Humans naturally react with pleasure to a beautiful smile. Starting with our mother's joy at seeing our first smile, we have learned throughout our lives that a smile is an invitation to a positive interaction. But are some smiles more beautiful than others? What is it that makes a smile beautiful?

As with art and music, people's perceptions of beauty differ with their backgrounds and culture. Most people respond well to an appearance of healthy teeth and gums. Some feel that teeth must be very white and bright, while others look for even alignment and proportionally sized teeth. With today's dentistry, all of these factors can be changed and enhanced.

Let's look at the components of a smile, starting with the teeth. Evenly sized, white teeth are generally considered to be the basis of an attractive smile. Chipped or discolored front teeth can be repaired by bonding tooth-colored composite resin restorations. Thin porcelain veneers can be applied to teeth that are too small, misshapen or discolored. Tooth colored fillings can be used to repair damaged or decayed back teeth, or porcelain crowns may be used to replace the top part of a tooth that has been seriously damaged. If teeth are missing because of trauma or loss due to decay, today they can be replaced by dental implants, topped with crowns that are colored and shaped exactly like the natural teeth.

Of course, if your teeth emerge from inflamed, infected gums, your smile needs improvement. Healthy teeth and gums result from good dental hygiene habits and regular professional dental cleanings and checkups. Teeth can be whitened and brightened both through home methods and in the dental office. Ask us about the options available for tooth whitening.

Another factor that goes into a smile is the relation of the upper to the lower jaw, or the bite. A poor bite is called a malocclusion. Orthodontic treatment, with the use of traditional braces or clear aligners, can move the teeth into a better bite position so that they look and function better.

Repairing parts of your smile that make you feel self conscious will help your smile in more ways than one. If you feel good about yourself, you look better. We get the process started, and you do the rest.

Contact us today to schedule an appointment to discuss your questions about cosmetic dentistry. You can also learn more by reading the Dear Doctor magazine article “Cosmetic Dentistry: A time for change.”

CAT scans or Computer Assisted Tomograph scans have been around for years. However, it is quickly becoming the new standard in dentistry. The reasons are clear both literally and figuratively, as they provide our office with millions of pictures so that we can combine them together to create 3-dimensional (3-D) images. Prior to this technology, we could only image the body in 2-dimensions with x-rays (radiographs) — a technology first developed by Roentgen.

One of the best features of CAT scans and CBCT (Cone Beam Computed Tomography) scanning is that they enable us to see and experience the body from the inside. Having this ability changes (and many times) improves upon the way we diagnose. Here's how they work in very simplistic terms. Picture your favorite multi-layered cake with each layer representing an image. A three-layer cake requires just three images. For us to build a 3-D image similar to the cake, we require millions of very thin layers (images) that we put together, one on top of another, until our results, one 3-D image. And by having so many thin layers, we are best able to diagnose. For example, in our cake analogy, it is easier to determine if the cake contains finely chopped nuts, berries or other ingredients when you cut numerous very thin slices of cake to examine versus having one large chunk of cake.

It is important to note that in our office we may not recommend using this technology in all cases, as it may not be necessary for your particular diagnosis and/or treatment. While the technology can prove invaluable, it is quite expensive and a simple 2-D x-ray may provide everything we need. However, some dental specialty areas where CAT scans are currently used include:

• Orthodontists and pediatric dentists
• Cosmetic dentists and tooth replacement specialists (prosthodontists)
• Oral surgeons
• Root canal specialists (endodontists)
• Gum specialist (periodontists)

To learn more about CAT scans and how they are used in the various specialty areas, read the Dear Doctor magazine article “CAT Scans in Dentistry.” Or you can contact us today to schedule an appointment to discuss your specific questions.

When it comes to your oral healthcare, we strive to provide state-of-the-art care along with education to both our patients and community. One way we do this is by taking a moment to answer some of the questions we are most often asked about a certain topic. And one topic that almost always ignites questions is the subject of lumps and bumps in the mouth.

Help! I just found a small lump in my mouth — what should I do?
Not to alarm you, but your first priority is to contact us as soon as possible to schedule an appointment so that we can review it. Most often, we will know what it is by taking a history, knowing how long it's been there and what it looks like. Depending on what we find, we may want to take a biopsy so that we can determine exactly what it is and how we need to treat it.

What is involved in having a biopsy performed?
A biopsy is a normal and routine procedure that is used to definitively diagnose and confirm exactly what the abnormal lump, bump or other tissue is. It is typically performed with local anesthesia so that a small tissue sample can be removed without any pain for examination under a microscope. Depending on the size of the wound, it may require two to three sutures (stitches), leaving a flat and flush surface that heals in a few days to a week. The procedure usually lasts between 10 and 15 minutes with the lab results processed within a few days.

Does this mean I have cancer?
No, the chances are slim that you actually have cancer. However any change or sore in the mouth that does not heal in a week or two should be evaluated by a dentist and if necessary biopsied. If it is pre-cancerous and removed, it could save your life. The most important fact you need to remember is that no one can tell for sure what the abnormal tissue growth is until an expert in oral pathology (“patho” – disease; “ology” – study of) examines it under a microscope. While it is human nature to be concerned, until you have the facts, you are suffering needlessly.

To learn more about this topic, continue reading the Dear Doctor magazine article “Common Lumps and Bumps In The Mouth.” Or you can contact us today to schedule an appointment to discuss your specific questions so that we can put your mind at ease.

What does it mean when your dental hygienist recommends root planing? To put it simply, root planing is a method of cleaning the roots of your teeth in order to avoid periodontal (“peri” – around, “odont” – tooth) disease.

Periodontal disease happens when dental plaque, a biofilm of bacteria, is not regularly removed and begins to build up on teeth near the gum line. The bacteria cause inflammation, and this in turn causes the gum tissue to detach from the teeth. The widening spaces between the gum tissue and the teeth, called pockets, are environments in which bacteria can continue to collect and cause further inflammation and infection. Ultimately, this can lead to infection, bone loss, and loss of teeth.

Root planing is a technique designed to avoid such dire results. The bacteria, along with products they manufacture as part of their metabolism, can become ingrained in the surfaces of the tooth's root (the part of the tooth that is below the enamel). These bacterial products will form hard deposits called tartar or calculus.

Deep Cleaning Your Teeth
Of course, the best idea is to brush and floss away the plaque before the bacteria begin to build up on your teeth. If this is not done and pockets begin to form, the bacteria and toxic products are more difficult to remove in order to deep clean your teeth.

The first step is scaling. My hygienist or I will remove superficial collections of calculus. If material still remains within deep pockets, root planing is the next step. It involves actually planing the surface of the root, smoothing the surface free of calculus, bacteria, and toxins that have ingrained into the root surfaces.

Root planing is most often done under local anesthesia so that you remain comfortable while the cleaning procedures are done. The initial cleaning may be done by an ultrasonic instrument that vibrates particles off the root surfaces and flushes the pockets with water. Small hand instruments called curettes are used to finish the process. Antibacterial medication may then be used to help clear away infection from the pockets. Sometimes you may experience some tooth sensitivity to hot and cold after the root planing. If needed, this can be treated by applying fluoride to the root surfaces.

Depending on the extent of your gum disease, it may not be possible to remove all the deposits at one appointment, and it may be necessary to have multiple appointments over a few weeks to remove the remaining deposits. Often after three to four weeks the inflamed tissues have healed, leaving you with healthy gums once again.

Contact us today to schedule an appointment to discuss your questions about dental hygiene and root planing. You can also learn more by reading the Dear Doctor magazine article “Root Planing.”

Gum recession is a common problem affecting millions of Americans to some degree. If you have it, you will notice that the pink gum tissue surrounding one or more of your teeth has shrunk or receded and left the tooth-root surfaces exposed. How does this happen? And does it require treatment? The answers to both of these questions will vary from person to person. The good news is that treatment is available for those who need it.

The way you care for your teeth can be a major factor in gum recession. If you do not effectively remove plaque (bacterial biofilm) from your teeth daily, you may develop gum inflammation, gum disease and/or recession. Conversely, if you brush or floss too hard or for too long, you can also damage your gums. Please remember that it doesn't take a lot of pressure to remove biofilm; you just need to make sure you get to each tooth, right down to the gum line.

Other causes of gum recession include: mal-positioned and/or prominent teeth that are not fully encased in supporting bone; muscle attachments (frenums) pulling at the gum line; habits such as holding foreign objects (nails, pins) between the teeth that press on the gum tissues; and badly fitting oral appliances such as dentures, braces – even tongue bolts and lip piercings.

Besides not looking too great, gum recession can lead to anything from minor tooth sensitivity to tooth loss in the most severe cases. If you are experiencing any discomfort from a loss of gum (also called “gingival”) tissue, we'd certainly like to know about it. We would be happy to examine your condition and make recommendations.

There are surgical procedures that are very effective in treating these problems. Procedures such as gingival grafting or periodontal plastic surgery (“peri” – around; “odont” – tooth), often involve taking a small piece of healthy gingival tissue from the roof of your mouth and grafting it to the area where it is needed. Ultrafine sutures hold the graft in place until it “takes.” Laboratory-processed donor tissue can also be used. In either case, the procedure has a terrific success rate.

If you have any questions about gum recession, please contact us or schedule an appointment for a consultation. To learn more about the topic of oral appliance therapy, please see the Dear Doctor magazine article “Periodontal Plastic Surgery.”