GUM RECONTOURING

Even if a person has teeth that are straight, healthy, and symmetrical, the beauty of their smile may be diminished if the gum line is uneven or falls too far below the lip line. Many dentists refer to gums that extend too far down as a “gummy” smile. It can make the teeth look small and cause people to feel self-conscious about the appearance of their smiles. Ideally, the gums should appear even and smooth, and should act as a frame to complement a person’s smile, rather than as a distraction from it. Fortunately, a gummy smile can now be corrected with cosmetic dentistry procedures such as gum contouring.

HOW IT WORKS

Gum reshaping is performed in the offices of most qualified dentists and periodontists. The patient receives a mild local anesthetic to numb the gums, and uses a soft tissue laser to trip away the excess gum tissue. Crown lengthening can help with a “gummy smile,” according to the American Academy of Periodontology. The laser is used to recontour and then seal the tissue to create the ideal shape and prevent ongoing bleeding. The dentist can also use the laser to eradicate hollows that trap bacteria to prevent future infections.

DENTAL FILLING OPTIONS

Composite resins, or tooth-colored fillings, are a mixture of glass or quartz filler that provide good durability and resistance to fracture in small- to mid-size fillings that need to withstand moderate pressure from chewing. They can be used on either front or back teeth.

WHAT ARE DENTAL CROWNS AND TOOTH BRIDGES?

Both crowns and most bridges are fixed prosthetic devices. Unlike removable devices such as dentures, which you can take out and clean daily, crowns and bridges are cemented onto existing teeth or implants, and can only be removed by a dentist.

HOW DO CROWNS WORK?

A crown is used to entirely cover or “cap” a damaged tooth. Besides strengthening a damaged tooth, a crown can be used to improve its appearance, shape or alignment. A crown can also be placed on top of an implant to provide a tooth-like shape and structure for function. Porcelain or ceramic crowns can be matched to the color of your natural teeth. Other materials include gold and metal alloys, acrylic and ceramic. These alloys are generally stronger than porcelain and may be recommended for back teeth. Porcelain bonded to a metal shell is often used because it is both strong and attractive.

HOW DO BRIDGES WORK?

A bridge may be recommended if you’re missing one or more teeth. Gaps left by missing teeth eventually cause the remaining teeth to rotate or shift into the empty spaces, resulting in a bad bite. The imbalance caused by missing teeth can also lead to gum disease and temporomandibular joint (TMJ) disorders.

Bridges are commonly used to replace one or more missing teeth. They span the space where the teeth are missing. Bridges are cemented to the natural teeth or implants surrounding the empty space. These teeth, called abutments, serve as anchors for the bridge. A replacement tooth, called a pontic, is attached to the crowns that cover the abutments. As with crowns, you have a choice of materials for bridges. Your dentist can help you decide which to use, based on the location of the missing tooth (or teeth), its function, aesthetic considerations and cost. Porcelain or ceramic bridges can be matched to the color of your natural teeth.

HOW ARE CROWNS AND BRIDGES MADE?

Before either a crown or a bridge can be made, the tooth (or teeth) must be reduced in size so that the crown or bridge will fit over it properly. After reducing the tooth/teeth, your dentist will take an impression to provide an exact mold for the crown or bridge. If porcelain is to be used, your dentist will determine the correct shade for the crown or bridge to match the color of your existing teeth.

Using this impression, a dental lab then makes your crown or bridge, in the material your dentist specifies. A temporary crown or bridge will be put in place to cover the prepared tooth while the permanent crown or bridge is being made. When the permanent crown or bridge is ready, the temporary crown or bridge is removed, and the new crown or bridge is cemented over your prepared tooth or teeth.

HOW LONG DO CROWNS AND BRIDGES LAST?

While crowns and bridges can last a lifetime, they do sometimes come loose or fall out. The most important step you can take to ensure the longevity of your crown or bridge is to practice good oral hygiene. A bridge can lose its support if the teeth or bone holding it in place are damaged by dental disease. Keep your gums and teeth healthy by Brushing with fluoride toothpaste twice a day and flossing daily. Also see your dentist and hygienist regularly for checkups and professional cleanings.

To prevent damage to your new crown or bridge, avoid chewing hard foods, ice or other hard objects.

HOW DOES TEETH WHITENING WORK?

Teeth whitening is a simple process. Whitening products contain one of two tooth bleaches (hydrogen peroxide or carbamide peroxide). These bleaches break stains into smaller pieces, which makes the color less concentrated and your teeth brighter.

DOES WHITENING WORK ON ALL TEETH?

No, which is why it’s important to talk to your dentist before deciding to whiten your teeth, as whiteners may not correct all types of discoloration. For example, yellow teeth will probably bleach well, brown teeth may not respond as well and teeth with gray tones may not bleach at all. Whitening will not work on caps, veneers, crowns or fillings. It also won’t be effective if your tooth discoloration is caused by medications or a tooth injury.

WHAT ARE MY WHITENING OPTIONS?

Talk to your dentist before starting. If you are a candidate, there are four ways to put the shine back in your smile:

Stain Removal Toothpastes
All toothpastes help remove surface stain through the action of mild abrasives that scrub the teeth. Look for whitening toothpastes that have earned the ADA Seal of Acceptance for stain removal (it will tell you on the package). These toothpastes have additional polishing agents that are safe for your teeth and provide stain removal effectiveness. Unlike bleaches, these types of ADA-Accepted products do not change the color of teeth because they can only remove stains on the surface.

In-Office Bleaching
This procedure is called chairside bleaching and usually requires only one office visit. The dentist will apply either a protective gel to your gums or a rubber shield to protect your gums. Bleach is then applied to the teeth.

At-Home Bleaching from Your Dentist
Your dentist can provide you with a custom-made tray for at-home whitening. In this case, the dentist will give you instructions on how to place the bleaching solution in the tray and for what length of time. This may be a preferred option if you feel more comfortable whitening in your own home at a slower pace, but still with the guidance of a dentist. Out-of-office bleaching can take anywhere from a few days to a few weeks.

ARE THERE ANY SIDE EFFECTS FROM TEETH WHITENING?

Some people who use teeth whiteners may experience tooth sensitivity. That happens when the peroxide in the whitener gets through the enamel to the soft layer of dentin and irritates the nerve of your tooth. In most cases the sensitivity is temporary. You can delay treatment, then try again.

Overuse of whiteners can also damage the tooth enamel or gums, so be sure to follow directions and talk to your dentist.