Baby teeth start erupting at around the age of 4 to 6 months and all the 20 primary teeth should be present in the toddler’s mouth when he turns three years old. The first baby teeth that usually erupt are the lower incisors followed by the upper incisors. The most evident sign that baby teeth are missing is when they fail to erupt or there are large spaces between those that had erupted. Since the “baby teeth” start developing when your child is in the womb, missing these teeth is rare.

The main reasons that baby teeth don’t develop and erupt are due to difficulties during the pregnancy, premature delivery or genetic factors. If the “baby teeth” are missing there is a need to find the reason for it. Dr. Kaufman can check and find out what the condition of the teeth is.

Permanent teeth start replacing the primary teeth or “baby teeth around the age of six years old. The first teeth to be replaced are the lower incisors, the same teeth which were first to erupt.

If permanent teeth fail to erupt usually it is because there are obstructions in their eruption path or they are missing. The obstructions can be a retained primary tooth or an “extra” tooth which is called an odontoma. If an obstruction is the reason for the tooth not erupting, many times removing the obstruction will allow for the tooth to naturally erupt. But if the are missing it is important to check what are the reasons and if there are more teeth missing. Dr. Kaufman can check if the teeth are present or not and what are the possible solutions to help them erupt or replace them.

If you have any concerns or if there are gaps in your child’s smile please make an appointment to see Dr. Kaufman to find what options your child has.

When permanent teeth naturally replace baby teeth, the root of the baby tooth is dissolved by the erupting permanent tooth. This way the baby tooth becomes loose and falls off. But if for some reason this process does not happen, the remanent tooth cannot erupt in its correct position and it has to shift place to come out. This can happen with the front teeth or the back teeth and it needs immediate attention.

If the permanent tooth grows into an incorrect position, in many cases it can get trapped between other permanent teeth, which will make the condition more permanent. For this reason, the solution many times, is to remove the delayed baby tooth, to allow the permanent tooth to correct its position.

If your child has a tooth that is erupting behind the baby ones, it is important to come and see Dr. Kaufman to check what the solution is. He will be happy to examine and explain what is the condition of your child’s teeth. Waiting for the teeth to sort themselves out will only lead to a more difficult condition.

• Crowding
• Gaps between teeth
• Underbite – when all the upper teeth sit behind the lower jaw
• Overbite – when the upper front teeth cover part of the lower front teeth
• Crossbite – when one or more upper teeth fit inside of the lower teeth

Dr. Daniel Kaufman has successfully treated patients experiencing the following bite problems with SureSmile^® Clear Aligners:

• Crowding
• Gaps between teeth
• Underbite – when all the upper teeth sit behind the lower jaw
• Overbite – when the upper front teeth cover part of the lower front teeth
• Crossbite – when one or more upper teeth fit inside of the lower teeth

To find out if aligner treatment is right for you, please make an appointment with Dr. Kaufman. We will be happy to examine and explain what is the condition of your teeth and the way to improve the appearance and function of your teeth.

Getting Started with SureSmile^® Clear Aligners

On your first appointment Dr. Kaufman will examine the condition of your teeth, take photos and a digital scan of your teeth to assess how clear aligners will work best for you.

1. Developing your treatment plan: Dr. Kaufman will instruct the technicians at the SureSmile^® Digital Lab, how to move each tooth for optimal movement.
2. Once your plan is ready, Dr. Kaufman will explain to you the planned treatment.
3. If you have happy with the plan your smile journey will begin: You will get your SureSmile^® Clear Aligners and you’re on your way to a smile you’ll feel confident about.
4. Periodically Dr. Kaufman will make sure everything is on track during routine check-in visits.

Everyone’s journey is different, and Dr. Kaufman wants to make the process is comfortable and rewarding at every step of the way. Let us know how we can support you or make an appointment to start your journey!

The wire retainers need to be left on the teeth, for years after the orthodontic treatment had been completed. They should not be removed till the person finishes his growth which in women is around the age of 20 years old and in men around the age of 25. Once growth had been completed there is a need to assess the position of the teeth and surrounding structures to see if the fixed retention is still needed.

There are several reasons, why it would be a good idea to have these wires removed:

• Fracture of the retainer wire or debonding of one or more of the resin pads that hold them to the teeth.
• Distortion of the retainer wire
• Unwanted tooth movement even when there is no change in the wire.
• Risk for Periodontal disease.
• Risk for food impaction that will cause gingival inflammation.

On the other hand if the wire is removed there is a risk that the teeth will start to move, without a brace that will hold them in place. In order to check if the wire on the upper or lower teeth can be removed, there is a need for an examination with Dr. Kaufman. Please do not hesitate to contact us for advice about your condition or to make an appointment. We will be happy to examine and explain what is the condition of your fixed retainer and if there is a risk of that the front teeth will shift.

Research that was done in 1961 by Bergstrom & Jensen in patients that had wisdom teeth on only one side and they found more crowding of the teeth in the side where the third molar was present. Later in 1982, another group of researchers found that once the wisdom teeth were removed on one side only, the crowding had decreased on that side compared to the side where the wisdom teeth were present, but that happened in only 70% of the patients. These articles point to wisdom teeth as the reason for the crowding and the solution then would be the removal of the wisdom teeth.

However,  other evidence in the literature did not find that third molars contribute to crowding. In those articles the researches compared the crowding of the teeth in patients that had undergone orthodontic treatment, who had  or had not wisdom teeth. In those articles researchers found that crowding occurs regardless of the presence of third molars, and they do not appear to have a significant influence on the changes of tooth position after orthodontic treatment.

In a large review of the literature that was done in 2020 it was found that in those that had their wisdom teeth removed there was only a very small change of 1mm in the crowding in the front teeth. Hence it was concluded that it was not justified to remove wisdom teeth on the grounds of preventing crowding.

In summary there can be many reasons for the growing crowding in adults. These can be related to diet, growth of the jaws, shape of the teeth or the way orthodontic treatment was done. In order to prevent or treat the crowding of the lower incisors, there is a need for an examination with Dr. Kaufman. Please do not hesitate to contact us for advice about your wisdom teeth and crowding. We will be happy to examine and explain how your wisdom teeth are positioned and if there is a risk of crowding in the front teeth.

Dr D’Aiuto explained that “evidence indicates that periodontal bacteria cause damage to the gums and also triggers inflammatory responses that can impact the development of systemic diseases including high blood pressure”.

The study analysed data from 250 adults with severe periodontitis and 250 adults without gum disease. All the participants were healthy otherwise. The findings were that participants with gum disease were twice as likely to have high systolic blood pressure (140 mm Hg or more), than those with healthy gums (14% and 7%, respectively). The results suggest that 50% of adults could have undetected high blood pressure due to gum disease and consequently many individuals may be unaware that they are at increased risk of heart-related problems.

The author of the present research explained that “Oral health strategies such as brushing teeth twice daily are proven to be very effective in managing and preventing the most common oral conditions, and our study’s results indicate they can also be a powerful and affordable tool to help prevent hypertension”.

Please contact the practice if you have any questions regarding your health condition.

According to the authors, COVID‐19 is associated with an exacerbated inflammatory response that can result in fatal outcomes. Since systemic inflammation is also a main characteristic of periodontitis, the association between periodontitis and COVID‐19 complications has been investigated.

COVID‐19 infection severity has been associated with patients suffering from hypertension, diabetes, cardiovascular disease, older age and obesity. However, the specific risk factors leading to severe clinical outcomes are still not clear.

The role of gum disease as exacerbated factor in severe Covid-19 outcomes has been investigated in this research.

Periodontitis is characterized by chronic non‐resolving gingival inflammation resulting in bone loss and teeth detachment, and it has been already linked by multiple studies as a risk factor in other medical conditions, like cardiovascular disease, hypertension, diabetes, renal disease, pneumonia and cancer.

The present study analysed the data of 568 Covid-19 patients. Among them, 40 experienced COVID-19 complications such as death, ICU admission and need for assisted ventilation, and 528 were discharged without any complications. The periodontal status was studied from these patients’ posterior bitewings and panoramic radiographs.

Out of the 568 patients included in the study, 258 presented periodontitis. Among the patients who presented periodontitis, 33 experienced Covid-19 complications, while only 7 of the 310 patients without periodontitis presented COVID‐19 complications

This study identified that the risk of COVID‐19 complications was significantly higher among patients with moderate‐to‐severe periodontitis compared to those with milder or no periodontitis.

Several hypothetical mechanisms may explain the strong associations observed between periodontitis and COVID‐19 severity. The oral cavity, and especially periodontal pockets could act as a viral reservoir and as a consequence the aspiration of periodontopathic bacteria might aggravate COVID‐19 virulence.

Gum disease is one of the most common chronic diseases in the world, although it being preventable and treatable. Multiple studies back the idea that by maintaining good oral health, specifically healthy gums, serious medical complications, from coronavirus included, can be reduced significantly.

Some of the signs of gum disease are bleeding when brushing or eating and bad breath. Since the symptoms are not painful, people tend to ignore them, leaving the disease untreated and increasing the risk of losing teeth and medical complications.

In order to prevent gum disease, it is very important to brush the teeth with a fluoride toothpaste at least twice a day, paying attention to clean along the gum line as well and flossing in between teeth.

Periodical visits to the dentist are important in assessing the teeth and gums condition and providing a professional clean.

For more information about gum disease, or if you are concerned about your oral health, please contact the practice.

Over time, after a crown is made, it is common to have black lines that form just at the base of the crown or visibly seen on the gums surrounding your crown. Typically, no pain is felt as this should only be a cosmetic problem.

If pain is present, it is recommended to see the dentist as soon as possible.

Whether it is an individual crown or a crown from a root canal treatment, the main causes of its unsightly appearance are:

• Having a porcelain-fused to metal (PFM) crown made by your dentist. When your gums recede as time goes, it reveals the top metal part of your crown
• Staining by the metal on your PFM crown where your gums touch the area with metal.
• Cavity formation between your crown and gums.

Dr Kaufman will assess the cause of the problem and recommend an appropriate solution, which can be:

• Replacing your old crown with a fully porcelain crown to get rid of the black lines and any stains that come along with it.
• In the case of a cavity, it  be treated as soon as possible to prevent further complications.
• Every treatment should be followed by proper dental hygiene at home and regular check up and  hygiene appointments at the dental practice.