How The Contours of Your Gums Can Enhance Smile’s Appearance
Posted on Aug 10, 2021 by William J. Claiborne, DDS MS
I remember the home of a beloved Great Aunt, whom I visited often growing up. One of the things that made her home so “homey” were the displays of bric-a-brac. As a youngster, I didn’t term her arrangements of china tea sets and Hummel figurines as bric-a-brac (they were “knick knacks,” to me). However, I found myself being drawn to her displays on shelves, in curios, and on tables moreso as I grew older.
To me, what was impressive about these groupings was how balanced they were. The china tea pots were centered, surrounded by carefully spaced cups and saucers. Hummel children were in playful arrays to appear as a happenstance assembly of friends.
As a Periodontist, I am now far more appreciative of how my Aunt kept such proper balance to these displays. Everything seemed so coordinated, harmonized.
As a specialist in the treatment of all stages of periodontal (gum) disease and the placement of dental implants, I am also the expert when it comes to the contours of gum tissues surrounding teeth. The gums are important to the health of your teeth as well as the appearance of a smile.
When it comes to protecting teeth, think of the gum tissues as a protective blanket. The gums cover over the under-structures of the mouth’s interior (oral cavity). If you’ll look at the base of each tooth, you’ll see that the gum tissues snugly wrap the base of each tooth. This protective seal is what prevents bacterial penetration below the gum line.
When gum tissues loosen their grip around teeth, the leading cause is gum disease. Gum disease weakens oral tissues and causes them to become inflamed. As the gums loosen, bacteria is able to work their way into the structures that support natural teeth (including bone).
When bacteria reach this level of oral structures, ridding it involves a more involved procedure than what a mere dental cleaning can combat. As it progresses, the gums become spongy and pus pockets form. Teeth loosen and may need removal. Gum disease is the leading cause of adult tooth loss.
Yet, gum tissues not only serve as a protective element of your mouth. The appearance of a smile can be greatly affected by the shape and amount of gum tissues exposed when smiling.
Balance is an element of beauty, according to studies. We are drawn to it. According to Penn State’s “Science in Our World: Certainty and Controversy”,
“Studies show that symmetrical faces are preferred and more attractive to others than people who have asymmetrical faces. Similarly shaped eyes and eyebrows, sides of the nose mouth can all fall into the symmetrical category.”
They shared findings of one study, performed over the course of two decades, that had men and women rank the attractiveness of people in photos. The study revealed:
“Men and women both overwhelmingly chose the most symmetric face. This test was an observational study, so it was only as clear and truthful as the participants of the study were. There wouldn’t really be a way to make this sort of study an experimental test, so as far as attraction goes, studies must rely on the opinions of the participants. However, the majority of the participants chose the most symmetrical faces as the most attractive ones, so it is easily said that it is true, symmetry equals attractiveness.”
Although “beauty is in the eye of the beholder,” symmetry seems to be a component of what humans define as beautiful and what we’re drawn to (although inner beauty is an important factor in what keeps us connected to an individual).
When a smile shows too much or too little gum tissue bordering the tops of teeth, it moves the smile line out of balance. For example, in a “beautiful” smile, the arches of gum tissues visible in a full smile are at a similar level. The amount of gum arches are in a complimentary line to teeth, rather than an amount that draws the eye. Too much gum tissue showing is referred to as a “gummy smile.”
A gummy smile is not an unattractive feature. Having one does, however, alter the appearance of a smile based on balance. For example, a diastema is a wide space between the two front teeth. It is often a hereditary trait. Although it is not unattractive feature, the eye seems drawn to that one spot rather than seeing the smile, as a whole, as a complement to other facial features. The individual may have beautiful lips or eyes, but the gap between the teeth is what is noticed as being “off.”
Quite frankly, some people are perfectly comfortable with having a gummy smile or a diastema. For them, it’s part of their personality or signature look. After all, what would Lauren Hutton, the famous model of the 70’s, have been without her diastema?
For other people, these features cause shyness, insecurity or a feeling of awkwardness. Some people try to smile with lips only. Others try to conceal a full smile with a hand. “Holding back” on a smile is a shame, especially since smiling is a proven asset to our frame of mind.
The act of smiling causes the brain to release chemicals known as endorphins. These trigger somewhat of a natural high, creating a happier mood. This has been shown to be true even when faking a smile.
Additionally, people who smile often are deemed happier, more confident and even younger. In smiling, the facial muscles pull upward and smooth out the skin to give the face a bit of a lift. Free of charge!
Another distortion in a balanced smile can be an uneven line of gum tissues, where there is more gum showing on some teeth than others. This up-and-down line of gum tissues creates a jumbled look. Again, the appeal of balance is disrupted.
In these cases, a “crown lengthening“ procedure is often advised. This is a simple procedure that alters the height of the gum tissues prior to placement of a crown (‘cap’). Not only does this provide a more flattering smile line, it protects the teeth involved while enhancing the tooth’s shape.
Another issue that impacts both appearance and the health of a tooth is gum recession. When the gums recede from the base of teeth, more sensitive and vulnerable areas of the tooth’s root are exposed. Exposure can lead to sensitivity and higher risk for bacterial penetration.
The procedure for most gum recontouring is known as a Gingivectomy. In this, our Asheville Periodontal dental office uses a dental laser. Gingivectomy is the most common procedure performed with a laser, which is used to precisely contour gingiva (gum tissue) for restorative, cosmetic, and periodontal needs.
The laser promotes rapid healing and reduces discomfort post-operatively with periodontal packing or sutures rarely needed. In the hands of a skilled periodontal specialist, laser technology also minimizes penetration depths. For minor procedures, lasers can sometimes require little or no anesthetic.
For more involved gum contouring, our Asheville periodontal office offers both oral and I.V. sedation. Oral sedation is a pill that helps patients relax. It also has an amnesiac effect, leaving most with little or no memory of treatment afterward.
I.V. sedation places the patient in a deeper sleep state, also erasing memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety. In our office, this is overseen by Dr. Brad Stone, a Medical Doctor (MD) who is a board certified Anesthesiologist & Pediatric Anesthesiologist.
With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.
The health and appearance of your smile are important. It is proven that good oral health is a supportive component to your overall health. It is also shown that the appearance of a smile can add positively to an individual’s perception of “self”.
If you’re interested in improvements in the health and appearance of your smile, let’s discuss the possibilities during a consultation appointment. Call 828-274-9440. A referral is not always needed.
Why Seek A Periodontist For Dental Implants
Posted on Jul 13, 2021 by William J. Claiborne, DDS MS
Like many people, I value my relationship with my Internist. Through his care, I am confident that he understands my specific needs to oversee all aspects of my health.
Some of this care occasionally involves being referred to a specialist. For example, my Internist may advise me to see a dermatologist for a particular skin condition. Together, my internist and the dermatologist are able to work in unison so I’m receiving the proper treatment plan according to my particular needs.
I am also a specialist in the dental field. I am a periodontist, which is a specialist who receives most patients through referrals by a general dentist or another dental specialist. This is because a periodontist offers a unique set of skills as well as an advanced level of understanding when it comes to oral tissues and dental implants.
The American Academy of Periodontology defines a Periodontist as: “A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants. Periodontists are also experts in the treatment of oral inflammation. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. They are familiar with the latest techniques for diagnosing and treating periodontal disease, and are also trained in performing cosmetic periodontal procedures.”
To reach this specialty requires an individual to be highly committed. A periodontist begins education by completing 4 years of college (undergraduate training) and then continues another 4 years in dental school to earn a doctorate. To specialize in Periodontics, he or she must further their education for another 3-4 years before completing the stringent requirements for a specialty certification in periodontics.
In addition to treating all phases of periodontal (gum) disease, a periodontal specialist is uniquely qualified to reshape gum tissues. This may be performed to correct a “gummy smile” or even out a smile line through crown lengthening. Periodontists also specialize in the diagnosis and placement of dental implants.
The advantages of a periodontist in dental implant treatment are multi-faceted. This specialist is trained to understand the intricate concepts involved in selecting the proper type of implant and skilled at placing implants at proper depths and angles. A periodontist is also able to optimize patient comfort during treatment and throughout the healing phase.
Using his or her advanced training in the diagnosis and placement of dental implants, a periodontist can help you enjoy a higher potential for dental implant treatment that lasts a lifetime. There are a number of reasons you should strongly consider having a periodontal specialist involved in dental implant treatment, including:
SELECTION OF IMPLANTS – Dental implants come in a wide array of shapes and sizes. Each system is designed to accommodate certain needs and preferences. For example, some implants are designed to support a full arch of teeth while others can be placed in areas where a great deal of bone loss has occurred. The selection of the implant type that is appropriate for your needs and goals requires a unique understanding of all implant types. That is, a periodontist can select the type that will work best for you rather than go with the one or two in which they have received training.
PLACEMENT OF IMPLANTS – In addition to selecting the best type for your needs, proper placement of implants has a great deal to do with having a successful outcome. When an implant that is too long, for instance, is placed in bone that is too shallow, it can have future repercussions that may require its removal. This could occur when a lower implant is placed too close to a nerve that runs horizontal through the jaw bone (mandible). Or, when an upper implant is placed in shallow bone, it can work its way into the sinus cavity. A periodontal specialist considers intricate factors that can effect your potential for success.
STRUCTURAL ISSUES – In addition to the factors involved with bone loss, other issues can ‘make or break’ having a successful treatment outcome with dental implants. For example, for people who have bite misalignment or TMJ disorders, they may be grinding or clenching their teeth during sleep – often unknowingly. Telltale signs of ‘bruxing’ including remaining, natural teeth that are chipped or worn. These forces are enough to crack a walnut. When dental implants endure these forces, especially during their ‘healing’ phase, there is greater risk for implant failure. A periodontist considers these issues prior to your treatment, helping you to bypass problems that can result in eventual removal.
INDIVIDUALIZED TREATMENT CONSIDERATIONS – Our goal is to help you get the most from your dental implants. When there are individual habits or preferences that can complicate success, we work with each patient to help them enjoy their dental implants for a lifetime. For smokers, we advise ways to support saliva flow and minimize oral bacteria levels. For people who take certain medications that can interfere with oral moisture, we recommend methods to keep the mouth properly hydrated. And so on. We want to make sure your care is individualized so your potential for implant success is high!
OPTIMAL COMFORT – For added comfort and relaxation, we offer Oral sedation or I.V. sedation (twilight sleep) for most procedures for those who want or need these options. Both sedations are administered to the highest standards of safety possible. Our sedated patients are closely monitored throughout treatment with advanced safety equipment and trained professionals. Oral sedation is a pill that helps patients relax. It also has an amnesiac effect, leaving most with little or no memory of treatment afterward. I.V. sedation places the patient in a deeper sedative state, also erasing memory of the procedure. At our Asheville office, Biltmore Periodontics administers sedation with the involvement of a highly-trained doctor of anesthesiology for optimal comfort and safety.
For individuals who wish to replace one or more missing teeth, it makes sense that dental implants have become the leading preference. Dental implants restore the look, feel, and function like that of natural teeth. They also help to prevent bone shrinkage that occurs when tooth roots are no longer present in the jaw bone. This process is known as resorption.
Resorption is what contributes to changes in facial appearance when the bone structures that give the face its shape start to shrink. When tooth roots no longer exist in the jaw bone, the stimulation once provided to the bone no longer exists. This causes the bone to shrink, or ‘resorb.’
As the bone mass declines in height and thins out, changes in facial appearance slowly evolve. For example, as the jaw bone thins, deep wrinkles form around the mouth. Eventually, the corners of the mouth will turn down even in a smile. Jowls form on each side of the face as facial muscles detach from the shrinking bone structure.
As the jaw bone continues to shrink, the chin becomes more pointed and the nose seems to get closer to it. This leads to a collapsed mouth that is known as a ‘granny look.’ This look ages the appearance of an individual far beyond their actual years.
Among the many benefits of dental implants, they also provide stimulation to the jaw bone. This helps to halt the process of bone loss. For those who have already lost a great deal of bone, bone rebuilding procedures can be performed to restore a healthy, more youthful face shape.
In addition to all the advantages of care through a periodontist, our Asheville periodontal office features some of the most advanced technology available. This includes laser dentistry and cone beam imaging as well as highly-advanced computerized options.
If you’ve considered dental implants to replace missing teeth, we invite you to consult with us during a private consultation appointment. A referral is not necessary. During this time, we will discuss your needs and goals as well as any concerns regarding comfort or costs.
To schedule, call (828) 274-9440.
Advanced Skills & Technology Enhance Comfort, Speed Healing
Posted on Apr 27, 2021 by William J. Claiborne, DDS MS
If you’ve ever watched a cabinet maker, his skill and attention to detail is impressive. He knows the various wood types, understands the details of joints and angles, and respects the individual components as interacting pieces that will work harmoniously as a whole.
Because he has the tools and skills specific to his craft, the coming-together of this typically provides a ‘forever’ result.
In the periodontal specialty, our specific skills create a number of advantages for patients who have different needs. Some of these skills are not always obvious, yet they allow for a higher level of success, greater comfort, and less time required for healing.
A periodontist, as defined by the American Academy of Periodontology (perio.org), is:
“A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants. Periodontists are also experts in the treatment of oral inflammation. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. They are familiar with the latest techniques for diagnosing and treating periodontal disease, and are also trained in performing cosmetic periodontal procedures.”
As an Asheville periodontal specialist for over 25 years, I’ve utilized my advanced skills to help patients with a variety of needs that involve the gum tissues. These include:
– Treatment of all stages of gum disease (gingivitis, pregnancy gingivitis, periodontal disease, periodontitis)
– Reshaping gum tissues for esthetic enhancement (crown lengthening, gingivectomy for ‘gummy smiles’, repairing areas of gum recession)
– Diagnosis and placement of dental implants
– Treatment of lesions or cysts in oral tissues
Although there are other treatments offered, our main goal is to provide the patient with a comfortable and positive experience within our specialized skills. We believe that patients will come to appreciate the advantages of having a healthy smile and understand how our involvement can create a healthier, more confident individual.
Here, our Western North Carolina periodontal dental office features some of the most advanced technology in dentistry. Many of these are not available in other dental offices elsewhere. Some of these features include:
LANAP With PerioLase MVP 7 – Laser-Assisted New Attachment Procedure is an advanced protocol that efficiently and effectively treats advanced gum disease with the added advantages of a dental laser. This offers a non-surgical alternative for patients with moderate to severe periodontal disease. LANAP treatment leaves very little discomfort and has a quick recovery time. It has also been found to stimulate bone regrowth in damaged areas.
3-D Cone Beam Imaging
– Ideal for diagnoses and treatment planning, these images provide a clear view of the upper and lower jaw, used for: intricate review of endodontics; periodontics; orthodontics; implantology: TMJ; and prosthodontics, as well as dental and maxillofacial surgery. Because cone beam radiographs show sagittal, axial, and coronal planes, locating and tracking nerve canals optimizes implant placement. The process is quick, painless and at minimal levels of radiation.
CareStream Cone Beam Computer Tomography Imaging
– This enhanced tomography works with 3D imaging for exceptional detail and range.
CS 3600 Intraoral Scanner
– Rather than make impressions with bulky, goopy trays, this scanner quickly and comfortably captures digital impressions accurately and easily for creating precision models or appliances (crowns, inlays, onlays, bridges, orthodontic appliances and aligners, custom abutments). The scanner can also reach difficult–to–access areas in the patient’s mouth for superior results with improved patient comfort.
Computerized Dental Implant Placement
– This advanced system for pre-surgical positioning of dental implants uses a 3D model of the patient’s jaw. Once the implant type is selected, a template is developed for optimal treatment success, even for complex cases.
In addition, we offer a unique environment for comfort. We understand how dental fear or anxiety can cause people to delay or avoid having dental treatment, sometimes for decades. Too, when regular dental cleanings and check-ups are not maintained, the results often culminate into more complex problems (and necessary repairs) in the future.
We help patients understand that these fears and concerns are not unusual. Our doctors and staff respect each patient and provide gentle, compassionate care – at every appointment.
For those who have high fear levels, we offer several sedation options, including oral and IV sedation. Oral sedation is a pill that helps patients relax. It also has an amnesiac effect, leaving most with little or no memory of treatment afterward.
I.V. sedation (also known as ‘twilight sleep’) places the patient in a deeper sleep state and erases memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety. In our Asheville office, anesthesia is overseen by a Medical Doctor (MD) who is a board certified Anesthesiologist.
With both sedation options, patients are closely monitored with advanced safety equipment throughout treatment.
How I would describe the difference between a periodontist and other dental specialists is in how gentle and respectful we are to the tissues in the mouth. These are tender layers that significantly affect the appearance of a smile and the health of teeth. By understanding the techniques to minimize incisions while effectively treating each area in the mouth, a periodontist is your expert.
We feel you’ll find no better periodontal dental environment. Call 828-274-9440 to learn more or to schedule a consultation appointment. New patients are always welcome and a referral is not required.
Are YOU One Who Is More Likely To Have Gum Disease?
Posted on Dec 10, 2020 by William J. Claiborne, DDS MS
As a periodontist, I have a pretty unique view of the inside of a mouth.
In my specialty, we are particularly focused on the condition of the gum tissues in the mouth, or “periodontal” tissues. We are specially trained to treat all stages of gum disease and in the diagnosis and placement of dental implants.
A periodontal specialist is also trained in performing esthetic procedures that involve gum tissues, such as crown lengthening and correcting a “gummy smile”.
To clarify, a periodontist is a dentist who extends his or her education and skills further (typically 3 years past completing dental school) to specialize in the prevention, diagnosis, and treatment of periodontal disease and other gum conditions.
1). THE NATURAL AGING PROCESS
Although we treat patients of all ages, there are certain segments of the population we see more often. For instance, a large segment of our patients are age 50 and older. In addition to having more susceptibility to have gum disease, many in this age group have lost teeth.
In a recent report by the Centers for Disease Control & Prevention (CDC) on data related to prevalence of periodontitis in the U.S.: over 47% of adults ages 30 years and older have some form of periodontal disease. For adults 65 years and older, that number rises to over 70%.
This is because the aging process causes the body begins to succumb to wear and tear. The skin sags, bones weaken, joints ache, hearing dulls, and eyesight wanes. This means that more precautions and measures are needed to keep the teeth and gum tissues in good shape.
In addition to healthy gums, it’s important to keep your natural teeth as you age. Natural teeth to support neighboring teeth and provide stimulation to the jaw bone is unsurpassed.
Having the ability to comfortably and efficiently bite and chew is vital to having a healthy body. When dentures or partials compromise the ability to eat a diet of healthy foods – and chew food properly – gastrointestinal problems are common.
Although dental implants are excellent replacements for missing teeth, there is nothing as perfect as your “permanent” teeth.
There are a number of reasons why seniors face more oral challenges, including:
• A dry mouth: The tissues inside the mouth need to be kept moist. Saliva is designed to do this. However, with age, the flow of saliva becomes less plentiful. Just as the skin and hair get drier with age, the mouth undergoes this as well. When saliva flow is less efficient at rinsing bacteria from the oral cavity, bacteria grow at a more rapid rate. This allows bacteria accumulation to occur more frequently than twice-a-day brushing can control.
• Reduced ability to maintain at-home oral hygiene: Aging causes the fingers to be less nimble and stiffens joints. This is a particular challenge when it comes to brushing and flossing. Angling a toothbrush to reach all areas in the mouth and proper flossing maneuvers require manual dexterity that are more difficult due to the natural aging process.
• Medication side effects: The average American adult in the 65-79 age group has over 27 prescriptions filled each year. (https://www.statista.com/statistics/315476/prescriptions-in-us-per-capita-by-age-group/). Although you may need these medications, keep in mind that some can be detrimental to your oral health. This is why it’s important to provide a complete list of all medications you take (including vitamins and herbal supplements) at every dental appointment so your dentist can adjust care to your specific needs.
• Hormonal changes: Due to declining estrogen levels, post menopausal females have a higher risk for gum disease and subsequent tooth loss. This causes an increased risk of bone loss or osteoporosis as well as inflamed gum tissues around the teeth (called periodontitis). When there is a decline in jaw bone mass, it can result in tooth loss.
Bacteria overgrowth in the mouth is the cause of gum disease. Periodontal disease is the nation’s leading cause of adult tooth loss. Its bacteria can also enter the bloodstream, causing inflammatory reactions far beyond the mouth.
Advanced gum disease bacteria has been linked to a number of serious health problems. These include heart disease, stroke, high blood pressure, diabetes, arthritis, memory loss, some cancers, impotency and Alzheimer’s disease.
Obviously, maintaining healthy gums and keeping your natural teeth is important. If you’ve experienced tooth loss, we can replace them with dental implants. These are the closest thing to the natural teeth you had and will restore stability and dependable biting and chewing.
At any age, the goal is to keep bacteria levels in the mouth to the lowest level possible. When oral bacteria are allowed to accumulate, it can lead to Gingivitis. This is an early stage of gum disease. As it progresses, periodontal disease continually worsens. Eventually, it becomes periodontitis, which is an advanced level of gum disease.
Although gum disease can exist without obvious signs or symptoms, the most commonly noticed are:
• Red, swollen or tender gums
• Seeing blood in the sink when brushing
• Receded gums
• Loose or separating teeth
• Pus pockets on gum tissues
• Sores in the mouth
• Persistent bad breath
2). ADULTS WITH DENTAL FEAR
Another large segment of our patients are those who have avoided dental care for years, often due to having dental fear.
One study, published by StudyFinds.org, shares recent findings of 2,000 adults in the U.S. regarding dental visits. Results show a whopping 62% of those surveyed stating they were too afraid to even visit a dentist’s office. (https://www.studyfinds.org/adults-too-scared-visit-dentist-teeth/)
If dental fears or anxiety have kept you from regular dental checkups for a year or more, it would be rare to NOT have some level of gum disease. Quite frankly, some people with high fear levels avoid seeing a dentist for decades. Those visits are vital in one’s ability to have healthy gums.
While twice daily brushing and daily flossing are necessary components for having good oral health, the routine alone isn’t enough to combat a number of additional factors that make one vulnerable to the disease.
For example, a study by Delta Dental revealed, only 7 out of 10 adults are brushing twice a day. This means that 30% aren’t brushing enough. (https://www.ada.org/en/publications/ada-news/2014-archive/october/survey-finds-shortcomings-in-oral-health-habits)
We also see a number of moms-to-be. For decades, the Surgeon General has warned that pregnant females who had gum disease had a far greater risk of a pre-term, low birth weight baby. Research has shown that gum disease increases the risk for pre-term delivery (prior to 37 weeks) and low birth weight babies (less than 5.5 lbs.).
“Studies have found that expectant mothers with periodontal disease are up to seven times more likely to deliver premature, low birth weight babies.” (https://www.adha.org/resources-docs/7228_Oral_Health_Total.pdf) One study showed the preterm birth rate for pregnant women with moderate to severe periodontal disease to be nearly 29%.
Estimates are that over half of pregnant women have some form of gingivitis (gum inflammation, an early stage of gum disease) or periodontitis (infectious, advanced gum disease). Nearly a third of pregnant females will acquire gum disease because of their higher vulnerability to inflammation.
When these indications exist, it is important to seek periodontal treatment as soon as possible. Gum disease only worsens without treatment, requiring more time and expense to rid this serious, even deadly, inflammatory disease.
4). ALL ADULTS
Regardless of age or health status, oral wellness has always been important to overall health. Without good gum health, there is a greater drain on the body’s immune system. This is now even more important than ever, due to COVID and the flu season upon us.
Remember, even a twice-daily brusher and daily flosser does not mean you will avoid gum disease. Avoiding regular dental check-ups is a sure recipe for needing treatment down the road that may have easily been prevented.
In our Asheville periodontal dental office, patients can begin with a consult in our private consultation room that’s removed from the clinical side of the practice. We are always happy to discuss oral health options with new patients. A referral is not needed.
Call 828-274-9440 to schedule.