Even with picture perfect teeth, you may still be unhappy with your appearance. The problem: too much of your upper gums show when you smile.
There’s no precise standard for a “gummy smile”—it’s often a matter of perception. As a rule of thumb, though, we consider a smile “gummy” if four or more millimeters of upper gum tissue show while smiling. In any event if you perceive you have a gummy smile, it can greatly affect your self-confidence and overall well-being.
The good news is we can often correct or at least minimize a gummy smile. The first step, though, is to find out why the gums are so prominent.
There are a few possible causes: the most obvious, of course, is that there’s more than normal gum tissue present. But the cause could be the front teeth didn’t fully erupt in childhood and so the gums appear more prominent. Other causes include the upper lip moving too far upward when smiling (hypermobile) or an elongated upper jaw that’s out of proportion with the face.
Finding the exact cause or combination of causes will determine what approach we take to minimize your gummy smile. If too much gum tissue or not enough of the teeth show, we can use a surgical procedure called crown lengthening to expose more of the crown (the visible part of a tooth), as well as remove excess gum tissues and reshape them and the underlying bone for a more proportional appearance.
A hypermobile upper lip can be treated with Botox, a cosmetic injection that temporarily paralyzes the lip muscles and restricts their movement. But for a permanent solution, we could consider a surgical procedure to limit upper lip movement.
Surgery may also be necessary for an abnormal jaw structure to reposition it in relation to the skull. If, on the other hand it’s the teeth’s position and not the jaw causing gum prominence, we may be able to correct it with orthodontics.
As you can see, there are several ways varying in complexity to correct a gummy smile. To know what will work best for you, you’ll need to undergo an orofacial examination to determine the underlying cause. It’s quite possible there’s a way to improve your smile and regain your self-confidence.
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.”
It takes only a few days of inadequate oral hygiene for bacterial plaque to trigger the periodontal (gum) disease gingivitis. Though sometimes subtle, there are signs to watch for like inflamed, reddened or bleeding gums.
Untreated gingivitis can develop into more advanced forms of gum disease that infect deeper levels of the gums and supporting bone and ultimately cause bone and tooth loss. Fortunately, though, prompt treatment by a dentist removing plaque from teeth and gums, along with you reinstituting daily brushing and flossing, can stop gingivitis and help restore health to your gums.
If you’re under acute stress or anxiety, however, basic gingivitis can develop into something much more serious and painful, a condition called Acute Necrotizing Ulcerative Gingivitis (ANUG). It’s also known as “trench mouth” from its common occurrence among World War I soldiers experiencing stressful periods in front line trenches without the means for proper oral hygiene.
ANUG develops from a “perfect storm” of conditions: besides anxiety and deficient hygiene practices, ANUG has a high occurrence risk in people who smoke (which dries the mouth and changes the normal populations of oral bacteria) or have issues with general health or nutrition.
In contrast to many cases of basic gingivitis, ANUG can produce highly noticeable symptoms. The gum tissues begin to die and become ulcerative and yellowish in appearance. This can create very bad breath and taste along with extreme gum pain.
The good news is ANUG can be treated and completely reversed if caught early. In addition to plaque removal, the dentist or periodontist (a specialist in the treatment of gum disease) may prescribe antibiotics along with an antibacterial mouthrinse to reduce bacteria levels in the mouth. A person with ANUG may also need pain relief, usually with over-the-counter drugs like aspirin or ibuprofen.
It’s important that you seek treatment as soon as possible if you suspect you have ANUG or any gum disease. It’s possible to lose tissue, particularly the papillae (the small triangle of tissue between teeth), which can have an adverse effect on your appearance. You can also reduce your risk by quitting smoking, addressing any stress issues, and practicing diligent, daily oral hygiene and visiting your dentist for cleanings and checkups twice a year or more if needed.
If you would like more information on the signs and treatments for gum disease, 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 “Painful Gums in Teens & Adults.”
On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.
“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”
Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.
Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.
A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.
Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.
So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.
If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”
The month of May has been designated “Better Speech & Hearing Month” by the American Speech-Language-Hearing Association. Why would this be of interest to dental professionals? Because teeth are vital for good speech, and missing teeth can make it very hard to speak properly.
Speech is all about sounds, and forming sounds correctly requires proper positioning of oral structures such as the lips, tongue and teeth. For example, there are some words that are almost impossible to pronounce correctly without touching your tongue to your teeth. In fact, one of the hardest words to say without teeth…is teeth!
Missing teeth can affect speech indirectly as well, by reducing self-confidence. People who are missing front teeth often develop the habit of talking behind their hand or mumbling to avoid revealing the gap in their smile. Not being able to speak clearly and confidently can affect not only your appearance, but also your job prospects and social life. So what can you do about missing teeth?
Dental implants are today’s preferred tooth-replacement method. Implants are small titanium posts that are inserted in the jaw bone beneath your gums. They serve as “roots” to hold realistic-looking prosthetic (artificial) teeth in place. Implants can be used to replace one tooth, a group of teeth, or an entire row of teeth (upper or lower). Sometimes a dental implant can be placed the same day a failing tooth is removed so that you won’t need a second surgical procedure.
The healthy natural teeth on either side of the gap can also be used to support one or more replacement teeth. This method, called bridgework, can be used to replace a single tooth or several teeth in a row. Another option is removable dentures, which do not stay in the mouth all the time.
Each of these options has its benefits and risks. We’d be happy to discuss all of them in detail and help you decide which would be best in your own situation. To learn more about tooth replacement, please contact us or schedule a consultation. You can also read the Dear Doctor magazine articles “Dental Implant Surgery” and “New Teeth in One Day.”
There’s more to teeth than meets the eye. Hidden beneath the visible crown are the tooth’s roots set within the jawbone, secured and protected by the gums from bacteria and infection. But if the gums shrink back (recede), the roots become exposed and susceptible to disease, especially at the points where multiple roots branch from each other, areas called furcations.
It all begins with periodontal (gum) disease caused by built-up bacterial plaque from insufficient brushing and flossing. The infection triggers inflammation that over time weakens gum tissues. They begin to detach from the teeth, which can eventually lead to gum recession and root exposure.
This also causes bone loss, especially at the furcations. We can detect any loss (known as a furcation invasion) and how far along it may be with x-ray imaging or by manually probing with an instrument called a periodontal probe.
There are three general classes measuring furcation invasions. In the earliest, Class I, we can feel the invasion as a slight groove; in Class II, it increases to two or more millimeters across. In Class III the bone loss extends from one side of the root all the way to the other (a “through and through”).
At this stage a patient is in danger of losing the tooth, so we’ll have to act promptly. This means first removing accumulated dental plaque and calculus (tartar) to stop the infection and allow the gums to heal. With severe damage, we may need to assist healing with bone and gum tissue grafting, in which we place donor grafts to serve as scaffolding for the appropriate tissue to grow upon.
You can help prevent this situation by practicing effective daily hygiene and visiting your dentist for thorough cleanings at least twice a year (or more if recommended). And at the first signs of a gum infection—swollen, reddened or bleeding gums—make an appointment as soon as possible to have it checked. The sooner we can detect and treat gum disease, the less likely a furcation invasion or worse will be in your future.
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