By Scott A. Leggio, DMD
July 09, 2020
Category: Oral Health
Tags: gum disease  
3ThingsThatCouldHelpYouAvoidAnotherRoundWithGumDisease

While periodontal (gum) disease could ruin your dental health, it doesn’t have to. Dentists and periodontists (specialists in gums and other supporting tooth structures) have effective methods for stopping it, especially if the infection is diagnosed and treated in its earliest stages. With effective treatment, those swollen, reddened and bleeding gums can return to a healthy shade of pink.

But even if we stop the infection, you’re not out of danger. If you’ve had at least one bout with gum disease, you’re at higher risk for another infection. We will need to maintain ongoing vigilance to prevent another infection.

If you’ve recently undergone treatment for gum disease, here are 3 things you should do to keep your now healthy gums continually healthy.

Practice daily oral hygiene. Gum disease arises most often from dental plaque, a thin biofilm of disease-causing bacteria that builds up on tooth surfaces. It’s important for everyone to remove this buildup with daily brushing and flossing, but it’s even more so if you’ve already experienced gum disease. Practicing effective oral hygiene every day will reduce the presence of bacteria that could ignite a new infection.

See the dentist more frequently. The general rule for routine dental cleanings and checkups is twice a year. But you may need more frequent visits, post-gum disease. Depending on the severity of your disease, we may recommend you make return visits at two- to three-month intervals of time. These visits may also include heightened screenings to ensure another infection hasn’t taken hold, as well as procedures to make it easier to clean certain tooth areas prone to plaque buildup.

Manage other health conditions. Gum disease’s severity is often caused by the inflammatory response your body initiates to fight the infection, which then becomes chronic. This is similar to other conditions like diabetes, heart disease or rheumatoid arthritis: There’s evidence inflammation elsewhere in the body could worsen a gum infection, and vice-versa. Managing other health conditions through medical care, medication and lifestyle changes could minimize the occurrence and severity of a future gum infection.

If you would like more information on remaining infection-free after gum disease, 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 “Periodontal Cleanings.”

By Scott A. Leggio, DMD
June 29, 2020
Category: Dental Procedures
HowAFVsAlfonsoRibeiroSavedHisTooth

Remembered fondly by fans as the wacky but loveable Carlton on The Fresh Prince of Bel-Air, Alfonso Ribeiro is currently in his fifth year hosting America's Funniest Videos. It's the perfect gig for the 48-year-old actor, who loves to laugh and make others laugh as well. This is quite the opposite experience from one he had a few years ago that he remembers all too well: a severely decayed tooth.

After seeing his dentist for an intense toothache, Ribeiro learned he had advanced tooth decay and would need root canal treatment. Ribeiro wasn't thrilled by the news. Like many of us, he thought the procedure would be unpleasant. But he found afterward that not only was the root canal painless, his toothache had vanished.

More importantly, the root canal treatment saved his tooth, as it has for millions of others over the last century. If you're facing a situation similar to Alfonso Ribeiro's, here's a quick look at the procedure that could rescue your endangered tooth.

Getting ready. In preparation for root canal therapy, the tooth and surrounding gums are numbed, often first with a swab of local anesthesia to deaden the surface area in preparation for the injection of the main anesthesia below the surface. A dental dam is then placed to isolate the infected tooth from its neighbors to prevent cross-contamination.

Accessing the interior. To get to the infection, a small access hole is drilled. The location depends on the tooth: in larger back teeth, a hole is drilled through the biting surface, and in front teeth, a hole is drilled on the backside. This access allows us to insert special tools to accomplish the next steps in the procedure.

Cleaning, shaping and filling. Small tools are used to remove the diseased tissue from the interior tooth pulp and root canals. Then the empty spaces are disinfected. This, in effect, stops the infection. Next, the root canals inside the tooth are shaped to allow them to better accept a special filling called gutta percha. The access hole is then sealed to further protect the tooth from future infection, and a temporary crown is placed.

A new crown to boot. Within a couple weeks, we'll cap the tooth with a long-lasting lifelike crown (or a filling on certain teeth). This adds further protection for the tooth against infection, helps strengthen the tooth's structure, and restores the tooth's appearance.

Without this procedure, the chances of a tooth surviving this level of advanced decay are very slim. But undergoing a root canal, as Alfonso Ribeiro did, can give your tooth a real fighting chance.

If you would like more information about root canal treatments, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: How Long Will It Last?

By Scott A. Leggio, DMD
June 19, 2020
Category: Oral Health
Tags: gummy smile  
WhyIsYourSmileGummyHereAre4Possibilities

What makes a beautiful smile? Beautiful teeth, for sure. But there's also another component that can make or break your smile, regardless of your teeth's condition: your gums. Although their primary function is to protect and stabilize the teeth, your gums also enhance them aesthetically by providing an attractive frame.

But just as a painting displayed in an oversized frame can lose some of its appeal, so can your smile if the size of your gums appears out of proportion with your teeth. Normally, a smile that displays more than four millimeters of gum tissue is considered “gummy.”

There are some things we can do to improve your gum to teeth ratios. What we do will depend on which of the following is the actual cause for your gummy smile.

Excess gum tissue. We'll start with the obvious: you have excess gum tissue that obscures some of the visible tooth crown. We can often correct this with a surgical procedure called “crown lengthening,” which removes some of the excess tissue and then reshapes the gums and bone to expose more teeth length.

Teeth that appear too short. The problem may not be your gums — it could be your teeth appear too short. This can happen if the teeth didn't erupt fully, or if they've worn down due to aging or a grinding habit. One option here is to “lengthen” the tooth cosmetically with veneers, crowns or other bonding techniques.

Higher lip movement. Rather than your teeth and gums being out of size proportion, your upper lip may be rising too high when you smile, a condition known as hypermobility. One temporary fix is through Botox injections that paralyze the lip muscles and prevent their movement from overextending. We could also use periodontal surgery to perform a lip stabilization procedure that permanently corrects the upper lip movement.

Overextended jaw. Your gums may seem more prominent if your upper jaw extends too far down and forward. In this case, orthognathic (jaw straightening) surgery might be used to reposition the jaw relative to its connection with the skull. Setting the jaw up and back in this way would reduce the prominence of the gums when you smile.

As you can see, treatments range from cosmetic techniques to moderate surgical procedures. A full dental exam will help determine which if any of these measures could reduce gumminess and improve your smile.

If you would like more information on correcting gummy smiles, 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 Scott A. Leggio, DMD
June 09, 2020
Category: Dental Procedures
Tags: dental implant  
YourGumsandBoneNeedtoBeHealthyBeforeGettingImplants

If you've been dealing with a tooth that needs to be removed—or it's already missing—you may be looking to replace it with a dental implant. And it's a great choice: No other restoration can provide the appearance and function of a real tooth like an implant.

You and your smile are ready for it. The question is, though, are your gums and underlying bone ready? These dental structures play a critical role in an implant's stability and eventual appearance. A problem with them may make placing an implant difficult if not impossible.

An implant requires around 2.0 millimeters of bone thickness surrounding the implant surface for adequate support and to minimize the chances of gum recession. But tooth loss often leads to bone loss that can drop its thickness below this threshold. This can make placing an implant problematic.

Fortunately, though, we may be able to address the lack of sufficient bone through bone grafting. By placing grafting material within the empty socket, we create a scaffold for new bone cells to grow upon. Over time this subsequent growth may be enough to maintain an adequate thickness of bone for an implant to be placed.

The gums may also pose a problem if they've shrunk back or receded from their normal positions, as often happens because of gum disease (which may also have precipitated the tooth loss). Again, grafting procedures can help ensure there's adequate gum coverage for the implant. And healthier gums may also help protect the underlying bone from loss.

There are several techniques for placing gum tissue grafts, depending on how much recession has taken place. One procedure in particular is often used in conjunction with implant placement. A small layer of synthetic collagen material or gum tissue referred to as pa dermal apron is included with the implant when its placed. Settling into the bone socket, this apron helps thicken the gum tissues, as well as preserve the underlying bone.

During your preliminary exams, we'll assess your bone and gum health to determine if we should take any steps like these to improve them. It may add some time to the implant process, but the end result will be well worth it.

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 “Immediate Dental Implants.”

TheseHigh-TechToolsHelpYourVeneersLookAttractiveandNatural

Porcelain veneers have been used for several decades to enhance a dental patient's smile. These thin wafers of color-matched dental porcelain are bonded to the visible surface of teeth to mask chips, disfigurements, discoloring or slight misalignments and gaps. Thanks to the artistry of dentists and dental lab technicians, the average observer often can't distinguish a veneered tooth from a natural one.

Veneers are great—but they're even more life-like and versatile thanks to recent technological advances. Here are a few of these high tech means that can help make your veneers as attractive as possible.

Digital photography. There's a lot that goes into making sure an individual's veneers seamlessly blend in with other teeth. Photographs in digital form that can be transferred electronically to dental labs are invaluable, especially for accurate color matching. A high resolution photograph can also relay an enormous amount of information about a patient's existing teeth including shape, size, length and position.

Computer imaging. We want you to be satisfied with your final veneer appearance. The best way to ensure that—and to relax any jitters you may have over the process—is to enable you to “see” your new smile before your veneers are even made. We can do that with computer imaging software that modifies a current photo of your smile to look as it will be with veneers. It's also a great tool for making changes to the veneer plan based on what you see in the model.

Tryout veneers. We can even take it a step further, by letting you see how your proposed veneers will look like on your own teeth. We do this by creating provisional veneers made of composite materials that we temporarily bond to your teeth. You can try them out for a while (and get others' impressions) until your permanent veneers are ready. And as with computer imaging, tryout veneers can guide updates to your veneer schematics before they're made.

Using these and other advanced techniques can help fine-tune the design of your new veneers to make sure they're the best they can be. They're great tools in achieving our ultimate goal with your veneers—a beautiful smile that everyone thinks is natural.

If you would like more information on the smile-transforming power of dental veneers, 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 “Porcelain Veneers: Your Smile—Better Than Ever.”





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