My Blog

By P Steven Wainess DDS
November 10, 2021
Category: Oral Health
Tags: oral health   gum disease  
KickingtheSmokingHabitBoostsYourHealthIncludingTeethandGums

Quitting smoking is hard. The love affair between your brain and nicotine chains the habit to your daily life. But it's still worth the effort to quit to save your health from disease—including those that impact your teeth and gums. And, there's no time better to launch your "kick the habit" project than the American Cancer Society's Great American Smokeout day this November 18.

As to smoking's impact on your teeth and gums: Two-thirds of America's 32 million smokers contend with gum disease. A smoker's risk for tooth decay is also higher, as well as their prospects for implant failure.

So, why is smoking hazardous to your oral health?

Primarily, nicotine constricts oral blood vessels, which in turn reduces the nutrients and antibodies reaching the teeth and gums. Your mouth thus struggles to fight bacteria that cause tooth decay or gum disease.

Inadequate blood circulation can also hide signs of gum disease like swollen, reddened or bleeding gums. Instead, a smoker's gums may look deceivingly healthy, although you may have a gum infection that could be well advanced when it's finally diagnosed.

Gum or bone grafting also depends on good blood flow, or the grafts may not fully regenerate new tissue. The situation's similar for an implant: Its titanium post needs bone to grow and adhere to its surface to acquire sufficient strength and stability. But slow wound healing due to poor circulation can interfere with this process and cause an implant to fail.

For your mouth's sake, as well as the rest of your body, quitting smoking could help you avoid these problems. But as an ingrained, addictive habit, your body needs to "unlearn" it to stop it. Here are some ideas to help make that process easier.

Nicotine Replacement Therapy. Under your doctor's guidance, you can take medications that deliver nicotine to the body without smoking, and gradually reduce its concentration. This approach can be costly, however, and cause unpleasant side effects.

Brand fading. With this technique, you continuously switch to cigarette brands with less nicotine. This gradually acclimates your body to lower concentrations of the chemical, and eventually wean off it entirely. Here's an online site listing nicotine strength by brand.

Don't do it alone. Quitting smoking doesn't need to be a solo act. Developing relationships with those who don't smoke or who are also quitting can make it easier. One way is to attend a smoking cessation group for support and encouragement from others who're also trying to quit.

Above all, speak with your doctor or dentist to learn more about what you can do to stop smoking. It can be difficult, but the rewards—especially for your oral health—are well worth it.

If you would like more information about smoking and oral health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Strategies to Stop Smoking.”

By P Steven Wainess DDS
October 31, 2021
Category: Oral Health
Tags: oral health  
CrackedMouthCornersHowtoResolveThisIrritatingProblem

In addition to the usual tooth and gum problems, dentists also see patients with soft tissue infections in and around the mouth. One of the more common of these is the irritation or "cracking" of the corners of the mouth.

Formally known as angular cheilitis (or perleche, a French word, meaning "to lick"), cracked mouth corners are localized irritations made worse by saliva accumulation or an accompanying yeast infection. They're prominent among children and young adults who drool during sleep or while wearing orthodontic braces.

Older adults can also develop cracked mouth corners because of deep wrinkle lines around the mouth ("marionette lines") or tissue irritation from wearing dentures. Teeth loss, especially in the back of the jaws, can weaken facial support leading to collapse of the bite, which can contribute to angular cheilitis.

The condition can cause anything from minor discomfort at the mouth corners to a yeast infection that spreads throughout the mouth and throat. Whatever the symptoms, treatment usually begins with antifungal medication in the form of a mouthrinse or a topical ointment. The dentist may also prescribe a steroid ointment like zinc oxide paste to control inflammation and serve as a barrier against infection.

If the infection has spread beyond the mouth corners, patients may also need to use an antibacterial mouthrinse (usually chlorhexidine) to clear up the infection and help prevent a relapse. Besides cleaning their appliances with chlorhexidine, denture wearers with angular cheilitis should also take their dentures out at night to reduce the chances of a reoccurrence.

Along the same vein, patients who contend with frequent cracked mouth corners and who have missing teeth should have those teeth replaced by some form of restoration. If that involves dentures, it's important to maintain a good fit with them to reduce the chances of tissue irritation. And patients with deep wrinkle lines around their mouth may be able to lessen them through dermatological treatment.

Even though cracked mouth corners rarely pose a major health problem, the discomfort they cause can be a drag on your daily life and activities. Remember that you don't have to suffer—a visit to your dentist could start you on your journey toward relief from this irritating problem.

If you would like more information on angular cheilitis and similar mouth 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 “Cracked Corners of the Mouth.”

By P Steven Wainess DDS
October 21, 2021
Category: Dental Procedures
Tags: gummy smile  
ThereAreaSeveralPossibleCausesforaGummySmile

Besides straight and translucent teeth, an attractive smile has another important component: balance. In a great smile, the visible areas of the teeth and gums are in balanced proportion to one another.

But what is the ideal proportion between teeth and gums? Although aesthetic appeal is largely “in the eye of the beholder,” dental professionals typically consider a properly sized tooth to be around 10 mm in visible length. As for the upper gums, no more than 4 mm of tissue should show when smiling. Teeth appearing shorter than 10 mm or the gums displaying more than 4 mm can create an effect called a “gummy smile.”

Fortunately, there are different approaches for correcting a gummy smile, depending on what's causing the appearance of gumminess. Not only are there different causes, but they can be diverse in nature.

Obviously, an actual excess of gum tissue can cause a smile to look gummy—but so can shortened teeth. One possible solution called crown lengthening could help correct either possibility. During the procedure, we remove any excess gum tissue or reposition the gums after reshaping the underlying bone to reveal more of the tooth crown. Worn or shortened teeth can also be made to look longer with porcelain veneers.

A gummy smile could also be caused by a hypermobile lip, in which the lip rises higher than normal while smiling. We may be able to prevent this temporarily by injecting Botox into the lip muscles, which paralyzes them and inhibits their ability to move upward. A more permanent approach is to surgically restrict the upward movement of the lip muscles.

The gums may also seem too prominent if the upper jaw is longer in proportion to the face. One way to correct this is orthognathic surgery, a procedure that moves the upper jaw to a higher position on the skull. This can reduce the jaw profile with the face and subsequently affect how much of the gums show while smiling.

These solutions range from relatively minor to significantly invasive. The first step, though, is to find out what's really behind your gummy smile before taking the next step to make it more attractive.

If you would like more information on improving 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.”

PorcelainVeneersTransformRealHousewivesStarsSmileSpoiledbyTeethGrinding

Dorit Kemsley isn't shy. Best known to fans as an outspoken and sometimes outrageous cast member of the reality show Real Housewives of Beverly Hills, Kemsley is never reticent about “mixing it up” with fellow castmates or their significant others. Recently, though, she confessed to something that left her less than confident: her smile.

Kemsley has been self-conscious about her smile because her teeth looked noticeably short, worn down from an unconscious habit of grinding her teeth. Although teeth grinding is more common among children (who normally grow out of it by adolescence), it can persist into adulthood, usually from difficulties managing high stress (a likely component in the fashion designer/reality show star's busy life).

Stress-induced teeth grinding can occur during waking hours or, more likely, during deep sleep. The accumulating, long-term effects from the habit can lead not only to worn teeth but to weakened gum support, a high risk of tooth fracture or jaw pain and dysfunction.

So, how do you know if you grind your teeth, especially if it's only happening at night? Typical signs include sore jaws after awaking from sleep, increased tooth pain or sensitivity or, like Kemsley, a noticeable difference in your tooth length. Your family or sleeping partner may also complain about the “skin-crawling” noise you make during the night.

There are ways to lessen the effects of teeth grinding. The first step is to have us verify the underlying cause for the habit. If it's tension from stress, then you might reduce the habit's occurrences by learning better stress management or relaxation techniques through individual counseling, group support or biofeedback therapy. We can also fit you with a mouth guard to wear at night or through the day that reduces the force generated during teeth grinding.

And if you've already experienced accelerated tooth wear like Kemsley with a resultant “small teeth” smile, you might pursue the same solution as the RHOBH star: dental veneers. These thin, life-like wafers of porcelain are custom-made to mask imperfections like chips, staining, slight tooth gaps and, yes, worn teeth.

Veneers are often less expensive and invasive than other cosmetic techniques, yet they can have a transformative effect, as Kemsley's Instagram followers have seen. In conjunction with other dental treatments needed to repair any underlying damage caused by a grinding habit, veneers are an effective fix for the smile you present to the world.

If you suspect you may have a grinding habit, see us for a complete examination. From there, we'll help you protect your teeth and your smile.

If you would like more information on teeth grinding habits and their effects, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Teeth Grinding.”

By P Steven Wainess DDS
October 01, 2021
Category: Oral Health
Tags: oral hygiene  
DentalHygieneandCareCriticalDuringCancerTreatment

After months or even years of radiation or chemotherapy, the words "cancer-free" is music to your ears. Your joy and relief, though, may be tempered by the toll these treatments can take on the rest of your body—including your mouth.

Both of these treatments can destroy healthy tissue along with targeted cancer cells. If the focus has been on the head and neck regions, they could damage the salivary glands to the point that they won't produce adequate saliva flow.

A lack of saliva can have a detrimental effect on your oral health. Saliva buffers and helps lower oral acid levels that soften and erode enamel and increase the likelihood of tooth decay. Saliva also supplies antibodies that fight disease-causing bacteria. Otherwise, bacteria—and the risk for disease—can rapidly grow.

If these or other scenarios occur, you may experience dental damage, even tooth loss. Fortunately, we can restore an injured smile in various ways, including dentures, bridges or dental implants. But we should also attempt to limit the potential damage by taking steps to prevent dental disease during cancer treatment.

The most important of these is to brush and floss daily. Everyone should practice these hygiene tasks to remove disease-causing dental plaque, regardless of their health status. But because some natural disease-fighting mechanisms in the mouth may be disrupted during either radiation or chemotherapy, it's even more important if you're a cancer patient.

It's equally important to maintain as much as possible regular dental visits during cancer treatment. Dental cleanings provided during these visits remove any residual plaque and tartar (hardened plaque), which further lowers your disease risk.

Your dentist can better monitor your overall dental condition during frequent visits and provide as much treatment as you can tolerate. They can also enhance your protection against disease by prescribing antibacterial mouthrinses, fluoride applications or products to boost saliva production.

Some teeth and gum problems may be unavoidable; in that case, you may need post-treatment dental care to restore your oral health as needed. But caring as much for your dental health as you're able during cancer treatment could help you realize a better outcome.

If you would like more information on dental care during cancer treatment, please contact us or schedule an appointment for a consultation.





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