A beautiful smile is a balanced smile, especially in regard to your gums. A normal smile usually shows 4 mm or less of gum tissue along with about 10 mm of tooth length. But if your gums show more than that, your smile may seem too gummy. In terms of perceived balance, this could detract from your smile's attractiveness.
Fortunately, you don't have to live with a gummy smile—there are various ways to correct or minimize its effect. First, though, we'll need to determine the underlying cause before deciding on the best treatment. And, there are several possible causes, the obvious being too much gum tissue present. Teeth that appear shorter due to wear or incomplete eruption could also make the gums appear larger.
We may be able to correct these size problems by surgically removing and reshaping excess gum tissues and possibly the underlying bone to reveal more of the teeth. We can also bond composite resins or porcelain veneers to shorter teeth to make them appear larger.
But not all gummy smile problems pertain directly to the teeth and gums; instead, it could be your upper lip moves too far up as you smile (hypermobility). Or, your upper jaw may be too long for your face, which can also cause too much of the gums to show during smiling.
With upper lip hypermobility, we may be able to inhibit the lip muscles' movement temporarily with Botox injections that partially paralyze the muscles (the effect eventually wears off, so this treatment will need to be repeated). A periodontist, an oral surgeon, or a plastic surgeon could also permanently alter the upper lip movement through a surgical procedure. Surgery may also be necessary for an abnormally long upper jaw: orthognathic surgery re-positions the jaw to the skull, which can lessen the amount of gums showing.
If your smile is too gummy, we can transform it. But first, let's find out what the real cause is with a comprehensive dental examination. Once we know, we can better advise you on the best way to bring beautiful balance to 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.”
For decades, traditional braces were the only orthodontic choice for moving misaligned teeth. Although they’re quite effective, they can cause discomfort and, for teens especially, embarrassment due to their noticeable metallic appearance.
In recent years, though, technology has produced an alternative to braces that’s proven effective for many types of patients. Besides being less cumbersome and disruptive to everyday life than braces, clear aligners have another advantage that appeals to teens — they’re much less visible.
Introduced in the late 1990s, clear aligners are a system of individual trays made of nearly invisible polyurethane plastic worn over the upper teeth. The trays are computer-generated based on the patient’s individual mouth structure captured in photographs and x-rays. Each tray in the sequence is incrementally smaller in size; the patient begins wearing the first aligner in the series for about two weeks, 20 to 22 hours a day. They then switch to the next tray in the series for about the same amount of time, and continue in this fashion until they’ve worn each aligner in the series.
Besides their improvement in appearance, aligners also have another advantage: unlike traditional braces, aligners can be removed from the mouth for eating or on a limited basis for rare important social occasions. Brushing and flossing are also much easier with aligners, which don’t pose the same access problems as traditional braces.
Clear aligners were once only effective with select types of orthodontic patients, which didn’t always include teens. Over the last decade, however, significant changes to design and additional implements have widened their application to more patients, especially teens. For example, we can now add tiny “power ridges” to the aligner design that give greater precision over desired tooth movement to create a more controlled and efficient force on the teeth. More recent aligners are also being produced with a thinner, more comfortable material.
A thorough orthodontic exam will tell whether your teen is a good candidate for clear aligners. If so, they’ll benefit from a more comfortable and less embarrassing experience while gaining a new smile for life.
If you would like more information on clear aligners, 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 “Clear Aligners for Teens.”
Congratulations—you’re engaged! It’s a stupendous (and hectic) time in your life as you plan your upcoming wedding.
You want to look your best for the big day—which means you may be dieting, exercising or making changes to your hairstyle and makeup. Be sure, though, to consider another important part of your appearance—your teeth and gums. Here are a few options that could help your wedding day smile shine even more.
Cleanings and whitening. While dental cleanings are primarily about removing disease-causing plaque and tartar they can also give your teeth that clean and polished look. And if you want an extra boost in brightness, consider whitening—we may be able to lighten up your teeth’s stain-induced dullness.
Bonding. If your teeth have slight imperfections—chipping, slight gaps or staining that doesn’t respond well to whitening, consider bonding techniques to repair or cover these defects. Composite resin is a dental material that can be shaped and bonded to teeth to reform a deformed tooth—and with color matching as well. For more extensive defects you can cover the front of imperfect teeth with bonded porcelain veneers or completely cap a tooth with a custom crown.
Tooth restorations. If you have missing teeth marring your smile, you have several options. The top choice: dental implants, which replaces the root of the tooth and will be able to have a crown attached to it. An implant can thus restore both better function and appearance. For more affordable options, you can also turn to fixed bridges or removable dentures. The latter can be custom designed to replace all the teeth on a jaw arch or just a few in different locations.
Gum enhancements. Teeth aren’t the only part of your smile that might need a helpful touch—your gums’ appearance might also be a problem. There are cosmetic procedures including plastic surgery and tissue grafting that can help correct overly prominent “gummy” smiles or, at the other end of the spectrum, longer appearing teeth because of gum recession.
Orthodontics. If you have extended time before the wedding date, we may be able to correct crooked teeth or a poor bite (malocclusion) that’s adversely impacting your smile. In some cases, you may be able to choose clear aligners, removable plastic trays that are hardly noticeable to others, over more visible braces to correct your bite.
The movie Bohemian Rhapsody celebrates the iconic rock band Queen and its legendary lead vocalist, Freddie Mercury. But when we see pictures of the flamboyant singer, many fans both old and new may wonder—what made Freddie’s toothy smile look the way it did? Here’s the answer: The singer was born with four extra teeth at the back of his mouth, which caused his front teeth to be pushed forward, giving him a noticeable overbite.
The presence of extra teeth—more than 20 primary (baby) teeth or 32 adult teeth—is a relatively rare condition called hyperdontia. Sometimes this condition causes no trouble, and an extra tooth (or two) isn’t even recognized until the person has an oral examination. In other situations, hyperdontia can create problems in the mouth such as crowding, malocclusion (bad bite) and periodontal disease. That’s when treatment may be recommended.
Exactly what kind of treatment is needed? There’s a different answer for each individual, but in many cases the problem can be successfully resolved with tooth extraction (removal) and orthodontic treatment (such as braces). Some people may be concerned about having teeth removed, whether it’s for this problem or another issue. But in skilled hands, this procedure is routine and relatively painless.
Teeth aren’t set rigidly in the jawbone like posts in cement—they are actually held in place dynamically by a fibrous membrane called the periodontal ligament. With careful manipulation of the tooth, these fibers can be dislodged and the tooth can be easily extracted. Of course, you won’t feel this happening because extraction is done under anesthesia (often via a numbing shot). In addition, you may be given a sedative or anti-anxiety medication to help you relax during the procedure.
After extraction, some bone grafting material may be placed in the tooth socket and gauze may be applied to control bleeding; sutures (stitches) are sometimes used as well. You’ll receive instructions on medication and post-extraction care before you go home. While you will probably feel discomfort in the area right after the procedure, in a week or so the healing process will be well underway.
Sometimes, dental problems like hyperdontia need immediate treatment because they can negatively affect your overall health; at other times, the issue may be mainly cosmetic. Freddie Mercury declined treatment because he was afraid dental work might interfere with his vocal range. But the decision to change the way your smile looks is up to you; after an examination, we can help you determine what treatment options are appropriate for your own situation.
If you have questions about tooth extraction or orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Simple Tooth Extraction” and “The Magic of Orthodontics.”
People have depended on dentures for generations—and they still do. That's because they work, both in restoring dental function and a smile marred by missing teeth.
But they have one major drawback related to bone health. That's because living bone has a life cycle: as older cells die, new ones form to take their place. The pressure generated when we chew stimulates this growth. But when this stimulus goes missing along with the teeth, the cell replacement rate slows and bone volume and density gradually diminishes.
Traditional dentures can't transmit this chewing pressure stimulus. And because they rest directly on the gum ridges, they can adversely affect the underlying bone and actually accelerate bone loss.
But implant technology potentially solves this bone loss problem with dentures by using implants rather than the gums to support them. It's a two-fold benefit: first, the implants relieve much of the irritation to the gums and bone caused by traditional dentures. Primarily, though, the implants themselves can slow or even stop continuing bone loss.
Most implants are made of titanium, not only because it's compatible with the body, but also because it has an affinity with bone. Over time bone cells grow on the titanium post imbedded in the jawbone. This process not only creates stability and durability, it can improve bone health.
In recent years dentists have incorporated implants with dentures to create two exciting treatment options. With one option, the dentist installs two or more implants in the jaw, to which a specially fitted removable denture can be attached. You would still have the ease of removing the denture for cleaning, while gaining greater stability and a reduced risk of bone loss.
The other option is a fixed denture (or bridge) attached permanently to implants. For this option, a patient's jawbone must be adequate and healthy enough to support at least four to six implants. A fixed denture is also often costlier and more complex than a removable denture, but it can feel more like real teeth. It also promotes better bone health too.
Although both options are more expensive than traditional dentures, they can pay dividends for long-term dental health. Implants could help you enjoy your new dentures and resulting smile for a long time to come.
If you would like more information on dental implant-supported restorations, 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 “Overdentures & Fixed Dentures.”
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