Posts for: November, 2013
Something about your smile isn’t quite right. It’s too “gummy” — too much of the upper gum line is visible and it looks out of proportion to your teeth and lips. Most dentists identify a smile as too gummy if four millimeters or more (approximately an eighth of an inch) of the gum tissue is visible at a full smile.
Fortunately, there are ways to minimize this effect. It’s important, though, to first determine the true cause before we embark on any treatment plan.
Your teeth may be the actual cause. As we mature, teeth “erupt” through the gums and the supporting bone and appear in the mouth. They continue to erupt until meeting their “antagonists,” the opposing teeth from the opposite jaw. In addition, the gums go to the proper position where the root meets the enamel of the teeth around late adolescence. The normal result is a length of the crown (the visible portion of the tooth) of approximately 10 mm.
If the teeth don’t erupt fully or the gums don’t go to their proper position, the teeth appear shorter and the gums more prominent. Using a surgical technique called crown lengthening, we remove excess gum tissue and, if necessary, reshape the underlying bone to reveal the proper amount of tooth length. Teeth also shorten due to excessive wear; the teeth continue to erupt to compensate for the wear that occurs over time. The attached gum tissue follows with the tooth. This can be corrected with orthodontic treatment (for bite correction) and porcelain veneers.
Two more causes of a gummy smile are when a person has a hyper-mobile upper lip — the upper lip can raise too much lift when smiling — and an upper jaw length that appears too long for the face. If lips rise higher than the normal 6-8 mm when we smile, too much of the gum line appears. This can be treated temporarily with Botox injections to reduce the mobility of the muscles, or there is a surgical procedure that reduces the mobility of the upper lip. For an elongated upper jaw, orthognathic (“to straighten the jaw”) surgery relocates the jaw to a more upward position that diminishes the amount of gum tissue that shows during smiling.
Treatments for a gummy smile range from simple techniques to more complex surgical procedures. Only a thorough dental exam will reveal the best treatment path to follow.
If you would like more information on treatments for “gummy” smiles, 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 “Gummy Smiles.”
If your infant is extra cranky and seems to want to chew everything in sight, it's a good bet that the first tooth is on the way! For parents, this is cause for both celebration and concern. After all, no parent wants to see a child suffer even a little bit. Decades ago, when a teething infant showed signs of discomfort, a parent might have rubbed some whisky or other strong liquor on the child's gums — a misguided and dangerous practice. There are far safer, more effective ways to help your child through this exciting yet sometimes uncomfortable phase of development. Here are our top five teething remedies:
Chilled rubber teething rings or pacifiers. Cold can be very soothing, but be careful not to freeze teething rings or pacifiers; ice can actually burn the sensitive tissues of the mouth if left in place too long.
Cold, wet washcloths. These are great for gnawing on. Make sure the washcloth is clean and that you leave part of it dry to make it more comfortable to hold.
Cold foods. When your child is old enough, cold foods such as popsicles may soothe sore gums. However, make sure you confine them to mealtimes because sugars can cause tooth decay — even in very young children.
Gum massage. Massaging inflamed gums with your clean finger can help counteract the pressure from an erupting tooth.
Over-the-counter medicine. If teething pain persists, you can give your baby acetaminophen or ibuprofen, but check with a pharmacist or this office for the correct dosage. The medicine should be swallowed and not massaged into the sore areas, as this, too, can burn.
So when does it all begin? Some babies start teething as early as three months or as late as twelve months, but the typical time frame is between six and nine months. Usually the two lower front teeth erupt first, followed by the two upper front teeth. The first molars come in next, followed by the canines (eyeteeth). Most children have all 20 of their baby teeth by age 3.
If you have any questions about teething or the development of your child's teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Teething Troubles.”
Today's periodontal (gum) surgical procedures are less painful and have fewer complications than ever before. Nevertheless, the best outcome still depends on how well you care for yourself as you recuperate. Here are some things you can do after surgery to lessen its effect.
In the first twenty-four hours after surgery, your primary objective is to prevent swelling, the major source of post-operative discomfort. You can accomplish this by applying an ice or cold pack to the outside of your face in the area of the surgery. It's best to alternate five minutes on and off with the pack for the outside, and ice chips, cold water or ice cream inside your mouth as often as possible. Your aim is to surround the surgical site with cold as much as you can with the five-minute on and off strategy.
You should eat only foods that are cold and soft (Jell-O™, applesauce, yogurt, ice cream, etc.), to help ease any swelling. The next day switch to hotter foods like soup, mashed potatoes or buttered pasta, as well as hot, salt water rinses as often as convenient. Avoid crumbly foods like chips, cookies or popcorn for a few days to help keep the incision site particle-free.
We typically prescribe a number of medications during recuperation: analgesics (usually of the aspirin or ibuprofen family) for swelling and pain, and antibiotics and antibacterial rinses to inhibit bacterial growth. Be sure to follow directions with each prescribed medication, taking the correct dosage and for the specified duration.
There is a possibility of post-operative bleeding — but don't panic. You should first attempt to locate the bleeding area, clean it, and then apply gentle pressure with moist, sterile gauze for ten to fifteen minutes. If the bleeding doesn't stop, give us a call.
You should keep the wound site as clean as possible to help avoid infection. However, don't brush, floss or rinse during the first twenty-four hours to avoid bleeding, and limit hygiene activities to antibacterial mouthrinses like chlorhexidine near the wound site for several days to weeks. During the first few days to a week after surgery avoid activities like strenuous exercise, drinking alcohol, sucking through a straw, or blowing up a balloon, as these can also increase your risk for bleeding. You should also avoid tobacco products during this time as these can inhibit the healing process. Each surgery is different and you should make sure you follow the specific instructions your surgeon will provide for you.
Taking these precautions will help keep discomfort and complications to a minimum. They will also help you recover quickly so that you can get back to your normal life.
If you would like more information on periodontal surgery and what to expect, 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 “Instructions Following Periodontal Surgery.”
Our smiles are our “calling cards” for first impressions. When our front teeth are missing, chipped or otherwise damaged, it will certainly make an impression — and not a positive one.
The good news is many aesthetic problems with front teeth can be remedied with the use of composite resins. This cost-effective treatment choice not only minimizes a negative appearance, but can actually create a positive smile transformation.
Composite resins are tooth-colored materials made up of two or more polymer substances. We call materials like these biomimetic, meaning something non-living that’s fashioned to appear or “mimic” something living. Composite resins are made of substances that aren’t teeth, but fashioned to look and function like teeth.
Composite resin restorations are bonded to the outside of the tooth with dental adhesive, with little to no preparation of the enamel surface of the tooth. They’re best suited for teeth with minor to moderate damage from decay or trauma, but where the majority of the structure is still viable and intact.
These restorations require skill and an artistic eye to achieve the most life-like result. One of the most important considerations is tooth color. The natural color of your teeth is actually a combination of color from the inner core of the tooth, the dentin, and the outer enamel layer. Much of the color comes from the dentin as it shows through the translucence of the enamel. The intensity and hue also changes along the length of the tooth — there are subtle zones of color that run vertically along the length of the crown (the visible portion of the tooth). Our aim is to replicate this variety of color in the restoration and affix it in such a way that it blends with the natural color of surrounding teeth.
Composite resins aren’t the best option for all situations; depending on the tooth’s condition and location, a porcelain veneer may be the better choice. After a thorough dental examination, we can make the best recommendation for your situation. If conditions are right, a composite resin restoration could transform your smile and your life.
If you would like more information on front teeth repair options, 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 “Artistic Repair of Front Teeth With Composite Resin.”