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Posts for: May, 2020

By Okun Dentistry
May 28, 2020
Category: Dental Procedures
Tags: gummy smile  
ImprovingaGummySmileDependsonitsCause

A “gummy” smile, in which the upper gums are too prominent, is a common condition. There are several causes for gummy smiles — determining which one is the first step to having your appearance changed.

Although perceptions vary from person to person, most dentists agree a gummy smile shows 4 mm or more of gum tissue, and the amount is out of proportion with the length of the crown (the visible tooth). Teeth normally erupt through the gums during childhood and continue development until early adulthood, shrinking back from the tooth until stabilizing in place.

This typically produces a crown length of about 10 mm, with a “width to length” ratio of about 75-85%. But variations can produce differences in the relationship between teeth and gums and the width to length ratio of the teeth. The teeth may appear shorter and the gums more prominent. Worn teeth, caused by aging or grinding habits, may also appear shorter.

If tooth to gum proportionality is normal, then the cause may be upper lip movement. When we smile, muscles cause our lips to retract 6-8 mm from the lip’s resting position. If the amount of movement is greater (meaning the lip is hypermobile), it may show too much of the gums. The upper jaw can also extend too far forward and cause the gums to appear too prominent.

There are a number of ways to improve gummy smiles, depending on the cause. Periodontal plastic surgery known as crown lengthening removes and reshapes excess gum tissue to reveal more of the tooth. Lip hypermobility can be reduced with Botox injections (to paralyze the muscles) or in some cases with surgery to reposition the muscle attachments. Orthognathic surgery can be used to surgically reposition an overextended upper jaw. Other cosmetic enhancements such as orthodontics, bonding or porcelain restorations can also prove effective.

The first step is to obtain an accurate diagnosis for your gummy smile. From there, we can devise the best treatment approach to bring your smile back into a more attractive proportion.

If you would like more information on minimizing a gummy smile, 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 “Gummy Smiles.”


By Okun Dentistry
May 18, 2020
Category: Dental Procedures
HowAFVsAlfonsoRibeiroSavedHisTooth

Remembered fondly by fans as the wacky but loveable Carlton on The Fresh Prince of Bel-Air, Alfonso Ribeiro is currently in his fifth year hosting America's Funniest Videos. It's the perfect gig for the 48-year-old actor, who loves to laugh and make others laugh as well. This is quite the opposite experience from one he had a few years ago that he remembers all too well: a severely decayed tooth.

After seeing his dentist for an intense toothache, Ribeiro learned he had advanced tooth decay and would need root canal treatment. Ribeiro wasn't thrilled by the news. Like many of us, he thought the procedure would be unpleasant. But he found afterward that not only was the root canal painless, his toothache had vanished.

More importantly, the root canal treatment saved his tooth, as it has for millions of others over the last century. If you're facing a situation similar to Alfonso Ribeiro's, here's a quick look at the procedure that could rescue your endangered tooth.

Getting ready. In preparation for root canal therapy, the tooth and surrounding gums are numbed, often first with a swab of local anesthesia to deaden the surface area in preparation for the injection of the main anesthesia below the surface. A dental dam is then placed to isolate the infected tooth from its neighbors to prevent cross-contamination.

Accessing the interior. To get to the infection, a small access hole is drilled. The location depends on the tooth: in larger back teeth, a hole is drilled through the biting surface, and in front teeth, a hole is drilled on the backside. This access allows us to insert special tools to accomplish the next steps in the procedure.

Cleaning, shaping and filling. Small tools are used to remove the diseased tissue from the interior tooth pulp and root canals. Then the empty spaces are disinfected. This, in effect, stops the infection. Next, the root canals inside the tooth are shaped to allow them to better accept a special filling called gutta percha. The access hole is then sealed to further protect the tooth from future infection, and a temporary crown is placed.

A new crown to boot. Within a couple weeks, we'll cap the tooth with a long-lasting lifelike crown (or a filling on certain teeth). This adds further protection for the tooth against infection, helps strengthen the tooth's structure, and restores the tooth's appearance.

Without this procedure, the chances of a tooth surviving this level of advanced decay are very slim. But undergoing a root canal, as Alfonso Ribeiro did, can give your tooth a real fighting chance.

If you would like more information about root canal treatments, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: How Long Will It Last?


WithOutdoorSportsHopefullyPoisedtoBeginBePreparedforOralInjuries

National Physical Fitness & Sports Month in May, sponsored by the President's Council on Sports, Fitness & Nutrition, is a fitting time to encourage us to play sports. Many of us already feel the Spring itch to get out there and get involved. Unfortunately, an increase in sports or exercise activities also means an increase in potential physical injury risks, including to the face and mouth.

Although COVID-19 protective measures are delaying group sports, there's hope that many leagues will be able to salvage at least part of their season. If so, you should know what to do to keep yourself or a family member safe from oral and dental injuries.

First and foremost, wear a sports mouthguard, a plastic device worn in the mouth to reduce hard impacts from other players or sports equipment. A custom-fitted guard made by a dentist offers the best level of protection and the most comfortable fit.

But even though wearing a mouthguard significantly lowers the chances of mouth injuries, they can still occur. It's a good idea, then, to know what to do in the event of an oral injury.

Soft tissues. If the lips, cheeks, gums or tongue are cut or bruised, first carefully clean the wound of dirt or debris (be sure to check debris for any tooth pieces). If the wound bleeds, place some clean cotton gauze against it until it stops. If the wound is deep, the person may need stitches and possible antibiotic treatments or a tetanus shot. When in doubt, visit the ER.

Jaws. A hard blow could move the lower jaw out of its socket, or even fracture either jaw. Either type of injury, often accompanied by pain, swelling or deformity, requires medical attention. Treating a dislocation is usually a relatively simple procedure performed by a doctor, but fractures often involve a more extensive, long-term treatment.

Teeth. If a tooth is injured, try to collect and clean off any tooth pieces you can find, and call us immediately. If a tooth is knocked out, pick it up by the crown end, clean it off, and place it back into the empty socket. Have the person gently but firmly clench down on it and call the office or go to the ER as quickly as possible. Prompt attention is also needed for teeth moved out of alignment by a hard blow.

Playing sports has obvious physical, mental and social benefits. Don't let an oral injury rob you or a family member of those benefits. Take precautions and know what to do during a dental emergency.

If you would like more information about, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “An Introduction to Sports Injuries & Dentistry” and “Dental Injuries: Field-Side Pocket Guide.”