What makes a beautiful smile? The teeth, of course: bright, evenly shaped and precisely aligned with each other. But your teeth can be as perfect as can be and your smile will still appear unattractive.
The reason? Your gums show more than they should when you smile.
What's considered a gummy smile is largely a matter of perception that can vary from person to person. As a rule of thumb, though, we consider a smile “gummy” if four millimeters (mm) or more of the gums show.
Fortunately, we can minimize the gums' prominence and make your smile more attractive. But what methods we use will depend on why your gums stand out. And it's not always because of the gums themselves.
It could be your teeth didn't erupt normally during dental development. Mature crown (the visible part of the tooth) length is normally about 10 mm with a width about 75-85% of that. But an abnormal eruption could result in teeth that appear too short, which can make the gums stand out more. We can correct this with a surgical procedure called crown lengthening in which we remove excess gum tissue and, if necessary, reshape the underlying bone to expose more of the tooth crown.
Another potential cause is how far your upper lip rises when you smile. Normally the lip rises only enough to reveal about 4 mm of teeth. In some cases, though, it may rise too high and show more of the gums. We can modify lip movement in a number of ways, including Botox injections to temporarily paralyze the lip. A more permanent solution is a lip stabilization procedure. It sounds bad, but it's a fairly simple procedure to surgically reposition the muscle attachments to restrict movement.
Your gummy smile may also result from an upper jaw too long for your facial structure. We can correct this with orthognathic (“ortho” – straighten, “gnathos” – jaw) surgery. During the procedure the surgeon permanently positions the jaw further up in the skull; this will reduce the amount of teeth and gums displayed when you smile.
Discovering the true cause of your gummy smile will determine how we treat it. After a complete oral examination, we can then discuss your options to transform your smile into a more attractive one.
If you would like more information on treating gummy smiles and other cosmetic problems, 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 you had chicken pox as a child, you're at higher risk for a painful viral infection later in life called shingles. Besides a painful skin rash and other symptoms that can develop, shingles could also affect your dental care.
About 90% of children contract chicken pox, a disease caused by the varicella zoster virus (VZV), which usually clears up on its own. But later in life, usually after age 50, about a quarter to a third of chicken pox patients will develop shingles.
The onset of shingles usually produces an itching or burning sensation on the skin that's either numb or overly sensitive to the touch. A red rash may ensue with crusty lesions, accompanied sometimes by pain, fever and fatigue. The rash often forms a belt-like or striped pattern along one side of the face or body.
For most patients this painful rash is the extent of their symptoms. But women who are pregnant, patients undergoing cancer treatment or people with compromised immune systems are at risk for more serious complications if they contract the disease. It's important for these at-risk patients to obtain a vaccination, as well as avoid contact with anyone with shingles.
Which brings us to your dental care: in its early stages shingles can be contagious, the virus passing to others through skin contact or by airborne respiratory secretions. That's why it's important if you're currently experiencing a shingles episode that you let us know before undergoing any kind of dental work.Â Even a routine teeth cleaning with an ultrasonic device could disrupt the virus and increase the chances of it spreading to someone else. We may need to postpone dental work until the virus is under control.
Antiviral drugs like acyclovir or famciclovir are highly effective in bringing the disease under control, especially if treatment starts within three days of the onset of symptoms. And don't forget the shingles vaccination: the U.S. Center for Disease Control recommends it for anyone 60 or older regardless of a past history with chicken pox.
See your physician as soon as possible if you begin to notice symptoms. Don't let shingles interfere with your life — or your dental care.
Academy Award-winning actress Kathy Bates knows how important it is to present your best face to the world — and one of the most important features of that face is a beaming smile. But there came a point when she noticed something was a little off. “I've always had good teeth, but it seemed to me as I was getting older that they weren't looking as good,” Kathy explained in a recent interview with Dear Doctor magazine.
That's when she decided it was time to take action. Kathy had orthodontic treatment when she was in her fifties, and she keeps her smile bright with tooth whitening treatments. She uses a kit provided by her dentist with a safe, effective whitening solution.
Of course, a bright, healthy smile looks great anywhere — whether you're on the red carpet or “off the grid.” And you don't have to be a Hollywood star to have professional whitening treatments. In fact, teeth whitening is one of the most popular and affordable cosmetic treatments modern dentistry offers.
The basic options for professional teeth whitening include in-office bleaching or take-home kits. Both types of dentist-supervised treatments offer a safe and effective means of getting a brighter smile; the main difference is how long they take to produce results. A single one-hour treatment in the office can make your teeth up to ten shades lighter — a big difference! To get that same lightening with at-home trays, it would take several days. On the plus side, the take-home kit is less expensive, and can achieve the same results in a bit more time.
It's important to note that not all teeth can be whitened with these treatments. Some teeth have intrinsic (internal) stains that aren't affected by external agents like bleaches. Also, teeth that have been restored (with bonding or veneers, for example) generally won't change color. And you can't necessarily whiten your teeth to any degree: Every tooth has a maximum whiteness, and adding more bleach won't lighten it beyond that level. Most people, however, find that teeth whitening treatments produce noticeable and pleasing results.
What about those off-the-shelf kits or in-the-mall kiosks? They might work… or they might not. But one thing's for sure: Without a dentist's supervision, you're on your own. That's the main reason why you should go with a pro if you're considering teeth whitening. We not only ensure that your treatment is safe — we can also give you a realistic idea of what results to expect, and we will make sure that other dental problems aren't keeping you from having a great-looking smile.
How often does Kathy Bates see her dentist for a checkup and cleaning? “I go about every four months,” she noted. “I'm pretty careful about it.” And if you've seen her smile, you can tell that it pays off. If you would like more information about teeth whitening, please contact us or schedule an appointment. You can learn more in the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “Teeth Whitening.”
For best results in cleaning your teeth of disease-causing plaque you need both the power of brushing open teeth surfaces and flossing in between them. But you may be wondering: should you perform one task before the other?
In general terms, no—there’s no solid evidence that flossing is better before brushing, or vice-versa. But that being said we do recognize each way has its own advantages.
If you floss before brushing, it’s possible you could loosen plaque that can then be easily brushed away when you perform your second hygiene task. Flossing first can also reveal areas that need a bit more attention from brushing if you suddenly encounter heavy particle debris or you notice a little bit of blood on the floss. And, by flossing first you may be able to clear away plaque from your tooth enamel so that it can more readily absorb the fluoride in toothpaste.
One last thing about flossing first: if it’s your least favorite task of the two and you’re of the “Do the Unpleasant Thing First” philosophy, you may want to perform it before brushing. You’re less likely to skip it if you’ve already brushed.
On the other hand, flossing first could get you into the middle of a lot sticky plaque that can gum up your floss. Brushing first removes a good portion of plaque, which can then make flossing a little easier. With the bulk of the plaque gone by the time you floss, you’ll not only avoid a sticky mess on your floss you’ll also have less chance of simply moving the plaque around with the floss if there’s a large mass of it present.
It really comes down to which way you prefer. So, brush first, floss last or vice-versa—but do perform both tasks. The one-two punch of these important hygiene habits will greatly increase your chances for maintaining a healthy mouth.
A toothache means you have tooth decay, right? Not necessarily — your pain could be signaling a number of potential causes. Determining where, how much and how often it hurts will help us find out the cause and apply the appropriate treatment.
A single symptom, for example, can mean many things. A twinge of tooth pain as you consume hot or cold foods might indicate localized tooth decay easily repaired by a filling. But it could also mean the tooth's root surface has been exposed as a result of periodontal (gum) disease — aggressive plaque removal and maybe even gum surgery might be necessary. Or it could be a sign of inner pulp decay: in this case you'll likely need a root canal treatment to save the tooth.
Pulp decay can also announce itself with a very sharp and constant pain radiating from one or more teeth. You shouldn't hesitate to see us for an examination — even if the pain goes away. Pain cessation most likely means the nerves in the pulp have died. The infection, however, still exists, so you'll still probably need a root canal treatment.
If you notice severe, continuous pain and pressure around a tooth, particularly about the gums, you may have a localized, inflamed area of infection called an abscess. An abscess can be the result of gum disease, but it might also stem from a foreign body like a popcorn husk, getting stuck below the gums. We'll need to conduct a complete dental examination to determine the cause and how to treat it.
Finally, a sharp pain when you bite down could mean many things such as a loose filling or a fractured (cracked) tooth. The latter especially requires immediate attention to save the tooth.
These are just a few of the possible causes behind mouth or facial pain. Although all of them are serious, a few are true dental emergencies and can't wait if we're going to save a tooth. The sooner you see us, the sooner we can help relieve the pain, minimize any damage and avert disaster.
If you would like more information on treating tooth pain, 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 “Tooth Pain? Don't Wait!”
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