My Blog

By Jeannie Chung, DDS, MS, Inc. Specialist in Periodontics
October 15, 2021
Category: Oral Health
Tags: gum disease  
SmokersAreMoreSusceptibletoHarmfulGumDiseaseHeresWhy

Along with tooth decay, periodontal (gum) disease is a primary enemy of oral health. If not caught and treated, a gum infection could spread and eventually cause tooth loss.

But although prevalent among the general population, one demographic in particular is highly susceptible to gum disease—smokers and tobacco users in general. It's estimated over 60 percent of all smokers will contend with a gum infection at some point during their lifetimes. Smokers are also twice as likely as non-smokers to develop advanced gum disease that could lead to serious dental damage.

The high rate of gum disease among smokers (and to some extent, all tobacco users) is connected to the effect that tobacco has on oral health in general. Studies show that nicotine constricts blood vessels in the mouth, which in turn reduces their delivery of antibodies to fight disease-causing bacteria. As a result, smokers have more harmful bacteria in their mouths than non-smokers, which increases their risk of dental disease.

Smokers are also less likely than non-smokers to display inflammation or redness, the initial signs of a burgeoning gum infection. This too has to do with the constricted blood vessels in the gums that can't deliver adequate oxygen and nutrients to these tissues. As a result, the gums can appear pink and healthy, yet still be infected. This could delay diagnosis of gum disease, allowing the infection to become more advanced.

Finally, smoking can interfere with the treatment of gum disease. Because of nicotine, a tobacco users' infections and wounds are often slower to heal. Combined with late diagnoses of gum disease, this slower healing creates an environment where smokers are three times more likely than non-smokers to lose teeth from gum disease.

If you do smoke, it's important to let your dentist know how much and for how long you've smoked, which could be relevant to any dental care or treatment. Better yet, quitting the habit could improve your oral health and lower your risk for teeth-destroying gum disease.

If you would like more information on the effects of smoking on oral 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 “Smoking and Gum Disease.”

By Jeannie Chung, DDS, MS, Inc. Specialist in Periodontics
October 05, 2021
Category: Oral Health
Tags: gummy smile  
WhyIsYourSmileGummyHereAre4Possibilities

What makes a beautiful smile? Beautiful teeth, for sure. But there's also another component that can make or break your smile, regardless of your teeth's condition: your gums. Although their primary function is to protect and stabilize the teeth, your gums also enhance them aesthetically by providing an attractive frame.

But just as a painting displayed in an oversized frame can lose some of its appeal, so can your smile if the size of your gums appears out of proportion with your teeth. Normally, a smile that displays more than four millimeters of gum tissue is considered “gummy.”

There are some things we can do to improve your gum to teeth ratios. What we do will depend on which of the following is the actual cause for your gummy smile.

Excess gum tissue. We'll start with the obvious: you have excess gum tissue that obscures some of the visible tooth crown. We can often correct this with a surgical procedure called “crown lengthening,” which removes some of the excess tissue and then reshapes the gums and bone to expose more teeth length.

Teeth that appear too short. The problem may not be your gums — it could be your teeth appear too short. This can happen if the teeth didn't erupt fully, or if they've worn down due to aging or a grinding habit. One option here is to “lengthen” the tooth cosmetically with veneers, crowns or other bonding techniques.

Higher lip movement. Rather than your teeth and gums being out of size proportion, your upper lip may be rising too high when you smile, a condition known as hypermobility. One temporary fix is through Botox injections that paralyze the lip muscles and prevent their movement from overextending. We could also use periodontal surgery to perform a lip stabilization procedure that permanently corrects the upper lip movement.

Overextended jaw. Your gums may seem more prominent if your upper jaw extends too far down and forward. In this case, orthognathic (jaw straightening) surgery might be used to reposition the jaw relative to its connection with the skull. Setting the jaw up and back in this way would reduce the prominence of the gums when you smile.

As you can see, treatments range from cosmetic techniques to moderate surgical procedures. A full dental exam will help determine which if any of these measures could reduce gumminess and improve your smile.

If you would like more information on correcting gummy smiles, 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 Jeannie Chung, DDS, MS, Inc. Specialist in Periodontics
September 25, 2021
Category: Dental Procedures
SupermodelAshleyGrahamsUnpleasantDentalEncounterWithaFrozenCookie

Ashley Graham has a beautiful and valuable smile—an important asset to her bustling career as a plus-size model and television host. But she recently revealed on Instagram a “confrontation” between one of her teeth and a frozen oatmeal cookie. The cookie won.

Holding her hand over her mouth during the video until the last moment, Graham explained how she sneaked a cookie from her mom's freezer and took a bite of the frozen treat. Taking her hand from her mouth, she revealed her broken tooth.

Okay, maybe it wasn't an actual tooth that was broken: the denticle in question appeared to have been previously altered to accommodate a porcelain veneer or crown. But whatever was once there wasn't there anymore.

Although her smile was restored without too much fuss, Graham's experience is still a cautionary tale for anyone with dental work (and kudos to her for being a good sport and sharing it). Although dental work in general is quite durable, it is not immune to damage. Biting down on something hard, even as delicious as one of mom's frozen oatmeal cookies, could run you the risk of popping off a veneer or loosening a crown.

To paraphrase an old saying: Take care of your dental work, and it will take care of you. Don't use your teeth in ways that put your dental work at risk, tempting as it may be given your mouth's mechanical capabilities.

¬†Even so, it's unwise—both for dental work and for natural teeth—to use your teeth and jaws for tasks like cracking nuts or prying open containers. You should also avoid biting into foods or substances with hard textures like ice or a rock-hard cookie from the freezer, especially if you have veneers or other cosmetic improvements.

It's equally important to clean your mouth daily, and undergo professional cleanings at least twice a year. That might not seem so important at first since disease-causing organisms won't infect your dental work's nonliving materials. But infection can wreak havoc on natural tissues like gums, remaining teeth or underlying bone that together often support dental enhancements. Losing that support could lead to losing your dental work.

And it's always a good idea to have dental work, particularly dentures, checked regularly. Conditions in the mouth can change, sometimes without you noticing them, so periodic examinations by a trained dental provider could prevent or treat a problem before it adversely affects your dental work.

We're glad Ashley Graham's trademark smile wasn't permanently harmed by that frozen cookie, and yours probably wouldn't be either in a similar situation. But don't take any chances, and follow these common sense tips for protecting your dental work.

If you would like more information on care and maintenance of cosmetic dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty as Never Before” and “Dental Implant Maintenance.”

By Jeannie Chung, DDS, MS, Inc. Specialist in Periodontics
September 15, 2021
Category: Oral Health
Tags: oral hygiene  
BrushorFlossFirstHeresWhatYouNeedtoKnowtoDecide

If you like conundrums like "Which came first? The chicken or the egg?", then you may enjoy this one: "Which should you do first, brush or floss?"

Both of these oral hygiene tasks are equally important for removing dental plaque, a thin bacterial film that forms on teeth after eating. Removing plaque on a daily basis minimizes your risk for developing tooth decay or periodontal (gum) disease, the top causes for tooth loss. Brushing removes plaque from broad tooth surfaces, while flossing removes it from between teeth where brushing can't reach.

There is wide consensus that you need both brushing and flossing to thoroughly remove plaque. But there is a debate over which of these two tasks you should do first for the most effective outcome. Those debates are more or less good-natured, but there are proponents on both sides on which task should come first.

Those on the "Brush First" side say brushing initially gets the bulk of accumulated plaque out of the way. If you floss first, you may be plowing through a lot of soft plaque, which can quickly turn your floss into a gunky mess. More importantly, you may only be moving plaque around with the floss, not actually removing it. By brushing first, there's less plaque to deal with when flossing.

"Floss First" folks, though, say flossing before you brush loosens plaque stuck between teeth that can be more easily brushed away. But perhaps a more important reason is psychological: People don't really like flossing as much as brushing. Because of this, putting it off to the end may mean it doesn't happen; doing it first will help ensure it actually gets done.

In the end, though, the order you perform these tasks comes down to personal preference. You can try both ways to see which one suits you best. The important thing, however, is that you do both tasks—if you do, you can greatly lower your risk of dental disease that could rob you of your teeth.

If you would like more information on effective oral hygiene, 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 “Brushing and flossing: Which Should Be Done First?

By Jeannie Chung, DDS, MS, Inc. Specialist in Periodontics
September 05, 2021
Category: Oral Health
Tags: oral hygiene   toothpaste  
HeresWhatsinYourToothpasteforKeepingYourTeethandGumsHealthy

We're all interested in how our toothpaste tastes, how it freshens breath or how it brightens teeth. But those are secondary to its most important function, which is how well our toothpaste helps us remove dental plaque, that thin bacterial film on teeth most responsible for both tooth decay and gum disease.

Daily brushing and flossing clear away dental plaque, resulting in a much lower risk for dental disease. But while the mechanical action of brushing loosens plaque, toothpaste helps complete its removal. It can do this because of two basic ingredients found in nearly every brand of toothpaste.

The first is an abrasive (or polishing agent), a gritty substance that boosts the effectiveness of the brushing action (which, by the way, alleviates the need for harmful aggressive brushing). These substances, usually hydrated silica, hydrated alumina or calcium carbonate, are abrasive enough to loosen plaque, but not enough to damage tooth enamel.

The other ingredient, a detergent, works much the same way as the product you use to wash greasy dishes—it breaks down the parts of plaque that water can't dissolve. The most common, sodium lauryl sulfate, a safe detergent found in other hygiene products, loosens and dissolves plaque so that it can be easily rinsed away.

You'll also find other ingredients to some degree in toothpaste: flavorings, of course, that go a long way toward making the brushing experience more pleasant; humectants to help toothpaste retain moisture; and binders to hold bind all the ingredients together. And many toothpastes also contain fluoride, a naturally-occurring chemical that strengthens tooth enamel.

You may also find additional ingredients in toothpastes that specialize in certain functions like reducing tartar buildup (hardened plaque), easing tooth or gum sensitivity or controlling bacterial growth. Many toothpastes also include whiteners to promote a brighter smile. Your dentist can advise you on what to look for in a toothpaste to meet a specific need.

But your first priority should always be how well your toothpaste helps you keep your teeth and gums healthy. Knowing what's in it can help you choose your toothpaste more wisely.

If you would like more information on oral hygiene products and aids, 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 “Toothpaste: What's in It?





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