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Cosmetic Dentistry and Periodontal Procedures

Not even the most beautiful teeth can look attractive if healthy and pleasing-looking gums do not surround them. That's because the gums frame the teeth like a picture frame frames a picture. To have a pleasing smile, the shape, color, and texture of the gums are just as important as that of the teeth they frame. Although tooth development, periodontal disease, trauma, or tooth loss can create esthetic gum deformities, modern periodontal procedures and cosmetic dentistry can give individuals a smile to smile about.

Common Cosmetic Gum Problems

Unhealthy Gums

As a result of periodontal disease, gums may appear red, swollen, and shiny. If an individual has gingivitis or periodontitis, the gums have to be periodontally treated prior to cosmetic dentistry procedures.

"Gummy Smile"

Teeth that appear too short may be normal-sized teeth hiding under too much gum. This can be the result of normal tooth development, or the use of certain medications that may cause gums to overgrow. Either way, a crown lengthening procedure can help reveal the normal tooth structure.

Gum Recession

If the teeth appear to be too long or if the root surfaces are exposed, it may be due to gum recession. Soft tissue grafting is very successful in correcting this problem.

Uneven Gum Margins

If the gum margins appear to be higher on some teeth and lower on others, this may be due to gum recession, altered eruption, or gum defects that resulted from tooth loss. The treatment of uneven gum margins may require crown lengthening, soft tissue grafting, ridge augmentation, or a combination of these procedures.

Gum Indentations

After a tooth is lost, the bone that encased it disintegrates and the gum around it may collapse, creating an indentation where the tooth used to be. Ridge augmentation procedures can help correct this problem.

Uneven Pigmentation

Changes in the color of the gums may be part of normal gum development, or the result of scarring. Soft tissue grafts can predictably correct this problem.

Spaces In Between the Teeth

Periodontal disease can result in spaces in between the teeth that may appear like black triangles. These spaces can be very difficult to treat. They can be made less unattractive by a combination of procedures that include orthodontics (braces), crowns (caps), and/or periodontal (gum) surgery. The best way to avoid these spaces is to treat periodontal disease in its early stages and avoid the need later for cosmetic dentistry.

Missing Teeth

One or more missing teeth can be predictably replaced with the aid of dental implants. Dental implants can look and feel like natural teeth.

Changes in the appearance of the gums can occur as a result of normal tooth development, periodontal disease, trauma, or tooth loss. By working with a restorative dentist who has expertise in cosmetic dental care and through the aid of modern periodontal techniques, individuals can design a smile that is both esthetic and youthful in appearance.

By Laura Minsk, DMD

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

Is Your Nose Getting Closer To Your Chin? Restorative Dentistry Can Help!

Everyone, even your dentist, knows that when we age, we see certain changes in our face (for example, wrinkled skin, less skin tone, shrunken appearance). The soft tissue in the lower one-third of the face is supported by the teeth and jawbone, and gives support to your smile. As we age, we lose support to our smile and we begin to appear older.

Anatomically, the face is divided into thirds: the upper, middle and lower one-third. The space between your nose and your chin is referred to as the lower one-third. The teeth support the vertical height of your lower face, and more specifically the back teeth support your lower face.

Most dentists agree that minimal and gradual wearing away of the top enamel of the teeth is considered normal during the lifespan of a patient. However, excessive wear on the top surfaces of the teeth can result in abscessed teeth, an irregular bite, decreased chewing capacity and esthetic disharmony. Patients with these types of problems often require extensive restorative cosmetic dentistry treatment.

How Common Is Tooth Wear?

Although the prevalence of tooth wear, or attrition, is not known, it is thought to be very common in adults over the age of 40. The wearing of the top surfaces of the teeth is most often attributed to attrition, which is the wearing away of one tooth surface by another tooth surface. Attrition is the result of bruxism, or the involuntary grinding of the teeth against each other.

How Does Attrition Occur?

Attrition can be the result of one or a combination of problems such as:

• Congenital Abnormalities: Hereditary abnormalities can cause the malformation of the surfaces of the teeth. This can result in a thin and/or brittle outer layer of the tooth. This leaves the tooth more susceptible to surface wear and a more rapid attrition of tooth structure.
• Parafunctional Habits: One type of parafunctional habit is bruxism, as explained above. Other habits often associated with attrition include biting on needles, pipe stems, pencils, or finger nails as well as clenching. Many studies have related stress to attrition.
• Abrasion: It is defined as the wearing away of tooth tissue through mechanical processes. The top surfaces of the teeth are abraded away usually by diet, chewing of abrasives such as tobacco and environmental factors such as constant exposure to dust and grit (in farming).
• Erosion: Erosion is the destruction of hard dental tissues by chemical action. Diets high in acidic content like juices, colas and other carbonated drinks are examples of the foods that cause erosion. Patients who suffer from anorexia nervosa or bulimia are prime examples of erosion due to the high acid nature of stomach acids that are constantly regurgitated into the mouth.

What Is the Result of Worn Teeth?

Depending on the severity of the tooth wear, teeth may be broken, shortened and unattractive. Having worn teeth can result in jaw joint pain (TMJ), a decreased ability to chew and a sunken appearance to the lower face. All of these results can make a person appear more wrinkled and older.

Can Worn Teeth Be Fixed with Fillings?

Generally, the worn teeth will have to have new fillings placed or redone. When severe wear occurs in the mouth, a dental crown or multiple crowns may be the only solution.

Can Tooth Wear Be Prevented?

Yes, tooth wear can be prevented, but only if you make regular visits to the dentist. If detected early enough, your dentist may prescribe a plastic night guard to protect your teeth, much like an athletic mouth guard.

By Benjamin O. Watkins, III, DDS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.