaw bone to remodel. This reduces the gumminess of the smile without shortening the teeth. For severely gummy smiles, we may recommend a combination of braces and jaw surgery. This type of treatment is a bit more involved than conventional braces, but the results can be spectacular, as seen in the video example above.

If you are bothered by a gummy smile, talk to us about your concerns. We can help!