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.

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.

Taking Prescriptions? Some Supplements Can Cause Problems.

Posted on Sep 27, 2016 by William J. Claiborne, DDS MS

As baby boomers age, a growing number are turning to alternatives to prescription medications. Thus, there has been a growing demand for natural supplements. It is estimated that over 15 million Americans are using vitamins and herbal supplements along with prescription medications.

Surveys estimates show that herbal supplements are used by 12 – 24% of the American adult population with usage of those aged 65 and older doubling from 1999 to 2002.

Since supplements are available over the counter (OTC), many adults don’t see them as medications. So, when a new patient is completing their medical history form, these are not always listed. They should be.

Both medical and dental health care providers need this information to determine how these supplements will effect your body’s ability to clot properly during procedures that cause bleeding. Too, excessive bleeding can occur when these supplements are not acknowledged prior to procedures.

A number of aging adults take prescription medications to prevent arterial or venous thrombosis and stroke. When completing your medical history form, most patients readily acknowledge their use of these medications and understand that some drugs increase bleeding during certain procedures or hamper their ability to clot when bleeding. Knowing the patient is on these medications enables the medical or dental caregiver to monitor bleeding and clotting before complications arise.

However, patients are less informed that the use of OTC medications can impact bleeding in conjunction with their prescription medications. Yet, according to the Natural Medicines Comprehensive Database, approximately 180 dietary supplements have the potential to interact with warfarin and more than 120 may interact with aspirin, such as clopidogrel (Plavix) and dipyridamole (Aggrenox).

The National Institutes of Health (NIH) identified these supplements as having the potential to cause adverse bleeding interactions:
• Anise
• Dong Quai
• Omega-3 fatty acids in fish oil
• Ajoene in Garlic
• Ginger
• Ginkgo
• Vitamin E
• Fucus
• Danshen
• St. John’s Wort
• American Ginseng

The Centers for Disease Control and Prevention (CDC) shows the supplements having the highest sales include ginseng, ginkgo blob, garlic, St John’s wort and ginger. It is not unusual for a patient to take up to seven dietary supplements at the same time with some taken inconsistently.

In addition, the following herbs may affect blood clotting:
• High doses of Vitamin E
• Alfalfa
• Coenzyme Q10

While more studies are needed to determine precisely how these supplements alter bleeding or interact with prescription medications, it is important for medical and dental professionals to have consumption information in order to properly plan for procedures.

Warfarin (Coumadin®, Jantoven™), an oral anticoagulant, is used prevent and treatment VTE (venous thrombo-embolism), PE (pulmonary embolism), and atrial fibrillation (A-Fib) patients who are at risk of embolism. Warfarin is highly affected by medication use. In fact, more food and drug interactions have been reported for warfarin than with any other prescription medication.

A study in England noted a high number of patients were taking herbal supplements along with warfarin. In a survey of nearly 1400 patients, it was found that nearly 9% regularly took one or more of garlic,  ginseng,  ginkgo biloba, feverfew, ginger, and St. John’s
wort. Yet, nearly all admitted to failing to share this information with any of their health care professionals.

In addition to many herbal supplements, alcohol has been found to increase bleeding in warfarin users along with Vitamin C and Cranberry juice. However, the herbal supplements that tend to complicate clotting ability the most during bleeding include:
• Bromelain
• Cat’s claw
• Dong quai
• Evening primrose
• Feverfew
• Garlic
• Green tea
• Ginseng
• Ginkgo
• Horse chestnut
• Red clover

In addition to Aspirin’s ability to reduce mild to moderate pain, inflammation, and fever, it is also used in the prevention of myocardial infarction (MI) and cardiovascular problems, such as stroke. Aspirin may also be advised as added therapy during procedures like coronary bypass. While many users of Aspirin realize it “thins the blood,” many regular users fail to notify their dental professional.

As a periodontist, I perform a number of procedures that cause bleeding to tissues in the mouth. It is important for your safety and a successful outcome of your procedure to have this information prior to treatment planning.

While filling out those often-lengthy medical history forms seem daunting, the information they provide is necessary. It is also necessary that it be complete. Herbal and vitamin supplements taken regularly should always be listed.

If you have questions, please call 828-274-9440.

Receded Gums – How They Occur & Why They Up Your Risk For Problems

Posted on Aug 15, 2016 by William J. Claiborne, DDS MS

The next time you look in the mirror, smile. Notice how each tooth is arched by gum tissue. This tissue seals off and protects the tooth root sections of teeth. When the gums pull away from the teeth, darker and sensitive portions of the root are exposed. This leaves tooth roots exposed and vulnerable.

While the darker segments of teeth detract from the appearance of a smile, they are also highly sensitive. Many people often first notice gum recession when getting a painful jolt when eating or drinking something hot or cold or even from the bristles of a tooth brush. Because gum recession occurs gradually, people don’t always notice it until they experience pain.

Special toothpastes may help with sensitivity, however, it’s best to determine what has led to gum recession so further recession doesn’t occur. Causes for receded gums include:
• Periodontal (gum) disease: When bacteria accumulates on teeth at the gum line, the gum tissues weaken and lose their grip on teeth. As gum disease progresses, the tissues and supporting bone are overwhelmed by oral bacteria.
• Rigorous brushing: Using a tooth brush with hard bristles or being over-zealous when brushing can wear down enamel as well as gum tissue. Also, using abrasive substances to brush (such as baking soda) are too gritty for teeth and can wear down gum tissues.
• Poor oral hygiene: Without thorough and regular brushing and flossing, oral bacteria accumulate and form a sticky film known as plaque. When plaque is not removed, it can harden into calculus, which is a cement-like colony of oral bacteria. Calculus (or tartar) can only be removed by a dental professional or it will continue to feed on gum tissues.
• Smoking: When saliva flow is insufficient to effectively wash bacteria from the mouth. The chemicals in tobacco are very drying to oral tissues, providing an ideal environment for the formation of plaque and calculus. Both are masses of oral bacteria that attacks gum tissue and contributes to recession.
• Grinding & clenching teeth: Clenching or grinding teeth during sleep can place such force on teeth that they tilt out of their positions. Eventually, the gums pull away from some teeth, exposing tender tooth root sections.
• Hormonal changes: Pregnancy, menopause and puberty can cause changes in hormone levels. These hormonal fluctuations can cause gums to feel tender and be more vulnerable to recession.
• Crowded or crooked teeth: When teeth are not properly aligned, they endure added force to bite and chew. This can also lead to strain on the TMJ (jaw joints), gums and bone structures that support tooth roots. This can eventually result in gum recession.

When darker portions of a tooth are visible, it detracts from a smile and leaves the tooth susceptible to decay or gum disease. For the comfort, appearance and health of the tooth, repairing the problem before costly damage occurs is the best move.

As a Periodontal Specialist, my specialty is in the treatment of gum tissues, including recontouring procedures that repair recession comfortably and quickly. However, it is important to repair recession before it becomes severe. Treatment delays may result in the need for more-extensive procedures that can increase treatment time and expense.

Call 828-274-9440 to learn more.