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.”
Entering your “sunset” years doesn't mean you're washed up—you still have a lot to offer the world. That's why the theme for this May's Older Americans Month (sponsored by the Administration for Community Living) is “Make Your Mark.” And to really make that difference, you'll have to maintain your health—including protecting your teeth from loss.
Once upon a time, it was considered the norm for older adults to experience tooth loss and the resulting consequences on their overall well-being. Today, though, not only can advanced restorations lessen the impact of lost teeth, it's also more likely that you can keep your teeth intact for the rest of your life.
To give your teeth their best chance for survival in your later years, here are 3 things you can do to promote their continuing health.
Brush and floss every day. Ridding your teeth of disease-causing plaque on a daily basis is important at any age, but perhaps even more so as you get older. However, hand weakness caused by arthritis or another health condition can make it more difficult to brush and floss. It may help to use a larger-handled toothbrush or an electric toothbrush, and a threading device may help with flossing. If manual flossing is still too difficult, you can try a water flosser that emits a water stream to loosen and flush plaque away.
Relieve chronic dry mouth. Older adults are more prone to chronic dry mouth because of increased use of medications, many of which interfere with saliva flow. It's more than an unpleasant feeling: Deprived of the protective properties of saliva, your mouth is at increased risk of dental disease. If dry mouth is a problem for you, speak with your doctor about alternatives to any saliva-inhibiting medications you're taking. Also, drink more water and use saliva boosters to promote better saliva flow.
Keep up dental visits. Regular dental visits become even more important as you age. Dental cleanings are especially necessary, particularly if you have dental work that can interfere with plaque removal during brushing and flossing. Disease monitoring and screening are more in-depth for older adults who are more prone to tooth decay, gum disease and oral cancer. And if you wear dentures, you should have them checked regularly for fit and overall condition.
If you've already enjoyed decades of dedicated dental care, you need only stay the course. But even if you haven't, adopting new dental care habits now can boost your teeth's health and longevity. To get started, make an appointment with us: We'll assess your current dental health and offer a care strategy for keeping your teeth healthy through the next exciting season of your life.
If you would like more information about dental care for older adults, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Aging & Dental Health” and “Understanding Aging Makes Beauty Timeless.”
To anyone immersed in the “X-Men Universe” Hugh Jackman will always be Wolverine, a role he played in seven movies. But there’s more to this Australian actor than mutant bone claws and mutton chops that would make Elvis envious. Jackman has also starred in over 20 non-superhero films, including Les Misérables, for which he won a Golden Globe. He is also a Tony award-winning Broadway performer—with a winning smile.
With his famed character Logan/Wolverine fading in the rearview mirror, Jackman has returned to his musical roots. He will play Harold Hill in the Broadway revival of The Music Man, set to open in Fall 2020. And since May 2019 he’s been on world tour with Hugh Jackman: The Man. The Music. The Show., featuring Jackman and a supporting cast performing songs from favorite shows and films, including Les Misérables and the 2017 hit The Greatest Showman.
The Show, with 90 planned stops throughout Europe, North America and Oceania, is a decidedly different “universe” from the X-Men. As Wolverine, Jackman could get away with a scruffier look. But performing as Jean Valjean or the bigger-than-life P.T. Barnum, he has to bring a vastly different look to the role, which brings us to Jackman’s teeth…
Once upon a time, Jackman’s teeth were an unflattering gray—definitely not a good look for stage or film. So with the help of his dentist, Jackman set about upgrading his smile with teeth whitening. Teeth whitening is a great way to take a dull, stained smile and turn up the volume on its brightness—and attractiveness—a notch or two. A dentist applies a bleaching solution that stays in contact with the teeth for a few minutes. The process is often aided by special lighting.
A professional application is especially desirable if, like Jackman, you want “Goldilocks” brightness: not too little, not too much, but just right for you. Dentists can precisely control the tint level to get a brighter but more naturally looking white. Of course, you can also get a dazzling “Hollywood” smile if you so desire.
And although the effect of teeth whitening isn’t permanent, a dental application can last a while, depending on how well you manage foods and beverages that stain teeth. With a touchup now and then, you may be able to keep your brighter smile for years before undergoing the full procedure again.
One important note, though: This technique only works with outer enamel staining. If the discoloration originates from within the tooth, the bleaching agent will have to be placed internally, requiring access to the inside of the tooth. An alternative would be porcelain veneers to mask the discoloration, an option that also works when there is ultra-heavy enamel staining.
If you’re tired of your dull smile, talk with us about putting some pizzazz back into it. Teeth whitening could be your way to get a smile worthy of Broadway.
If you would like more information about teeth whitening, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Whitening Traumatized Teeth.”
If you're one of over 30% of Americans who wince in pain when eating and drinking certain foods and beverages, you may have tooth sensitivity. Although there are a number of possible causes, the most common place to look first is tooth dentin.
Lying just under the enamel, dentin consists of tiny tubules that transmit sensations like pressure or temperature variation to the nerves of the inner pulp. The enamel, the gums and a covering on the roots called cementum help dampen these sensations.
But over-aggressive brushing or periodontal (gum) disease can cause the gums to shrink back (recede) and expose the dentin below the gum line; it can also cause cementum to erode from the roots. This exposure amplifies sensations to the nerves. Now when you eat or drink something hot or cold or simply bite down, the nerves inside the dentin receive the full brunt of the sensation and signal pain.
Enamel erosion can also expose dentin, caused by mouth acid in contact with the enamel for prolonged periods. Acid softens the minerals in enamel, which then dissolve (resorb) into the body. Acid is a byproduct of bacteria which live in dental plaque, a thin film of food particles that builds up on teeth due to poor oral hygiene. Mouth acid may also increase from gastric reflux or consuming acidic foods or beverages.
Once we pinpoint the cause of your tooth sensitivity we can begin proper treatment, first and foremost for any disease that's a factor. If you have gum disease, we focus on removing bacterial plaque (the cause for the infection) from all tooth and gum surfaces. This helps stop gum recession, but advanced cases may require grafting surgery to cover the root surfaces.
You may also benefit from other measures to reduce sensitivity:Â applying less pressure when you brush; using hygiene products like toothpastes that block sensations to the dentin tubules or slow nerve action; and receiving additional fluoride to strengthen enamel.
There are effective ways to reduce your tooth sensitivity. Determining which to use in your case will depend on the cause.
If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity: Understanding Your Options.”
Let's say you have a diseased tooth you think might be on its last leg. It might be possible to save it, perhaps with a significant investment of time and money. On the other hand, you could have it replaced with a life-like dental implant.
That seems like a no-brainer, especially since implants are as close as we have to natural teeth. But you might want to take a second look at salvaging your tooth—as wonderful as implants are, they can't beat the real thing.
Our teeth, gums and jaws form an intricate oral system: Each part supports the others for optimum function and health. Rescuing a troubled tooth could be the best way to preserve that function, and replacing it, even with a dental implant, a less satisfying option.
How we save it will depend on what's threatening it, like advanced tooth decay. Caused by bacterial acid that creates a cavity in enamel and underlying dentin, decay can quickly spread into the tooth's pulp and root canals, and eventually threaten the supporting bone.
We may be able to stop decay and save the tooth with a root canal treatment. During this procedure, we remove diseased tissue from the pulp and root canals through a drilled access hole, and then fill the empty spaces. We then seal the access and later crown the tooth to protect it against future infection.
A second common threat is periodontal (gum) disease. Bacteria in dental plaque infect the outer gums and, like tooth decay, the infection quickly spreads deeper into the root and bone. The disease weakens gum attachments to affected teeth, hastening their demise.
To treat gum disease, we manually remove built-up plaque and tartar (hardened plaque). This deprives the infecting bacteria of their primary food source and “starves” the infection. Depending on the disease's advancement, this might take several cleaning sessions and possible gum surgery to access deep pockets of infection around the root.
Because both of these treatment modalities can be quite in-depth, we'll need to assess the survivability of the tooth. The tooth could be too far gone and not worth the effort and expense to save it. If there is a reasonable chance, though, a rescue attempt for your troubled tooth might be the right option.
If you would like more information on whether to save or replace a tooth, 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 “Save a Tooth or Get an Implant?”
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