Have you noticed your gum tissue pulling away from your teeth, making them appear “longer”? This is called gingival recession and affects more people than you might imagine. When the gum tissue starts to recede, there is bone loss as well that exposes the root surface, which is more porous and softer than your enamel. As a result, many patients with gingival recession will experience sensitivity, abrasion, and/or decay.  In very severe cases, the root surface can abrade so much around the neck of the tooth that the tooth is weakened to the point of fracture. 

Gingival recession is often the result of thin gum tissue and if left untreated, can lead to one or more of the aforementioned negative effects. Thankfully, there is a periodontal surgery available to help restore the tissue in recessed areas. Gum grafting involves placing your own oral tissue, or special donor tissue, across the recessed areas.  In doing so, the gum graft helps to protect the vulnerable root surfaces of the teeth by helping to prevent cavities, abrasion, and sensitivity. Often patients with root surface sensitivity have a difficult time finding products that work well enough to consistently reduce or eliminate the sensitivity, creating a daily battle that can be exhausting.  Imagine being able to eliminate that sensitivity with just one periodontal surgery! 

Preparing for Gum Graft Surgery

Prior to starting your gum graft surgery, a consultation with any one of our board-certified periodontists here at Laser Periodontics & Gum Surgery will be necessary. During your consultation visit, your treating doctor will perform a very thorough periodontal examination. Your chief complaint will be addressed, and you will be evaluated for various signs of periodontal disease, such as loose teeth and bone loss. X-rays will be consulted at this visit as well. We ask that you please provide a thorough medical history so that we can ensure you are healthy enough for periodontal surgery.         

This is the Gum Graft

Local anesthesia is all that is needed to make you comfortable for your periodontal surgery. Once you are completely numb, one of our highly esteemed periodontists will begin the gum grafting surgery, which is typically a 60 to 90-minute procedure depending on the case. The tissue used to cover the exposed root surfaces can either be sourced from your own oral tissue or can be a special donor tissue. In the case that the tissue is your own, most often it is harvested from the palate of your mouth where the tissue is the thickest. This means that after the periodontal surgery, you will have stitches to care for in two areas of your mouth. In other cases, sometimes all that is needed is to simply move and reposition tissue that is adjacent to the exposed root surfaces. In cases such as these, donor sites are not needed and you will only have stitches in the site of the gum graft.  

You Have Had Gum Surgery, Here is Your Aftercare Plan

After your gum grafting surgery, you will be at a much-reduced risk of developing sensitivity, root surface cavities, and abrasion! Following the surgery, it is essential to keep your head elevated and rest quietly for the remainder of the day. As mentioned earlier, following gum grafting surgery you may have stitches to care for in one to a few sites in your mouth. If donor tissue was taken from your palate, often you will receive a splint to wear over the palate to reduce swelling and help keep you comfortable. 

Slight bleeding and oozing are to be expected, however, if the bleeding seems excessive apply firm pressure with a moist gauze or tea bag for about 40 minutes. Post-surgical pain can generally be well controlled with the prescribed pain medication. Be sure to take your medication as prescribed to aid the healing process.         

Healing time is generally around two to three weeks. During this time, special care will need to be taken regarding diet and oral hygiene. Cool, soft foods are recommended, and it is best to avoid any food that is too hot, hard, or spicy that could aggravate the surgical sites. You may gradually begin to eat harder foods but avoid eating any sharp foods such as peanuts, nachos, tacos, etc. 

Oral hygiene is encouraged to resume 24 hours after surgery, but care should be taken to avoid disturbing the newly grafted tissue. Swelling can be controlled by holding ice packs on the face outside the surgical sites, alternating between 20 minutes on and 20 minutes off the face. Additionally, you will be seen in the office to evaluate post-surgical healing. Should any severe pain, extreme swelling, or prolonged bleeding occur, please do not hesitate to contact our office! 

Other Options for Periodontal Surgery

While gum grafting is excellent for covering exposed root surfaces that tend to make teeth appear very long, some patients have the opposite problem where teeth appear too short due to an excess of gum tissue. For cases such as these, a gingivectomy may be the perfect solution. A gingivectomy is done by simply removing excess or overgrown tissue around the teeth, and is often performed by using a sophisticated laser, which greatly reduces postoperative pain and healing time. A laser can also be used as part of the Laser Assisted New Attachment Procedure, or LANAP, to help remove harmful bacteria from deep pockets in patients with gum disease to promote periodontal health.  To find out which periodontal surgery would best benefit you, please contact Laser Periodontics & Gum Surgery today by calling (877) 316-4330 to get your consult scheduled!

Can I Fix My Gummy Smile?

Many people complain of having a “gummy smile,” medically known as, an excessive gingival display. What does that mean, exactly? For some, it means their teeth look too short when they smile. For others, it means they see too much gum tissue covering their teeth when they look in the mirror. 

There are two main reasons why someone would want to correct their excessive gingival display. Sometimes, an excessive gingival display is simply a physical trait that you believe is not aesthetically pleasing. You may look for ways to correct your gummy smile as you would, for example, look to cosmetically correct the size and/or shape of your nose. In other, more extreme cases, overgrowth of gum tissue on the front teeth can cause serious concerns for the patient that only a dentist or surgeon can correct.

With that said, the answer is YES! — We would be happy to correct your gummy smile. Read on! There’s more to know. 

Symptoms of a Gummy Smile

Gummy smile, aka, excessive gingival display, is a condition where a person can see too much gum tissue when they talk, laugh, or smile. For many people, this is of little or no concern. But for others, this overexposure of gum tissue causes a lack of confidence. 

Some patients report that people tease or bully them, mocking their “baby” teeth. This can lead to serious self-esteem problems, especially in children and adolescents.

An excessive gingival display may affect only one or two teeth. It may also be more generalized, involving all six of the top front teeth. The excessive gum tissue makes the natural teeth look short and stubby.

What Causes a Gummy Smile?

There are many different causes for excessive gingival display. A thorough examination by a dentist can help determine the specific causes and recommend a treatment plan to address your unique situation.

Overgrowth of the gum tissue is one common cause of this condition. This means the gums have grown or swollen so that the tissue covers too much of the front teeth. The most common cause of gum overgrowth is a bacterial infection. A professional cleaning, along with improvement in-home care (brushing and flossing), can reverse this type of infection.

Delayed eruption of the upper teeth during childhood is another common cause of an excessive gingival display. Some upper teeth do not erupt fully during childhood. Instead of extending fully into the mouth, something causes the eruption to stop before the full crown of the tooth comes through the gums.

In some cases of excessive gingival display, rather than the cause of laying with the gums, the problem originates when the teeth are too short. Short teeth may be hereditary (passed down by parents or grandparents), or they could be due to teeth-grinding habits or teeth breakage due to trauma.

Some medications and certain medical conditions can also cause overgrown gums. Medicines that stop seizures, as well as some that treat blood pressure and heart conditions, can cause excessive gingival display. In these cases, the treating medical doctor might be able to substitute another drug that treats the condition without the unwanted side effect of gum overgrowth. In rare cases, conditions like leukemia or diabetes can cause excessive gingival display.

A short upper lip can also cause excessive gingival display, especially in cases where the muscles of the upper lip pull the lip closer to the nose. When this happens, more of the gums are visible when smiling.

Some excessive gingival displays are due to the shape of the upper jawbone. Overgrowth of the bone under the nose that supports the front teeth may cause the teeth to appear short and protruded.

In many cases, excessive gingival display is due to one or more of these factors. Skeletal shape, a short upper lip, slowed eruption, gum swelling, medications, and simply having unusually short teeth are all conditions that may result in an excessive gingival display. Deciding the best treatment depends on finding the underlying cause or causes then making a treatment plan to address them.

Treatment Options For Gummy Smiles

Because of the many causes of excessive gingival display, treatments for this condition vary. First, it is important to schedule a consultation in regards to the various treatment options offered. Once one of our experienced cosmetic dentists examines you to determine the cause of your excessive gingival display, they will thoroughly discuss treatment options and next steps. 

Dentists treat the overgrowth of the gum tissue in several ways. A professional cleaning to remove debris from under the gums is sometimes all that it takes to get the swollen tissue back to normal. Mouth rinses and antibiotics may also help in some cases.

For severe cases of overgrowth, your dentist may need to surgically remove some of the tissue, referred to as “crown lengthening.” They will sculpt the gum tissue back to a pleasing shape and position on the teeth. Most dentists use lasers for this type of excessive gingival display surgery and complete the treatment right in their office.

If your excessive gingival display is due to delayed eruption of your front teeth or unusually short front teeth from grinding or trauma, your dentist will probably recommend crowns to make the teeth longer. Crowns, along with anti-grinding mouthguards, will restore your short teeth to a normal, pleasing length with the gums in a better position.

Cases where the dentist determines that a short upper lip or overgrowth of the upper jawbone are the cause of your excessive gingival display may need more extensive surgery. Oral surgeons and plastic surgeons have several reliable procedures to correct these conditions.

Deciding to Correct Your Gummy Smile

Many people complain about having an excessive gingival display. Diagnosing the causes of this condition is the first step in deciding which treatment is best. Understanding what is causing your excessive gingival display is important so that you can make an informed decision about the treatment to have.

Whether you need a thorough cleaning, crown lengthening, crowns, or procedure for your excessive gingival display, going ahead with a corrective procedure is a decision you will not regret. Having a beautiful, healthy smile is something you deserve. With so many treatment options available, call us at (877)316-4330 to discuss your situation and find out the best way to improve upon that excessive gingival display.

Gum disease is one of the most common dental diseases. According to the Centers for Disease Control and Prevention (CDC), over 47% of adults over the age of 30 have some form of gum disease. It is more common in men than women, in people living at or below the poverty level, in those with less than a high school education, and smokers.

In most cases, gum diseases are reversible and can be cured. In this article, we discuss the stages of gum disease, the difference in gingivitis and periodontitis, and how to prevent and maintain healthy gums for a lifetime.

Stages of Gum Disease

There are several stages of gum disease ranging from easily reversible gingivitis up to advance stage periodontal disease that affects the jawbones.

Symptoms of early gum disease stages, such as gingivitis, include gums that bleed easily and that appear red and slightly swollen. This is a sign of gum infection. Bad breath can also indicate gingivitis. Gums should not bleed when you brush your teeth any more than hands should bleed when you wash them. Bleeding gums are not normal.

In later stages of gum disease, the infection spreads from the gums into the bone. This is called “periodontal disease” or “periodontitis” because it affects not just the gums but also the bone surrounding the teeth. The teeth may become loose in their sockets. Not only is the breath bad, but there is sometimes a constant, sour taste coming from the teeth.

How to Identify Gingivitis

If you see pink in your saliva when you brush your teeth or notice blood on your toothbrush, this is an early sign of gingivitis. Make an appointment to see your dentist or dental hygienist as soon as possible to rule out anything more serious.

If it has been more than six months since you last had your teeth professionally cleaned, that procedure will usually be the first service needed to address your gingivitis.

Plaque Buildup and Gingivitis

Over time, bacteria, food debris, and a sticky film called “plaque” build up around the edges of your gums and in between your teeth. This build-up eventually hardens and acts like tiny splinters under your gums, keeping them irritated and sore. Removing those deposits will usually relieve the symptoms of gingivitis and get you back on the road to good oral health.

Sometimes, the buildup on your teeth has gotten so deep that it requires more than just a simple cleaning to remove. In these cases, the dentist or dental hygienist may need to numb your gums to get their instruments beneath them to remove the bacterial build-up. You may need to make several trips to complete this type of gingivitis treatment because the dentist or hygienist can only numb a portion of your mouth at one visit.

Diagnosing Gingitivits

Diagnosing gingivitis and the more serious periodontitis requires the expertise of a dentist or dental hygienist. They examine the teeth and gums using special measuring devices that show how deep the deposits extend beneath the gums and may need x-rays to see if the jawbone has been affected. 

Periodontal Charting can also be performed to examine the health of the teeth and gums. This technique is the best way to determine if a patient is periodontally healthy or suffering from periodontal disease. During periodontal charting, the “pocket,” which is the area between the gums and teeth, will be examined using a periodontal probe. A periodontal probe measures the depth of the pockets in millimeters. Gums measuring anywhere between 2-3 mm are considered healthy, anything over 5 mm means the bone supporting your teeth is beginning to deteriorate. Bleeding is also an indicator of gingivitis and gum disease. 

After gathering the needed information and making a diagnosis, the dentist will make a treatment plan unique to your situation. They will explain each step in the plan, what is involved, how many trips it will take, and the cost. You might want to check with your insurance company to find out if your plan covers some or all the costs.

Once you have a diagnosis and a gingivitis treatment plan in place, the next step is to schedule your appointments. It may take anywhere from one trip for mild cases up to five or six for advanced cases. If the periodontal disease is far advanced past the stage where gingivitis treatment is not enough, the dentist may need to perform gum surgery. But for gingivitis and early-stage periodontal disease, treatments usually do not require surgery.

Prevention & Maintenance

After completing all stages of the gingivitis treatment plan, your journey back to good oral health is not over. Maintaining healthy gums and bone is a lifetime commitment that you should take seriously.

After your battle with gingivitis, maintaining excellent oral health practices is necessary. Commit to daily brushing with a soft toothbrush, flossing to remove bacteria and food debris from between your teeth, and having regular cleanings as advised by your dentist or hygienist.

Healthy gums should be pink and tough, much like a callus on your hand. They should never bleed. Occasionally, a popcorn hull, tomato seed, or a similar irritant might get stuck under the gums and cause temporary soreness. But you should report any soreness or bleeding with no identifiable cause that lasts more than a day or two to your dentist.

Preventing gum disease from returning is much easier than having it treated. Not only is daily brushing and flossing necessary but eating a healthy diet helps keep your gums and bones in top condition. Avoid sugary foods and drinks, including diet sodas that are high in acids.

Maintaining Dental Hygiene with Regular Cleanings

Going to see your dentist or dental hygienist regularly allows them to remove buildup under your gums and between your teeth that you are not able to reach with a brush and floss. Much like taking your car for regular oil changes and tire rotations, seeing your dentist on a regular schedule ensures that your oral health will not deteriorate again.  It is recommended to visit your dentist for a cleaning every six months.  

Gum diseases like gingivitis and periodontitis are preventable. Removing bacteria, plaque, and food debris daily along with having regular checkups and professional cleanings helps to ensure that your teeth will last for many years.

Everyone wants a beautiful healthy smile! Keeping your gums strong and pink requires a team effort—you carry the ball of daily cleaning and your dentist carries the ball for early diagnosis and treatment. Together you can be confident that your gums will stay healthy for a lifetime. To ensure your smile is healthy, schedule an appointment with us at Advanced Periodontics & Implant Dentistry by calling (877) 316-4330.