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.”
Applying braces or clear aligners to move misaligned teeth is only part of an orthodontist's overall mission to eliminate poor bites (malocclusions). Sometimes a malocclusion isn't caused by the teeth at all—the size of the jaw is the problem!
One type in particular, a cross-bite, often happens because the upper jaw has developed too narrowly. As a result, many of the upper teeth fit inside the lower, the opposite of normal. But a tool called a palatal expander can alleviate the problem if it's applied at an early enough age.
The device works because the upper jawbone initially forms as two halves that fit together along a center line in the roof of the mouth (the palate) running from the back of the mouth to the front. These two bone halves remain separate during childhood to facilitate jaw growth, but eventually fuse around puberty.
Consisting of two sets of wire arms joined together by a hinge mechanism in the middle, the expander device is positioned up against the palate. The orthodontist extends each arm to press against the inside of the back teeth, then adds more outward pressure by turning the mechanism in the middle with a small key. During wear, the patient or caregiver will turn the mechanism in the same way to keep up the pressure on the two sides of the jaw.
This continual pressure keeps the two bones moving away from each other and maintaining a center gap between them. In response, more bone forms on the two halves to fill the gap. In time, the newly formed bone should widen the jaw enough to correct any developing malocclusion.
Timing is everything with a palatal expander—if not used before the jaw bones fuse, the patient will need a surgical procedure to separate the bones to pursue treatment. To catch the problem early enough, children should have an orthodontic evaluation on or before they turn six. An orthodontist may be able to identify this or other emerging bite problems and intervene before it becomes worse. Taking this approach can help save you and your child more expensive orthodontic treatment down the road.
If you would like more information on correcting poor bites, 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 “Palatal Expanders: Orthodontics is more than just Moving Teeth.”
When they’re introducing a new movie, actors often take a moment to pay tribute to the people who helped make it happen — like, you know, their dentists. At least that’s what Charlize Theron did at the premiere of her new spy thriller, Atomic Blonde.
"I just want to take a quick moment to thank my dentists," she told a Los Angeles audience as they waited for the film to roll. "I don’t even know if they’re here, but I just want to say thank you."
Why did the starring actress/producer give a shout-out to her dental team? It seems she trained and fought so hard in the action sequences that she actually cracked two teeth!
“I had severe tooth pain, which I never had in my entire life,” Theron told an interviewer from Variety. At first, she thought it was a cavity — but later, she found out it was more serious: One tooth needed a root canal, and the other had to be extracted and replaced with a dental implant — but first, a bone grafting procedure was needed. “I had to put a donor bone in [the jaw] to heal,” she noted, “and then I had another surgery to put a metal screw in there.”
Although it might sound like the kind of treatment only an action hero would need, bone grafting is now a routine part of many dental implant procedures. The reason is that without a sufficient volume of good-quality bone, implant placement is difficult or impossible. That’s because the screw-like implant must be firmly joined with the jawbone, so it can support the replacement tooth.
Fortunately, dentists have a way to help your body build new bone: A relatively small amount of bone material can be placed in the missing tooth’s socket in a procedure called bone grafting. This may come from your own body or, more likely, it may be processed bone material from a laboratory. The donor material can be from a human, animal or synthetic source, but because of stringent processing techniques, the material is safe for human use. Once it is put in place your body takes over, using the grafted material as a scaffold on which to build new bone cells. If jawbone volume is insufficient for implants, it can often be restored to a viable point in a few months.
Better yet, when grafting material is placed in the tooth socket immediately after extraction, it can keep most of the bone loss from occurring in the first place, enabling an implant to be placed as soon as possible — even before the end of a movie’s shooting schedule.
Will Atomic Blonde prove to be an action-movie classic? Only time will tell. But one thing’s for sure: When Charlize Theron walks down the red carpet, she won’t have to worry about a gap in her smile.
If you have questions about bone grafting or dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Immediate Dental Implant.”
Lately, you’ve noticed your young child’s primary teeth don’t appear to be coming in straight. Is it a problem?
The answer to that question is best answered by an early orthodontic evaluation performed by an orthodontist. It’s advisable for a child as young as 7 to undergo such an exam.
While a child’s primary teeth have a short life span of a few years, that doesn’t make them less important than the permanent teeth that replace them. In fact, they’re extremely influential for permanent tooth development — each one serves as a guide for its replacement to erupt in a proper position. A future malocclusion (bad bite) that becomes more apparent later in life would have been well underway years before.
Orthodontists have the training and expertise to spot these emerging problems in their early stages. Early detection can reduce the extent — and costliness — of future orthodontic treatment by introducing preventative or interceptive measures — even while there’s still a mix of primary and permanent teeth in the mouth. For example, a child wearing a simple type of retainer that influences the development of the bite could minimize or even correct a growing malocclusion.
You can also take advantage of opportunities to discover potential orthodontic problems early through a general or pediatric dentist. By having regular dental cleanings and checkups, the dentist might observe early bite development that should be reviewed by an orthodontist. If not, it’s still a good idea to undergo an orthodontic evaluation no later than age 7.
Given the stage of jaw and facial structure development, waiting until puberty to focus on orthodontic problems may be too late for some problems — and much more expensive than if caught and treated earlier. Getting ahead of these issues earlier in your child’s dental development will help ensure they’ll have a healthy bite throughout their life.
If you would like more information on early orthodontic monitoring, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Early Orthodontic Evaluation” and “Preventative & Cost Saving Orthodontics.”
It might not rise to the level of a miracle, but cosmetic dentistry can achieve some amazing outcomes with unattractive teeth. A skilled and experienced dentist can turn "ugly ducklings" into beautiful "swans." And that achievement might not be as in-depth or expensive as you might think, thanks to the increased use of dental materials called composite resins.
Composite resins are pliable, tooth-colored materials we apply directly to tooth surfaces. They're most often used with broken, chipped or misshapen front teeth—the composite material replaces the missing tooth structure.
Composite resins have been around for decades, but haven't been widely used because they didn't have the strength of dental porcelain. In recent years, though, dentists have perfected techniques for bonding and shaping composites to teeth that have increased their durability. With just the right skill and artistry, composites can look like natural teeth.
We can correct many tooth flaws using composite resins right in our office. After roughening up the outer enamel surface of the tooth and performing other steps to aid bonding, we begin applying liquid resins to form a base layer that we then harden with a special light source. We continue to add layers to increase the color depth and shape of the restoration, before finally polishing it to resemble natural teeth.
Composite restorations are ideal for moderate tooth structure loss, but may not be appropriate for heavily worn, previously root canal-treated or fractured teeth. These and other kinds of flaws may require a different solution such as a dental porcelain restoration with veneers or crowns. Where composites can be used, though, they provide an affordable option that doesn't require an outside dental lab for fabrication—we can often perform it in one visit.
If you'd like to consider a composite resin restoration for a less than perfect tooth, see us for a complete examination and consultation. If your situation appears to be compatible for using this particular technique, composite resins could change your smile for the better in just a few minutes.
If you would like more information on how we can improve your 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 “Artistic Repair of Front Teeth with Composite Resin.”
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