EVER SEEN A DOUBLE TOOTH?

Many parents wait with great excitement and anticipation for the eruption of their baby's first tooth. Once in a while baby teeth don't quite look right. This can cause extreme worry among parents. Pictured to the left is one such scenario of a baby's two upper teeth. The tooth on the left is a "double tooth" while the one on the right is normal.

Double teeth are two teeth that are joined together by dentin or even by the pulp. If you're not sure what dentin and pulp are, take a look at the layers of a tooth.

In 20 years of dental practice, Dr. Jolley has only seen one case of ‘Fusion’ and that happens to be our own son! He has one giant front bottom tooth with two roots. (The front teeth normally only have one root.)  It was quite exciting and fun for Dr. Jolley to finally see an x-ray of the tooth when our son became old enough. Now that our son has arrived to the age for his permanent teeth erupt, we have been watching this tooth with a lot of curiosity.

There are two scientific terms for teeth that appear to be two teeth stuck together as one tooth: gemination and fusion.

Teeth Stuck Together: What is Gemination?

Gemination is when one developing tooth has split off into two distinct teeth that remain attached to each other and develop together. Gemination comes from the latin word geminus which means twin. You can think of gemination as two "twins" that are permanently attached.

When you count the geminated tooth as one tooth, there are a normal number of teeth in the mouth. The picture of the baby is shown to have gemination because he has all of his other teeth when you count the "double-tooth" as one tooth.

The same boy pictured above, a year or so later. He has all four upper incisors including the double tooth. If he only had three upper incisors including the double tooth, it would be fusion.

Teeth Stuck Together: What is Fusion?

Fusion is when two different developing teeth have joined together to create one tooth. You can think of it as two teeth fusing together. Gemination and fusion look very similar. Sometimes the only way to tell them apart is to count the number of teeth.

When you count the fused teeth as one tooth, the person will appear to be missing one tooth. (See the picture of our son’s teeth shown on the right.) Notice there are only three teeth where there would normally be four, but the one on the left is extra wide.

How Common Are Double Teeth?

Gemination and fusion have been reported to occur in the baby teeth in anywhere from 0.5% to 2.5% of Caucasian children. It is more common in Asian children, where it has been reported to occur sometimes in excess of 5% of Asian kids.

Gemination and fusion occur most commonly in the upper front teeth. However, it can also occur on the lower teeth as well. As a general rule, if a double tooth is located in the upper teeth, it is probably gemination and if the double tooth is found in the lower teeth, then it is probably fusion.

Interestingly enough that is exactly what we have in our two scenarios. The baby boy pictured 1^st above and to the left, has an upper ‘double tooth’ which is Gemination. Our son, the toddler pictured 2^nd, has a lower ‘double tooth’ which is Fusion.

Can Gemination and Fusion Happen with Permanent Teeth, Too?

Gemination and fusion do occur in permanent teeth, although it is not nearly as common as in baby teeth. It reportedly occurs in one out of every 250 people.

Can Gemination and Fusion Cause Any Problems?

Gemination and fusion in the baby teeth can cause crowding, atypical spacing between the teeth, and can cause problems with or delay the eruption of the permanent teeth underneath.

Because of this, when a double tooth is found, you should have your dentist monitor the permanent teeth underneath it to ensure that they come in normal. (Which means Dr. Jolley can check it during each of your regular 6 month check-ups.) Sometimes, your dentist will have to remove the double tooth in order to allow the permanent tooth to erupt normally. Dr. Jolley's 1st recommendation though is to not pull it until seen as necessary.

Rarely, there are no permanent teeth located under fused double teeth. Your dentist will be able to provide more information about the permanent teeth through a simple x-ray.

One thing to watch out for is the propensity for fused and geminated teeth to have deep grooves between the "two" teeth. This groove can be very susceptible to developing cavities as it is hard to get a toothbrush all the way down in the crevice to clean it properly. You may want Dr. Jolley to put a sealant in this groove to help prevent a cavity. (See our previous blog post or website on sealants.)

How Are Gemination and Fusion Treated?

Dr. Jolley’s recommendation for his own son is to let the tooth run its own course. In other words, we treat the tooth as a normal tooth. There aren’t any deep grooves to worry about, and there is no reason to split the tooth, because his mouth appears to be allowing for ample space for both permanent teeth to come in.

Sometimes, your dentist will be able to shave down and smooth the double tooth so that it doesn't appear very obvious to the casual observer. (Cosmetics shouldn’t be an issue yet.) I say sometimes because the anatomy of twinned teeth can be complex. If the pulp (click here to learn about the different layers of the tooth) is too close to the surface, then the dentist won't be able to shave down very much of the surface.

Very rarely, the dentist may be able to surgically divide the teeth but usually this is not necessary. This often works best with fusion because both teeth usually have their own separate pulp chambers and root systems. In any case, when surgically dividing the teeth, both teeth will need to have root canal treatment performed on them, which can end up being quite costly. Again, not a recommendation by Dr. Jolley.

In case you're curious - no one really notices it at all. Only a few family members asked about the tooth when our son was a baby. When he was pre-school age to present, no one can even tell. Now that his permanent teeth are erupting there is a little bit of crowding and crooked teeth, but Dr. Jolley has learned through his education and experience that the tongue, to some degree, is a natural aid in pushing permanent teeth into place. We are keeping an eye on it and hoping not to have to pull the fused tooth. If we do, even that is minimal in treating it.

Since kids will most likely lose all of their front teeth by the time they're 9, you may elect to do nothing about the double tooth ~ unless it's a huge orthodontic concern. I noticed some pictures on the web show an open bite caused by it, but this is even rarer than the tooth itself. One lady commenting on a blog discussing a geminated tooth said to just "enjoy its cuteness"...and that may very well be sound advice!

Conclusion & Further Reading

Do you have any questions or comments about double teeth? Do you or your child have double teeth? If so, what did you do, if anything, to treat it?

Please share your experiences in the comments section below, so we can all learn from them. Thanks for reading!

Portions of this article were written and edited by Debie Jolley. (Dr. Jolley’s wife) My resource of expertise comes from the answers I get from Dr. Jolley himself. 

Article source:Tom @ http://www.oralanswers.com/2010/09/double-teeth-gemination-and-fusion/

Tom is a 4^th year dental student who has a lot of really interesting articles on his blog! Thanks Tom!

For the record, (Tom, a blogger and dental student) got his facts (the statistics) about gemination and fusion from this book: Oral and Maxillofacial Pathology by Neville. If you want to read more on double teeth, Tom highly recommends that book.

Thumb Sucking
Thumb sucking in preschool children is a very normal response to anxiety and stress and does not point to insecurity or emotional problems in your child. While thumb sucking is normal for infants and toddlers, this behavior should decrease by ages 3-4 and stop by age five. Unfortunately, many youngsters are slow to break the habit. Continued sucking of thumbs or fingers can cause serious dental problems with chewing, speech, and facial appearance in children.

Effects on the Jawbone

The more time a child sucks his thumb and the greater the sucking pressure, the more harm is done to teeth and jaws. Day and night forceful thumb sucking makes front teeth move, and can even reshape the jaw-bone. Upper front teeth flare out and tip upward while lower front teeth move inward.

The reason that thumbs and fingers are effective tooth movers and bone shapers is that the jaw bones of children under age eight are especially soft and malleable. Unfortunately for children and parents, prolonged thumb or finger sucking easily deforms the bone surrounding upper and lower front teeth, producing a hole or gap when teeth are brought together, known as an "open bite".

If a child stops thumb sucking before loss of baby front teeth and permanent front tooth eruption, most or all harmful effects disappear within six months. However, if the habit persists through permanent front tooth eruption, there can be lasting damage: flared or protruded upper teeth, delayed eruption of upper or lower front teeth, and the aforementioned open bite. This can result in chewing difficulties, speech abnormalities, and an unattractive smile.

Do Home Remedies Work?

Some parents try home remedies to break the habit. Some try placing gloves on their children before bedtime. Others paint thumbs and fingers with various foul-tasting substances. All of these measures are typically easy to overcome and, unless done with care or under psychological supervision, may be unsuccessful because thumb sucking is a deeply ingrained behavior.

The Dental Solution: A Crib That's Not for Sleeping

One treatment to break the thumb-sucking habit is a simple device called a "crib." Placed by Dr. Jolley on the child's upper teeth, the crib usually stops the habit cold the first day of use. The appliance's technical name is a "fixed palatal crib," and is a type of brace that sits full-time on the upper teeth and roof of the mouth.

The Tongue and Habit Appliance

The crib consists of semicircular stainless steel wires connected to supporting steel bands or rings. The half-circle of wires fits behind the child's upper front teeth, barely visible in normal view. The bands are fastened to the baby molars. There are a number of different crib designs used, all variations on the same theme.

Dr. Jolley will initially analyze the child’s teeth and jaws to check for problems with tooth position and bite. If the child's teeth and jaws show changes from prolonged thumb sucking, he will usually recommend a crib or a Thumb Tongue Habit Appliance to eliminate the habit.

 It is one of the simplest, yet most effective orthodontic devices. Crib wires prevent the thumb or finger from touching the gums behind the front teeth and on the palate (roof of the mouth). Patients turn the bead with their tongue which replaces the desire to suck the thumb and the child has no incentive to continue.

When Does Crib Treatment Begin?

The ideal time is when upper front baby teeth become loose, just prior to eruption of adult or permanent front teeth. This usually occurs just before or after age six, well beyond the maximum "normal" age for thumb sucking to stop. Prompt thumb removal at this time allows permanent teeth to assume a much better position than waiting until their full eruption to break the habit.

Sucking on a thumb, finger, or blanket may be noted in preteens, teenagers and even adults. Despite the age differences, the initial orthodontic treatment is the same for all: placement of a crib to break the habit. For teens and adults, counseling may be indicated to deal with any underlying psychological problems.

Article source: Stock dental articles

 

Grilled Fruit with Strawberry Dip

With the upcoming holiday weekend, grilling is once again on our mind. I thought this recipe sounded too good to pass up and no one will know you were trying to throw something healthy into your meal! lol

You can actually use any “in season” fruit that you think would taste great.

Ingredients:

Sauce ~

8 ounces part-skim ricotta cheese

2 Tblsp plain nonfat yogurt

¼ tsp dried, ground ginger

8 Strawberries, halved

Fruit to grill ~

4 peaches, halved or quartered

8 chunks pineapple

4 plums, nectarines, or papayas,halved

¼ cup balsamic vinegar (apple cider will do)

2 tsp granulated sugar

Instructions:

·        In a blender puree cheese, yogurt, ginger, and strawberries together until smooth. Refrigerate for two hours before grilling fruit.

·        When ready to grill fruit, thread pieces of prepared fruit onto eight skewers. Mix together vinegar and sugar. Grill fruit until lightly browned, turning frequently and brushing with vinegar mixture during grilling.

·        Serve grilled fruit with sauce on side.

As Always, ENJOY! and Happy Memorial Day!

The Importance of addressing ortho issues

We’d all like to have perfectly straight teeth.  The thing that many are unaware of is….a straight smile is not only nice to look at, but is ultimately better for you.  That’s why treating bite problems is so important.

There are a variety of conditions that require orthodontic procedures to correct them. 

Actual patient of Dr. Jolley wearing ceramic brackets
Can you see her braces?

These include:

·       Crowded teeth

·       Crooked teeth

·       Too much space between teeth

·       Overbite

·       Under bite

·       Over jet

·       Open bite

Orthodontic issues can be caused by heredity (which can’t be avoided)  and also by bad habits, such as thumb sucking or tongue thrusting – which can be corrected before damage is done.

You see, when you have a bite issue, not only does it affect your appearance (and thus your self esteem) but it can also create other problems.  You will likely find that teeth can be harder to clean properly leading to cavities and periodontal (gum) issues.  Also, it may be hard to chew, teeth are more likely to get chipped or broken, it’s hard on your jaw joints and muscles, and misalignment can cause grinding or clenching of the teeth, all of which can mean costly restorations down the road.

Although there are ortho treatments available for all ages, children should be assessed before the age of seven to determine any bite issues that need early correction.

Article source: Stock dental articles

A personal note by Debie Jolley. "I was thrilled when Dr. Jolley (my husband) decided to persue orthodontics. My teeth weren't really all that crooked, but enough that I was self-conscious about it. Through Dr. Jolley's classes and study he discovered that I had TMJ problems. The Orthodontics that Dr. Jolley has provided for me not only created straighter teeth, but also eliminated the constant headaches my TMJ was causing. I am so excited for all the benefits it has created for me."

Ready to become a Dental Assistant, but don't know how to become one? Look no further as 'The Academy of Dental Assisting' will give you the best complete training you can get anywhere.

You will learn everything about assisting a General Dentist as well as doing procedures not often done at a General Dentist office, because Dr. Jolley loves to do a variety of work and is Great at it!  You will see and learn how to assist in Orthodontics, Wisdom teeth, Root Canals etc. You learn how to make temporary crowns and bridges. The fun never ends when you learn with us. 

Call us now to get the skills you need for a job in this very competitive market. 801-796-0344 - Chris M Jolley DDS



The Curriculum

You will learn a full-curriculum to prepare you for your career. It includes:

• dental terminology so you become an expert source of knowledge to teach patients,
• a full spectrum of dental procedures, including cleanings, fillings, crowns, root canals,
• asepsis in the dental office to keep instruments and equipment clean and sterile,
• sterilizaion of instruments to prepare instruments for use,
• dental computer software to chart dental procedures and notes for the dentist or hygienist and make appointments,
• Utah State Radiology certification to satisfy Utah law to take x-rays,
• Cardiopulmonary Resusitation (CPR) certification to satisfy federal law to work in the health-care field,
• x-ray technique to be able to take quality x-rays on patients and knowledge on how to problem-solve for quality control,
• and how to be a valuable employee in any field and how to land your position in the dental field.

Upon receiving your certificate from the Academy, you will be able to assist dentists with confidence.

One of the most valuable skills of a dental assistant is to be able to take quality x-rays. The quality of x-ray skills taught at the Academy of Dental Assisting of Pleasant Grove are unsurpassed in the state of Utah.

There is no set length of course as each student learns at his/her own pace. Typically students complete their coursework in 10-12 weeks. Since the class size is one, there is no waiting around for other students to catch up, or waiting for your turn to learn. You complete the coursework fast so that you can enter the workforce soon and start earning real money.