Category: Uncategorized

Category: Uncategorized

Space Regaining

Space Regaining

Space maintenance is pretty straightforward. But what can be done in case it has been many years since extraction of milk teeth and space “loss” has already occurred?

That is when we “regain the space”. Why? Because we do not want the permanent teeth to erupt crookedly!

“If braces are anyway needed, why should we go through all this earlier? Can’t we correct it in one go?”..This is another question normally asked by parents. You have to understand, the main aim is to reduce the severity and duration of orthodontic treatment later. Also, we are trying to bypass crowding and avoid extraction of permanent teeth while fixing braces, which may otherwise be required.

The designs are similar to space maintainers, except a spring or screw may be inserted to open up space

How much time should these be worn? Depends on amount of space needed to “regain”. Your dentist will generally start fixed treatment with braces soon after this step.

Contact your nearest clinic today for more information!

Fractured teeth? Can be managed naturally! Here’s how:

Imagine this, summer vacation, football or some other “outdoorsy” sport, a fall and the result, a badly broken tooth.

A very common scenario in most of our households. Worried parents come to us, clutching the broken fragment and ask, “Can it be re-attached?” Our answer is, Yes.

  • In the case of a simple fracture of the tooth’s crown (the portion that is seen outside), we can attempt to attach the same tooth fragment.
  • If the fracture is very deep and has involved the nerves, a root canal therapy may be required. Still, the same fragment can be used to give more a natural, aesthetically pleasing appearance.

But what if the fracture involves the root (the portion inside the gum) as well?

In that case, it is termed as a complicated crown-root fracture. This too, may or may not involve the nerves.

  • Taking an X-ray is a must to see the extent of fracture because, it cannot be predicted.
  • Emergency treatment involves fixing a splint to reduce the mobility of the affected tooth- in the same way a general fracture is fixed.
  • We can attempt to expose the fractured area by slightly cutting the gum and giving a crown after root canal treatment
  • If the child is very young and there is no sufficient amount of root, we may have to modify the root canal treatment slightly and give a calcium rich material called MTA to seal the root.
  • Maximum attempt is made to save the tooth. If the fracture is really very deep and most of the root is gone too, we may have to consider extraction. Of course, an artificial tooth will be given in place.

For more details, refer


What does crowding of teeth mean?

The condition basically means there is not enough space within the jaw for all the teeth to develop properly. Children usually have a considerable amount of space between their teeth as a normal phenomenon so that the developing adult teeth also develop properly.

Thus if your child’s teeth seem to be overcrowded and crooked due to lack of normal spacing within their teeth, it is a major concern to be corrected at their right age.

What will be the causes of crowding of teeth in your children?

  1. Hereditary factors
  2. Oral habits like thumb sucking, finger biting, tongue thrusting etc.

What are all the problems your child will face due to crowding of teeth?

  1. It is not only just an aesthetic problem to your child
  2. It makes your child more difficult to keep their teeth and gums clean
  3. Dental caries
  4. Gum disease
  5. Makes chewing more difficult
  6. Speech difficulties
  7. Bad breath

Treatment options for crowded teeth…

A dentofacial orthodontist helps children to solve their crowded teeth problem.

They provide you orthodontic braces to deal with the crowded teeth and give your child a natural, more attractive smile and help them to develop healthy teeth, gums and bones.

We love giving your young kids new confidence.

Some of our kids treated for crowding and ended up with a confident smile!!!


Thumb sucking is one of the most common oral habits seen in children.

What is Thumb sucking?

Thumb sucking is forceful sucking of the thumb in children which will become an act out of repeated habit

Is Thumb sucking normal?

Thumb sucking is normal up to pre-school age i.e., till 2 years.

It becomes abnormal and creates problems to teeth and jaw if it persists beyond 2 years.

Why your child sucks their thumb?

Till 2 years of life your child performs thumb sucking due to various reasons like :

  1. Hunger
  2. Feeding problems
  3. Teething, etc.

Beyond 2 years it may be due to :

  1. Feeling of Insecurity
  2. Desire to draw attention
  3. Anxiety, fear

What you think will be the major causes of your child’s abnormal thumb sucking?

  • Working Mother– A major cause in today’s metropolitan cities like Chennai, Mumbai etc. Children brought up in the hands of caretaker may have feelings of insecurity that makes the child to suck their thumb.

Other causes include:

  1. Increased number of siblings at home
  2. Late order of birth at home
  3. Low socioeconomic status

What you can notice if your child is thumb sucking for long years?

Thumb and other fingers:

  1. Reddened
  2. Clean chapped
  3. Short finger nail


  1. Short upper lip
  2. Your child will not able to close lips at rest.


  1. Upper front teeth will be forwardly placed
  2. Front teeth bite of the child will be opened

What will be the effect of thumb sucking?

  1. Since the upper front teeth are forwardly placed. It is more common for your child to get teeth injury during play.
  2. Poor esthetic appearance while smiling.

How to prevent?

Since the major reason lies in psychological insecurity for the child, it is very important to provide a close emotional union between mother and the baby by proper breast feeding activities, spending ample amount of time with them and child’s engagement in various activities like sports.

Treatment considerations:

  1. Use of physiological nipple
  2. Applying neem oil, Asafetida over the digits
  3. Use of Elastic bandages , long-sleeve night gown

Parental counseling and motivation to child to stop the habit are always better provided by the pediatric dentist you visit.

He / she will also provide habit breaking appliances based on the extent of habit.

We are responsible for your child’s better smile!

One of our kid underwent treatment and ended in everlasting happy smile!!!


If you have brought your child into the dental office for a checkup lately, the dental sealants will become mandatory.

What are dental sealants?

To reduce your child’s risk of tooth decay, we place sealants on permanent molar after they erupt. Sealants acted as a protective coating for the tooth. Because they cover deep grooves and crevices of hard cleaning areas, sealants help children get through the early formative years with fewer cavities.

Does your child have to be numbed?

No. There is no numbing or drilling or anything that can be potentially scary to your child.

You could describe it as if we are painting the teeth!

How long does it take to apply dental sealants?

It can be done completely in just a few minutes. In most cases, they are just added to your child’s routine examination appointment.

How long sealants do last?

Sealants aren’t permanent, but they can last for several years though. Sometimes sticky foods such as taffy or caramel can pull them off. The sealants will need to be checked at each of your child’s appointment to see if a replacement is needed.

Which teeth get sealants?

In most cases, the dentist seals the “6 year” and “12 year” molars which erupt around those ages, respectively.

It is usually recommended sealing all teeth containing grooves, including front teeth, back teeth, baby teeth and adult teeth.


We live in a sports-minded society where millions of kids and children are keen on playing various kinds of sports including athletics.
Sporting is a healthy practice but the bitter truth is that it always accompanies injuries where facial and dental injuries are most common among other injuries of the body.

The most possible sports activity your children might get an injury
• Bicycling
• Athletics
• Basketball, volleyball
• Badminton, Tennis etc…
• Swimming

Swimming is the most entertaining sports for children usually during summer times, and the common dental problems swimmers usually face include,

  • Athlete’s swimmers who often swim more than 6 hours a week, expose their teeth to a large amount of chemically exposed water.
  • Pool water usually contains chemical additives like chlorine leading to the breakdown of proteins in saliva and thus depositing dark brown tartar usually on the front teeth.

What could be the possible effects on the face and teeth after an injury?
• Abrasions, lacerations on facial skin
• Chipping, cracking of the tooth
• Broken tooth
• completely knocked out tooth

• Fracture of jaw bones etc…

Emergency care is the most important thing to be done to the children met with sports.
Are the parents who are having a look at this are aware of dental emergency care?
This is a survey fact for parents to know how bad awareness is among people regarding dental trauma due to sports,

  • Visit a doctor immediately-16.6%
  • Clean the wound and then visit the dentist-26%
  • Clean the wound and take medications for pain-18%
  • Children not visiting the dentist -26.6%

• Helmets
• Facemasks
• Mouth guards

How a pediatric dentist will help you find a way in case of sports injury to your children?
• She/he gives the best counseling to parents regarding the dos and don’ts in sports injury for better prevention
• The treatment in emergency cases of injury to your child is always best provided by them.

Impaction of a primary mandibular canine : combined surgical and orthodontic management


Unerupted teeth are seen more commonly in the permanent and early mixed dentition.Unerupted primary teeth are far less common and commonly involve the lower and upper second molars. Thecauses for the unerupted tooth may include another supernumerary tooth,odontoma, a cyst or tumor and inadequate space foreruption.Primary failure of eruption though uncommon may exist as do syndromic and non-syndromic associations like Gardeners syndrome and Cleido-cranial Dysostosis where often multipleteeth remain unerupted.

Odontomas are developmental anomalies due to complete differentiation of epithelial and mesenchymal cells resulting in fully functional ameloblasts and odontoblasts. They are further classified into compound and complex odontomas depending on the level of differentiation of the hard tissue. Often, they are asymptomatic presenting as routine radiographic findings or may hamper the eruption of teeth. There are very few case reports indicating the association of an odontoma and an unerupted primary tooth, especially a primary canine.

Themost common technique of management of these unerupted primary teeth is surgical exposure or surgical exposure followed by extraction of the unerupted tooth. In this case report, an unerupted primary mandibular canine is managed via a combined surgical – orthodontic approach to ensure optimum position of the tooth. This report documents the first instance of use of use of orthodontic forces to aid in eruption of an impacted primary tooth.

Case report

A 48-month-oId female presented with a chief complaint of anunerupted mandibular right primary canine.The parents reported that the mandibular left primary canine had erupted almost a year previously. Prenatal, natal and postnatal history from the hospital records did not show any need for neonatal laryngoscopy or endotracheal intubation. Nor was there any history of natal/neonatal tooth which might have warranted early extraction. This was the patients first dental visit and patient’s medical history was unremarkable. Patient’s parents did not reveal any family history of similarly unerupted teeth.There was no history of any trauma that might have caused premature loss or intrusion of the tooth.

On examination the patient was found to be uncooperative with a Frankels behavior rating of negative.

Clinical examinationrevealed a flush terminal plane occlusion, adequatearch length, and normal relationships in the verticaland transverse dimensions. The whole complement of primary dentition was erupted except for the right mandibular canine despite presence of adequate space for its normal eruption. Adiscrete hard swelling could be palpated in the gingiva overlying the unerupted tooth.

Anorthopantomogram was advised which revealed the presence of the unerupted primary canine with one third root formation was complete and an age-appropriate complement of developing permanent teeth. A small single discrete mixed radiopacity overlying the unerupted caninecrown was visible on examination of the OPG.The radiopacity was surrounded by a thin radiolucent line. The left mandibular canine was on the other hand was fully erupted with root formation almost complete. The lower right permanent canine tooth germ was also visible on the radiograph. On the basis of clinical and radiographic examination a provisional diagnosis of odontoma was made impeding the eruption of the tooth.

Considering the young age of the child and heruncooperativebehavior, the parents were counselled about the various treatment options available i.e. adopt a wait and watch approach, consider only surgical exposure and surgical exposure followed by immediate bracket bonding and application of orthodonticforces. As per the parents’ wishes, surgical exposure followed by orthodontics under GA was chosen as line of therapy.

The patient was referred to a physician for pre-anesthetic clearance following which the procedure was scheduled in a hospital OT setting. Theentire surgical procedure was done under GA. An incision was made over the edentulous ridge fromthe distal of the right central incisor to the mesial of thesecond molar. A full thickness mucoperiosteal flap wasreflected labially and the overlying alveolar bone wasremoved to expose the crown of the canine. During surgery, a small calcified mass was located labial to and separate from the canine crown which was removed with a periosteal elevator under saline irrigation.

Before closing the surgical site, the option of allowing spontaneouseruption of the canine was considered. The canine in addition to being prevented from eruption appeared to have been rotated around its axis. Since exposurehad been accomplished, in consultation with the parents, we chose to initiateorthodontic treatment immediately.

After ensuring adequate isolation of the deciduous canine, an acid etchant was applied for a period of 20 seconds followed by the bonding agent application and light cured for 20 seconds.In caseof contamination due to blood or saliva was suspected the whole sequence of etching and bonding was repeated.A small amount of orthodontic light cure composite was placed on the bonding surface of orthodontic bracket. The bracket was then oriented on the exposed canine and cured with light curing unit. Followingthis orthodontic bracket were bonded on all the remaining teeth with banding of the 75 and 85.

The surgical incision was closed after bonding a bracket on the surgically exposed canine which was united by an arch wire to the remaining erupted mandibular primary teeth. Surgical suturing was done with 3-0 silk sutures.Force application was delayed for one week to allow the site to heal. The patient was seen everythree weeks, to monitor the status of eruption.

At the time of debonding after six months the teeth had erupted perfectly into occlusion with correction of the initial minor rotation. The OPG indicated the normal development of the permanent canine underneath with continued root formation of the deciduous canine. At follow up after one year the patient was asymptomatic with no changes in the occlusion. Normal development of the underlying permanent canine was also evident from the OPG.


In conclusion, early detection and management of unerupted primary teeth is essential to prevent problems in the eruption of their permanent successors. In this report the combined use of surgical exposure and excision of overlying odontoma under GA followed by orthodontic therapy has improved the chances of tooth eruption into a proper occlusion. This report presents a case for early application of orthodontic forces to ensure an optimum outcome.