Posts for: September, 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.”
Often as children grow older, their participation in sports or similar activities increases. While generally encouraged, this greater activity does increase injury risk, especially to the mouth.
In fact, the late childhood to early adulthood demographic is the most prone portion of the population to incur dental injuries. To complicate matters, their dental development is often incomplete, posing a number of treatment obstacles for an injured tooth.
For example, the primary means for preserving an injured adult tooth is a root canal treatment: damaged or diseased tissue within the pulp, the tooth’s innermost layer, is removed and the empty chamber and root canals filled and sealed to prevent infection. But while a fully matured tooth can function without the nerves and blood vessels of the pulp, a developing tooth needs these tissues for continued tooth formation. Otherwise, tooth development can stall and cause problems later on.
The most common solution for younger teeth is to remove any damaged tooth structure without disturbing the pulp if at all possible followed by a filling. That’s contingent, though, on whether we find the pulp unexposed or undamaged—if it is, we’ll try to remove only damaged or diseased pulp tissue and leave as much healthy tissue intact as possible. To aid with healing and tissue re-growth, we may also place medicinal stimulators between the pulp and the filling.
Jaw development may also pose a challenge if the injured tooth is too far gone and must be removed. Our best choice is to replace it with a dental implant; but if we install the implant while the jaw is still growing, it may eventually appear out of place with the rest of the teeth. It’s best to postpone an implant until full jaw maturity in early adulthood.
In the meantime we could provide a temporary solution like a removable partial denture or a modified bonded bridge that won’t permanently alter nearby teeth. These methods can adequately restore the function and appearance of missing teeth until the jaw is mature enough for an implant.
While injuries with young permanent teeth do pose extra challenges, we have effective ways to address them. With the right approach, the outcome can be just as successful as with a mature tooth.
If you would like more information on dental care in the formative years, 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 “Saving New Permanent Teeth after Injury.”
Autumn begins in the month of September, a season that promises cooler days and longer nights. But more significantly for sports fans, September marks the start of football season. Football remains America’s favorite spectator sport—and it’s also played by countless college and high school athletes, as well as those who enjoy an occasional pickup game in the back yard or on the beach. Yet, like many contact sports, football (even touch football) carries a risk of injury—and one of the areas of the body most vulnerable to injury is the mouth.
Some of the most common dental injuries in contact sports include lacerations (cuts), tooth fractures, displacement (teeth pushed deeper into or out of their sockets), knocked-out teeth, and temporomandibular joint problems. While it’s hard to pin down the exact statistics, researchers estimate that over 5 million teeth are avulsed (completely knocked out) every year in the U.S. alone—a significant number of which are due to sports injuries. It is also estimated that the lifetime cost to treat an avulsed tooth ranges from $5,000 to $20,000!
Given the prevalence of sports-related dental injuries, it’s no wonder that protective devices have been developed to minimize the risk. Properly fitted mouthguards have been shown time and again to be effective at preventing many types of dental injuries. Yet the use of devices isn’t always required by rule-making organizations—and many casual players don’t use them at all. That’s a shame, because so many of the injuries are preventable.
Custom-made mouthguards are available right here at the dental office. Strong and durable, these protective devices are specially fabricated from a model of the player’s own teeth. That means they offer the maximum protection, yet can be comfortably worn during practices, backyard games or championships—an important consideration, since accidents often happen when least expected. (And if you’re a parent of a child who plays sports, that’s probably something you already know.)
It isn’t just football players who can benefit from mouthguards: Those with a passion for soccer, basketball, baseball, martial arts, and dozens of other sports can also get the protection they need from this small (but important) item. So this season, when you’re watching or playing your favorite game, think about the extra safety and peace of mind you could gain from a custom-made mouthguard.
If you have questions about custom-made mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “An Introduction to Sports Injuries & Dentistry” and “Athletic Mouthguards.”