Choose A Periodontist To Correct A Gummy Smile


Posted on Aug 29, 2022 by William J. Claiborne, DDS MS

About Periodontal Plastic Surgery

When Lauren Hutton, the model well-known for a space between her front teeth, began modeling, she felt she needed to camouflage the gap (or “diastema”). Yet, she soon began to feel it was a unique feature that set her apart from the others. She was right, and now at the age of 77, she’s been on more front covers than nearly any other model.

Each smile is unique. Hopefully, your smile makes you feel good every time you share it. And, the very act of smiling has been shown to release endorphins in the brain. Those are the chemicals that create a bit of a ‘natural high.’ Smiling is obviously an asset to our well-being.

If you have a “gummy” smile, you may be perfectly fine with it. After all, it is not detrimental to oral health if you care for your gums properly (which goes for everyone). And, it can be a positive part of your personality. Katie Couric has a gummy smile and shares hers openly.

“Gummy” Smile

However, not everyone with this trait feels comfortable with the look nor the way it makes them feel when smiling. Some people tend to suppress  a full smile. Others often conceal their smile with a hand when smiling fully or laughing. Some people smile with their lips only.

A gummy smile, in the periodontal specialty, is known as EGD, an abbreviation for excessive gingival display or a gingival smile (GS). The trait occurs more often in females than in males. (Gingival is of or relating to the gums.)

Esthetically, a balanced smile typically shows the front top 6 or 8 teeth. Arching each tooth, there is generally minimal gum tissues showing , and sometimes none. Another esthetic complement to a smile is having gum tissues that  show a slight arch over each tooth at a similar line as those that arch adjacent teeth. Gums that are lower over one or two teeth tend to create a jumbled look in a full smile.

When the height of gum tissues distract from the appearance of a smile, a periodontist is your expert. This dental specialist has specialized skills in all aspects of oral tissues. Through their advanced training, they are able to safely and beautifully reshape the tissues that surround teeth.  

For people who wish to have a gummy smile or uneven gum line re-contoured, a periodontist performs a gingivectomy. A gingivectomy is a procedure during which excess gum tissue is remove. During this, the gumline is sculpted to give your smile balance with a more even smile line.

In addition to repairing a gummy smile, a gingivectomy is involved in a procedure known as crown lengthening. Crown lengthening involves removing the excessive gum tissue to expose more of the crown of the tooth, as well as sculpting the gumline to make it higher up. After the gum tissues are shaped, a crown is typically placed to protect the tooth above the gum line and to create a more beautiful smile.

A crown lengthening may also help to save a tooth from removal. When a tooth breaks off near the gum line, a crown lengthening can be performed to expose a sufficient amount of the tooth’s base so it can support a crown.

Another procedure a periodontist  expertly performs is gum grafting. This is often to cover exposed roots, to reduce further gum recession, protect vulnerable tooth roots from decay, and improve your smile. Recession can occur as a result of periodontal disease, which causes tooth roots to become exposed and makes the teeth look long.

Gum tissues are very tender tissues with many nerves. Procedures that involve the gums must be performed with precision to minimize discomfort and speed healing time. A periodontist excels in the skills to create an optimal outcome with the most conservative treatment needed.

Our Asheville periodontal dental office provides some of the most advanced imaging and computerized technology available. This includes cone beam 3D imaging and laser dentistry. Additionally, we provide oral and IV sedation (“twilight sleep”) so patients are able to relax or snooze comfortably while being monitored by specially-trained team members who use advanced safety equipment.

Begin with a consultation with an experienced periodontist, who can answer your questions thoroughly and determine the best treatment option for your individual needs. Call 828-274-9440.

Some sources:

https://www.colgate.com/en-us/oral-health/mouth-and-teeth-anatomy/3-treatment-options-for-a-gummy-smile

https://www.researchgate.net/figure/Female-and-male-percentages-in-the-gummy-smile-sample_tbl1_340258838

Dental Implants’ Value Gives ‘Priceless’ Smiles


Posted on Jul 25, 2022 by William J. Claiborne, DDS MS

Times are tight. With the higher cost of gas, groceries and utilities, people are getting very value-conscious with their dollars. The ‘frills’ we once indulged in are now being scrutinized as to the value they truly bring.

Yet, there is no better time to explain the wisdom of investing in dental implants. For people who have shed dentures, partials, and gaps in their smiles with this ideal tooth replacement option, they are “priceless.”

Although our ‘permanent’ teeth are intended to last a lifetime, we know that not all of them do, no matter how diligent we are with at-home oral hygiene and regular dental check-ups. Teeth can break or be “knocked out.” Cavities can weaken a tooth, even after it’s been ‘filled.’ That’s why your general dentist may advise a crown, to help you avoid this risk.

A general dentist is a proponent of helping patients keep their natural teeth healthy. Your dentist knows that a lost tooth can lead to a long list of time and expense in the future. And, not promptly replacing a tooth can lead to a higher risk for adjacent teeth to be lost as well.

The teeth you see in the mirror are held in stable position because of the roots that are firmly embedded in the jaw bone. In these roots are veins and nerves that extend into the bone that supports them. From this, the jaw bone is supplied with blood while the presence of the roots provide stimulation that helps the bone to maintain its mass.

The stimulation that tooth roots provide is similar to how muscle will atrophy if not used. For example, when an arm or leg is confined to a cast for an extended time, the doctor will often advise physical therapy to rebuild the muscle after its removed. Unused, the muscle mass declines.

Unfortunately, when the jaw bones decline in mass, rebuilding requires the intervention of a periodontal specialist. (Fear not, however. A periodontist can provide this.)

Bone loss is what causes a change in how partials and dentures fit. These appliances, when first made, are custom-made for the unique contours of your gum “ridge.” A ridge is the raised arch in your mouth where tooth roots are (or were once) held.

As the bone height declines, the denture or partial becomes less secure as the foundation flattens.  Adhesives or pastes are needed more frequently. Relines may help, but only temporarily.

And, the down side continues. When bone loss begins, it accelerates with each passing year. Eventually, a shrinking jaw bone reveals itself in changes in facial appearance. Initially, there may be deep wrinkling around the mouth. The corners of the mouth turn downward. Jowls form and the chin becomes pointed.

As bone loss becomes more severe, the mouth seems to sink into the face. The nose and chin get closer, giving a “granny look”. A thin jaw bone is also more vulnerable to breaks.

This is where dental implants have a particular edge (amongst other things). Like natural teeth, implants are held by the upper or lower jaws. Dental implants are able to mimic the stimulation needed to prevent the process of “resorption,” as its known.

Another bonus of dental implants is their ability to help surrounding natural teeth remain healthy. Unlike a crown-&-bridge combination, dental implants do not rely on neighboring teeth for support. Thus, the integrity of surrounding teeth is protected.

Because dental implants are supported by the jaw bone, sturdy and dependable biting and chewing strength is restored. For people who experienced the frustrations of trying to eat with a “wobbly” or “slippery” denture, they love the restored ability to eat a healthy diet. And, the shadow of embarrssment no longer looms when eating out with friends.

Dental implants come in many sizes and shapes, each system designed to accommodate various needs and preferences. Couple this with the extremely high success rate of dental implants, higher than any implant-in-bone option.

Dental implants are also designed to last a lifetime. I can think of very few things that provide this kind of value. With proper selection and maintenance, they will never need replacing or repair. This makes them an excellent investment.

A periodontist is a dental specialist who 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.

In addition to this advanced training, our dental office offers some of the most advanced technology available. This aids in the diagnosis and treatment planning of dental implants, providing patients with optimized comfort and outcomes. This technology, combined with our advanced skill level, can help you enjoy a comfortable, efficient experience that allows you to enjoy a lifetime of confident smiles.

As a periodontist in Western NC, we have also developed a reputation for respectful, gentle care. Here, oral and IV sedation are available as needed, administered safely and to the highest standards by a doctor of anesthesiology. If fear or anxiety is a concern, feel free to mention these during a private consultation.

To learn more or to schedule a consultation, call 828-274-9440. Or, ask to begin with an initial periodontal examination.

Pregnancy Gingivitis Can Affect More Than The Mother’s Health


Posted on Jul 14, 2022 by William J. Claiborne, DDS MS

Is there any other time in a female’s life when they must be as health conscious as during pregnancy?

Pregnant women, it seems, are given a long list of guidelines to follow… What they should not eat or drink, what medications to avoid, and even down to what beauty products to give up. Yet, the 9 months of discipline is well worth the greater potential to bring a healthy baby into the world.

Along with the other health guidelines, obstetricians are now urging pregnant women to pay particular attention to their oral health. For decades, research has tracked a correlation between inflammatory bacteria in the mouth to a number of serious health problems, including many far beyond the mouth.

Once the infectious bacteria of gum disease enter the bloodstream (typically through tears in weakened gum tissues), it can trigger inflammatory reactions, many serious and some that can have deadly consequences. It is the nation’s’ leading cause of adult tooth loss and has been linked to heart disease, stroke, some cancers, diabetes, arthritis, high blood pressure and impotency.

However, because of their susceptibility, the risk for full-blown gum disease is higher for pregnant females with nearly a third developing gum disease. Yet, it’s not just the oral (and overall) health of the mother that can be affected.

Research has shown that gum disease increases the risk for pre-term delivery (prior to 37 weeks) and babies of low birth weight (less than 5.5 lbs.). One study showed the preterm birth rate for females without gum disease to be approximately 11% compared to nearly 29% for pregnant women with moderate to severe periodontal disease.

One study showed that pregnant women with gum disease were 4 – 7 times more likely to deliver prematurely (before week 37) and underweight babies than mothers with healthy gums. Too, the women with the most severe periodontal (gum) disease delivered most prematurely, at 32 weeks.

Other findings show that gum disease increases the risks of late-term miscarriage and pre-eclampsia. When oral bacteria reach placental membranes via the bloodstream, inflammatory reactions can trigger pre-eclampsia or early labor.

In one study, for example, pregnant females with higher blood levels of antibodies to oral bacteria also had higher rates of preterm birth and babies of low birth weight. These elevated antibodies have been found in amniotic fluid and fetal cord blood samples of infants who were preterm or of low birth weight at birth.

Oral problems in pregnant females can begin even when the mother-to-be is following the same oral hygiene routine as they have previously. The greater susceptibility can be blamed on fluctuating hormone levels during pregnancy. These changes increase the risk for gingivitis (inflammation of the gums) and periodontal disease.

This is why approximately 40% of women develop gingivitis during pregnancy, known as pregnancy gingivitis. Pregnancy gingivitis is a mild form of gum disease that causes gums to become swollen, tender and bleed easily when brushing.

This is the result of an increased level of progesterone in pregnancy, which makes oral bacterial growth easier. Progesterone also makes gum tissues more sensitive to plaque. For those who have significant gum disease prior to pregnancy, being pregnant can make the condition worse.

Gum inflammation typically appears between months 2 and 8 of pregnancy. Signs of pregnancy gingivitis range from gums that are red rather than a healthy pink. Gums will often bleed when brushing teeth and be swollen and tender in spots.

The goal is to prevent pregnancy gingivitis before it occurs. Be committed to a thorough oral hygiene regimen at home, which includes brushing twice a day, flossing daily and swishing with an antimicrobial mouth rinse. Be sure to keep your 6-month cleanings and exams. These will remove any plaque buildup that has occurred between visits.

A periodontist has specialized training in the diagnosis and treatment of all levels of gum disease – in a way that is safe for pregnant women (as well as all patients). Signs and symptoms of gum disease include gums that bleed when brushing, frequent bad breath, swollen or tender gums, gums that loosen or pull away from the base of teeth, or gums that darken in color.

If you have any of these symptoms (whether pregnant or not), you are urged to schedule an appointment at your earliest convenience. Call our Asheville periodontal dental office at 828-274-9440 to arrange an examination to begin.

Our Asheville Periodontal Dental Office Offers Some Unique Services


Posted on Jun 13, 2022 by William J. Claiborne, DDS MS

As a Periodontist in Asheville, I’ve helped hundreds of patients overcome periodontal (gum) disease and the many repercussions that come with tooth loss. Helping to save teeth that were on the verge of requiring removal has also been a victory for the patient as well as me.

I take great pride in being a part of the transformations of patients who achieve healthy, confident smiles. This is why I’ve created an environment that affords every patient with the most advanced options available for restoring oral health and replacing lost teeth with dental implants.

Let me begin by clarifying the benefits our periodontal office brings…

• A periodontist has advanced training to properly diagnose and treat all stages of gum disease.

• We are known for never over-treating or under-treating with a commitment to provide the most successful treatment for each patient’s specific needs.

• Our periodontal office is specially equipped for the diagnosis and treatment of all stages of gum disease as well as placement of dental implants.

• Diagnosis and treatment planning is backed by an immense array of advanced technology, including:

    • LANAP (Laser-Assisted New Attachment Procedure) with PerioLase MVP 7 – 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 and has even been found to stimulate bone regrowth in damaged areas.
    • 3-D Cone Beam Imaging – is ideal for diagnoses and treatment planning through images that provide a clear view of the upper and lower jaw (including nerve canals), with rotations that show sagittal, axial, and coronal planes in a process that is quick, painless and at minimal radiation levels.
    • CareStream Cone Beam Computer Tomography Imaging – is enhanced tomography that works with 3D imaging for exceptional detail and range.
    • CS 3600 Intraoral Scanner – quickly and comfortably captures digital impressions to accurately and easily create precision models or appliances (crowns, inlays, onlays, bridges, orthodontic appliances, aligners, custom abutments) without the need for bulky, goopy trays.
    • Computerized Dental Implant Placement – an advanced system for pre-surgical positioning of dental implants using a 3D model of the patient’s jaw. Once the implant type is selected, a template is developed for optimal treatment success.

 

• A commitment to comfort including I.V. sedation (twilight sleep) as well as oral sedation for total relaxation. On our team is a Board Certified Anesthesiologist to provide sedation and anesthesia for optimal comfort and safety.

Treatment options in our specialty dental office also include reshaping gum tissues for esthetic enhancement (crown lengthening, gingivectomy for ‘gummy smiles’, repairing areas of gum recession); diagnosis and placement of dental implants; and treatment of lesions or cysts in oral tissues.

With specialized skills, a periodontist is especially respectful to oral tissues as tender layers that significantly affect the appearance of a smile and the health of teeth. Utilizing special skills to minimize incisions while effectively treating each area in the mouth, a periodontist is your expert.

Call 828-274-9440 to learn more or to schedule a consultation appointment. New patients are always welcome and a referral is not required.

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