Ectopic canines are generally found in the Buccal Vestibule. Impacted canines may be retrieved with braces, using a surgical approach via a gold chain or straight wire. Tissue covering the tooth is uncovered. A chain or wire is attached to the tooth crown. Tissue is placed back over the tooth leaving the chain or wire coming out of the gum. For the purpose of this illustration a gold chain is used to retrieve the canines. The chain is attached to the tooth crown and the link is attached to a flexible archwire so that the wire is active (bent). Once a month, the wire is reactivated by using the next link up on the chain until the impacted canine erupts enough to attach a regular bracket on the canine. With the regular bracket in place, a more flexible wire is added directly to the bracketed canine. This process will bring the canine into position within the arch by forcing the canine to conform to the straight archwire form. This is a long process taking anywhere from 8-12 months.
Baby teeth that have large caries (cavities) and some degree of pain occasionally require that the 'coronal' (top) portion of that tooth's nerve be removed before a filling or a crown (preferably) is placed. The main goal of this procedure is to preserve the baby tooth, since baby teeth help to maintain adequate room for the permanent teeth. Pulpotomies have published success rates that range from 60% to 90% and represent a good and reliable way to save a badly decayed baby tooth.
Recent controversy regarding the use of Stainless Steel Crowns (SSCs) in some states have led some parents to question dental care providers more thoroughly on their use and on other alternatives. SSCs have been used in dentistry for over 50 years for primary and permanent dentition. For primary teeth, SSCs are usually placed on teeth that have extensive caries (where two or more surfaces are extensively involved), or teeth that have pulp treatment (such as pulpotomy or pulpectomy). We also use them in teeth that will remain in the mouth for a considerably long period of time; where other materials will not last long enough. SSCs become loose and come out of the mouth just like normal primary teeth. They work just like normal teeth do, and require the same care. Alternatives to Stainless Steel Crowns do exist, particularly for front teeth.
Usually these can be one of the following:
- A prefabricated SSC that has a white facing bonded to it on the front (Commonly we use the Nu-Smile brand: www.nusmilecrowns.com)
- A white cap fabricated with a white filling material (Usually we call these strip crowns).
- A normal SSC that we modify by building a window in the front of it, which we later fill with a white filling material.
Strip crowns, also known as 'white crowns', is an alternative to placing crowns on primary incisors (top baby teeth) with large caries. Because these teeth are fixed using the same material that is used to place 'white fillings', this procedure is very technique sensitive and may not be an option for young children. With proper case selection, these 'fillings' may last for at least two to three years. Stainless steel crowns with 'white' facings (the front part is white) are also available, in the event that strip crowns are not an option. Your dentist will be happy to discuss all options available for aesthetic restorations on primary teeth.