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COSMETIC DENTISTRY

Gum Contouring and Reshaping

Gums Frame the Teeth

Healthy, well-contoured, pink gum tissue compliments and frames the teeth. The esthetic framing of the gum tissue is as important to the teeth as a quality frame is to a painting. Gum tissue that is red and swollen, and unsymmetrical in appearance detracts from teeth that are otherwise healthy.

Making Gums Healthy

The first order of business is to return the tissue to a healthy state. That is to reduce any inflammation and get the tissue tight and pink. Once that is achieved, you evaluate the contours of the tissue.

When you look at an attractive smile you not only see beautiful teeth but also gum tissue that is symmetrically draped around each tooth. The edge of the gum tissue (gingival margins) should be at the same height for the two front teeth and the two canines.

The gingival margin of the two lateral incisors, which are next to the front teeth, should be about 1 to 1 1/2 millimeters lower than the other teeth. Now we know what is normal gum tissue. What about tissue with poor contours?

Gum Contours

A common problem is unsymmetrical gum tissue. By that I mean the gingival margins are not at an esthetic position. The gum tissue could be lower on one front tooth and not the other, thereby; creating the appearance that one tooth is longer than the other.

Another scenario would be that the gingival margins of all the teeth are at the same height or the teeth appear to be too short. Then there is the gummy smile. When an individual smiles, they show too much gum tissue.

How are these problems corrected?

Gum Lift and Contouring

Sometimes all that may be required is to surgically contour the gum tissue to a more esthetically balanced appearance. This is called a simple cosmetic gum lift. I perform this procedure utilizing a laser and only a topical anesthetic (no needles). The tissue heals very quickly with very little discomfort.

Of course, there are times when contouring the tissue alone is not enough. In those circumstances the bone at the front of the root may have to be reduced. This is done because the gingival margins need to be about 3 millimeters from the edge of the bone. If you don't reduce the bone the tissue will grow back. This procedure, while more invasive than a simple gum lift, is still relatively comfortable when done properly.

The cosmetic gum lift is a remarkably simple cosmetic procedure that can make a tremendous difference to one's smile. Consult your dentist if you think that you are a candidate for this procedure.


Pros and Cons of a tooth contouring and reshaping

Advantages:

Your dentist can remove only a small amount of tooth enamel, contouring your problem tooth into a more pleasing shape for an improved smile. The tooth contouring procedure is quick, simple, painless, and inexpensive.


Disadvantages:

There are limits. You may be at risk for tooth breakage and decay if too much enamel is removed your teeth. If your teeth were uneven because you grind them, they'll become uneven again until the grinding issue is resolved. Your dental insurance is likely to cover tooth contouring and reshaping only if it is needed as a result of an accident.

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Dental Bridges

Dental bridges literally bridge the gap created by one or more missing teeth.

A bridge is made up of two crowns for the teeth on either side of the gap these two anchoring teeth are called abutment teeth and a false tooth/teeth in between. These false teeth are called pontics and can be made from gold, alloys, porcelain or a combination of these materials. Dental bridges are supported by natural teeth or implants.

What Are the Benefits of Dental Bridges?

Bridges:
Restore your smile
Restore your ability to properly chew and speak
Maintain the shape of your face
Distribute the forces in your bite properly by replacing missing teeth
Prevent remaining teeth from drifting out of position


What Types of Dental Bridges Are Available?

There are three main types of bridges:

Traditional bridges involve creating a crown for the tooth or implant on either side of the missing tooth, with a pontic in between. Traditional bridges are the most common type of bridge and are made of either porcelain fused to metal or ceramics.
Cantilever bridges are used when there are adjacent teeth on only one side of the missing tooth or teeth.
Maryland bonded bridges (also called a resin-bonded bridge or a Maryland bridge) are made of plastic teeth and gums supported by a metal framework. Metal wings on each side of the bridge are bonded to your existing teeth.


What Is the Process for Obtaining a Dental Bridge?

During the first visit, the abutment teeth are prepared. Preparation involves recontouring these teeth by removing a portion of enamel to allow room for a crown to be placed over them. Next, impressions of your teeth are made, which serve as a model from which the bridge, pontic, and crowns will be made by a dental laboratory. Your dentist will make a temporary bridge for you to wear to protect the exposed teeth and gums while your bridge is being made.

During the second visit, your temporary bridge will be removed and the new permanent bridge will be checked and adjusted, as necessary, to achieve a proper fit. Multiple visits may be required to check the fit of the metal framework and bite. This is dependent on each individual's case. If the dental bridge is a fixed (permanent) bridge, your dentist may temporarily cement it in place for a couple of weeks to make sure it is fitting properly. After a couple weeks, the bridge is permanently cemented into place.

How Long Do Dental Bridges Last?

Dental bridges can last 5 to 15 years and even longer. With good oral hygiene and regular prophylaxis, it is not unusual for the life span of a fixed bridge to be over 10 years.

Will It Be Difficult to Eat With a Dental Bridge?

Replacing missing teeth should actually make eating easier. Until you become accustomed to the bridge, eat soft foods that have been cut into small pieces.

Will the Dental Bridge Change How I Speak?

It can be difficult to speak clearly when teeth are missing in the front or anterior areas. Wearing a dental bridge with the anterior teeth in their proper relationship will help you speak properly.

How Do I Care for My Bridges?

It is important to keep your remaining teeth healthy and strong as the success of the bridge (depending on the type selected) depends on the solid foundation offered by the surrounding teeth. Brushing twice a day and flossing daily helps prevent tooth decay and gum disease that can lead to tooth loss. Your dentist or dental hygienist can demonstrate how to properly brush and floss your teeth. Keeping a regular cleaning schedule will help diagnose problems at an early stage when treatment has a better prognosis. Selecting a balanced diet for proper nutrition is also important.

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