Posts for: May, 2018
A “gummy” smile, in which the upper gums are too prominent, is a common condition. There are several causes for gummy smiles — determining which one is the first step to having your appearance changed.
Although perceptions vary from person to person, most dentists agree a gummy smile shows 4 mm or more of gum tissue, and the amount is out of proportion with the length of the crown (the visible tooth). Teeth normally erupt through the gums during childhood and continue development until early adulthood, shrinking back from the tooth until stabilizing in place.
This typically produces a crown length of about 10 mm, with a “width to length” ratio of about 75-85%. But variations can produce differences in the relationship between teeth and gums and the width to length ratio of the teeth. The teeth may appear shorter and the gums more prominent. Worn teeth, caused by aging or grinding habits, may also appear shorter.
If tooth to gum proportionality is normal, then the cause may be upper lip movement. When we smile, muscles cause our lips to retract 6-8 mm from the lip’s resting position. If the amount of movement is greater (meaning the lip is hypermobile), it may show too much of the gums. The upper jaw can also extend too far forward and cause the gums to appear too prominent.
There are a number of ways to improve gummy smiles, depending on the cause. Periodontal plastic surgery known as crown lengthening removes and reshapes excess gum tissue to reveal more of the tooth. Lip hypermobility can be reduced with Botox injections (to paralyze the muscles) or in some cases with surgery to reposition the muscle attachments. Orthognathic surgery can be used to surgically reposition an overextended upper jaw. Other cosmetic enhancements such as orthodontics, bonding or porcelain restorations can also prove effective.
The first step is to obtain an accurate diagnosis for your gummy smile. From there, we can devise the best treatment approach to bring your smile back into a more attractive proportion.
If you would like more information on minimizing a gummy smile, 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.”
It’s likely you depend on your regular dentist for the lion’s share of your dental care. But in cases of advanced disease or trauma, you may need the services of a dental specialist.
This could be the case with periodontal (gum) disease, a bacterial infection triggered by a thin biofilm on tooth surfaces called dental plaque that isn’t adequately removed through daily oral hygiene practices. While your regular dentist can effectively treat many forms of gum disease, there are times when you should see a periodontist who specializes in the gum, supporting bone and connective tissues.
So, when should you see a periodontist for gum disease treatment? Here are 3 situations that may call for this important dental specialist.
If your dentist refers you. Your dentist may be quite proficient in treating gum disease, mainly by removing the dental plaque and tartar sustaining the infection. But if the infection has advanced deep within the gum tissues especially around the roots and bone, you may need more advanced measures, including surgery, performed by a periodontist.
If you’d like a second opinion. Of course, you don’t need a referral to see a periodontist. You can make an appointment with one for another opinion about your diagnosis and recommended treatment plan. If you choose to see a periodontist, make sure they have access to all your dental and medical records, as well as your past health history.
If you have other health issues. Gum disease often doesn’t occur in a vacuum – it may exist and even influence (or be influenced by) other inflammatory medical conditions. If you have such a condition like diabetes or cardiovascular disease, you may opt to see a periodontist first for a more comprehensive evaluation.
In the meantime, keep an eye out for the first signs of disease including red, swollen or bleeding gums (if you smoke, be aware smoking hides these signs of disease). And practice daily brushing and flossing as well as obtaining regular dental cleanings to keep plaque accumulation to minimum. Preventing gum disease and getting treatment as early as possible may help you avoid more invasive treatments later.
If you would like more information on treating gum disease, 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 “When to See a Periodontist.”
Famed educator Maria Montessori once said, “Play is the work of the child”—and most kids take their “work” very seriously. But their avid enthusiasm might also raise the risk of blunt force injuries, particularly to the mouth.
While you should certainly take steps to protect their mouth (like a custom-made guard for contact sports), you can’t completely erase the risk. You should know, therefore, what to do in case of a mouth injury.
The lips, tongue, and other soft oral tissues often get the brunt of any contact injury, ranging from minor bruising and swelling to severe cuts that require medical attention. First, clean the area as thoroughly as possible to remove trapped dirt or debris in the wound. If bleeding occurs, apply continuous gentle pressure with a clean cloth or gauze for 10-15 minutes until it stops, and cold compresses for any swelling. If the wound looks deep or severe, take them to an emergency room.
Blunt force can also impact teeth in a variety of ways. If part of a tooth chips, attempt to find the pieces and see a dentist as soon as possible—they may be able to bond the pieces back to the tooth. If a tooth gets moved out of place, call your dentist immediately or go to an emergency room after hours.
If a permanent tooth gets completely knocked out, find it and rinse off any debris with clean water. Then, place it gently back into its socket, or alternatively between the child’s cheek and gum or in a glass of cold milk. You’ll need to see a dentist as soon as possible to have the tooth replanted. With this kind of injury, time is of the essence.
A hard impact can also fracture the jawbone, which may be suspected if the face appears distorted or the teeth can’t make contact with each other when the jaws are shut. Control any bleeding, apply cold compresses or mild pain relievers to ease any pain or swelling, and go to an emergency room immediately.
A traumatic injury can heighten everyone’s emotions, including yours. You can avoid your emotions turning into panic, though, by following these common sense guidelines to help your child get through this unfortunate event.