My Blog

Posts for: June, 2020

By Rudolph E. Roman, DMD
June 23, 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 Rudolph E. Roman, DMD
June 13, 2020
Category: Oral Health
Tags: mouth sore  
ThatOddLacyMouthSoreisNoCauseforAlarm

Looking in the mirror, you probably focus on your teeth and gums—i.e., your smile. Your dentist, though, will take the time to look deeper into your mouth, searching for anything out of the ordinary. That could be a type of mouth sore known as lichen planus.

Lichen planus are lesions that can appear on skin or mucus membranes, including inside the mouth. The name comes from their resemblance to lichens, a fungus found on trees or rocks (although the sore itself isn't fungi). As such, they often have a lacy pattern of lines emanating from purplish bumps.

Again, the first indication you have such a condition may come from your dentist. Sometimes, though, you may notice greater sensitivity to spicy or acidic foods and, if the gums are affected, irritation when you eat or brush.

If you find out you have lichen planus, don't be alarmed—it usually doesn't pose harm to your health and it's not contagious. Its appearance, though, could be mimicked by more harmful medical conditions, so your dentist will want to confirm the lesion observed is truly lichen planus.

It's routine, then, for your dentist to excise a small sample of the sore's tissue and send it to a pathology lab for biopsy. Although results will more than likely confirm lichen planus or some other benign lesion, it's better to err on the side of caution and ensure you're not dealing with something more serious.

If you are diagnosed with lichen planus, you may need to take steps to manage symptoms. In most people, the sore will go away on its own, although there's no guarantee it won't reappear sometime later. In the event it lingers, your dentist may prescribe a topical steroid to help ease any discomfort.

You can also minimize a future outbreak by practicing effective daily oral hygiene to reduce the bacterial populations that may contribute to the condition. And when you're symptomatic, try avoiding spicy or acidic foods like citrus, peppers or caffeinated beverages.

Lichen planus is more bothersome than harmful. Taking the above steps can help you avoid it or deal with it more effectively when it occurs.

If you would like more information on lichen planus, 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 “Lichen Planus: Mouth Lesions That are Usually benign.”


ExcitingNewDiscoveryCouldHelpintheFightAgainstAntibioticResistance

Like the rest of healthcare, antibiotics have transformed dentistry. Advanced oral infections that once eluded successful treatment are routinely stopped with the use of these “wonder drugs.” But their overuse over the years has given rise to dangerous “superbugs” resistant to many antibiotics.

Antibiotics are one of the 20th Century's most significant healthcare achievements. Drugs like penicillin played a major role ending the global threat of tuberculosis, cholera and bacterial meningitis. Over the last few decades, more antibiotics have been developed to defend against an even wider array of bacterial dangers.

But along the way doctors and dentists began prescribing antibiotics for all manner of illnesses including viral infections like colds or flu for which they're less effective. They've also been increasingly used as a preventive measure, including inclusion in animal feed to fight disease.

But our tiny biological nemeses are adaptable. As bacterial strains come in contact with greater amounts of antibiotics, individual bacterium that survive transmit their resistance to subsequent generations. This can produce new strains like Staphylococcus aureus (MRSA) that are resistant to methicillin and other common antibiotics that once contained them.

There's deep concern that these new resistant strains, often recent incarnations of old diseases once thought defeated, will lead to higher rates of sickness and death. Increasing resistance could also make common procedures like those performed by dentists and oral surgeons, much riskier to undertake.

To combat this, pharmaceutical companies are racing to create new drugs to compensate. Recently, they've received an encouraging sign of hope in this battle from an unlikely source: viruses. Researchers in Tel Aviv, Israel have discovered an antagonistic protein to bacteria among a group of viruses called bacteriophages. The protein, injected into a bacterium, commandeers the cell's DNA function to aid virus reproduction, which kills the host.

In the words of one researcher, this makes these particular “enemy of our enemy” viruses our “friend.” Although the discovery is still a long way from practical use in antibiotics, harnessing it in future drug versions could help pack a greater punch against resistant bacteria.

In the meantime, providers and patients alike must practice and advocate for stricter protocols regarding the use of antibiotics. The viability of tomorrow's healthcare is on the line.

If you would like more information on the use of antibiotics in dentistry, please contact us or schedule an appointment for a consultation.