Posts for: June, 2014
Something about your smile isn’t quite right. It’s too “gummy” — too much of the upper gum line is visible and it looks out of proportion to your teeth and lips. Most dentists identify a smile as too gummy if four millimeters or more (approximately an eighth of an inch) of the gum tissue is visible at a full smile.
Fortunately, there are ways to minimize this effect. It’s important, though, to first determine the true cause before we embark on any treatment plan.
Your teeth may be the actual cause. As we mature, teeth “erupt” through the gums and the supporting bone and appear in the mouth. They continue to erupt until meeting their “antagonists,” the opposing teeth from the opposite jaw. In addition, the gums go to the proper position where the root meets the enamel of the teeth around late adolescence. The normal result is a length of the crown (the visible portion of the tooth) of approximately 10 mm.
If the teeth don’t erupt fully or the gums don’t go to their proper position, the teeth appear shorter and the gums more prominent. Using a surgical technique called crown lengthening, we remove excess gum tissue and, if necessary, reshape the underlying bone to reveal the proper amount of tooth length. Teeth also shorten due to excessive wear; the teeth continue to erupt to compensate for the wear that occurs over time. The attached gum tissue follows with the tooth. This can be corrected with orthodontic treatment (for bite correction) and porcelain veneers.
Two more causes of a gummy smile are when a person has a hyper-mobile upper lip — the upper lip can raise too much lift when smiling — and an upper jaw length that appears too long for the face. If lips rise higher than the normal 6-8 mm when we smile, too much of the gum line appears. This can be treated temporarily with Botox injections to reduce the mobility of the muscles, or there is a surgical procedure that reduces the mobility of the upper lip. For an elongated upper jaw, orthognathic (“to straighten the jaw”) surgery relocates the jaw to a more upward position that diminishes the amount of gum tissue that shows during smiling.
Treatments for a gummy smile range from simple techniques to more complex surgical procedures. Only a thorough dental exam will reveal the best treatment path to follow.
If you would like more information on treatments for “gummy” smiles, 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.”
Most people agree that bad breath is more than embarrassing. It affects personal, social and business relationships. Although Americans spend roughly $3 billion annually on gum, mints and mouth rinses that promise relief, they are nothing more than temporary cover ups. Discovering the underlying cause of the problem is the only way to effectively eliminate the halitosis (“halitus” – breath; “osis” – disorder) long term. If you have bad breath, we can help.
While it's true that there are a few systemic (general body) medical conditions that can cause bad breath, including lung infections, liver disease, diabetes and cancer, the majority of causes originate in the mouth. We can conduct a simple oral examination to help diagnose the underlying cause of your bad breath. We will check your mouth thoroughly for signs of any dental problems that can produce an odor, including decayed or abscessed teeth, diseased gums, a coated tongue or infected tonsils. Typically, halitosis occurs when bacteria collect on the surface and back of the tongue where it is drier. Bacteria thrive in this environment, resulting in a “rotten egg” odor that so many of us are all too familiar with. This odor actually emanates from volatile sulfur compounds (VSFs), but will go away with proper treatment.
Once the exact cause is pinpointed, your halitosis can be treated in several ways. For example, we can show you how to brush and floss properly to more effectively remove bacteria responsible for tooth decay and gum disease — don't be embarrassed, nobody really knows until they're shown by a professional. We can also show you how to use a tongue scraper or brush to carefully clean the surface of your tongue. Treatment of tooth decay, the repair of defective or broken fillings, extraction of wisdom teeth (third molars) and periodontal (gum) therapy such as scaling and root planing (deep cleaning) will all help treat infection and consequently bad breath.
You don't have to be embarrassed by bad breath any longer! The sooner you call our office to schedule an examination, the sooner you will be able to breathe a lot more freely. For more information about the causes of bad breath, read the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”
If you have pain in your jaws or related headaches, you may have Temporo-mandibular Joint Disorder, TMD. You are probably wondering what this is — and how it can be treated. If this sounds like something you may have, read on for some answers.
What is TMD? TMD describes a group of disorders or diseases that have the same symptoms, but may have different causes, hence it is known as “The Great Imposter.” Pain in and around the temporo-mandibular joint (TMJ), the jaw joint involved in opening and closing your mouth — is characterized by pain and soreness in the region of one or both joints, ears, jaw muscles and even the sinuses.
How does the temporo-mandibular joint work? You can feel your jaw joints working if you place your fingers in front of your ears and move your lower jaw up and down. On each side the joint is composed of an almond shaped structure at the end of the lower jaw, called the condyle, which fits neatly into a depression in the temporal bone (the bone on the side of your skull near your ear). A small disc between the two bones allows the lower jaw to move forward and sideways. The joints are stabilized by ligaments and moved by muscles, like all your joints.
What is the most common cause of TMD? Many people clench or grind their teeth as a reaction to stress. This is generally a subconscious habit, and can even occur during sleep. Continual tooth grinding habits can cause the muscles to go into spasm, which is the most common cause of TMD pain. Structures associated with the jaws — teeth, air sinuses, and even neck and back muscles — share nerves with the muscles in the joints, so the pain may be felt in those structures too, making the exact source of the pain difficult to diagnose. Symptoms of TMD may limit your ability to open your jaw and talk or eat normally.
What is the treatment for TMD? Treatment will depend on the cause, but generally the first step is to relieve pain and discomfort with heat, mild painkillers, muscle relaxants, a soft diet, and simple jaw exercises. A bite guard may be recommended, which should be custom made in our office; a rigid yet unobtrusive plastic appliance that fits over the biting surfaces of your upper teeth. Properly fitted and adjusted, it aids and causes jaw muscle relaxation by preventing clenching and grinding. It is worn during times of stress when oral habits tend to recur, and can also be worn at night.
If you are suffering from TMD — whether the pain is moderate or severe — schedule an appointment with us to have it evaluated and treated. You can learn more about TMD by reading the Dear Doctor magazine article “TMD: Understanding the Great Imposter.”