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.

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

Many Reasons To Repair Gum Recession

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

If you are occasionally experiencing sensitivity around one or more teeth, especially when eating ice-cream or drinking hot coffee, this is likely due to receded gums.

While using a sensitivity toothpaste can somewhat minimize these sensations (which can become painful jolts), the problem will remain. The source of sensitivity, most often, is because the highly-sensitive tooth’s root area has been exposed by the pulling away of gum tissues.

The gum tissues are designed to provide a tight seal around the base of each tooth, which blocks bacterial entry to the sensitive tooth root area. In addition to sensitivity, recession means oral bacteria can penetrate beneath the gum’s surface. Once beneath the surface, the accumulating presence of this bacteria can lead to inflammation of the gums.

Eventually, the infectious bacteria attack the structures that support natural teeth. This bacteria indicates the presence of periodontal (gum) disease. Signs and symptoms of gum disease in its first stage include:

• Gum tissues that turn red

• Gums that become tender or swollen

• Gums that bleed when brushing

• Persistent bad breath

Obviously, it’s important to ensure the gums are healthy so the grip they have around teeth is snug. It’s also important to be aware of the causes of gum recession. These are:

The aging process – As people age, their gums become drier. This causes them to shrink and be less capable of keeping a secure grip around the base of teeth.

Periodontal (gum) disease – As mentioned above, gum disease destroys oral tissues and the bone that supports natural tooth roots. A sign of periodontal disease is gum recession. Gum disease is also the nation’s leading cause of adult tooth loss.

Poor dental hygiene – When twice-daily brushing, daily flossing, and keeping the mouth moist are insufficient to rid the mouth of bacteria, their accumulation can result in the sticky film you feel on teeth. This is plaque. In just a day or so, plaque can harden on teeth into tartar. This is a cement-hard bacterial colony that cannot be removed by brushing or flossing . It can only be removed during a professional tooth cleaning. If not removed, teeth, gums and the structures below the gum line can be damaged.

Brushing too hard – Brushing teeth rigorously doesn’t mean you are doing a good job. Using a scrubbing, back-&-forth motion can wear away tooth enamel and cause the gums to recede. Other damaging actions when brushing are or using a hard bristled toothbrush or abrasive substances, such as baking soda.

Hormones – Females experience fluctuations in estrogen levels during puberty, menstrual periods, pregnancy and menopause. During these times, the gums can be more sensitive and vulnerable to gum recession.

Tobacco use – In addition to the many health hazards smokers risk, they are more likely to develop plaque due to the oral drying effects of smoking. This dryness can lead to gum recession (not to mention brown teeth and bad breath).

Bite misalignment – When teeth don’t come together evenly, too much force can be exerted on the gums and surrounding bone, allowing gums to recede. Bite misalignment can also lead to grinding or clenching teeth. These harsh forces on teeth can cause the gums to loosen their grip.

If you have mild sensations of sensitivity, desensitizing toothpastes can help soothe the nerves by forming a protective barrier over teeth while blocking sensitivity signals. Although this type of toothpaste can be helpful, it should be used as a temporary aid.

The goal should be to repair recession and halt the problem from recurring. To do this, we begin by determining why the gum recession is occurring. The next step is to restore the gums to their proper positions.

The corrective procedure most often performed is a “gingivectomy” performed by a periodontal specialist. In addition to treating all stages of gum disease, a periodontist specializes in contouring gum tissues. Using advanced skills, a periodontist is able to create a natural look and restore your oral health.

A gingivectomy can reposition or graft gum tissues over the area of recession to restore a healthy seal and protect the tooth structures below the surface.

Another advantage of a gingivectomy is to help save a natural tooth. When a tooth breaks near the gum line, a “crown lengthening” procedure may be advised. In this, a periodontist may be able to expose enough of the tooth structure for the placement of a crown.

A crown lengthening procedure is an ideal accompaniment to many cosmetic dentistry treatments. When there are different heights of gum tissues framing the teeth most visible in a smile. This tends to create a jumbled looking smile, when when the teeth are straight.

Crown lengthening rebalances the height of gum tissues that arch the teeth to restore a smile that is balanced. From this, the eye is drawn to the smile as a whole rather than one or two teeth with varying heights of gum tissue.

A gingivectomy is also performed for individuals who wish to correct a “gummy smile.” This is when a smile shows too much gum tissue above upper teeth when smiling fully.

Gingivectomies are performed while the patient is comfortably numbed. For some people, sedation may be a preference for enhanced relaxation. Oral sedation is available in pill form, which allows patients to ‘doze’ through procedures. I.V. sedation, also known as “twilight sleep”, is available for patients who prefer a deeper level of sedation.

Both sedations are administered by fully trained team members who use advanced safety monitoring equipment. We believe your safety is as important as your comfort.

In our Asheville periodontal dental office, we also offer a wide array of technology. This often saves the patient time in treatment, enhances comfort, and speeds healing. For example, our dental laser can seal tissues as it contours it. This eliminates or greatly minimizes bleeding.

Pain is how the body indicates that something is wrong. When the gum tissues have receded, they are not going to repair on their own. Let’s discuss your particular needs, whether for improved oral health or to enhance the appearance of your smile (or both) during a consultation appointment.

Call 828-274-9440 to schedule a time.

 

 

Optimize Your Dental Implant Experience, Results.

Posted on Jan 24, 2022 by William J. Claiborne, DDS MS

I recently had to return a small appliance at a “big box” store. I didn’t have the receipt but hoped I could at least get a store credit. When I explained this to the customer service rep, she said a receipt wasn’t necessary. She scanned the bar code and asked me if I wanted the refunded amount applied to the credit card I used to purchase it. No receipt needed, no credit card, and I was in and out of the line in no time.

With today’s technology, many processes that were once time-consuming and complicated are now simple and “painless.” Less time is required with better results. Technology has made this true, too, in dentistry.

As a periodontist, I specialize in the prevention, diagnosis, and treatment of all stages of periodontal (gum) disease. I also have advanced training and skills in the selection and placement of dental implants. In addition, periodontists are particularly skilled in performing cosmetic periodontal procedures.

As an Asheville periodontal specialist for over 30 years, I’ve treated a variety of needs that involve the gum tissues. These include:

– Treatment of all stages of gum disease (gingivitis, pregnancy gingivitis, periodontal disease, periodontitis)

– Reshaping gum tissues for esthetic enhancement (crown lengthening, gingivectomy for ‘gummy smiles’, repairing areas of gum recession)

– Diagnosis and placement of dental implants

– Treatment of lesions or cysts in oral tissues

To receive the extensive, additional 3 years of training after dental school to become a periodontist, (I believe) an individual must be passionate about the specialty. I certainly am, which is why I’m so committed to stay on top of the latest developments in the field.

This includes incorporating some of the most advanced technology available for the betterment of our Western North Carolina patients.

Our periodontal dental office features cutting edge technology, much of which is not available in other dental or periodontal offices in this region. These features help to diagnose with precision, treatment plan with superior accuracy and reduces the patient’s treatment time while optimizing comfort.

For our dental implant patients, these options have been significantly beneficial in maximizing results. Some specifically helpful in dental implant diagnosis and planning are:

LANAP With PerioLase MVP 7 – Laser-Assisted New Attachment Procedure is an advanced protocol that efficiently and effectively treats advanced gum disease with the added advantages of a dental laser. For patients who are preparing for dental implant placement, resolving gum disease prior to treatment is mandatory. LANAP offers a non-surgical alternative for patients with moderate to severe periodontal disease with very little discomfort and a quick recovery time.

Cone Beam Imaging – These amazing 3D “x-rays’ are ideal for diagnosing and treatment planning. The highly-detailed images provide a clear view of the upper and lower jaw. Because cone beam radiographs show sagittal, axial, and coronal planes, locating and tracking nerve canals optimizes implant placement. The images are captured in a quick, painless process and at minimal levels of radiation.

CareStream Cone Beam Computer Tomography Imaging – This enhanced tomography works with 3D imaging for exceptional detail and range.

Computerized Dental Implant Placement – This system provides the futuristic ability to position dental implants before the process actually begins. Through computerized technology, the implants are selected and “ideally positioned” on a 3D model of the patient’s jaw. From this, a template is developed for optimal treatment success, even for complex cases.

CS 3600 Intraoral Scanner – Rather than make impressions with bulky, goopy trays, this scanner quickly and comfortably captures digital impressions accurately and easily. These are used to create precision models or appliances (dental implant crowns, bridges, or full arches). The scanner can also reach hard–to–access areas in the patient’s mouth for superior results with improved patient comfort.

Sedation – Our Asheville periodontal practice is known for its environment of comfort and respectful care. We understand that over 70 percent of the adult population have some level of dental fear or anxiety. For optimal comfort and relaxation, we offer several sedation options, including oral and IV sedation.
Oral sedation is a pill that helps patients relax. It also has an amnesiac effect, leaving most with little or no memory of treatment afterward.
I.V. sedation (also known as ‘twilight sleep’) places the patient in a deeper sleep state and erases memory of the procedure. It is administered by a Medical Doctor (MD) who is a board certified Anesthesiologist.
With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.

When it comes to placement of dental implants, a periodontist has a unique understanding of the tender layers of gum tissues. Using gentle and precise skills when it comes to any treatment involving oral tissues, the patient experiences less disruption and incisions. When it comes to the gums, less is definitely more. We strive to optimize comfort levels and speed the healing process.

If you are considering dental implants, you may wish to begin with a consultation appointment. During this time, we can explain the vast difference in comfort, treatment time, and success available through our specialized skills and extensive technology.

Call 828-274-9440 to schedule. New patients are always welcome and a referral is not required.

Cut Dental Costs With Simple Steps

Posted on Dec 15, 2021 by William J. Claiborne, DDS MS

In order to avoid costly repairs on our vehicles, we rotate our tires, have the oil changed periodically, and make sure certain fluids are at sufficient levels. This is why our annual inspections are so important; risks can be pointed out to keep us safely on the road.

The same is true with our family’s health. We stay proactive by eating healthy, staying active and having regular check-ups along with periodic screenings.

It simply makes sense to be committed to preventing problems or catch any that do arise at early stages. Research has shown that your oral health deserves the same commitment you give to maintaining a healthy body.

Studies have found a correlation between the bacteria of periodontal (gum) disease and serious problems elsewhere in the body. These include heart disease, stroke, diabetes, arthritis, preterm babies,  impotency and more.

Another reason to maintain a healthy smile is to save money. By devoting about 5 minutes per day to your oral hygiene routine, coupled with having dental exams and cleanings every six months, you can prevent many problems from occurring in the first place. The reward is a savings in time and expense that may be needed for repairs – repairs that may have been prevented from occurring in the first place.

Your twice-a-year dental check-ups are opportunities to remove tartar. Tartar is a cement-hard mass of oral bacteria that forms when plaque (the sticky film that coats teeth and gums) is not removed thoroughly attaches to teeth and can no longer be brushed or flossed away.

Both plaque and the hardened mass of tartar are the result of accumulated bacteria. Oral bacteria continually reproduce in the mouth, which provides a warm, dark and moist environment. As they thrive and reproduce, they attack gum tissues.

As they amass to levels beyond what the immune system, oral bacteria can lead to gingivitis (an early stage of gum disease). Unresolved, gingivitis can develop into periodontal disease, an infection. Eventually, periodontitis develops, which is an advanced level of gum disease. At this level, teeth often loosen and must be removed.

While gingivitis causes tender gums to bleed when brushing, periodontal disease symptoms are more severe, including persistent bad breath, sore gums that bleed easily, gums that darken in color, receded gums, and pus pockets that form between teeth.

As devastating as adult tooth loss can be, the potent bacteria of gum disease can enter the bloodstream through tears in disease gum tissues. Research has shown the infectious bacteria of gum disease can activate or worsen the development of certain pathogens.

Obviously, oral bacteria is highly potent. However, it’s easy to control with twice daily brushing and daily flossing combined with regular dental checkups. For added protection, limit sugary snacks and either swish after eating or chew sugarless gum when brushing is inconvenient. Not only will you help to reduce your risk for cavities and gum problems, you’ll be able to enjoy fresher breath and smiling confidence.

It is also important to respond early to signs and symptoms of gum disease. As mentioned above, things like frequent bad breath or seeing blood in the sink when brushing are warning signs that something is wrong.

A periodontist is a dentist who has specialized skills in the diagnosis and treatment of all levels of periodontal disease. He or she can also recontour the shape of gums and place dental implants for optimal results.

If you have not seen a dentist on a regular basis, you may be experiencing symptoms that indicate gum disease. As you would respond to a warning sign with your overall health, so should you with your oral health.

Begin with a thorough examination to determine what your needs are and the best way to achieve and maintain good oral health. You’ll be supporting your overall health in addition to having a confident smile.

If dental fear has prevented you from having regular dental care, ask about sedation options. We offer both oral sedation and IV sedation (twilight sleep). Both are safely administered and you are closely monitoring throughout treatment.

You may wish to begin with a consultation. To schedule, call 828-274-9440.