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Choose A Periodontist To Correct A Gummy Smile


Posted on Aug 29, 2022 by William J. Claiborne, DDS MS

About Periodontal Plastic Surgery

When Lauren Hutton, the model well-known for a space between her front teeth, began modeling, she felt she needed to camouflage the gap (or “diastema”). Yet, she soon began to feel it was a unique feature that set her apart from the others. She was right, and now at the age of 77, she’s been on more front covers than nearly any other model.

Each smile is unique. Hopefully, your smile makes you feel good every time you share it. And, the very act of smiling has been shown to release endorphins in the brain. Those are the chemicals that create a bit of a ‘natural high.’ Smiling is obviously an asset to our well-being.

If you have a “gummy” smile, you may be perfectly fine with it. After all, it is not detrimental to oral health if you care for your gums properly (which goes for everyone). And, it can be a positive part of your personality. Katie Couric has a gummy smile and shares hers openly.

“Gummy” Smile

However, not everyone with this trait feels comfortable with the look nor the way it makes them feel when smiling. Some people tend to suppress  a full smile. Others often conceal their smile with a hand when smiling fully or laughing. Some people smile with their lips only.

A gummy smile, in the periodontal specialty, is known as EGD, an abbreviation for excessive gingival display or a gingival smile (GS). The trait occurs more often in females than in males. (Gingival is of or relating to the gums.)

Esthetically, a balanced smile typically shows the front top 6 or 8 teeth. Arching each tooth, there is generally minimal gum tissues showing , and sometimes none. Another esthetic complement to a smile is having gum tissues that  show a slight arch over each tooth at a similar line as those that arch adjacent teeth. Gums that are lower over one or two teeth tend to create a jumbled look in a full smile.

When the height of gum tissues distract from the appearance of a smile, a periodontist is your expert. This dental specialist has specialized skills in all aspects of oral tissues. Through their advanced training, they are able to safely and beautifully reshape the tissues that surround teeth.  

For people who wish to have a gummy smile or uneven gum line re-contoured, a periodontist performs a gingivectomy. A gingivectomy is a procedure during which excess gum tissue is remove. During this, the gumline is sculpted to give your smile balance with a more even smile line.

In addition to repairing a gummy smile, a gingivectomy is involved in a procedure known as crown lengthening. Crown lengthening involves removing the excessive gum tissue to expose more of the crown of the tooth, as well as sculpting the gumline to make it higher up. After the gum tissues are shaped, a crown is typically placed to protect the tooth above the gum line and to create a more beautiful smile.

A crown lengthening may also help to save a tooth from removal. When a tooth breaks off near the gum line, a crown lengthening can be performed to expose a sufficient amount of the tooth’s base so it can support a crown.

Another procedure a periodontist  expertly performs is gum grafting. This is often to cover exposed roots, to reduce further gum recession, protect vulnerable tooth roots from decay, and improve your smile. Recession can occur as a result of periodontal disease, which causes tooth roots to become exposed and makes the teeth look long.

Gum tissues are very tender tissues with many nerves. Procedures that involve the gums must be performed with precision to minimize discomfort and speed healing time. A periodontist excels in the skills to create an optimal outcome with the most conservative treatment needed.

Our Asheville periodontal dental office provides some of the most advanced imaging and computerized technology available. This includes cone beam 3D imaging and laser dentistry. Additionally, we provide oral and IV sedation (“twilight sleep”) so patients are able to relax or snooze comfortably while being monitored by specially-trained team members who use advanced safety equipment.

Begin with a consultation with an experienced periodontist, who can answer your questions thoroughly and determine the best treatment option for your individual needs. Call 828-274-9440.

Some sources:

https://www.colgate.com/en-us/oral-health/mouth-and-teeth-anatomy/3-treatment-options-for-a-gummy-smile

https://www.researchgate.net/figure/Female-and-male-percentages-in-the-gummy-smile-sample_tbl1_340258838

Dental Pain Relief With Patient’s Well-Being In Mind


Posted on Aug 19, 2022 by William J. Claiborne, DDS MS

The body relies on a nervous system for many reasons; one reason being to alert us that something is wrong. For example, when we burn our finger on the stove, the brain quickly sends pain sensations so we can remove the finger and take action to help it repair.

As a periodontal specialist in Asheville NC, I know how sensitive the gums can be, as well as teeth. A toothache or a cut in the mouth can be miserable for days. As a periodontist, ideally my skills allow patients to avoid being in pain by keeping their mouths healthy. When an individual maintains a clean mouth that has a low level of bacteria, they can avoid developing cavities and gum disease, which can both result in a significant amount of constant pain.

Yet, caregivers in the American healthcare system are very much aware of the opioid epidemic. We don’t want to deny legitimate patients the medications they need to get them out of pain, however, neither do we want to be a catalyst or contributor to an individual who becomes dependent on these or is trying to feed an already existing habit.

The dental profession has been very careful in this regard, according to the American Journal of Preventive Medicine. In 2012, dentists in the U. S. prescribed only 6.4% of the total opioid prescriptions. For procedures such as root canals or extractions, they help patients get through the initial part of recovery when pain levels are most extreme.

As opioid abuse became such a significant problem, dentists became more sensitive to prescribing these medications. In 2016, American Dental Association (ADA) issued a Statement on the Use of Opioids in the Treatment of Dental Pain.

“Dentists should consider non-steroidal anti-inflammatory analgesics as the first-line therapy for acute pain management … [and]should recognize multimodal pain strategies for management for acute postoperative pain as a means for sparing the need for opioid analgesics.”

Non-steroidal anti-inflammatory analgesics are commonly known as NSAIDs. These are typically over-the-counter meds, such as Advil, Aleve, Motrin, etc. These are non-opioid, oral medications for temporary relief of acute dental pain.

NSAIDs work to provide effective pain relief by reducing inflammation in the bone, dental pulp, and gum tissues. The ADA encourages dentists to consider NSAIDs as the preferred go-to method for managing acute pain. When NSAIDs are taken after a dental procedure, they have been shown as effective as opioids for reducing pain intensity. For some pain levels, the dentist may prescribe a higher dose (by prescription).

Although NSAIDs are effective and less likely to cause dependency, they can also inhibit the an enzyme responsible for producing other prostaglandins that provide numerous beneficial effects. This includes those that protect the gastrointestinal mucous lining, blood flow to the kidneys, and blood clotting.

NSAIDs could also heighten the risks for serious cardiovascular issues, including heart attack and stroke. NSAIDs gave the potential to trigger issues that complicate the effects of low-dose aspirin.

Another option for managing dental pain is the use of Acetaminophen (such as Excedrin and Tylenol). Acetaminophen is an internal analgesic available in over-the-counter medicines for the temporary relief of minor aches and pains and helping to reduce fever. It can also be found in medicines that contain more than one active ingredient to treat migraines.

Acetaminophen is often used for things like headaches, muscle aches and menstrual cramps. It can also be an ingredient in other medicines.

Please know that I want no less for my patients’ comfort than I would want for myself or loved ones. Pain can be an overwhelming problem, although gum disease and cavities are highly preventable. With proper at-home oral hygiene and regular dental check-ups, an individual can keep a healthy smiles and prevent tooth loss (to a signifiant degree).

Even so, the Agency for Healthcare Research & Quality shared that there were more than 615 emergency room visits for every 100,000 people in the U.S. in 2018. The statistic is much higher for low-income and minority groups.

Let’s work together to protect our population from the impact it has endured from opioid addiction. Prior to treatment, we will discuss the potential for discomfort or pain afterward and standard treatment options to help ease you through recovery.

If you are experiencing sore, tender gums that bleed easily when brushing or a deep ache like a toothache, do not delay in seeking dental care. When something is wrong in the mouth, there are very few instances that will go away on their own. Most problems worsen over time, leading to higher levels of discomfort and more-involved treatment to resolve the problem.

In our Asheville eriodontal dental office, we offer some of the most advanced technology available in dentistry, including ConeBeam 3D imaging, laser dentistry, and computerized dental implant placement technology. Additionally, we provide oral and I.V. sedation, safely and monitored closely.

Call 828-274-9440 or tap here to arrange an appointment.

Sources:

https://www.rdhmag.com/patient-care/article/14279378/the-dental-hygienists-guide-to-dental-pain-and-pain-management

https://www.deltadentalwa.com/blog/entry/2019/09/dental-pain-management

https://hcup-us.ahrq.gov/reports/statbriefs/sb280-Dental-ED-Visits-2018.pdf

What Is Causing You To Have Bad Breath Odor


Posted on Aug 09, 2022 by William J. Claiborne, DDS MS

It’s one thing to have “coffee mouth” or give off telltale signs of having onions on a burger at lunch. It’s another to be “that person” who has an embarrassing reputation for bad breath.

Bad breath happens to us all. After all, waking up first thing in the morning reminds us that our mouths are “not so fresh.” However, bad breath is generally easy to avoid. Below, I’ll share some ways to feel confident in closeness.

But first, let me explain how bad breath begins. The origin of most bad breath occurs from too many bacteria in the mouth. On a day-to-day basis, oral bacteria are normal and not problematic. However, when the mouth contains an overload of oral bacteria.

Bacteria thrive in warm, dark, moist places. That’s precisely the environment they have in the oral cavity (the mouth). Bacteria are living, eating and reproducing organisms. They thrive on rotting food particles in the mouth and attack tender gum tissues.

As they amass, a sticky film forms, known as plaque. If not brushed away daily, plaque hardens on teeth into tartar (or calculus). This cement-hard form of bacteria attacks tooth enamel and gums.

The faster bacteria reproduce, the faster is the damage potential caused by these destructive organisms. The accumulation of these bacteria results in the production and release of volatile sulfur compounds (VSCs), which causes a smelly breath odor.

The most common causes of bad breath include poor oral hygiene, gum diseases and dry mouth, a condition in which the salivary glands cannot make enough saliva to keep the mouth moist.

Not surprisingly, one of the symptoms of periodontal (gum) disease is persistent bad breath. This is a foul odor in the mouth that exists even shortly after brushing. Gum chewing and mints may mask it temporarily, but it is actually the scent of gum tissues being destroyed in the mouth. You may also notice tender gums that bleed easily when brushing.

Dry mouth is another contributing factor to bad breath, primarily because oral bacteria thrive when they are not being rinsed away through saliva. Saliva is the mouth’s natural rinsing agent and sweeps bacteria out on a continual basis. Without sufficient saliva, bacteria are able to reproduce at a more rapid pace.

Several causes for dry mouth are smoking, some illnesses, snoring and mouth-breathing, and certain medications. The aging process also leaves adults with less saliva flow. Drinking alcohol and caffeinated beverages are drying to the mouth as well.

When you feel your mouth is dry, the ideal aid to the saliva you have is drinking filtered water. Water is the perfect beverage when it comes to supporting your oral health. It also helps to keep your body more hydrated, which aids in overall function. Chewing sugarless gum also enhances saliva flow and is advised after meals when brushing is not possible.

The tongue is also a tremendous source of oral bacteria. With its tiny grooves, bacteria embed in the tongue and enjoy a warm, moist haven for reproduction. This is why using a tongue scrapper daily or brushing the tongue with your tooth brush can help reduce the amount of bacteria in your mouth quite a bit. Be sure to get to the back of the tongue where the majority of oral bacteria live (even though you may cause some slight gagging while doing so).

If you want fresh breath, the key, obviously, is to control the amount of bacteria in your mouth. Begin with a clean mouth through your six-month dental cleanings and exams. These appointments help to remove buildup that has accumulated between visits, reducing the amount of bacteria in the mouth.

Then, twice daily, brush for at least two minutes, floss daily and use a tongue scraper or brush your tongue. Drink lots of water during the day. Limit sugary treats or drinks since bacteria are super-charged by sugars and carbohydrates. Swish after eating or drinking, especially coffee or a glass of wine to counteract drying effects.

If you are dealing with bad breath on a persistent basis, a periodontal exam is recommended. Through this, we can determine its cause and help to remedy or control it so you have worry-free closeness. The specialized skills of a periodontist provides you with a direct path to fresh breath.

Call our Asheville periodontal dental office at 828-274-9440. If fear or anxiety associated with dental visits has kept you from having regular dental care, please mention this when you schedule as well as during our initial consultation. We have an exceptional track record in caring for fearful dental patients and also offer oral or I.V. sedation, when desired.