Posts for: May, 2018
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.”
If you've suddenly noticed your smile looking more “toothy,” you may have a problem with your gums. They may have lost their normal attachment to your tooth and begun to shrink back — or recede.
Millions of people have some form of gum recession. The most common cause is periodontal (gum) disease, but it's not the only one. You may be more susceptible to gum recession because of heredity — you have thin gum tissues passed down to you from your parents. You may also be brushing too hard and too often and have damaged your gums.
Healthy gums play an important role in dental health. The crown, the tooth's visible part, is covered with a hard, protective shell called enamel. As the enamel ends near where the root begins, the gums take over, forming a tight band around the tooth to protect the roots from bacteria and acid.
Receding gums expose these areas of the tooth meant to be covered. This can lead to another tell-tale sign — tooth sensitivity. You begin to notice pain and discomfort while you consume hot or cold foods. And because it leaves your teeth and gums looking much less attractive, it can affect your confidence to smile.
Fortunately, though, we can help restore receded gums. If you have gum disease, it's imperative we treat it as early as possible. We do this by removing plaque, a thin film of bacteria and food particles that triggers the infection. We use special techniques and hand instruments to remove plaque and calculus (hardened plaque deposits) from all tooth surfaces including along the roots.
Gum disease treatment can help stop and even reverse gum recession. In some cases, though, the recession may have advanced too far. If so, we may need to consider surgically grafting donor tissue to the recessed areas. Depending on the site and extent of recession, this can be a very involved procedure requiring microscopic techniques.
The best approach, though, is to take care of your gums now. Daily brushing and flossing removes harmful plaque; regular dental visits take cleaning a step further and also give us an opportunity to detect disease early. By looking out for your gums now you might be able to avoid gum recession in the future.
In 2016, voters in three states—California, Massachusetts and Nevada—joined Alaska, Colorado, Oregon, Washington and the District of Columbia in legalizing the use of recreational marijuana. These referenda moved the country closer to what may soon be a monumental political showdown between the states and the federal government, which still categorizes marijuana as a controlled substance.
But there’s another angle to this story often overshadowed by the political jousting: is increased marijuana use a good thing for your health and overall physical well-being?
When it comes to your dental health, the answer might be no. The Journal of Periodontology recently published a study that included frequent marijuana users showing increased signs of periodontal (gum) disease. This harmful bacterial infection triggered by plaque buildup can cause weakening of gum attachment to teeth and create the formation of large voids between teeth and gums called periodontal pockets. Left untreated, the disease can also cause supporting bone loss and eventually tooth loss.
The study looked at the dental treatment data of over 1,900 adults of which around one-quarter used marijuana once a month for at least a year. Marijuana users in the study on average had 24.5% of pocket sites around their teeth with depths of at least eight millimeters (an indication of advanced gum disease). In contrast, non-users averaged around 18.9% sites.
To be sure, there are several risk factors for gum disease like genetics, oral hygiene (or lack thereof), structural problems like poor tooth position or even systemic conditions elsewhere in the body. This published study only poses the possibility that marijuana use could be a risk factor for gum disease that should be taken seriously. It’s worth asking the question of whether using marijuana may not be good for your teeth and gums.