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YouDontHavetoLivewithaGummySmileHeresHowWeCanChangeit

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.”

By Daniel J Poticny DDS
April 10, 2019
Category: Oral Health
NBAPlayersInjuryPointsOutNeedforMouthguards

Basketball isn't a contact sport—right? Maybe once upon a time that was true… but today, not so much. Just ask New York Knicks point guard Dennis Smith Jr. While scrambling for a loose ball in a recent game, Smith's mouth took a hit from an opposing player's elbow—and he came up missing a big part of his front tooth. It's a type of injury that has become common in this fast-paced game.

Research shows that when it comes to dental damage, basketball is a leader in the field. In fact, one study published in the Journal of the American Dental Association (JADA) found that intercollegiate athletes who play basketball suffered a rate of dental injuries several times higher than those who played baseball, volleyball or track—even football!

Part of the problem is the nature of the game: With ten fast-moving players competing for space on a small court, collisions are bound to occur. Yet football requires even closer and more aggressive contact. Why don't football players suffer as many orofacial (mouth and face) injuries?

The answer is protective gear. While football players are generally required to wear helmets and mouth guards, hoopsters are not. And, with a few notable exceptions (like Golden State Warriors player Stephen Curry), most don't—which is an unfortunate choice.

Yes, modern dentistry offers many different options for a great-looking, long lasting tooth restoration or replacement. Based on each individual's situation, it's certainly possible to restore a damaged tooth via cosmetic bonding, veneers, bridgework, crowns, or dental implants. But depending on what's needed, these treatments may involve considerable time and expense. It's better to prevent dental injuries before they happen—and the best way to do that is with a custom-made mouthguard.

Here at the dental office we can provide a high-quality mouthguard that's fabricated from an exact model of your mouth, so it fits perfectly. Custom-made mouthguards offer effective protection against injury and are the most comfortable to wear; that's vital, because if you don't wear a mouthguard, it's not helping. Those "off-the-rack" or "boil-and-bite" mouthguards just can't offer the same level of comfort and protection as one that's designed and made just for you.

Do mouthguards really work? The same JADA study mentioned above found that when basketball players were required to wear mouthguards, the injury rate was cut by more than half! So if you (or your children) love to play basketball—or baseball—or any sport where there's a danger of orofacial injury—a custom-made mouthguard is a good investment in your smile's future.

If you would like more information about custom-made athletic mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”

ATraditionalBridgeMightbetheRightSolutionforYourMissingTeeth

We can do a great many things to preserve diseased teeth, from filling cavities to crowning damaged but still viable teeth to protect them and restore their attractiveness. But there may come a point where continued treatment just isn't worth it, and it may be time to remove and replace your troubled teeth.

Dental implants have become the premier restoration for missing teeth. But they have some anatomical limitations and may not work for some situations like excessive bone loss or close nerve proximity. And while a removable partial denture is a solid option, perhaps you'd rather have a fixed solution.

You might then want to consider a fixed bridge to replace one or more missing teeth. This tried and true option has been a mainstay in dentistry for several decades; and while implants may have surpassed them in popularity, they're still available and effective as a restorative option.

A traditional fixed bridge is composed of three or more life-like crowns that are fused together like pickets in a fence. The crown or crowns in the middle fill the empty tooth space; the outside crowns fit over and are bonded to the natural teeth on either side of the empty space to support the bridge. These natural teeth must be reduced in size to accommodate the crowns to fit over them.

Depending on how many teeth are missing, fixed bridges can be a more affordable alternative to dental implants and can achieve life-like results in both form and dental function. But the alterations required for the supporting teeth are permanent and can weaken them. The interface between the natural teeth and the bridge crowns has a higher risk of decay and periodontal disease, so you'll need to be extra vigilant with daily hygiene and regular dental cleanings and checkups.

And even though implants can be more expensive in the short-term, they typically have better durability and less maintenance costs than other restorations. Over the long-term, an implant restoration might actually incur less cost than a fixed bridge.

Still, a fixed bridge can be an effective way to replace missing teeth. Depending on your finances and your overall dental health, a bridge could help you regain an attractive smile.

If you would like more information on options for replacing missing teeth, 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 “Crowns & Bridgework.”

DontPanicTakeMethodicalApproachtoHelpYourChildStopThumbSucking

One of the most frequent concerns parents express to us is their child’s thumb or finger sucking habit. The good news, though, is that thumb sucking is a completely normal activity for babies and young children, and if they stop by age 4 it should have no adverse effects on their future bite.

In fact, there are positive aspects to thumb sucking: it provides babies with a sense of security, as well as a way to learn about the world. As a child grows and becomes more confident with their surroundings, the thumb sucking habit will fade and eventually stop: for most children this occurs between the ages of two and four.

If, however, the habit continues later in childhood, there is a chance the upper front teeth may be influenced to tip toward the lip during eruption and come into an improper position that could also adversely affect jaw development. The same concern exists for pacifier use — we recommend weaning a child off a pacifier by the time they’re eighteen months of age.

If your child still has a thumb or finger sucking habit as they prepare to enter school, it’s quite appropriate to work on getting them to stop. Punishment, shaming or similar negative approaches, however, aren’t the best ways to accomplish this: it’s much more effective to try to modify their behavior through reward, praise or some creative activity.

Another factor that may help is to begin regular dental visits around their first birthday. Regular checkups give us a chance to monitor the development of their bite, especially if thumb sucking continues longer than normal. We can also assist you with strategies to encourage them to stop thumb sucking or pacifier use.

Thumb sucking that continues later than normal isn’t a cause for panic, but it does require attention and action. Helping your child “grow” past this stage in their life will improve their chances of developing a normal and healthy bite.

If you would like more information on thumb sucking, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Thumb Sucking in Children.”

YoullExperienceLittletoNoDiscomfortDuringandAfterImplantSurgery

You’ve decided to obtain dental implants for your missing teeth. It’s a good choice — they provide the closest restoration to the function and appearance of natural teeth. You will, however, need to undergo a surgical procedure to imbed the implants’ threaded titanium posts into supporting bone.

It’s understandable if you’re a little apprehensive about undergoing surgery. We’re here, though, to set your mind at ease: implantation is a relatively minor procedure carefully planned in advance. Most patients experience no discomfort during the procedure and very little afterward.

We begin by completely numbing the surgical site with a local anesthetic. If you have a high level of anxiety, we can also administer a sedative or similar medication to help you relax. We then access the underlying bone through a series of incisions that create a flap in the gum tissue that we’ll later suture closed.

It’s quite common to have prepared a surgical guide or template beforehand. The template placed in the mouth marks the exact site for a small channel (or hole) we create in the bone. We then incrementally increase the size of the hole by drilling until it matches precisely the implant’s size and shape. This takes time to avoid overheating and damaging the bone.

We then remove the implant from its sterile packaging and insert it into the opening. We’ll also take x-rays to ensure correct positioning, which is critical for achieving an attractive result. We then suture the gum flap in place using stitches that will eventually dissolve. The implant will then integrate with the bone for a few weeks to create a strong, durable hold before we continue with the restoration.

Most patients can manage any post-surgical discomfort with mild anti-inflammatory pain relievers like aspirin or ibuprofen, although we can prescribe something stronger if you need it. We may also prescribe a mouthrinse with an anti-bacterial agent like chlorhexidine for you to use while the gums are healing to reduce the risk of infection.

Implant surgery is part of a long process that will eventually result in regaining the function of your lost teeth. What’s more, undergoing this minor procedure will also help you regain something just as important — a beautiful smile.

If you would like more information on dental implant restoration, 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 Implant Surgery.”





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