Smiles matter, probably more than we realize. Volumes of research confirm the influential role of smiles on our relationships and our self-esteem. If you're confident, you smile more. If you smile more, you feel more confident. But what if you don't want to flash your smile because you're embarrassed by bad teeth? It becomes a psychological short-circuit, with effects that may ripple through your life. Fortunately, a growing range of options opens doors for anyone to enjoy a stunning new smile. Dr. Adatrow's passion for enhancing smiles brings you the best in modern dentistry.
Cosmetic dental treatments can:
Brighten stained or discolored teeth
Repair cracks or fractures
Fill gaps between teeth
Replace missing teeth
Replace old metallic restorations, such as fillings and crowns
Crown lengthening (or crown exposure) is required when your tooth needs a new crown or other restoration. The edge of that restoration is deep below the gum tissue and not accessible. It is also usually too close to the bone or below the bone.
The procedure involves adjusting the level of the gum tissue and bone around the tooth in question to create a new gum-to tooth relationship. This allows us to reach the edge of the restoration, ensuring a proper fit to the tooth. It should also provide enough tooth structure so the new restoration will not come loose in the future. This allows you to clean the edge of the restoration when you brush and floss to prevent decay and gum disease. The procedure takes approximately one hour.
When the procedure is completed, sutures and a protective bandage are placed to help secure the new gum-to-tooth relationship. You will need to be seen in one or two weeks to remove the sutures and evaluate your healing.
Esthetic Crown Lengthening
In many individuals with gummy smiles, it may appear that the teeth are shorter than normal. In reality, it is often simply a case of the natural contour and beauty of the enamel being hidden behind the gums. By repositioning the gum line and exposing the full contour of the enamel, an immediate and dramatic improvement in the smile occurs.
One of the major advantages of esthetic crown lengthening is that it is usually completed in one visit. Essentially, the excessive gum tissue that is hiding your teeth, is removed to expose the normal length of the tooth.
With esthetic crown lengthening, you’ll benefit from:
An enhanced appearance of your teeth so that they no longer look short or like "baby teeth"
A much more attractive and harmonious smile
An improved self-image and more self-confidence
A relatively short healing period with little to no discomfort
Immediate visible results
In addition to the esthetic benefits derived from crown lengthening, correcting a “gummy” smile can also improve your overall periodontal health. When the gum tissue does not recede normally as adult teeth emerge, pockets can form in the gums, which can result in advanced periodontal disease. By contouring the gums through crown lengthening, you can improve the look and confidence of your smile and also prevent future problems.
Pre-Treatment: Short stubby teeth make the face appear fuller just like horizontal stripes on a shirt.
Post-Treatment: Longer Teeth accentuate the face. Longer teeth make the face look longer which makes one look thinner just like vertical stripes on a shirt.
Laser Removal of Dark Gums
Dark Gums typically occur when there is excess pigmentation, called melanin, in the gums. Dark gums are more frequently noted in some cultures. This condition is also called Hyper-Pigmentation or Ethnic Pigmentation of the Gums. Typically these tissues are healthy and the appearance may bother some patients. If the discoloration is caused by excess pigmentation, the pigmentation can easily be removed.
Patients with dark gums typically complain of having light brown to dark brown to black gums. The dark gums can be splotchy or spotty or may involve almost all the gums. Sometimes the dark gums can be seen when a patient smiles. A common goal for patients with dark gums is simply the desire to have pink gums.
Historically, dark gums have been removed by placing a soft tissue graft under the dark gums. Later, a second procedure called derma-abrasion removes the dark gums to uncover the tissue added by the soft tissue graft. If the dark gums are very thin, sometimes the soft tissue grafting procedure may still be necessary.
Today’s laser treatments can effectively remove the excess melanin deposits in gum tissues to achieve the same esthetic result as soft tissue grafting with less trauma and quicker healing.
Frenum is a naturally occurring muscle and predominant tissue attachment seen between the two front teeth either upper or lower. It connects the inner aspect of the lip with the gum. There is also what we call a lingual frenum and it attachs the tongue to the floor of the mouth and to the gum tissue just behind the lower two front teeth. Finally there is what we refer to as the buccal frenum which attaches the cheeks to the gums.
The frenum sometimes becomes a problem of being too low in its in attachment and or too thick. If left alone, it can cause or help lead to separation of the two front teeth. It may also help in causing gum recession in the area as well. If the frenum becomes a problem it must be removed or repositioned. This is also done many times prior to or after orthodontic tooth movement.
The lingual (tongue) frenum if abnormally present may cause tongue-tie, leading to speech and eating problems.
Dr. Adatrow uses laser to remove frenum attachments (Frenectomy). Laser is a wonderful surgical instrument to remove the frenum as there is minimal need to local anesthesia, no bleeding, no suturing required, minimal to absent swelling and scarring and a decreased to complete absence of pain post surgically.
If bone shrinks away around your teeth, it never grows back. In some cases, bone can be encouraged to fill in with grafting materials placed by Dr. Adatrow. Every situation offers a different scenario, but more options than ever exist to promote bone repair in the jaw. For example, when a tooth needs removal a large hole then exists in the bone. While it will fill in naturally, the site tends to shrink, drawing bone away from the area. Grafting materials can be placed simply at the time of tooth removal to help preserve the bone. Grafts prove especially beneficial if you’d like to consider an implant-supported replacement in the future.
Soft Tissue Grafting
A soft tissue graft is done to cover exposed roots due to gum recession or bone loss.
What is Gum Recession?
Gum recession happens gradually, and many people don’t realize how “toothy” their smile has become until their dentist or periodontist says something. Gingival recession occurs when gum tissue starts to pull away from your teeth and supporting bone structure, exposing more of your teeth including their root surface. Several factors contribute to gingival recession including poor oral hygiene habits, genetics, bone loss, orthodontic treatment, teeth grinding, tobacco use, periodontal disease, aggressive brushing, and oral piercings.
What is a Soft Tissue Graft?
There are four different types of soft tissue graft procedures, and your doctor will decide which is best for your situation.
A connective-tissue graft is the most common. A flap of skin is cut on the roof of your mouth and tissue from under the flap, called subepithelial connective tissue, is removed. It is then stitched into place where there is exposed root. After the graft tissue has been removed from under the palatal flap, the flap is stitched back down.
A free gingival graft is similar to a connective-tissue graft, except instead of a flap, a small amount of tissue is removed directly from the roof of your mouth and sutured over the recession site. A healing, periodontal dressing is placed over the operation site on the roof of your mouth until the tissue regenerates. This method is generally used when a patient has thin gums and needs additional tissue to fill out the area.
A pedicle graft procedure is performed when tissue is grafted from the surrounding gum tissue. A flap is partially cut so that a piece of the tissue remains and is pulled over or down and sutured into place over the affected area. This procedure is usually recommended for patients that have plenty of gum tissue and only has one or two small areas of root exposure.
Sometimes, instead of using tissue from your own mouth, graft material from a tissue bank is used. Your periodontist can help you decide which is the best, based on your individual needs.
Following your graft, you will get specific post-op instructions regarding home care. Don’t floss or brush the area unless directed by your dentist and use all rinses and medications your doctor prescribes. While it may take a week or two for your mouth to fully heal, you should be able to return to work or normal activity the day after surgery.
Veneers provide an artist's touch to your smile. Custom-crafted, these ultra-thin porcelain creations work in magical ways. Regardless of your vision for your smile, chances are veneers offer an answer. When today's modern materials meet our passion for cosmetic excellence, you'll be amazed at what you see smiling back at you in the mirror.
Cavities, chips, and fractures occur on any tooth surface throughout the mouth. Composite filling material provides a versatile solution to many common problems. Blended into a prepared area, the composite polishes to a smooth, undetectable surface.
Nothing boosts your confidence like a terrific smile. But when yellow stain dims the brilliance, it's time to give it a lift. Professional whitening systems provide the ultimate in whitening results, quickly removing years of discoloration with quality controlled materials.
Damaged teeth might seem hopeless, but there's often still a solid foundation that leaves you with options. A crown, or cap, can bring a compromised tooth back to full function. And with modern porcelains, you'll probably have a difficult time trying to find where the crown ends and the tooth starts.
Teeth rarely fracture in a perfectly predictable way. Sometimes a break is too big for a filling, but not big enough for a crown. Porcelain onlays provide an excellent solution for teeth that need extra reinforcement without being covered entirely. Bonded into a place, they provide years of natural feel, function, and esthetics.