The various structures in your mouth — your teeth and gums, of course, as well as periodontal tissues that hold teeth in place within the jaw — all function together to create your smile. This includes muscles like the frenum, a fold of muscle tissue that connects the gums to the upper lip, which helps pull the lip upward when you smile.
Unfortunately, an overly large frenum could contribute to an unattractive space between your two upper front teeth. The problem occurs when the frenum grows beyond its normal range and runs between the front teeth to connect with the gums behind them at the forefront of the roof of your mouth. The resulting space that may develop can be closed with orthodontics, but unless the excess frenum tissue is addressed the space may eventually reopen.
The frenum is just one cause among many for a noticeably wide space, including bite problems (malocclusions), finger-sucking habits or missing teeth. We would, therefore, need to examine your mouth to determine the exact cause before beginning any treatment. If indeed the frenum is the source of the problem, it will be necessary to ultimately remove the excess portion through a procedure known as a frenectomy.
A frenectomy is a minor surgical procedure performed by a periodontist, oral surgeon or a general dentist with surgical training. After numbing the area with local anesthesia, the tissue behind the teeth is dissected or reduced in size with a small scalpel or a surgical laser. The wound is then closed with a few stitches; any post-surgical discomfort is usually minimal and managed with non-steroidal anti-inflammatory pain medication. The wound will completely heal within a few weeks.
Most frenectomies are performed after orthodontics to close the space. Removing it prior to tooth movement may result in scar tissue that prevents the space from closing. It’s also easier for the surgeon to gauge how much tissue to remove after space closure to avoid removing too much, which can leave a “black” triangular hole where gum tissue should normally be.
Treating an abnormally large frenum isn’t difficult, but it needs to be coordinated with orthodontic treatment for the best outcome. The end result is a smile that’s both healthy and attractive.
If you would like more information on teeth spacing problems, 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 “Space between Front Teeth.”
Gastroesophageal reflux disease (GERD) is a digestive disorder that can lead to a number of serious health problems. One of them, tooth erosion, could ruin your dental health.
Your stomach uses strong acids to break down food during digestion. A ring of muscle just above the stomach called the esophageal sphincter works as a one-way valve to allow food contents into the stomach but prevent acid from traveling back up through the esophagus.
GERD occurs when the esophageal sphincter weakens and starts allowing acid into the esophagus and potentially the mouth. The acid wash can eventually damage the esophageal lining, causing pain, heartburn, ulcers or even pre-cancerous cells.
Acid coming up in the mouth can cause the mouth’s normally neutral pH to slide into the acidic range. Eventually, these high acid levels soften and erode tooth enamel, increasing the risk of decay and tooth loss.
Accelerated erosion is often a sign of GERD—in fact, dentists may sound the first warning that a patient has a gastrointestinal problem. Unfortunately, a lot of damage could have already occurred, so it’s important to take steps to protect your teeth.
If you’ve been diagnosed with GERD, be sure to maintain good oral hygiene practices like brushing or flossing, especially using fluoride toothpaste to strengthen enamel. But try not to brush right after you eat or during a GERD episode: your teeth can be in a softened condition and you may actually brush away tiny particles of mineral. Instead, wait about an hour after eating or after symptoms die down.
In the meantime, try to stimulate saliva production for better acid neutralization by chewing xylitol gum or using a saliva booster. You can also lower mouth acid by rinsing with a cup of water with a half teaspoon of baking soda dissolved in or chewing on an antacid tablet.
You can also minimize GERD symptoms with medication, as well as avoiding alcohol, caffeine or spicy and acidic foods. Try eating smaller meals, finishing at least three hours before bedtime, and avoid lying down immediately after eating. Quitting smoking and losing weight may also minimize GERD symptoms.
GERD definitely has the potential to harm your teeth. But keeping the condition under control will minimize that threat and benefit your health overall.
If you would like more information on the effects of GERD on dental health, 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 “GERD and Oral Health.”
During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.
Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.
For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.
When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.
But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.
Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.
So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…
If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”
The American Diabetes Association has declared November National Diabetes Month. If you or a loved one has diabetes, you may already know that diabetes puts you at greater risk for gum disease. Let's look at four must-know facts about diabetes and gum disease.
#1. Gum disease is an acknowledged complication of diabetes.
High levels of blood sugar can interfere with your mouth's ability to fight infection, making you more susceptible to gum disease. People with poorly controlled diabetes may have more severe gum disease and may ultimately lose more teeth due to gum disease—in fact, one in five people who have lost all their teeth have diabetes.
#2. Gum disease makes diabetes harder to control.
Diabetes and gum disease are a two-way street when it comes to adverse health effects. Not only does diabetes increase the risk of gum disease, but gum disease can make diabetes harder to manage. Infections such as gum disease can cause blood sugar levels to rise. This is because chronic inflammation can throw the body's immune system into overdrive, which affects blood sugar levels. Since higher blood sugar weakens the body's ability to fight infection, untreated gum disease may raise the risk of complications from diabetes.
#3. You can do a lot to take charge of your health.
If you have diabetes and gum disease, you may feel as if you've been hit with a double whammy. While it's true that having both conditions means you are tasked with managing two chronic diseases, there is a lot you can do to take care of your health. Do your best to control blood sugar by taking prescribed medications, following a balanced diet, and exercising. In addition, pay special attention to your oral healthcare routine at home: Brushing your teeth twice a day and flossing once a day can go a long way in preserving good oral health.
#4. Preventing and managing gum disease should be a team effort.
We can work together to prevent, treat, and control periodontal disease. Come in for regular professional dental cleanings and checkups so we can monitor the health of your teeth and gums and provide specialized treatment such as deep cleanings when necessary. Diligent dental care can improve your oral health and help control your diabetes.
Remember, we're on your team. Let us know if there have been changes in your diabetes, your medication, or your oral health. If you have questions about diabetes and your oral health, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine article “Good Oral Health Leads to Better Health Overall.”
Waiting is part of life for a teenager: waiting to get a driver’s license, to graduate high school or to leave home and stretch their wings. A teenager with lost teeth may also need to wait until they’re older to obtain dental implants.
The reason arises from the differences in how implants and natural teeth attach to the jaw. Although natural teeth may seem rigidly set in the bone, they’re actually held in place by an elastic tissue between them and the bone known as the periodontal ligament. Tiny filaments that attach to the teeth on one side and the bone on the other hold the teeth in place, but also allow the teeth to move gradually in response to mouth changes.
A titanium implant post doesn’t have this relationship with the periodontal ligament — it’s attached directly to the jaw bone. Over time the bone, which has a special affinity with titanium, grows and adheres to it to form a durable bond without an attachment to the periodontal ligament. Because of this the implant can’t move like a natural tooth.
This is extremely important for implant placement because the jaws in particular won’t fully develop in most people until their late teens or early twenties: the upper jaw in particular will tend to grow out and down. Natural teeth accommodate to these changes, but the implant can’t — it will appear to retreat into the jaw. The gum tissues surrounding the implant also won’t conform to the continuing growth and may appear receded.
The best approach is to choose a temporary replacement option until the jaws and other facial bone structures have finished growing. One example is a bonded bridge in which we use a bonding agent to attach a bridge of artificial teeth to teeth on either side of a missing tooth — bonding won’t permanently alter them as with a traditional bridge. Once the jaws have finished growing, we can remove the bonded bridge and install the more permanent implant.
Ask any teenager: waiting can be hard. But with dental implants, waiting until the right time will help ensure the attractive result is a permanent one.
If you would like more information on dental restorations and teenagers, 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 “Teenagers & Dental Implants.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.