You’re a bit self-conscious about your smile. But not because of your teeth — it’s your upper gums, which seem too prominent when you smile. While “too much” is a matter of perception varying from individual to individual, it’s generally accepted that a smile is “gummy” if four or more millimeters (a bit more than an eighth of an inch) of the gums are visible.
The good news is there are ways to improve the appearance of your gums. Which method we use, though, will depend on the underlying reason why the gums are prominent. The amount of gum tissue, in fact, may not be the problem at all, but could be the size of the crowns (the visible parts of teeth), the upper lip’s range of motion, the upper jaw’s position in relation to the face, or a combination of any of these.
For example, if your teeth didn’t erupt and develop properly, the gums might not have moved back to their proper position and stabilized as they should in your late teens or early twenties. A normal crown (the visible part of a tooth) is about 10 millimeters long, with a ratio of width to length of about 75-85%. Below those measurements the teeth can appear smaller, making even normal gum tissue appear larger. In another scenario, the upper lip may rise too high when you smile (hypermobility), which reveals too much of the gums.
If tooth size is the problem, we may recommend a periodontal surgical procedure called crown lengthening that reveals more of the tooth. A hypermobile lip can be treated with Botox shots to temporarily restrict the movement (it must be repeated every six months) or by surgically repositioning the lip muscles that control movement. Similarly, surgically repositioning an overlong upper jaw to make it appear shorter may be the right course.
That’s why our first step is to determine why your gums are too prominent with a complete dental examination. Knowing exactly why they stand out will help us devise a treatment plan that will greatly enhance your smile.
If you would like more information on improving 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.”
Periodontal (gum) disease is mainly caused by bacterial plaque built up on tooth surfaces due to ineffective oral hygiene. For most cases, treatment that includes plaque and calculus (tartar or calcified plaque) removal and renewed daily hygiene is highly effective in stopping the disease and restoring health to affected gum tissues.
However, you might have additional health factors that may make it more difficult to bring the disease under control. If your case is extreme, even the most in-depth treatment may only buy time before some or all of your teeth are eventually lost.
Genetics. Because of your genetic makeup, you could have a low resistance to gum disease and are more susceptible to it than other people. Additionally, if you have thin gum tissues, also an inherited trait, you could be more prone to receding gums as a result of gum disease.
Certain bacteria. Our mouths are home to millions of bacteria derived from hundreds of strains, of which only a few are responsible for gum disease. It’s possible your body’s immune system may find it difficult to control a particular disease-causing strain, regardless of your diligence in oral care.
Stress. Chronic stress, brought on by difficult life situations or experiences, can have a harmful effect on your body’s immune system and cause you to be more susceptible to gum disease. Studies have shown that as stress levels increase the breakdown of gum tissues (along with their detachment from teeth) may also increase.
Disease advancement. Gum disease can be an aggressive infection that can gain a foothold well before diagnosis. It’s possible, then, that by the time we begin intervention the disease has already caused a great deal of damage. While we may be able to repair much of it, it’s possible some teeth may not be salvageable.
While you can’t change genetic makeup or bacterial sensitivity, you can slow the disease progression and extend the life of your teeth with consistent daily hygiene, regular cleanings and checkups, and watching for bleeding, swollen gums and other signs of disease. Although these additional risk factors may make it difficult to save your teeth in the long-run, you may be able to gain enough time to prepare emotionally and financially for dental implants or a similar restoration.
If you would like more information on the treatment of 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 “Periodontal (Gum) Treatment & Expectations.”
If you have chronic jaw pain, you know how difficult eating, speaking or even smiling can be. Many sufferers will do anything to gain relief, even surgery. But before you go down that road, consider the traditional conservative approach to temporomandibular disorders (TMD) management first—it could provide the most relief with the least risk of side effects.
The temporomandibular joints connect the lower jaw to the skull on either side of the head. These ball and socket joints also contain a cushioning disk to facilitate movement. This disk is believed to be the primary focus for jaw pain problems known collectively as TMD.
Doctors now believe injury, stress, metabolic issues, jaw anatomy defects or similar factors trigger the chain reaction of muscle spasms, pain and soreness that can erupt during a TMD episode. A TMD patient may experience pain within the jaw muscles or joints themselves, clicking sensations, or an inability to open the jaw to its full range.
TMD therapy has traditionally followed an orthopedic path—treating jaw joints like any other joint. In recent years, though, a more aggressive treatment model has emerged that promotes more invasive techniques like orthodontics, dental work or jaw surgery to relieve discomfort. But the track record for this model, especially concerning jaw surgery, remains hazy at best and offers no guarantee of relief. These techniques are also irreversible and have even made symptoms worse in some patients.
It’s usually prudent, then, to try conservative treatments first. This can include pain and muscle relaxant medication, jaw exercises, stretching and massage, and dietary changes to reduce chewing force. Patients with teeth grinding habits may also benefit from a bite guard worn at night to reduce the biting force during sleep and help the joints relax.
By finding the right mix of treatments, you may be able to find significant relief from TMD symptoms with the conservative approach. If not, you might then discuss more invasive options with your dentist. But even if your dentist recommends such a procedure, you would be wise to seek a second opinion.
TMD can definitely interfere with your quality of life and peace of mind. But there are ways to reduce its effects and make for a happier life.
If you would like more information on managing chronic 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 “Seeking Relief from TMD.”
What's an actor's most important feature? According to Vivica A. Fox, whose most recent big-screen role was in Independence Day: Resurgence, it's what you see right up front.
"On screen, your smile and your eyes are the most inviting things that bring the audience in" she said. "Especially if you play the hot chick."
But like lots of people, Vivica reached a point where she felt her smile needed a little help in order to look its best. That's when she turned to a popular cosmetic dental treatment.
"I got veneers years ago," Ms. Fox told Dear Doctor magazine in a recent interview, "just because I had some gapping that probably only I noticed."
What exactly are dental veneers? Essentially, they are thin shells of lustrous porcelain that are permanently attached to the front surfaces of the teeth. Tough, lifelike and stain-resistant, they can cover up a number of defects in your smile — including stains, chips, cracks, and even minor spacing irregularities like the ones Vivica had.
Veneers have become the treatment of choice for Hollywood celebs — and lots of regular folks too — for many reasons. Unlike some treatments that can take many months, it takes just a few appointments to have veneers placed on your teeth. Because they are custom made just for you, they allow you to decide how bright you want your smile to be: anywhere from a natural pearly hue to a brilliant "Hollywood white." Best of all, they are easy to maintain, and can last for many years with only routine care.
To place traditional veneers, it's necessary to prepare the tooth by removing a small amount (a millimeter or two) of its enamel surface. This keeps it from feeling too big — but it also means the treatment can't be reversed, so once you get veneers, you'll always have them. In certain situations, "no-prep" or minimal-prep veneers, which require little or no removal of tooth enamel, may be an option for some people.
Veneers aren't the only way to create a better smile: Teeth whitening, crowns or orthodontic work may also be an alternative. But for many, veneers are the preferred option. What does Vivica think of hers?
"I love my veneers!" she declared, noting that they have held up well for over a decade.
Vacationing abroad can be the trip of a lifetime — or a nightmare if you have a medical or dental emergency while traveling. Dental care in many locations around the world can be limited, expensive or even dangerous.
Here are 3 important things you should to do to prepare for a possible dental emergency during that dream vacation in a foreign country.
Have a complete checkup, cleaning and necessary dental work before you leave. Whoever said, “An ounce of prevention is worth a pound of cure,” must have been a traveler. Better to take care of problems beforehand than have them erupt into an emergency far from home. Be sure especially to have decayed or cracked teeth repaired, as well as any planned dental work like root canal treatments before you go. This is especially important if you’re flying — high altitudes can increase pressure and pain for many dental problems.
Research your destination’s available dental and medical care ahead of time. Standards and practices in other countries can differ from those in the United States, sometimes drastically. Knowing what’s available and what’s expected in terms of service and price will help immensely if you do encounter a health emergency while traveling. A good starting place is A Traveler’s Guide to Safe Dental Care, available at www.osap.org.
Know who to contact if you have a dental emergency. While it may be frightening having a dental issue in a strange place, you’re not alone — there are most likely a number of fellow Americans in your location who can help. Have contact information ready for people you know or military personnel living in your locale, as well as contacts to the American Embassy in that country. And if you’re staying in a hotel, be sure to make friends with the local concierge!
It’s always unsettling to have a dental emergency, but especially so when you’re far from home. Doing a little preparation for the possibility will help lessen the stress if it happens and get you the help you need.
If you would like more information on preparing for dental emergencies while traveling, 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 “Traveling Abroad? Tips for Dealing with Dental Emergencies.”
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