By Dr. Raymond B. van Gennip
October 15, 2021
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 Dr. Raymond B. van Gennip
October 05, 2021
Category: Oral Health
Tags: gum disease  
GumDiseaseCanBeStoppedbutYouCouldBeinForaLongFight

It often begins without you realizing it—spreading ever deeper into the gums and damaging tissue attachments, teeth and supporting bone in its way. In the end, it could cause you to lose your teeth.

This is periodontal (gum) disease, a bacterial infection caused by dental plaque, a thin biofilm that accumulates on tooth surfaces. It in turn triggers chronic inflammation, which can cause the gum attachments to teeth to weaken. Detaching gum ligaments may then produce diseased voids—periodontal pockets—that can widen the gap between the teeth and the gums down to the roots.

There is one primary treatment objective for gum disease: uncover and remove any and all plaque and tartar (hardened plaque). If the infection has advanced no further than surface gum tissues, it may simply be a matter of removing plaque at or just below the gum line with hand instruments called scalers or ultrasonic equipment.

The disease, however, is often discovered in more advanced stages: The initial signs of swollen, reddened or bleeding gums might have been ignored or simply didn't appear. Even so, the objective of plaque and tartar removal remains the same, albeit the procedures may be more invasive.

For example, we may need to surgically access areas deep below the gum line. This involves a procedure called flap surgery, which creates an opening in the gum tissues resembling the flap of an envelope. Once the root or bone is exposed, we can then remove any plaque and/or tartar deposits and perform other actions to boost healing.

Antibiotics or other antibacterial substances might also be needed for stopping an infection in advanced stages. Some like the antibiotic tetracycline can be applied topically to the affected areas to directly stop inflammation and infection; others like mouthrinses with chlorhexidine might be used to fight bacteria for an extended period.

Although effective, treatment for advanced gum disease may need to continue indefinitely. The better approach is to focus on preventing a gum infection through daily brushing and flossing and regular dental cleanings. And at the first sign of problems with your teeth and gums, see us as soon as possible—the earlier in the disease progression that we can begin treatment, the better the outcome.

If you would like more information on preventing and treating 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 “Treating Difficult Areas of Periodontal Disease.”

By Dr. Raymond B. van Gennip
September 25, 2021
Category: Dental Procedures
Tags: gum disease  
DontDelayTreatmentofGumDisease

Periodontal (gum) disease is a bacterial infection, which if left untreated could cause gum recession, bone loss and eventually tooth loss. Caused mainly by plaque left on tooth surfaces from poor hygiene practices, the deeper the infection spreads below the gum line, the more difficult it is to treat.

One possible scenario involves parts of a tooth’s root structure known as furcations. These are branching forks formed during the early development of teeth with multiple roots where they take different paths from the base of the crown. As gum disease spreads around the root it may cause different degrees of bone loss at the point of the branch.

It’s imperative when treating gum disease to uncover and remove any bacterial plaque or calculus (hardened plaque deposits) found, including below the gum line. To address bacterial plaque at the root level, it’s important to first determine if bone loss has involved the furcations (where the roots separate, also referred to as a “furcation invasion”) and to what degree.

We usually classify this degree of involvement in three classes: Class I, the invasion has created a groove in the furcation, but minimal significant bone loss; Class II, the bone loss has extended into the furcation by at least two millimeters; or Class III, the bone loss extends completely from one end of the furcation to the other (or “through and through”).

Depending on the class, cleaning plaque and calculus from furcations and then maintaining them thereafter can be quite challenging. We may need to use specially shaped hand instruments known as scalers or curettes to reach and clean root surfaces, or ultrasonic scalers that use high-frequency vibrations and streaming water to loosen and flush away plaque debris. It may also prove helpful, though limited, to apply antimicrobials or antibiotics to the area to help limit the levels of bacteria.

Disease damage around furcations may also require surgical treatment to encourage new tissue and bone growth in the area. Surgery can also help make the area more accessible to future cleaning and maintenance, both for you and us. Renewed hygiene practices on your part and regular cleaning and checkups with us will help ensure that the situation involving your tooth roots can be kept under control and your tooth preserved for many years to come.

If you would like more information on treatments for gum disease, please contact us or schedule an appointment for a consultation.

By Dr. Raymond B. van Gennip
September 15, 2021
Category: Dental Procedures
VivicaFoxandZendayaHaveThisinCommonAGorgeousSmile

Kill Bill fans have been pressing for a third installment of the stylized revenge tale since Kill Bill, Volume 2 hit the theaters in 2004. Finally, filmmaker Quentin Tarantino is talking about the long-awaited Volume 3 as if it might soon become a reality. The third movie in the franchise would most likely focus on the now-grown daughter of the character played by Vivica A. Fox in the first two. Vivica recently made known that should Kill Bill, Volume 3 go into production, she thinks 24-year-old actress and singer Zendaya would be perfect for the role.

Although Zendaya is a few inches taller than Vivica, the two women have a few things in common. Besides being talented movie and television actresses who have won awards for their roles, they both have camera-ready smiles. And both Vivica and Zendaya can thank their dentists for helping their smiles be their best.

In 2016, Vivica told Dear Doctor magazine that her smile needed a boost, so she opted for dental veneers to correct gaps between her teeth—and she's very happy with them. “I love my veneers!” she exclaimed. Zendaya also had help in achieving her Hollywood-perfect smile. In 2011, early in her career on the Disney channel, she wore clear orthodontic aligners to straighten her teeth. To further perfect her smile, she visited her dentist for professional teeth whitening in 2016, inviting a film crew along to show how easy and effective in-office tooth whitening is.

But you don't have to be a celebrity to enjoy smile-enhancing dental treatments. They are great options for anyone who wants to improve the look of their smile.

Teeth whitening. If your teeth are looking yellowed, in-office whitening can make them up to 10 shades brighter in one visit! Some people prefer professional at-home whitening kits, which produce great results more gradually.

Bonding or veneers. For small chips and cracks, cosmetic bonding can cover flaws by adding layers of a tooth-colored material over the tooth. For bigger flaws, heavy discoloration or gaps between teeth as Vivica had, dental veneers may be the answer. These custom-made thin porcelain shells cover the front-facing surface of the tooth, hiding imperfections to give anyone a Hollywood smile.

Orthodontics. Crooked teeth can detract from the look of a smile. While traditional braces are an option, many people with mild to moderate alignment issues find removable clear aligners the perfect way to get the smile they desire with minimal impact on their daily activities. Clear aligners are very subtle and can be removed for eating and cleaning as well as for special occasions—or for filming scenes, as Zendaya knows.

Contact us or schedule an appointment for a consultation to see if professional teeth whitening, cosmetic bonding or veneers, orthodontics, or another dental treatment could enhance your smile. You can also learn more by reading the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “How Your Dentist Can Help You Look Younger.”

By Dr. Raymond B. van Gennip
September 05, 2021
Category: Oral Health
Tags: dental injuries  
BeBetterPreparedForTooth-RelatedInjuries

Disasters are an unfortunate part of life—and not just on the epic scale of a hurricane, flood or earthquake. You could easily find yourself having your own "personal pizza"-sized disaster—a car accident, a sports injury or even a tumble on a leisurely hike. And oftentimes, the consequences could affect your mouth, teeth or jaws.

We can't always account for every variable in life, but we can prepare for possible disasters, big or small. That includes being ready for a possible dental injury.

September is National Preparedness Month, when safety and emergency professionals seek to raise awareness about what people can do to prepare for when disaster strikes. When it comes to protecting you and your family's oral health, here are a few things you can do to stop or lessen the impact of a dental injury.

Use a mouthguard. These soft, plastic appliances that fit in the mouth cushion the force of a hard blow to the face and jaws. They're a must for any contact sport like football or basketball, but also for other outdoor activities like trail biking. It's also worth the investment in comfort and effectiveness to have your dentist create a mouthguard customized just for you.

Create a dental first aid kit. It's a good idea to carry along a first aid kit during sports or other physical activities. It's a great idea to include a few extra items in case of injuries to the teeth or gums. A dental mirror and flashlight, medical-grade gloves, "Save a Tooth" kits (for knocked out teeth) or even tea bags to help stop bleeding gums are handy to have if you or someone with you suffers a dental-related injury.

Know what to do in case of dental injury. As careful as you might be, you can't completely eliminate the risk of dental injury, so it's wise to know how to render specific first aid for a variety of mouth-related injuries. To that end, we've provided a free dental injury field guide that you can print to review or to include in your emergency first aid kit.

Locate dental providers away from home. Serious injuries that result in loose, knocked out or misaligned teeth need immediate dental care. No problem if your regular dentist is close at hand—but what if you're out of town or on vacation? Before you go, locate a dental provider at your destination that you can see in case of emergency, and keep their contact information close at hand.

It's no fun going through an adverse event, especially with the possibility of injury. It's even worse to meet disaster unprepared. By following these guidelines, you can have a better handle on the injury risks to you and your family's dental health.

If you would like more information about protecting your teeth from injury, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “An Introduction to Sports Injuries & Dentistry.”





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Dr. Raymond B. van Gennip

(301) 565-8030
8630 Fenton Street, Suite 212 Silver Spring, MD 20910