Your gums don't just attractively frame your teeth—they protect them as well. If they shrink back (recede) from their normal covering, portions of the teeth could become exposed to bacteria and other hazards.
Unlike the visible crown, which is protected by enamel, the tooth root depends largely on the gums as a shield against bacteria and other hazards. When the gums recede, it exposes the roots and makes them more susceptible to disease or trauma. It may also cause sensitivity to hot and cold foods as the now exposed dentin gets the full brunt of temperature and pressure sensations once muffled by the gums.
There are actually a number of causes for gum recession. In rare cases, a tooth may not have erupted normally within its bony housing, which inhibits the gums from covering it fully. Thinner gum tissues, passed down genetically, are also more susceptible to recession. And a person can even damage their gums and cause them to recede if they brush too aggressively.
The most common cause, though, is advanced periodontal (gum) disease. This bacterial infection arises from dental plaque, a thin biofilm that accumulates on tooth surfaces, usually because of poor hygiene practices. As the infection and resulting inflammation in the gums worsens, they lose their attachment to teeth resulting in a number of harmful outcomes that include recession.
The first step then in treating gum recession is to treat the underlying problem as much as possible. In the case of gum disease, effective treatment could stop mild to moderate recession and sometimes reverse it. For more extensive recession, a patient may need gum grafting surgery to help regenerate lost gum tissue.
You can help prevent gum disease, and thus lower your risk for recession, with daily brushing and flossing to remove bacterial plaque. Likewise, see your dentist at least twice a year for dental cleanings to remove any residual plaque and tartar (hardened plaque).
You should also visit your dentist promptly if you notice swollen or bleeding gums, or more of your teeth surfaces showing. The earlier your dentist diagnoses and begins treatment for gum recession, the better your chances for a healthy and more attractive outcome.
If you would like more information on maintaining good gum health, 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 “Gum Recession.”
Your teeth can take decades of daily biting and chewing and not miss a beat. But they do have a nemesis, dental disease, which can easily get the upper hand. As a result, millions of people lose teeth each year to tooth decay and periodontal (gum) disease.
But while both the living tissue that makes up teeth and gums are susceptible to bacterial attack, the non-living materials in a life-like dental implant are impervious to disease. That being the case, you would think your implants wouldn't need as much hygiene as your other teeth.
But they still do. True, implants in themselves aren't affected by infection, but the bone and other tissues that support them can become diseased. This often happens with advanced cases of gum disease.
There is, in fact, a particular form of gum infection associated with implants called peri-implantitis ("peri"—around; "it is"—inflammation), which occurs in the gums around an implant. Once it starts, peri-implantitis can advance at a rapid pace.
This is because implants don't have the gum attachment of real teeth, which can fight and slow the advance of a gum infection. Because an implant doesn't have this attachment, any infection around it continues virtually unimpeded. If the bone supporting an implant becomes infected, it can weaken to the point that the implant fails.
But this dire scenario can be avoided with continuing hygiene and maintenance of the gum tissues surrounding the implant. You should brush and floss every day around implants to remove dental plaque, the bacterial film most responsible for dental disease, just as you do with natural teeth.
It's also important to keep up regular dental visits for cleanings to remove lingering plaque and tartar (hardened plaque). Your dentist may also notice and clean away any residual cement from the restoration, which can also cause gum inflammation.
And, you should promptly see your dentist if you notice any telltale signs of a gum infection, such as swelling, redness or bleeding, especially around implants. The quicker we diagnose and treat a case of gum disease, particularly peri-implantitis, the less likely it will endanger your implant.
Correcting a bite problem involves more than applying braces. Orthodontists must consider a wide range of factors, including the type of bite problem involved, complications like impacted or missing teeth, and their patient's overall dental condition.
Orthodontists must also keep in mind the future—how will a treatment implemented now impact a patient's appearance and dental function many years from now? In reality, orthodontists perform these treatments within a dynamic growth environment, especially involving children and teenagers whose mouth and facial structures are still maturing.
And although these growth changes slow in adulthood, they don't stop—orofacial structures continue to change throughout life. For example, a person's lips steadily thicken in size until the mid-teen years, and then slowly thin out over the rest of their lifetime. The distance between the lips both at rest and while smiling may also narrow in later years. Other changes continue to occur in the bones and soft tissues of the mouth and face.
Fortunately, this structural growth follows a fairly consistent track. Although variations do occur, an orthodontist can project the growth changes their patients will undergo as they age, and use that knowledge to plan out bite treatment. With this understanding, orthodontists plan not only what treatments will be needed, but when to perform them, and to what extent.
This may involve a number of treatment stages, spaced out to coincide with regular development. An orthodontist may focus first on general bite correction to bring the teeth and jaws into a reasonable state of alignment. Later, they'll use more refined methods to fine-tune corrections that better align with later adult growth.
More intensive treatments may be necessary to build a foundation for future treatment. For example, orthognathic surgery may be needed to correct a severe case of an over-extended lower jaw. During the procedure, surgeons move the lower jaw to a joint position higher on the skull. This retracts the lower jaw into a more normal alignment with the upper jaw, and can dramatically change the facial profile for the better.
Each orthodontic patient is different, and each requires their own a unique treatment plan. That plan has a greater chance of long-term success by applying knowledge of future growth changes.
If you would like more information on orthodontic treatment, 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 “Understanding Aging Makes Beauty Timeless.”
We're all tempted occasionally to use our teeth in ways that might risk damage. Hopefully, though, you've never considered anything close to what singer, songwriter and now social media persona Jason Derulo recently tried in a TikTok video—attempting to eat corn on the cob spinning on a power drill. The end result seemed to be a couple of broken front teeth, although many of his followers suspected an elaborate prank.
Prank or not, subjecting your teeth to “motorized corn”—or a host of other less extreme actions or habits—is not a good thing, especially if you have veneers, crowns or other dental work. Although teeth can withstand a lot, they're not invincible.
Here, then, are four things you should do to help ensure your teeth stay healthy, functional and intact.
Clean your teeth daily. Strong teeth are healthy teeth, so you want to do all you can to prevent tooth decay or gum disease. Besides semi-annual dental cleanings, the most important thing you can do is to brush and floss your teeth daily. These hygiene tasks help remove dental plaque, a thin biofilm that is the biggest culprit in dental disease that could weaken teeth and make them more susceptible to injury.
Avoid biting on hard objects. Teeth's primary purpose is to break down food for digestion, not to break open nuts or perform similar tasks. You should also avoid habitual chewing on hard objects like pencils, nails or ice to relieve stress. And, you may need to be careful eating apples or other foods with hard surfaces if you have veneers or composite bonding on your teeth.
Wear a sports mouthguard. If you or a family member are regularly involved with sports like basketball, baseball/softball or football (even informally), you can protect your teeth from facial blows by wearing an athletic mouthguard. Although you can obtain a retail variety in most stores selling sporting goods, a custom-made guard by a dentist offers the best protection and comfort.
Visit your dentist regularly. As mentioned before, semi-annual dental cleanings help remove hidden plaque and tartar and further minimize your risk of disease. Regular dental visits also give us a chance to examine your mouth for any signs of decay or gum disease, and to check on your dental health overall. Optimizing your dental health plays a key part in preventing dental damage.
You should expect an unpleasant outcome involving your teeth with power tools. But a lot less could still damage them: To fully protect your dental health, be sure you practice daily oral care, avoid tooth contact with hard objects and wear a mouthguard for high-risk physical activities.
If you would like more information on caring for your cosmetic dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “An Introduction to Sports Injuries & Dentistry.”
Temporomandibular joint disorder (TMD) is an umbrella term for a number of chronic jaw problems. These conditions cause recurring pain for 10 to 30 million Americans, especially women of childbearing age.
But even after decades of treatment and research, a full understanding of TMD's underlying causes eludes us. That doesn't mean, however, that we haven't made progress—we have indeed amassed a good deal of knowledge and experience with TMD and how best to treat it.
A recent survey of over a thousand TMD patients helps highlight the current state of affairs about what we know regarding these disorders, and where the future may lie in treatment advances. Here are a few important findings gleaned from that survey.
Possible causes. When asked what they thought triggered their TMD episodes, the top answers from respondents were trauma, stress and teeth clenching habits. This fits in with the consensus among experts, who also include genetic disposition and environmental factors. Most believe that although we haven't pinpointed exact causes, we are over the target.
Links to other disorders. Two-thirds of survey respondents also reported suffering from three or more other pain-related conditions, including fibromyalgia, rheumatoid arthritis and chronic headaches. These responses seem to point to possible links between TMD and other pain-related disorders. If this is so, it could spur developments in better diagnostic methods and treatment.
The case against surgery. Surgical procedures have been used in recent years to treat TMD. But in the survey, of those who have undergone surgery only one-third reported any significant relief. In fact, 46% considered themselves worse off. Most providers still recommend a physical joint therapy approach first for TMD: moist heat or ice, massage and exercises and medications to control muscle spasms and pain.
These findings underscore one other important factor—there is no “one size fits all” approach to TMD management. As an individual patient, a custom-developed action plan of therapy, medication, and lifestyle and diet practices is the best way currently to reduce the effects of TMD on your life.
If you would like more information on TMD management and treatment, 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 “Chronic Jaw Pain and Associated Conditions.”
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