Posts for: August, 2015

By Sarah J. Morris, DDS, PLLC
August 28, 2015
Category: Dental Procedures
Tags: gummy smile  
ImprovingaGummySmileDependsonitsCause

A “gummy” smile, in which the upper gums are too prominent, is a common condition. There are several causes for gummy smiles — determining which one is the first step to having your appearance changed.

Although perceptions vary from person to person, most dentists agree a gummy smile shows 4 mm or more of gum tissue, and the amount is out of proportion with the length of the crown (the visible tooth). Teeth normally erupt through the gums during childhood and continue development until early adulthood, shrinking back from the tooth until stabilizing in place.

This typically produces a crown length of about 10 mm, with a “width to length” ratio of about 75-85%. But variations can produce differences in the relationship between teeth and gums and the width to length ratio of the teeth. The teeth may appear shorter and the gums more prominent. Worn teeth, caused by aging or grinding habits, may also appear shorter.

If tooth to gum proportionality is normal, then the cause may be upper lip movement. When we smile, muscles cause our lips to retract 6-8 mm from the lip’s resting position. If the amount of movement is greater (meaning the lip is hypermobile), it may show too much of the gums. The upper jaw can also extend too far forward and cause the gums to appear too prominent.

There are a number of ways to improve gummy smiles, depending on the cause. Periodontal plastic surgery known as crown lengthening removes and reshapes excess gum tissue to reveal more of the tooth. Lip hypermobility can be reduced with Botox injections (to paralyze the muscles) or in some cases with surgery to reposition the muscle attachments. Orthognathic surgery can be used to surgically reposition an overextended upper jaw. Other cosmetic enhancements such as orthodontics, bonding or porcelain restorations can also prove effective.

The first step is to obtain an accurate diagnosis for your gummy smile. From there, we can devise the best treatment approach to bring your smile back into a more attractive proportion.

If you would like more information on minimizing 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.”


By Sarah J. Morris, DDS, PLLC
August 20, 2015
Category: Oral Health
Tags: gum disease   birth control  
SomeBirthControlDrugsCouldIncreaseRiskofGumDisease

One of the health issues pregnant women should be concerned about is a higher risk of periodontal (gum) disease. But you don’t have to be pregnant to have an increased risk — you also may be more susceptible to dental disease if you’re taking certain birth control pills.

Gum disease is a bacterial infection caused by plaque, food debris that builds up on tooth and gum surfaces due to poor oral hygiene. If left untreated gum disease can eventually lead to the breakdown of connective gum tissue and cause tooth loss.

Pregnant women are at greater risk because of an increased level of female hormones (estrogen) in their blood stream. This causes a change in the blood vessels that supply the gums, making them more susceptible to the effects of bacteria. A number of birth control options also increase estrogen levels, causing much of the same effect. To heighten the effect, you may also have a predisposition toward gum disease by your genetics or a high stress level.

There are some things you can do, however, to help lower your risk if you’re taking birth control medication. First and foremost, practice a consistent, daily habit of brushing and flossing. If you’re unsure if your technique is effective, we can provide guidance and training to make sure you’re performing these tasks properly. You should also visit us at least twice a year for office cleanings and checkups: no matter how effective you are with brushing and flossing, plaque can still accumulate in hard to reach places and form hardened deposits known as calculus.

You should also be on the lookout for signs of disease like gum redness, swelling or bleeding. If you see any of these signs, contact us as soon as possible for a thorough examination. As with many other issues involving health, the sooner we begin treatment for gum disease the better your chances of stopping it before it does too much harm.

If you would like more information on the relationship between gum disease and pregnancy or birth control, 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 “Pregnancy & Birth Control.”


By Sarah J. Morris, DDS, PLLC
August 12, 2015
Category: Oral Health
Tags: medicine  
InformYourDentistifYoureTakingBloodThinners

Dental work isn’t performed in a vacuum — the state of your general health can have an impact on procedures and vice-versa. This is especially true if you’re taking certain medications like blood thinners.

Blood thinners such as Warfarin or Clopidogrel are used for a number of medical conditions as an anti-coagulant (inhibiting blood from clotting). They’re commonly part of a stroke or heart attack prevention strategy in patients with cardiovascular disease, or those with tendencies for thrombosis (blood clot formation within blood vessels) or pulmonary embolisms (blood clots within the lungs). They’re also used with patients with artificial heart valves or on a temporary basis with patients who’ve recently undergone knee replacement or similar surgical procedures.

In most cases, dental work won’t be affected by your use of a blood thinner. An issue might arise, however, if an invasive procedure has the potential to cause bleeding, like a tooth extraction or gum surgery. Because the blood doesn’t clot normally it may be difficult to stop the bleeding during such procedures.

To avoid undue complications, it’s always best to let your dentist or oral surgeon know what medications you’re taking, especially blood thinners (this includes low-dose aspirin, a common over-the-counter drug that’s often prescribed as a mild blood thinner). Depending on the procedure and your dosage, they may consult with your prescribing doctor to see if temporarily stopping the medication or reducing the dosage is an acceptable precautionary measure for your dental treatment. Your dentist may also take precautions during the procedure to help reduce bleeding such as using haemostatic agents around the wound site to help stabilize blood clotting, while carefully suturing the wound to avoid disrupting smaller blood vessels (capillaries) that easily bleed.

If your dosage has been temporarily stopped or reduced, you’ll usually be able to resume blood thinners immediately after the dental procedure. Working together, your dentist and doctor will help ensure that your health won’t be at risk and your dental procedure will occur without undue complications.

If you would like more information on dental work precautions with medications, 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 “Oral Surgery & Blood Thinners.”


ThreeConsiderationsforWorkingwithYourDentistonYourSmileMakeover

Cosmetic and restorative dentistry is filled with a varied array of procedures, materials and techniques that can address any shortcoming with your smile. Whatever your condition, there’s a means to correct or enhance your smile.

The real question, though, is whether we’re both, patient and dentist, on the same page as to what’s best to enhance your smile. Dentists have a different perspective on smile outcomes than the average layperson. We’re clued into aspects like tooth alignment with facial features or gum-to-lip distance influenced by our professional training and experience. You, though, may see your smile in terms of other features that define beauty like mouth expressions or lip shape.

Bridging these differing points of view requires open and honest communication. Here are three considerations to make that happen.

Build trust between you and your dentist. It’s natural for us to have differing views on what constitutes proper smile aesthetics based on the perspectives previously mentioned. Working through those perspectives to arrive at a unified plan requires trust that both of us desire the same outcome: a beautiful smile you’re happy to display to the world.

“Seeing” your future smile can help ease your misgivings. It’s one thing to try to imagine a certain treatment outcome — it’s quite another to actually see it beforehand. And you can, through computer simulation that takes a picture of your current face and smile and then augments them digitally so you can see how your smile will appear after proposed treatment. It’s also possible in some cases for you to wear temporary or “provisional” restorations so that not only can you see how they look, but also how they feel and function in the mouth.

Understand what “type” of restoration patient you are. Although everyone is different, we can usually characterize patients and their expectations in two ways. Some patients are “perfect-minded” — they want restorations that offer the maximum symmetry, regularity and tooth brightness. Others are more “natural-minded” in that the changes they seek don’t drastically alter their natural appearance, but are just enough to look different and create a sense of character. Knowing what you really want — a drastic change or a subtle enhancement — will help you communicate your desires more clearly and help us design the treatment options that best fit your expectations.

If you would like more information on fostering communication between dentists and patients, 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 “Great Expectations.”




Dentist - Fort Worth
2551 River Park Plaza
Fort Worth, TX 76116
817-732-4419

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