Ask the Dental Experts

Ask The Dentist
The Cosmetic Dentistry Center in the Houston Medical Center Dental Group offers the full range of cosmetic dentistry procedures and general dentistry practices. Every patient is treated as a genuinely unique individual with his or her own set of unique and specific needs. We like to say that no two smiles are exactly alike, so when you come to our office, you can be confident we provide your smile with a restorative or cosmetic solution that is specifically created just for you.

Do you have a procedure to correct gummy smile? I have large teeth and my gums show when I smile. I've heard about removing or cutting the gum to extend the lip and botox.

Please advise if you treat this condition and what treatments you use.
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Hi, Carolyn. There are various treatments for this problem, depending upon the severity. When we do cosmetic dentistry, we routinely recontour and sculpt the gum tissue for esthetics. The use of a laser can make dramatic changes.

If your problem is more complex, there are surgical treatments to change the relation of the lip and the display of gum tissue.

We will have to see you for an examination to evaluate your problem and see what would be appropriate for you. Please make an appointment for consultation and we can help you to understand the options for your problem. Call us at (713) 795-5905

Chuck Campbell, DDS

Dale Brant, DDS

Labels: gingival recession, gingivectomy, gummy smile

Hi doctor,

Is it possible for a teeth's nerve to die off after putting braces?
I have my ceramic braces on for about 2 months now. Recently, I have been experiencing sharp pain on two of my teeth after drinking cold drinks for a week. I understand that the movement of the teeth would cause sensitivity issue. However, the pain which I was experiencing was somehow different. I went back to see my dentist and was told that this was an unusual encounter that the worse scenario is that my nerve may have possibility died off. Nevertheless, he give me some anti-swelling oral medication and ensure me that the problem will be resolve in a few days time.

However, 2 weeks later the same symptom happen again, but this time it lasted for 5 hrs. I went back to the dentist again and I was told that the nerve is going to died off soon. I was so shocked and disappointed after hearing that. He said that I have exceptionally sensitive tooth and that the force he applied to tighten the braces was generally acceptable by all his patients. He told me that the only solution now is to undergo root canal treatment. I was so shocked to hear that. How can a set of teeth that was previously healthy become bad teeth after putting these braces? Is this true? How can it happen and is the root canal treatment the only solution? Kindly reply to me. Thank you for your time.

Regards,
John

Good question – Your story is not unusual. The nerves of the teeth can respond negatively to trauma, whether the trauma is from a blow, a fall, grinding your teeth, deep decay, deep fillings, fractured root, gingival recession, orthodontic movement – sometimes it just seems to be nothing in particular, the simplest thing, that triggers nerve sensitivity. Nerve sensitivity can be reversible and slowly go away, or it can respond to treatments for sensitivity such as topical fluoride, topical fluoride varnish, Sensodyne tooth paste, bite adjustment, etc. Or, sensitivity can be irreversible – such that nothing that is done will make it better… and in this case, root canal treatment is the most common treatment.

Tooth sensitivity is our most common complaint in general dentistry. It is sometimes obvious as to the cause, but it is also common to have the cause very vague and hard to figure out. Your dentist is doing appropriate conservative treatments, trying to allow some time to pass, since sometimes the problem goes away without treatment. He is also correct in telling you that sometimes these problems will only resolve with root canal treatment…true. Nothing has been done wrong, it is just that some people have very sensitive teeth – if you look around your mouth, you will probably find other signs that predispose you to tooth sensitivity:

Ø Large, deep fillings
Ø Muscular grinding / clenching habits
Ø Gingival recession
Ø Gingival abfractions
Ø Fractures in teeth
Ø Old trauma – falls, etc.

This is all difficult to predict and very different from person to person. Sit down and have a discussion with your dentist about your situation relative to other teeth that might have similar potential problems. It is much more complicated than you are assuming.

Labels: dental abfraction, dental fillings, gingival recession, tooth fractures, tooth sensitivity

Monday, July 6, 2009

Ask The Dentist: Reducing a Gummy Smile

Monday, April 6, 2009

Tooth Sensitivity