You’re a bit self-conscious about your smile. But not because of your teeth — it’s your upper gums, which seem too prominent when you smile. While “too much” is a matter of perception varying from individual to individual, it’s generally accepted that a smile is “gummy” if four or more millimeters (a bit more than an eighth of an inch) of the gums are visible.
The good news is there are ways to improve the appearance of your gums. Which method we use, though, will depend on the underlying reason why the gums are prominent. The amount of gum tissue, in fact, may not be the problem at all, but could be the size of the crowns (the visible parts of teeth), the upper lip’s range of motion, the upper jaw’s position in relation to the face, or a combination of any of these.
For example, if your teeth didn’t erupt and develop properly, the gums might not have moved back to their proper position and stabilized as they should in your late teens or early twenties. A normal crown (the visible part of a tooth) is about 10 millimeters long, with a ratio of width to length of about 75-85%. Below those measurements the teeth can appear smaller, making even normal gum tissue appear larger. In another scenario, the upper lip may rise too high when you smile (hypermobility), which reveals too much of the gums.
If tooth size is the problem, we may recommend a periodontal surgical procedure called crown lengthening that reveals more of the tooth. A hypermobile lip can be treated with Botox shots to temporarily restrict the movement (it must be repeated every six months) or by surgically repositioning the lip muscles that control movement. Similarly, surgically repositioning an overlong upper jaw to make it appear shorter may be the right course.
That’s why our first step is to determine why your gums are too prominent with a complete dental examination. Knowing exactly why they stand out will help us devise a treatment plan that will greatly enhance your smile.
If you would like more information on improving 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.”
It's no secret that many of Hollywood's brightest stars didn't start out with perfectly aligned, pearly-white teeth. And these days, plenty of celebs are willing to share their stories, showing how dentists help those megawatt smiles shine. In a recent interview with W magazine, Emma Stone, the stunning 28-year-old star of critically-acclaimed films like La La Land and Birdman, explained how orthodontic appliances helped her overcome problems caused by a harmful habit: persistent thumb sucking in childhood.
“I sucked my thumb until I was 11 years old,” she admitted, mischievously adding “It's still so soothing to do it.” Although it may have been comforting, the habit spelled trouble for her bite. “The roof of my mouth is so high-pitched that I had this huge overbite,” she said. “I got this gate when I was in second grade… I had braces, and then they put a gate.”
While her technical terminology isn't quite accurate, Stone is referring to a type of appliance worn in the mouth which dentists call a “tongue crib” or “thumb/finger appliance.” The purpose of these devices is to stop children from engaging in “parafunctional habits” — that is, behaviors like thumb sucking or tongue thrusting, which are unrelated to the normal function of the mouth and can cause serious bite problems. (Other parafunctional habits include nail biting, pencil chewing and teeth grinding.)
When kids develop the habit of regularly pushing the tongue against the front teeth (tongue thrusting) or sucking on an object placed inside the mouth (thumb sucking), the behavior can cause the front teeth to be pushed out of alignment. When the top teeth move forward, the condition is commonly referred to as an overbite. In some cases a more serious situation called an “open bite” may develop, which can be difficult to correct. Here, the top and bottom front teeth do not meet or overlap when the mouth is closed; instead, a vertical gap is left in between.
Orthodontic appliances are often recommended to stop harmful oral habits from causing further misalignment. Most appliances are designed with a block (or gate) that prevents the tongue or finger from pushing on the teeth; this is what the actress mentioned. Normally, when the appliance is worn for a period of months it can be expected to modify the child's behavior. Once the habit has been broken, other appliances like traditional braces or clear aligners can be used to bring the teeth into better alignment.
But in Stone's case, things didn't go so smoothly. “I'd take the gate down and suck my thumb underneath the mouth appliance,” she admitted, “because I was totally ignoring the rule to not suck your thumb while you're trying to straighten out your teeth.” That rule-breaking ended up costing the aspiring star lots of time: she spent a total of 7 years wearing braces.
Fortunately, things worked out for the best for Emma Stone: She now has a brilliant smile and a stellar career — plus a shiny new Golden Globe award! Does your child have a thumb sucking problem or another harmful oral habit? For more information about how to correct it, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”
X-rays are an important diagnostic tool in dentistry because of their ability to penetrate and pass through body tissues. Because they penetrate at different speeds depending on tissue density (shorter and thus darker on exposed film for soft tissues, longer and lighter for hard tissues like bone or teeth), we’re able to detect decay which appear as dark areas on x-ray film.
Without x-rays, the early detection and diagnosis of dental problems would be quite difficult. But despite its obvious benefits, it’s still a form of released energy that exposes patients to a certain amount of radiation. Since the potential health risk from radiation depends on the amount released (the dosage) and for how long and often a person is exposed, we must determine if the dosage and frequency from dental x-rays is a cause for concern.
It’s a common misconception to view any radiation exposure as dangerous. The truth is, however, we’re all exposed daily to radiation from the natural environment — about 2 to 4.5 millisieverts (the dosage measurement for radiation exposure) a year, or about 10 microsieverts (one-thousandth of a millisievert) every day.
In comparison, radiation exposure from routine dental x-rays is a fraction of this if measured over time. A set of four bitewing images of the back teeth produces 4 microsieverts of radiation, less than half the average daily exposure. One of the most comprehensive x-ray sets, a full mouth series of 18-20 images using “D” speed film, results in an exposure of 85 microsieverts, equaling about a week of normal radiation exposure.
These thoroughly researched rates help demonstrate that regular dental x-rays are relatively safe. What’s more, x-ray technology has continued to advance since first used in the mid-20th Century. With innovations in film and digital processing, today’s equipment produces only 80% of the radiation exposure of earlier machines. In effect, we’ve increased our capabilities to more accurately detect and diagnose issues through x-rays, while lowering the amount of radiation exposure.
Of course, a person’s annual exposure rate may differ from others. If you have concerns for yourself or your family about x-ray radiation exposure, please feel free to discuss this with us. Our primary goal is to improve your oral health without undue risk to your health in general.
If you would like more information on x-ray diagnostics and safety, 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 “X-Ray Frequency and Safety.”
No two smiles are alike, particularly when tooth loss occurs. Replacing one or more missing teeth takes the expertise of a highly experienced dental team such as your Washington, DC, dentists, Dr. Carlos Abreu and Dr. Mahvassh Abreu. They fill smile gaps with innovative dental implants, customizing them for individual patient preferences and health needs. Learn here about the many benefits of dental implants!
You're created to have a specific number of teeth, and losing even one changes how you look, speak, and eat. Even supporting tissues, such as bone and gums, change after a tooth is extracted or avulsed (knocked out).
In the past, partial and full dentures or fixed bridgework were the only solutions for smile gaps. Today, dentists, such as Dr. Abreu in Washington, DC, prefer placing dental implants. These lifelike and highly functional artificial teeth actually improve gum tissue and jaw bone density. Plus, they give patients the most natural-looking, feeling, and acting prosthetics available.
What makes dental implants so great
A single dental implant replaces a lost tooth from root to crown. Implant-supported dentures and bridgework anchor artificial teeth with multiple implants. Either option uses titanium implant screws surgically-inserted right into the jaw. The single implant includes a metal alloy extension post and customized porcelain crown.
Through a natural bonding process called osseointegration, the jaw bone wraps around the implant and keeps it in place just as strongly as a natural tooth root would. Osseointegration takes some time but practically guarantees the longevity of a dental implant. The Institute of Dental Implant Awareness says that about 97 percent of dental implant treatments succeed and stay in place for decades.
Can you benefit from implants?
Many older teens and adults do. Dr. Abreu will review your health history and perform a complete examination, including special three-dimensional imaging to view your bone structure. Your jaw bone must have sufficient density, width, and height to accept the implant. If it does not, your dentist can build it up through special materials and procedures. Bone augmentation does add time to the implant process, however.
Dr. Carlos Abreu and Dr. Mahvassh Abreu are here at our Washington, DC, office to discuss your tooth replacement options. To arrange a personal consultation, call today at (202) 496-0891.
There are several reasons why dental implants are so popular. Perhaps the most important, though, is their longevity: if maintained properly implants can last for decades. However, they’re not indestructible—certain mouth conditions could put them at risk for early failure. But if you address emerging problems early, you may be able to prevent that unfortunate outcome.
Your implants may be in danger, for example, if you have a teeth grinding or clenching habit. This occurs when a person involuntarily and repeatedly bites down on their teeth when not chewing or speaking. Usually triggered in adults by high stress, teeth grinding can subject both natural teeth and implants to damaging levels of force. Over time this can cause bone loss around an implant and weaken their support. It could also cause a direct break in an implant.
But there are ways to stop or at least reduce the effects of teeth grinding. One effective way is a custom-made bite guard you wear while you sleep. Made of hard plastic, the guard prevents the teeth from making solid contact with each other, reducing the amount of force generated.
A more prominent problem is periodontal (gum) disease, a bacterial infection caused by built-up dental plaque on tooth surfaces. This can trigger inflammation, a normal defensive response that when it persists for an extended period of time can damage tissues and supporting bone. It can also cause a specific form of gum disease related to implants called peri-implantitis, in which the tissues that support an implant become infected and weaken, leading eventually to possible implant failure.
If you have implants, then, you should brush and floss daily to prevent gum disease, as well as see your dentist at least every six months for cleanings and checkups. And if you notice anything like reddened, swollen or bleeding gums, see your dentist immediately. The sooner you undergo treatment, the better the outcome for your implants as well as your overall health.
Dental implants can give you years of great service and can prove to be well worth the cost. But you’ll have to stay on your guard against gum disease and other mouth conditions that could endanger them down the road.
If you would like more information on dental implants, 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 “Dental Implants: A Tooth-Replacement Method that Rarely Fails.”
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