Posts for: July, 2016

By Edward Joseph, D.D.S.
July 30, 2016
Category: Dental Procedures
Tags: gummy smiles  
TreatingaGummySmileStartswithFindingouttheCause

You’re a bit self-conscious about your smile. But not because of your teeth — it’s your upper gums, which seem too prominent when you smile. While “too much” is a matter of perception varying from individual to individual, it’s generally accepted that a smile is “gummy” if four or more millimeters (a bit more than an eighth of an inch) of the gums are visible.

The good news is there are ways to improve the appearance of your gums. Which method we use, though, will depend on the underlying reason why the gums are prominent. The amount of gum tissue, in fact, may not be the problem at all, but could be the size of the crowns (the visible parts of teeth), the upper lip’s range of motion, the upper jaw’s position in relation to the face, or a combination of any of these.

For example, if your teeth didn’t erupt and develop properly, the gums might not have moved back to their proper position and stabilized as they should in your late teens or early twenties. A normal crown (the visible part of a tooth) is about 10 millimeters long, with a ratio of width to length of about 75-85%. Below those measurements the teeth can appear smaller, making even normal gum tissue appear larger. In another scenario, the upper lip may rise too high when you smile (hypermobility), which reveals too much of the gums.

If tooth size is the problem, we may recommend a periodontal surgical procedure called crown lengthening that reveals more of the tooth. A hypermobile lip can be treated with Botox shots to temporarily restrict the movement (it must be repeated every six months) or by surgically repositioning the lip muscles that control movement. Similarly, surgically repositioning an overlong upper jaw to make it appear shorter may be the right course.

That’s why our first step is to determine why your gums are too prominent with a complete dental examination. Knowing exactly why they stand out will help us devise a treatment plan that will greatly enhance your smile.

If you would like more information on improving a gummy smile, 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 “Gummy Smiles.”


By Edward Joseph, D.D.S.
July 22, 2016
Category: Dental Procedures
Tags: x-rays  
BitewingX-RaysanImportantToolinEarlyToothDecayDetection

It's difficult to measure how x-ray imaging has transformed dentistry since its use became prominent a half century ago. As equipment and methods standardized, the technology revolutionized the way we diagnose tooth decay and other mouth-related issues.

One of the more useful of these methods is called the bitewing x-ray. The term comes from the shape of the device a patient holds between their teeth with the film attached on the side toward their tongue. We direct the x-ray beam to the outside of the patient's cheek, where it passes through the teeth to expose on the film. Its particular design provides clearer images since the patient's bite helps keep the film still and distortion-free, making it easier to view signs of early tooth decay.

Bitewing x-rays usually consist of four films, two on either side of the mouth, necessary to capture all of the teeth (children with smaller jaws, however, often only require one film per side). How frequently they're conducted depends on a number of factors, including the patient's age: children or young adolescents are usually filmed more frequently than adults, usually every six to twelve months. Frequency also depends on a patient's particular decay risk — the higher the risk the more frequent the x-ray.

Regardless of how often they're performed, a similar application principle applies with bitewing x-rays as with any other radiological method: As Low As Reasonably Achievable (ALARA). With the ALARA principle in other words, we're looking for that sweet spot where we're able to detect the earliest stages of dental disease with the least amount of radiation exposure.

Bitewings fit this principle well: a patient receives only a fraction of the radiation exposure from a four-film bitewing as they do from a daily dose of environmental radiation. Factor in new digital technology that reduces exposure rates and bitewings pose virtually no health risk to patients, especially if conducted in a prudent manner.

The benefits are well worth it. Thanks to bitewing x-rays we may be able to diagnose decay early and stop it before it causes you or your family member extensive tooth damage.

If you would like more information on the importance of x-rays in dentistry, please contact us or schedule an appointment for a consultation.


By Edward Joseph, D.D.S.
July 14, 2016
Category: Oral Health
Tags: oral health   seniors  
4DentalCareAreastoKeepinMindfortheSeniorAdultinYourLife

Like many people, you might be caring for an elderly parent or family member. That care should include a focus on their teeth and gums — a healthy mouth is vitally important to their overall health, nutrition and well-being. Because of the aging process, this can be challenging.

Here are 4 areas where you should focus your attention to assure the senior adult in your life has the healthiest mouth possible.

Make adjustments for hygiene. As we grow older, arthritis and similar conditions make brushing and flossing difficult to perform. You can help your senior adult keep up these vital tasks by switching to a powered toothbrush or refitting their brush with a bike handle or tennis ball to make gripping easier. Pre-loaded floss holders or water irrigators are effective alternatives to manual flossing if it becomes too difficult.

Have dentures or other appliances checked regularly. Many older people wear full or partial dentures. Due to the nature of these appliances, the risk of bone loss over time is greater, which can eventually affect their fit. Their dentist should check them regularly and reline or repair them if possible. Eventually, they may need a new appliance to match any changing contours in the mouth.

Be aware of age-related dental issues. Age-related conditions of both the mouth and the body (like osteoporosis, which can affect bone density) can impact dental health. For example, an older person can develop lower saliva flow, often due to medications they’re taking. This, as well as gastric reflux common in older people, increases acidity and a higher risk of tooth decay. Past dental work like fillings, crowns or bridges may also make hygiene and additional treatment more difficult.

Keep up regular dental visits. In light of all this, it’s crucial to keep up with regular dental visits for continuing teeth and gum health. Besides cleanings, these visits are also important for monitoring signs of tooth decay, periodontal (gum) disease and oral cancer. It’s also a good opportunity to gauge the effectiveness of their hygiene efforts and suggest adjustments.

If you would like more information on dental care for older adults, 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 “Aging & Dental Health.”


By Edward Joseph, D.D.S.
July 06, 2016
Category: Oral Health
Tags: oral health  
PatchyDiscolorationsontheTongueArentaCauseforWorry

Some things in life look worse than they really are. A condition known as “geographic tongue” is a good example: while it may look serious, it’s not a cause for real concern.

If you’ve never heard of geographic tongue it’s because it’s not a common ailment: it only affects one to three percent of the population. The name comes from patches of redness on the top surface of the tongue surrounded by grayish white borders, which gives the red patches a look similar to land masses on a map.

It’s known formally as “benign migratory glossitis,” which tells us more about the condition: “benign” means the patches aren’t cancerous; “migratory” indicates the patches tend to move and take different shapes along the surface of the tongue. In fact, it’s possible for them to appear, disappear, and then reappear over the course of a few days.

The exact causes of geographic tongue haven’t been fully substantiated. Researchers believe emotional stress, psychological problems or hormonal disturbances (especially women during pregnancy or ovulation) could be triggers for its occurrence. Certain dietary deficiencies like zinc or vitamin B, or acidic foods are also believed to be factors.

While geographic tongue isn’t painful, it can leave your tongue feeling more sensitive with a mild burning or stinging sensation. If you’re prone to having geographic tongue, there are some things you can do to reduce the irritation. Try to avoid eating acidic or spicy foods like tomatoes, citrus fruits or mint, as well as astringent substances like alcohol or certain mouthwashes. We may also prescribe anesthetic mouthrinses, antihistamines or steroid ointments to help ease any discomfort.

The good news, though, is that this harmless condition is more irritating than anything else. With a little care and forethought you won’t even know you have it.

If you would like more information on geographic tongue, 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 “Geographic Tongue.”




Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #503
Burbank, CA 91505
(818) 842-7628

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