We all know Madonna, Seal, David Letterman, Anna Paquin and Michael Strahan (of the talk show Kelly and Michael). What do all of these celebrities have in common? Each has a “signature gap” between their front teeth. Given that they have been in the public eye for quite some time, it's not likely that these famous faces will choose to change their well-known smile. In fact, Michael Strahan has publically stated that he will never close his gap.

However, it is not uncommon for people to desire to fix a small gap in their teeth, particularly in advance of important events, such as weddings. Often times, fixing this small gap requires relatively simple orthodontic movements or tooth straightening. Since the teeth don't have to be moved very far, we can usually use simple appliances to correct the issue within a few months.

In order for us to determine your course of treatment, you'll need to make an appointment with our office for a thorough examination. When we examine you, we'll be looking for a number of items that will affect our treatment recommendation:

• Is there enough room to close the space without creating other bite problems?
• Are the roots of the teeth in reasonably good position to allow for minor tooth movement to close the space? X-rays will be required to make a proper assessment.
• Is there an involuntary tongue habit that has pushed the teeth forward and created the gap? If so, this could be difficult to fix quickly.
• Are the surrounding gum tissues and bone healthy?

Based on our assessment and your individual needs, we may recommend one of the following options:

• Clear retainers, a computer-generated series of clear retainers customized for your bite to move the teeth
• Removable orthodontic retainers to which we will attach small springs or elastics to facilitate the minor tooth movement
• Traditional fixed orthodontic appliances (most commonly known as braces), small metal or clear brackets bonded to your teeth through which tiny wires are used to move the teeth

Regardless of the method we choose, once your teeth have moved into the new position, it is important for you to remember that they must be kept in this position until the bone stabilizes around the teeth. We may therefore advise you to wear a retainer for a few months to a few years, depending on your situation.

If you would like more information about orthodontic treatments, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Minor Tooth Movement.”

Do you still feel tired or unfocused even after a full night’s sleep? Do others complain about your snoring? It’s possible these are signs that you may have sleep apnea.

Sleep apnea is a condition in which you stop breathing while you sleep. Your brain will awaken you to breathe, although you may not consciously realize it since the waking period can be less than a second. But it does disrupt your sleep rhythm, especially during the all-important deep sleep period called Rapid Eye Movement (REM). These disruptions don’t allow your body to receive the full benefit of sleep, hence your lack of energy and focus during the day.

One of the most common causes for sleep apnea is the collapse of soft tissues near the throat as they relax during sleep that restrict the airway. Snoring is an indication this may be occurring: air vibrates rapidly (and loudly) as it passes through this restriction when you breathe in.

As your dentist, we’re well-trained in the anatomy and function of the entire oral structure, and qualified to offer solutions for sleep apnea. If you’ve been diagnosed with sleep apnea (after a complete examination, including an observation session at a sleep laboratory), we can then help you decide on a treatment approach. The following are three such options, depending on the severity of your sleep apnea.

Oral Appliance Therapy. An oral appliance you wear while you sleep is a first line treatment for mild or moderate sleep apnea. The appliance, which we custom design for you, helps hold the lower jaw in a forward position: this moves the tongue and other soft structures away from the back of the throat, thereby opening the airway.

Continuous Positive Airway Pressure (CPAP). Intended for more moderate to severe forms of sleep apnea, a CPAP machine produces continuous air pressure to the throat through a mask you wear during sleep. This forces the tongue forward and the airway open.

Surgical Intervention. These procedures remove excess tissue that may be obstructing the airway. Due to its invasiveness and permanent alteration of the throat area, surgery is reserved for patients who haven’t responded to other therapies in a satisfactory manner.

Whether mild or severe, it’s possible to effectively treat sleep apnea. If successful, not only will you benefit from better sleep and greater alertness, you’ll also improve your long-term health.

If you would like more information on treating sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

Supermodel Christie Brinkley has a one-in-a-million smile, but she is just one of millions who have benefited from today's preferred tooth-replacement technique: the dental implant. In a wide-ranging interview, Brinkley told Dear Doctor magazine about a helicopter accident she suffered while back-country skiing.

“I fractured two molars in the back of my mouth and I had to get two dental implants,” Brinkley told the magazine. “I am grateful for the dental implant technology that feels and looks so natural.”

You might think it serves little purpose to replace a missing back tooth that was barely visible in your smile to begin with — especially if you don't spend a lot of time posing for magazine covers. But this is actually not the case. Your molars are extremely important for chewing and even for maintaining a more youthful appearance.

Dentists generally agree that losing posterior (back) teeth can have many consequences for the remaining teeth and their surrounding structures, i.e., bone and gums. If back teeth are missing, the front teeth end up bearing more stress than they were built for. And there are certain things that happen when any tooth is lost, whether front or back, that can affect function and appearance.

For one thing, when a tooth is lost the adjacent teeth tend to drift into the empty space or tip towards it. This can adversely affect your bite. Too much shifting can render a tooth basically useless and also leave it more vulnerable to gum disease.

Another complication is the loss of tooth-supporting bone that inevitably occurs when teeth are lost. When a tooth comes out, the bone under it actually begins to melt away. Since back teeth support the vertical dimension of the face, their loss can cause what's known as “bite collapse” — a reduction in facial height that becomes increasingly noticeable over time and can make you look older.

A dental implant can prevent all of these things, while providing you with a replacement that looks and feels just like the tooth you lost.

If you are interested in learning more about implants, please contact us or schedule an appointment for a consultation. If you would like to read Dear Doctor's entire interview with Christie Brinkley, please see “The Secret Behind Christie Brinkley's Supermodel Smile.” Dear Doctor magazine also has more on “Replacing Back Teeth.”