The various structures in your mouth — your teeth and gums, of course, as well as periodontal tissues that hold teeth in place within the jaw — all function together to create your smile. This includes muscles like the frenum, a fold of muscle tissue that connects the gums to the upper lip, which helps pull the lip upward when you smile.
Unfortunately, an overly large frenum could contribute to an unattractive space between your two upper front teeth. The problem occurs when the frenum grows beyond its normal range and runs between the front teeth to connect with the gums behind them at the forefront of the roof of your mouth. The resulting space that may develop can be closed with orthodontics, but unless the excess frenum tissue is addressed the space may eventually reopen.
The frenum is just one cause among many for a noticeably wide space, including bite problems (malocclusions), finger-sucking habits or missing teeth. We would, therefore, need to examine your mouth to determine the exact cause before beginning any treatment. If indeed the frenum is the source of the problem, it will be necessary to ultimately remove the excess portion through a procedure known as a frenectomy.
A frenectomy is a minor surgical procedure performed by a periodontist, oral surgeon or a general dentist with surgical training. After numbing the area with local anesthesia, the tissue behind the teeth is dissected or reduced in size with a small scalpel or a surgical laser. The wound is then closed with a few stitches; any post-surgical discomfort is usually minimal and managed with non-steroidal anti-inflammatory pain medication. The wound will completely heal within a few weeks.
Most frenectomies are performed after orthodontics to close the space. Removing it prior to tooth movement may result in scar tissue that prevents the space from closing. It’s also easier for the surgeon to gauge how much tissue to remove after space closure to avoid removing too much, which can leave a “black” triangular hole where gum tissue should normally be.
Treating an abnormally large frenum isn’t difficult, but it needs to be coordinated with orthodontic treatment for the best outcome. The end result is a smile that’s both healthy and attractive.
If you would like more information on teeth spacing problems, 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 “Space between Front Teeth.”
Via a recent Instagram post, pop diva Ariana Grande became the latest young celebrity to publicly acknowledge a dental milestone: having her wisdom teeth removed. The singer of hits such as “Break Free” and “Problem” posted an after-surgery picture of herself (wearing her signature cat-eye eyeliner), with a caption addressed to her teeth: “Peace out, final three wisdom teeth. It’s been real.”
With the post, Grande joined several other celebs (including Lily Allen, Paris Hilton and Emile Hirsch) who have shared their dental surgery experience with fans. Will "wisdom teeth removal" become a new trending topic on social media? We aren’t sure — but we can explain a bit about the procedure, and why many younger adults may need it.
Technically called the “third molars,” wisdom teeth usually begin to emerge from the gums between the ages of 17 and 25 — presumably, around the same time that a certain amount of wisdom emerges. Most people have four of these big molars, which are located all the way in the back of the mouth, on the left and right sides of the upper and lower jaws.
But when wisdom teeth begin to appear, there’s often a problem: Many people don’t have enough space in their jaws to accommodate them. When these molars lack sufficient space to fully erupt (emerge), they are said to be “impacted.” Impacted teeth can cause a number of serious problems: These may include pain, an increased potential for bacterial infections, periodontal disease, and even the formation of cysts (pockets of infection below the gum line), which can eventually lead to tooth and bone loss.
In most cases, the best treatment for impacted wisdom teeth is extraction (removal) of the problem teeth. Wisdom tooth extraction is a routine, in-office procedure that is usually performed under local anesthesia or “conscious sedation,” a type of anesthesia where the patient remains conscious (able to breathe normally and respond to stimuli), but is free from any pain or distress. Anti-anxiety medications may also be given, especially for those who are apprehensive about dental procedures.
So if you find you need your wisdom teeth extracted, don’t be afraid to “Break Free” like Ariana Grande did; whether you post the results on social media is entirely up to you. If you would like more information about wisdom tooth extraction, please call our office to schedule a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
If you had chicken pox as a child, you're at higher risk for a painful viral infection later in life called shingles. Besides a painful skin rash and other symptoms that can develop, shingles could also affect your dental care.
About 90% of children contract chicken pox, a disease caused by the varicella zoster virus (VZV), which usually clears up on its own. But later in life, usually after age 50, about a quarter to a third of chicken pox patients will develop shingles.
The onset of shingles usually produces an itching or burning sensation on the skin that's either numb or overly sensitive to the touch. A red rash may ensue with crusty lesions, accompanied sometimes by pain, fever and fatigue. The rash often forms a belt-like or striped pattern along one side of the face or body.
For most patients this painful rash is the extent of their symptoms. But women who are pregnant, patients undergoing cancer treatment or people with compromised immune systems are at risk for more serious complications if they contract the disease. It's important for these at-risk patients to obtain a vaccination, as well as avoid contact with anyone with shingles.
Which brings us to your dental care: in its early stages shingles can be contagious, the virus passing to others through skin contact or by airborne respiratory secretions. That's why it's important if you're currently experiencing a shingles episode that you let us know before undergoing any kind of dental work.Â Even a routine teeth cleaning with an ultrasonic device could disrupt the virus and increase the chances of it spreading to someone else. We may need to postpone dental work until the virus is under control.
Antiviral drugs like acyclovir or famciclovir are highly effective in bringing the disease under control, especially if treatment starts within three days of the onset of symptoms. And don't forget the shingles vaccination: the U.S. Center for Disease Control recommends it for anyone 60 or older regardless of a past history with chicken pox.
See your physician as soon as possible if you begin to notice symptoms. Don't let shingles interfere with your life — or your dental care.
Your diet can play as important a role in your dental health as brushing and flossing. What you eat (particularly sugar) could increase your risk of tooth decay despite your hygiene habits. And vice-versa: a nutritious diet may help boost your preventive efforts even more.
Let’s look at two very different approaches to diet and see how your dental health is likely to fare under each.
A High Sugar/Low Fiber Diet. Modern western diets heavy with processed foods are inundated with two particular types of refined sugars. The first is sucrose, which comes mainly from either beets or sugar cane. Foods (and beverages) may also contain a refined sugar from corn known as high fructose corn syrup. Refined sugars are added for taste to thousands of products like cake, candy, soft drinks or even condiments like catsup. These “free” sugars are easily processed by bacteria into acid. Combine that with fewer fibrous vegetables in the diet and you have a recipe not only for obesity and other health issues, but tooth decay as well.
A High Fiber/Low Sugar Diet. Fruits and vegetables make up a large part of this kind of diet, while added free sugars much less so. That doesn’t make this diet sugar-free: all plant products contain simple sugars produced by photosynthesis. The difference, though, is that these sugars — glucose, fructose and sucrose (natural, not the refined versions) — are more slowly absorbed into the bloodstream during digestion because of the fiber content of fruits and vegetables. You’ll also receive other nutrients like vitamins and minerals necessary for good health. Eating this kind of diet will help decrease the risk of tooth decay.
So there you have it: eat more fresh fruits and vegetables and restrict your intake of processed foods and sweets. You may also want to fine-tune a few items to maximize decay prevention: for example, eat starches in their natural form (whole grains, beans or certain fruits) as much as possible rather than refined or in combination with added sugar (cakes, cookies, etc.). And while fresh fruits with their naturally occurring sugars aren’t a significant factor in tooth decay, dried fruits (especially with added sugar) might.
If you would like more information on proper diets for better 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 “Nutrition & Oral Health.”
Saliva probably doesn’t rate high on your amazement meter. You’re more likely to notice its absence and the dry irritation that results.
But you might be more impressed with this unsung bodily fluid if you knew all the things it does. It’s definitely a multi-tasker, performing a number of jobs (including aiding in digestion) that not only keep your oral health on track, but your general well-being too. And there are even new testing methods where saliva may even tell us when you’re not doing so well.
Here are 3 more tasks your saliva is doing for your mouth right now that truly makes it amazing.
Cleansing. Your teeth’s chewing action shreds food so it’s easier to digest. But that also leaves behind tiny particles in your mouth. Bacteria feast on these particles (especially carbohydrates like sugar) and produce acid as a byproduct, which can increase your risk of tooth decay. Saliva serves as a kind of “rinse cycle” for your mouth, helping to wash a good bit of these errant particles down your throat and away from hungry bacteria.
Defense. Speaking of bacteria, your mouth is home to millions of them. While most are harmless or even beneficial, a fraction can harm your teeth and gums. Saliva is your first line of defense, emitting an antibody known as Immunoglobulin A that targets these bacteria. Saliva also produces an antibacterial substance called lyzozyme that prevents bacteria from growing.
Enamel Protection. Although it’s the strongest substance in the body, your teeth’s enamel can’t withstand the effects of mouth acid, the by-product of bacterial feeding and growth. Acid levels naturally rise after eating; but even this sudden rise can begin the process of demineralization where minerals in enamel dissolve. Saliva saves the day by first neutralizing the acid and restoring the mouth’s normal pH in about thirty minutes to an hour. It also helps restore minerals in enamel, a process called remineralization. It’s all in a day’s work for this remarkable fluid.
If you would like more information on the importance of saliva to 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 “Saliva: How it is used to Diagnose Disease.”
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