Posts for: May, 2018
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.”
As a regular part of your daily hygiene you may be using a mouthrinse — or “mouthwash” — mainly to keep your mouth feeling fresh and clean. Some mouthrinses, though, do more than give you fresher breath.
While there are countless mouthrinses available, we can place all of them into two broad categories: cosmetic and therapeutic. The first refresh your mouth and breath, usually with a mentholated or minty taste and smell that masks unpleasant odors. How well they work is mainly subjective: if you feel better after using them, they’ve done their job.
Therapeutic rinses have a different role, intended to improve oral health in some way. We can divide these into anti-cariogenic (decay prevention) or anti-bacterial rinses. You can find fluoride-based anti-cariogenic rinses over-the-counter in retail or drug stores, usually containing about .05% sodium fluoride per volume. Numerous studies have shown these rinses highly effective in preventing tooth decay when used with daily brushing and flossing.
Likewise, over-the-counter antibacterial rinses have proven somewhat effective in reducing bacteria that leads to dental disease. Formulated usually with triclosan, sanguinaria extract, zinc or essential oils, they can also help reduce the incidence of gingivitis (inflammation of the gums), but only if used in conjunction with brushing and flossing.
Perhaps, though, the most widely studied and substantiated therapeutic mouthrinse is chlorhexidine, a prescription-only rinse. Chlorhexidine inhibits the formation of bacterial plaque on tooth surfaces, the main trigger for both tooth decay and periodontal (gum) disease. It’s often used as a post-surgery rinse when brushing and flossing may not be possible, but dentists will often prescribe it for patients who have a high propensity for dental disease.
Using a mouthrinse depends on your current oral health and personal preferences. Therapeutically, most people gain some added tooth strength protection from using a fluoride rinse in their daily hygiene. If fresh breath and the way your mouth feels are important to you, you should consider such a rinse that also has a pleasant taste and effect for you. We can further discuss with you whether a different type of rinse, or a prescription-strength formula, might be best for your particular needs.
If you would like more information on mouthrinses, 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 “Mouthrinses.”
Dental implants are among the most popular tooth replacements with their high success rate, durability and life-like beauty. But obtaining them is a process that requires commitment, planning, and coordination — it takes a team.
Your general dentist is often the first team member you’ll encounter: because they’re most familiar with your mouth’s condition the implant discussion naturally begins here. They can help you determine if you’re a good candidate for implants, such as if you have sufficient bone mass at the intended site or if you have dental disease that must be treated first. They’ll also continue monitoring your general dental health throughout the process.
Your general dentist may also have the special training for surgically placing implants. If not, he or she may refer you to your next team member: an oral surgeon or periodontist skilled in implantation procedures. This step first requires careful planning, including developing a surgical guide for precise placement of the implant. These specialists may also contribute to other aspects of the implant process such as tooth extraction or bone grafting.
A few weeks after surgery bone will have grown and adhered to the implant to form a solid bond. It’s time for you to go back to your dentist who will work in conjunction with another member of your team, a dental lab technician. Together, your dentist and laboratory technician will guide the development, manufacture and placement of the implant’s life-like porcelain crown. The technician will take their specifications from the surgeon and your general dentist and, with his or her skill and artistry, form a crown that will blend well in color and shape with the rest of your teeth.
We also can’t forget another important team member: you. Without your input, especially in the early planning stages, your expectations for a more attractive smile might not be met. The rest of your implant team depends on you communicating your desires and wishes to balance with the technical requirements they must achieve.
The process for dental implants can take months. But with the coordinated efforts of your implant team you’ll be able to enjoy results — renewed function and a more attractive smile — that could last for decades.
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.”