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By Catherine Pike, DDS, PC
March 24, 2020
Category: Dental Procedures
Tags: gum surgery  
GumSurgeryCanImproveYourSmileandSaveYourTeeth

While the term “plastic surgery” might bring to mind face lifts or tummy tucks, not all procedures in this particular surgical field are strictly cosmetic. Some can make a big difference in a person’s health.

One example is periodontal plastic surgery, which corrects gum tissue loss around the teeth. Although these procedures can indeed improve appearance, they more importantly help save teeth.

Gum loss is most often a consequence of periodontal (gum) disease, a bacterial infection arising from a thin film of food particles on the teeth called dental plaque. As the disease weakens the gums’ attachment to teeth, they shrink back or recede, exposing the area around the roots. Without the protective cover the gums provide the roots, they become more susceptible to decay.

In milder cases of gum recession, treating the infection often results in the gums regaining their normal attachment to teeth. But with more advanced recession, natural gum healing may not be enough to reverse it. For such situations grafting donor tissue to the recessed area can help stimulate new tissue growth.

While gum tissue grafts can come from an animal or other human, the most likely source is from the person themselves. In one type of procedure, free gingival grafting, the surgeon locates and completely removes (or “frees”) a thin layer of skin resembling gum tissue, typically from the roof of the mouth, shapes it and then transplants it by suturing it to the recession site. Both donor and recipient sites heal at about the same rate in two to three weeks.

Another technique is known as connective tissue grafting. In this procedure the surgeon partially removes the donor tissue from its site while leaving a portion containing blood vessels intact. The palatal tissue is still used and transported to fit beneath the tissue that’s still attached to the blood supply. This connective tissue graft is then positioned and sutured to the recipient site while still maintaining its blood supply connection at the donor site. Maintaining this connection facilitates healing and increases the chances the graft will “take” and become firmly attached to the new site.

Grafting procedures require advanced techniques and skills. But with them we may be able to restore gum attachment to teeth with an impact on appearance and dental health that’s well worth the effort.

If you would like more information on 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 “Periodontal Plastic Surgery.”

CosmeticQuestionstoAsktoGetYouontheRightPathtoaBetterSmile

For some time now, you’ve noticed things about your teeth and gums — your overall smile — that you would like to change. But you’re in unfamiliar territory: you don’t know where to begin.

Here, then, are a few basic cosmetic dentistry questions you should ask yourself and us to get you moving in the right direction.

Am I a candidate for cosmetic dentistry? Invariably, the answer is yes — there’s always a way to enhance your appearance, starting with basic hygiene or whitening. But whether you’re a candidate for a particular procedure will depend on a full examination of your mouth — a “smile analysis” — to assess its current condition and needs, and what cosmetic options would best fit those needs.

Are my expectations realistic? That will first depend on what we find with your smile analysis. It will, however, also include studying the bigger picture — how certain changes might affect not only your smile but your overall facial appearance. Your wants and desires are extremely important in this process, but they should also be balanced with a dose of reality — some things may not be in your best interest health-wise to undertake, or are not in keeping with basic aesthetic principles of beauty.

Will I be able to have an idea beforehand how the changes will look? We’ve come a long way in providing patients ways to preview their new smile before undertaking a procedure. It’s often possible to “see” your proposed smile through computer simulation, or in some cases “test drive” it with temporary (provisional) crowns or veneers. For restorations involving porcelain crowns, it may be possible to take your input and fine-tune the shape and color of the permanent crown before it’s completed.

What will it cost? This will depend on the treatment plan we develop. Some treatments like teeth whitening are relatively inexpensive, while procedures like dental implants or orthodontics are major investments. You should also consider the costs to your time — some treatments require only a single visit, while others may take months or even years to complete. Depending on your financial means and comfort level, cost will need to be factored into the final plan, as well as your expectations.

If you would like more information on cosmetic dentistry, 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 “Cosmetic Dentistry: A Time for a Change.”

HughJackmanIsAllSmilesforHisNewBroadway-InspiredShow

To anyone immersed in the “X-Men Universe” Hugh Jackman will always be Wolverine, a role he played in seven movies. But there’s more to this Australian actor than mutant bone claws and mutton chops that would make Elvis envious. Jackman has also starred in over 20 non-superhero films, including Les Misérables, for which he won a Golden Globe. He is also a Tony award-winning Broadway performer—with a winning smile.

With his famed character Logan/Wolverine fading in the rearview mirror, Jackman has returned to his musical roots. He will play Harold Hill in the Broadway revival of The Music Man, set to open in Fall 2020. And since May 2019 he’s been on world tour with Hugh Jackman: The Man. The Music. The Show., featuring Jackman and a supporting cast performing songs from favorite shows and films, including Les Misérables and the 2017 hit The Greatest Showman.

The Show, with 90 planned stops throughout Europe, North America and Oceania, is a decidedly different “universe” from the X-Men. As Wolverine, Jackman could get away with a scruffier look. But performing as Jean Valjean or the bigger-than-life P.T. Barnum, he has to bring a vastly different look to the role, which brings us to Jackman’s teeth…

Once upon a time, Jackman’s teeth were an unflattering gray—definitely not a good look for stage or film. So with the help of his dentist, Jackman set about upgrading his smile with teeth whitening. Teeth whitening is a great way to take a dull, stained smile and turn up the volume on its brightness—and attractiveness—a notch or two. A dentist applies a bleaching solution that stays in contact with the teeth for a few minutes. The process is often aided by special lighting.

A professional application is especially desirable if, like Jackman, you want “Goldilocks” brightness: not too little, not too much, but just right for you. Dentists can precisely control the tint level to get a brighter but more naturally looking white. Of course, you can also get a dazzling “Hollywood” smile if you so desire.

And although the effect of teeth whitening isn’t permanent, a dental application can last a while, depending on how well you manage foods and beverages that stain teeth. With a touchup now and then, you may be able to keep your brighter smile for years before undergoing the full procedure again.

One important note, though: This technique only works with outer enamel staining. If the discoloration originates from within the tooth, the bleaching agent will have to be placed internally, requiring access to the inside of the tooth. An alternative would be porcelain veneers to mask the discoloration, an option that also works when there is ultra-heavy enamel staining.

If you’re tired of your dull smile, talk with us about putting some pizzazz back into it. Teeth whitening could be your way to get a smile worthy of Broadway.

If you would like more information about teeth whitening, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Whitening Traumatized Teeth.”

By Catherine Pike, DDS, PC
February 23, 2020
Category: Oral Health
Tags: gum disease  
UncoveringEarlyGumDiseaseThroughPeriodontalProbing

How do you know if you have periodontal (gum) disease? Sometimes your gums will tell you—when they’re red, swollen or bleed easily.

But your gums can also look and feel healthy while a gum infection still brews below the gum line. In this case, a regular dental visit could make the difference. Even without overt signs of infection, we may be able to detect gum disease with a slender metal instrument called a periodontal probe.

Gum disease is a bacterial infection that most of the time arises from dental plaque. This thin film of bacteria and food particles accumulates on tooth surfaces, especially because of poor or non-existent oral hygiene. A continuing infection can weaken gum tissues and cause them to pull away or detach from the teeth.

Normally, there’s a slight gap between the gums and teeth. But as the infected gums pull away, the gaps grow larger and deeper, forming what are known as periodontal pockets. They become filled with infection that soon spreads to the root and bone and increases the risk of tooth loss.

These pockets, though, could be the means for detecting a gum infection with the help of the periodontal probe. During a dental exam we gently insert the probe, which has millimeter depth markings etched on it, between a tooth and its adjacent gums. While a depth of 1 to 3 mm is normal, a probe measurement of 4 to 5 mm could be a sign of an early stage infection. A reading of 7 to 10 mm, on the other hand, may indicate more advanced disease.

Along with other factors, periodontal probing can be quite useful identifying both the presence and extent of a gum infection and then how to treat it. The goal of any treatment is to remove plaque and tartar (calculus) deposits that sustain the infection. But probing, along with other diagnostic methods like x-rays, could point to deeper infection below the gum line that require more extensive methods, including surgery, sometimes to access and remove the disease.

Achieving the best treatment outcome with gum disease often depends on finding the infection early. Periodontal probing helps to make that discovery more likely.

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

By Catherine Pike, DDS, PC
February 13, 2020
Category: Dental Procedures
StopBiteProblemsEarlyWithInterceptiveOrthodontics

Every year many parents learn their “tweenager” or teenager needs their bite corrected, often with specialized orthodontics. Imagine, though, if these families could go back in time to when their child’s poor bite was just developing to stop or slow it from forming.

Time travel may still be science fiction, but the approach suggested isn’t. It’s called interceptive orthodontics, a group of techniques and procedures performed during the early stages of jaw development. The focus is usually on getting abnormal jaw growth back on track, enough so that a poor bite won’t form.

The upper jaw, for example, may be growing too narrow, reducing the amount of available space for tooth eruption. If it isn’t corrected, teeth can erupt out of position. To correct it, an orthodontist places a palatal expander in the roof of the child’s mouth (palate). The appliance applies gentle pressure against the inside of the teeth, which stimulates the jaws to develop wider.

The expander works because of a separation in the bones at the center of the palate, which later fuse around puberty. The pressure applied from the expander keeps this gap slightly open; the body then continues to fill the widening expansion with bone, enough over time to widen the jaw. If you wait until puberty, the gap has already fused, and it would have to be reopened surgically to use this technique. Ideally, then, a palatal expander should be employed at a young age.

Not all interceptive techniques are this extensive—some, like a space maintainer, are quite simple. If a primary (baby) tooth is lost prematurely, teeth next to the empty space tend to drift into it and cause the intended permanent tooth to erupt out of place due to a lack of space. To prevent this an orthodontist places a small wire loop within the space to prevent other teeth from moving into it.

These are but two examples of the many methods for stopping or slowing a developing bite problem. To achieve the best outcome, they need to be well-timed. Be sure, then, to have your child undergo an orthodontic evaluation around age 6. If an interceptive orthodontic approach is needed, it could eliminate the need for more extensive—and expensive—treatment later.

If you would like more information on treatments to get ahead of bite problems, please contact us or schedule an appointment for a consultation.





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