Our Blog

Closing Space for Missing Front Teeth

March 23rd, 2021

Closing Space for Missing Front Teeth

Missing an upper front tooth (or teeth) is difficult for anyone but especially a teen. They have to have a temporary fix ( i.e. Maryland bridge or removable “flipper” with a false tooth on it) until they stop growing. Then an implant (post placed in the bone) can be placed upon which a crown is attached. This can occur in females around 18 years and males 22 yrs. Over the years the crown and implant will have to be replaced (every 15-25 years).

So you can see the process for replacing a missing tooth is long and never ending, not to mention the many times when the cosmetics are just not that good.

Dr. Michael Sebastian has spent countless hours developing strategies to avoid this potential nightmare by closing the space for a missing tooth. As the following example demonstrates. This 12 year old boy was missing teeth on both sides adjacent to the front teeth (lateral incisors). The strategy for closure is outlined below:

1) Encourage upper eye teeth to come in by the front teeth by selective removal of baby teeth over a 2 to 3 year period. (no braces involved) 4 office visits are needed.

2) Orthodontically manipulate the eye teeth and first bicuspids into a position which simulates the tooth and gum positioning of the teeth they are replacing (lateral incisors and eye teeth).

3) Cosmetically contour these teeth to develop the  shape of the missing teeth.

If these strategies are followed then very nice cosmetic results through Orthodontics can be attained.  The best of which is they can enjoy their smile when they are teens and don’t have a lifetime of implants and crowns!

Let us know how we can help!



Do you know which electric toothbrush to choose?

March 9th, 2021


Do you know which electric toothbrush to choose?

There are 2 basic types of electric toothbrushes depending on how the toothbrush bristles rotate.

  • Side to Side
  • Oscillating (moves in a circular pattern) 

Well, the American Dental Association recently published an extensive study of these 2 types. Which one was best?

Neither! They both were equally as effective in removing plague thereby improving gum and tooth health (Look Ma, no cavities!)

 So, if you are in the market for an electric toothbrush, either of these types will do a great job. Just remember to brush 2 times a day for 2 minutes each time. Focus on brushing the area where the teeth and gums meet. Floss once per day.


Your teeth and jaws under pressure

February 11th, 2021


Do you clench your teeth when you are feeling stressed? Do you wake up with a headache? Do your jaw muscles hurt? Call our office for an appointment. You may have a habit called bruxism.


Bruxism is a habit during which you grind your teeth or clench or thrust your jaw forward over and over again. This habit can affect you’re your oral health. It can cause teeth to break or crack, and increase the chance of gum problems. Adults are not the only ones affected. Studies have found that this can be a problem in children as young as preschool aged.


Researchers do not know for sure what causes people to do this. Some think stress could be a factor. In preschoolers, studies find an association between grinding their teeth or clenching their jaws and signs of stress such as anxiety or social withdrawal.

Children also can develop this habit when they are losing their baby teeth and their permanent teeth are coming in. Nail biting also may lead to grinding of teeth or jaw clenching. Some children outgrow this, but often adults who grind their teeth or clench their jaws did so as children.

Like many habits, you may be unaware that you do this. You may even do it in your sleep. Tobacco and alcohol use may increase your chances of doing this when you are sleeping. Large amounts of caffeine--for example, 8 or more cups of coffee a day—also can increase this risk. Some medications or illegal drugs may cause users to grind their teeth or clench or thrust their jaws as well.


You should contact our office if you notice any of the following:

  • Jaw pain
  • Headaches when you wake up
  • Teeth sensitivity to hot or cold drinks or food
  • Chipped teeth or fillings


A number of things can contribute to the problem of bruxism, and there has not been a lot of research on how best to treat it. We may suggest some options, such as:

  • Decreasing or quitting tobacco use
  • Limiting how much caffeine you eat or drink
  • Seeking counseling to help you identify when you are doing it while you are awake to develop ways to relax
  • Looking at the medications you take and talking to your physician about other options


We also may talk to you about using an oral appliance, which is a plastic tray that fits over either your top or bottom teeth. Use of an appliance may help reduce grinding, clenching, thrusting and may protect your gums and teeth.



Why does my jaw hurt?

January 27th, 2021

Why does my jaw hurt?


Do you have pain in or around your jaws? Does your jaw get stuck? Do you have painful clicking or popping? Are frequent headaches, a problem? If so, you may want to ask us about temporomandibular disorders (TMD).

Your temporomandibular joint (jaw joint) allows you to open or close your mouth and slide your jaw from side to side or back and forth. It is a complicated system of muscles, connective tissues, and the bony joint itself. Because it is so complex, your jaw joint can develop a number of problems.

Some possible causes of TMD include

Diseases that affect the muscles or joints, like arthritis

  • Injury to the jaw joint or connective tissues
  • Habitual movements of the teeth and jaws, like grinding or clenching

Other things, like sinus infections, can cause pain in your jaw area. We may want to rule some of these out before identifying TMD as the source of your pain.


Signs and symptoms of TMD can include

  • Pain in or around the ear
  • Pain when chewing
  • Tender jaw muscles
  • Painful clicking or popping when opening or closing the jaw
  • Difficulty opening and closing the mouth
  • Pain when opening your mouth wide
  • Headaches, facial, or neck pain

One large, multiyear study also found that people who develop TMD are more likely to report chronic somatic symptoms-like runny nose, fatigue, or dizziness. Anxiety and depression have also been associated with TMD.

If TMD is suspected, we may check your joints and muscles for tenderness and listen for noises like clicking or popping, ask you about pain, and examine how your jaw moves. Symptoms may come and go or may bother you all the time.


It is difficult to identify the causes of TMD. Treatment usually focuses on relieving the symptoms associated with it.

There are several things you can try that might help:

  • Eat softer foods
  • Limit wide jaw movements
  • Avoid chewing gum or biting down on anything hard
  • Apply moist, warm compresses

If your pain is still a problem, we suggest scheduling an appointment for an exam. We might suggest:

  • A night guard or bite plate to decrease stress placed on the TM joints and muscles
  • Physical therapy
  • Consultation with another specialist


Because the jaw joint is so complex, it can be difficult to identify what causes pain in and around the joint. Most treatment focuses on relieving the painful symptoms which may be multifactorial and include other specialists. However, most treatments involve reversible modalities which if followed can relieve the TMD discomfort long term!