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Julie M. Gillis, DDS, PC Blog

Crooked Teeth? Correct with Braces or Veneers?

August 31, 2017

Crooked Teeth –  Should You Choose Braces or

Porcelain Veneers?

If your teeth are crooked and it bothers you, now is a good time to do something about this!  But what should you do?  Do you have crooked teeth – should you choose braces or porcelain veneers?  This blog will review a case that could be treated with either option or both.  See if you agree with our patient’s choices.  The right answer for you and your crooked teeth is something that requires evaluation of your smile and your concerns with a dentist who understands that the ‘best’ treatment option is different for different people. Braces may mean straightening the teeth with Invisalign, Clear Correct, an Inman Appliance or similar or limited orthodontics with braces.

Crowded and poorly aligned teeth detract from this smile!

Crowded and poorly aligned teeth detract from this smile! Note crooked teeth!

Your dentist should be able to review with you the advantages and disadvantages of one option over another to treat crooked teeth and help you make the decision that is right for you and for your smile.  If you have crooked teeth and you have made the decision to improve your smile, you probably want to do this right away!  That usually means having your dentist prepare your teeth for veneers or crowns that make it look like you have spent years in braces and were born with a beautiful smile.  While this may be the fastest decision, it is not always the best solution for crooked teeth.  You will have to live with the result for many years and your dental health – the health of your teeth should be one of your concerns.

Conservative treatment with a combination of orthodontic movement of the teeth and porcelain veneers made a big difference in this smile!

Conservative treatment with a porcelain veneers made a big difference in this smile!

In the case shown here, the teeth are very crooked and crowded.  You can see a very thin, worn area on the left front tooth that is almost see through.  The right lateral incisor appears to have an odd shape.  If the teeth were moved into better alignment with braces, these problems would still need to be addressed.  Our office likes to do study models of your teeth to show you the results you can expect with different types of treatment.  One of our concerns is being very conservative with the preparation (grinding!) of your teeth because we want you to have your teeth your whole life.

It is best to select a dentist for this type of treatment who is willing to show you before and after photos of patients they have treated in their office so that you can observe for yourself the quality of the dental care.  Anyone can post beautiful photos with amazing results, but your concern should be whether your dental office can do the dental work that you desire.  For this type of treatment, the dentist should have advanced training in cosmetic dentistry beyond just listing that they do porcelain veneers on their website.  The American Academy of Cosmetic Dentistry (AACD) has an accreditation process that includes completing a written examination and presenting several different cosmetic cases for evaluation in front of a panel of experts in cosmetic dentistry.  An accredited dentist has met these rigorous standards with their dental treatment and can help you achieve your smile goals.

Before treatment

Before treatment

After movement of the teeth any further correction becomes very easy to accomplish!

After movement of the teeth any further correction becomes very easy to accomplish!

 

Our office carefully examines different treatment options and we can tell you approximately how long treatment will take and the advantages/disadvantages of doing different types of treatment.  In the case shown here, orthodontic treatment can be used to improve the alignment before the teeth are prepared for porcelain veneers.  As a patient you can decide if the small amount of additional time for the orthodontic treatment (six months) can fit into your schedule.

If you are trying to improve your smile and you would like to know your options, we would love to help!  Dr. Gillis is an accredited member of the AACD and now serves as an examiner for other dentists going through the accreditation process. She serves on the American Board of Cosmetic Dentistry and is the chair of the Written Examination Committee for the accreditation process.  Our office wants you to achieve your smile goals in the best way possible for you!

Yours for better dental health,

Julie Gillis DDS, AAACD

Restoring Teeth/Restoring Smiles

 

Should Gingival Recession Be Treated?

August 21, 2017

Filed under: Gum Recession — Tags: — Dr Gillis @ 6:53 am

Should Gingival Recession Be Treated?

Please see our previous blog on what IS gingival recession.

Should gingival recession be treated?  The answer is, it depends!  This blog will explore some of the reasons to treat or not to treat gingival recession.  We hope you enjoy it!

We care about gingival recession for many reasons.  Mostly because we want you to save your teeth for a lifetime and gingival recession is not a normal process of aging.  Most importantly your dentist should help you determine the cause of your gingival recession and then tell you the things you can do to prevent it from continuing.

Gingival Recession

Several areas of gingival or gum recession noted

The gingival recession pictured here is severe.  The patient has been informed as to the likely causes of his recession (Orthodontic movement of the teeth combined with excessive and hard tooth brushing) and instructed in how to prevent it from getting worse.  Our patient really wants to have a better looking smile!  The following are the patient’s main concerns:

  • Dark colored front teeth
  • Short side teeth (lateral incisors)
  • Poor alignment of the front teeth
  • Gingival recession is only a minor concern

Now, please look at the photo of our patient’s smile.  Even with a wide smile, the gingival recession cannot be seen.  The most noticeable things about the smile are the discolored or dark front teeth and the short side teeth that seem to stick out.

The patient's concerns are apparent in this smile photo.

The patient’s concerns are apparent in this smile photo.

Our office decided to start with study models to show the patient what could be done to improve his smile.  Conservative treatment including four porcelain veneers on his front teeth would take care of his esthetic concerns.  We elected not to treat the gingival recession for these reasons:

  1. The gingival recession was not visible in his smile
  2. Gingival recession is very difficult to treat successfully
  3. We can monitor the recession over time and assure that it is not getting worse
  4. The patient has been instructed in the things he can do to prevent further gingival recession. This includes proper brushing and a gentle or no tooth paste.
  5. The gentlest thing next to gums is healthy tooth structure – not dental restorations
  6. Even with the recession, there is still adequate healthy gums around each tooth.

Stubler-10 G.Stubler6

When you look at our result compared to the before treatment photo, you can see how well the gum tissue is responding to the new porcelain veneers.  The improvement in the smile was perfect for our patient and addressed his cosmetic concerns while conserving healthy tooth structure and minimizing unnecessary surgery.

 

Our office would be happy to help you take the best care possible of your teeth.  You can reach our Grand Junction, Colorado office at (970) 242-3635.  Or visit our website at www.juliegillisdds.com for more information.  We would love to have you visit and like us on Facebook or Instagram.  Find us at Julie Gillis DDS on Facebook or DDSJulie on Instagram

Yours for better dental health,

Julie Gillis DDS, AAACD

Restoring Teeth/Restoring Smiles

 

 

What is Gingival or Gum Recession?

August 16, 2017

Filed under: Gum Recession — Tags: — Dr Gillis @ 6:48 pm

What is Gingival Recession?

This blog reviews what gingival recession is and the typical causes of gingival recession.  Photos display gingival recession on both front and back teeth.  By reading this blog is is hoped that you will become more aware of this problem and the ways that gingival recession can be prevented.  If gingival recession is already present, you will read how you can help prevent it from progressing.

Gingival Recession

Several areas of gingival or gum recession noted

What is gingival recession?  See the photo above.  Gingival recession happens when the gums recede or move away from their normal position near the edge of the tooth’s enamel and move toward the tip of the tooth’s root exposing the root surface of the tooth.  Once gingival recession has occurred, it will not go away on its own.  Typical causes of gingival recession are as follows:

  1. Overly aggressive tooth brushing
  2. Brushing the teeth with a hard-bristled toothbrush
  3. Brushing the teeth with an abrasive toothpaste
  4. A gum infection, periodontitis or gingivitis may cause attachment loss especially if not treated early
  5. Orthodontic movement of the teeth into an area of very thin bone so that the bone resorbs and the gums move down the roots of the teeth
  6. Trauma
  7. An ill-fitting appliance that presses on the gums
  8. Clenching and grinding of the teeth alone or combined with any of the above

We care about gingival recession for many reasons.  Mostly because we want you to save your teeth for a lifetime and gingival recession is not a normal process of aging.  Most importantly your dentist should help you determine the cause of your gingival recession and then tell you the things you can do to prevent it from continuing!

G.Stubler6

In the photo shown here, the gingival recession is present in most areas of the mouth.  As you can see, the front teeth have been beautifully restored with porcelain veneers.  The likely causes of the gingival recession is Orthodontic movement of the teeth combined with excessive and hard tooth brushing.  Look closely at the gingival recession present on the back teeth.  The exposed root is much softer than the adjacent enamel on the crown of the tooth and because this exposed part is softer, the root is more likely to be damaged or worn away by excessive tooth brushing.

So, what should you do?  If you believe that you have gingival recession you should talk about this with your dentist.  We recommend the following:

  • Use a soft toothbrush and a very mild or no toothpaste.
  • Your teeth will get clean if you dip your toothbrush in a mouth rinse for brushing. This eliminates the problem of the paste wearing away your tooth.
  • Review your brushing techniques with your dentist or dental hygienist.
  • Have photos taken of your teeth that show the recession and then compart the amount of recession over time. It should not get worse if you are doing the right things!

Our office would be happy to help you take the best care possible of your teeth.  You can reach our Grand Junction, Colorado office at (970) 242-3635.  Or visit our website at www.juliegillisdds.com for more information.  We would love to have you visit and like us on Facebook or Instagram.  Find us at Julie Gillis DDS on Facebook or Julie Gillis DDS on Instagram

 

 

Preventing Tooth Erosion or Tooth Attrition

July 1, 2017

Filed under: Tooth Erosion,Tooth Reshaping/Bite Adjustment — Tags: — Dr Gillis @ 8:00 am

Is tooth erosion or attrition part of the normal aging process?  Yes and NO!

Severe wear into the softer dentin of both upper and lower teeth.

Severe tooth erosion into the softer dentin of both upper and lower teeth.

Tooth erosion is not from normal aging, tooth attrition is.  See below for definitions.

Is it natural for our teeth to wear down and become shorter as we age?  Yes, your teeth will wear from chewing food, but not very much!  Normal chewing  should only cause you to lose about 1 mm of tooth length over a lifetime of 100 years!  The type of food eaten will make a difference in the amount of wear as well.  Ages ago when people ground grains between stones to make their breads and other foods, some bits of stone would be in the resulting flour or meal and eating foods prepared with this would, over years of time, cause excessive wear of tooth structure.

Severe erosion into the softer dentin of the lower teeth. Note the 'cupped' shape of the top or chewing surface of the tooth.

Severe erosion into the softer dentin of the lower teeth. Note the ‘cupped’ shape of the top or chewing surface of the tooth.

The more severe wear we are talking about in this blog is preventable tooth wear from tooth erosion.  Think of the ways that people use their teeth as tools (trimming nails, breaking string, cracking nuts, holding tools) and you can imagine that this causes way more wear than any type of natural chewing.    Sometimes, even your occupation will make your teeth more likely to undergo heavy wear.  If you work in an area of heavy dust and grit this gritty film will often be present on your teeth and if this is combined with any type of clenching and grinding, the wear can be severe over a short time.

Why do some people’s teeth look old and worn while they are still young?  This is most likely due to tooth or dental erosion or attrition.

Tooth Erosion  results in the loss of tooth structure due to softening of the tooth surface from an acidic diet. the softened tooth wears away more easily during chewing and is especially prone to more severe wear if you clench or grind your teeth.   Tooth attrition  is a type of irreversible wear caused by the contact of the upper and lower teeth resulting in loss of tooth structure.  This type of wear starts in the areas where the teeth contact during normal chewing.  Tooth wear is a physiological process and is commonly seen as a normal part of aging.

Note that the upper teeth are almost see-thorough at the edge. Severe erosion into the inner layer of the teeth (the dentin) on both upper and lower teeth.

Note that the upper teeth are almost see-thorough at the edge. Severe erosion into the inner layer of the teeth (the dentin) on both upper and lower teeth.

Our friends at Wikipedia note that, “Advanced and excessive wear and tooth surface loss can be defined as pathological in nature, requiring intervention by a dental practitioner. The pathological wear of the tooth surface can be caused by bruxism, which is clenching and grinding of the teeth. If the attrition is severe, the enamel can be completely worn away leaving underlying dentin exposed, resulting in an increased risk of dental caries and dentin hypersensitivity. It is best to identify pathological attrition at an early stage to prevent unnecessary loss of tooth structure as enamel does not regenerate.”

Our office would be happy to answer your questions about tooth erosion. We will let you know your options!

Yours for better dental health,

Julie Gillis DDS

Restoring Smiles/Restoring Health

 

 

Perio Breath – It’s Real, It’s Nasty, and It’s Treatable!

June 26, 2017

Filed under: Perio Breath & Bad Breath,Uncategorized — Tags: — Dr Gillis @ 12:16 pm

Perio Breath – It’s Real, It’s Nasty, and It’s Treatable!

Perio breath can be so distracting that your message may not get across!

Perio breath can be so distracting that your message may not get across!

Perio breath is probably equal across men and women. This treatable condition deserves more press!

Perio breath is probably equal across men and women. This treatable condition deserves more press!

Perio breath – by this I mean the breath of someone who has active and probably untreated periodontal disease is unmistakeable and I wish I could just guide any person with this condition into prompt treatment!  Just do it!  Do this for you, for your improved health, for improved taste, and for improved interpersonal conversations!

Using a hand actually does help direct your breath downward and away form your listener! There are more permanent solutions however.

Using a hand actually does help direct your breath downward and away form your listener! There are more permanent solutions however.

Everyone has bad breath on occasion! Perio breath is an especially bad form of this and won't go away with better eating and brushing. It takes the intervention of dentists and dental hygienists to cure!

Everyone has bad breath on occasion! Perio breath is an especially bad form of this and won’t go away with better eating and brushing. It takes the intervention of dentists and dental hygienists to cure!

I can smell periodontal breath across the room.  And I know our office could make such a difference in improved health for whichever person has this! It is the smell of deep infection and rot.  For patient’s with this condition, they may even be unaware that they have this problem.  And if they are aware, they may try to cover up the        condition with gum or breath mints or toothbrushing.  These may help a little but if your bad breath is due to active periodontal disease, treatment with your dentist and dental hygienist is the only way to cure this problem.

A spritz can help common bad breath. Perio breath needs treatment!

A spritz can help common bad breath. Perio breath needs treatment!

If bad breath was visible maybe we would do more to prevent it!

If bad breath was visible maybe we would do more to prevent it!

Let me take you to why I am blogging about this now.  I just got off an airplane and no, I did not have to sit directly beside someone with perio breath.  This has happened to me and it is not pretty!  But periodically the smell would blow over us from the vents where we passengers are all exchanging air and it got me wondering who was the breather causing this and do they even know there is fairly simple treatment?  Granted, it could have been something else (standard bad breath, medical issue related bad breath etc.,) but I am pretty sensitized to the real perio breath.  If you or someone you know and love has this problem, kindly and sweetly suggest that they or you should have a consult with their dentist.  Periodontal disease causing bad breath is not painful but the stigma of having bad breath may be!  We can help!

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1190 Bookcliff Ave. Suite 201, Grand Junction, CO 81501 USA
Julie M Gillis DDS Grand Junction, CO cosmetic, general, & restorative dentist. (970) 242-3635 (970) 242-8479 jgillis@juliegillisdds.com