We most often associate plastic surgery with cosmetic enhancements to our outer appearance. While this is their primary purpose, some forms of reconstructive surgery restore lost function and health as well as improve appearance. A classic example is cosmetic periodontal (gum) surgery that restores receded gum tissues that have exposed more of the tooth than is visually appealing.
Gum recession occurs primarily because of excessive brushing (too hard or for too long) or because of periodontal (gum) disease, a bacterial infection that ultimately causes gum tissue to detach and pull away from the teeth. Gum recession not only affects the appearance of the teeth, it can expose the tooth’s root surface to further infection and decay. Without treatment, the disease could progress causing further damage with the potential for the tooth to be eventually lost.
In conjunction with plaque removal to stop gum disease and possibly other treatments like orthodontics to correct misaligned teeth, cosmetic gum surgery is used to rejuvenate lost gum tissues around teeth through tissue grafting. In these procedures, a combination of surgical approaches and/or grafting materials are attached to the area of recession to stimulate the remaining tissue to grow upon the graft and eventually replace it.
Donor grafts can originate from three sources: from the patient (an autograft); another person (an allograft); or another animal species, usually a cow (a xenograft). Tissues from outside the patient are thoroughly treated to remove all cellular material and bacteria to eliminate any possibility of host rejection or disease transmission.
Depending on the nature of the gum recession and tooth condition, the procedure can take different forms. It could involve completely detaching the graft tissue from the host site and re-attaching it to the recipient site. But if more of the tooth root is exposed, the surgeon may cover the graft with tissue adjacent to the host site to supply blood to the graft, and affix the loosened pedicle to the graft site. While any technique requires advanced training and experience, the latter procedure involves microsurgical techniques that require the highest levels of technical skill and art.
Cosmetic gum surgery can result in healthier gum tissues and teeth that are less susceptible to infection and loss. No less important, though, these procedures can return a more natural look to your teeth and gums — and a more pleasing smile.
If you would like more information on gum tissue reconstruction, 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 “Periodontal Plastic Surgery.”
You might think David Copperfield leads a charmed life:Â He can escape from ropes, chains, and prison cells, make a Learjet or a railroad car disappear, and even appear to fly above the stage. But the illustrious illusionist will be the first to admit that making all that magic takes a lot of hard work. And he recently told Dear Doctor magazine that his brilliant smile has benefitted from plenty of behind-the-scenes dental work as well.
“When I was a kid, I had every kind of [treatment]. I had braces, I had headgear, I had rubber bands, and a retainer afterward,” Copperfield said. And then, just when his orthodontic treatment was finally complete, disaster struck. “I was at a mall, running down this concrete alleyway, and there was a little ledge… and I went BOOM!”
Copperfield’s two front teeth were badly injured by the impact. “My front teeth became nice little points,” he said. Yet, although they had lost a great deal of their structure, his dentist was able to restore those damaged teeth in a very natural-looking way. What kind of “magic” did the dentist use?
In Copperfield’s case, the teeth were repaired using crown restorations. Crowns (also called caps) are suitable when a tooth has lost part of its visible structure, but still has healthy roots beneath the gum line. To perform a crown restoration, the first step is to make a precise model of your teeth, often called an impression. This allows a replacement for the visible part of the tooth to be fabricated, and ensures it will fit precisely into your smile. In its exact shape and shade, a well-made crown matches your natural teeth so well that it’s virtually impossible to tell them apart. Subsequently, the crown restoration is permanently attached to the damaged tooth.
There’s a blend of technology and art in making high quality crowns — just as there is in some stage-crafted illusions. But the difference is that the replacement tooth is not just an illusion: It looks, functions and “feels” like your natural teeth… and with proper care it can last for many years to come.Â Besides crowns, there are several other types of tooth restorations that are suitable in different situations. We can recommend the right kind of “magic” for you.
If you would like more information about crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Crowns & Bridgework” and “Porcelain Crowns & Veneers.”
Anybody can contract periodontal (gum) disease if they don't brush and floss every day. Inadequate hygiene allows a thin film of disease-causing bacteria and food particles called plaque to build up.
But while we're all at risk for gum disease, some people are more so. This is especially true for those with diabetes, heart disease or other systemic conditions. The common denominator among all these conditions is inflammation, the body's defensive response to disease or injury.
When tissues become infected or damaged, the body causes swelling at the site to isolate the affected tissues, clear out diseased or dead cells and start tissue repair. Inflammation also produces redness, pain and, particularly with gum tissues, bleeding.
Inflammation is an important part of the body's ability to heal itself. It's possible, though, for the inflammatory response to become chronic. If that happens, it can actually begin doing more harm than good.
We're learning that chronic inflammation is a factor in many systemic diseases. For example, it can interfere with wound healing and other issues associated with diabetes. It also contributes to fatty deposit buildup in arterial blood vessels, which can lead to heart attacks or strokes. And in gum disease, chronic inflammation can cause gum detachment, followed by bone and tooth loss.
We're also learning that inflammation can create connections between these various health conditions. If you have an inflammatory disease like heart disease or diabetes, your risk for gum disease not only increases but it may also be difficult to bring under control. Likewise, if you have persistent gum disease, the associated inflammation could aggravate or even increase your risk for other systemic diseases.
Researchers hope continued discoveries about the interrelationship of inflammation with various conditions will lead to better treatment strategies, including for gum disease. In the meantime, getting prompt treatment for any inflammatory condition, especially gum disease, could help your treatment prospects with other conditions.
If you would like more information on connections between dental disease and other health conditions, 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 “The Link between Heart & Gum Diseases.”
Because the mouth is one of the most sensitive areas of the body, we go to great lengths to eliminate pain and discomfort associated with dental work. Anesthesia, both local and general, can achieve this during the actual procedure—but what about afterward while you’re recuperating?
While a few procedures may require prescription opioids or steroids to manage discomfort after a procedure, most patients need only a mild over-the-counter (OTC) pain reliever. There are several brands available from a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs like aspirin or ibuprofen work by blocking the release of prostaglandins into the body, which cause inflammation in tissues that have been damaged or injured.
Unlike their stronger counterparts, NSAIDs have fewer side-effects, cost less and aren’t addictive. And unlike opioids NSAIDs don’t impair consciousness, meaning patients can usually resume normal activities more quickly.
But although they’re less dangerous than opioids or steroids, NSAIDs can cause problems if taken at too strong a dose for too long. Its major side effect is interference with the blood’s clotting mechanism, known as “thinning the blood.” If a NSAID is used over a period of weeks, this effect could trigger excessive external and internal bleeding, as well as damage the stomach lining leading to ulcers. Ibuprofen in particular can damage the kidneys over a period of time.
To minimize this risk, adults should take no more than 2400 milligrams of a NSAID daily (less for children) and only for a short period of time unless directed otherwise by a physician. For most patients, a single, 400 milligram dose of ibuprofen can safely and effectively relieve moderate to severe discomfort for about 5 hours.
Some patients should avoid taking a NSAID: pregnant women, those with a history of stomach or intestinal bleeding, or heart disease (especially if following a daily low dose aspirin regimen). If you have any of these conditions or similar concerns, be sure you discuss this with your dentist before your procedure for an alternative method for pain management.
If you would like more information on managing discomfort after dental procedures, 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 “Treating Pain with Ibuprofen.”
Treating advanced periodontal (gum) disease takes time. If you have this destructive disease, it wouldn’t be uncommon for you to undergo several cleaning sessions to remove plaque from tooth and gum surfaces. This built-up film of bacteria and food particles is primarily responsible for triggering and fueling gum disease.
These cleaning sessions, which might also involve surgery and other advanced techniques to access deep pockets of infection, are necessary not only to heal your gums but to preserve the teeth they support. With these intense efforts, however, we can help rescue your teeth and return your reddened and swollen gums to a healthy, pink hue.
But what then — is your gum disease a thing of the past?
The hard reality is that once you’ve experienced gum disease your risk of another occurrence remains. From now on, you must remain vigilant and disciplined with your oral hygiene regimen to minimize the chances of another infection. You can’t afford to slack in this area.
Besides daily brushing and flossing as often as your dentist directs, you should also visit your dentist for periodontal maintenance (PM) on a regular basis. For people who’ve experienced gum disease, PM visits are more than a routine teeth cleaning. For one, your dentist may recommend more than the typical two visits a year: depending on the severity of your disease or your genetic vulnerability, you may need to increase the frequency of maintenance appointments by visiting the dentist every two to three months.
Besides plaque and calculus (tartar) removal, these visits could include applications of topical antibiotics or other anti-bacterial substances to curb the growth of disease-causing bacteria in your mouth. You may also need to undergo surgical procedures to make particular areas prone to plaque buildup easier to clean.
The main point, though, is that although you’ve won your battle with gum disease, the war isn’t over. But with your own daily hygiene maintenance coupled with your dentist’s professional attention, you’ll have a much better chance of avoiding a future infection.
If you would like more information on preventing and treating gum disease, 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 “Periodontal Cleanings.”
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