Correcting A Gummy Smile With Beautiful Results!

Posted on Sep 06, 2017 by William J. Claiborne, DDS MS

A smile says a lot. A warm, genuine smile sends a message to others of acceptance and joy. A beautiful smile also complements appearance and can relay an impression of confidence, happiness and openness.

As a Periodontist, I treat the soft tissues of the mouth in addition to placing dental implants and treating gum disease. As an expert in oral gum tissues, I have advanced training that enables me to create gum tissue contours to give a natural appearance and provide healthy seals around teeth.

For people who have a ‘gummy smile,’ too much gum line is visible above the upper teeth in a full smile. While this trait does not interfere with the ability to have and maintain a healthy smile, for many, it causes them to ‘hold back’ rather than smile fully. Some people cover their smiles with a hand or try to smile with lips only.

For many with a gummy smile, the deterrents to having it repaired are (1) cost; (2) treatment discomfort; and (3) treatment time. However, in consultations with patients, I explain how modern techniques ensure exceptional comfort and reduce healing time. Often, once the patient is better informed as to what to expect, they are receptive to proceeding.

Gum re-contouring is the procedure to correct a gummy smile, referred to as a ‘gingivectomy.’ It is performed to remove the excess gum tissue that arches over the teeth most visible in a smile.

To begin, we numb the gum tissues and carefully trim the excess. As a Periodontist, I take specific measures to ensure a natural looking arch remains over the teeth while preserving the natural points that ‘dip’ between each tooth.

It’s normal to experience some tenderness or swelling after the procedure, however, most patients do fine by applying an ice pack off and on for the first day. In most cases, over-the-counter pain medications are sufficient, however, we make prescription strength options available to ensure comfort during the healing process.

Healing time depends on each individual and can vary from a few days to a few weeks. For patients who smoke, healing times are longer due to smoking’s drying effect on gum tissues.

Most gingivectomies are followed by crown lengthening procedures that enhance the appearance of the teeth most visible in a smile. Crown lengthening uses porcelain veneers or crowns to give a beautiful, even smile line.

Treatment fees depend on the extent of the condition and whether crowns or veneers will be applied following treatment. In either case, beautiful results can occur, helping the individual who once ‘held back’ to smile confidently and reveal a more outgoing, vibrant personality!

A healthy smile is a benefit to our overall health. An attractive, confident smile is beneficial to our self-image, helping us to feel good from the inside out! Call 828-274-9440 for a consultation to discuss a gingivectomy and what is recommended for your specific need.

Reshaping Gum Tissues Can Greatly Improve Smile’s Appearance

Posted on Jun 07, 2017 by William J. Claiborne, DDS MS

As a Periodontist, I have advanced training and skills in the placement of Dental Implants and treating all stages of periodontal (gum) disease. Another realm of the periodontal specialty is in the recontouring of gum tissues, referred to as Periodontal Plastic Surgery.

While the shape, shade and length of teeth have a major impact on the appearance of a smile, so does the gum tissues that frame each tooth. The uniformity of gum tissues creates an appealing balance of gums to teeth. Thus, the appearance of your smile is greatly affected by the appearance of teeth and their ‘frames’ of gum tissue.

There are several ways that gum reshaping can have a dramatic impact on a smile’s appearance. Gum reshaping is recommended when certain teeth are bordered by more gum tissue than that which borders surrounding teeth. The procedure to correct this is crown lengthening, which is usually done in conjunction with crown placement.

Crown lengthening provides an appealing, balanced smile line that ‘frames’ each tooth with an arch similar to that over adjoining teeth. The procedure requires just one visit and healing time is generally minimal.

However, crown lengthening may also be performed to save a tooth from removal. For example, when a tooth has broken close to the gum line, crown lengthening procedures can remove gum tissue to expose more of the tooth. Because a tooth that breaks at the gum line must be removed, this procedure can make sufficient tooth structure available to support a crown.

Crown lengthening is also beneficial in sealing gum tissues surrounding a tooth at its base. This is important after a new crown is placed as it prevents bacteria from penetrating the gums during the vulnerable stage of attaching. By securing the gum tissue around the crown, bacterial entry is avoided and the risk for periodontal (gum) disease decreased.

Another way that Periodontal Plastic Surgery can enhance both the health and appearance of a smile is grafting to repair gum recession. This is when the gum tissue pulls away from the base of the tooth, exposing darker, more sensitive tooth root sections. Causes of receded gums are often due to age, bite misalignment, gum disease and over-zealous brushing.

Also referred to as Gingival Grafting, this procedure typically involves taking a small area of tissue from the roof of your mouth (which heals quickly) and placing it over the area of recession. It is secured in place for a healing period of approximately two weeks. The results restore the look of a healthy, naturally-framed tooth.

For those who are born with a ‘gummy smile,’ gum reshaping can restore the balance of gums to teeth for a more appealing smile. In a gummy smile, too much gum tissue is exposed above the teeth most visible in a smile. This is a genetic trait and doesn’t affect one’s oral health. However, many who have this particular smile trait feel self-conscious when they smile and tend to hold back from smiling fully.

The procedure to correct a gummy smile is a gingivectomy and can be done in one visit. Excess gum tissue is removed and the remaining gums are shaped to arch over each tooth for a natural appearance. In most cases, porcelain crowns or veneers are placed to accentuate the natural look and feel of the teeth involved.

A Periodontal Specialist provides you with advanced skills for these procedures. He or she also understands the delicate touch needed for minimal disruption to the gums involved in treatment. This tender tissue requires precision care to provide exceptional results with minimal healing time needed.

If Periodontal Plastic Surgery could improve the appearance and health of your smile, call 828-274-9440 to schedule a consultation appointment. During this time, we can discuss the options that would work best for your needs.

Meds For Osteoporosis Can Cause Severe Damage To Jaw Bone

Posted on Mar 06, 2017 by William J. Claiborne, DDS MS

It seems every time I turn on the television, I see a commercial touting some new ‘wonder drug.’ Typically, I’m blown away when the list of potential side effects are mentioned. Apparently, many of these drugs solve one problem only to create ten more. This brings to mind a concern for those who are taking drugs for osteoporosis.

As we age, so does the structure of our bones. After the age of 40, adults begin to lose bone as the body’s ability to build up bone tissues decreases. Adults who have the most risk for bone loss include:

• Females
• Being over the age of 65
• Women who are going through menopause or are post-menopausal
• Being small in statue or having low body weight
• Using tobacco and excessive alcohol use
• Having a family history of fractures associated with osteoporosis
• Seventy percent of people with osteoporosis are women. Because men lose calcium at a slower rate than women, their risk is lower. However, older men are also at risk for osteoporosis.
• Osteoporosis is also more common in people who have a small body frame and bone structure. Low body weight also contributes to osteoporosis risk.
• Calcium and vitamin D deficiencies are risk factors for both males and females.

Osteoporosis literally means ‘porous bone’ and occurs when bones become weak and fragile. People who have osteoporosis are at greater risk for fracturing their bones, especially in the hip, vertebrae (spine) and wrist.

For an aging adult, the dreaded risk of breaking a hip is one reason many consider taking osteoporosis medications. Hip fractures often require hospitalization, surgical procedures, and can require lengthy healing periods. Some never fully recover after a hip fracture.

Among the aging, these fractures are a common cause of disability and death, especially in post-menopausal women. Only 40% of hip fracture patients ever regain their independence and nearly 25% die within a year. Vertebral fractures can cause debilitating back pain, and they, too, increase the risk of premature death. (see interesting information at: http://www.health.harvard.edu/diseases-and-conditions/whats_the_story_with_fosamax)

Bisphosphonates have emerged as the leading medication for preventing and treating osteoporosis. Studies show these drugs are effective and safe for up to 5 years. Eventually, however, bone loss continues with bisphosphonates.

So, what does this have to do with your dental health? Keep in mind that the teeth, their roots and the bones that support them are bone. Add to that the fact that many people are often surprised by the wide range of medications that affect their oral health.

Some medications – including prescription, over-the-counter and even herbal supplements – can cause complications during oral surgeries like extractions or dental implant placement. While drugs such as Coumadin, a commonly-prescribed blood thinner, may cause more bleeding during oral procedures, certain drugs create a much greater risk. 

The complication with bisphosphonates, often prescribed to treat osteoporosis, is a risk for jaw osteonecrosis. In simple terms, this is death of the jaw bone. Jaw osteonecrosis occurs when the bone fails to heal after a surgery, even a minor procedure such as a tooth extraction. The risk for jaw necrosis is highest with procedures that directly expose the jaw bone, such as tooth extractions and other oral surgery.

Osteonecrosis results from obstruction of blood supply from the drug’s potential interference with the bone’s ability to repair itself. Initially, it causes pain, swelling or infection of the gums and jaw. It also prevents gum tissues from healing and can lead to tooth loss. Its onset, however, can occur without obvious symptoms.

Trade names of the most prescribed bisphosphonates are Fosamax, Actonel, Boniva, Reclast, Binosto, Prolia, Zometa and Xgeva. The most prescribed, Fosamax, is one of the top 25 most prescribed drugs on the drug market today. Approved by the FDA in 1995, reports began surfacing in 2003 that linked Fosamax with jaw osteonecrosis.

Jaw osteonecrosis risk seems to increase with the amount of time the medications are taken. However, researchers have determined that bisphosphonates can create a risk for necrosis with even short-term use.

In a study of 208 participants who took Fosamax for varying durations, 4% developed osteonecrosis. Not only did the study show that short-term usage can place the patient at risk, the drug can maintain a 10-year ‘half-life’ in bone tissue. This finding was in contrast to the drug makers’ claims that bisphosphonate use only posed a noticeable risk for those who took the medication intravenously, such as in treating cancer patients.

Although the drug makers of bisphosphonates claim a low risk to any adverse reactions, prescribing physicians have often failed to warn patients of actual risks when having dental procedures. This is why it is important to make us aware of all the drugs you take, including over-the-counter types.

Our goal is to provide you with a successful outcome for every procedure. If you have questions regarding the medications you are taking in regard to oral risks, call our office at 828-274-9440.

Reshaping Gums For Dramatic Improvements To Smile’s Appearance

Posted on Nov 07, 2016 by William J. Claiborne, DDS MS

When a Periodontist is mentioned, many people think the treatment we provide is dental implant placement and treating periodontal (gum) disease. However, another part of the periodontal specialty is reshaping gum tissues, known as periodontal plastic surgery.

In addition to the shape, shade and length of teeth, the gum tissue that surrounds teeth has a significant effect on the appearance of a smile. Think about a print you wish to hang on a wall. The matting and frame can have a tremendous role in how the print is displayed. Along the same lines, your teeth also rely on a balanced, properly-aligned amount of gum tissue, which is the frame around each tooth.

With unique expertise in the re-contouring of oral tissues, a periodontist offers several ways to improve a smile’s appearance.

Gum reshaping is often performed when certain teeth are bordered by more gum tissue than that bordering surrounding teeth. Crown lengthening is the procedure most commonly performed to correct this. This is usually done in conjunction with crown placement but may be possible in mild cases of excess gum tissue.

Crown lengthening creates an appealing, balanced smile line that frames each tooth with an arch that is balanced to that over adjoining teeth. This procedure typically requires only one visit with minimal healing time.

Another way that Periodontal Plastic Surgery can enhance the appearance of a smile is grafting to repair gum recession. Receded gums are the result of gum tissue that pulls away from the base of the tooth, exposing darker, more sensitive tooth root sections. Receded gums are often the result of age, bite misalignment, gum disease and too-rigorous tooth brushing.

Also referred to as Gingival Grafting, this procedure uses a small section of tissue from the roof of your mouth, which heals quickly. The section is placed over the receded area and allowed to heal (normally requiring only a week or two). The results restore the look of a healthy tooth with a natural gum arch.

Another example is repositioning gum tissues for those who are born with a Gummy Smile, or a gingivectomy. This creates a balance of gums to teeth for a more beautiful smile.

In a gummy smile, too much gum tissue is exposed above the teeth most visible in a smile. This causes many people to ‘hold back’ from smiling fully. Some with this trait smile with their lips only or conceal their smile with a hand.

The procedure to correct a gummy smile can be done in one visit. Excess gum tissue is removed and the remaining gums are arched over each tooth for a natural appearance. In most cases, porcelain crowns or veneers are placed to accentuate the natural look and feel of the teeth involved. The result is a fabulous smile that can be shared fully and joyfully!

The bonus of using a Periodontist to create an optimal outcome is the skill level needed to minimize disruption to the gums involved. Tender gum tissues heal faster and more predictably when the precision skills of a periodontal specialist incorporates their ability to tend gently and adeptly to each patient’s individual needs.

When it comes to your smile, your gum tissues are truly a significant part of its appearance. To improve the health and appearance of your smile, call 828-274-9440 for a consultation. During this time, I’ll gladly make recommendations and discuss specifics of each part of the process.