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New Orleans Dental Center Newsletter
Return to: Newsletter Archives - Dental Health Topics


This is a question every dentist has heard at some time, from a parent who's faced with the need for treatment of decay in their children's teeth. Why not just "pull it?" It's only a baby tooth, right? By all means, yes they are important!!

Primary ("baby") teeth are very important to growing children. They allow for proper chewing, and therefore, contribute to proper nutrition. The front teeth allow for proper speech development by allowing a place for the tongue to push against. Decay in primary teeth can cause pain and infection. In addition, a child's beautiful smile helps his or her self-esteem because people respond (without realizing it) more favorably to attractiveness. An extremely important reason to maintain primary back teeth is to hold space for the developing permanent teeth. As a population, we have much more crowding of teeth than in generations ago (in other words, there's generally much less available space for the permanent teeth in our mouths, nowadays). The reasons for the increase in crowding aren't fully understood, but researchers have found that an increase in airway issues (inability to breathe well enough through the nose) and our modern, soft diet (compared to ancient people) seem to be causes. At around age 6, the permanent firstmolars ('six-year molars") come in behind the primary molars. Later, between the ages of about 9 and 12, the primary molars (two in each back corner of the mouth, a total of eight) come out naturally as the permanent premolars (or "bicuspids") replace them. When decay in primary back teeth is allowed to go untreated, so that "holes" develop on the side of the teeth, the permanent molars can shift forward in the mouth, causing even less room for the future permanent teeth. Since today's children already have so many crowding issues, losing this space can make the existing crowding much worse. Without question, the most exciting area of development with respect to treating our younger patients has been in the study of growth and development of children. Because of technological advances, today we can guide our younger patients into healthy, beautiful smiles by treating them at the proper stage of development. Modern orthodontics has a philosophy of treatment that includes preventing problems before they manifest, as opposed to "watching" a child grow in a poor direction and then attempting to "fix" it or compensate for it in the teenage years with such treatments as extracting teeth (once growth has basically finished). Of course, minimizing or preventing a growth problem will always result in a more beautiful face than camouflaging the problem. Evaluating children during the primary-teeth phase is important, as some severe problems can be prevented by timely treatment. During this phase, we check for and treat functional and orthopedic problems.

When we use the word "function," we mean how a child breathes, talks, chews and swallows. For instance, if a child can't breathe properly through the nose (airway obstruction), the structures associated with the airway will not develop properly (which creates even more difficulty in breathing). The bony floor of the nose is actually the palate, which is the upper jaw in which upper teeth are developing. The result of airway obstruction is an underdeveloped (narrow) upper jaw and often a wide lower jaw, which can compromise a patient?s smile, his or her "bite," and the development of the Temporomandibular joints (jaw joints, or TMJs). Abnormal swallowing patterns can also have a negative effect on the growth and development of the jaws of a growing child. The tongue places about a pound of force during swallowing, and we swallow up to 3000 times a day! If the tongue is positioned forward, between the upper and lower front teeth (instead of upward on the palate, behind the upper front teeth), this "tongue thrust" deforms the shape of the upper and lower jaws and front teeth positions, causing excessive space between the upper and lower front teeth (called, an "open bite"). An abnormal tongue position will also tend to adversely affect a child's speech, and the deformation of the jaws and teeth positions will result in an unattractive smile and a poor "bite" relationship. Abnormal tongue position is often caused by a finger/thumb habit or pacifier use longer than 6 months of age. We have seen many children who have had deformations to the jaws due to pacifier use - pacifiers aren't meant to be used past 6 months of age! (Plus, pacifiers have been proven to cause an increased risk of middle ear infections in children.) We are fortunate to be able to offer a very comfortable and very effective appliance which helps eliminate habits and retrain the patient's tongue position during treatment.

Orthopedics refers to how a patient grows. As you know, it takes two adults to make one child. The genetic information passed on from the parents can result in undesirable growth patterns in a child's jaws. For example, a child can appear as if he received his mother's upper jaw and his father's lower jaw, or, his father's teeth and his mother's jaws. The result of mixing the parents' genes can be jaws that don't align with each other, or crowding or spacing of the teeth. With the extensive data bases of growth pattern information that we have today, as well as the high quality images created by today's technology, we can determine the growth pattern of a child's jaws and redirect growth discrepancies before they manifest as problems later in life. From the ages of about 6 to 10, a very important growth issue takes place: the Temporomandibular joints (TMJs) "mature," or take their adult shapes. Prior to this time, a child can open as wide as his or her muscles allow, with little restriction from the joints themselves. Adults, however, open as wide as the joints allow their mouths to open. This final joint development usually begins at the time that the upper lateral incisors (teeth to the right and left of the center teeth) are erupting. It is important at this time that both the front teeth and back teeth are in a good "bite" relationship, so that the TMJs can form into healthy shapes. The bony portions of the joints actually form their shapes as the child functions with the teeth (moves during chewing, etc.), so if the "bite" is too far from ideal, the joints will develop into less than ideal shapes. With this in mind, we feel that it's important to evaluate the growth and development of children's jaws. Once some of the permanent teeth are present, braces and other appliances can be used to not only make a more attractive smile, but also help the TMJs to grow in a favorable position. Often, if orthodontic treatment is delayed until all of the permanent teeth have erupted, compromisesin final results have to be made and tend to increase the treatment time. By evaluating children as they growth through different developmental phases, the time the patient is in braces can be reduced. Cleaning teeth while in braces does prove to be more of a challenge. The longer a patient wears braces, the more potential the teeth and gums have to become unhealthy with decay and gingivitis; therefore, our goal is to achieve the desired result in the shortest time possible.

For more information about us, please visit our website at and remember to visit us on Facebook!

We are continuing our previous gift offers to you, listed in last month?s article:
For new patients, aged 12 and under, a free first visit. This will include x-rays, exam, cleaning and topical fluoride treatment; simply mention this article (ADA codes: D0150/0145, D2072, D1120, D1203; $125 to $127 value; restrictions may apply)

For existing child patients, we will be happy to see you and your child for a complimentary consultation to see whether he/she could benefit from orthodontic treatment. If so, we will reduce the cost of the diagnostic records by half, a $158.50 value; simply mention this article. (ADA codes: 09987, 00330, 00340, 00470, 00350, 08995; restrictions may apply)

Drs. Landry and Maes

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Please call New Orleans Dental Center today at 504-347-6000
to schedule an examination.

Past New Orleans Dental Center Newsletters



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Below are some of the communities in the New Orleans area proudly served by the dentists and staff at New Orleans Dental Center :

New Orleans, Metairie, Kenner, Harahan, River Ridge, Chalmette, Arabi, Meraux and all the communities of Orleans, Jefferson and Saint Bernard Parishes.
Algiers, Avondale, Barataria, Belle Chasse, Boothville, Braithwaite, Bridge City, Buras, Crown Point, Devant, Empire, Gretna, Harvey, Jean Lafitte, Jesuit Bend, Lafitte, Marrero, Nairn, Pilottown, Point A La Hache, Port Sulphur, Terrytown, Waggaman, West Pointe A La Hache, Westwego and all the communities of Orleans and Jefferson Parishes.
River Parishes: Boutte, Des Allemands, Destrahan, Good Hope, Hahnvlle, Luling, New Sarpy, Paradis, St. Rose and all the communities of St. Charles, St. John and Ascension Parishes.


New Orleans Dental Center
1901 Manhattan Blvd., Suite F-201
Harvey, LA 70058
Phone: (504) 347-6000 ~ Fax: (504) 367-6232

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