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.”
Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.
“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into cavities. How did this happen?
Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.
While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods. Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.
This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”
Here are some other basics of infant dental care that every parent should know:
- Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
- Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
- Start regular dental checkups by the first birthday.
Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.
“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”
If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”
Although preventable, the occurrences of tooth decay are all too common. Yet decay doesn’t appear out of the blue: certain mouth conditions set the disease in motion.
Here are a few signs of such conditions to watch for — they could be telling you you’re at higher risk for tooth decay.
Visible plaque. Plaque is a thin film of bacteria and food accumulating on tooth surfaces and a prime haven for causing periodontal disease. If you actually see it — a crusty, yellowish film — that means there’s a large, unhealthy amount of it. It’s essential to remove it daily through diligent brushing and flossing and more thorough office cleanings at least twice a year.
Poor saliva flow. One of this bodily fluid’s functions is to neutralize mouth acid, usually thirty minutes to an hour after we eat. If saliva flow is inadequate, though, acid levels may remain high and endanger the enamel. “Dry mouth” can occur from a number of causes, including some medications and chemotherapy treatments. It’s important to alleviate the cause if possible by changing medications or stimulating saliva flow through other means.
Tooth shape and appliances. Largely determined by heredity, your teeth contain unique, tiny grooves known as pits and fissures that could harbor plaque. Certain appliances like retainers, braces or night guards can inhibit saliva flow and cause your teeth to retain more plaque. It’s important then to adjust your hygiene efforts to offset these anatomical or treatment factors.
Acid-producing conditions. Diseases like gastro-esophageal reflux disease (GERD) or eating disorders can introduce stomach acid into the mouth that is highly erosive to tooth enamel. It’s imperative for you or a family member to control these conditions through medication, dietary changes, or — in the case of eating disorders — behavioral therapy.
Eating habits. Sugar and other carbohydrates are a ready food source for bacteria. Likewise, acidic foods and beverages (like coffee, tea, and sports or energy drinks) can cause high acid levels for too long. Cut back on eating and drinking these foods and beverages, especially as snacks, to reduce acid levels that could lead to decay.
If you would like more information on strategies to prevent tooth decay, 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 “Tooth Decay: How to Assess Your Risk.”
So you’re tearing up the dance floor at a friend’s wedding, when all of a sudden one of your pals lands an accidental blow to your face — chipping out part of your front tooth, which lands right on the floorboards! Meanwhile, your wife (who is nine months pregnant) is expecting you home in one piece, and you may have to pose for a picture with the baby at any moment. What will you do now?
Take a tip from Prince William of England. According to the British tabloid The Daily Mail, the future king found himself in just this situation in 2013. His solution: Pay a late-night visit to a discreet dentist and get it fixed up — then stay calm and carry on!
Actually, dental emergencies of this type are fairly common. While nobody at the palace is saying exactly what was done for the damaged tooth, there are several ways to remedy this dental dilemma.
If the broken part is relatively small, chances are the tooth can be repaired by bonding with composite resin. In this process, tooth-colored material is used to replace the damaged, chipped or discolored region. Composite resin is a super-strong mixture of plastic and glass components that not only looks quite natural, but bonds tightly to the natural tooth structure. Best of all, the bonding procedure can usually be accomplished in just one visit to the dental office — there’s no lab work involved. And while it won’t last forever, a bonded tooth should hold up well for at least several years with only routine dental care.
If a larger piece of the tooth is broken off and recovered, it is sometimes possible to reattach it via bonding. However, for more serious damage — like a severely fractured or broken tooth — a crown (cap) may be required. In this restoration process, the entire visible portion of the tooth may be capped with a sturdy covering made of porcelain, gold, or porcelain fused to a gold metal alloy.
A crown restoration is more involved than bonding. It begins with making a 3-D model of the damaged tooth and its neighbors. From this model, a tooth replica will be fabricated by a skilled technician; it will match the existing teeth closely and fit into the bite perfectly. Next, the damaged tooth will be prepared, and the crown will be securely attached to it. Crown restorations are strong, lifelike and permanent.
Was the future king “crowned” — or was his tooth bonded? We may never know for sure. But it’s good to know that even if we’ll never be royals, we still have several options for fixing a damaged tooth. If you would like more information, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Crowns and Bridgework.”
A comedian once quipped "I know how hard it is to quit smoking; it's as hard as it is to start flossing!" Brushing our teeth has been a habit since childhood; we know to do it each morning and night, and between meals sometimes. But why is it so difficult to start flossing? Dr. John Leitner, your general dentist in Grand Haven, MI, believes that educating patients is the key to helping them make good decisions about their dental care. Here, he explains the importance of flossing each day.
Why is flossing important?
It may seem like brushing your teeth is enough to keep them clean. However, the bristles of a toothbrush can often miss the spaces in between teeth, allowing plaque to collect in these tiny crevices. It only takes about 24 hours before plaque begins to harden into tartar, a chalky substance that contains harmful bacteria that attacks the gum tissue and enamel on the teeth. Without the intervention of a dental hygienist at your Grand Haven general dentist's office to remove this tartar, it can advance into serious gum disease and tooth loss.
I can never remember to floss!
This is a comment we hear frequently from our patients at Dr. John Leitner's dental office. Your Grand Haven general dentist has a few tips for those who can't seem to get into the habit of flossing.
- Choose a time that's convenient for you. It doesn't matter what time of the day you floss; the most important thing is to do it daily to break up the plaque formations.
- Carry floss with you. Don't confine your flossing to the bathroom. While the spool floss can be unwieldy, flossing picks are easy to stash in a pocket or purse, or next to your bed to use at night while unwinding.
- Check it off. Make a notation in your digital or paper calendar for every day you floss. This visual reminder can motivate you to keep going and turn flossing into a habit.
If you'd like more information on the best flossing techniques or any other dental care procedure, contact the office of Dr. John Leitner, your general dentist in Grand Haven, MI.
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