Posts for category: Oral Health
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.”
You've been brushing your teeth since you were big enough to look over the bathroom sink: now you brush and floss every day. You do it because you know it's important — but do you know why?
It's because your teeth and gums have enemies: oral bacteria in particular, the major cause for tooth decay and periodontal (gum) disease. The vehicle for these infections is a thin-film of food particles on tooth surfaces called plaque.
Daily brushing removes plaque from broad tooth surfaces, while flossing removes it from between teeth. If you don't brush or floss every day — or you aren't effective enough — then plaque becomes a haven for bacteria which then produce high levels of acid that soften and erode enamel. Bacterial plaque can also trigger gum disease: gingivitis (inflamed gum tissues) can begin in just a few days of not brushing and flossing.
You could avoid these diseases and their high treatment costs with an effective, daily hygiene regimen. There are things you can start doing right now to improve your efforts: be sure to hold your toothbrush (soft, multi-tufted is best for most people) at a 45-degree angle to the gum line and gently scrub or wiggle the bristles across the teeth; cover all tooth surfaces on both sides of the teeth — about two minutes of brushing. Be sure to use a fluoride toothpaste to boost enamel strength and don't apply too much pressure when you brush to avoid damaging your gums.
With flossing it's best to hold a small amount of string between fingers from each hand and work it gently between the gaps of each tooth. You then wrap the floss around each tooth in the form of a “C” and gently move up and down three or four times.
You can check to see if you're performing these tasks adequately by running your tongue across your teeth — they should feel smooth and a little squeaky. The real test, though, is during your next checkup. Hopefully we'll find the hygiene habits you've been practicing your whole life are helping you keep your teeth healthy and disease-free.
Fans of the legendary rock band Steely Dan received some sad news a few months ago: Co-founder Walter Becker died unexpectedly at the age of 67. The cause of his death was an aggressive form of esophageal cancer. This disease, which is related to oral cancer, may not get as much attention as some others. Yet Becker's name is the latest addition to the list of well-known people whose lives it has cut short—including actor Humphrey Bogart, writer Christopher Hitchens, and TV personality Richard Dawson.
As its name implies, esophageal cancer affects the esophagus: the long, hollow tube that joins the throat to the stomach. Solid and liquid foods taken into the mouth pass through this tube on their way through the digestive system. Worldwide, it is the sixth most common cause of cancer deaths.
Like oral cancer, esophageal cancer generally does not produce obvious symptoms in its early stages. As a result, by the time these diseases are discovered, both types of cancer are most often in their later stages, and often prove difficult to treat successfully. Another similarity is that dentists can play an important role in oral and esophageal cancer detection.
Many people see dentists more often than any other health care professionals—at recommended twice-yearly checkups, for example. During routine examinations, we check the mouth, tongue, neck and throat for possible signs of oral cancer. These may include lumps, swellings, discolorations, and other abnormalities—which, fortunately, are most often harmless. Other symptoms, including persistent coughing or hoarseness, difficulty swallowing, and unexplained weight loss, are common to both oral and esophageal cancer. Chest pain, worsening heartburn or indigestion and gastroesophageal reflux disease (GERD) can also alert us to the possibility of esophageal cancer.
Cancer may be a scary subject—but early detection and treatment can offer many people the best possible outcome. If you have questions about oral or esophageal cancer, call our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Oral Cancer.”
X-rays are an important diagnostic tool in dentistry because of their ability to penetrate and pass through body tissues. Because they penetrate at different speeds depending on tissue density (shorter and thus darker on exposed film for soft tissues, longer and lighter for hard tissues like bone or teeth), we’re able to detect decay which appear as dark areas on x-ray film.
Without x-rays, the early detection and diagnosis of dental problems would be quite difficult. But despite its obvious benefits, it’s still a form of released energy that exposes patients to a certain amount of radiation. Since the potential health risk from radiation depends on the amount released (the dosage) and for how long and often a person is exposed, we must determine if the dosage and frequency from dental x-rays is a cause for concern.
It’s a common misconception to view any radiation exposure as dangerous. The truth is, however, we’re all exposed daily to radiation from the natural environment — about 2 to 4.5 millisieverts (the dosage measurement for radiation exposure) a year, or about 10 microsieverts (one-thousandth of a millisievert) every day.
In comparison, radiation exposure from routine dental x-rays is a fraction of this if measured over time. A set of four bitewing images of the back teeth produces 4 microsieverts of radiation, less than half the average daily exposure. One of the most comprehensive x-ray sets, a full mouth series of 18-20 images using “D” speed film, results in an exposure of 85 microsieverts, equaling about a week of normal radiation exposure.
These thoroughly researched rates help demonstrate that regular dental x-rays are relatively safe. What’s more, x-ray technology has continued to advance since first used in the mid-20th Century. With innovations in film and digital processing, today’s equipment produces only 80% of the radiation exposure of earlier machines. In effect, we’ve increased our capabilities to more accurately detect and diagnose issues through x-rays, while lowering the amount of radiation exposure.
Of course, a person’s annual exposure rate may differ from others. If you have concerns for yourself or your family about x-ray radiation exposure, please feel free to discuss this with us. Our primary goal is to improve your oral health without undue risk to your health in general.
If you would like more information on x-ray diagnostics and safety, 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 “X-Ray Frequency and Safety.”
It’s hard to avoid stress in the 21st Century. We’re all bombarded with stressors, from work to family — even our smart phones!
The problem really isn’t the stressors themselves but how we respond to them and try to relieve stress. This can often have a negative effect on our health. One example: bruxism, also known as teeth grinding or clenching.
These habits involve the rhythmic or spasmodic clenching, biting or grinding of the teeth, often involuntarily, beyond normal chewing function. It often occurs while we sleep — jaw soreness the next morning is a telltale sign. While there are other causes, stress is one of the most common for adults, bolstered by diet and lifestyle habits like tobacco or drug use, or excessive caffeine and alcohol.
Teeth grinding’s most serious consequence is the potential for dental problems. While teeth normally wear as we age, grinding or clenching habits can accelerate it. Wearing can become so extensive the enamel erodes, possibly leading to fractures or cracks in the tooth.
When dealing with this type of bruxism, we must address the root cause: your relationship to stress. For example, if you use tobacco, consider quitting the habit — not only for your overall health, but to remove it as a stress stimulant. The same goes for cutting back on your consumption of caffeinated or alcoholic drinks.
Adopt an “unwinding” pattern at night before you sleep to better relax: for example, take a warm bath or keep work items or digital media out of the bedroom.Â Many people also report relaxation or stress-relief techniques like meditation, mindfulness or biofeedback helpful.
There’s another useful tool for easing the effects of nighttime teeth grinding: an occlusal guard. This custom-fitted appliance worn while you sleep prevents teeth from making solid contact with each other when you clench them. This can greatly reduce the adverse effects on your teeth while you’re working on other stress coping techniques.
Teeth grinding or clenching can prove harmful over time. The sooner you address this issue with your dentist or physician, the less likely you’ll experience these unwanted consequences.
If you would like more information on the causes and treatments for teeth grinding, 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 “Teeth Grinding: Causes and Therapies for a Potentially Troubling Behavior.”