1901 Pennsylvania Avenue NW Suite 905
Washington, DC 20006
Rodriguez-Rad, Carolina D.D.S.
919 18th St Nw # Ll52
Washington, DC, 20006-5503
Cohen, Steven C D.D.S.
1140 19th St Nw # 400
Washington, DC, 20036-6610
Oleary, Dennis S D.D.S.
5840 Macarthur Blvd Nw
Washington, DC, 20016-2542
Krainson, Paul M D.D.S.
4740 Connecticut Ave Nw # 102
Washington, DC, 20008-5604
Not even the most beautiful teeth can look attractive if healthy and pleasing-looking gums do not surround them. That's because the gums frame the teeth like a picture frame frames a picture. To have a pleasing smile, the shape, color, and texture of the gums are just as important as that of the teeth they frame. Although tooth development, periodontal disease, trauma, or tooth loss can create esthetic gum deformities, modern periodontal procedures and cosmetic dentistry can give individuals a smile to smile about.
As a result of periodontal disease, gums may appear red, swollen, and shiny. If an individual has gingivitis or periodontitis, the gums have to be periodontally treated prior to cosmetic dentistry procedures.
Teeth that appear too short may be normal-sized teeth hiding under too much gum. This can be the result of normal tooth development, or the use of certain medications that may cause gums to overgrow. Either way, a crown lengthening procedure can help reveal the normal tooth structure.
If the teeth appear to be too long or if the root surfaces are exposed, it may be due to gum recession. Soft tissue grafting is very successful in correcting this problem.
If the gum margins appear to be higher on some teeth and lower on others, this may be due to gum recession, altered eruption, or gum defects that resulted from tooth loss. The treatment of uneven gum margins may require crown lengthening, soft tissue grafting, ridge augmentation, or a combination of these procedures.
After a tooth is lost, the bone that encased it disintegrates and the gum around it may collapse, creating an indentation where the tooth used to be. Ridge augmentation procedures can help correct this problem.
Changes in the color of the gums may be part of normal gum development, or the result of scarring. Soft tissue grafts can predictably correct this problem.
Periodontal disease can result in spaces in between the teeth that may appear like black triangles. These spaces can be very difficult to treat. They can be made less unattractive by a combination of procedures that include orthodontics (braces), crowns (caps), and/or periodontal (gum) surgery. The best way to avoid these spaces is to treat periodontal disease in its early stages and avoid the need later for cosmetic dentistry.
One or more missing teeth can be predictably replaced with the aid of dental implants. Dental implants can look and feel like natural teeth.
Changes in the appearance of the gums can occur as a result of normal tooth development, periodontal disease, trauma, or tooth loss. By working with a restorative dentist who has expertise in cosmetic dental care and through the aid of modern periodontal techniques, individuals can design a smile that is both esthetic and youthful in appearance.
By Laura Minsk, DMD
There are two reasons why individuals need a dental crown lengthening procedure: to properly restore a tooth or to make a "gummy smile" more attractive and cosmetic dentistry can help with both.
To properly restore a tooth, several millimeters of healthy tooth structure must be available above the crest of supporting bone. However, this often is not the case when teeth are fractured, severely decayed, or worn. If enough tooth structure is not available, and the restorations are placed too close to the bone, the body reacts by creating a chronic inflammatory reaction that can create red, swollen, and sensitive gums. The gums can bleed easily and even become painful. Eventually, the inflammatory reaction may lead to bone loss around the tooth. To prevent these problems and to properly restore the tooth, the patient should have a dental crown lengthening procedure before restorative treatment.
The gummy smile may be the result of gum tissue growing over teeth that are of proper size. Often times teeth that appear small are, in fact, normal-sized teeth that are hiding under excess gum tissue. Dental crown lengthening removes the excess gum tissue and establishes a more appealing gum line.
Dental crown lengthening is a surgical procedure in which gum and bone tissue is removed from the circumference of the tooth. It is done in the dentist's office with local anesthesia (lidocaine). One or several teeth can be treated at the same time. After carefully reshaping the gum and the bone to expose healthy tooth structure, stitches (sutures) are placed to aid in healing. The stitches are usually removed five to ten days after the surgery. Follow-up appointments are scheduled as necessary to evaluate healing and plaque control. The gums should be allowed to heal for six to eight weeks before making any new restorations. At that time, the gums are more stable and better esthetic results can be achieved.
Post-surgical discomfort can last a few days and is usually minimal. It can be easily managed with commonly available over-the-counter medications such as aspirin, acetaminophen, or ibuprofen. Patients can expect to follow their normal routine the day after surgery.
Crown lengthening is recommended to properly restore a broken down tooth or to improve the esthetics of a gummy smile. If a general or cosmetic dentist does not frequently do surgeries, he or she may refer the individual to a periodontist who specializes in dental crown lengthening.
By Laura Minsk, DMD