17250 N. 43rd Ave #3
Glendale, AZ 85308
Tonioli, Matthew B D.D.S.
4141 N 32nd St # 100
Phoenix, AZ, 85018-4775
Peterson, Jonathan R D.D.S.
2220 W Southern Ave # 102
Mesa, AZ, 85202-4706
Endodontics, Allen D.D.S.
10585 N Tatum Blvd # D132
Paradise Valley, AZ, 85253-1073
Prescott Endodontic Assoc Pc
1658 Oaklawn Dr # B
Prescott, AZ, 86305-1110
The appearance of your teeth is heavily impacted by the position of the surrounding gum tissue. In a normal situation, two teeth that are side by side in your mouth have contact with each other. Below this contact, the area is filled in with gum tissue in the shape of a triangle. This triangular-shaped gum tissue is called the papilla. It is not uncommon to have an empty space in the area where the papilla is supposed to be. If this occurs, the result is perceived as a black space.
They are caused by a loss of the gum tissue itself or by the shape and/or position of the teeth. For any black space that is present, the first thing that needs to be done is to diagnose what caused it to occur. Once this is done, the restorative dentistry treatment choice can be made. The best decision will be the most conservative treatment that corrects the black space.
One of the most common causes of loss of gum tissue is due to the gum disease known as periodontitis. This gum disease acts on the supporting bone around the teeth, causing a loss of bone. This loss of bony support causes the papilla to slump and flatten, creating a black space between the teeth. The first step in treating the resulting black space in this situation is to treat the cause. Once the gum disease is under control, the black spaces can then be addressed with restorative dentistry.
To remove the black spaces, the teeth need to have restorations placed that will change the shape of the teeth and fill in this space. The type of restorative dentistry can vary depending on whether or not there are any other problems with the teeth. The simplest and most conservative restoration is composite, a tooth-colored filling material. It can be bonded directly on the tooth in the area of the black space. Since it is placed only in the affected area, the situation where this is used requires that the overall appearance of the tooth is acceptable and does not need to be changed.
If the overall appearance of the tooth needs to be altered, then a different type of restorative dentistry needs to be used. The choice is either a dental veneer or a dental crown. The choice between the two depends on both the appearance and the structural changes that need to be done. Usually, to correct a black space, both teeth on either side need to be restored. In doing this, the symmetry between the teeth will remain the same. If you restored just one tooth, you would end up with one tooth being wider than the other. The advantage of using restorative dentistry to correct black spaces is that it usually results in a shorter treatment time.
Another cause of the black space is due to the position of the teeth themselves. One example is teeth that are tilted towards each other. When this occurs, the area for your gum tissue to fill becomes too large for the amount of tissue you have. This same concept may occur with certain types of tooth shapes. In these instances, the restorative dentistry treatment of choice is to use orthodontics (braces) to align the teeth. The advantage of doing this is that the black space will disappear without having to do any restorations on the teeth.
By Greggory Kinzer, DDS, MSD
The color, size, and shape of your teeth all have a profound impact on your appearance. While it is often the desire of people to improve the look of their smiles, it should be the goal of aesthetic dentistry, or cosmetic dentistry, to do this while still maintaining a "natural" appearance of the teeth. This often requires addressing one or all of the above-mentioned criteria. How is it that alterations in these three characteristics enhance your smile?
Tooth color is most commonly what people see first. As you get older, your teeth get darker. The reasons for this include normal changes that occur within the tooth and repeated insults from environmental conditions (coffee or tea stains, for example). Generally, then, darker teeth are associated with older age. The easiest way that cosmetic dentistry can correct this is by teeth bleaching. But this alone may not entirely create a natural-looking appearance.
Size and shape also are major factors that define the appearance of teeth. The most common cause of changing tooth size and shape over time is tooth wear; and the most common cause of wear is tooth-to-tooth contact, or grinding. Wear on the edges of the teeth can give the appearance of aging because you do not show as much of your teeth when you smile. Another factor that affects how much of your teeth show when you smile is the loss of skin tone as you age.
This loss of tone causes your face to sag, thereby showing less of your upper teeth and more of your lower teeth. The aesthetic dentistry treatment to enable more teeth to show when you smile will depend on the cause. If the cause is due to wear of the teeth, dental veneers or dental crowns can be used to regain the lost length and fill out the smile. On the other hand, this may not have a significant effect if the cause is due to the loss of skin tone associated with age. If this is the case, plastic surgery may be indicated as part of the treatment.
Wear on teeth also will make the edges of the front teeth very flat. As this occurs, the edges of the front teeth will form a straight line rather than the more youthful appearance when the two front teeth are slightly longer than the teeth next to them. Also, as they wear, the proportion of length to width will be altered. Teeth will start to appear more square in their shape rather than rectangular.
Basically, any treatment that counteracts the above-mentioned appearance changes has the ability to enhance the appearance of your teeth and smile. The aesthetic dentistry treatment can vary from teeth bleaching to dental crowns or dental veneers. Depending on the severity, other forms of treatment such as braces and gum surgery also may be indicated to enhance the appearance and function of your teeth. It is important to remember that all areas need to be addressed. If treatment for teeth that are worn and dark only involves teeth bleaching, the final result will be whiter teeth that are still worn and short. The teeth will not appear natural, as there will be a conflict between white teeth (youthful) and worn teeth (aged) that do not work together. Instead, it is necessary to correct the color, size, and shape to create a more natural appearance.
By Greggory Kinzer, DDS, MSD