Posts for: September, 2014
It's not just your teeth that are on display when you smile; it's also your gums. For a smile to look appealing, there needs to be a frame of healthy pink tissue to set off those pearly whites. But just as there can be cosmetic issues with teeth, the shape or condition of the gums, too, can create an aesthetic problem. If you feel the appearance of your gums is in any way detracting from the appeal of your smile, we can help with a variety of in-office surgical procedures.
Here are some common cosmetic gum problems — and possible solutions:
Problem: Too Much Gum Tissue. A smile can look “gummy” when excessive gum tissue covers more of the enamel surface of a tooth's crown (upper portion) than normal.
Solution: Crown Lengthening. This is a procedure in which gum tissue (and rarely but sometimes a small amount of bone tissue) is removed to expose more tooth surface.
Problem: Not Enough Gum Tissue. Sometimes your gums can shrink down (recede), exposing some of a tooth's root — which is more yellow than the enamel surface of the tooth.
Solution: Gum Grafting. There are various grafting procedures that can be used to cover exposed roots by moving gingival (gum) tissue from one site in the mouth to another. Sometimes laboratory-processed donor tissue can even be used to minimize the surgery.
Problem: Uneven Gum Line. This means that some teeth are covered by more gum tissue than others, which can make a smile seem off-kilter.
Solution: Gum tissue can be recontoured (reshaped) for a very pleasing effect with either conventional surgery or the newer dental laser technology.
All of the above procedures can be performed at the dental office — usually with only a local anesthetic (numbing shot). In fact, for laser surgery you may need only a topical anesthetic gel. An examination is required to determine whether conventional or laser treatment is in your best interests. Whatever your cosmetic gum surgery needs may be, the procedures are routine and predictable — and they can work wonders for your smile!
If you have any questions about cosmetic gum surgery, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Gummy Smiles” and “Periodontal Plastic Surgery.”
You may not realize it, but the simple act of eating can generate a tremendous amount of force on teeth and jaws. Fortunately, your teeth can absorb much of this biting force — but within limits. If the force exceeds normal limits on a continual basis, you may begin to notice aching teeth or sore jaws, and we may begin to notice unusual tooth wear during your dental checkups.
The most common cause for this is a chronic habit of grinding or clenching the teeth, also known as bruxism. It can manifest itself by teeth grinding against each other, teeth pressing against soft tissue (as with thumb-sucking) or biting or chewing on hard objects such as pencils or nails. We commonly see bruxism with patients who are experiencing excessive stress, sleep-related problems or as a result of lifestyle habits such as smoking or excessive alcohol consumption. You may not even be consciously aware of it as in the case of bruxism that occurs while you sleep, but your sore jaws in the morning (as well as your sleeping partner’s complaints of noise) may be evidence of it.
Treatment involves a two-part approach. First, we want to relieve the pain symptoms and stop the damage. To relieve pain we’ll often prescribe mild, anti-inflammatory or muscle-relaxant drugs, or perhaps medication to help you sleep better. We may also design a bite guard for wear on your upper teeth at night: the lower teeth will tend to glide or skate on the wear-resistant plastic and prevents them from placing excessive forces on your teeth.
The other part is to address the underlying cause for long-term results. If the habit arises from severe stress or other lifestyle issues, we may recommend biofeedback therapy or psychotherapy to improve your coping mechanisms. If an abnormality like a bad bite (malocclusion) is an underlying factor, we may recommend a minor bite adjustment by reshaping the teeth to lessen the bite impact.
The right course of action depends on a thorough dental examination to determine the exact nature of your clenching or grinding habit. From there we can discuss your options on how to relieve the soreness and pain, as well as prevent problems in the future.
If you would like more information on bruxism and its effects, 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 “Stress & Tooth Habits.”
A dental implant can permanently restore the form and function of a missing natural tooth. But there’s an important prerequisite for this smile-transforming therapy — you must have enough bone remaining at the implant site to securely anchor the implant and ensure proper crown placement for the most natural looking result.
Patients who don’t meet this prerequisite may need to consider other restorative options. In some cases, however, we may be able to encourage sufficient bone growth to support an implantation through a technique called bone grafting.
Bone grafting involves opening the gum tissues at the intended implant site to expose the underlying bone. We then place the grafting material (usually a processed material) around the bone, sometimes with collagen membranes that serve as subterranean band-aids to guide bone growth. In most cases, the graft is actually a scaffold for the natural bone to grow upon; the natural bone will eventually replace the graft material. The procedure is normally performed with local anesthesia to minimize discomfort.
While bone grafting is a fairly routine procedure, it shouldn’t be undertaken unless there’s a firm prognosis it can successfully support a future implant. We must therefore determine if anything else in your oral health would disqualify you as an implant candidate, even if sufficient bone existed or not. We must also determine if there’s enough remaining bone currently at the site to even attach a bone graft.
Once we’re satisfied that bone grafting would be both possible and helpful, we must then consider what type of grafting material to use. If we’re only replacing one tooth we may choose to use an autograft, bone material taken from another area of your own body. Although autografts have advantages because of their regeneration ability, it does involve creating another surgical site within the body. In most cases we may use processed materials, for example allografts, material that originates from another human being; xenografts, taken from another species of animal; or synthetic (man-made) materials. Regardless of the source, these materials are first processed to be safe for human use.
If successful, the regeneration process will result in enough new bone structure to make dental implants a reality. Your mouth will be healthier — and your resulting smile will be more beautiful than ever.
If you would like more information on bone grafting, 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 “Can Dentists Rebuild Bone?”
Tooth decay (dental caries) is one of the world’s most common infectious diseases. Left untreated, it can lead to tooth loss. The best treatment strategy, of course, is to prevent it from occurring in the first place with a long-term approach that begins in early childhood and continues throughout our lifetime.
Here are some basic components for just such a prevention strategy.
Know your risk. We each don’t share the same level of risk for tooth decay, so it’s important to come to terms with any factors that raise your personal risk for the disease — your dental history, inadequate oral hygiene, absence of fluoride use, and lifestyle habits like smoking. Coming to terms with these and other factors — and altering those you can change — can lower your risk.
Reduce acid-producing bacteria in your mouth. Tooth decay usually arises from elevated acidic levels in the mouth caused by certain strains of oral bacteria. You can reduce these bacteria by removing plaque, a thin film of food particles that collect on tooth surfaces, with daily oral hygiene and regular cleanings in our office. In some cases, we may also recommend antibacterial mouthrinses like chlorhexidine to further lower the bacterial population.
Apply protective measures to teeth. Fluoride, a naturally occurring chemical, has been proven effective in strengthening tooth enamel and reducing tooth decay. In addition to fluoride found in many oral hygiene products and public water systems, children can also benefit from a direct application of fluoride to the enamel surface just after the teeth have erupted in the mouth. Many clinical studies have shown 99% cavity free results in over a thousand teeth receiving a fluoride application with sealants.
Control your diet. Bacteria ferment leftover sugars and other carbohydrates in the mouth; this creates acid, which can soften tooth enamel and lead to decay. You can limit this effect by eating more fresh fruits and vegetables and reducing your consumption of refined sugar. You should also limit between meal snacking — constant snacking prevents saliva, the mouth’s natural acid neutralizer, from effectively restoring the mouth’s pH balance.
A prevention strategy for tooth decay will help you avoid unnecessary pain and problems — physically and financially. You’ll also reap the rewards that come from a lifetime of good dental health.
If you would like more information on preventing tooth decay, 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 Decay.”
You’ve suddenly noticed a significant amount of pain radiating from your jaw, so severe you can barely bring your teeth together.
First things first: with this level of pain you should see us as soon as possible. There are a number of possible causes, but only a thorough examination will give us the correct diagnosis and answers we need to develop a plan to treat the cause and alleviate the pain.
With that said, here are a few possible causes for that severe jaw pain.
Injured or diseased teeth. Although the pain you feel seems to come from the jaw in general, the true source may be an individual tooth that’s been traumatized or infected. Because of the interconnectivity of nerves throughout the oral structure, the pain could be radiating from the teeth to the jaws. By effectively treating the affected tooth, we may in turn reduce the jaw pain.
Trauma around the joint. If you’ve taken a physical blow to the area around the jaw joint, the resulting swelling in the joint space is keeping the head of the jaw joint (the “condyle”) from seating in the space properly. You may also notice the upper and lower teeth in the back of your jaw won’t touch. As the swelling from the injury subsides (aided by anti-inflammatory drugs that also reduce pain), the joint should eventually return to its normal position.
Jaw fracture. The most common jaw fracture occurs in the area just below the condyle. The pain is usually much more severe than you might experience with indirect trauma. Fractures are normally treated by repositioning the broken bone and immobilizing the area to allow healing.
Joint dislocation. The injury you’ve sustained may have actually moved the condyle out of the joint space. If this is the case careful manipulation may be needed to reseat the condyle back into place, along with anti-inflammatory medication to reduce swelling.
TMJ or TMD. Muscle spasms can cause significant pain with similar symptoms, including limiting jaw movement. Only an examination with x-rays (to determine if it’s a soft tissue or bone-related injury) can narrow down the possibilities to the true cause. The sooner we make that determination and begin treatment the better you’ll feel — and the less likely the injury will result in irreversible damage.
If you would like more information on the causes of jaw 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 “Jaw Pain — What’s the Cause.”