Besides straight and translucent teeth, an attractive smile has another important component: balance. In a great smile, the visible areas of the teeth and gums are in balanced proportion to one another.
But what is the ideal proportion between teeth and gums? Although aesthetic appeal is largely “in the eye of the beholder,” dental professionals typically consider a properly sized tooth to be around 10 mm in visible length. As for the upper gums, no more than 4 mm of tissue should show when smiling. Teeth appearing shorter than 10 mm or the gums displaying more than 4 mm can create an effect called a “gummy smile.”
Fortunately, there are different approaches for correcting a gummy smile, depending on what's causing the appearance of gumminess. Not only are there different causes, but they can be diverse in nature.
Obviously, an actual excess of gum tissue can cause a smile to look gummy—but so can shortened teeth. One possible solution called crown lengthening could help correct either possibility. During the procedure, we remove any excess gum tissue or reposition the gums after reshaping the underlying bone to reveal more of the tooth crown. Worn or shortened teeth can also be made to look longer with porcelain veneers.
A gummy smile could also be caused by a hypermobile lip, in which the lip rises higher than normal while smiling. We may be able to prevent this temporarily by injecting Botox into the lip muscles, which paralyzes them and inhibits their ability to move upward. A more permanent approach is to surgically restrict the upward movement of the lip muscles.
The gums may also seem too prominent if the upper jaw is longer in proportion to the face. One way to correct this is orthognathic surgery, a procedure that moves the upper jaw to a higher position on the skull. This can reduce the jaw profile with the face and subsequently affect how much of the gums show while smiling.
These solutions range from relatively minor to significantly invasive. The first step, though, is to find out what's really behind your gummy smile before taking the next step to make it more attractive.
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.”
Although we've known for some time how tooth decay forms, it's still prevalent across the population—even more so than cancer or heart disease. Along with gum disease, it's a leading cause of tooth loss.
Fortunately, our knowledge about tooth decay has grown considerably, to the point that we now recognize a number of risk factors that make it more likely a person will develop this disease. By first identifying them in individual patients, we can take steps to address them specifically to reduce the chances of this destructive disease.
Genetics. Researchers have identified around 40 to 50 genes that can influence cavity development. The best way to assess your genetic risk is through family history—if numerous close family members contend with tooth decay, your risk may be high. If so, it's important to be extra vigilant with addressing other areas over which you have more control.
Saliva. Cavities are directly caused by oral acid, a byproduct of bacteria, that can erode tooth enamel over prolonged contact. This is minimized, though, through a normal saliva flow that neutralizes acid and helps remineralize enamel. But poor saliva production can slow acid neutralization. You can improve your saliva flow by drinking more water, changing medications or using saliva-boosting products.
Oral hygiene. You can reduce bacteria (and thus acid) by removing their "room and board"—dental plaque. This accumulating film of food particles harbors the bacteria that feed on it. Daily brushing and flossing, accompanied by regular dental cleanings, effectively removes dental plaque, which in turn lowers the levels of oral bacteria and acid.
Dental-friendly diet. Even if you diligently address the previous risk factors, your diet may fight against your efforts. Diets high in processed and refined foods, especially sugar, provide abundant food sources for bacteria. On the other hand, a diet primarily of whole foods rich in vitamins (especially D) and minerals like calcium and phosphorous strengthen teeth against decay.
Preventing tooth decay isn't a "one-size-fits-all" approach. By identifying your own particular risk, we can craft a care strategy that can be your best defense against this destructive dental disease.
Around one in ten U.S. adults have diabetes, a metabolic disease that can disrupt other aspects of a person's health like wound healing and vision. It could also cause complications with dental implants, the premier replacement choice for missing teeth.
There are two basic types of diabetes. In type 1 diabetes, the pancreas stops producing insulin, a hormone needed to regulate the amount of sugar glucose in the bloodstream. With the more prevalent type 2 diabetes, the body either doesn't produce enough insulin or doesn't respond efficiently to the insulin produced.
Uncontrolled diabetes can contribute to several dangerous health conditions. In addition to vision impairment and poor wound healing, diabetics are at higher risk for other problems like kidney disease or nerve damage. Drastic swings in blood glucose levels can also cause coma or death.
Many diabetics, though, are able to manage their condition through diet, exercise, medications and regular medical care. Even so, they may still encounter problems with wound healing, which could complicate getting a dental implant.
An implant is composed of a titanium metal post imbedded into the jawbone. Because of its affinity with titanium, bone cells naturally grow and adhere to the implant's metal surface. Several weeks after implant surgery, enough bone growth occurs to fully secure the implant within the jaw.
But this integration process may be slower for diabetics because of sluggish wound healing. It's possible for integration to not fully occur in diabetic patients after implant surgery, increasing the risk of eventually losing the implant.
Fortunately, though, evidence indicates this not to be as great a concern as once thought. A number of recent group studies comparing diabetic and non-diabetic implant patients found little difference in outcomes—both groups had similar success rates (more than 95 percent).
The only exception, though, were diabetic patients with poor glucose control, who had much slower bone integration that posed a threat to a successful implant outcome. If you're in this situation, it's better if you're first able to better control your blood glucose levels before you undergo surgery.
So, while diabetes is something to factor into your implant decision, your chances remain good for a successful outcome. Just be sure you're doing everything you can to effectively manage your diabetes.
If you would like more information on diabetes and dental health, 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 “Dental Implants & Diabetes.”
Since his breakout role as Dr. Doug Ross in the 90's TV drama ER, George Clooney has enjoyed a blockbuster career as an award-winning actor, director and producer. He's still going strong, as seen in the recent film The Midnight Sky, which Clooney directed and starred in. This sci-fi drama set a record as the most-watched movie on Netflix for the first five days after its late December release. And although now well into middle age, Clooney still possesses a winsome charm epitomized by his devil-may-care smile.
But he didn't always have his enigmatic grin. Early on, his struggles pursuing his burgeoning acting career triggered a stressful habit of grinding his teeth. This took a toll, as his teeth began to look worn and yellowed, giving his smile—and him—a prematurely aged appearance.
Clooney's not alone. For many of us, our fast-paced lives have created undue stress that we struggle to manage. This pent-up stress has to go somewhere, and for a number of individuals it's expressed through involuntary grinding or gritting of the teeth. This may not only lead to serious dental problems, but it can also diminish an otherwise attractive smile.
There are ways to minimize teeth grinding, the most important of which is to address the underlying stress fueling the habit. It's possible to get a handle on stress through professional counseling, biofeedback therapy, meditation or other relaxation techniques. You can also reduce the habit's effects with a custom-made oral device that prevents the teeth from making solid contact during a grinding episode.
But what if teeth grinding has already taken a toll on your teeth making them look worn down? Do what Clooney did—put a new “face” on your teeth with dental veneers. These thin layers of porcelain are bonded to teeth to mask all sorts of blemishes, including chips, heavy staining and, yes, teeth that appear shortened due to accelerated wearing. And they're custom-designed and fashioned to blend seamlessly with other teeth to transform your smile. Although they're not indestructible, they're quite durable and can last for years.
Veneers can correct many mild to moderate dental defects, but if your teeth are in worse shape, porcelain crowns may be the answer. A crown, which bonds to a prepared tooth to completely cover it, allows you the advantage of keeping your natural tooth while still enhancing its appearance.
Although different in degree, both veneers and crowns require permanently altering the teeth, such that they will require a dental restoration from then on. But if you're looking for an effective way to transform your worn or otherwise distressed teeth into a beautiful smile, it's a sound investment.
Just like George Clooney, your smile is an important part of who you are. We can help you make it as appealing as possible with veneers or other dental enhancements. Call us today to get started on the path to a more attractive smile.
If you would like more information about dental veneers and other smile enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Veneers.”
A wise sage once said the largest room in the world is the "room for improvement." Indeed, many modern advances would never have happened if someone hadn't first asked, "How can I make this better?"
Dentures and bridges are a case in point. Both of these tooth replacement methods have a long, successful track record in restoring functional, life-like teeth. But a recent development has made them even better: the incorporation of dental implants.
Most people associate implants, metallic posts imbedded in the jawbone, with single tooth replacements. But a few strategically placed implants can connect to and support a full removable denture (or overdenture). We can also use them to permanently affix a full or partial bridge without altering any remaining teeth as with a regular bridge.
There are two great benefits to using implants in this way. The most obvious is that they provide greater support for restorations than the traditional means for securing them in place. But there's also a less obvious benefit: They help sustain and improve bone health.
When you lose teeth, there's a high probability of bone loss. The bone is constantly forming new cells to replace older cells that have dissolved. The forces generated during chewing travel up through the teeth and help stimulate new bone growth. When teeth go missing, though, that stimulus disappears.
As a result, new cell formation can't keep up with the loss of older cells, causing the volume and density of jawbone to diminish over time. And this gradual bone loss continues to occur even with dentures or bridges, which can't replicate the chewing stimulus. Even worse, dentures irritating the bony ridges of the jaw may actually accelerate bone loss.
But the titanium in dental implants attracts bone cells, which readily grow and adhere to the implant surface. They can stop the progression of bone loss, or even help stimulate more growth. That bone growth benefit is also applicable when incorporated with dentures or bridges.
If you're looking at a denture or bridge restoration, consider implant support. It may even be possible to retrofit your existing dentures for implants. It could give you a more secure restoration and healthier bone.
If you would like more information on implant-supported dentures and bridges, 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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