At any given time some 4 million teens and pre-teens are wearing braces or other orthodontic appliances to correct a malocclusion (poor bite). While most cases are straightforward, some have difficulties that increase treatment time and cost.

But what if you could reduce some of these difficulties before they fully develop? We often can through interceptive orthodontics.

This growing concept involves early orthodontic treatment around 6 to 10 years of age with the goal of guiding the development of a child’s jaws and other mouth structures in the right direction. These early years are often the only time of life when many of these treatments will work.

For example, widening the roof of the mouth (the palate) in an abnormally narrow upper jaw takes advantage of a gap in the bone in the center of the palate that doesn’t fuse until later in adolescence. A device called a palatal expander exerts outward pressure on the back teeth to influence the jawbone to grow out. New bone fills in the gap to permanently expand the jaw.

In cases with a developing overbite (the upper front teeth extending too far over the lower teeth when closed), we can install a hinged device called a Herbst appliance to the jaws in the back of the mouth. The hinge mechanism coaxes the lower jaw to develop further forward, which may help avoid more extensive and expensive jaw surgery later.

Interceptive treatments can also be fairly simple in design like a space retainer, but still have a tremendous impact on bite development. A space maintainer is often used when a primary (“baby”) tooth is lost prematurely, which allows other teeth to drift into the empty space and crowd out the incoming permanent tooth. The wire loop device is placed within the open space to prevent drift and preserve the space for the permanent tooth.

To take advantage of these treatments, it’s best to have your child’s bite evaluated early. Professional organizations like the American Association of Orthodontists (AAO) recommend a screening by age 7. While it may reveal no abnormalities at all, it could also provide the first signs of an emerging problem. With interceptive orthodontics we may be able to correct them now or make them less of a problem for the future.

If you would like more information on orthodontic treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Interceptive Orthodontics.”


Everyone loves a concert where there's plenty of audience participation… until it starts to get out of hand.├é┬áRecently, the platinum-selling band Fifth Harmony was playing to a packed house in Atlanta when things went awry for vocalist Camila Cabello. Fans were batting around a big plastic ball, and one unfortunate swing sent the ball hurtling toward the stage — and directly into Cabello's face. Pushing the microphone into her mouth, it left the “Worth It” singer with a chipped front tooth.

Ouch! Cabello finished the show nevertheless, and didn't seem too upset. “Atlanta… u wild… love u,” she tweeted later that night. “Gotta get it fixed now tho lol.” Fortunately, dentistry offers a number of ways to make that chipped tooth look as good as new.

A small chip at the edge of the tooth can sometimes be polished with dental instruments to remove the sharp edges. If it's a little bigger, a procedure called dental bonding may be recommended. Here, the missing part is filled in with a mixture of plastic resin and glass fillers, which are then cured (hardened) with a special light. The tooth-colored bonding material provides a tough, lifelike restoration that's hard to tell apart from your natural teeth. While bonding can be performed in just one office visit, the material can stain over time and may eventually need to be replaced.

Porcelain veneers are a more long-lasting solution. These wafer-thin coverings go over the entire front surface of the tooth, and can resolve a number of defects — including chips, discoloration, and even minor size or spacing irregularities. You can get a single veneer or have your whole smile redone, in shades ranging from a pearly luster to an ultra-bright white; that's why veneers are a favorite of Hollywood stars. Getting veneers is a procedure that takes several office visits, but the beautiful results can last for many years.

If a chip or crack extends into the inner part of a tooth, you'll probably need a crown (or cap) to restore the tooth's function and appearance. As long as the roots are healthy, the entire part of the tooth above the gum line can be replaced with a natural-looking restoration. You may also need a root canal to remove the damaged pulp material and prevent infection if the fracture went too far. While small chips or cracks aren't usually an emergency (unless accompanied by pain), damage to the tooth's pulp requires prompt attention.

If you have questions about smile restoration, please contact us and schedule an appointment. You can read more in the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty As Never Before” and “Porcelain Crowns & Veneers.”

By Dr. Howard
December 17, 2014
Category: Oral Health
Tags: Children's Teeth  

Your dentist in 20024 shares how to properly care for your child’s baby teeth.

By about the six-month marker, you child will start developing those cute little baby teeth. By the time your child is three, he or she will most likely have all 20 baby teeth, saying goodbye to those snaggle-toothed smiles. While baby teeth are certainly not forever, it Babydoesn’t make them any less vital to your child’s oral health.

What is the importance of baby teeth?

  • They help children chew food easily
  • They help children speak
  • They hold the space for where permanent teeth will eventually grow in

Also, baby teeth are just as likely to develop cavities as permanent teeth, so it’s important to keep them healthy to avoid premature tooth loss in your child.

What happens if my child loses a baby tooth too early?

The most common issue that occurs is that permanent teeth will begin to take over the empty space left behind by the baby tooth, which will make it more challenging for the other permanent teeth to find room in your child’s mouth when they erupt. This can often lead to serious overcrowding and crooked smiles, which will later need to be fixed by orthodontics.

What can I do to keep my child’s baby teeth healthy?

Adopting good oral hygiene is key to maintaining your child’s healthy smile. The minute your child is born, you should be focused on his or her oral hygiene, even if there are no teeth present.

Also, schedule your child’s first dental visit after the first tooth erupts (or no later than your child’s first birthday). The first dental appointment is crucial to maintaining good oral health. At your child’s visit we can pinpoint problem areas and decay early on before it causes tooth loss.

How do I clean my baby’s teeth?

At-home cleanings should begin right away. After feedings, use a damp cloth to wipe your baby’s gums. You may also opt for a toothbrush that’s designed specially for babies.

When the first baby teeth erupt, you will want to brush them with a toothbrush and a very tiny amount of non-fluoride toothpaste. Be sure to brush not just your child’s teeth but also the gum line. Brushings should happen twice a day, just like with adults.

If it’s time for your child’s first dental appointment in 20024, call us right away to schedule a visit for your little one. The sooner you can make the dentist a regular part of your child’s life, the better!

By Patrick Howard, D.D.S.
September 25, 2014
Category: Oral Health

Oral Health

To keep teeth pretty looking and pretty healthy, there are some basic dental practices your family needs to follow. You probably already know that teeth need to be brushed twice a day and flossed at least once a day. But you don’t want to forget some friendly dental advice to make your oral hygiene routine better. Check it out below!

Tips for Oral Hygiene in the Morning and Night

When you wake up in the morning, you need to consider your oral hygiene routine. Do you brush and floss before breakfast? Or are you the person that runs the toothbrush over your teeth for a second before running out the door? In our professional opinion, we recommend that you take care of your teeth after you eat a healthy breakfast. It’s more beneficial to eat as soon as you get up because your metabolism is running fast, and it’ll kick-start your day. Plus, eating and then getting ready lets your tooth enamel remineralize before you brush. 
In recent years, research has suggested that acidic foods and beverages once consumed can soften the tooth enamel. If you brush and floss right after eating, softened enamel may be damaged. You don’t want to damage the enamel because it’s your first line of defense against cavity-causing plaque bacteria.

Pack a Tooth-Friendly Lunch

It’s tempting to rush through a drive through during a short lunch hour, but fast food restaurants are notorious for having meals high in sugars and acidity levels that aren’t good for your teeth and overall health. Our tips for eating healthy are to:
  • Make a grocery list with healthy and filling items
  • Buy groceries on a full stomach, so you aren’t tempted to buy junk food and sugary snacks
  • Make your lunch the night before so you have time to pack a balanced lunch
  • Create a weekly meal plan to keep your family on track and on time
Our best tip—check to make sure your family’s dental appointments are updated! You don’t want to go more than six months without a checkup—decay could already be present.

Contact Us for a Dental Checkup 

We hope our patients are going the extra mile for their teeth because it will be the best thing in the long run. If you want to regain your basic dental habits, start with a checkup. We can tell you what your teeth need on a daily basis. To schedule an appointment, please call our dental practice in the 20024 area of Washington
Are you a patient of Patrick Howard, D.D.S.? If so, we would love to hear about your experiences below!
By Dr. Howard
May 20, 2014
Category: Dental Implants
Tags: Untagged
Dental implants have proven to be an extremely successful method when replacing a missing tooth or teeth. In fact, implantsdental implants have a success rate of over 95%! Dr. Patrick Howard is trained and certified to help you get that smile you’ve always wanted, and dental implants just might be an option for you.
When considering dental implants, it’s important to know how they work and how they are placed in your mouth. Implants are inserted directly into your jawbone where the missing tooth was through a small surgical procedure. The implant will need time to heal before a final crown is put on. The implant fuses to the bone around it during the healing phase.
Am I a Good Candidate?
Patients who are missing a single tooth, multiple teeth, or all teeth are ideal candidates for dental implants. Listed below are some different options to look at to see which procedure is right for you.
  • Single Tooth Replacement - This option is best for patients who are missing a single tooth, and only need one implant. The implant is inserted into the bone and replaces the root part of the tooth. A crown is placed on top to make it look and feel like a normal tooth.
  • Multiple Teeth Replacement - If you have more than one tooth missing, this might be an option for you. If you have multiple teeth next to one another that are missing, implant teeth will be a support for the crown in between.
  • All Teeth Replacement - If you have been using dentures and want a more comfortable and effective mouth, you should consider replacing all teeth. Dr. Howard can attach your removable dentures onto the implants. This puts pressure into the bone structures, rather than the surface as regular dentures do. This means no more slipping and annoying sounds.
Only Dr. Howard will be able to fully explain the options and treatment of dental implants. If you live in the Washington, DC area, and feel you ready for that perfect smile and an easier life, contact us today!

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Washington, DC Dentist
Patrick Howard, D.D.S.
501 School Street Ste. 350 SW
Washington, DC 20024
(202) 863-0688